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Sample records for cardiopulmonary exercise testing

  1. Assessing Exercise Limitation Using Cardiopulmonary Exercise Testing

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    Michael K. Stickland

    2012-01-01

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

  2. Cardiopulmonary Exercise Test: Background, Applicability and Interpretation

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

    2016-01-01

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

  3. Strategies for cardiopulmonary exercise testing of pectus excavatum patients

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    Moh H. Malek

    2008-01-01

    Full Text Available The purpose of this paper is to provide strategies for cardiopulmonary exercise testing of pectus excavatum patients. Currently, there are no standardized methods for assessing cardiovascular and pulmonary responses in this population; therefore, making comparisons across studies is difficult if not impossible. These strategies are intended for physicians, pulmonary technicians, exercise physiologists, and other healthcare professionals who conduct cardiopulmonary exercise testing on pectus excavatum patients. By using the strategies outlined in this report, comparisons across studies can be made, and the effects of pectus excavatum on cardiopulmonary function can be assessed with greater detail.

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

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

    2011-12-15

    In patients affected by chronic obstructive pulmonary disease (COPD), cardiopulmonary response to exercise was never related to the severity of emphysema (E) measured by high resolution computed tomography (HRCT). Sixteen patients (age=65±8 yrs; FEV(1)=54±18%pred; RV=160±28%pred) with moderate to severe E (quantified by lung HRCT as % voxels cycle-ergometer to exhaustion. Oxygen uptake (V˙(O2)), carbon dioxide output (V˙(CO2)), ventilation (V˙(E)), tidal volume (V(T)), and end-tidal P(CO2) (PET(CO2)) derived variables were measured breath-by-breath. The % of E correlated with: (1) the ratio V(Tpeak) (r=0.74; p=0.001); (2) the V˙(E)/V˙(CO2) slope (r=-0.77; p=0.0004); (3) PET(CO2) values at peak exercise (r=0.80; p=0.0001). Also, the %E was strongly predicted by the following exercise equation: %E(EST) = 58.1 + 11.9 × ΔV˙(E)/V˙(CO2) (r=0.94; p1 is typically observed in severe E patients; furthermore, the V˙(E)/V˙(CO2) slope and the PET(CO2peak) values decrease and increase respectively as more as the emphysema is severe.

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

    Science.gov (United States)

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

    2016-11-01

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

  6. Hitos sobre el test cardiopulmonar de ejercicio Cardiopulmonary exercise test

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    RODRIGO SOTO F

    2008-01-01

    Full Text Available El test cardiopulmonar de ejercicio TCPE (CPET en la literatura anglosajona evalúa aspectos dinámicos de la la fisiología cardiorespiratoria, en contraste, las pruebas funcionales estáticas no reproducen la condición activa de un individuo. No obstante su complejo montaje e interpretación, en el último decenio ha habido un creciente interés en aplicarlo en la detección de mecanismos de disnea. Al respecto, la curva flujo/volumen dinámica permite demostrar limitación de flujos e hiperinflación dinámica, también esta prueba permite profundizar en el análisis del intercambio gaseoso en ejercicio. La utilidad de estas pruebas en la evaluación funcional pre-operatoria compleja es destacada. Dada su alta reproducibilidad, el TCPE continúa siendo un alto referente en pruebas cardíacas de esfuerzo. Publicaciones cardiológicas enfatizan su valor pronóstico como indicador de sobrevida, seguimiento de terapias y enlistado para trasplante en insuficiencia cardíaca congestiva, utilizando parámetros máximos y submáximos. Entre los primeros el consumo cumbre o punta de oxígeno, y en los submáximos el equivalente ventilatorio de anhídrido carbónico y el consumo de oxígeno en el umbral lácticoCardiopulmonary exercise test (CPET evaluates cardiorespiratory function in dynamic conditions, in contrast to static pulmonary function tests which can not reproduce the dynamic situation of an individual. Despite its complex implementation there has been growing interest in CPET in evaluating the mechanisms of dyspnoea With this respect dynamic flow/volume curve is useful in identifying expiratory airflow limitation and dynamic hyperinflation. Besides gas exchange analysis during exercise deepens the quality of information in that subject. Its utility for decision making in complex perioperative evaluation can not be overemphasized. Considering its high reproducibility, this method is a highly valuable tool in cardiac stress testing. Several

  7. Cardiopulmonary exercise testing – Its application in cardiology and occupational medicine

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    Małgorzata Kurpesa

    2014-10-01

    Full Text Available Cardiopulmonary exercise testing is a method used to assess the exercise capacity. It is used in cardiology to define the diagnostic and prognostic information, the treatment and its effectiveness. This method is also useful in sport medicine and in occupational medicine. The cardiopulmonary exercise test involves measuring of gas exchange during exercise testing. The article presents the main parameters assessed during the test and the indications and contraindications for conducting the test. It also reveals the results of recently published clinical trials on the use of cardiopulmonary exercise test in patients with cardiovascular disease and in the working population. The study included variability of respiratory parameters during the cardiopulmonary exercise test and after its completion, as well as their impact on the prognostic value. In addition, the results of a study involving an optimal choice of interval training on the basis of oxygen consumption at peak exercise are summarized. Med Pr 2014;65(5:665–674

  8. Cardiopulmonary exercise testing in the evaluation of high risk patients with lung cancer

    Institute of Scientific and Technical Information of China (English)

    MAO You-sheng; WANG Yong-gang; HUANG Jin-feng; HE Jie; YAN Shao-ping; Dong Jing-si; CHENG Gui-yu; SUN Ke-lin; LIU Xiang-yang; FANG De-kang; LI Jian

    2010-01-01

    Background It is still unclear whether pulmonary function tests (PFTs) are sufficient for predicting perioperative risk,and whether all patients or only a subset of them need a cardiopulmonary exercise test (CPET) for further assessment.Thus, this study was designed to evaluate the CPET and compare the results of CPET and conventional PFTs to identify which parameters are more reliable and valuable in predicting perioperative risks for high risk patients with lung cancer.Methods From January 2005 to August 2008, 297 consecutive lung cancer patients underwent conventional PFTs (spirometry + single-breath carbon monoxide diffusing capacity of the lungs (DLCOsb) for diffusion capacity) and CPET preoperatively. The correlation of postoperative cardiopulmonary complications with the parameters of PFT and CPET was retrospectively analyzed using the chi-square test, independent sample t test and binary Logistic regression analysis.Results Of the 297 patients, 78 did not receive operation due to advanced disease stage or poor cardiopulmonary function. The remaining 219 underwent different modes of operations. Twenty-one cases were excluded from this study due to exploration alone (15 cases) and operation-related complications (6 cases). Thus, 198 cases were eligible for evaluation. Fifty of the 198 patients (25.2%) had postoperative cardiopulmonary complications. Three patients (1.5%)died of complications within 30 postoperative days. The patients were stratified into groups based on VO2max/pred respectively. The rate of postoperative cardiopulmonary complications was significantly higher in the group with cardiopulmonary complications were significantly correlated with age, comorbidities, and poor PFT and CPET results.used to stratify the patients' cardiopulmonary function status and to predict the risk of postoperative cardiopulmonary predicting perioperative risk. If available, cardiopulmonary exercise testing is strongly suggested for high-risk lung cancer patients in

  9. The role of cardiopulmonary exercise test for individualized exercise training recommendation in young obese subjects

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    Lucian Hoble

    2010-06-01

    Full Text Available Obesity is affecting a growing segment of the population and should be considered a serious health problem which will lead to medical complications and decreased life span. Lifestyle changes by adopting healthy food and increase energy consumption through physical activity is the most important treatment for obesity. Cardiopulmonary exercise test (CPET is considered the gold standard for exercise capacity assessment. Purpose: This study is aiming to demonstrate that individualized exercise training programs, designed using CPET results, leads to increase of physical fitness, aerobic capacity, ventilatory and cardiac exercise performance in young obese subjects.Material and method:We performed a prospective research study of 6 months. 43 sedentary subjects without contraindications to exercise, 21.3±3.1 years old, 93% female were included in the study. Assessments were made at baseline and after six months of intervention and consists of cardiopulmonary exercise test on bicycle ergometer. After we recorded oxygen uptake at aerobic threshold (AT, anaerobic threshold (in the range of respiratory compensation point – RCP and maximal oxygen uptake (VO2max we designed the training program according to these parameters and individualized heart rate training zones of each subject. Exercise training (60 minutes/session, 3 sessions/week was performed taking in consideration the training zones and using a circuit on cardio devices. Each subject was supervised by a physiotherapist and using heart rate monitors. The number of subjects evaluated at the end of the study was 27 (dropout rate 37%.Results:After six months of intervention we noticed an improvement of maximum oxygen uptake (VO2max (from 22.7±3.69 to 27.44±5.55, aerobic threshold (VO2_AT (from 15.48±2.66 to 20.07±4.64 ml/min/kg, p<0.0001 and anaerobic threshold (VO2_RCP (from 20.3±3.66 to 25.11±5.84 ml/min/kg, p<0.0001, cardiac performance during exercise evaluated trough maximal oxygen

  10. Accuracy of transcutaneous carbon dioxide tension measurements during cardiopulmonary exercise testing.

    NARCIS (Netherlands)

    Stege, G.; Elshout, F.J.J. van den; Heijdra, Y.F.; Ven, M.J.T. van de; Dekhuijzen, P.N.R.; Vos, P.J.E.

    2009-01-01

    BACKGROUND: Measurements of transcutaneous carbon dioxide tension (PtcCO(2)) with current devices are proven to provide clinically acceptable agreement with measurements of partial arterial carbon dioxide tension (PaCO(2)) in several settings but not during cardiopulmonary exercise testing (CPET). O

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

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

    2009-02-01

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

  12. Cardiopulmonary exercise testing – the gold standard in physical performance assesment

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    Claudiu Avram

    2008-12-01

    Full Text Available Background: Cardiopulmonary exercise testing (CPX is a modern procedure that allows us to evaluate the global performanceof a subject. Because CPX devices are expensive and less popular due to a less amount of specialists in this field, many oflaboratories uses the more common ECG stress tests for physical performance assessment. Aim: to demonstrate theimportance and accuracy of cardiopulmonary exercise testing comparing with traditional maximal electrocardiographic (ECGstress test without gas exchange analysis. Methods: 18th elite soccer players (age 22.7±6 years, body mass 74.6±9.5 kg,height 175.4±9.8 cm participated in the study. The subjects accomplished two treadmill effort tests with and without gasanalyses, in 2 consecutive days interval. Results: At the end of the study we noticed a highly significant statistical difference(p<0.0001 between the investigated testing methods. In gas exchange testing method we found a decreased level of all theparameters evaluated comparing to stress ECG: VO2 peak (ml*kg-1*min-1 = 55.4±5.2 vs. 67.8±5.7; AT (ml*kg-1*min-1 =41.2±7.6 vs. 47.4±6.9; VO2/HR (ml = 23.8±2.5 vs. 23.8±2.5. Conclusions: Asessment of exercise performance based solelyon a maximal stress ECG without gas analyzing is inaccurate. Furthermore, estimation of peak exercise responses based uponcalculation of VO2 peak from peak work rate are inappropriate in sportsman. The study demonstrate once again that CPXremain the most accurate and reliable test for detection of AT and for a comprehensive physical performance assessment andcannot be replace by other surrogate laboratory exercise tests like stress ECG.

  13. Exertional-induced bronchoconstriction: Comparison between cardiopulmonary exercise test and methacholine challenging test

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    Mostafa Ghanei

    2015-01-01

    Full Text Available Introduction: Exertional-induced bronchoconstriction is a condition in which the physical activity causes constriction of airways in patients with airway hyper- responsiveness. In this study, we tried to study and evaluate any relationship between the findings of cardiopulmonary exercise testing (CPET and the response to methacholine challenge test (MCT in patients with dyspnea after activity. Materials and Methods: Thirty patients with complaints of dyspnea following activity referred to "Lung Clinic" of Baqiyatallah Hospital but not suffering from asthma were entered into the study. The subjects were excluded from the study if: Suffering from any other pulmonary diseases, smoking more than 1 cigarette a week in the last year, having a history of smoking more than 10 packets of cigarettes/year, having respiratory infection in the past 4 weeks, having abnormal chest X-ray or electrocardiogram, and cannot discontinue the use of medicines interfering with bronchial provocation. Baseline spirometry was performed for all the patients, and the values of forced expiratory volume in 1 second (FEV1, forced vital capacity (FVC, and FEV/FVC were recorded. The MCT and then the CPET were performed on all patients. Results: The mean VO 2 (volume oxygen in patients with positive methacholine test (20.45 mL/kg/min was significantly lower than patients with negative MCT (28.69 mL/kg/min (P = 0.000. Respiratory rates per minute (RR and minute ventilation in the group with positive MCT (38.85 and 1.636 L were significantly lower than the group with negative methacholine test (46.78 and 2.114 L (P < 0.05. Also, the O 2 pulse rate in the group with negative methacholine test (116.27 mL/beat was significantly higher than the group with positive methacholine test (84.26 mL/beat (P < 0.001. Conclusion: Pulmonary response to exercise in patients with positive methacholine test is insufficient. The dead space ventilation in these patients has increased. Also, dynamic

  14. Exertional dyspnoea in COPD: the clinical utility of cardiopulmonary exercise testing

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    Denis E. O'Donnell

    2016-09-01

    Full Text Available Activity-related dyspnoea is often the most distressing symptom experienced by patients with chronic obstructive pulmonary disease (COPD and can persist despite comprehensive medical management. It is now clear that dyspnoea during physical activity occurs across the spectrum of disease severity, even in those with mild airway obstruction. Our understanding of the nature and source of dyspnoea is incomplete, but current aetiological concepts emphasise the importance of increased central neural drive to breathe in the setting of a reduced ability of the respiratory system to appropriately respond. Since dyspnoea is provoked or aggravated by physical activity, its concurrent measurement during standardised laboratory exercise testing is clearly important. Combining measurement of perceptual and physiological responses during exercise can provide valuable insights into symptom severity and its pathophysiological underpinnings. This review summarises the abnormal physiological responses to exercise in COPD, as these form the basis for modern constructs of the neurobiology of exertional dyspnoea. The main objectives are: 1 to examine the role of cardiopulmonary exercise testing (CPET in uncovering the physiological mechanisms of exertional dyspnoea in patients with mild-to-moderate COPD; 2 to examine the escalating negative sensory consequences of progressive respiratory impairment with disease advancement; and 3 to build a physiological rationale for individualised treatment optimisation based on CPET.

  15. Progress of cardiopulmonary exercise testing%心肺运动试验研究进展

    Institute of Scientific and Technical Information of China (English)

    蔡永前; 苏建奎; 桂星雨; 王芳利; 李建国; 王二鹏

    2015-01-01

    Cardiopulmonary exercise testing (CPET) provides a global assessment of the integrative exercise responses involving the pulmonary and cardiovascular systems by testing the gas exchange in airway. CPET is commonly used to evaluate the presence and severity of coronary ischemia, as well as exertional symptoms, heart rate and blood pressure responses and estimated aerobic capacity. CPET has become an important global clinical detection tool, while fewer related researches are carried out in China. The parameters, methods, exercise protocol, equipment, cardiopulmonary function evaluation and clinical application of CPET are introduced in this review.%心肺运动试验(CPET)是在一定运动负荷下,通过检测代谢与生理指标反映心、肺储备能力以及2者的协调性,进而同步、整体评估运动状态下呼吸系统、心血管系统、神经系统、骨骼肌肉系统等多器官、系统的功能。 CPET综合各种工程及医学技术,具有相对无创、客观定量等优点,目前已成为国际上用于评价心肺储备能力和心肺协调性水平的普遍且重要的临床检测手段,但我国的相关研究较少。从测量参数、试验方法、运动方案、试验设备、评价指标及临床应用等方面对CPET作一综述。

  16. Cardiopulmonary exercise testing – effective method for evaluation and recommendation of individualized exercise training in patients with metabolic syndrome

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    Claudiu Avram

    2011-12-01

    Full Text Available The present study aims to emphasize the role of cardiopulmonary exercise training (CPET in evaluation and recommendation of individualized exercise training in patients with a metabolic syndrome. Methods: We performed a prospective longitudinal study of 9 months. The study group consisted of 28 young patients (21.3±3.1 years old without contraindications to exercise, previously diagnosed with metabolic syndrome according to NCEP-ATPIII criteria. All patients were evaluating at baseline and after 3 months of intervention and at the end of the study (after 9 months. The evaluation consists in performing a CPET on bicycle ergometer in which subjects were monitored in terms of cardiac and respiratory parameters. The CPET results allow us to establish the range of effort intensity in which the patient should exercise in order to burn calories and achieve the maximum fat oxidation rate. All patients benefit from an intensive interval exercise training programme, supervised and guided by a physical therapist. Exercise training consisted in 50 minutes sessions, 3 times per week, at intensive endurance training zone (in the range of anaerobic threshold, completed by 1 minute interval in the range between anaerobic threshold (AT and respiratory compensation point (RCP, for every 5 minutes of training. Results: After 9 months of intervention we noticed an improvement of abdominal obesity (waist circumference decreased from 98.98±10.14 cm to 89.54±12.32 cm, p<0.001, physical fitness (V’O2peak increased from 1.83±0.33 l/min to 2.13±0.4 l/min, p<0.001 and endurance (Oxygen uptake in the range of anaerobic treshold increase from 1.27±0.27 l/min to 1.55±0.31 l/min, p<0.001. Conclusions: Cardiopulmonary exercise testing together with training zones determinations is a useful tool for assessing the exercise capacity and drawing up individual workouts. Active and closely monitored intervention by individualized exercise training programmes leads to

  17. Unexplained exertional dyspnea caused by low ventricular filling pressures: results from clinical invasive cardiopulmonary exercise testing

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    Lewis, Gregory D.; Opotowsky, Alexander R.; Waxman, Aaron B.; Systrom, David M.

    2016-01-01

    Abstract To determine whether low ventricular filling pressures are a clinically relevant etiology of unexplained dyspnea on exertion, a database of 619 consecutive, clinically indicated invasive cardiopulmonary exercise tests (iCPETs) was reviewed to identify patients with low maximum aerobic capacity (V̇o2max) due to inadequate peak cardiac output (Qtmax) with normal biventricular ejection fractions and without pulmonary hypertension (impaired: n = 49, V̇o2max = 53% predicted [interquartile range (IQR): 47%–64%], Qtmax = 72% predicted [62%–76%]). These were compared to patients with a normal exercise response (normal: n = 28, V̇o2max = 86% predicted [84%–97%], Qtmax = 108% predicted [97%–115%]). Before exercise, all patients received up to 2 L of intravenous normal saline to target an upright pulmonary capillary wedge pressure (PCWP) of ≥5 mmHg. Despite this treatment, biventricular filling pressures at peak exercise were lower in the impaired group than in the normal group (right atrial pressure [RAP]: 6 [IQR: 5–8] vs. 9 [7–10] mmHg, P = 0.004; PCWP: 12 [10–16] vs. 17 [14–19] mmHg, P < 0.001), associated with decreased stroke volume (SV) augmentation with exercise (+13 ± 10 [standard deviation (SD)] vs. +18 ± 10 mL/m2, P = 0.014). A review of hemodynamic data from 23 patients with low RAP on an initial iCPET who underwent a second iCPET after saline infusion (2.0 ± 0.5 L) demonstrated that 16 of 23 patients responded with increases in Qtmax ([+24% predicted [IQR: 14%–34%]), V̇o2max (+10% predicted [7%–12%]), and maximum SV (+26% ± 17% [SD]). These data suggest that inadequate ventricular filling related to low venous pressure is a clinically relevant cause of exercise intolerance. PMID:27162614

  18. Noninvasive assessment of normality of VD/VT in clinical cardiopulmonary exercise testing utilizing incremental cycle ergometry.

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    Roman, Michael A; Casaburi, James D; Porszasz, Janos; Casaburi, Richard

    2013-01-01

    Dead space to tidal volume ratio (V(D)/V(T)), a measure of pulmonary gas exchange efficiency, cannot be accurately calculated without arterial blood sampling. We sought to determine, in patients presenting for diagnostic cardiopulmonary exercise tests, whether there are ranges of the ratio of exhaled ventilation to carbon dioxide output (V(E)/VCO(2)) measured at the lactate threshold that are highly predictive of normality or abnormality of exercise V(D)/V(T) (below or above 0.3) and whether other demographic or physiologic variables aid in this prediction. We reviewed 691 incremental cycle ergometer cardiopulmonary exercise tests featuring breath-by-breath gas exchange measurement and serial arterial blood sampling that were performed for patients with a range of disorders. When V(E)/VCO(2) at the lactate threshold was ≤28, 96 % of subjects had normal V(D)/V(T). For V(E)/VCO(2) 29-32, V(D)/V(T) was normal in 83 % of cases. V(E)/VCO(2) of 33-38 provided no useful information; V(D)/V(T) was normal and abnormal in 50 % of cases each. When V(E)/VCO(2) was ≥39, V(D)/V(T) was abnormal in 87 % of cases. For V(E)/VCO(2) ≥ 39, when FEV(1)/VC was VCO(2) range. Our results reveal that certain values of V(E)/VCO(2) at LT (V (E)/VCO(2) ≤ 28 and V(E)/VCO(2) ≥ 39), but not others (V(E)/VCO(2) 29-32 and especially V(E)/VCO(2) of 33-38), can be helpful in determining normality of V(D)/V(T) during exercise in patients presenting for cardiopulmonary exercise testing.

  19. The clinical utility of cardiopulmonary exercise testing: results of a university hospital

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    Tajana Jalusic-Gluncic

    2012-08-01

    Full Text Available Objective: To determine the main reasons for cardiopulmonary exercise test (CPET referrals in our hospital over the last two years; to evaluate clinical usefulness of CPET. Methods: We included 207 patients between 17 and 76 years of age. For every patient, we measured electrocardigraphy (ECG, arterial blood gases, spirometry, maximal voluntary ventilation (MVV and diffusing capacity. CPET was then performed; using a treadmill, according to the modified Bruce protocol; then spirometry and diffusing capacity were repeated. Results: The most common reason for sending patients for CPET was dyspnea during exertion (85%, then preoperative assessment of lung cancer patients (11.6%, and preoperative assessment of heart transplant candidates (3.4%. After CPET in a dyspnea group, 33.5% had normal findings, 22.2% had pulmonary limitation, 31.8% had non pulmonary pathology, and 12.5% reached submaximal effort due to subjective problems (poor condition, feeling discomfort but no objective reasons to stop. From a lung cancer group, 25% were deemed unsuitable surgical candidates, and 14.29% of a heart transplant group was recommended immediate surgery, the remainder needed re-evaluation. Conclusion: Dyspnea of unknown cause is optimally investigated with CPET, allowing us to differentiate between the major causes of limitation (lung, heart, cardiovascular, muscular and, within each area, the specific causes of limitation. The most common diagnoses after CPET are pulmonary and cardiac diagnoses. CPET helps us to detect concurrent cardiovascular disease at respiratory impaired patients. CPET is the gold standard for evaluation of morbidity and mortality risk of lung cancer surgery and for selection of patients for heart transplant. [J Exp Integr Med 2012; 2(4: 297-303

  20. Prognostic significance of cardiopulmonary exercise testing for 10-year survival in patients with mild to moderate heart failure.

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    Koike, A; Koyama, Y; Itoh, H; Adachi, H; Marumo, F; Hiroe, M

    2000-12-01

    Although a number of studies have investigated the prognostic significance of exercise variables, they have focused only on short-term prognosis in relatively severe heart failure. This study was carried out to determine whether the indices obtained during cardiopulmonary exercise testing have prognostic significance during a 10-year follow-up in mild to moderate heart failure. Three hundred and sixty-four consecutive patients with cardiac disease performed 4 min of 20-W warm-up, followed by a symptom-limited incremental exercise test on a cycle ergometer. In addition to the measurements of peak oxygen uptake (VO2) and gas exchange (anaerobic) threshold, the time constant of VO2 kinetics during the onset of warm-up exercise was calculated using a single exponential equation. Data on mortality were available for follow-up in 260 patients. After 3,331+/-610 days of follow-up, 29 cardiovascular-related deaths occurred. The time constant of VO2 in the nonsurvivors was 76.7+/-43.3 s and was significantly prolonged compared with that of survivors (55.3+/-30.6 s, p=0.001). Peak VO2 and gas exchange threshold were both significantly lower in nonsurvivors than in survivors. Kaplan-Meier survival curves for 10 years of follow-up demonstrated a survival rate of 89.0% for patients with a normal VO2 time constant ( or = 80 s), showing a significant difference in survival (p=0.0028). Respiratory gas parameters obtained during exercise testing, particularly the time constant of VO2 kinetics, were found to be useful for predicting long-term prognosis in patients with chronic heart failure. These results suggest that cardiopulmonary exercise testing could be more applicable in ambulatory patients with minimal symptoms or minimal functional impairment.

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

    Science.gov (United States)

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

    2014-08-01

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

  2. Physiological parameters during the initial stages of cardiopulmonary exercise testing in patients with chronic heart failure - Their value in the assessment of clinical severity and prognosis

    NARCIS (Netherlands)

    de Vries, RJM; van Veldhuisen, DJ; Dunselman, PHJM; van der Veer, N; Crijns, HJGM

    1997-01-01

    Aims To analyse the relationship between initial exercise parameters and peak oxygen consumption and prognosis in 96 patients with congestive heart failure. Methods and Results Comparison of responses during the initial 6 min of cardiopulmonary exercise testing (Naughton modified protocol) in patien

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

    NARCIS (Netherlands)

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

    2014-01-01

    Background: Exercise capacity is seriously reduced after stroke. While cardiopulmonary assessment and intervention strategies have been validated for the mildly and moderately impaired populations post-stroke, there is a lack of effective concepts for stroke survivors suffering from severe motor lim

  4. [Cardiopulmonary exercise testing in chronic obstructive pulmonary disease (COPD) - breath-functional characterization and disease severity assessment].

    Science.gov (United States)

    Mühle, A; Obst, A; Winkler, J; Ewert, R

    2015-09-01

    COPD is a heterogeneous disease with a wide range of clinical phenotypes and breath-functional dysfunctions. Cardiopulmonary exercise testing (CPET) allows describing all component parts of breathing and determining exercise capacity and the mechanisms of exercise limitation. From these aspects 64 COPD patient stages II, III and IV according to the conventional GOLD classification were examined by means of CPET to evaluate whether CPET can provide a better functional characterization of COPD than the standard investigation procedures in pulmonary practice.We could show that in pulmonary practice CPET is safely and effectively practicable in stable COPD patients of all GOLD stages. This method allowed a clinical and prognostic disease severity assessment of all patients, proving important differences of peak oxygen uptake in each GOLD stage, so that patients in spite of identical GOLD disease severity were to be assigned to different prognostic groups according CPET criteria. Furthermore, we found relevant differences of individual breath-functional patterns in exercise, which can neither be objectified nor be prognosticated by standard investigation procedures at rest.Therefore CPET allows, aside from an objective clinical and prognostic disease severity assessment, also a breath-functional evaluation in a subtly way in COPD patients reflecting the multidimensional background of the disease with variable dysfunctions in pulmonary ventilation, gas exchange, circulation and muscular function as well as associated cardio vascular comorbidities. The breath-functional phenotyping of the COPD patient seems to be meaningful in particular for an individualised therapy management.

  5. Relations between cardiopulmonary function during exercise and exercise tolerance in patients with COPD

    OpenAIRE

    Cuypers, Maarten; Vos, Tine

    2015-01-01

    Methods: In part 1, a cross-sectional study took place. Sixty COPD patients performed a spirometry and a cardiopulmonary exercise test (CPET). Predictors of exercise tolerance were examined. In part 2, a longitudinal observational study took place. Twelve COPD patients completed an exercise training intervention. A study on relations between changes in cardiopulmonary function and changes in exercise tolerance was performed. Results: Significant predictors of VO2peak are peak carbon d...

  6. Cardiopulmonary exercise testing responses to different external portable drivers in a patient with a CardioWest Total Artificial Heart.

    Science.gov (United States)

    Tarzia, Vincenzo; Braccioni, Fausto; Bortolussi, Giacomo; Buratto, Edward; Gallo, Michele; Bottio, Tomaso; Vianello, Andrea; Gerosa, Gino

    2016-06-01

    Management of patients treated with CardioWest Total Artificial Heart (CW-TAH) as a bridge to heart transplantation (HTx) is complicated by difficulties in determining the optimal timing of transplantation. We present a case of a 53-year-old man supported as an outpatient with a CW-TAH, whose condition deteriorated following exchange of the portable driver. The patient was followed-up with serial cardiopulmonary exercise testing (CPET) which demonstrated a fall of peak VO2 to below 12 ml/kg/min following driver substitution, and the patient was subsequently treated with urgent orthotopic HTx. This case highlights the potential utility of CPET as a means for monitoring and indicating timing of HTx in patients with CW-TAH, as well as the potential for clinical deterioration following portable driver substitution.

  7. Exponential protocols for cardiopulmonary exercise testing on treadmill and cycle ergometer.

    Science.gov (United States)

    Jamison, J P; Megarry, J; Riley, M

    2010-01-01

    An extended exponential exercise protocol was validated by comparing submaximal and maximal parameters with those obtained by linear protocol. Normal subjects (n = 16, 20-69 years) undertook maximal exercise tests on treadmill and cycle ergometer. The subjects had a wide range of exercise capacity, and all were accommodated by the protocol. Mean oxygen uptake (V(O2)) agreed between protocols at gas exchange anaerobic threshold (theta) (95% CI of difference -0.1 to +0.06 l min(-1)) and at peak (95% CI of difference -0.1 to +0.1 l min(-1)). Mean pre-thetaDeltaV(O2)/Deltawork rate (W) slope on the cycle ergometer agreed between protocols (95% CI of the difference -0.9 to +0.25 ml min(-1) W(-1)). Post-thetaDeltaV(O2)/DeltaW slope was steeper than pre-theta, and steeper by linear than by exponential protocol (P = 0.0001). It is concluded that the exponential protocol is valid for the measurement of submaximal and maximal exercise parameters in subjects with a wide range of exercise capacity.

  8. Reduced fitness and abnormal cardiopulmonary responses to maximal exercise testing in children and young adults with sickle cell anemia.

    Science.gov (United States)

    Liem, Robert I; Reddy, Madhuri; Pelligra, Stephanie A; Savant, Adrienne P; Fernhall, Bo; Rodeghier, Mark; Thompson, Alexis A

    2015-04-01

    Physiologic contributors to reduced exercise capacity in individuals with sickle cell anemia (SCA) are not well understood. The objective of this study was to characterize the cardiopulmonary response to maximal cardiopulmonary exercise testing (CPET) and determine factors associated with reduced exercise capacity among children and young adults with SCA. A cross-sectional cohort of 60 children and young adults (mean 15.1 ± 3.4 years) with hemoglobin SS or S/β(0) thalassemia and 30 matched controls (mean 14.6 ± 3.5 years) without SCA or sickle cell trait underwent maximal CPET by a graded, symptom-limited cycle ergometry protocol with breath-by-breath, gas exchange analysis. Compared to controls without SCA, subjects with SCA demonstrated significantly lower peak VO2 (26.9 ± 6.9 vs. 37.0 ± 9.2 mL/kg/min, P < 0.001). Subjects demonstrated slower oxygen uptake (ΔVO2/ΔWR, 9 ± 2 vs. 12 ± 2 mL/min/watt, P < 0.001) and lower oxygen pulse (ΔVO2/ΔHR, 12 ± 4 vs. 20 ± 7 mL/beat, P < 0.001) as well as reduced oxygen uptake efficiency (ΔVE/ΔVO2, 42 ± 8 vs. 32 ± 5, P < 0.001) and ventilation efficiency (ΔVE/ΔVCO2, 30.3 ± 3.7 vs. 27.3 ± 2.5, P < 0.001) during CPET. Peak VO2 remained significantly lower in subjects with SCA after adjusting for age, sex, body mass index (BMI), and hemoglobin, which were independent predictors of peak VO2 for subjects with SCA. In the largest study to date using maximal CPET in SCA, we demonstrate that children and young adults with SCA have reduced exercise capacity attributable to factors independent of anemia. Complex derangements in gas exchange and oxygen uptake during maximal exercise are common in this population.

  9. Metabolic and clinical comparative analysis of treadmill six-minute walking test and cardiopulmonary exercise testing in obese and eutrophic women

    Directory of Open Access Journals (Sweden)

    Luciana Di Thommazo-Luporini

    Full Text Available BACKGROUND: Impaired exercise tolerance is directly linked to decreased functional capacity as a consequence of obesity. OBJECTIVES: To analyze and compare the cardiopulmonary, metabolic, and perceptual responses during a cardiopulmonary exercise test (CPX and a treadmill six-minute walking test (tread6MWT in obese and eutrophic women. METHOD: Twenty-nine female participants, aged 20-45 years were included. Fourteen were allocated to the obese group and 15 to the eutrophic group. Anthropometric measurements and body composition assessment were performed. RESULTS: In both tests, obese women presented with significantly higher absolute oxygen uptake, minute ventilation, and systolic and diastolic blood pressure; they also presented with lower speed, distance walked, and oxygen uptake corrected by the weight compared to eutrophics. During the maximal exercise test, perceived dyspnea was greater and the respiratory exchange ratio was lower in obese subjects compared to eutrophics. During the submaximal test, carbon dioxide production, tidal volume, and heart rate were higher in obese subjects compared to eutrophic women. When analyzing possible correlations between the CPX and the tread6MWT at peak, there was a strong correlation for the variable heart rate and a moderate correlation for the variable oxygen uptake. The heart rate obtained in the submaximal test was able to predict the one obtained in the maximal test. Bland-Altman plots demonstrated the agreement between both tests to identify metabolic and physiological parameters at peak exercise. CONCLUSIONS: The six-minute walking test induced ventilatory, metabolic, and cardiovascular responses in agreement with the maximal testing. Thus, the six-minute walking test proves to be important for functional evaluation in the physical therapy routine.

  10. Comparison of Predicted Exercise Capacity Equations and the Effect of Actual versus Ideal Body Weight among Subjects Undergoing Cardiopulmonary Exercise Testing

    Directory of Open Access Journals (Sweden)

    H. Reza Ahmadian

    2013-01-01

    Full Text Available Background. Oxygen uptake at maximal exercise (VO2 max is considered the best available index for assessment of exercise capacity. The purpose of this study is to determine if the use of actual versus ideal body weight in standard regression equations for predicted VO2 max results in differences in predicted VO2 max. Methods. This is a retrospective chart review of patients who were predominantly in active military duty with complaints of dyspnea or exercise tolerance and who underwent cardiopulmonary exercise testing (CPET from 2007 to 2009. Results. A total of 230 subjects completed CPET on a bicycle ergometer with a male predominance (62% and an average age of 37 ± 15 years. There was significant discordance between the measured VO2 max and predicted VO2 max when measured by the Hansen and Wasserman reference equations (P<0.001. Specifically, there was less overestimation when predicted VO2 max was based on ideal body weight as opposed to actual body weight. Conclusion. Our retrospective analysis confirmed the wide variations in predicted versus measured VO2 max based on varying prediction equations and showed the potential advantage of using ideal body weight as opposed to actual body weight in order to further standardize reference norms.

  11. Comparison of Predicted Exercise Capacity Equations and the Effect of Actual versus Ideal Body Weight among Subjects Undergoing Cardiopulmonary Exercise Testing.

    Science.gov (United States)

    Ahmadian, H Reza; Sclafani, Joseph J; Emmons, Ethan E; Morris, Michael J; Leclerc, Kenneth M; Slim, Ahmad M

    2013-01-01

    Background. Oxygen uptake at maximal exercise (VO2 max) is considered the best available index for assessment of exercise capacity. The purpose of this study is to determine if the use of actual versus ideal body weight in standard regression equations for predicted VO2 max results in differences in predicted VO2 max. Methods. This is a retrospective chart review of patients who were predominantly in active military duty with complaints of dyspnea or exercise tolerance and who underwent cardiopulmonary exercise testing (CPET) from 2007 to 2009. Results. A total of 230 subjects completed CPET on a bicycle ergometer with a male predominance (62%) and an average age of 37 ± 15 years. There was significant discordance between the measured VO2 max and predicted VO2 max when measured by the Hansen and Wasserman reference equations (P VO2 max was based on ideal body weight as opposed to actual body weight. Conclusion. Our retrospective analysis confirmed the wide variations in predicted versus measured VO2 max based on varying prediction equations and showed the potential advantage of using ideal body weight as opposed to actual body weight in order to further standardize reference norms.

  12. Cardiopulmonary Exercise Testing in Fontan Patients With and Without Isomerism (Heterotaxy) as Compared to Patients With Primary Ciliary Dyskinesia and Subjects With Structurally Normal Hearts

    DEFF Research Database (Denmark)

    Loomba, Rohit S; Danduran, Michael; Nielsen, Kim G;

    2016-01-01

    Isomerism, also known as heterotaxy, is a clinical entity that impacts multiple organ systems both anatomically and functionally. The airways and lungs are involved in a great number of these patients, leading to increased sinopulmonary symptoms, increased need for oxygenation, and increased post...... isomerism. The results are likely limited by selection bias and highlight the need for multicentric efforts to characterize cardiopulmonary exercise testing in those patients with pulmonary isomerism.......Isomerism, also known as heterotaxy, is a clinical entity that impacts multiple organ systems both anatomically and functionally. The airways and lungs are involved in a great number of these patients, leading to increased sinopulmonary symptoms, increased need for oxygenation, and increased...... postoperative ventilatory support. Additionally, these patients often have congenital heart disease requiring Fontan palliation. What has not been previously described, and is the focus of this study, is the results of cardiopulmonary exercise testing in those who have undergone Fontan palliation...

  13. Use of the Wasserman equation in optimization of the duration of the power ramp in a cardiopulmonary exercise test: a study of Brazilian men

    OpenAIRE

    COSTA,D. C.; de Santi, G. L.; J. C. Crescêncio; Seabra, L. P.; E.E.V. Carvalho; Papa, V.; Marques, F.,; GALLO JUNIOR, L; Schmidt, A.

    2015-01-01

    This study aimed to analyze the agreement between measurements of unloaded oxygen uptake and peak oxygen uptake based on equations proposed by Wasserman and on real measurements directly obtained with the ergospirometry system. We performed an incremental cardiopulmonary exercise test (CPET), which was applied to two groups of sedentary male subjects: one apparently healthy group (HG, n=12) and the other had stable coronary artery disease (n=16). The mean age in the HG was 47±4 years and that...

  14. Reference Standards for Cardiorespiratory Fitness Measured With Cardiopulmonary Exercise Testing Using Cycle Ergometry: Data From the Fitness Registry and the Importance of Exercise National Database (FRIEND) Registry.

    Science.gov (United States)

    Kaminsky, Leonard A; Imboden, Mary T; Arena, Ross; Myers, Jonathan

    2017-02-01

    The importance of cardiorespiratory fitness (CRF) is well established. This report provides newly developed standards for CRF reference values derived from cardiopulmonary exercise testing (CPX) using cycle ergometry in the United States. Ten laboratories in the United States experienced in CPX administration with established quality control procedures contributed to the "Fitness Registry and the Importance of Exercise: A National Database" (FRIEND) Registry from April 2014 through May 2016. Data from 4494 maximal (respiratory exchange ratio, ≥1.1) cycle ergometer tests from men and women (20-79 years) from 27 states, without cardiovascular disease, were used to develop these references values. Percentiles of maximum oxygen consumption (VO2max) for men and women were determined for each decade from age 20 years through age 79 years. Comparisons of VO2max were made to reference data established with CPX data from treadmill data in the FRIEND Registry and previously published reports. As expected, there were significant differences between sex and age groups for VO2max (Pstandard differences from treadmill testing reference values.

  15. Cardiopulmonary exercise testing in improving the rehabilitation of patients with heart failure and anemia

    Directory of Open Access Journals (Sweden)

    Guşetu G.

    2015-09-01

    Full Text Available Anemia is known to be recurrent in heart failure patients and its presence is an unfavorable prognostic factor (1,2. However, treatment with iron supplements or erythropoietin has proven to improve the health of this category of patients (1,3. Except in cases when hemoglobin value is below 8g %, anemia does not exclude patients with ischemic cardiomyopathy and/or heart failure from rehabilitation programs, but patients with anemia have lower exercise capacity and significantly lower VO2 peak increase than patients without anemia (4,5. Anemia associated with sedentary lifestyle complicates the situation, since they both decrease exercise capacity, and makes the choice of rehabilitation programs and exercise intensity more difficult, chiefly in patients with left ventricular systolic dysfunction, which has a considerable impact on the beneficial effects of physical activity.

  16. MRC chronic Dyspnea Scale: Relationships with cardiopulmonary exercise testing and 6-minute walk test in idiopathic pulmonary fibrosis patients: a prospective study

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    Roussos Charis

    2010-05-01

    Full Text Available Abstract Background Exertional dyspnea is the most prominent and disabling feature in idiopathic pulmonary fibrosis (IPF. The Medical Research Chronic (MRC chronic dyspnea score as well as physiological measurements obtained during cardiopulmonary exercise testing (CPET and the 6-minute walk test (6MWT are shown to provide information on the severity and survival of disease. Methods We prospectively recruited IPF patients and examined the relationship between the MRC score and either CPET or 6MWT parameters known to reflect physiologic derangements limiting exercise capacity in IPF patients Results Twenty-five patients with IPF were included in the study. Significant correlations were found between the MRC score and the distance (r = -.781, p 2 at the initiation and the end (r = -.542, p = 0.005 and r = -.713, p VO2 peak/kg (r = -.731, p 2 at peak exercise (r = -. 682, p 2 slope (r = .731, p 2 at AT (r = .630, p = 0.002 and the Borg scale at peak exercise (r = .50, p = 0.01 for the CPET. In multiple logistic regression analysis, the only variable independently related to the MRC is the distance walked at the 6MWT. Conclusion In this population of IPF patients a good correlation was found between the MRC chronic dyspnoea score and physiological parameters obtained during maximal and submaximal exercise testing known to reflect ventilatory impairment and exercise limitation as well as disease severity and survival. This finding is described for the first time in the literature in this group of patients as far as we know and could explain why a simple chronic dyspnea score provides reliable prognostic information on IPF.

  17. A systematic review and meta-analysis comparing cardiopulmonary exercise test values obtained from the arm cycle and the leg cycle respectively in healthy adults

    DEFF Research Database (Denmark)

    Larsen, Rasmus Tolstrup; Christensen, Jan; Tang, Lars Hermann

    2016-01-01

    INTRODUCTION: The cardiopulmonary exercise test (CPET) assesses maximal oxygen uptake (VO2max) and is commonly performed on a leg cycle ergometer (LC). However, some individuals would rather perform the CPET on an arm cycle ergometer (AC). OBJECTIVE: The objectives of this study were to undertake...... a systematic review and meta-analysis of the difference in VO2max achieved by AC compared to LC in healthy adults and to explore factors that may be predictive of this difference. METHODS: MEDLINE, EMBASE, CINAHL, and PEDro were searched in April 2015. The differences in VO2max (ACLCdiff) were pooled across...

  18. A SYSTEMATIC REVIEW AND META-ANALYSIS COMPARING CARDIOPULMONARY EXERCISE TEST VALUES OBTAINED FROM THE ARM CYCLE AND THE LEG CYCLE RESPECTIVELY IN HEALTHY ADULTS

    DEFF Research Database (Denmark)

    Larsen, Rasmus Tolstrup; Christensen, Jan; Tang, Lars Hermann

    2016-01-01

    INTRODUCTION: The cardiopulmonary exercise test (CPET) assesses maximal oxygen uptake (VO2max) and is commonly performed on a leg cycle ergometer (LC). However, some individuals would rather perform the CPET on an arm cycle ergometer (AC). OBJECTIVE: The objectives of this study were to undertake...... a systematic review and meta-analysis of the difference in VO2max achieved by AC compared to LC in healthy adults and to explore factors that may be predictive of this difference. METHODS: MEDLINE, EMBASE, CINAHL, and PEDro were searched in April 2015. The differences in VO2max (ACLCdiff) were pooled across...

  19. Intensity and physiological responses to the 6-minute walk test in middle-aged and older adults: a comparison with cardiopulmonary exercise testing

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    E.F. Sperandio

    2015-04-01

    Full Text Available The 6-minute walk test (6MWT is a simple field test that is widely used in clinical settings to assess functional exercise capacity. However, studies with healthy subjects are scarce. We hypothesized that the 6MWT might be useful to assess exercise capacity in healthy subjects. The purpose of this study was to evaluate 6MWT intensity in middle-aged and older adults, as well as to develop a simple equation to predict oxygen uptake (V˙O2 from the 6-min walk distance (6MWD. Eighty-six participants, 40 men and 46 women, 40-74 years of age and with a mean body mass index of 28±6 kg/m2, performed the 6MWT according to American Thoracic Society guidelines. Physiological responses were evaluated during the 6MWT using a K4b2 Cosmed telemetry gas analyzer. On a different occasion, the subjects performed ramp protocol cardiopulmonary exercise testing (CPET on a treadmill. Peak V˙O2 in the 6MWT corresponded to 78±13% of the peak V˙O2 during CPET, and the maximum heart rate corresponded to 80±23% of that obtained in CPET. Peak V˙O2 in CPET was adequately predicted by the 6MWD by a linear regression equation: V˙O2 mL·min-1·kg-1 = -2.863 + (0.0563×6MWDm (R2=0.76. The 6MWT represents a moderate-to-high intensity activity in middle-aged and older adults and proved to be useful for predicting cardiorespiratory fitness in the present study. Our results suggest that the 6MWT may also be useful in asymptomatic individuals, and its use in walk-based conditioning programs should be encouraged.

  20. Cardiopulmonary Exercise Capacity and Preoperative Markers of Inflammation

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    Pervez Sultan

    2014-01-01

    Full Text Available Explanatory mechanisms for the association between poor exercise capacity and infections following surgery are underexplored. We hypothesized that aerobic fitness—assessed by cardiopulmonary exercise testing (CPET—would be associated with circulating inflammatory markers, as quantified by the neutrophil-lymphocyte ratio (NLR and monocyte subsets. The association between cardiopulmonary reserve and inflammation was tested by multivariable regression analysis with covariates including anaerobic threshold (AT and malignancy. In a first cohort of 240 colorectal patients, AT was identified as the sole factor associated with higher NLR (P=0.03 and absolute and relative lymphopenia (P=0.01. Preoperative leukocyte subsets and monocyte CD14+ expression (downregulated by endotoxin and indicative of chronic inflammation were also assessed in two further cohorts of age-matched elective gastrointestinal and orthopaedic surgical patients. Monocyte CD14+ expression was lower in gastrointestinal patients (n=43 compared to age-matched orthopaedic patients (n=31. The circulating CD14+CD16− monocyte subset was reduced in patients with low cardiopulmonary reserve. Poor exercise capacity in patients without a diagnosis of heart failure is independently associated with markers of inflammation. These observations suggest that preoperative inflammation associated with impaired cardiorespiratory performance may contribute to the pathophysiology of postoperative outcome.

  1. Teste de esforço cardioplumonar na avaliação de doenças musculares Cardiopulmonary exercise testing for evaluation of muscle diseases

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    HELGA C. ALMEIDA SILVA

    1998-06-01

    Full Text Available OBJETIVO: Analisar o teste de esforço cardiopulmonar (TECP no diagnóstico de miopatias. MÉTODOS: 27 pacientes com miopatia realizaram TECP (protocolo de bicicleta em rampa, máximo, interrompido por sintoma. RESULTADOS: Pacientes distróficos e pacientes com mitocondriopatias mostraram diferenças significativas em relação aos controles para as variáveis potência do trabalho desenvolvido (watt e pico do consumo de oxigênio (VO2 máx. Pacientes com mitocondriopatias mostraram diminuição significativa do limiar anaeróbio em relação aos controles, além de elevação dos valores do quociente respiratório (QR do pico do exercício em relação aos demais grupos. CONCLUSÕES: TECP pode ser útil na avaliação evolutiva do grau de limitação física dos pacientes com miopatia. As variáveis potência do trabalho desenvolvido, VO2 máx, limiar anaeróbio e QR do pico do exercício podem sugerir o diagnóstico de miopatia e seus subtipos, excluindo quadros psicológicos.PURPOSE: To evaluate the cardiopulmonary exercise testing (CPX for the diagnosis of myopathies. METHODS: 27 patients with myopathy were submitted to CPX testing (symptom limited bike protocol. RESULTS: Dystrophic patients and patients with mitochondrial disease, compared with controls, showed significant differences for the power of work perfomed (watt and the maximum oxygen consumption (VO2 max. Patients with mitochondrial disease presented significantly lower values of anaerobic threshold when compared to controls and elevation of exercise peak respiratory exchange ratio (RER values when compared to the others groups. CONCLUSIONS: CPX testing may be useful in evaluating degree of physical limitation of patients with myopathy at inicial stage as well on follow-up examinations. Power of work performed, VO2 max, anaerobic threshold and RER at exercise peak may suggest the diagnosis of myopathy and its sub-types and therefore exclude psychologic causes of limitation.

  2. Effects of resistance exercise on cardiopulmonary factors in sedentary individuals.

    Science.gov (United States)

    Janyacharoen, Taweesak; Thayon, Methiya; Bushong, Wanwisa; Jaikla, Nussamol; Sawanyawisuth, Kittisak

    2016-01-01

    [Purpose] This study investigated the effects of resistance exercise on cardiopulmonary functions in young sedentary subjects. [Subjects] Forty-two young and healthy subjects with a sedentary lifestyle were included in this study. [Methods] The subjects were randomly divided into 2 groups: control and experimental. The control group (n=21) received health education and continued with normal activities of daily living. The experimental group (n=21) underwent resistance training, health education, and continued with normal activities of daily living. The resistance exercise program consisted of 3 postural exercises: chest press, dumbbell pullover, and flat-bench dumbbell fly. The subjects received this intervention 3 times/week for 8 weeks. [Results] The baseline characteristics were comparable between the 2 groups. The 6-minute-walk test score, peak expiratory flow, forced vital capacity, forced expiratory volume in 1 second, maximal voluntary ventilation, and chest expansions were significantly improved post-intervention in the experimental group and between the 2 groups. [Conclusion] Cardiopulmonary functions in young sedentary subjects were significantly improved with the 8-week resistance exercise program.

  3. Use of the Wasserman equation in optimization of the duration of the power ramp in a cardiopulmonary exercise test: a study of Brazilian men.

    Science.gov (United States)

    Costa, D C; Santi, G L de; Crescêncio, J C; Seabra, L P; Carvalho, E E V; Papa, V; Marques, F; Gallo Junior, L; Schmidt, A

    2015-12-01

    This study aimed to analyze the agreement between measurements of unloaded oxygen uptake and peak oxygen uptake based on equations proposed by Wasserman and on real measurements directly obtained with the ergospirometry system. We performed an incremental cardiopulmonary exercise test (CPET), which was applied to two groups of sedentary male subjects: one apparently healthy group (HG, n=12) and the other had stable coronary artery disease (n=16). The mean age in the HG was 47±4 years and that in the coronary artery disease group (CG) was 57±8 years. Both groups performed CPET on a cycle ergometer with a ramp-type protocol at an intensity that was calculated according to the Wasserman equation. In the HG, there was no significant difference between measurements predicted by the formula and real measurements obtained in CPET in the unloaded condition. However, at peak effort, a significant difference was observed between oxygen uptake (V˙O2)peak(predicted)and V˙O2peak(real)(nonparametric Wilcoxon test). In the CG, there was a significant difference of 116.26 mL/min between the predicted values by the formula and the real values obtained in the unloaded condition. A significant difference in peak effort was found, where V˙O2peak(real)was 40% lower than V˙O2peak(predicted)(nonparametric Wilcoxon test). There was no agreement between the real and predicted measurements as analyzed by Lin's coefficient or the Bland and Altman model. The Wasserman formula does not appear to be appropriate for prediction of functional capacity of volunteers. Therefore, this formula cannot precisely predict the increase in power in incremental CPET on a cycle ergometer.

  4. Use of the Wasserman equation in optimization of the duration of the power ramp in a cardiopulmonary exercise test: a study of Brazilian men

    Directory of Open Access Journals (Sweden)

    D. C. Costa

    2015-12-01

    Full Text Available This study aimed to analyze the agreement between measurements of unloaded oxygen uptake and peak oxygen uptake based on equations proposed by Wasserman and on real measurements directly obtained with the ergospirometry system. We performed an incremental cardiopulmonary exercise test (CPET, which was applied to two groups of sedentary male subjects: one apparently healthy group (HG, n=12 and the other had stable coronary artery disease (n=16. The mean age in the HG was 47±4 years and that in the coronary artery disease group (CG was 57±8 years. Both groups performed CPET on a cycle ergometer with a ramp-type protocol at an intensity that was calculated according to the Wasserman equation. In the HG, there was no significant difference between measurements predicted by the formula and real measurements obtained in CPET in the unloaded condition. However, at peak effort, a significant difference was observed between oxygen uptake (V˙O2peak(predictedand V˙O2peak(real(nonparametric Wilcoxon test. In the CG, there was a significant difference of 116.26 mL/min between the predicted values by the formula and the real values obtained in the unloaded condition. A significant difference in peak effort was found, where V˙O2peak(realwas 40% lower than V˙O2peak(predicted(nonparametric Wilcoxon test. There was no agreement between the real and predicted measurements as analyzed by Lin’s coefficient or the Bland and Altman model. The Wasserman formula does not appear to be appropriate for prediction of functional capacity of volunteers. Therefore, this formula cannot precisely predict the increase in power in incremental CPET on a cycle ergometer.

  5. Resposta cronotrópica ao teste cardiopulmonar após o uso de cimetidina Effects of cimetidine on chronotropic response to cardiopulmonary exercise t esting

    Directory of Open Access Journals (Sweden)

    Gicela Risso Rocha

    2006-03-01

    Full Text Available OBJETIVO: Testar a hipótese, por meio de ensaio clínico randomizado, de que a administração de cimetidina altera a resposta cronotrópica ao exercício. MÉTODOS: Foram selecionados 24 indivíduos saudáveis, com idade entre 20 e 68 anos, não-atletas, os quais concordaram em ser submetidos a testes cardiopulmonares, após uso de placebo e de cimetidina, 400 mg, duas vezes ao dia, durante uma semana. Os testes foram realizados em esteira rolante, com protocolo de rampa com análises diretas dos gases expirados. Foi avaliada freqüência cardíaca máxima atingida, além da freqüência cardíaca de repouso e do limiar anaeróbico. RESULTADOS: Os indivíduos estudados foram igualmente distribuídos por sexo, com idade média (± desvio padrão de 43 ±11 anos. Os exames com placebo e com cimetidina tiveram igual duração (578±90 seg vs 603±131 seg e igual VO2 pico (35±8 ml/kg.min vs 35±8 ml/kg.min. A administração de cimetidina não apresentou efeito significativo na freqüência cardíaca de repouso (75±10 vs 74±8 bpm, no pico do esforço (176±12 vs 176±11 bpm e, da mesma forma, também não houve diferença entre as variações das freqüências cardíacas (pico - repouso, nos dois estudos (101±14 vs 101±13 bpm. CONCLUSÃO: A administração de cimetidina por sete dias não altera a resposta cronotrópica ao exercício.OBJECTIVE: To test the hypothesis that the administration of cimetidine will modify the chronotropic response to exercise testing through a random clinical trial. METHODS: The study selected 24 eligible healthy subjects, ages between 20 and 68 years, not athletes, who agreed to undergo cardiopulmonary exercise testing after the administration of placebo and 400 mg of cimetidine twice a day for one week. The tests were performed on a treadmill using a ramp protocol and direct analysis of the expired gases. Peak, resting and anaerobic threshold heart rate were recorded. RESULTS: The twenty subjects studied were

  6. From Clinical Application of Cardiopulmonary Exercise Testing to View the Requirement for Holistic Integrative Physiology and Medicine%从心肺运动的应用价值看医学整体整合的需求

    Institute of Scientific and Technical Information of China (English)

    谭晓越; 孙兴国

    2013-01-01

    The cardiopulmonary exercise testing is one important clinical functional test method.While patients do the loaded exercise, from rest to peak exercise to recovery, we continuously record the functions of respiratory, circulatory, metabolic and neurohumoral etc.systems.Based on these results, we can non-invasively evaluate the whole functional capacity and healthy condition, diagnose the diseases, grade the diseases' severity, evaluate the effective effect of the drug or treatment, and prognoses the death survival outcome.From the view of clinical using of cardiopulmonary exercise testing, we need a theoretical system of physiology and medicine for the all systems in human body in whole.%心肺运动试验是一个重要的人体整体功能学检测方法.让患者运动,连续动态记录以呼吸、循环、代谢和神经体液等多系统的功能活动,由此实现人体整体生理功能状态评价、疾病诊断、病情评估、治疗效果评估和预后转归预测.从心肺运动试验的临床应用出发,需要建立生理学医学的整体整合理论用以指导该技术的正确运用和解读.

  7. 心肺运动试验在慢性阻塞性肺疾病中的应用%Application of Cardiopulmonary Exercise Testing in the Chronic Obstructive

    Institute of Scientific and Technical Information of China (English)

    李清云

    2015-01-01

    Objective Toinvestigate the significance of cardiopulmonary exercise testing in the application of chronic obstructive. Methods 46 patientswith chronic obstructive pulmonary disease (COPD group) and 46 healthy volunteers (control group) in our hospital were takenfor cardiopulmonary exercise testing, and the cardiopulmonary exercise testing in heart and lung function for the two groups were compared. Results The cardiac function Wmax VO2max, VO2max/kg, VO2/HRmax, SpO2, AT in the COPD group were significantly lower than the control group, <<0.05. The lung function VEmax, VTmax , VCO2max in the cardiopulmonaryexercise testingin for the COPD group were significantly lower than the control group, <<0.05. BFmax, VE/VO2AT,VE/VCO2AT were significantly higher than the control group, <<0.05. Conclusion Cardiopulmonary function tests can ful y reflect the disease status of patients with chronic obstructive pulmonary disease, and it plays an objective assessment of the role for the treatment and prognosis of the disease.%目的:探讨心肺运动试验在慢性阻塞性肺疾病中的应用意义。方法对我院收治的46例慢性阻塞性肺疾病患者(COPD组)和46例健康志愿者(对照组)进行心肺运动试验,比较两组在心肺运动试验后的心、肺功能指标。结果 COPD组患者的心功能指标Wmax、VO2max、VO2max/kg、VO2/HR max、SpO2、AT均显著低于对照组患者,<0.05;心肺运动试验中COPD组患者的肺功能指标VEmax、VTmax、VCO2max均显著低于对照组患者,<0.05;BFmax、VE/VO2AT、VE/VCO2 AT均显著高于对照组患者,<0.05。结论心肺功能试验能全面的反映慢性阻塞性肺疾病患者的疾病状况,对疾病的治疗和预后起到客观的评估作用。

  8. Relationship Between Reverse Remodeling and Cardiopulmonary Exercise Capacity in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Sant, Jetske Van't; Versteeg, Henneke

    2016-01-01

    -defibrillator (mean age 65 ± 11; 73% male) underwent echocardiography and cardiopulmonary exercise testing (CPX) before implantation (baseline) and 6 months after implantation. At baseline, patients also completed a set of questionnaires measuring mental and physical health. The association between echocardiographic......BACKGROUND: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive. METHODS AND RESULTS: Eighty-four patients with a 1st-time CRT...... response (left ventricular end-systolic volume decrease ≥15%) and a comprehensive set of CPX results was examined. Echocardiographic responders (54%) demonstrated higher peak oxygen consumption and better exercise performance than nonresponders at baseline and at 6-month follow-up. Furthermore, only...

  9. Vitamin D is associated with cardiopulmonary exercise capacity: results of two independent cohorts of healthy adults.

    Science.gov (United States)

    Kaul, A; Gläser, S; Hannemann, A; Schäper, C; Nauck, M; Felix, S B; Bollmann, T; Ewert, R; Friedrich, N

    2016-02-14

    Vitamin D has an important role in calcium homeostasis and is known to have various health-promoting effects. Moreover, potential interactions between vitamin D and physical activity have been suggested. This study aims to investigate the relationship between 25-hydroxyvitamin D (25(OH)D) and exercise capacity quantified by cardiopulmonary exercise testing (CPET). For this, 1377 participants from the Study of Health in Pomerania (SHIP-1) and 750 participants from the independent SHIP-TREND cohort were investigated. Standardised incremental exercise tests on a cycle ergometer were performed to assess exercise capacity by VO2 at anaerobic threshold, peakVO2, O2 pulse and peak power output. Serum 25(OH)D levels were measured by an automated chemiluminescence immunoassay. In SHIP-1, 25(OH)D levels were positively associated with all considered parameters of cardiopulmonary exercise capacity. Subjects with high 25(OH)D levels (4th quartile) showed an up to 25% higher exercise capacity compared with subjects with low 25(OH)D levels (1st quartile). All associations were replicated in the independent SHIP-TREND cohort and were independent of age, sex, season and other interfering factors. In conclusion, significant positive associations between 25(OH)D and parameters of CPET were detected in two large cohorts of healthy adults.

  10. Pediatric exercise testing. In health and disease

    NARCIS (Netherlands)

    Bongers, B.C.

    2013-01-01

    Measuring peak oxygen uptake (VO2peak) during progressive cardiopulmonary exercise testing (CPET) up to maximal exertion is widely recognized as the best single measure of aerobic exercise capacity. It is an important determinant of health, even in childhood and adolescence. Measuring VO2peak facili

  11. Reproducibility of cardiac power output and other cardiopulmonary exercise indices in patients with chronic heart failure.

    Science.gov (United States)

    Jakovljevic, Djordje G; Seferovic, Petar M; Nunan, David; Donovan, Gay; Trenell, Michael I; Grocott-Mason, Richard; Brodie, David A

    2012-02-01

    Cardiac power output is a direct measure of overall cardiac function that integrates both flow- and pressure-generating capacities of the heart. The present study assessed the reproducibility of cardiac power output and other more commonly reported cardiopulmonary exercise variables in patients with chronic heart failure. Metabolic, ventilatory and non-invasive (inert gas re-breathing) central haemodynamic measurements were undertaken at rest and near-maximal exercise of the modified Bruce protocol in 19 patients with stable chronic heart failure. The same procedure was repeated 7 days later to assess reproducibility. Cardiac power output was calculated as the product of cardiac output and mean arterial pressure. Resting central haemodynamic variables demonstrate low CV (coefficient of variation) (ranging from 3.4% for cardiac output and 5.6% for heart rate). The CV for resting metabolic and ventilatory measurements ranged from 8.2% for respiratory exchange ratio and 14.2% for absolute values of oxygen consumption. The CV of anaerobic threshold, peak oxygen consumption, carbon dioxide production and respiratory exchange ratio ranged from 3.8% (for anaerobic threshold) to 6.4% (for relative peak oxygen consumption), with minute ventilation having a CV of 11.1%. Near-maximal exercise cardiac power output and cardiac output had CVs of 4.1 and 2.2%, respectively. Cardiac power output demonstrates good reproducibility suggesting that there is no need for performing more than one cardiopulmonary exercise test. As a direct measure of cardiac function (dysfunction) and an excellent prognostic marker, it is strongly advised in the assessment of patients with chronic heart failure undergoing cardiopulmonary exercise testing.

  12. Orbital Fitness: An Overview of Space Shuttle Cardiopulmonary Exercise Physiology Findings

    Science.gov (United States)

    Moore, Alan D.

    2011-01-01

    Limited observations regarding the cardiopulmonary responses to aerobic exercise had been conducted during short-duration spaceflight before the Space Shuttle program. This presentation focuses on the findings regarding changes observed in the cardiopulmonary exercise responses during and following Shuttle flights. During flight, maximum oxygen uptake (VO2max) remained unchanged as did the maximum work rate achievable during cycle exercise testing conducted during the last full flight day. Immediately following flight, the ubiquitous finding, confirmed by investigations conducted during the Spacelab Life Sciences missions 1 and 2 and by NASA Detailed Supplemental Objective studies, indicated that VO2max was reduced; however, the reduction in VO2max was transient and returned to preflight levels within 7 days following return. Studies regarding the influence of aerobic exercise countermeasures performed during flight on postflight performance were mostly limited to the examination of the heart rate (HR) response to submaximal exercise testing on landing day. These studies revealed that exercise HR was elevated in individuals who performed little to no exercise during their missions as compared to individuals who performed regular exercise. In addition, astronauts who performed little to no aerobic exercise during flight demonstrated an increased HR and lowered pulse pressure response to the standard stand test on landing day, indicating a decrease in orthostatic function in these individuals. With regard to exercise modality, four devices were examined during the Shuttle era: two treadmills, a cycle ergometer, and a rowing device. Although there were limited investigations regarding the use of these devices for exercise training aboard the Shuttle, there was no clear consensus reached regarding which proved to be a "superior" device. Each device had a unique operational or physiologic limitation associated with its use. In conclusion, exercise research conducted

  13. 心肺运动试验在慢性阻塞性肺疾病中的应用%Application of Cardiopulmonary Exercise Test in Patients With Chronic Obstructive Pulmonary Disease

    Institute of Scientific and Technical Information of China (English)

    李清云

    2016-01-01

    目的:探讨心肺运动试验在慢性阻塞性肺疾病中的应用意义。方法对我院收治的96例慢性阻塞性肺疾病患者和96名健康志愿者(对照组)进行心肺运动试验,比较两组在心肺运动试验后的心肺功能指标。结果健康对照组患者心功能指标W max、VO 2max/kg、VO 2/HR max t、AT、VE max、BF max、VE/VO 2 AT、VE/VCO 2 AT均显著高于Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级COPD组患者,差异有统计学意义(P<0.05);COPD四组间指标Wmax、VO2max、VO2max/kg、VO2/HRmax、SpO2、AT、VEmax、VCO2max、BRmax均随病情严重程度而逐渐显著下降,差异有统计学意义(P<0.05)。结论心肺功能试验能全面的反映慢性阻塞性肺疾病患者的疾病状况,对疾病的治疗和预后起到客观的评估作用。%Objective To investigate the significance of cardiopulmonary exercise test in patients with chronic obstructive pulmonary disease( COPD) . Methods 96 cases of patients with COPD admitted by our hospital and 96 healthy volunteers( con-trol group) were treated with cardiopulmonary exercise test,and cardiopulmonary function indexes of two groups were made a com-parison after the test. Results Cardiac function index like W max ,VO 2/HR max t,AT,VE max ,BF max ,VE/VO 2 AT and VE/VCO 2 AT in control group were significantly higher than those in 4 COPD patients groups grouped by level(P <0. 05). Wmax,VO2max, VO2max/kg,VO2/HRmax,SpO2,AT,VEmax,VCO2max and BRmaxwere significantly different between 4 COPD patients groups,decli-ning visibly as the severity of the illness(P<0. 05). Conclusion Cardiopulmonary function tests could comprehensively reflect the disease status of patients with COPD,and evaluate the treatment and prognosis of the disease.

  14. Comparação entre a prescrição de intensidade de treinamento físico baseada na avaliação ergométrica convencional e na ergoespirométrica Comparison between exercise intensity prescription based on a standard exercise test and cardiopulmonary exercise test

    Directory of Open Access Journals (Sweden)

    Maria Urbana Pinto Brandão Rondon

    1998-03-01

    Full Text Available OBJETIVO: Comparar os limites inferiores (L.inf. e superiores (L.sup. da prescrição de treinamento físico aeróbio determinada pelo teste ergométrico convencional (60-70% do VO2máx estimado ou 70-85% da FCmáx atingida, com a prescrição obtida pelo teste ergoespirométrico [limiar anaeróbio (LA e ponto de compensação respiratória (PCR]. MÉTODOS: Realizaram teste ergoespirométrico progressivo até a exaustão 47 homens (30±5 anos, divididos em subgrupos, de acordo com a velocidade da esteira durante o teste (4 ou 5mph e a capacidade física medida [baixa (BCF e moderada (MCF]. RESULTADOS: Os L.inf. de prescrição indireta apresentaram valores de VO2 e FC significantemente maiores que os valores de VO2 e FC no LA (4mph= 34,4±4,5 vs 19,6±4,6 e 5mph= 28,9±2 vs 18,9±5,4, e BCF= 32,0±4,1 vs 17,2±2,8 e MCF= 31,6±4,9 vs 21,1±5,7(mlO2.kg-1.min-1 e (4mph = 128,9±7,8 vs 113,1± 15,6 e 5mph= 130,3±5,2 vs 114,1± 18,9, e BCF= 127,6±7,2 vs 109,3±13,2 e MCF= 131,2± 5,7 vs 117,4± 19,2bpm. Os L.sup. de prescrição indireta no grupo de 4mph e BCF apresentaram valores de VO2 significantemente maiores que os valores medidos no PCR (40,1±5,3 vs 32,2±4,3 e 37,4±4,8 vs 30,6±2,5 mlO2.kg-1.min-1, respectivamente, e valores de FC semelhantes aos medidos no PCR. CONCLUSÃO: Os L.inf. da prescrição indireta de treinamento físico superestimam o LA, enquanto os L.sup. parecem adequados somente para indivíduos ativos com MCF.PURPOSE: To compare the lower (LL and upper limits (UL of exercise intensity prescription based on standard exercise test (60-70% of estimated VO2max or 70-85% of HRmax measured with exercise intensity prescription based on cardiopulmonary exercise test [anaerobic threshold (AT and respiratory compensation point (RCP]. METHODS: Fourty seven men (30±5 years who were submitted to a progressive cardiopulmonary exercise test until exhaustion were divided in subgroups according to treadmill speed during exercise test (4

  15. A STUDY ON CARDIOPULMONARY CHANGES WITH EXERCISE IN ADOLESCENT BOYS AND GIRLS

    Directory of Open Access Journals (Sweden)

    Lakshmi

    2015-02-01

    Full Text Available INTRODUCTION: Exercise is an important part of keeping adolescents healthy . The prevalence of obesity - related hypertension , in children and adolescents is on the rise . Exercise regimen can reverse or retard the rate of progression from prehypertension to hypertension in adolescents . The incidence of lung diseases including bronchial asthma is high in adolescent age group . There are gender differences in cardiopulmonary changes with exercise . The pulmonary function testing during exercise is often used for further assessme nt and determ in ing the degree of airway impairment and response to treatment . The present study was performed t o study the effect of various intensity of exercise on cardiopulmonary variables and to evaluate quantitative relationship between the variables . MATERIALS AND METHODS: The present study is carried out in a group of 100 healthy First year medical students of both sexes , who were not regular athletes . The subjects being medical students presented an added advantage of belonging to matching age groups of between 18 - 21 years of comparable physical standards and also medically screened at the time of admission . Before undertaking the exercise regimen blood hemoglobin concentration , RMV , MVV , FVC , FEV1 , PEFR , RR , HR and Blood Pressure ( BP were determined in all the subjects . Then the subject exercised on a bicycle ergometer with incremental loads . The Pulse Rate of the subject is noted and mentioned as the heart rate per minute . During the exercise the pulse was monitored by a pulse Oximeter . Blood Pressure was manually measured using standard mercury sphygmomanometer . The recordings before exercise , during exercise and 30 minutes after end of exercise of FVC , FEV - 1 and PEFR were measured using a digital spirometer . RESULTS: All the observations recorded in Group - A ( Boys subjects and of Group - B ( Girls subjects were noted . The arithmetical mean , standard deviation and standard

  16. Cardiopulmonary response to exercise and cardiac assessment in patients with turner syndrome.

    Science.gov (United States)

    Tancredi, Giancarlo; Versacci, Paolo; Pasquino, Anna Maria; Vittucci, Anna Chiara; Pucarelli, Ida; Cappa, Marco; Di Mambro, Corrado; Marino, Bruno

    2011-04-01

    Turner syndrome (TS) is a chromosomal disorder; however, little is known about the exercise tolerance of patients with this syndrome. The aim of the present study was to measure the maximal aerobic capacity and cardiac function using cardiopulmonary exercise testing and lung function tests and to evaluate the cardiac parameters using echocardiography in patients with TS and control subjects. A total of 50 women with TS (mean age 21.3 ± 8.5 years) and 56 age-matched controls (mean age 21.1 ± 3.7 years) were enrolled from the Pediatric Department of "Sapienza" University of Rome and underwent cardiopulmonary exercise testing, lung function testing, and echocardiography. The maximal oxygen uptake was lower in the patients with TS than in the controls (28.4 ± 4.0 vs 35.6 ± 6.2 ml/min/kg; p <0.0001). Also, the forced expiratory volume in 1 second, expressed as a percentage of the predicted value, was greater in the patients with TS than in the controls (116.2 ± 15.2% vs 102.8 ± 4.8%, p <0.0001). The patients with TS had a smaller left ventricle than did the controls. Tissue Doppler imaging revealed subclinical systolic and diastolic dysfunction in the left ventricle in those with TS but not in the controls. The left ventricular mass index was greater in the patients with TS than in the controls (38.6 ± 9.3 vs 27.2 ± 4.5 g/m(2.7), p <0.0001). In conclusion, the patients with TS had a lower maximal aerobic capacity and exercise tolerance than did the controls. The anatomic and functional cardiac aspects were peculiar to those with TS and might represent a specific cardiac phenotype.

  17. 心肺运动试验在心肌缺血早期诊断中的应用价值探讨%The value of cardiopulmonary exercise testing in patients with myocardial ischemia

    Institute of Scientific and Technical Information of China (English)

    邓思健; 袁桂影; 伍惠红; 钟海波; 余慧文; 汪得喜

    2011-01-01

    Objective To investigate the value of cardiopulmonary exercise testing in patients with myocardial ischemia. Methods Fifty-two patients with chest pain were divided into two groups according the results of 99Tcm-MIBI stress-rest perfusion imaging: ischemia group and non- ischemia group. All patients received cardiopulmonary exercise testing and noninvasive echocardiography. The differences of cardiopulmonary exercise testing data were evaluated. Results No significant difference in age, gender, body weight index, E/A and EF between two groups. Compared to non-ischemia group, VO2 peak/kg[(27 ±6)ml/(kg · min) vs (33 ±7)ml/(kg · min) ,P<0.01], VO2 peak[(1.5 ±0.5)L/min vs (2.1 ±0.5)L/min,P<0.01],VO2 peak/HR[(10.7 ±2.6) ml/beat vs (14.1 ±3.0)ml/beat,P <0.01],HR[(143 ± 15)beats/min vs (154 ± 17)beats/min,P <0.05]and AT[(16.4 ±3. 0) ml/( kg · min) vs ( 20.6 ± 5. 0) ml/( kg · min) , P < 0. 01], VO2 peak/HR @ AT in eardiopulmonary exercise [(9.0 ± 1.8) m l/beat vs (11.3 ±2.3) ml/beat, P <0.01]in ischemia group were significant decreased.Conclusion VO2 peak/Kg, VO2 peak, VO2peak/HR, AT and VO2/HR @ AT have potential value in early discovery of myocardial ischemia.%目的 研究心肺运动试验(CPET)相关指标在心肌缺血患者诊断中的价值。方法 52例胸痛患者患者分别行CPET、99Tcm-MIBI心肌灌注显像检查及心脏彩色多普勒超声检查。根据心肌灌注显像检查结果分为心肌缺血组(30例)及非缺血组(22例)。比较2组患者的CPET相关指标如每千克体重峰摄氧量( VO2 peak/kg)、峰摄氧最(VO2 peak)、峰氧脉搏(VO2 peak/HR)、最大呼吸频率、氧斜率、呼吸储备、最大心率、心率储备和无氧阈、无氧阈时氧气通气当最、无氧阈时二氧化碳通气当量、无氧阈时氧脉搏以及心脏彩色多普勒超声检查二尖瓣口血流舒张早期峰值速度(E)与舒张晚期峰值速度(A)的比值(E/A值)和左

  18. The Effects of Cigarette Smoking on Cardiopulmonary Function and Exercise Tolerance in Teenagers

    Directory of Open Access Journals (Sweden)

    Dianna Louie

    2001-01-01

    Full Text Available Teenagers who smoke are frequently warned that cigarette smoking will have detrimental effects on the function of their cardiopulmonary system and on their ability to perform exercise. However, there is little published evidence to support this statement. Therefore, in the present study, peak expiratory flow was measured as an indicator of lung function, expired carbon monoxide level was measured as an indicator of current smoking and the associated reduction in the oxygen carrying capacity of the blood, and blood pressure and heart rate were measured as indicators of cardiovascular hemodynamics before and after a one-mile run in 27 teenagers. The results show that, even at a young age, cigarette smoking is associated with significant detrimental effects on cardiopulmonary function and exercise tolerance. Objective evidence of an effect of smoking on cardiopulmonary function and exercise tolerance in this age group may assist educators and health care professionals in convincing teenagers to quit smoking.

  19. VO2@RER1.0: a novel submaximal cardiopulmonary exercise index.

    Science.gov (United States)

    Chin, Clifford; Kazmucha, Jeffrey; Kim, Nancy; Suryani, Reny; Olson, Inger

    2010-01-01

    Maximal oxygen consumption (VO2max) is the "gold standard" by which to assess functional capacity; however, it is effort dependent. VO2@RER1.0 is defined when VO2 = VCO2. Between December 22, 1997 and November 9, 2004, 305 pediatric subjects underwent cycle ergometer cardiopulmonary exercise testing, exercised to exhaustion, and reached a peak respiratory exchange ratio > or = 1.10. Group 1 subjects achieved a peak VO2 > or = 80% of predicted VO2max; group 2 subjects achieved a peak VO2 equation was created. VO2@RER1.0 data from groups 2 and 3 were plotted onto the normative graph. Contingency table and relative-risk analysis showed that an abnormal VO2@RER1.0 predicted an abnormal peak VO2(positive-predictive value 83%, negative-predictive value 85%, sensitivity 84%, and specificity 84%). VO2@RER1.0 is a highly sensitive, specific, and predictive submaximal index of functional capacity. This submaximal index is easy to identify without subjectivity. This index may aid in the evaluation of subjects who cannot exercise to maximal parameters.

  20. Relationship Between Reverse Remodeling and Cardiopulmonary Exercise Capacity in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy

    NARCIS (Netherlands)

    Mastenbroek, Mirjam H; van t Sant, Jetske; Versteeg, Henneke; Cramer, MJ; Doevendans, Pieter A; Pedersen, Susanne S; Meine, Mathias

    2016-01-01

    BACKGROUND: Studies on the relationship between left ventricular reverse remodeling and cardiopulmonary exercise capacity in heart failure patients undergoing cardiac resynchronization therapy (CRT) are scarce and inconclusive. METHODS AND RESULTS: Eighty-four patients with a 1st-time CRT-defibrilla

  1. Can the Cardiopulmonary 6-Minute Walk Test Reproduce the Usual Activities of Patients with Heart Failure?

    Directory of Open Access Journals (Sweden)

    Guimarães Guilherme Veiga

    2002-01-01

    Full Text Available OBJECTIVE: The 6-minute walk test is an way of assessing exercise capacity and predicting survival in heart failure. The 6-minute walk test was suggested to be similar to that of daily activities. We investigated the effect of motivation during the 6-minute walk test in heart failure. METHODS: We studied 12 males, age 45±12 years, ejection fraction 23±7%, and functional class III. Patients underwent the following tests: maximal cardiopulmonary exercise test on the treadmill (max, cardiopulmonary 6-minute walk test with the walking rhythm maintained between relatively easy and slightly tiring (levels 11 and 13 on the Borg scale (6EB, and cardiopulmonary 6-minute walk test using the usual recommendations (6RU. The 6EB and 6RU tests were performed on a treadmill with zero inclination and control of the velocity by the patient. RESULTS: The values obtained in the max, 6EB, and 6RU tests were, respectively, as follows: O2 consumption (ml.kg-1.min-1 15.4±1.8, 9.8±1.9 (60±10%, and 13.3±2.2 (90±10%; heart rate (bpm 142±12, 110±13 (77±9%, and 126±11 (89±7%; distance walked (m 733±147, 332±66, and 470±48; and respiratory exchange ratio (R 1.13±0.06, 0.9±0.06, and 1.06±0.12. Significant differences were observed in the values of the variables cited between the max and 6EB tests, the max and 6RU tests, and the 6EB and 6RU tests (p<0.05. CONCLUSION: Patients, who undergo the cardiopulmonary 6-minute walk test and are motivated to walk as much as they possibly can, usually walk almost to their maximum capacity, which may not correspond to that of their daily activities. The use of the Borg scale during the cardiopulmonary 6-minute walk test seems to better correspond to the metabolic demand of the usual activities in this group of patients.

  2. Cardiopulmonary exercise testing for elderly with chronic thromboembolic pulmonary hypertension%老年慢性血栓栓塞性肺动脉高压患者的心肺运动试验研究

    Institute of Scientific and Technical Information of China (English)

    奚群英; 柳志红; 赵智慧; 顾晴; 罗勤; 马秀平; 熊长明; 倪新海

    2015-01-01

    目的:明确老年慢性血栓栓塞性肺动脉高压(CTEPH)患者与年轻患者相比心肺运动试验(CPET)指标的变化。方法2011年1月至2014年5月在阜外医院肺血管病房住院的57名CTEPH患者行CPET。按年龄是否≥60岁分为老年组(19例)和青年组(38例)。结果两组间性别、既往深静脉血栓形成(DVT)病史的概率、接受肺动脉高压靶向药物治疗的概率、基于核素肺通气/灌注显像计算的肺血管阻塞率、世界卫生组织(WHO)功能分级差异无统计学意义(P>0.05)。与青年组相比,老年CTEPH患者运动心率反应减慢,一秒用力呼气量(FEV1)、用力肺活量(FVC)下降,峰值分钟通气量(VE@峰值)、峰值潮气量(VT@峰值)更低,峰值氧脉搏(VO2/HR@峰值)占预计值的百分率增高,无氧阈(AT)时的生理死腔通气与潮气量比值(VD/VT)增高,峰值时的潮气末氧分压更低。结论老年CTEPH患者有特殊的CPET表现。%ObjectiveTo investigate the differences in the indices of cardiopulmonary exercise testing (CPET) between the elderly and young patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods Fifty-seven CTEPH patients admitted to the Center for Pulmonary Vascular Diseases, Fuwai Hospital during January 2011 to May 2014 were enrolled in this study. They all underwent CPET, and were divided into 2 groups according to their age, that is, the elderly group (≥60 years old,n=19), and the younger group (<60 years old,n=38).Results There was no difference in gender, prevalence of deep venous thrombosis (DVT), pulmonary targeted drug therapy, pulmonary vascular occlusion rate detected by ventilation-perfusion lung scanning, and WHO functional class between the 2 groups. Compared with the younger patients, the elderly CTEPH patients had lower heart rate response during exercise, decreased forced expiratory volume in one second (FEV1) and forced vital

  3. Study of cardiopulmonary exercise test COPD patients complicated with depression%慢性阻塞性肺疾病合并抑郁症患者心肺运动试验研究

    Institute of Scientific and Technical Information of China (English)

    杜康; 郝建; 钱钧; 李树雯; 贺慧博; 李成恩; 钱忠立

    2015-01-01

    Objective To observe the changes of related indexes in COPD patients complicated with depres-sion by cardiopulmonary exercise test (CPET) to study the effect of depression on COPD patients. Methods 85 pa-tients with stable COPD were divided into the depression group and the non-depression group according to Zung self-rating depression scale (SDS), and all of them were given CPET. Results (1) A total of 26 patients were compli-cated with depression, accounting for 30. 6% . (2) Compared with the non-depression group, the depression group had a higher level of shortness of breath (P < 0. 05), despite of similar respiratory functional impairment. (3) 4 ca-ses quitted. The value of peak oxygen consumption and anaerobic threshold percentage of predicted peak oxygen up-take (AT% pred) was lower in the depression group than in the non-depression group, and the slope of ventilatory e-quivalent for carbon dioxide output was higher in the depression group than in the non-depression group (P < 0. 05). Conclusion Depression occurs in more than 30% of stable COPD patients and has a negative impact on ventilatory function and exercise capacity.%目的:观察稳定期慢性阻塞性肺疾病(简称慢阻肺)合并抑郁症患者心肺运动试验(CPET)各参数变化,研究抑郁症对慢性阻塞性肺疾病的影响。方法入选了稳定期慢阻肺患者85例,根据 Zung 抑郁自评量表(SDS)分成抑郁组和对照组,并分别进行 CPET。结果(1)合并抑郁症患者共26例,占慢阻肺总人数30.6%。(2)与非抑郁组相比,抑郁组具有相似水平的肺功能损害,但表现出更加明显的呼吸困难(P <0.05)。(3)共4例患者未能完成试验,完成试验的患者结果显示抑郁组在峰值摄氧量(VO2peak )、无氧阈占预估峰值摄氧量百分比(AT% pred)低于非抑郁组、而二氧化碳通气当量斜率(VE/ VCO2 slope )高于非抑郁组,差异有统计学意义(P <0.05)。结论超过30%的稳定期慢阻肺患者

  4. Metabolic and clinical comparative analysis of treadmill six-minute walking test and cardiopulmonary exercise testing in obese and eutrophic women Análise clínica e metabólica comparativa entre o teste de caminhada de seis minutos e o teste de exercício cardiopulmonar em mulheres obesas e eutróficas

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    Luciana Di Thommazo-Luporini

    2012-01-01

    Full Text Available BACKGROUND: Impaired exercise tolerance is directly linked to decreased functional capacity as a consequence of obesity. OBJECTIVES: To analyze and compare the cardiopulmonary, metabolic, and perceptual responses during a cardiopulmonary exercise test (CPX and a treadmill six-minute walking test (tread6MWT in obese and eutrophic women. METHOD: Twenty-nine female participants, aged 20-45 years were included. Fourteen were allocated to the obese group and 15 to the eutrophic group. Anthropometric measurements and body composition assessment were performed. RESULTS: In both tests, obese women presented with significantly higher absolute oxygen uptake, minute ventilation, and systolic and diastolic blood pressure; they also presented with lower speed, distance walked, and oxygen uptake corrected by the weight compared to eutrophics. During the maximal exercise test, perceived dyspnea was greater and the respiratory exchange ratio was lower in obese subjects compared to eutrophics. During the submaximal test, carbon dioxide production, tidal volume, and heart rate were higher in obese subjects compared to eutrophic women. When analyzing possible correlations between the CPX and the tread6MWT at peak, there was a strong correlation for the variable heart rate and a moderate correlation for the variable oxygen uptake. The heart rate obtained in the submaximal test was able to predict the one obtained in the maximal test. Bland-Altman plots demonstrated the agreement between both tests to identify metabolic and physiological parameters at peak exercise. CONCLUSIONS: The six-minute walking test induced ventilatory, metabolic, and cardiovascular responses in agreement with the maximal testing. Thus, the six-minute walking test proves to be important for functional evaluation in the physical therapy routine.CONTEXTUALIZAÇÃO: A reduzida tolerância ao exercício está relacionada à diminuída capacidade funcional consequente da obesidade. Objetivos

  5. Metabolic and clinical comparative analysis of treadmill six-minute walking test and cardiopulmonary exercise testing in obese and eutrophic women Análise clínica e metabólica comparativa entre o teste de caminhada de seis minutos e o teste de exercício cardiopulmonar em mulheres obesas e eutróficas

    Directory of Open Access Journals (Sweden)

    Luciana Di Thommazo-Luporini

    2012-12-01

    Full Text Available BACKGROUND: Impaired exercise tolerance is directly linked to decreased functional capacity as a consequence of obesity. OBJECTIVES: To analyze and compare the cardiopulmonary, metabolic, and perceptual responses during a cardiopulmonary exercise test (CPX and a treadmill six-minute walking test (tread6MWT in obese and eutrophic women. METHOD: Twenty-nine female participants, aged 20-45 years were included. Fourteen were allocated to the obese group and 15 to the eutrophic group. Anthropometric measurements and body composition assessment were performed. RESULTS: In both tests, obese women presented with significantly higher absolute oxygen uptake, minute ventilation, and systolic and diastolic blood pressure; they also presented with lower speed, distance walked, and oxygen uptake corrected by the weight compared to eutrophics. During the maximal exercise test, perceived dyspnea was greater and the respiratory exchange ratio was lower in obese subjects compared to eutrophics. During the submaximal test, carbon dioxide production, tidal volume, and heart rate were higher in obese subjects compared to eutrophic women. When analyzing possible correlations between the CPX and the tread6MWT at peak, there was a strong correlation for the variable heart rate and a moderate correlation for the variable oxygen uptake. The heart rate obtained in the submaximal test was able to predict the one obtained in the maximal test. Bland-Altman plots demonstrated the agreement between both tests to identify metabolic and physiological parameters at peak exercise. CONCLUSIONS: The six-minute walking test induced ventilatory, metabolic, and cardiovascular responses in agreement with the maximal testing. Thus, the six-minute walking test proves to be important for functional evaluation in the physical therapy routine.CONTEXTUALIZAÇÃO: A reduzida tolerância ao exercício está relacionada à diminuída capacidade funcional consequente da obesidade. Objetivos

  6. Exercise and NO production: relevance and implications in the cardio-pulmonary system

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    Alexei V Nosarev

    2015-01-01

    Full Text Available This article reviews the existing knowledge about the effects of physical exercise on nitric oxide (NO production in the cardiopulmonary system. The authors review the sources of NO in the cardiopulmonary system; involvement of three forms of NO synthases (eNOS, nNOS, and iNOS in exercise physiology; exercise-induced modulation of NO and/or NOS in physiological and pathophysiological conditions in human subjects and animal models in the absence and presence of pharmacological modulators; and significance of exercise-induced NO production in health and disease. The authors suggest that physical activity significantly improves functioning of the cardiovascular system through an increase in NO bioavailability, potentiation of antioxidant defense, and decrease in the expression of reactive oxygen species-forming enzymes. Regular physical exercises are considered a useful approach to treat cardiovascular diseases. Future studies should focus on detailed identification of (i the exercise-mediated mechanisms of NO exchange; (ii optimal exercise approaches to improve cardiovascular function in health and disease; and (iii physical effort thresholds.

  7. Exercises commonly used in rehabilitation of patients with chronic obstructive pulmonary disease: cardiopulmonary responses and effect over time

    NARCIS (Netherlands)

    Helvoort, H.A.C. van; Boer, R.C. de; Broek, L. van den; Dekhuijzen, R.; Heijdra, Y.F.

    2011-01-01

    OBJECTIVES: To compare conventional exercise-based assessment of pulmonary rehabilitation (PR) with improvement in training exercises employed during a PR program, and to describe the cardiopulmonary response of different training exercises during PR of patients with chronic obstructive pulmonary di

  8. 心肺运动试验比较三种肺动脉高压患者心肺功能状态的价值%Value of cardiopulmonary exercise testing in comparing cardio-pulmonary function among patients with three kinds of pulmonary artery hypertension

    Institute of Scientific and Technical Information of China (English)

    赵青; 柳志红; 马秀平; 赵智慧; 罗勤; 顾晴; 熊长明; 张洪亮; 王勇

    2015-01-01

    目的 探讨心肺运动试验(CPET)比较3种肺动脉高压(PAH)患者心肺功能状态的价值.方法 入选2012年12月至2013年5月入住阜外心血管病医院肺血管病诊治中心确诊的特发性PAH(特发组)、先天性心脏病性PAH(先心组)和结缔组织病相关性PAH(免疫组),均进行CPET,同时收集3组的一般资料、常规检查、氨基末端B型脑钠肽原(NT-proBNP)及6 min步行距离(6MWD)等结果并进行比较分析.结果 共入选特发组32例、先心组38例、免疫组25例.特发组、先心组、免疫组峰值氧耗量与体重的比值(VO2 max/kg)分别为(12.3±2.3)、(14.9±4.0)、(11.1±2.5)ml·min-1·kg-1,3组间差异有统计学意义(P<0.001),其中先心组显著高于其他两组(P=0.003,P<0.001);峰值氧脉搏(VO2与心率比值的峰值)分别为(5.8±1.4)、(6.4±1.8)、(5.3±1.7)ml·次-1·min-,3组间差异亦有统计学意义(P =0.034),其中先心组显著高于免疫组(P=0.012);峰值心率分别为(136.1±21.4)、(140.8±19.9)、(124.5 ±21.6)次/min,3组间差异有统计学意义(P =0.011),其中免疫组最低且显著低于先心组(P =0.009).免疫组6MWD均显著低于特发组、先心组(P =0.006、0.010);免疫组Nt-proBNP显著高于先心组(P =0.012).VO2 max/kg与峰值氧脉搏、峰值心率、峰值收缩压、6MWD、Nt-proBNP、左心室舒张末内径、右心室舒张末内径均显著相关(r=0.477、0.518、0.387、0.465、-0.350、0.349、-0.259).结论 CPET可以客观、定量地评价PAH的心肺功能状态和运动耐量.%Objective To assess the exercise capacity of three kinds of pulmonary artery hypertension using cardiopulmonary exercise testing (CPET).Methods In the Center for Pulmonary Vascular Disease Diagnosis and Treatment of Fuwai Hospital, idiopathic pulmonary artery hypertension (IPAH), congenital heart disease associated pulmonary artery hypertension (CHD-PAH), connective tissue disease associated pulmonary artery hypertension (CTD-PAH) were

  9. Role of exercise and nutrition on cardiopulmonary fitness and pulmonary functions on residential and non-residential school children.

    Science.gov (United States)

    Khodnapur, Jyoti P; Dhanakshirur, Gopal B; Aithala, Manjunatha

    2012-01-01

    Physical fitness is the prime criterion for survival and to lead a healthy life. Our aim is to find out effect of exercise and nutrition on physical fitness on growing children with scientific records. The present study was designed on healthy school children of a Residential-Sainik (100) and Non-Residential (100) school children (12-16 yrs) of Bijapur. To evaluate cardiopulmonary fitness parameters included are VO2Max (ml/kg/min) and Physical Fitness Index (PFI %). Harvard Step Test determined VO2 Max and PFI. Also recorded pulmonary function parameters like Forced Expiratory Volume in 1 sec (FEV1 in %) by recording spirometry. Peak Expiratory Flow Rate (PEFR in L/Min) by Peak flow meter and Maximal Expiratory Pressure (MEP in mmHg) by modified Black's apparatus. We found statistically significant higher values (p = 0.000) of VO2Max, PFI, FEV1, PEFR and MEP in residential school children compared to nonresidential school children higher. So, our study shows that regular exercise and nutritious food increase the cardiopulmonary fitness values and pulmonary functions in Residential school children.

  10. Exercise stress test

    Science.gov (United States)

    ... Heart disease - treadmill References Balady GJ, Morise AP. Exercise testing. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015: ...

  11. Analysis of physiological indexes of 128 healthy children receiving cardiopulmonary exercise testing%健康儿童128例心肺运动试验生理指标分析

    Institute of Scientific and Technical Information of China (English)

    相婷; 杨巧芝

    2015-01-01

    评价运动能力的有价值指标之一.%Objective To study the physiological indexes of children receiving cardiopulmonary exercise testing (CPET) in order to provide some data for establishing the normal CPET reference value in Chinese children.Methods One hundred and twenty-eight healthy children underwent the CPET with the standard scheme.All children were divided into 3 groups according to ages:3-6 years old, >6-10 years old and > 10-14 years old.The physiological indexes of CPET were collected, including maximal oxygen uptake (VO2max/kg) , oxygen uptake at anaerobic threshold (VO2/kg@AT), maximal tolerance power (Pmax), maximal heart rate (HRmax), peak respiratory minute volume to CO2 (peak VE/VCO2), slope of respiratory minute volume to CO2 (VE/VCO2 slope), maximal tidal volume (VTmax) and the maximal minute ventilation (VEmax).The range in normal values for physiological CPET variables was recorded.Results The VO2max/kg was (31.71 ± 7.31) mL/(min · kg), (31.05 ± 5.96) mL/(min · kg), and (34.10 ±8.72) mL/(min · kg) in the 3-6 years old group, >6-10 years old group and > 10-14 years old group of boys.The VO2/kg@AT was (28.32 ± 10.20) mL/ (min · kg), (23.13 ± 9.56) mL/(min · kg), and (22.18 ± 7.72) mL/(min · kg)in the 3-6 years old group, >6-10 years old group and > 10-14 years old group of boys.The VO2 max/kg was (29.27 ± 4.19) mL/(min · kg), (30.67 ± 5.59) mL/ (min · kg) (29.18 ± 6.56) mL/ (min · kg) in the 3-6 years old group, > 6-10 years old group and > 10-14 years old group of girls.The VO2@AT was (26.64 ±9.49) mL/(min · kg) ,(20.53 ±7.66) mL/(min · kg) ,(17.83 ±6.49) mL/(min · kg)in the 3-6 years old group, >6-10 years old group and > 10-14 years old group of girls.VO2max/kg and VO2/kg@AT did not change with age,there was no gender difference in VO2max/kg(P >0.05).VO2/kg@AT of boys was higher than girls in the 3-6 years old group(t =2.351 ,P =0.023).The Pmax,VEmax and VTmax increased with the growth of age

  12. Application of exercise testing in the diagnosis, prognosis, and treatment of patients with Pulmonary Hypertension

    OpenAIRE

    Fuentes Sánchez, Darío

    2016-01-01

    Background Recent developments have added exercise testing and training as part of the clinical practice in the diagnosis, treatment, and prognosis of diseased populations. Exercise testing has been used widely in cardiovascular disease and in some circumstances in pulmonary disease. Cardiopulmonary Exercise Testing has been used in the diagnosis and prognosis of pulmonary hypertension patients. However, no many studies have tried to evaluate functional capacity, explore prediction of cardio...

  13. Valuation of cardiopulmonary exercise test on the early COPD patients' rehabilitation%运动心肺功能参数对轻度慢性阻塞性肺疾病患者康复治疗的指导作用

    Institute of Scientific and Technical Information of China (English)

    王新本; 周新春; 滕志涛; 郭志勇; 陈聪

    2013-01-01

    目的 探讨运动心肺功能参数指导轻度慢性阻塞性肺疾病(COPD)康复治疗的价值.方法 选择轻度COPD患者85例,随机分为运动康复组45例和常规康复组40例.运动康复组根据检查参数选择适当运动康复方案,常规康复组根据自身情况进行锻炼,疗程为半年.治疗前后两组行静态或运动心肺功能、心脏彩超检查,比较两组第1秒用力肺活量(FEV1)、用力肺活量(FVC)、左室射血分数(LVEF)、最大摄氧量(VO2max)、6min步行距离(6 min WD)、最大负荷功率(LPmax)的差异.结果 半年后两组FEV1/FVC、LVEF比较差异无统计学意义(P均>0.05);运动康复组VO2 max、LPmax、6 min WD较常规康复组均明显改善(P均<0.05).结论 轻度COPD患者基于运动心肺试验参数指导下的康复治疗可以明显改善心肺功能.%Objective To investigate the valuation of cardiopulmonary exercise test (CPET) on the early COPD patients' rehabilitation.Methods 85 COPD patients were randomly divided into exercise rehabilitation group(n =45) and regular group(n =40).Patients in exercise rehabilitation group were accepted exercise rehabilitation method according to CPET data.Patients in regular group were accepted normal rehabilitation method.All patients were accepted CEPT.After 6 months,VO2 max,6-minute walk distance(6 minWD),FEV1/FVC and LVEF LPmax of patients were detected.Results The differences of FEV1/FVC and LVEF in both groups were not statistically significant(all P >0.05).Compared with the regular group,VO2 max,6-minMD and LPmax of patients in the exercise rehabilitation group became better(all P <0.05).Conclusions Exercise rehabilitation method with the guidance of CPET parameter can improve the cardiopulmonary functions of the early COPD patients

  14. The clinical importance of cardiopulmonary exercise testing and aerobic training in patients with heart failure A importância clínica de testes de exercícios cardiopulmonares e treinamento aeróbico em pacientes com insuficiência cardíaca

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    R Arena

    2008-04-01

    Full Text Available INTRODUCTION: The appropriate physiological response to an acute bout of progressive aerobic exercise requires proper functioning of the pulmonary, cardiovascular and skeletal muscle systems. Unfortunately, these systems are all negatively impacted in patients with heart failure (HF, resulting in significantly diminished aerobic capacity compared with apparently healthy individuals. Cardiopulmonary exercise testing (CPX is a noninvasive assessment technique that provides valuable insight into the health and functioning of the physiological systems that dictate an individual’s aerobic capacity. The values of several key variables obtained from CPX, such as peak oxygen consumption and ventilatory efficiency, are often found to be abnormal in patients with HF. In addition to the ability of CPX variables to acutely reflect varying degrees of pathophysiology, they also possess strong prognostic significance, further bolstering their clinical value. Once thought to be contraindicated in patients with HF, participation in a chronic aerobic exercise program is now an accepted lifestyle intervention. Following several weeks/months of aerobic exercise training, an abundance of evidence now demonstrates an improvement in several pathophysiological phenomena contributing to the abnormalities frequently observed during CPX in the HF population. These exercise-induced adaptations to physiological function result in a significant improvement in aerobic capacity and quality of life. CONCLUSIONS: Furthermore, there is initial evidence to suggest that aerobic exercise training improves morbidity and mortality in patients with HF. This paper provides a review of the literature highlighting the clinical significance of aerobic exercise testing and training in this unique cardiac population.INTRODUÇÃO: A resposta fisiológica aguda ao exercício aeróbio progressivo demanda funcionamento adequado dos sistemas pulmonares, cardiovasculares e m

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

    Science.gov (United States)

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

    2016-09-01

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

  16. Valores de referência para o teste cardiopulmonar para homens e mulheres sedentários e ativos Valores de referencia para el test cardiopulmonar para hombres y mujeres sedentarios y activos Reference values for cardiopulmonary exercise testing for sedentary and active men and women

    Directory of Open Access Journals (Sweden)

    Artur Haddad Herdy

    2011-01-01

    laboratorio. Atletas, fumantes, portadores de cualquier patología conocida, usuarios de medicación continua y obesos fueron excluidos. VO2 pico fue considerado VO2 máx. Analizamos también VO2 de umbral anaeróbico, ventilación máxima y pulso de oxígeno de acuerdo con sexo, franja etárea, sedentarios y activos. Las franjas etáreas fueron así divididas: G1 (15-24 años, G2 (25-34, G3 (35-44, G4 (45-54, G5 (55-64 y G6 (65-74. RESULTADOS: De acuerdo con las franjas etáreas, los valores medios de VO2 en ml/kg/min con los respectivos desviación-estándar fueron: Hombre activo: G1-50,6 ± 7,3; G2-47,4 ± 7,4; G3-45,4 ± 6,8; G4-40,5 ± 6,5; G5-35,3 ± 6,2; G6-30,0 ± 6,1. Mujer activa: G1-38,9 ± 5,7; G2-38,1 ± 6,6; G3-34,9 ± 5,9; G4-31,1 ± 5,4; G5-28,6 ± 6,1; G6-25,1 ± 4,4. Hombre sedentario: G1-47,4 ± 7,9; G2-41,9 ± 7,2; G3-39,0 ± 6,8; G4-35,6 ± 7,7; G5-30,0 ± 6,3; G6-23,1 ± 6,3. Mujer sedentaria: G1-35,6 ± 5,7; G2-34,0 ± 4,8; G3-30,0 ± 5,4; G4-27,2 ± 5,0; G5-23,9 ± 4,2; G6-21,2 ± 3,4. CONCLUSIÓN: Este artículo provee valores de referencia de VO2 máx, entre otros parámetros, en el Test Cardiopulmonar realizados en la cinta ergométrica en individuos de ambos sexos, activos y sedentarios.BACKGROUND: The reference values for cardiopulmonary exercise testing (CPET available in Brazil were derived from a cycle ergometer in a sedentary and relatively small population. OBJECTIVE: Provide reference values for CPET in Brazilians of both sexes, either sedentary or active. METHODS: From 2006 to 2008, 3,992 CEPT of healthy individuals were selected from our laboratory. Athletes, smokers, patients with any known pathology, users of continuous medication and obese patients were excluded. Peak VO2 was considered max VO2. We also analyzed the anaerobic threshold VO2, maximum ventilation and oxygen pulse according to sex, age, sedentary and active patients. Age groups were divided as follows: G1 (15-24, G2 (25-34, G3 (35-44, G4 (45-54, G5 (55-64 and G6 (65

  17. The effectiveness of specific exercise types on cardiopulmonary functions in patients with ankylosing spondylitis: a systematic review.

    Science.gov (United States)

    Saracoglu, Ismail; Kurt, Gamze; Okur, Eda Ozge; Afsar, Emrah; Seyyar, Gulce Kallem; Calik, Bilge Basakci; Taspinar, Ferruh

    2017-03-01

    The aim of this review was to assess the effectiveness of specific exercise types on pulmonary functions, aerobic and functional capacity in patients with ankylosing spondylitis (AS). A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID) was conducted in January 2016. The outcome measures were spirometric measurements, chest expansion, 6 minute walk distance (6MWD), pVO2, Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). The search strategy was applied with limitation of date and language and this initial electronic search resulted in 143 relevant studies. After duplicates were removed, the titles and abstracts of 52 articles were screened. Of these, 14 full-text articles met initial criteria and were retrieved for review, with eight studies meeting final inclusion criteria. Both specific and conventional exercise groups showed significant improvements in BASDAI and BASFI scores (p  0.05). Specific exercises are an effective adjuvant therapy to enhance cardiopulmonary functions in patients with AS; therefore, it is assumed that in addition to the medical treatments, specific exercise therapy might reduce the cardiopulmonary complications related with AS.

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

    Directory of Open Access Journals (Sweden)

    Paolo T. Pianosi

    2017-01-01

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

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

    Science.gov (United States)

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

    2017-01-24

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

  20. 频发室性早搏患儿心脏储备功能的变化及心肺运动试验的应用研究%Effect of frequent premature ventricular contraction on cardiac reserve function in children and clinical application of cardiopulmonary exercise test

    Institute of Scientific and Technical Information of China (English)

    郑彤; 汪芸; 刘艳; 任军; 赵地; 石琳

    2012-01-01

    目的 观察频发室性早搏(premature ventricular contraction,PVC)患儿磷酸肌酸治疗前、后的心肺运动试验(cardiopulmonary exercise test,CPET)各项参数变化,比较与正常儿童的差异,了解频发PVC对患儿心脏储备功能的影响.方法 采用心肺运动测试系统和活动平板对109例频发PVC患儿于治疗前、后分别进行CPET及98例健康儿童进行CPET,记录3组CPET指标,包括最大公斤体重摄氧量(maximal oxygen consumption/kg,VO2max/kg)、最大每搏摄氧量(maximal oxygen consumption/heart rate,VO2max/HR)、不同时段HR、无氧阈(anaerobic threshold,AT)、无氧阈占预计最大摄氧量的百分比( AT/VO2max pred).结果 频发PVC患儿组磷酸肌酸治疗前VO2max/kg、VO2max/HR及AT分别为(22.9 ±7.4)ml/(kg·min)、(9.3±1.5)ml、(15.5±2.7)ml/(kg·min),治疗后分别为(26.4±6.0) ml/(kg·min)、(11.4±3.3) ml、(17.4±3.8)ml/(kg·min),频发PVC患儿治疗后VO2max/kg、VO2max/HR、AT明显高于治疗前,差异均有统计学意义:VO2max/kg(t =2.11,P<0.001)、VO2max/HR(t=4.02,P<0.001)、AT(t=10.2,P<0.001).健康对照组进行的运动试验结果判定皆为阴性.结论 频发PVC患儿心脏储备功能降低,经临床治疗后,运动耐力得到改善,心脏储备功能增强,CPET可较好地反映患儿心脏储备功能的变化.%Objective To observe the changes in cardiopulmonary exercise test (CPET) variables of children with frequent premature ventricular contraction (PVC)before and after creatine phosphate treatment,to examine the difference of CPET results between PVC patients and healthy children,and to evaluate the effect of frequent PVC on the cardiac reserve function in children.Methods One hundred and nine frequent PVC children and 98 healthy children underwent treadmill exercise test and CPET respectively,the changes of CPET variables were observed among patients before and after treatment as well as among the healthy children.CPET variables include maximal oxygen

  1. Avaliação ergoespirométrica em atleta paraolímpico de esqui alpino: estudo de caso = Cardiopulmonary exercise test on a treadmill for a paralympic alpine skiing athlete: case study

    Directory of Open Access Journals (Sweden)

    Vinagre, Nelson Alexandre Campos

    2012-01-01

    Conclusões: O esquiador pôde responder ao procedimento de diferentes cargas durante o teste. No teste aplicado o atleta tem que aprender a gerenciar sua resistência, força e capacidades coordenativas. A avaliação da capacidade aeróbica poderá ajudar o desempenho durante o treinamento e competições, visto que os atletas devem dividir sua atenção com uma gama de exigências que juntas são atendidas em grande parte pelo sistema aeróbio

  2. Exercise Testing in Hypertension Patients

    Science.gov (United States)

    2001-10-25

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

  3. The implication of tissue Doppler echocardiography and cardiopulmonary exercise in early detection of cardiac dysfunction in systemic lupus erythematosus patients

    Science.gov (United States)

    Elnady, Basant M.; Abdelghafar, Ayman Saeed Mohamed; Khalik, El Shazly Abdul; Algethami, Mohammed Mesfer; Basiony, A.S.; Al-otaibi, Mona Dhaif Allah; Al-otaibi, Maram Eidhah

    2016-01-01

    Objective Systemic lupus erythematosus (SLE) can present limitations to exercise capacity and quality of life (QoL) because of various clinical conditions, such as pulmonary disease or heart disease. Tissue Doppler echocardiography (TDE) offers the promise of an objective measurement to quantify regional and global ventricular function through the assessment of myocardial velocity data. This study aimed to assess the intensity of left ventricular (LV) and right ventricular (RV) systolic and diastolic dysfunction in SLE patients by means of TDE and cardiopulmonary exercise (CPX) testing to determine their impact on QoL. Material and Methods Overall, 56 SLE patients within two tertiary healthcare centers as well as 50 healthy controls were examined with TDE after the exclusion of cardiovascular risk factors. TDE was performed for maximal systolic (S), early diastolic (E′), and late diastolic (A′) velocities of the mitral and tricuspid annulus. Pulsed wave (PW) Doppler of mitral and tricuspid valve inflow was performed in addition to the estimation of the left ventricle ejection fraction and assessment of right ventricle systolic function by tricuspid annular plane systolic excursion (TAPSE). Disease activity was assessed by the Systemic Lupus Activity Measure (SLAM), and the damage index was assessed by the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI). CPX tests according to the modified Bruce protocol were performed. Results SLE patients in both subgroups had more or less similar laboratory data and statistically higher values of ESR, CRP, and anticardiolipin (aCL) antibodies compared to the control group. LV function showed statistically insignificant EF compared to the control group, being lower in the patient group. Tissue Doppler image revealed that E′ and A′ of the mitral annulus were lower in the patient group than in the control group. Concerning RV, TAPSE in the patient group was

  4. 呼吸康复锻炼对老年慢性阻塞性肺疾病患者运动心肺功能的影响%The effects of respiratory rehabilitation training to cardiopulmonary exercise testing in geriatric patients with chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    田银君; 刘前桂; 赵黎黎; 李金红; 赵双燕; 周苗子; 张媛

    2015-01-01

    目的 探讨呼吸康复锻炼对老年COPD稳定期患者运动心肺功能及症状改善的影响.方法 97例稳定期老年COPD患者随机分为康复组55例和对照组42例,康复组除常规内科药物治疗外均进行12周的呼吸康复锻炼,对照组只采用常规内科药物治疗.2组患者治疗前及12周时均进行运动心肺试验、圣乔治呼吸问卷(SGRQ)及BODE评分.结果 康复锻炼前后静态肺功能未见明显变化(P>0.05).康复组反应运动耐力和心功能的指标Wmax、VO2 max、VO2 max/kg、VO2/HR、HRR较自身康复前及对照组均显著改善(P<0.01),反应通气功能的指标VEmax、VTmax、BR较自身康复前及对照组均显著增加(P <0.01),反应气体交换的指标VD/VT@rest、VD/VT@peak较自身康复前及对照组均显著降低(P<0.01),SGRQ评分及BODE指数较自身康复前及对照组均显著降低(P<0.01).对照组的Wmax前后对比平均降低(2.15±5.90) W(P <0.05),其余指标前后对比差异无统计学意义(P>0.05).结论 呼吸康复锻炼能显著改善老年COPD患者的有氧代谢能力和肺通气、换气水平,提高运动耐量及改善症状.%Objective To explore the effects of respiratory rehabilitation training in geriatric patients with stable chronic obstructive pulmonary disease (COPD),which focuse on the changes of cardiopulmonary exercise function and COPD symptoms.Methods Ninety-seven cases of geriatric patients with stable COPD were randomly divided into rehabilitation group of 55 cases and control group of 42 cases.All patients received conventional medical therapy.Meanwhile,the rehabilitation group received respiratory rehabilitation training for 12 weeks.The improvements of cardiopulmonary exercise test (CPET),St George's Respiratory Questionnaire (SGRQ) and BODE index were evaluated before and after the training scheme.Results There was no significant difference in resting spirometry after respiratory rehabilitation training (P >0.05).The

  5. Does exercise training improve cardiopulmonary fitness and daily physical activity in children and young adults with corrected tetralogy of Fallot or Fontan circulation? A randomized controlled trial

    NARCIS (Netherlands)

    Duppen, Nienke; Etnel, Jonathan R.; Spaans, Laura; Takken, Tim; Van Den Berg-Emons, Rita J.; Boersma, Eric; Schokking, Michiel; Dulfer, Karolijn; Utens, Elisabeth M.; Helbing, Willem; Hopman, Maria T.

    2015-01-01

    Background Many patients with congenital heart disease do not meet current public health guidelines to participate in moderate-to-vigorous physical activity for ≥60 minutes per day. They are less fit than their healthy peers. We hypothesized that exercise training would increase cardiopulmonary fitn

  6. Proprioceptive isokinetic exercise test

    Science.gov (United States)

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

    1993-01-01

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

  7. Role of cardiopulmonary exercise testing in evaluating the efficiency of targeted drug therapy for patients with chronic thromboembolic pulmonary hypertension%心肺运动试验在评估慢性血栓栓塞性肺动脉高压患者靶向药物治疗效果中的作用

    Institute of Scientific and Technical Information of China (English)

    奚群英; 柳志红; 赵智慧; 顾晴; 罗勤; 马秀平; 熊长明; 倪新海

    2015-01-01

    目的:以心肺运动试验(CPET)评估慢性血栓栓塞性肺动脉高压(CTEPH)患者接受肺动脉高压靶向药物治疗后运动能力有无改善。方法2011年1月至2014年5月在阜外医院心内科肺血管病房住院的14例CTEPH患者,接受肺动脉靶向药物治疗3~12个月,治疗前后均进行CPET评估其运动能力。结果 CTEPH患者接受靶向药物治疗3~12个月后峰值氧耗量和氧脉搏均有明显改善(P<0.05);潮气末肺泡二氧化碳分压明显增加(P<0.001);分钟通气量/二氧化碳排出量(VE/VCO2)斜率及VE/VCO2最低值均显著下降(P<0.05)。但世界卫生组织功能分级较治疗前无明显改变(P>0.05);超声心动图检测右心室舒张末期内径及其与左心室舒张末期内径之比、肺动脉收缩压无明显差异(P>0.05);N端脑钠肽前体水平在治疗前后无显著性差异(P>0.05)。结论 CPET是评估CTEPH患者肺动脉高压靶向药物治疗后运动耐力的良好工具。%ObjectiveTo investigate the value of cardiopulmonary exercise testing (CPET) in the evaluation of the motor function improvement in the patients with chronic thromboembolic pulmonary hypertension (CTEPH) after targeted therapeutic drugs.Methods Fourteen CTEPH patients admitted to the Center for Pulmonary Vascular Diseases, Fuwai Hospital from January 2011 to May 2014 were enrolled in this study. They all received targeted drug therapy for 3 to 12 months. CPET was employed to evaluate their motor functions before and after the treatment.Results Significant improvements were observed in peak oxygen consumption (peak VO2), oxygen consumption/heart rate peak (VO2/HR peak), along with remarkably reduced minute ventilation volume/CO2 production (VE/VCO2) slope, the lowest VE/VCO2 ratio, and the increased levels of end-tidal partial pressure of CO2 (PetCO2) after 3 to 12 months’ treatment with targeted drug therapy for pulmonary arterial

  8. Exercise electrocardiogram testing in two brothers with different outcome – a case study exercise testing in master cyclists

    Directory of Open Access Journals (Sweden)

    Rüst CA

    2013-06-01

    Full Text Available Christoph Alexander Rüst,1 Beat Knechtle,1,2 Thomas Rosemann11Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland; 2Gesundheitszentrum St Gallen, St Gallen, SwitzerlandAbstract: The cases of two brothers training and competing as master cyclists and both preparing for a cycling tour are presented. The older brother aged 66 years went first to the primary care physician and presented with an asymptomatic depression in the exercise stress test of the ST segment in V5 and V6 during recovery after complete exhaustion. Coronary angiography revealed a multi vessel coronary artery disease and he underwent bypass surgery. One year later, he successfully completed his planned cycling tour of ~600 km in seven stages and covering ~12,000 m of total ascent. The younger brother aged 59 years went a few months later to the primary care physician and also performed asymptomatic exercise stress testing without changes in the ST segments. Unfortunately, 2 months later he suffered a cardiac arrest during his cycling tour and survived following immediate successful cardiopulmonary resuscitation on the road by his cycling colleagues. Immediate invasive coronary arteriography showed a complete stenosis of the trunk of arteria coronaria sinistra (left coronary artery, a 40%–50% stenosis of ramus circumflexus, and a 20% stenosis of arteria coronaria dextra (right coronary artery. The left coronary artery was dilated and he continued cycling 2 months later. In both brothers, familial hypercholesterolemia was the main cardiovascular risk factor for the multi vessel coronary artery disease. A negative exercise electrocardiogram in siblings with an increased risk for coronary artery disease seemed not to exclude an advanced multi vessel coronary artery disease. In master athletes with asymptomatic exercise electrocardiogram but a positive family history, further examinations should be performed in order to detect

  9. Effect of low altitude at the Dead Sea on exercise capacity and cardiopulmonary response to exercise in cystic fibrosis patients with moderate to severe lung disease.

    Science.gov (United States)

    Falk, Bareket; Nini, Asaph; Zigel, Levana; Yahav, Yaacov; Aviram, Micha; Rivlin, Joseph; Bentur, Lea; Avital, Avraham; Dotan, Raffy; Blau, Hannah

    2006-03-01

    Oxygen supplementation may improve exercise tolerance and the physiological response to exercise in cystic fibrosis (CF) patients. Elevated barometric pressure at low altitude is a simple means of increasing the quantity of inspired oxygen. Our objectives were to examine the effect of natural oxygen enrichment (at the Dead Sea, 396 m below sea level) on exercise capacity, and the physiological responses to maximal and submaximal exercise in CF patients. Patients were tested twice: at sea level (barometric pressure, 754 +/- 6 mmHg, mean +/- SD), and at the Dead Sea (barometric pressure, 791 +/- 3 mmHg), in a randomized crossover design. We studied 14 CF patients (6 females, 8 males), aged 15-45 years, with moderate to severe lung disease (mean forced expired volume in 1 sec = 50.0 +/- 11.2% predicted). Tests at each site included resting spirometry, anthropometry, a graded submaximal exercise test, a maximal exercise test on a treadmill, and a 6-min walk test. Tests were performed in identical order at both sites. Tests at the Dead Sea were performed 72 hr after arrival. No differences between sites were observed in lung function at rest. Peak oxygen consumption was significantly improved at the Dead Sea compared with sea level (1.68 +/- 0.73 vs. 1.57 +/- 0.74 l/min, respectively, P = 0.05), along with an improvement in the ventilatory equivalent for oxygen (41.2 +/- 6.3 vs. 46.1 +/- 7.1, respectively, P Dead Sea compared with sea level at all exercise intensities (P Dead Sea area may have physiological benefits for CF patients with moderate to severe lung disease.

  10. Eccentric exercise testing and training

    Science.gov (United States)

    Clarkson, Priscilla M.

    1994-01-01

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

  11. Clinical Study of Cardiopulmonary Exercise Testing in the Evaluation of the Changes of Holistic Function of Patients With Esophagus Cancer After Chemotherapy%心肺运动试验评价食管癌患者化疗后整体功能变化的临床研究

    Institute of Scientific and Technical Information of China (English)

    孙兴国; Curtis Hightower; 刘方; William W. Stringer; 葛万刚

    2016-01-01

    Background Chemotherapy has a serious damage on the holistic function of human body,while there is a lack of reliable methods for the objective and quantitative assessment of the changes of holistic function of patients after chemotherapy. Objective To investigate the role of cardiopulmonary exercise testing(CPET)in the evaluation of the changes of holistic function of patients with esophagus cancer after chemotherapy. Methods From 2006 to 2007,we enrolled 6 Caucasian male patients with esophagus cancer who underwent preoperative chemotherapy in MD Anderson Cancer Center of University of Texas and conducted CPET examinations on them before and after chemotherapy. According to standard continuously increasing power scheme of UCLA Medical Center,we completed symptom - limited extreme sports and calculated the core indexes by standardized data analysis. The circulation indexes and respiration indexes in a quiescent state,a warm - up state,an anaerobic threshold(AT)state and an extreme state were derived by system software. Results Of the 6 esophagus cancer patients,only one patient had increase in AT and the rest patients all saw decrease in peak VO2 ,AT,peak oxygen pulse,oxygen uptake efficiency plateau,peak load power and increasing power movement time after chemotherapy;only one patient had decrease in the slope of ventilatory equivalent for carbon dioxide and the rest patients all had increase in the slope of ventilatory equivalent for carbon dioxide and the minimum ventilatory equivalent for carbon dioxide. The AT(L/ min,ml·min - 1 ·kg - 1 ,% pred),slope of ventilatory equivalent for carbon dioxide(slope,% pred),and increasing power movement time(min)after chemotherapy of the patients were not significantly different from those before chemotherapy(P > 0. 05);the peak VO2 (L/ min,ml·min - 1 · kg - 1 ,% pred),peak oxygen pulse(ml/ time,% pred),oxygen uptake efficiency plateau(ratio,% pred),and peak load power (W)were lower than those before chemotherapy

  12. Cardiopulmonary stress testing using ambulatory radionuclide monitoring system: The relationship between vascular endothelial function and cardiac response in patients with ischemic heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Akima, Takashi; Tabata, Hirotsugu [Self-Defense Forces Central Hospital, Tokyo (Japan); Takase, Bonpei [National Defense Medical Coll., Tokorozawa, Saitama (Japan)] [and others

    2002-02-01

    The relationship in the title was studied with a new type ambulatory radionuclide monitoring system. Subjects were 12 male patients with ischemic heart diseases. After cardiac scintigraphy at rest of {sup 99m}Tc-human serum albumin (740 MBq) with GE Mirenium, patients wore the C-VEST jacket (Capintec medset cardiolight), which consisted from 2 radioactivity detectors and Holter ECG recorder, and underwent the cardiopulmonary stress testing with Treadmill Ramp exercise to evaluate the anaerobic threshold (AT), VO{sub 2}, left ventricular ejection flow (EF) and stroke volume (SV). Vascular endothelial function was recorded by ultrasonography of brachial artery by monitoring the flow-mediated dilation (FD). Mean EF at rest was 56% and there was no relationship between VO{sub 2} at rest or exercise and FD. However, the relationship between FD and change of SV or EF from rest to AT was recognized and thus FD was suggested to participate in cardiac function change at exercise of those patients. (K.H.)

  13. Breathing pattern and gas exchange at cardiopulmonary exercise testing in stable moderate to severe chronic obstructive pulmonary chisease patients with different extent of lung hyperinflation%肺过度充气对稳定期中重度慢性阻塞性肺疾病患者在运动过程中呼吸模式及气体交换的影响

    Institute of Scientific and Technical Information of China (English)

    张艳; 刘锦铭; 谭晓越; 杨文兰; 孙兴国; 刘海舰; 陈淑娟

    2012-01-01

    下降、通气功能受限、换气效率下降及呼吸困难程度.%Objective To study the influence of lung hyperinflation on breathing pattern and gas exchange at cardiopulmonary exercise testing (CPET) in stable moderate to severe chronic obstructive pulmonary disease (COPD) patients.Methods Pulmonary function test (PFT) and CPET were tested in 54 patients with stable moderate to severe COPD,and measured the parameters of ventilation,breathing pattern and gas exchange.The stopped reasons at the end of exercise testing were be noted.Patients who had an emphysematous profile with the perccntage of thoracic gas volume predicted value (Vtg%pred)<150% and the percentage of diffusing lung capacity for carbon monoxide predicted value (DL.CO%pred)≥80% (low lung hyperinflation,Group A),versus patients with Vtg%pred≥150% and DLCO%pred<80% (high lung hyperinflation,Group B).Results At rest,there was no significant difference in tidal volume (VT) and breathing frequency between these two groups,at peak exercise,VT and minute volume ((V)E) in Group A were significant higher than Group B (P<0.001).Between the two groups,tl/tE,VT/tl and VT/tE had significant difference at peak exercise (P<0.01).The dyspnea of Group B was more severe than Group A (P<0.001).At peak exercise,the peak load,peak oxygen consumption ((V)O2),the efficiency of gas exchange and peak oxygen pulse (O2 pulse) in Gropu B were lower than Group A (P<0.05).The reason for stopping exercise was significantly different between the two groups.Peak (V)O2%pred was significant associated with Vtg%pred and DLCO%pred(r=-0.55and 0.68,P<0.001),peak (V)O2 was significant associated with peak VT (r=0.77,P<0.001),moreover,peak VT was significant associated with inspiratory capacity (r=0.63,P<0.001).Conclusions COPD patients who with the higher lung hyperinflation had the less exercise capacity,less ventilation function,reduced efficiency of gas exchange,and worse dyspnea.

  14. Reversibility of cardiopulmonary impairment after laparoscopic repair of large hiatal hernia

    Directory of Open Access Journals (Sweden)

    Emanuele Asti

    2015-01-01

    Full Text Available Giant hiatus hernia with or without intrathoracic gastric volvulus often presents with symptoms suggestive of both cardiac and pulmonary compression. Cardiopulmonary impairment may be reversible in these patients by laparoscopic crural repair and fundoplication as shown in this case report. Cardiac magnetic resonance and the cardiopulmonary exercise test may help selecting patients for surgery. These preliminary findings led us to start a prospective study using this multimodality diagnostic approach.

  15. A new model of centrifugal blood pump for cardiopulmonary bypass: design improvement, performance, and hemolysis tests.

    Science.gov (United States)

    Leme, Juliana; Fonseca, Jeison; Bock, Eduardo; da Silva, Cibele; da Silva, Bruno Utiyama; Dos Santos, Alex Eugênio; Dinkhuysen, Jarbas; Andrade, Aron; Biscegli, José F

    2011-05-01

    A new model of blood pump for cardiopulmonary bypass (CPB) application has been developed and evaluated in our laboratories. Inside the pump housing is a spiral impeller that is conically shaped and has threads on its surface. Worm gears provide an axial motion of the blood column. Rotational motion of the conical shape generates a centrifugal pumping effect and improves pumping performance. One annular magnet with six poles is inside the impeller, providing magnetic coupling to a brushless direct current motor. In order to study the pumping performance, a mock loop system was assembled. Mock loop was composed of Tygon tubes (Saint-Gobain Corporation, Courbevoie, France), oxygenator, digital flowmeter, pressure monitor, electronic driver, and adjustable clamp for flow control. Experiments were performed on six prototypes with small differences in their design. Each prototype was tested and flow and pressure data were obtained for rotational speed of 1000, 1500, 2000, 2500, and 3000 rpm. Hemolysis was studied using pumps with different internal gap sizes (1.35, 1.45, 1.55, and 1.7 mm). Hemolysis tests simulated CPB application with flow rate of 5 L/min against total pressure head of 350 mm Hg. The results from six prototypes were satisfactory, compared to the results from the literature. However, prototype #6 showed the best results. Best hemolysis results were observed with a gap of 1.45 mm, and showed a normalized index of hemolysis of 0.013 g/100 L. When combined, axial and centrifugal pumping principles produce better hydrodynamic performance without increasing hemolysis.

  16. Exercise stress testing in clinical practice

    Directory of Open Access Journals (Sweden)

    Francesco Giallauria

    2011-07-01

    Full Text Available Exercise stress testing is an important diagnostic tool for evaluating patient’s cardiovascular performance. The present review describes the accuracy and the value of exercise stress testing in different settings: after an acute coronary event, after percutaneous coronary intervention or coronary artery bypass graft; in patients risk assessment before non-cardiac surgery; in diabetic population; in patients with baseline electrocardiographic abnormalities. Moreover, this review provides insights relating to test accuracy in women and geriatric patients. Finally, this review explores new variables/parameters (dyspnea, chronotropic incompentence, heart rate recovery, functional capacity, integrated scores that in the last few years added an incremental value to conventional analysis of exercise-induced angina or electrocardiographic changes.

  17. Six-minute stepper test: a valid clinical exercise tolerance test for COPD patients

    Directory of Open Access Journals (Sweden)

    Grosbois JM

    2016-03-01

    Full Text Available JM Grosbois,1,2 C Riquier,3 B Chehere,4 J Coquart,5 H Béhal,6 F Bart,2 B Wallaert,2,3 C Chenivesse3 1FormAction Santé, Pérenchies, France; 2Department of Respiratory Medicine, Centre Hospitalier Germon et Gauthier, Béthune, France; 3Department of Respiratory Medicine Immunology and Allergy, Centre Hospitalier Universitaire de Lille, Competence Center for rare lung diseases, University Lille 2, Lille, France; 4EA 7369, URePSSS, Multidisciplinary Research Unit in Sport Health Society, University Lille 2, Lille, France; 5Faculty of Sport Sciences, Sports and Physical Activity, Center for Ecology and Transformation, University of Rouen, Mont Saint Aignan, France; 6Department of Statistical Methods and Biostatistics, Centre Hospitalier Universitaire de Lille, University of Lille Nord, Lille, France Introduction: Exercise tolerance testing is an integral part of the pulmonary rehabilitation (PR management of patients with chronic obstructive pulmonary disease (COPD. The 6-minute stepper test (6MST is a new, well-tolerated, reproducible exercise test, which can be performed without any spatial constraints.Objective: The aim of this study was to compare the results of the 6MST to those obtained during a 6-minute walk test (6MWT and cardiopulmonary exercise testing (CPET in a cohort of COPD patients.Methods: Ninety-one COPD patients managed by outpatient PR and assessed by 6MST, 6MWT, and CPET were retrospectively included in this study. Correlations between the number of steps on the 6MST, the distance covered on the 6MWT, oxygen consumption, and power at the ventilatory threshold and at maximum effort during CPET were analyzed before starting PR, and the improvement on the 6MST and 6MWT was compared after PR.Results: The number of steps on the 6MST was significantly correlated with the distance covered on the 6MWT (r=0.56; P<0.0001, the power at maximum effort (r=0.46; P<0.0001, and oxygen consumption at maximum effort (r=0.39; P<0

  18. Angiotensin-converting enzyme inhibitors in preventing remodeling and development of heart failure after acute myocardial infarction: results of the German multicenter study of the effects of captopril on cardiopulmonary exercise parameters (ECCE).

    Science.gov (United States)

    Kleber, F X; Sabin, G V; Winter, U J; Reindl, I; Beil, S; Wenzel, M; Fischer, M; Doering, W

    1997-08-04

    Early action of angiotensin-converting enzyme (ACE) inhibitors after myocardial infarction (MI) has been shown in large scale clinical trials to reduce mortality over the first weeks. However, the mechanisms involved are yet unclear and several trials showed a tendency toward a small, albeit unexpected, rise in cardiogenic shock or mortality. Since cardiopulmonary exercise testing (CPX) has become a "gold standard" in assessing the severity of heart failure, we studied--after finishing a pilot trial--the effect of captopril versus placebo in 208 patients who were individually titrated (titrated dose, mean 46/69 mg/day after 7 days/4 weeks, respectively) in order to preserve their blood pressure in the acute phase of myocardial infarction; we followed the development of congestive heart failure (CHF) over 4 weeks by measuring oxygen consumption. After 4 weeks, overall oxygen consumption at the anaerobic threshold (VO2-AT; 13.7 vs 13.1), maximal oxygen consumption (VO2max 19.3 vs 18.9 mL/kg per min) and exercise duration (896 vs 839 sec) showed a nonsignificant difference in favor of the captopril group. The predefined, categorized, combined endpoint of severe heart failure or death (heart failure necessitating ACE inhibition, VO2max 10 patients per 100 treated gained major benefits from this therapy.

  19. [Exercise tests in unstable angina suspects].

    Science.gov (United States)

    2012-01-01

    The review is devoted to exercise tests (ET) potential in patients with different forms of coronary heart disease (CHD) exacerbation and suspected unstable angina. It is well known that unstable angina untreated pharmacologically is a contraindication for ET. Of interest in clinical practice is diagnosis, risk assessment and treatment policy in patients with chest pain. The main focus is on ET conduction in unstable angina suspects with low and intermediate risk, on safety and validity of ET conduction in these patients.

  20. Cardiorespiratory endurance evaluation using heart rate analysis during ski simulator exercise and the Harvard step test in elementary school students.

    Science.gov (United States)

    Lee, Hyo Taek; Roh, Hyo Lyun; Kim, Yoon Sang

    2016-01-01

    [Purpose] Efficient management using exercise programs with various benefits should be provided by educational institutions for children in their growth phase. We analyzed the heart rates of children during ski simulator exercise and the Harvard step test to evaluate the cardiopulmonary endurance by calculating their post-exercise recovery rate. [Subjects and Methods] The subjects (n = 77) were categorized into a normal weight and an overweight/obesity group by body mass index. They performed each exercise for 3 minutes. The cardiorespiratory endurance was calculated using the Physical Efficiency Index formula. [Results] The ski simulator and Harvard step test showed that there was a significant difference in the heart rates of the 2 body mass index-based groups at each minute. The normal weight and the ski-simulator group had higher Physical Efficiency Index levels. [Conclusion] This study showed that a simulator exercise can produce a cumulative load even when performed at low intensity, and can be effectively utilized as exercise equipment since it resulted in higher Physical Efficiency Index levels than the Harvard step test. If schools can increase sport durability by stimulating students' interests, the ski simulator exercise can be used in programs designed to improve and strengthen students' physical fitness.

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

    Science.gov (United States)

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

    2015-11-01

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

  2. Do We Need Exercise Tests to Detect Gas Exchange Impairment in Fibrotic Idiopathic Interstitial Pneumonias?

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    Benoit Wallaert

    2012-01-01

    Full Text Available In patients with fibrotic idiopathic interstitial pneumonia (f-IIP, the diffusing capacity for carbon monoxide (DLCO has been used to predict abnormal gas exchange in the lung. However, abnormal values for arterial blood gases during exercise are likely to be the most sensitive manifestations of lung disease. The aim of this study was to compare DLCO, resting PaO2, P(A-aO2 at cardiopulmonary exercise testing peak, and oxygen desaturation during a 6-min walk test (6MWT. Results were obtained in 121 patients with idiopathic pulmonary fibrosis (IPF, n=88 and fibrotic nonspecific interstitial pneumonias (NSIP, n=33. All but 3 patients (97.5% had low DLCO values (35 mmHg and 100 (83% demonstrated significant oxygen desaturation during 6MWT (>4%. Interestingly 27 patients had low DLCO and normal P(A-aO2, peak and/or no desaturation during the 6MWT. The 3 patients with normal DLCO also had normal PaO2, normal P(A-aO2, peak, and normal oxygen saturation during 6MWT. Our results demonstrate that in fibrotic IIP, DLCO better defines impairment of pulmonary gas exchange than resting PaO2, exercise P(A-aO2, peak, or 6MWT SpO2.

  3. Testing an intervention to improve functional capability in advanced cardiopulmonary illness.

    Science.gov (United States)

    Dougherty, Cynthia M; Steele, Bonnie G; Hunziker, Jim

    2011-01-01

    The development of a conceptually driven exercise and self-management intervention for improving functional capability and reducing health care costs using social cognitive theory is described. The intervention has 2 components: a 1-month outpatient exercise intervention followed by a home component, lasting 5 months. The intervention is expected to have significant impact on daily function, quality of life, gait/balance, self-efficacy, and health care utilization in persons with advanced heart failure or chronic obstructive pulmonary disease. We report preliminary results related to process-related variables, including feasibility, safety, and intervention adherence. Intervention outcomes are currently under study and will be reported when available.

  4. Surgical Placement of Catheters for Long-term Cardiovascular Exercise Testing in Swine.

    Science.gov (United States)

    De Wijs-Meijler, Daphne P M; Stam, Kelly; van Duin, Richard W B; Verzijl, Annemarie; Reiss, Irwin K; Duncker, Dirk J; Merkus, Daphne

    2016-02-09

    This protocol describes the surgical procedure to chronically instrument swine and the procedure to exercise swine on a motor-driven treadmill. Early cardiopulmonary dysfunction is difficult to diagnose, particularly in animal models, as cardiopulmonary function is often measured invasively, requiring anesthesia. As many anesthetic agents are cardiodepressive, subtle changes in cardiovascular function may be masked. In contrast, chronic instrumentation allows for measurement of cardiopulmonary function in the awake state, so that measurements can be obtained under quiet resting conditions, without the effects of anesthesia and acute surgical trauma. Furthermore, when animals are properly trained, measurements can also be obtained during graded treadmill exercise. Flow probes are placed around the aorta or pulmonary artery for measurement of cardiac output and around the left anterior descending coronary artery for measurement of coronary blood flow. Fluid-filled catheters are implanted in the aorta, pulmonary artery, left atrium, left ventricle and right ventricle for pressure measurement and blood sampling. In addition, a 20 G catheter is positioned in the anterior interventricular vein to allow coronary venous blood sampling. After a week of recovery, swine are placed on a motor-driven treadmill, the catheters are connected to pressure and flow meters, and swine are subjected to a five-stage progressive exercise protocol, with each stage lasting 3 min. Hemodynamic signals are continuously recorded and blood samples are taken during the last 30 sec of each exercise stage. The major advantage of studying chronically instrumented animals is that it allows serial assessment of cardiopulmonary function, not only at rest but also during physical stress such as exercise. Moreover, cardiopulmonary function can be assessed repeatedly during disease development and during chronic treatment, thereby increasing statistical power and hence limiting the number of animals

  5. Impact of diabetes mellitus and its control on pulmonary functions and cardiopulmonary exercise tests

    Directory of Open Access Journals (Sweden)

    Mahmoud M. El-Habashy

    2014-04-01

    Conclusion: The findings of the present study suggest that, the lung is a target organ for damage in DM and diabetics show a decrease in PFTs and VO2 max compared to non-diabetics. And this deterioration is exaggerated in uncontrolled diabetics.

  6. Clinical value of exercise testing in elderly patients

    NARCIS (Netherlands)

    J. Pool (Jan); M.G. Scheffer; M.L. Simoons (Maarten); N. Patijn

    1984-01-01

    textabstractBetween 1978 and 1983, 1391 exercise tests were performed by 1083 males and 308 females over 64 years of age. This represents 17% of the total number of 8213 exercise tests. A history of myocardial infarction was present in 53% of the males and 30% of the females, while 12% of patients h

  7. ENERGY SYSTEM CONTRIBUTIONS DURING INCREMENTAL EXERCISE TEST

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    Rômulo Bertuzzi

    2013-09-01

    Full Text Available The main purpose of this study was to determine the relative contributions of the aerobic and glycolytic systems during an incremental exercise test (IET. Ten male recreational long-distance runners performed an IET consisting of three-minute incremental stages on a treadmill. The fractions of the contributions of the aerobic and glycolytic systems 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 considered as the sum of these two energy systems. The aerobic (WAER and glycolytic (WGLYCOL system contributions were expressed as a percentage of the WTOTAL. The results indicated that WAER (86-95% was significantly higher than WGLYCOL (5-14% throughout the IET (p < 0.05. In addition, there was no evidence of the sudden increase in WGLYCOL that has been previously reported to support to the "anaerobic threshold" concept. These data suggest that the aerobic metabolism is predominant throughout the IET and that energy system contributions undergo a slow transition from low to high intensity

  8. Factors Affecting Exercise Test Performance in Patients After Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Kotarska

    2016-03-01

    Full Text Available Background Cardiovascular diseases are a leading cause of morbidity and mortality in solid organ transplant recipients. In addition, low physical activity is a risk factor for cardiac and cerebrovascular complications. Objectives This study examined potential relationships between physical activity, health-related quality of life (HRQoL, risk factors for cardiovascular disease, and an exercise test in liver-graft recipients. Patients and Methods A total of 107 participants (62 men/45 women who had received a liver transplantation (LT at least 6 months previously were evaluated. Physical activity was assessed using three different questionnaires, while HRQoL was assessed using the medical outcomes study short form (SF-36 questionnaire, and health behaviors were evaluated using the health behavior inventory (HBI. The exercise test was performed in a standard manner. Results Seven participants (6.5% had a positive exercise test, and these individuals were older than those who had a negative exercise test (P = 0.04. A significant association between a negative exercise test and a higher level of physical activity was shown by the Seven-day physical activity recall questionnaire. In addition, HRQoL was improved in various domains of the SF-36 in participants who had a negative exercise test. No correlations between physical activity, the exercise test and healthy behaviors, as assessed via the HBI were observed. Conclusions Exercise test performance was affected by lower quality of life and lower physical activity after LT. With the exception of hypertension, well known factors that affect the risk of coronary artery disease had no effect on the exercise test results.

  9. Cardio-Pulmonary Function Testing. Continuing Education Curriculum for Respiratory Therapy.

    Science.gov (United States)

    Saint Paul Technical Vocational Inst., MN.

    Compiled from interviews with personnel in pulmonary function testing (PFT) laboratories in the Minneapolis/St. Paul area, this competency-based curriculum guide is intended to provide a knowledge of PFT for persons who provide respiratory care. The guide contains 20 sections covering the following topics: vital capacity, flow measurements,…

  10. The value of exercise tests after acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, F E; Nielsen, S L; Knudsen, F

    1992-01-01

    The aim of the present study was to relate the clinical course in patients after a first acute myocardial infarction with the response to exercise-tests performed one month after discharge. 90 consecutive patients who suffered an acute myocardial infarction for the first time were followed-up after...... (W) were predictive with respect to mortality, heart failure, and angina pectoris requiring drug treatment. Exercise tests following acute myocardial infarction could not predict the chances of returning to work....

  11. Exercise Testing and Stress Imaging in Valvular Heart Disease.

    OpenAIRE

    Henri, Christine; Pierard, Luc; Lancellotti, Patrizio; Mongeon, Francois-Pierre; Pibarot, Philippe; Basmadjian, Arsene J.

    2014-01-01

    The role of exercise testing and stress imaging in the management of patients with valvular heart disease (VHD) is reviewed in this article. The American College of Cardiology/American Heart Association and the European Society of Cardiology/European Association of Cardiothoracic Surgery have recently put emphasis on the role of exercise testing to clarify symptom status and the use of stress imaging to assess the dynamic component of valvular abnormalities and unmask subclinical myocardial d...

  12. Cardiopulmonary response during whole-body vibration training in patients with severe COPD

    Science.gov (United States)

    Richter, Petra; Winterkamp, Sandra; Pfeifer, Michael; Nell, Christoph; Christle, Jeffrey W.; Kenn, Klaus

    2017-01-01

    Several studies in patients with chronic obstructive pulmonary disease (COPD) have shown that whole-body vibration training (WBVT) has beneficial effects on exercise capacity. However, the acute cardiopulmonary demand during WBVT remains unknown and was therefore investigated in this study. Ten patients with severe COPD (forced expiratory volume in 1 s: 38±8% predicted) were examined on two consecutive days. On day one, symptom-limited cardiopulmonary exercise testing was performed on a cycle ergometer. The next day, six bouts of repeated squat exercises were performed in random order for one, two or three minutes either with or without WBVT while metabolic demands were simultaneously measured. Squat exercises with or without WBVT induced comparable ventilatory efficiency (minute ventilation (VE)/carbon dioxide production (V′CO2): 38.0±4.4 with WBVT versus 37.4±4.1 without, p=0.236). Oxygen uptake after 3 min of squat exercises increased from 339±40 mL·min−1 to 1060±160 mL·min−1 with WBVT and 988±124 mL min−1 without WBV (p=0.093). However, there were no significant differences between squat exercises with and without WBVT in oxygen saturation (90±4% versus 90±4%, p=0.068), heart rate (109±13 bpm versus 110±15 bpm, p=0.513) or dyspnoea (Borg scale 5±2 versus 5±2, p=0.279). Combining squat exercises with WBVT induced a similar cardiopulmonary response in patients with severe COPD compared to squat exercises without WBVT. Bearing in mind the small sample size, WBVT might be a feasible and safe exercise modality even in patients with severe COPD. PMID:28326310

  13. Exercise training after burn injury: a survey of practice.

    Science.gov (United States)

    Diego, Alejandro M; Serghiou, Michael; Padmanabha, Anand; Porro, Laura J; Herndon, David N; Suman, Oscar E

    2013-01-01

    Exercise programs capable of contributing positively to the long-term rehabilitation of burn patients should be included in outpatient rehabilitation programs. However, the extent and intensity of the resistance and cardiopulmonary exercise prescribed are unclear. This study was conducted to investigate the existence, design, content, and prescription of outpatient cardiopulmonary and resistance exercise programs within outpatient burn rehabilitation. A survey was designed to gather information on existing exercise programs for burn survivors and to assess the extent to which these programs are included in overall outpatient rehabilitation programs. Three hundred and twenty-seven surveys were distributed in the licensed physical and occupational therapists part of the American Burn Association Physical Therapy/Occupational Therapy Special Interest Group. One hundred and three surveys were completed. Eighty-two percent of respondents indicated that their institutions offered outpatient therapy after discharge. The frequency of therapists' contact with patients during this period varied greatly. Interestingly, 81% of therapists stated that no hospital-based cardiopulmonary endurance exercise programs were available. Patients' physical function was infrequently determined through the use of cardiopulmonary parameters (oxygen consumption and heart rate) or muscle strength. Instead, more subjective parameters such as range of motion (75%), manual muscle testing (61%), and quality of life (61%) were used. Prescription and follow-up assessment of cardiopulmonary endurance training are inconsistent among institutions, underscoring the need for greater awareness of the importance of exercise in any burn rehabilitation program. Identification of cardiopulmonary and progressive resistance parameters for establishing and tracking exercise training is also needed to maximize exercise-induced benefits.

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

    Science.gov (United States)

    Carter, R; Banham, S W

    2000-04-01

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

  15. Transient global amnesia: a complication of incremental exercise testing.

    Science.gov (United States)

    Richardson, R S; Leek, B T; Wagner, P D; Kritchevsky, M

    1998-10-01

    Incremental exercise testing is routinely used for diagnosis, rehabilitation, health screening, and research. We report the case of a 71-yr-old patient with chronic obstructive pulmonary disease (COPD) who suffered an episode of transient global amnesia (TGA) several minutes after successfully completing an incremental exercise test on a cycle ergometer. TGA, which is known to be precipitated by physical or emotional stress in about one-third of cases, is a transient neurological disorder in which memory impairment is the prominent deficit. TGA has a benign course and requires no treatment although 24-h observation is recommended. Recognition of TGA as a potential complication of incremental graded exercise testing is important to both aid diagnosis of the amnesia and to spare a patient unnecessary evaluation.

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

    Science.gov (United States)

    Saunier, Carole

    2013-01-01

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

  17. Validity of the Eating Attitude Test among Exercisers.

    Science.gov (United States)

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

    2004-12-01

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

  18. Negative Exercise Stress Test: Does it Mean Anything? Case study

    Directory of Open Access Journals (Sweden)

    Hassan A. Mohamed

    2007-01-01

    Full Text Available Despite its low sensitivity and specificity (67% and 72%, respectively, exercise testing has remained one of the most widely used noninvasive tests to determine the prognosis in patients with suspected or established coronary disease.As a screening test for coronary artery disease, the exercise stress test is useful in that it is relatively simple and inexpensive. It has been considered particularly helpful in patients with chest pain syndromes who have moderate probability for coronary artery disease, and in whom the resting electrocardiogram (ECG is normal. The following case presentation and discussion will question the predictive value of a negative stress testing in patients with moderate probability for coronary artery disease.

  19. Exercise testing in Warmblood sport horses under field conditions

    NARCIS (Netherlands)

    Munsters, Carolien C B M; van Iwaarden, Alexandra; van Weeren, René; Sloet van Oldruitenborgh-Oosterbaan, Marianne M

    2014-01-01

    Regular exercise testing in Warmblood sport horses may, as in racing, potentially help to characterise fitness indices in different disciplines and at various competition levels and assist in understanding when a horse is 'fit to compete'. In this review an overview is given of the current state of

  20. Development and implementation of treadmill exercise testing protocols in COPD

    Directory of Open Access Journals (Sweden)

    Christopher B Cooper

    2010-10-01

    Full Text Available Christopher B Cooper1, Marlon Abrazado1, Daniel Legg2, Steven Kesten21David Geffen School of Medicine, University of California, Los Angeles, CA, USA; 2Boehringer Ingelheim Pharmaceuticals Inc., Ingelheim, GermanyBackground: Because treadmill exercise testing is more representative of daily activity than cycle testing, we developed treadmill protocols to be used in various clinical settings as part of a two-year, multicenter, chronic obstructive pulmonary disease (COPD trial evaluating the effect of tiotropium on exercise.Methods: We enrolled 519 COPD patients aged 64.6 ± 8.3 years with a postbronchodilator forced expiratory volume in one second (FEV1 of 1.25 ± 0.42 L, 44.3% ± 11.9% predicted. The patients performed symptom-limited treadmill tests where work rate (W was increased linearly using speed and grade adjustments every minute. On two subsequent visits, they performed constant W tests to exhaustion at 90% of maximum W from the incremental test.Results: Mean incremental test duration was 522 ± 172 seconds (range 20–890, maximum work rate 66 ± 34 watts. For the first and second constant W tests, both at 61 ± 33 watts, mean endurance times were 317 ± 61 seconds and 341 ± 184 seconds, respectively. The mean of two tests had an intraclass correlation coefficient of 0.85 (P < 0.001. During the second constant W test, 88.2% of subjects stopped exercise because of breathing discomfort; 87.1% for Global Initiative for Chronic Obstructive Lung Disease (GOLD Stage II, 88.5% for GOLD Stage III, and 90.2% for GOLD Stage IV.Conclusion: The symptom-limited incremental and constant work treadmill protocol was well tolerated and appeared to be representative of the physiologic limitations of COPD.Keywords: chronic obstructive pulmonary disease, exercise testing, endurance, tiotropium

  1. 有氧运动对维持性血液透析患者生理功能、心肺耐力及生活质量的影响%Effects of aerobic exercise training on physical functioning, cardiopulmonary endurance and health related quality of life in maintenance hemodialysis patients

    Institute of Scientific and Technical Information of China (English)

    王欣欣; 宋桂芸; 宿志梅; 恽小平; 马迎春

    2012-01-01

    Objectives To explore the effect of the 12-week aerobic exercise on physiology function, cardiopulmonary endurance and health related life quality in maintenance hemodialysis (MHD) patients. Methods Fourteen patients from our hospital were enrolled in this study. We measured peak oxygen uptake (VO2peak), metabolic equivalents (METs) and stress test duration while taking treadmill exercise of Bruce Sport program, meanwhile, blood pressure and heart rate were recorded. Furthermore, the physical function was evaluated by the results of six-minute walking test (6MWT), cardiopulmonary endurance was measured by VO2peak, METs and stress test duration, and health related quality of life was evaluated by the Health-Related Short Form questionnaire (SF-36) recommended by Kidney Disease Outcomes Quality Initiative (K/ DOQI) clinical practice. Aerobic exercise was defined as treadmill exercise in inter-dialysis of moderate intensity that reaches 50%~80% VO2peak. The strategy of exercise was 30 minutes each time, three times per week for 12 weeks, which included 15 minutes warming-up before exercises and 5 minutes relaxing after exercises. We then evaluated the parameters after 12 weeks, and explored if there were statistical differences in these parameters before and after aerobic exercise training for 12 weeks. Results 6MWT slightly enhanced (Z =-1.132, P= 0.241), and VO2peak and stress test duration increased obviously (Z =-2.226, P =0.028 and Z=-2.701, P =0.007, respectively). MRTs was partially improvement but without statistical significance (Z = -1.632, P =0.103). The results of SF-36 improved significantly (Z =-2.701, P=0.007) after the 12-week exercise. Conclusion The 12-week exercise can partially improve physiological function, cardiopulmonary endurance and health related quality of life in M.HD patients.%目的 探讨12周有氧运动对维持性血液透析(maintenance hemodialysis,MHD)患者生理功能、心肺耐力、健康相关生活质量的影响.

  2. Exercise testing, limitation and training in patients with cystic fibrosis. A personalized approach

    OpenAIRE

    Werkman, M.S.

    2014-01-01

    Exercise testing and training are cornerstones in regular CF care. However, no consensus exists in literature about which exercise test protocol should be used for individual patients. Furthermore, divergence exists in insights about both the dominant exercise limiting mechanisms and the possibilities to aim and institute exercise training strategies, based on these individual limitations. Therefore, this thesis intends to expand current knowledge in [1] alternative exercise test procedures i...

  3. Submaximal Exercise Testing Treadmill and Floor Walking.

    Science.gov (United States)

    1978-05-01

    Association, 65(Suppl 1): 18-25, 1969. 35. Traugh, G. H., Corcoran, P. J., and Reyes , R. L., "Energy Expenditure of Ambulation in Patients with Above Knee...subjects were measured over three walking velocities. 1 No comments were offered on the subjects attire during the testa or the experimental conditions...Testing," Journal of the South Carolina Medical Association, 65(Suppl 1): 18- ,- _19-69.7 .. i 35. Traugh, G. H., Corcoran, P. J., and Reyes , R. L

  4. Physiological responses to maximal exercise testing and the modified incremental shuttle walk test in adults after thermal injury: a pilot study.

    Science.gov (United States)

    Stockton, Kellie Anne; Davis, Mark John; Brown, Michael Graeme; Boots, Robert; Paratz, Jennifer Davida

    2012-01-01

    The ongoing hypermetabolic response associated with burn injury contributes significantly to loss of function, morbidity, and mortality. Exercise is strongly recommended to assist recovery and overall functional outcome. To date, there have been limited studies investigating the validity and practicality of both maximal laboratory and field tests in adult burns survivors. The objective of this study was to determine the metabolic and ventilatory response to cardiopulmonary maximal exercise testing (CPET) and the modified shuttle walk test (MSWT) in adult burns patients. Fifteen people (13 male) with a mean TBSA of 38.5% (16.0%) underwent both MSWT and CPET within a 5-day period in random order. The majority of participants demonstrated a normal response to CPET. Two participants with a history of inhalation burns demonstrated a respiratory limitation to exercise with desaturation (91 and 89%) at the end of the CPET, which returned to normal within 2 minutes after exercise. The correlation between VO(2peak) as measured via CPET and distance as measured in MSWT was 0.7. Mean results measured in MSWT for maximal heart rate and perceived exertion scores were lower than those achieved with CPET results: 91 and 88%, respectively. There were no adverse events during both the MSWT and CPET. This study demonstrates that after burn injury, CPET and MSWT can be performed safely in the majority of patients early in the postdischarge rehabilitation period. MSWT is likely to be submaximal at 80 to 90% of CPET results but is easy to replicate and cost-effective, thus a viable mechanism for monitoring aerobic capacity.

  5. Modeling the oxygen uptake kinetics during exercise testing of patients with chronic obstructive pulmonary diseases using nonlinear mixed models

    Directory of Open Access Journals (Sweden)

    Florent Baty

    2016-06-01

    Full Text Available Abstract Background The six-minute walk test (6MWT is commonly used to quantify exercise capacity in patients with several cardio-pulmonary diseases. Oxygen uptake ( V ̇ $\\dot {\\mathrm {V}}$ O2 kinetics during 6MWT typically follow 3 distinct phases (rest, exercise, recovery that can be modeled by nonlinear regression. Simultaneous modeling of multiple kinetics requires nonlinear mixed models methodology. To the best of our knowledge, no such curve-fitting approach has been used to analyze multiple V ̇ $\\dot {\\mathrm {V}}$ O2 kinetics in both research and clinical practice so far. Methods In the present study, we describe functionality of the R package medrc that extends the framework of the commonly used packages drc and nlme and allows fitting nonlinear mixed effects models for automated nonlinear regression modeling. The methodology was applied to a data set including 6MWT V ̇ $\\dot {\\mathrm {V}}$ O2 kinetics from 61 patients with chronic obstructive pulmonary disease (disease severity stage II to IV. The mixed effects approach was compared to a traditional curve-by-curve approach. Results A six-parameter nonlinear regression model was jointly fitted to the set of V ̇ $\\dot {\\mathrm {V}}$ O2 kinetics. Significant differences between disease stages were found regarding steady state V ̇ $\\dot {\\mathrm {V}}$ O2 during exercise, V ̇ $\\dot {\\mathrm {V}}$ O2 level after recovery and V ̇ $\\dot {\\mathrm {V}}$ O2 inflection point in the recovery phase. Estimates obtained by the mixed effects approach showed standard errors that were consistently lower as compared to the curve-by-curve approach. Conclusions Hereby we demonstrate the novelty and usefulness of this methodology in the context of physiological exercise testing.

  6. Acute Anteroseptal Myocardial Infarction after a Negative Exercise Stress Test

    Directory of Open Access Journals (Sweden)

    Abdullah M. Al-Alawi

    2016-05-01

    Full Text Available A myocardial infarction is a rare complication which can occur after an exercise stress test. We report a 48-year-old male who was referred to the Mildura Cardiology Practice, Victoria, Australia, in August 2014 with left-sided chest pain. He underwent an exercise stress test which was negative for myocardial ischaemia. However, the patient presented to the Emergency Department of the Mildura Base Hospital 30 minutes after the test with severe retrosternal chest pain. An acute anteroseptal ST segment elevation myocardial infarction was observed on electrocardiography. After thrombolysis, he was transferred to a tertiary hospital where coronary angiography subsequently revealed significant left anterior descending coronary artery stenosis. Thrombus aspiration and a balloon angioplasty were performed. The patient was discharged three days after the surgical procedure in good health.

  7. [Exercise test and ventricular tachycardia: the French experience].

    Science.gov (United States)

    Douard, H; Mora, B; Broustet, J P

    1987-03-01

    The incidence of severe ventricular arrhythmia requiring electric shock or prompt intravenous therapy was evaluated during or immediately after 458,000 exercise tests performed in 46 french centres between 1975 and 1985; 177,000 tests were performed exclusively in cardiac patients during supervised exercise training sessions. Sixty cases of severe arrhythmia (ventricular fibrillation 23, ventricular tachycardia 35, asystole 2) occurred (1/7600 tests). One or several electric shocks were necessary in 35 cases. Six patients died (1/76,333 tests), 2 of them during training sessions; 5 had phase II or III myocardial infarction, and the 6th patient had moderately tight valvular aortic stenosis. The five coronary patients were taking various anti-arrhythmic drugs. Among the 54 survivors, 14 were lost sight of and 4 died, 2 of these suddenly including one who passed away during a bicycle ride. All others are alive after a 3.25 +/- 2.9 years follow-up. The association of a multiple-vessel disease with an extensive fibrous plaque is a syndrome that is highly sensitive but fortunately little specific in predicting severe arrhythmia during exercise tests.

  8. VALIDITY OF THE EATING ATTITUDE TEST AMONG EXERCISERS

    Directory of Open Access Journals (Sweden)

    Hilary Matheson

    2004-12-01

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

  9. A comparison of methods of analysing exercise tests for diagnosis of coronary artery disease

    NARCIS (Netherlands)

    J.W. Deckers (Jaap); B.J.W.M. Rensing (Benno); J.G.P. Tijssen (Jan); R.V.H. Vinke (Ruud); A.J. Azar (Aida); M.L. Simoons (Maarten)

    1989-01-01

    textabstractThe diagnostic accuracy of the following methods of analysing exercise tests were evaluated: (a) the cumulative area of ST segment depression during exercise normalised for workload and heart rate (exercise score); (b) discriminant analysis of electrocardiographic exercise variables, wor

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

    Science.gov (United States)

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

    2014-09-01

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

  11. Does exercise training improve cardiopulmonary fitness and daily physical activity in children and young adults with corrected tetralogy of Fallot or Fontan circulation? A randomized controlled trial

    NARCIS (Netherlands)

    Duppen, N.; Etnel, J.R.; Spaans, L.; Takken, T.; Berg-Emons, R.J. van den; Boersma, E.; Schokking, M.; Dulfer, K.; Utens, E.M.; Helbing, W.; Hopman, M.T.E.

    2015-01-01

    BACKGROUND: Many patients with congenital heart disease do not meet current public health guidelines to participate in moderate-to-vigorous physical activity for >/=60 minutes per day. They are less fit than their healthy peers. We hypothesized that exercise training would increase cardiopulmonar

  12. Transient left ventricular apical ballooning and exercise induced hypertension during treadmill exercise testing: is there a common hypersympathetic mechanism?

    Directory of Open Access Journals (Sweden)

    Oh Jae K

    2008-07-01

    Full Text Available Abstract Objective To describe two cases of Takotsubo like myocardial contractile pattern during exercise stress test secondary to hypertensive response. Background Treadmill exercise testing is known to cause sympathetic stimulation, leading to increased levels of catecholamine, resulting in alteration in vascular tone. Hypertensive response during exercise testing can cause abnormal consequences, resulting in false positive results. Cases We present the cases of two patients experiencing apical and basal akinesis during exercise stress echocardiography, in whom normal wall motion response was observed on subsequent pharmacologic stress testing. The first patient developed transient left ventricular (LV apical akinesis during exercise stress echocardiography. Due to high suspicion that this abnormality might be secondary to hypertensive response, pharmacologic stress testing was performed after three days, which was completely normal and showed no such wall motion abnormality. Qualitative assessment of myocardial perfusion using contrast was also performed, which showed good myocardial blood flow, indicating low probability for significant obstructive coronary artery disease. The second patient developed LV basal akinesis as a result of hypertensive response during exercise testing. Coronary angiogram was not performed in either patient due to low suspicion for coronary artery disease, and subsequently negative stress studies. Results Transient stress induced cardiomyopathy can develop secondary to hypertensive response during exercise stress testing. Conclusion These cases provide supporting evidence to the hyper-sympathetic theory of left ventricular ballooning syndrome.

  13. Testing the effects of message framing, kernel state, and exercise guideline adherence on exercise intentions and resolve

    NARCIS (Netherlands)

    de Bruijn, G.J.; Out, K.; Rhodes, R.E.

    2014-01-01

    Objectives To study the effects of framed messages on exercise intention and resolve. Design Two (type of frame: gain or loss) × 2 (type of kernel state: desirable or undesirable outcome) post-test study. Methods Participants were recruited online and questioned about their previous exercise behavio

  14. Ventilatory regulation of arterial H(+) (pH) during exercise.

    Science.gov (United States)

    Wasserman, Karlman; Cox, Timothy A; Sietsema, Kathy E

    2014-01-01

    We hypothesized that exercise ventilation and arterial H(+) ([H(+)]a) are mutually interactive, [H(+)]a stimulating V(E) and V(E) regulating [H(+)]a increase. Fifty-five patients were studied, 10 normal and 45 with cardio-respiratory disorders. Each patient underwent cardiopulmonary exercise testing with simultaneous serial arterial blood gas and pH measurements. Subsequently, they were classified into one of 7 clinical groups: (1) normal, (2) exercise-induced hypoxemia (PaO2blood to become more alkaline during exercise in the patient groups studied.

  15. Exercise testing, limitation and training in patients with cystic fibrosis. A personalized approach

    NARCIS (Netherlands)

    Werkman, M.S.

    2014-01-01

    Exercise testing and training are cornerstones in regular CF care. However, no consensus exists in literature about which exercise test protocol should be used for individual patients. Furthermore, divergence exists in insights about both the dominant exercise limiting mechanisms and the possibiliti

  16. Evaluation of automated blood pressure measurements during exercise testing.

    Science.gov (United States)

    Hossack, K F; Gross, B W; Ritterman, J B; Kusumi, F; Bruce, R A

    1982-11-01

    Measurements of systolic (SBP) and diastolic (DBP) blood pressure were made at rest and during symptom-limited exercise with an automated blood pressure measuring device (EBPM). Comparisons were made between the EBPM readings and those made with mercury manometer. Correlations were high (SBP r = 0.92, DBP r = 0.80) when readings were made in the same arm, but were less satisfactory when the cuffs were on different arms (SBP r = 0.80, DBP r = 0.46). The correlation between two mercury manometer readings was SBP r = 0.90, and DBP r = 0.75. Comparison between EBPM and intra-arterial measurements were similar (SBP r = 0.74, DBP r = 0.79) to comparison between mercury manometer and intra-arterial measurements (SBP r = 0.81, DBP r = 0.61). The EBPM detected SBP at consistently higher levels than did physicians, which may be an advantage in the noisy environment of an exercise test. There was a definite tendency for physicians to record blood pressure to the nearest 10 mm Hg, whereas the frequency distribution curve for EBPM measurements was smoother. The EBPM operated satisfactorily at rest and during maximal exercise and gave as reliable measurements as a physician using a mercury manometer and, in the small number of available cases, detected exertional hypotension more often than the physician.

  17. Benefits of exercise training and the correlation between aerobic capacity and functional outcomes and quality of life in elderly patients with coronary artery disease.

    Science.gov (United States)

    Chen, Chia-Hsin; Chen, Yi-Jen; Tu, Hung-Pin; Huang, Mao-Hsiung; Jhong, Jing-Hui; Lin, Ko-Long

    2014-10-01

    Cardiopulmonary exercise training is beneficial to people with coronary artery disease (CAD). Nevertheless, the correlation between aerobic capacity, and functional mobility and quality of life in elderly CAD patients is less addressed. The purpose of the current study is to investigate the beneficial effects of exercise training in elderly people with CAD, integrating exercise stress testing, functional mobility, handgrip strength, and health-related quality of life. Elderly people with CAD were enrolled from the outpatient clinic of a cardiac rehabilitation unit in a medical center. Participants were assigned to the exercise training group (N = 21) or the usual care group (N = 15). A total of 36 sessions of exercise training, completed in 12 weeks, was prescribed. Echocardiography, exercise stress testing, the 6-minute walking test, Timed Up and Go test, and handgrip strength testing were performed, and the Short-Form 36 questionnaire (SF-36) was administered at baseline and at 12-week follow-up. Peak oxygen consumption improved significantly after training. The heart rate recovery improved from 13.90/minute to 16.62/minute after exercise training. Functional mobility and handgrip strength also improved after training. Significant improvements were found in SF-36 physical function, social function, role limitation due to emotional problems, and mental health domains. A significant correlation between dynamic cardiopulmonary exercise testing parameters, the 6-minute walking test, Timed Up and Go test, handgrip strength, and SF-36 physical function and general health domains was also detected. Twelve-week, 36-session exercise training, including moderate-intensity cardiopulmonary exercise training, strengthening exercise, and balance training, is beneficial to elderly patients with CAD, and cardiopulmonary exercise testing parameters correlate well with balance and quality of life.

  18. Responsiveness of Various Exercise-Testing Protocols to Therapeutic Interventions in COPD

    OpenAIRE

    Benoit Borel; Steeve Provencher; Didier Saey; François Maltais

    2013-01-01

    Exercise intolerance is a key element in the pathophysiology and course of Chronic Obstructive Pulmonary Disease (COPD). As such, evaluating exercise tolerance has become an important part of the management of COPD. A wide variety of exercise-testing protocols is currently available, each protocol having its own strengths and weaknesses relative to their discriminative, methodological, and evaluative characteristics. This paper aims to review the responsiveness of several exercise-testing pro...

  19. Baseline Systolic Blood Pressure Response to Exercise Stress Test Can Predict Exercise Indices following Cardiac Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Akram Sardari

    2010-11-01

    Full Text Available Background: Systolic blood pressure recovery (rSBP is of prognostic value for predicting the survival and co-morbidity rate in patients with coronary artery disease (CAD. This study investigated the association between rSBP and exercise indices after complete cardiac rehabilitation program (CR in a population-based sample of patients undergoing coronary artery bypass grafting (CABG.Methods: The sample population consisted of 352 patients who underwent pure CABG. The patients underwent standard symptom-limited exercise testing immediately before and also after the completion of the CR sessions. rSBP was defined as the ratio of the systolic blood pressure at 3 minutes in recovery to the systolic blood pressure at peak exercise.Results: An abnormal baseline rSBP after exercise was a strong predictor of exercise parameters in the last session, including metabolic equivalents (β = -0.617, SE = 0.127, p value < 0.001 and peak O2 consumption (β = -1.950, SE = 0.363, p value < 0.001 measured in the last session adjusted for baseline exercise characteristics, demographics, function class, and left ventricular ejection fraction.Conclusion: The current study strongly emphasizes the predictive role of baseline rSBP after exercise in evaluating exercise parameters following CR. This baseline index can predict abnormal METs value, peak O2 consumption, post-exercise heart rate, and heart rate recovery after a 24-session CR program.

  20. Predicting utility of exercise tests based on history/holter in patients with premature ventricular contractions.

    Science.gov (United States)

    Robinson, Brad; Xie, Li; Temple, Joel; Octavio, Jenna; Srayyih, Maytham; Thacker, Deepika; Kharouf, Rami; Davies, Ryan; Gidding, Samuel S

    2015-01-01

    Premature ventricular contractions (PVCs) are considered benign in patients with structurally normal hearts, particularly if they suppress with exercise. Catecholaminergic polymorphic ventricular tachycardia (CPVT) requires exercise testing to unmask the malignant phenotype. We studied risk factors and Holter monitor variables to help predict the necessity of exercise testing in patients with PVCs. We retrospectively reviewed 81 patients with PVCs that suppressed at peak exercise and structurally normal hearts referred to the exercise laboratory in 2011. We reviewed 11 patients from 2003 to 2012 whose PVCs were augmented at peak exercise (mean age 13 ± 4 years; 52 % male, 180 exercise studies). We recorded clinical risk factors and comorbidities (family history of arrhythmia or sudden unexpected death [SUD], presence of syncope) and Holter testing parameters. Family history of VT or SUD (P = 0.011) and presence of VT on Holter (P = 0.011) were significant in predicting failure of PVCs to suppress at peak heart rate on exercise testing. Syncope was not statistically significant in predicting suppression (P = 0.18); however, CPVT was diagnosed in four patients with syncope during exercise. Quantity of PVCs, Lown grade, couplets on Holter, monomorphism, and PVC elimination at peak heart rate on Holter were not predictors of PVC suppression on exercise testing. Patients with syncope during exercise, family history of arrhythmia or SUD, or a Holter monitor showing VT warrant exercise testing to assess for CPVT.

  1. Teste cardiopulmonar do exercício na prática clínica Cardiopulmonary stress testing in clinical practice

    Directory of Open Access Journals (Sweden)

    Eva Cantalejo Munhoz Stadler de Souza

    2000-12-01

    Full Text Available O teste cardiopulmonar do exercício (CPX apresenta-se como uma metodologia de grande utilidade diagnóstica e prognóstica. O presente estudo teve por objetivo demonstrar que os dados obtidos em laboratório fora do ambiente hospitalar comportam-se como os dados descritos na literatura, com aplicabilidade na prática clínica em nosso meio. METODOLOGIA: Trata-se de um relato de experiência, através da análise retrospectiva dos casos. O CPX foi realizado em condições de laboratório controladas, com bocal e clipe nasal, protocolo de rampa em esteira rolante e eletrocardiograma de 13 canais. RESULTADOS: Entre os 261 testes, 53,3% eram em homens, idade média de 48,2 ± 14,3 anos; ativos (45,2% ou sedentários (34,5%. A capacidade aeróbia máxima foi superior e com declínio significativo para cada década de aumento na faixa etária entre os homens, enquanto nas mulheres o declínio significativo ocorreu entre os 30 e 60 anos. As mulheres apresentaram maior distribuição (p = 0,0006 nas classes funcionais "em programa de treinamento ou bem treinadas e motivadas". O consumo de oxigênio pico (O2 foi significativamente superior nos testes máximos, mas o O2 do limiar anaeróbio (O2LA não apresentou diferenças significativas, quando o teste obtido foi máximo ou submáximo. A capacidade funcional, avaliada pelo O2LA como porcentagem do O2 máximo previsto, comparado à porcentagem do O2 máximo atingido, classificou mais indivíduos com compromisso circulatório (p = 0,002 ou com menor aptidão física em comparação com pacientes ativos ou em programa de treinamento (p O2 máximo previsto foi a causa mais comum de anormalidade, mais freqüente e significativo entre as mulheres. CONCLUSÃO: Os dados obtidos são comparáveis aos descritos na literatura, sugerindo que o CPX é uma metodologia factível, que poderia ser empregada rotineiramente na prática clínica em nosso meio.Cardiopulmonary stress testing (CPT is a very useful tool to

  2. Insuficiência cardíaca: comparação entre o teste de caminhada de seis minutos e o teste cardiopulmonar Insuficiencia cardíaca: comparación entre el test de esfuerzo de seis minutos y el test cardiopulmonar Heart failure: comparison between six-minute walk test and cardiopulmonary test

    Directory of Open Access Journals (Sweden)

    Eduardo Elias Vieira de Carvalho

    2011-07-01

    6' (TC6'1 y TC6'2, con un intervalo de 30 minutos entre ellos. Posteriormente realizaron un TECP máximo. RESULTADOS: Todas las variables obtenidas en los dos TE6' fueron significativas, y con altas correlaciones: distancia recorrida (DR (r = 0,93; p BACKGROUND: Chronic heart failure (HF is a syndrome characterized by reduced cardiac output in relation to the metabolic needs of the organism, as well as metabolic and neurohormonal axis abnormalities. Symptoms such as fatigue and dyspnoea are notorious and stress tests are widely used to assess functional capacity, prognosis and effectiveness of therapeutic interventions in this syndrome. OBJECTIVE: To evaluate the reproducibility of the six-minute walk test (6MW in patients with HF and correlate the magnitude of the variables reached at peak exercise of the 6MWT with a cardiopulmonary exercise test (CPET. METHODS: We studied 16 patients (12 men and 4 women diagnosed with HF FC I-II (NYHA. The volunteers underwent two 6MWT (6MWT'1 and 6MWT'2 with 30-minute interval between them; then, they underwent a maximum CPET. RESULTS: All variables obtained in the two 6MWT' proved to be significant with high correlations: distance walked (DW (r = 0.93, p < 0.0001, heart rate (HR (r = 0.89, p < 0.0001, oxygen consumption (VO2 (r = 0.93, p < 0.0001 and scale of perceived exertion (r = 0.85, p < 0.0001. In turn, all variables analyzed in the 6MWT' showed significant and moderate correlations with the variables obtained from the CPET, namely: peak HR (r = 0.66; p = 0.005; VO2 (r = 0.57; p = 0.02 and VO2 in the CPET and DT in the 6MWT'2 (r = 0.70; p = 0.002. CONCLUSION: The 6MWT was reproducible in this group of patients with HF (NYHA - I-II and correlated with the CPET. Therefore, it is a tool for reliable evaluation, and a suitable, safe and low-cost alternative for the prescription of aerobic exercise in patients with HF.

  3. Successful application of acute cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Derya ztrk; Erturul Altinbilek; Murat Koyuncu; Bedriye Mge Snmez; ilem altili; Ibrahim Ikzcel; Cemil Kavalci; Glsm Kavalci

    2015-01-01

    Objective: To compare the quality and correct the deficiencies of cardiopulmonary resuscitation (CPR) procedures performed in patients who developed cardiopulmonary cardiopulmonary arrest before or after Emergency Department admission. Methods: This study was conducted on patients who were applied CPR atŞŞişli Etfal Training and Research and Research Hospital, Emergency Department between 01 January 2012 and 31 December 2012. Chi-square and Mann-Whitney U test were used to compare the patients' data. The study data were analyzed in SPSS 18.0 software package. A P value less than 0.05 was considered statistically significant. Results: A total of 155 patients who were applied CPR were included in the analysis. Among the study patients, seventy eight (50.3%) were brought to Emergency Department after developing cardiopulmonary arrest while 77 (49.7%) developed cardiopulmonary arrest at Emergency Department. The mean age of the study population was (66 ± 16) years and 64%of the patients were male. The initial rhythms of the CPR-applied patients were different (P 0.05). The CPR response time was longer in ED (P Conclusions: The scientific data obtained in this study suggest that an early response and therapy improves outcomes in CPR procedure.

  4. Exercise

    Science.gov (United States)

    ... guidelines, an exercise program can help maintain good health. Physical activity Exercise doesn't have to be a rigorous cardiovascular workout to provide benefits. Physical activity in general ...

  5. Refined Exercise testing can aid DNA-based Diagnosis in Muscle Channelopathies

    OpenAIRE

    Tan, S V; Matthews, E.; Barber, M.; Burge, J. A.; Rajakulendran, S; Fialho, D; Sud, R.; Haworth, A; Koltzenburg, M.; Hanna, M. G.

    2011-01-01

    Objective: To improve the accuracy of genotype prediction and guide genetic testing in patients with muscle channelopathies we applied and refined specialized electrophysiological exercise test parameters.Methods: We studied 56 genetically confirmed patients and 65 controls using needle electromyography, the long exercise test, and short exercise tests at room temperature, after cooling, and rewarming.Results: Concordant amplitude-and-area decrements were more reliable than amplitude-only mea...

  6. Exercise induced fatigue: unfit or unwell?

    LENUS (Irish Health Repository)

    Moore, D M

    2011-05-01

    This case report outlines the diagnoses of a rare myophosphorylase deficiency (McArdle Syndrome) in a unique way. A set of characteristic values from a Cardiopulmonary Exercise Test (CPET) combined with a typical patient history pointed to a failure of the glycolytic pathway in the skeletal muscle. McArdle Syndrome was confirmed with a skeletal muscle biopsy. There is no evidence of such a diagnostic method in the literature.

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

    Directory of Open Access Journals (Sweden)

    Keisuke Nakamura, Masayoshi Ohira, Yoshiharu Yokokawa, Yuya Nagasawa

    2015-12-01

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

  8. Effect of different forms of exercise on the cardiopulmonary function of female college students%不同运动形式对女大学生心肺功能的影响

    Institute of Scientific and Technical Information of China (English)

    车广伟

    2015-01-01

    为了分析不同形式有氧运动对女大学生心肺功能的影响,采用对照组、匀速组、完全恢复组和不完全恢复组对参加有氧运动的女大学生心肺功能进行测量研究.研究显示:经过16周不同形式有氧运动,匀速组、完全恢复组和不完全恢复组女大学生心肺功能都有所提升,其中匀速组和不完全恢复组的心率指标呈现显著性改变(P<0.05);肺活量(VC)、每分最大通气量(MVV)、用力肺活量(FVC)和第1秒用力呼气量(FEV1)各指标在运动前后也呈显著性改变(P<0.05);不完全恢复组各心肺功能指标的改变均优于其它组.说明有持续有规律的有氧健身运动对女大学生心肺功能的改变有积极意义,从三种运动形式对心肺功能的改变情况看:不完全恢复组最优,匀速组次之,完全恢复组较差.%In order to analyze the different forms of the effect of Aerobics on female college students'' heart and lung function, the control group, uniform group, complete recovery group and incomplete recovery group to participate in the exercise of female college students'' heart and lung function measurements were performed on. Study shows: after 16 weeks of different forms of aerobic exercise, uniform group, complete recovery group and incomplete recovery of heart and lung function of female college students have improved, the indexes of the uniform group and incomplete recovery group of heart rate index shows a significant change (P < 0. 05); vital capacity (VC), every maximal ventilatory volume (MVV), forced vital capacity (FVC) and one second forced expiratory volume (FEV1) before and after exercise was also significantly changed (P < 0.05); incomplete recovery group, heart and lung function index were higher than those of other groups. Continue to have regular aerobic exercise on female college students'' heart and lung function change has a positive meaning, from three forms of exercise on cardiopulmonary function changes

  9. Increased physiological dead space/tidal volume ratio during exercise in burned children.

    Science.gov (United States)

    Mlcak, R P; Desai, M H; Robinson, E; McCauley, R L; Richardson, J; Herndon, D N

    1995-08-01

    Exercise testing enables the simultaneous evaluation of the cardiovascular and respiratory systems' ability to perform gas exchange. The physiological responses to exercise have not been previously reported in the postburn child. This investigation was designed to evaluate residual cardiopulmonary impairment in patients convalescing from severe burns. Spirometry, lung volumes and exercise stress testing were completed on 40 children with a mean time postburn injury of 2.6 +/- 1.9 years and mean burn size of 44 +/- 22 per cent TBSA. Respiratory variables studied during exercise included expired volume, tidal volume and respiratory rate, and physiological dead space/tidal volume (VD/VT) ratios. Stress testing revealed an increased VD/VT ratio consistent with uneven ventilation-perfusion relationships. The data indicate that patients who survive thermal injury may not regain normal cardiopulmonary homeostasis.

  10. Usefulness of myocardial perfusion imaging with exercise testing in children.

    Science.gov (United States)

    Robinson, Brad; Goudie, Brett; Remmert, Jenna; Gidding, Samuel S

    2012-10-01

    Myocardial perfusion imaging (MPI) provides additional clinical information on children with cardiac disease but will not benefit children with chest pain and normal cardiac studies. This study reviewed all technetium-99 m ((99m)Tc) sestamibi stress MPI studies between 2004 and 2010 performed in association with graded exercise testing (86% with bicycle ergometer, 14% with treadmill). A positive test was defined as a perfusion defect or abnormal ventricular function response. Clinical records were reviewed, including follow-up assessment to determine accuracy of MPI interpretation. False-positive and false-negative rates were recorded. A total of 197 patients (mean age, 13.4 ± 3.6 years, 70% male) underwent 218 MPI studies. Group A had 42 patients (43 studies) with isolated chest pain and normal studies. Of the 43 studies, 39 had negative results, and 4 had false-positive results. Group B had 155 patients (175 studies) with known or suspected cardiac disease, and 39 tests (33 patients) had positive results. Whereas 32 studies were considered true-positive, 7 were false-positive. There was one false-negative test. According to the findings, (99m)Tc sestamibi MPI studies are clinically useful but not perfect tests in the setting of known or suspected cardiac disease based on clinical evaluation, electrocardiography (ECG), or echocardiography. Children who had isolated chest pain with a normal ECG and echocardiogram often have false-positive studies.

  11. New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

    Science.gov (United States)

    Cortinas, Inés Vidal; Beretta, Mario; Alonso, Omar; Mut, Fernando

    2015-01-01

    Background Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity. Objectives In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP) was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols. Methods In patients not reaching a sufficient exercise (SE) test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection. Results Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (≥ 85% MPHR) and 67 underwent the dipyridamole alone test (DIP). They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ≥ 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43). For lesions ≥ 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35). Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001). Conclusions The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP. PMID:26039661

  12. New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

    Directory of Open Access Journals (Sweden)

    Inés Vidal Cortinas

    2015-08-01

    Full Text Available AbstractBackground:Myocardial perfusion scintigraphy (MPS in patients not reaching 85% of the maximum predicted heart rate (MPHR has reduced sensitivity.Objectives:In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols.Methods:In patients not reaching a sufficient exercise (SE test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection.Results:Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (≥ 85% MPHR and 67 underwent the dipyridamole alone test (DIP. They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ≥ 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43. For lesions ≥ 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35. Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001.Conclusions:The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP.

  13. New Exercise-Dipyridamole Combined Test for Nuclear Cardiology in Insufficient Effort: Appropriate Diagnostic Sensitivity Keeping Exercise Prognosis

    Energy Technology Data Exchange (ETDEWEB)

    Cortinas, Inés Vidal, E-mail: invi@montevideo.com.uy; Beretta, Mario; Alonso, Omar; Mut, Fernando [Departamento de Medicina Nuclear do Hospital ‘Asociación Española’, Br. Artigas 1515, Montevideo (Uruguay)

    2015-08-15

    Myocardial perfusion scintigraphy (MPS) in patients not reaching 85% of the maximum predicted heart rate (MPHR) has reduced sensitivity. In an attempt to maintain diagnostic sensitivity without losing functional exercise data, a new exercise and dipyridamole combined protocol (EDCP) was developed. Our aim was to evaluate the feasibility and safety of this protocol and to compare its diagnostic sensitivity against standard exercise and dipyridamole protocols. In patients not reaching a sufficient exercise (SE) test and with no contraindications, 0.56 mg/kg of dipyridamole were IV administered over 1 minute simultaneously with exercise, followed by 99mTc-MIBI injection. Of 155 patients, 41 had MPS with EDCP, 47 had a SE test (≥ 85% MPHR) and 67 underwent the dipyridamole alone test (DIP). They all underwent coronary angiography within 3 months. The three stress methods for diagnosis of coronary lesions had their sensitivity compared. For stenosis ≥ 70%, EDCP yielded 97% sensitivity, SE 90% and DIP 95% (p = 0.43). For lesions ≥ 50%, the sensitivities were 94%, 88% and 95%, respectively (p = 0.35). Side effects of EDCP were present in only 12% of the patients, significantly less than with DIP (p < 0.001). The proposed combined protocol is a valid and safe method that yields adequate diagnostic sensitivity, keeping exercise prognostic information in patients unable to reach target heart rate, with fewer side effects than the DIP.

  14. Nonsustained wide QRS tachycardia during an exercise ECG stress test.

    Science.gov (United States)

    MacKenzie, Ross

    2007-01-01

    The evaluation of a nonsustained wide QRS tachycardia in a life insurance applicant's exercise test presents a special challenge to the medical director because of the unpredictable and potentially lethal nature of these arrhythmias. Ventricular tachycardia accounts for up to 80% of wide QRS tachycardias in unselected populations and more than 95% of cases with a prior myocardial infarction. Malignant ventricular arrhythmias usually occur in the presence of significant structural heart disease. In this setting, ventricular arrhythmias carry a high risk of sudden cardiac death. Less commonly, ventricular tachycardia occurs in hearts that appear normal. In many such cases, however, the heart is in fact not normal, but rather has less visible abnormalities including derangements of cardiac ion channels or structural proteins. In these individuals, ventricular arrhythmias also carry a high risk of sudden cardiac death. There are, however, some ventricular tachycardia syndromes which occur in normal hearts that have a more benign prognosis.

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

    Science.gov (United States)

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

    1996-06-01

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

  16. Diagnostic and prognostic implications of exercise testing in coronary artery disease

    NARCIS (Netherlands)

    J.W. Deckers (Jaap)

    1988-01-01

    textabstractThe clinical indications for exercise testing as a diagnostic and prognostic tool in the assessment of patients with ischemic heart disease have gradually evolved since Master introduced the two-step exercise test in 1929 (1). New information from correlations between electrocardiographi

  17. DIMENSIONS OF COMPULSIVE EXERCISE ACROSS EATING DISORDER DIAGNOSTIC SUBTYPES AND THE VALIDATION OF THE SPANISH VERSION OF THE COMPULSIVE EXERCISE TEST.

    OpenAIRE

    Sarah Sauchelli; Jon Arcelus; Roser Granero; Susana Jiménez-Murcia; Zaida Aguera; Amparo Del Pino-Gutiérrez; Fernando Fernandez-Aranda

    2016-01-01

    Objectives: Compulsive exercise in eating disorders has been traditionally considered as a behavior that serves the purpose of weight/shape control. More recently, it has been postulated that there may be other factors that drive the compulsive need to exercise. This has led to the development of the Compulsive Exercise Test (CET); a self-reported questionnaire that aims to explore the cognitive-behavioral underpinnings of compulsive exercise from a multi-faceted perspective. The objectives o...

  18. Exercise testing and exercise rehabilitation for patients with peripheral arterial disease: status in 1997.

    Science.gov (United States)

    Regensteiner, J G; Gardner, A; Hiatt, W R

    1997-01-01

    Intermittent claudication is a common manifestation of peripheral arterial occlusive disease (PAOD). Patients with claudication are limited in terms of work, housework and leisure activities so that functional status is very impaired. Therefore, the goals for treatment should focus on improving the functional impairment as well as on modifying risk factors. Evaluation of the functional status is of critical importance before beginning any therapy so that any resultant changes can be assessed. A validated graded treadmill protocol and validated questionnaires are used for this purpose. Three questionnaires that are currently used include the Walking Impairment Questionnaire, the PAOD Physical Activity Recall and the Medical Outcomes Study SF-36. Exercise rehabilitation is a method that has been particularly efficacious for treating the functional impairment associated with intermittent claudication. Exercise rehabilitation has been shown to improve pain-free treadmill walking distance by 44% to 300% and absolute walking distance by 25% to 442%. In addition, improvements have also been reported (using questionnaire data) in the ability to walk distances and speeds, in amount of habitual physical activity and in physical functioning. Thus, exercise rehabilitation has caused improvements not only in exercise capacity but also in community-based functional status. Because of the benefits of this treatment, in addition to the low associated morbidity, exercise therapy is recommended as an important treatment option for people with intermittent claudication due to PAOD.

  19. Measuring behavioral outcomes in cardiopulmonary rehabilitation: AN AACVPR STATEMENT.

    Science.gov (United States)

    Verrill, David; Graham, Helen; Vitcenda, Mark; Peno-Green, Laura; Kramer, Valerie; Corbisiero, Teresa

    2009-01-01

    Outcome measurement in cardiopulmonary rehabilitation is required for optimal assessment of program quality, effectiveness of treatments, and evaluation of patient progress. Recent position statements from the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), American College of Cardiology, American Heart Association, American Thoracic Society, and American College of Chest Physicians have provided state-of-the-art information on the importance of assessing performance and outcome measures for optimal program effectiveness. Such measures are also required for AACVPR program certification. To meet current standards of practice, the AACVPR developed an Outcomes Matrix that includes 4 domains: Health, Clinical, Behavioral, and Service. Although the Clinical and Health domains have been most commonly used in outcome reporting (eg, 6-minute walk test, quality-of-life survey scores), behavioral measures have received less attention, primarily because they have been perceived as being more difficult to measure and quantify over time. This statement describes 5 common behavioral outcome measures: smoking cessation, medication use, supplemental oxygen use, exercise habits, and nutritional behaviors. Sample questions and calculations for each of these behavioral measures are also provided. By using these measures at program entry and completion, cardiac and pulmonary rehabilitation practitioners can effectively track and document behavioral changes over time for physicians, third-party insurance providers, or hospital administrators and thus demonstrate the effectiveness of exercise and educational interventions on patient overall health and well-being.

  20. The effect of high and low exercise intensity periods on a simple memory recognition test

    Directory of Open Access Journals (Sweden)

    Ben Rattray

    2016-09-01

    Conclusion: Changes in cognitive performance with variations in exercise intensity are likely to have implications for sport and occupational settings. The timing of cognitive tests to exercise intensity changes as well as use of short cognitive assessments will be important for future work.

  1. Flow for Exercise Adherence: Testing an Intrinsic Model of Health Behavior

    Science.gov (United States)

    Petosa, R. Lingyak; Holtz, Brian

    2013-01-01

    Background: Health behavior theory generally does not include intrinsic motivation as a determinate of health practices. Purpose: The purpose of this study was to test the flow theory of exercise adherence. Flow theory posits that exercise can be intrinsically rewarding if the experiences of self/time transcendence and control/mastery are achieved…

  2. Understanding exercise behavior among Korean adults: a test of the transtheoretical model.

    Science.gov (United States)

    Kim, YoungHo; Cardinal, Bradley J; Lee, JongYoung

    2006-01-01

    The purpose of this study was to examine the theorized association of Transtheoretical Model (TTM) of behavior change constructs by stage of change for exercise behavior among Korean adults. A total of 1,335 Korean adults were recruited and surveyed from the Nowon district, geographically located in northern Seoul. Four Korean-version questionnaires were used to identify the stage of exercise behavior and psychological attributes of adolescents. Data were analyzed by frequency analysis, MANOVA, correlation analysis, and discriminant analysis. Multivariate F tests indicated that behavioral and cognitive processes of change, exercise efficacy, and pros differentiated participants across the stages of exercise behavior. Furthermore, the findings revealed that adults' exercise behavior was significantly correlated with the TTM constructs and that overall classification accuracy across the stages of change was 50.6%. This study supports the internal and external validity of the TTM for explaining exercise behavior.

  3. The effect of high and low exercise intensity periods on a simple memory recognition test

    Institute of Scientific and Technical Information of China (English)

    Ben Rattray; Disa J. Smee

    2016-01-01

    Purpose: The purpose of this study was to investigate the effect of variable intensities on a simple memory recognition task during exercise. Methods: Twenty active participants took part in initial testing, a familiarization trial and then four 60 min cycling interventions in a randomized order. Interventions consisted of no exercise (control), constant exercise at 90%ventilatory threshold (constant) and 2 trials that initially mimicked the constant trial, but then included periods of high (∼90%VO2peak) and low intensities (∼50%VO2peak). Cardiorespiratory measures and capillary blood samples were taken throughout. A short tablet-based cognitive task was completed prior to and during (50 and 55 min into exercise) each intervention. Results: The exercise conditions facilitated response time (p=0.009), although the extent of this effect was not as strong in the variable exercise conditions (p = 0.011–0.089). High intensity exercise periods resulted in some cognitive regression back towards control trial performance. Elevations in cardiorespiratory measures and periods of hypocapnia could not explain changes in cognitive performance. Conclusion: Changes in cognitive performance with variations in exercise intensity are likely to have implications for sport and occupational settings. The timing of cognitive tests to exercise intensity changes as well as use of short cognitive assessments will be important for future work.

  4. Exercise

    DEFF Research Database (Denmark)

    Idorn, Manja; thor Straten, Eivind Per

    2016-01-01

    We recently demonstrated that voluntary exercise leads to an influx of immune cells in tumors and a greater than 60% reduction in tumor incidence and growth across several mouse models. Improved immunological control of tumor progression may have important clinical implications in the prevention...

  5. Narrative and framing: a test of an integrated message strategy in the exercise context.

    Science.gov (United States)

    Gray, Jennifer B; Harrington, Nancy G

    2011-03-01

    Health communication interventions encouraging exercise may aid in mitigating the obesity crisis in the United States. Although much research has investigated behavioral predictors of exercise, little work has explored message characteristics most persuasive in the exercise context. The purpose of this study, therefore, was to test a message strategy drawing on previous work in health behavior theory combined with persuasion theories (exemplification theory and prospect theory) to encourage positive exercise attitudes, control beliefs, and intentions. The authors report the results of a controlled experiment testing messages using gain or loss frames and narrative or statistical evidence. Results indicate that gain-framed messages are significantly more successful in promoting positive exercise variables and are perceived as more effective than are loss-framed or control messages. The authors discuss the implications of the results for future research.

  6. Combined Home Exercise Is More Effective Than Range-of-Motion Home Exercise in Patients with Ankylosing Spondylitis: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Lin-Fen Hsieh

    2014-01-01

    Full Text Available Home exercise is often recommended for management of patients with ankylosing spondylitis (AS; however, what kind of home exercise is more beneficial for patients with AS has not been determined yet. We aimed to compare the effectiveness of combined home exercise (COMB and range-of-motion home exercise (ROM in patients with AS. Nineteen subjects with AS completed either COMB (n=9 or ROM (n=10 program. The COMB program included range-of-motion, strengthening, and aerobic exercise while the ROM program consisted of daily range-of-motion exercise only. After exercise instruction, subjects in each group performed home exercise for 3 months. Assessment included cardiopulmonary exercise test, pulmonary function test, spinal mobility measurement, chest expansion, Bath Ankylosing Spondylitis Functional Index (BASFI, and other functional ability and laboratory tests. After exercise, the COMB group showed significant improvement in peak oxygen uptake (12.3%, P=0.008 and BASFI (P=0.028, and the changed score between pre- and postexercise data was significantly greater in the COMB group regarding peak oxygen uptake and BASFI. Significant improvement in finger-to-floor distance after 3-month exercise was found only in the COMB group (P=0.033. This study demonstrates that a combined home exercise is more effective than range-of-motion home exercise alone in aerobic capacity and functional ability.

  7. Non-invasive measurement of adrenal response after standardized exercise tests in prepubertal children

    NARCIS (Netherlands)

    Heijsman, Sigrid M.; Koers, Nicoline F.; Bocca, Gianni; van der Veen, Betty S.; Appelhof, Maaike; Kamps, Arvid W. A.

    2012-01-01

    Objective: To determine the feasibility of non-invasive evaluation of adrenal response in healthy prepubertal children by standardized exercise tests. Methods: On separate occasions, healthy prepubertal children performed a submaximal cycling test, a maximal cycling test, and a 20-m shuttle-run test

  8. Exercise stress testing before and after successful multivessel percutaneous transluminal coronary angioplasty

    Directory of Open Access Journals (Sweden)

    W.A. Chalela

    2006-04-01

    Full Text Available Controversy exists regarding the diagnostic accuracy, optimal technique, and timing of exercise testing after percutaneous coronary intervention. The objectives of the present study were to analyze variables and the power of exercise testing to predict restenosis or a new lesion, 6 months after the procedure. Eight-four coronary multi-artery diseased patients with preserved ventricular function were studied (66 males, mean age of all patients: 59 ± 10 years. All underwent coronary angiography and exercise testing with the Bruce protocol, before and 6 months after percutaneous coronary intervention. The following parameters were measured: heart rate, blood pressure, rate-pressure product (heart rate x systolic blood pressure, presence of angina, maximal ST-segment depression, and exercise duration. On average, 2.33 lesions/patient were treated and restenosis or progression of disease occurred in 46 (55% patients. Significant increases in systolic blood pressure (P = 0.022, rate-pressure product (P = 0.045 and exercise duration (P = 0.003 were detected after the procedure. Twenty-seven (32% patients presented angina during the exercise test before the procedure and 16 (19% after the procedure. The exercise test for the detection of restenosis or new lesion presented 61% sensitivity, 63% specificity, 62% accuracy, and 67 and 57% positive and negative predictive values, respectively. In patients without restenosis, the exercise duration after percutaneous coronary intervention was significantly longer (460 ± 154 vs 381 ± 145 s, P = 0.008. Only the exercise duration permitted us to identify patients with and without restenosis or a new lesion.

  9. Comparison between treadmill and bicycle ergometer exercise tests in mild-to-moderate hypertensive Nigerians

    Directory of Open Access Journals (Sweden)

    Abiodun OO

    2015-08-01

    Full Text Available Olugbenga O Abiodun, Michael O Balogun, Anthony O Akintomide, Rasaaq A Adebayo, Olufemi E Ajayi, Suraj A Ogunyemi, Valentine N Amadi, Victor O Adeyeye Cardiology Unit, Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC, Ile-Ife, Osun state, Nigeria Background: Comparative cardiovascular responses to treadmill and bicycle ergometer (bike exercise tests in hypertensive Nigerians are not known. This study compared cardiovascular responses to the two modes of exercise testing in hypertensives using maximal exercise protocols. Methods: One hundred and ten male subjects with mild-to-moderate hypertension underwent maximal treadmill and bike test one after the other at a single visit in a simple random manner. Paired-sampled t-test was used to compare responses to both exercise tests while chi-squared test was used to compare categorical variables. Results: The maximal heart rate (P<0.001, peak systolic blood pressure (P=0.02, rate pressure product (P<0.001, peak oxygen uptake (P<0.001, and exercise capacity (P<0.001 in metabolic equivalents were significantly higher on the treadmill than on the bike. Conclusion: Higher cardiovascular responses on treadmill in Nigerian male hypertensives in this study, similar to findings in non-hypertensives and non-Nigerians in earlier studies, suggest that treadmill may be of better diagnostic utility in our population. Keywords: maximal exercise, treadmill, bicycle ergometer, hypertension, Nigerians

  10. Cardiopulmonary bypass in pregnancy

    Directory of Open Access Journals (Sweden)

    Mukul Chandra Kapoor

    2014-01-01

    Full Text Available Cardiac surgery carried out on cardiopulmonary bypass (CPB in a pregnant woman is associated with poor neonatal outcomes although maternal outcomes are similar to cardiac surgery in non-pregnant women. Most adverse maternal and fetal outcomes from cardiac surgery during pregnancy are attributed to effects of CPB. The CPB is associated with utero-placental hypoperfusion due to a number of factors, which may translate into low fetal cardiac output, hypoxia and even death. Better maternal and fetal outcomes may be achieved by early pre-operative optimization of maternal cardiovascular status, use of perioperative fetal monitoring, optimization of CPB, delivery of a viable fetus before the operation and scheduling cardiac surgery on an elective basis during the second trimester.

  11. Biochemical changes in relation to a maximal exercise test in patients with fibromyalgia

    DEFF Research Database (Denmark)

    Nørregaard, J; Bülow, P M; Mehlsen, J

    1994-01-01

    Patients with fibromyalgia often complain of fatigue and pain during exercise and of worsening of pain days after exercise. The aim of the study described here was to determine if abnormal changes in potassium or lactate could be observed during an exercise test in fibromyalgia. Whether an abnormal...... incline in plasma creatine kinase or myoglobin could be observed days after the test was studied also. Fifteen female fibromyalgia patients and 15 age- and sex-matched controls performed a stepwise incremental maximal bicycle-ergometer test. Blood samples were collected from a catheter in a cubital vein......-1 was reached at a heart rate of 124 min-1 in the patients with fibromyalgia as compared to 140 min-1 in the controls (P = 0.02). In relation to workload, the patients scored higher on a Borg scale for perceived exertion during exercise, but if the Borg score was related to lactate no significant...

  12. Studies with the USF/NASA toxicity screening test method - Exercise wheels and oxygen replenishment

    Science.gov (United States)

    Hilado, C. J.; Cumming, H. J.

    1977-01-01

    Continuing efforts to improve the University of San Francisco/NASA toxicity screening test method have included the addition of exercise wheels to provide a different measure of incapacitation, and oxygen replenishment to offset any effect of oxygen depletion by the test animals. The addition of exercise wheels limited the number of animals in each test and doubled the required number of tests without any significant improvement in reproducibility. Oxygen replenishment appears to have an effect on survival in the last 5 minutes of the 30-minute test, but the effect is expected to be similar for most materials.

  13. Exercise stress testing in healthy subjects during cholinergic stimulation after a single dose of pyridostigmine

    Directory of Open Access Journals (Sweden)

    Salvador M. Serra

    2001-04-01

    Full Text Available OBJETIVE: The evaluation, by exercise stress testing, of the cardiorespiratory effects of pyridostigmine (PYR, a reversible acetylcholinesterase inhibitor. METHODS: A double-blind, randomized, cross-over, placebo-controlled comparison of hemodynamic and ventilation variables of 10 healthy subjects who underwent three exercise stress tests (the first for adaptation and determination of tolerance to exercise, the other two after administration of placebo or 45mg of PYR. RESULTS: Heart rate at rest was: 68±3 vs 68±3bpm before and after placebo, respectively (P=0.38; 70±2 vs 59±2bpm, before and after pyridostigmine, respectively (P<0.01. During exercise, relative to placebo: a significantly lower heart rate after PYR at, respectively, 20% (P=0.02, 40% (P=0.03, 80% (P=0.05 and 100% (P=0.02 of peak effort was observed. No significant differences were observed in arterial blood pressure, oxygen consumption at submaximal and maximal effort, exercise duration, respiratory ratio, CO2 production, ventilation threshold, minute ventilation, and oxygen pulse. CONCLUSION: Pyridostigmine, at a dose of 45mg, decreases heart rate at rest and during exercise, with minimal side effects and without interfering with exercise tolerance and ventilation variables.

  14. Do muscle strengthening exercises improve performance in the 6-minute walk test in postmenopausal women?

    Directory of Open Access Journals (Sweden)

    Júlia G. Reis

    Full Text Available BACKGROUND: Walking speed seems to be related to aerobic capacity, lower limb strength, and functional mobility, however it is not clear whether there is a direct relationship between improvement in muscle strength and gait performance in early postmenopausal women. OBJECTIVE: To evaluate the effect of muscle strengthening exercises on the performance of the 6-minute walk test in women within 5 years of menopause. METHODS: The women were randomized into control group (n=31, which performed no exercise, and exercise group (n=27, which performed muscle strengthening exercises. The exercises were performed twice a week for 3 months. The exercise protocol consisted of warm-up, stretching, and strengthening of the quadriceps, hamstring, calf, tibialis anterior, gluteus maximus, and abdominal muscles, followed by relaxation. Muscular strength training started with 60% of 1MR (2 series of 10-15 repetitions, reaching 85% until the end of the 3-month period (4 series of 6 repetitions each. RESULTS: The between-group comparisons pre- and post-intervention did not show any difference in distance walked, heart rate or blood pressure (p>0.05, but showed differences in muscle strength post-intervention, with the exercise group showing greater strength (p CONCLUSION: The results suggest that muscle strengthening of the lower limbs did not improve performance in the 6-minute walk test in this population of postmenopausal women.

  15. Estimation of VO2 Max: A Comparative Analysis of Five Exercise Tests.

    Science.gov (United States)

    Zwiren, Linda D.; And Others

    1991-01-01

    Thirty-eight healthy females measured maximal oxygen uptake (VO2max) on the cycle ergometer and treadmill to compare five exercise tests (run, walk, step, and two tests using heart-rate response on the bicycle ergometer) in predicting VO2max. Results indicate that walk and run tests are satisfactory predictors of VO2max in 30- to 39-year-old…

  16. 高血压飞行人员运动负荷试验研究%Research of exercise load test in hypertensive aircrews

    Institute of Scientific and Technical Information of China (English)

    刘晶; 王露今; 刘玉华; 徐先荣; 刘红巾; 徐蜀宣; 崔丽; 付兆君; 熊巍

    2015-01-01

    目的 探讨影响高血压飞行人员心肺储备能力的主要因素. 方法 根据《中国高血压防治指南2010》选择高血压和非高血压飞行人员各17例,进行心肺运动试验,测量并比较两组的每千克体重峰值摄氧量(peak oxygen uptake per kilogram,VO2peak/kg)、无氧阈(anaerobic threshold,AT)时的摄氧量(oxygen uptate per kilogram at AT,VO2/kg@AT)、峰值氧脉搏(peak oxygen pulse,O2 pulsepeak)、血压、心率、运动时间等指标. 结果 高血压组与正常组的VO2peak、VO2@AT、O2 pulsepeak差异无统计学意义(P>0.05);两组的运动峰值收缩压、舒张压、峰值心率、运动前后收缩压变化值、心率变化值、运动后6 min血压、运动时间比较差异有统计学意义(t=2.622~4.945,P<0.01或P<0.05). 结论 高血压飞行人员运动耐量的气体代谢指标变化不明显,血压的运动反应更敏感.在飞行人员高血压病的诊治、鉴定和随访中,运动血压应作为诊室血压和动态血压的补充.%Objective To investigate the main factors influencing cardiac pulmonary reserve of hypertensive aircrews.Methods The aircrews were divided into hypertension group (n=17) and normal group (n=17) by the diagnosis of hypertension that defined in Chinese Hypertension Guideline 2010.Such parameters as peak oxygen uptake per kilogram (VO2peak/kg),VO2/kg at anaerobic threshold (VO2/kg@AT),peak oxygen pulse (O2 pulsepeak),blood pressure (BP),heart rate (HR),exercise time in cardiopulmonary exercise test (CPET) were recorded in cardiopulmonary exercise and analyzed.Results There were no differences in VO2peak,VO2@AT and VO2peak between two groups (P>0.05).Significant differences existed in peak SBP,DBP and HR,△SBP,△HR,BP levels at 6 minutes after exercise,exercise time between groups (t=2.622-4.945,P<0.01or <0.05).Conclusions BP responses are more sensitive than gaseous metabolism indexes during hypertensive aircrews' CPET.Exercise BP would be the

  17. Quantitative evaluation of cardiopulmonary functional reserve in treated patients with pulmonary embolism

    Institute of Scientific and Technical Information of China (English)

    YAN Wen-wen; WANG Le-min; CHE Lin; SONG Hao-ming; JIANG Jin-fa; XU Jia-hong; SHEN Yu-qin; ZHANG Qi-ping

    2012-01-01

    Background There is no research,either at home or abroad,focusing on assessing the cardiopulmonary functional reserve and exercise tolerance in patients with pulmonary embolism (PE),but the benefits of early exercise are well recognized.The goals of this study were to assess cardiopulmonary functional reserve in treated PE patients using the inert gas rebreathing method of the cardiopulmonary exercise test (CPET),and to compare it with traditional methods.Methods CPET on the bicycle ergometer were performed in 40 patients with age,gender,body mass index,systolic blood pressure,and pulmonary function matched.The first group was the PE group composed of 16 PE patients (5 male,11 female) who were given the standard antithrombotic therapy for two weeks.The second group was composed of 24 normal individuals (10 male,14 female).Both groups were evaluated by cardiac ultrasound examination,6-minute walking test (6MVVT),and CPET.Results (1) Right ventricular systolic pressure (RVSP) in the PE group increased significantly compared to the control group,(34.81±8.15) mmHg to (19.75±3.47) mmHg (P <0.01).But neither right atrial end-systolic diameter (RASD) nor right ventricular end-diastolic diameter (RVDD) in the PE patients had changed when compared with the controls.The 6-minute walk distance was significantly reduced in the PE patients compared with normal subjects,(447.81±79.20) m vs.(513.75±31.45) m (P <0.01).Both anaerobic threshold oxygen consumption (VO2AT) and peak oxygen consumption (VO2peak) were significantly lower in patients with PE,while CO2 equivalent ventilation (VE/VCO2 slope) was higher;VO2AT (9.44±3.82) ml·kg1.min-1 vs.(14.62±2.93) ml.kg-1.min-1 (P <0.01) and VO2peak (12.26±4.06) ml.kg-1.min-1 vs.(23.46±6.15) ml.kg-1.min-1 (P <0.01) and VE/VCO2 slope 35.47±6.66 vs.26.94±3.16 (P <0.01).There was no significant difference in resting cardiac output (CO) between the PE and normal groups,whereas peak cardiac output (peak CO)and the

  18. Predischarge maximal exercise test identifies risk for cardiac death in patients with acute myocardial infarction

    DEFF Research Database (Denmark)

    Nielsen, J R; Mickley, H; Damsgaard, E M

    1990-01-01

    A maximal exercise test was performed in 54 patients with acute myocardial infarction (AMI) before discharge and in 49 age-matched control subjects. The long-term prognosis was assessed after an average follow-up of 7.6 years in AMI patients and 5.8 years in control subjects. The maximal work...... capacity and systolic blood pressure increase in AMI patients was 59% that of control subjects (p less than 0.001). Seventeen AMI patients had significant ST-segment shifts, 13 with ST depression and 4 with ST elevation. In AMI patients experiencing a cardiac death during follow-up the maximal work...... were of no significant value. In this study maximal work capacity turned out to be the best single exercise variable for identifying groups of AMI patients with very low and relative high risk of cardiac death. When all 3 exercise variables were combined, the predischarge maximal exercise test...

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

    Science.gov (United States)

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

    2015-01-01

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

  20. Ethical issues in cardiopulmonary resuscitation.

    Science.gov (United States)

    Holm, S; Jørgensen, E O

    2001-08-01

    If patients are to benefit from resuscitation, they must regain consciousness and their full faculties. In recent years, we have acquired important information about the natural history of neurological recovery from circulatory arrest. There are clinical tests that predict the outcome, both during ongoing cardiopulmonary resuscitation (CPR) and in the period after restoration of spontaneous circulation. The ability to predict neurological outcome at this stage offers a basis for certain ethical considerations, which are not exclusively centered on "do-not-attempt-resuscitation" (DNAR)- orders. Instead of being forced to make the decision that "I do not want CPR", the patient should be able to decide that "I want resuscitation to be discontinued, if you predict that I will not recover to a level of neurological function that is acceptable to me". Ideally, no competent patient should be given a DNAR-status without his or her consent. No CPR-attempt should be stopped, and no treatment decision for a patient recovering after CPR should be taken without knowing and assessing the available information. Good ethical decision-making requires reliable facts, which we now know are available.

  1. The effect of regular Taekwondo exercise on Brain-derived neurotrophic factor and Stroop test in undergraduate student

    OpenAIRE

    Kim, Youngil

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effect of Taekwondo exercise on Brain-derived neurotrophic factor and the Stroop test in undergraduate students. [Methods] Fourteen male subjects participated in this study. They were separated into a Control group (N = 7) and an Exercise group (N = 7). Subjects participated in Taekwondo exercise training for 8 weeks. They underwent to Taekwondo exercise training for 85 minutes per day, 5 times a week at RPE of 11~15. The taekwondo ex...

  2. Aerobic exercise and cold pressor test induce hypoalgesia in active and inactive men and women

    DEFF Research Database (Denmark)

    Vaegter, Henrik Bjarke; Handberg, Gitte; Jørgensen, Maria N.;

    2015-01-01

    and after exercise, PPTs increased to the same degree in active and inactive subjects, and the CPM and EIH responses were correlated (P aerobic exercise caused......). Conditioned pain modulation (CPM) was assessed by cold pressor testing. Exercise-induced hypoalgesia (EIH) was assessed after 15 minutes bicycling at a heart rate corresponding to 75% VO2max. A control session of 15 minutes quiet rest was also included. Pressure pain thresholds (PPTs) were recorded...... at the dominant arm and leg before, immediately after, and 15 minutes after conditioning and exercise as well as before and after rest. PPTs were also recorded during conditioning. RESULTS: At baseline, PPTs in inactive men were increased compared with inactive women (P 

  3. Effect of Semirecumbent and Upright Body Position on Maximal and Submaximal Exercise Testing

    Science.gov (United States)

    Scott, Alexander; Antonishen, Kevin; Johnston, Chris; Pearce, Terri; Ryan, Michael; Sheel, A. William; McKenzie, Don C.

    2006-01-01

    The study was designed to determine the effect of upright-posture (UP) versus semirecumbent (SR) cycling on commonly used measures of maximal and submaximal exercise capacity. Nine healthy, untrained men (M age = 27 years, SD = 4.8 years) underwent steady-state submaximal aerobic testing followed by a ramped test to determine maximal oxygen…

  4. Effects of the oral contraceptive pill cycle on physiological responses to hypoxic exercise

    Science.gov (United States)

    Sandoval, Darleen A.; Matt, Kathleen S.

    2003-01-01

    To test whether the oral contraceptive pill cycle affects endocrine and metabolic responses to hypoxic (fraction of inspired oxygen = 13%, P(IO2): 95 mmHg; H) versus normoxic (P(IO2):153 mmHg; N) exercise, we examined eight women (28 +/- 1.2 yr) during the third (PILL) and placebo (PLA) weeks of their monthly oral contraceptive pill cycle. Cardiopulmonary, metabolic, and neuroendocrine measurements were taken before, during, and after three 5-min consecutive workloads at 30%, 45%, and 60% of normoxic V(O2peak) in H and N trials. Heart rate response to exercise was greater in H versus N, but was not different between PILL and PLA. Lactate levels were significantly greater during exercise, and both lactate and glucose levels were significantly greater for 30 min after exercise in H versus N (p exercise (p exercise.

  5. Radionuclide observables during the Integrated Field Exercise of the Comprehensive Nuclear-Test-Ban Treaty

    Energy Technology Data Exchange (ETDEWEB)

    Burnett, Jonathan L.; Miley, Harry S.; Milbrath, Brian D.

    2016-03-01

    In 2014 the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO) undertook the Integrated Field Exercise (IFE) in Jordan. The exercise consisted of a simulated 0.5 – 2 kT underground explosion triggering an On-site Inspection (OSI) to search for evidence of a Treaty violation. This research evaluates two of the OSI techniques, including laboratory-based gamma-spectrometry of soil samples and in situ gamma-spectrometry for 17 particulate radionuclides indicative of nuclear weapon tests. The detection sensitivity is evaluated using real IFE and model data. It indicates that higher sensitivity laboratory measurements are the optimum technique during the IFE and OSI timeframes.

  6. What is the real practice of exercise echocardiographic testing inasymptomatic patients with severe aortic stenosis?

    Institute of Scientific and Technical Information of China (English)

    Eun Jeong Cho; Sung-Ji Park; Jung-Eun Song; Seol-Hwa Kim; Yung-Joo Lee; Ji-Hye Gak; Sung-A Chang

    2013-01-01

    Background Although exercise testing has been suggested to help predict clinical outcome,limited data are available to guide how exercise Doppler echocardiography (ECG) can be used clinically in asymptomatic patients with aortic stenosis (AS).The aim of this study was to assess the clinical value of exercise echocardiographic testing in asymptomatic patients with severe AS.Methods Symptom-limited treadmill exercise testing using the modified Bruce protocol was performed in 31 asymptomatic patients (mean age (62±11) years) with severe AS (aortic valve area <1 cm2,peak aortic velocity (AV Vmax) >4 m/sec,or a mean transaortic pressure gradient (AV mean PG) >40 mmHg (1 mmHg=0.133 kPa)) with normal left ventricular (LV)systolic function (LV ejection fraction (EF) >50%).Clinical symptoms,vital signs,ECG,and Doppler hemodynamics were obtained during and/or immediately after exercise.Results Aortic valve replacement (AVR) was performed in 18 patients during follow-up.The patients who had AVR exhibited higher baseline AV mean PG (51 (35-84) vs.44 (25.2-57.0) mmHg; P=0.031).There were no significant differences between the AVR group and non-AVR group including exercise duration (7.47 (2.32-11.59) vs.7.25 (4.06-10.52) minutes,P=0.917),exercise capacity (10.1 (4.6-12.8) vs.10.1 (7.0-12.8) metabolic equivalents,P=0.675),and an increment in AV mean PG by exercise (18.5 (3.2-48.0) vs.12.6 (4.4-32.1) mmHg,P=0.366).Univariate regression analysis revealed that independent determinant of AVR was the baseline AV mean PG (P=0.031).Conclusions Although additional value of exercise ECG was demonstrated,baseline transaortic mean pressure gradient is the major determinant of AVR.Further large-scale prospective studies are required to determine whether surgery should be recommended in the presence of an abnormal exercise ECG in asymptomatic severe AS.

  7. Antecedent acute cycling exercise affects attention control: an ERP study using attention network test

    Directory of Open Access Journals (Sweden)

    Yu-Kai eChang

    2015-04-01

    Full Text Available The purpose of this study was to investigate the after-effects of an acute bout of moderate-intensity aerobic cycling exercise on neuroelectric and behavioral indices of efficiency of three attentional networks: alerting, orienting, and executive (conflict control. Thirty young, highly fit amateur basketball players performed a multifunctional attentional reaction time task, the attention network test (ANT, with a two-group randomized experimental design after an acute bout of moderate-intensity spinning wheel exercise or without antecedent exercise. The ANT combined warning signals prior to targets, spatial cueing of potential target locations and target stimuli surrounded by congruent or incongruent flankers, which were provided to assess three attentional networks. Event-related brain potentials and task performance were measured during the ANT. Exercise resulted in a larger P3 amplitude in the alerting and executive control subtasks across frontal, central and parietal midline sites that was paralleled by an enhanced reaction speed only on trials with incongruent flankers of the executive control network. The P3 latency and response accuracy were not affected by exercise. These findings suggest that after spinning, more resources are allocated to task-relevant stimuli in tasks that rely on the alerting and executive control networks. However, the improvement in performance was observed in only the executively challenging conflict condition, suggesting that whether the brain resources that are rendered available immediately after acute exercise translate into better attention performance depends on the cognitive task complexity.

  8. Cardiac arrhythmias during exercise testing in healthy men.

    Science.gov (United States)

    Beard, E. F.; Owen, C. A.

    1973-01-01

    Clinically healthy male executives who participate in a long-term physical conditioning program have demonstrated cardiac arrhythmia during and after periodic ergometric testing at submaximal and maximal levels. In 1,385 tests on 248 subjects, it was found that 34% of subjects demonstrated an arrhythmia at some time and 13% of subjects developed arrhythmia on more than one test. Premature systoles of ventricular origin were most common, but premature systoles of atrial origin, premature systoles of junctional origin, paroxysmal atrial tachycardia, atrioventricular block, wandering pacemaker, and pre-excitation were also seen. Careful post-test monitoring and pulse rate regulated training sessions are suggested for such programs.

  9. Inverse correlation between testosterone and ventricle ejection fraction, hemodynamics and exercise capacity in heart failure patients with erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Edimar A. Bocchi

    2008-06-01

    Full Text Available BACKGROUND: Neurohormonal activation and abnormalities in growth hormone and testosterone concentrations have been reported in heart failure (HF. Erectile dysfunction(ED is common in these patients and contributes to a low quality of life. No data are known regarding the correlation between testosterone and hemodynamics, exercise capacity and cardiac function in HF patients with ED, a marker of endothelial dysfunction. The aim of this study was to correlate testosterone levels with cardiac function, hemodynamic and exercise capacity in HF patients with ED. MATERIALS AND METHODS: Fifteen HF patients underwent a six-minute treadmill cardiopulmonary walking test (6'CWT and, ten minutes later, a maximum cardiopulmonary exercise test. Also, testosterone and other hormones were determined at rest. RESULTS: Among hemodynamic variables only diastolic blood pressure on 6'CWT was correlated with testosterone levels(r =- 0.66, p = 0.007. The variables on exercise tests, VE/VCO2 slope and oxygen consumption did not show any correlation, except the distance at 6'CWT (r = 0.50, p = 0,047. Right and left ventricle ejection fraction showed inverse correlation with testosterone (r =- 0.55, p = 0.03 and r =- 0.69, p = 0.004 respectively. CONCLUSION: Testosterone levels correlated directly with distance at six-minute cardiopulmonary walk test and inversely with diastolic blood pressure, right and left ventricle ejection fraction in heart failure patients with erectile dysfunction. Further elucidation of mechanisms as regards testosterone action in these patients is warranted.

  10. Bronchial provocation testing does not detect exercise-induced laryngeal obstruction

    DEFF Research Database (Denmark)

    Walsted, Emil Schwarz; Hull, James H; Sverrild, Asger;

    2016-01-01

    and possible asthma referred over 6 months. All subjects received comprehensive assessment including a detailed clinical evaluation; pulmonary function testing, indirect and direct bronchial provocation testing, and CLE testing. Results Out of 37 subjects, moderate or severe EILO was diagnosed in 8 subjects......Introduction Exercise-induced laryngeal obstruction (EILO) is a key differential diagnosis for asthma in the presence of exertional respiratory symptoms. Continuous laryngoscopy during exercise (CLE), the current gold standard diagnostic test for EILO, has practical limitations. We aimed...... to establish if inspiratory flow data obtained during standard bronchoprovocation testing, to establish the presence of extra-thoracic hyper-responsiveness, may prove diagnostic for EILO and thus preclude requirement for CLE testing. Methods We consecutively evaluated 37 adult subjects with exertional dyspnoea...

  11. Impairment on cardiovascular and autonomic adjustments to maximal isometric exercise tests in offspring of hypertensive parents.

    Science.gov (United States)

    Francica, Juliana V; Heeren, Marcelo V; Tubaldini, Márcio; Sartori, Michelle; Mostarda, Cristiano; Araujo, Rubens C; Irigoyen, Maria-Cláudia; De Angelis, Kátia

    2013-06-01

    The objective of the present study was to compare cardiovascular and autonomic responses to a mental stress test and to a maximal isometric exercise test between offspring of normotensive (ON, n = 10) and hypertensive parents (OH, n = 10). Subjects underwent a 3-min Stroop Color Word Test and a maximal isometric exercise test performed in an isokinetic dynamometer with continuous RR interval monitoring. At rest, arterial pressure and heart rate were similar between groups, but there was a significant reduction in total RR interval variance (ON: 5933 ± 493 vs. OH: 2967 ± 390 ms(2)) and an increase in low-high frequency components ratio of heart rate variability (ON: 2.3 ± 0.4 vs. OH: 4.6 ± 0.8) in OH group. In the first minute of the mental stress test and after both tests, the OH group presented increased heart rate as compared with the ON group. After both tests, only the ON group presented an increase in sympathetic component, thus reaching resting values similar to those of the OH group. Our data demonstrated increased resting cardiac sympathetic modulation in offspring of hypertensive parents at similar levels to that observed in offspring of normotensive parents after a mental stress test or a maximal isometric exercise test. Additionally, the exacerbated heart rate responses to these physiological tests in OH subjects may be associated with resting autonomic dysfunction, thus reinforcing these evaluations as important tools for detecting early dysfunctions in this genetically predisposed population.

  12. Genetic research and testing in sport and exercise science: a review of the issues.

    Science.gov (United States)

    Wackerhage, Henning; Miah, Andy; Harris, Roger C; Montgomery, Hugh E; Williams, Alun G

    2009-09-01

    This review is based on the BASES position stand on "Genetic Research and Testing in Sport and Exercise Science". Our aims are first to introduce the reader to research in sport and exercise genetics and then to highlight ethical problems arising from such research and its applications. Sport and exercise genetics research in the form of transgenic animal and human association studies has contributed significantly to our understanding of exercise physiology and there is potential for major new discoveries. Researchers starting out in this field will have to ensure an appropriate study design to avoid, for example, statistically underpowered studies. Ethical concerns arise more from the applications of genetic research than from the research itself, which is assessed by ethical committees. Possible applications of genetic research are genetic performance tests or genetic tests to screen, for example, for increased risk of sudden death during sport. The concerns are that genetic performance testing could be performed on embryos and could be used to select embryos for transplantation or abortion. Screening for risk of sudden death may reduce deaths during sporting events but those that receive a positive diagnosis may suffer severe psychological consequences. Equally, it will be almost impossible to keep a positive diagnosis confidential if the individual tested is an elite athlete.

  13. The Role of Exercise Testing in the Modern Management of Pulmonary Arterial Hypertension

    Directory of Open Access Journals (Sweden)

    Martin K. Johnson

    2014-05-01

    Full Text Available A culture of exercise testing is firmly embedded in the management of pulmonary arterial hypertension (PAH but its clinical relevance and utility have recently been under some debate. The six minute walk test (6MWT has been used as a primary outcome measure to enable the licensing of many of the medications used for this condition. Recent reviews have questioned the validity of this test as a surrogate of clinical outcomes. At the same time, other questions are emerging where exercise testing may be the solution. With the rise in understanding of genetic markers of idiopathic PAH (IPAH, the screening of an otherwise healthy population for incipient pulmonary hypertension (PH will be required. The proliferation in treatment choices and identification of populations with PH where PAH treatment is not indicated, such as left heart and lung disease, requires more definitive differentiation from patients with PAH. There is a continuing question about the existence and clinical relevance of exercise induced PAH as a cause of unexplained dyspnoea and fatigue and as a latent phase of resting PH. This review presents a summary and critical analysis of the current role of exercise testing in PAH and speculates on future trends.

  14. Protective effect of D-ribose against inhibition of rats testes function at excessive exercise

    Directory of Open Access Journals (Sweden)

    Chigrinskiy E.A.

    2011-09-01

    Full Text Available An increasing number of research studies point to participation in endurance exercise training as having significant detrimental effects upon reproductive hormonal profiles in men. The means used for prevention and correction of fatigue are ineffective for sexual function recovery and have contraindications and numerous side effects. The search for substances effectively restoring body functions after overtraining and at the same time sparing the reproductive function, which have no contraindications precluding their long and frequent use, is an important trend of studies. One of the candidate substances is ribose used for correction of fatigue in athletes engaged in some sports.We studied the role of ribose deficit in metabolism of the testes under conditions of excessive exercise and the potentialities of ribose use for restoration of the endocrine function of these organs.45 male Wistar rats weighing 240±20 g were used in this study. Animals were divided into 3 groups (n=15: control; excessive exercise; excessive exercise and received ribose treatment. Plasma concentrations of lactic, β-hydroxybutyric, uric acids, luteinizing hormone, total and free testosterone were measured by biochemical and ELISA methods. The superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glucose-6-phosphate dehydrogenase activities and uric acids, malondialdehyde, glutathione, ascorbic acids, testosterone levels were estimated in the testes sample.Acute disorders of purine metabolism develop in rat testes under conditions of excessive exercise. These disorders are characterized by enhanced catabolism and reduced reutilization of purine mononucleotides and activation of oxidative stress against the background of reduced activities of the pentose phosphate pathway and antioxidant system. Administration of D-ribose to rats subjected to excessive exercise improves purine reutilization, stimulates the pentose phosphate pathway work

  15. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  16. Electrophysiological predictors of sudden cardiac death on physical exercise test in young athletes

    Science.gov (United States)

    Balykova, L. A.; Kotlyarov, A. A.; Ivyanskiy, S. A.; Shirokova, A. A.; Miheeva, K. A.; Makarov, L. M.

    2017-01-01

    The problem of sudden death of young athletes continues to be actual. Among its reasons, primary electric myocardium diseases along with organic heart troubles (cardiomyopathies, cordites, anomalies of coronary arteries) take an important place. The most frequent variant of channelopathesis long QT syndrome (LQTS). Both inherited and acquired LQTS may be the reason of sudden cardiac death during physical activity and have to be revealed prior to sports admission. LQTS diagnostics in young athletes become problematic due to secondary exercise-related QT prolongation. Physical load test may reveal myocardium electric instability and enhance LQTS diagnostics accuracy without genetic testing. The aim was to study electrophysiological parameters of myocardium repolarization and reveal the signs of electrical instability as predictors of the life-threatening arrhythmias in young athletes during physical exercise test. In conclusion, electrophysiological myocardium parameters during physical exercise test noted to be markers of electrical myocardial instability and in combination with the other Schwartz criteria, was evidenced the inherited or acquired LQTS. QTc prolongation in athletes at the peak of exercise as well as in early recovery period were noted to be additional predictor life-threatening arrhythmias and sudden cardiac death in young athletes

  17. The impact of discussing exercise test results of young asthmatic children on adherence to maintenance medication

    NARCIS (Netherlands)

    Visser, R.; Brusse-Keizer, M.; Palen, van der J.; Klok, T.; Thio, B.J.

    2015-01-01

    Objective: Parents’ awareness of their child’s asthma may improve by discussing an exercise challenge test (ECT) result with them. We investigated the influence of discussing an ECT result with parents on adherence to inhaled maintenance medication, parental illness perceptions and medication belief

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

    Science.gov (United States)

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

    1995-01-01

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

  19. Exercise persistence in the face of varying exercise challenges: a test of self-efficacy theory in working mothers.

    Science.gov (United States)

    Jung, Mary E; Brawley, Lawrence R

    2011-07-01

    Self-regulatory efficacy (SRE) should influence persistence towards goals. Mothers attempting to exercise while managing work and young children (N = 49, M(age) = 35.69, M(children) = 1.88) were stratified into high or low concurrent SRE groups, then randomized to read a hypothetical scenario detailing numerous or minimal exercise barrier conditions. Consistent with self-efficacy theory, when exercise barriers were numerous, mothers with higher concurrent SRE demonstrated greater persistence towards exercise goals, and perceived concurrent management of exercise with their other valued goals as more positively challenging, than mothers with lower concurrent SRE.

  20. Effect of preoperative exercise training on cardiopulmonary function in perioperative period of lung cancer patients with COPD%术前运动训练对肺癌合并 COPD 患者围术期心肺功能的影响

    Institute of Scientific and Technical Information of China (English)

    贺斌; 李新; 张鹏; 曹玎

    2015-01-01

    目的:探讨术前心肺运动训练对肺癌合并慢性阻塞性肺疾病(COPD)患者围术期心肺功能及术后并发症的影响。方法选取98例拟行肺癌切除术且合并COPD的肺癌患者,随机分为观察组和对照组各49例,两组术前均给予改善肺功能治疗,观察组同时行心肺运动训练2周。比较两组术前1天静态肺功能[用力肺活量(FVC)、1秒用力呼气容积、最大自主通气量(MVV)、一氧化碳弥散总量(DLCO)及术后预计FEV1]运动心肺功能[最大摄氧量(VO2max)、公斤摄氧量(VO2/kg)、无氧阈(AT)、氧脉搏(O2 pulse)、最大心率、最大分钟通气量(VEmax)及呼吸困难指数]的变化。比较两组术后并发症、氧疗时间、机械通气时间和住院时间。结果观察组FVC、MVV、DL CO、VO2 max、VO2/kg、AT、O2 pulse、VEmax较对照组均有不同程度的改善(P均<0.05);两组术后总体心肺并发症及单个并发症的发生率、术后氧疗时间、机械通气时间及住院天数比较差异均有统计学意义(P均<0.05)。结论术前心肺运动训练能明显改善肺癌合并 COPD患者的心肺功能,减少术后并发症、缩短住院时间,利于患者早日康复。%Objective To investigate the effect of preoperatively cardiopulmonary exercise training on the cardiopul -monary function and postoperative complications in lung cancer patients with chronic obstructive pulmonary disease ( COPD) .Methods Ninety-eight lung cancer patients with COPD who would receive lung cancer resection were randomly divided into two groups:the observation group and the control group , 49 cases in each group .Both groups were treated to improve the lung function before surgery , and the observation group was treated with cardiopulmonary exercise training for two weeks .The indicators of static lung function and dynamic cardiopulmonary exercise were compared between the two groups the day

  1. Comparison of exercise tests in French trotters under training track, racetrack and treadmill conditions.

    Science.gov (United States)

    Couroucé, A; Geffroy, O; Barrey, E; Auvinet, B; Rose, R J

    1999-07-01

    Standardised exercise tests were performed at 2 different tracks and on an uninclined treadmill during the same week to determine the influence of exercise surface on different measured variables such as heart rate (HR), blood lactate concentration, packed cell volume, stride frequency, stride length, gait symmetry and regularity and on different derived physiological variables such as the speed at a HR of 200 beats/min (V200), the speed at a blood lactate concentration of 4 mmol/l (V4), the speed at a maximal HR (VHRmax). Five French Trotters, age 3 years, in training for 3 months prior to the test, performed 3 exercise tests on a training track (Test 1), a racetrack (Test 2) and an uninclined treadmill (Test 3). Test 1 utilised 3 steps each of 3 min at speeds of 490, 560 and 630 m/min. Tests 2 and 3 utilised the same speeds and a fourth step in which the horse was accelerated for 30 s to speed approaching maximal. No significant differences (P < 0.05) were found for the physiological and locomotor variables between the 2 tracks. In contrast, there was a significant difference (P < 0.05) for these variables between the tracks and the treadmill, horses showing lower heart rate and blood lactate response, reduced stride frequency and increased stride length and regularity on the uninclined treadmill. We concluded that this standardised exercise test was repeatable on various tracks even when the surface and geometry vary. In contrast, both physiological and locomotor variables were different when comparing the tracks with the uninclined treadmill.

  2. Cardiopulmonary Fitness and Endurance in Children with Developmental Coordination Disorder

    Science.gov (United States)

    Wu, Sheng K.; Lin, Hsiao-Hui; Li, Yao-Chuen; Tsai, Chia-Liang; Cairney, John

    2010-01-01

    The purpose of this study was to compare cardiopulmonary fitness and endurance in 9-11-year-old children with DCD against a group of typically developing children in Taiwan. The Movement ABC test was used to evaluate the motor abilities of children. Forty-one participants (20 children with DCD and 21 children without DCD) were recruited for this…

  3. ROLE OF EXERCISE STRESS TEST IN DETECTING UNDERLYING MYOCARDIAL ISCHEMIA

    Directory of Open Access Journals (Sweden)

    Sachin N.

    2014-07-01

    Full Text Available BACKGROUND: Ischemic heart disease (IHD is the leading cause of death and disability in industrialized countries. In India also there is increasing trends of death and disability due to IHD. The prevalence of IHD in India is 96.7/1000 in urban and 27.1/1000 in rural areas. Main risk factors for IHD are diabetes mellitus, hypertension, obesity, smoking and hyperlipidemia. AIM: The present study aims at early detection of IHD which can prevent death and disability in persons with risk factors. DESIGN: The present study is cross sectional observational study carried out in the govt. medical college of rural Indian set-up. MATERIALS AND METHODS: The present study was carried out on 70 asymptomatic patients of age group 30-70 years with any of the above mentioned risk factors for IHD. The treadmill test was performed in these patients. STATISTICAL ANALYSIS: The analysis was done using MS office excel 2007 software. RESULTS: 24.22% patients showed positive treadmill test. This means 24.22% of patients were having underlying IHD though they were asymptomatic. CONCLUSION: Thus treadmill test is a valuable, non-invasive tool for early detection of myocardial ischemia among the asymptomatic patients with risk factors for coronary artery disease.

  4. QT hysteresis in long-QT syndrome children with exercise testing

    Institute of Scientific and Technical Information of China (English)

    GAO Dong-sheng; FANG Wei-yi; Christine Chiu-Man; Joel Kirsh; Gil Gross; Robert M.Hamilton

    2007-01-01

    Background Congenital long QT syndrome (LQTS) is an inherited ion channel disorder resulting in abnormal cardiac repolarization that can cause syncope and sudden death associated with a prolonged rate-corrected QT interval and polymorphic ventricular tachycardia. Several studies in adults showed that LQTS patients have altered QT adaptation to heart rate changes compared with normal subjects which forming a "hysteresis loop" in the QT-circle length plot. This study was to observe the QT interval changing during exercise testing in children long QT syndrome (LQTS) patients,explore the new diagnosis methods of LQTS.Methods The subjects were divided into 3 groups according to 1993 LQTS diagnostic criteria. Group 1: LQTS group(n=17) who scored > or = 4 points indicating definite LQTS. Group 2: Middle group (n=16), patients who have prolonged QT interval but scored 1.5 to 3.5. Group 3: Normal control group (n=18). The average age of all study population is (12.3±5.8) years. No case had beta-adrenergic antagonists administration before exercise testing. All subjects were underwent tread mill exercise testing and electrocardiograph in whole exercise testing and recovery were recorded. QT and heart rate changing during whole exercise testing period were recorded. △QT, the QT interval at 1, 2, 4, 6 minutes into recovery subtract from the QT interval at a similar heart rate during exercise, were calculated.Results In all three groups, QT intervals were shortening with the increasing of heart rate, but QTc had no significant change. △QT at 1 minute ((45±11) ms), 2 minutes ((37±15) ms), 4 minutes ((23±12) ms) into recovery in LQTS group were significantly greater than that of the other two groups (P<0.05, P<0.01, P<0.01, respectively). There was no△QT significant difference between middle group and normal control group at recovery time. During the recovery phase in LQTS group, the QT interval remained shortened despite a decelerating heart rate, forming a

  5. Blunted heart rate recovery is associated with exaggerated blood pressure response during exercise testing.

    Science.gov (United States)

    Dogan, Umuttan; Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Gok, Hasan

    2013-11-01

    Increased sympathetic activity and endothelial dysfunction are the proposed mechanisms underlying exaggerated blood pressure response to exercise (EBPR). However, data regarding heart rate behavior in patients with EBPR are lacking. We hypothesized that heart rate recovery (HRR) could be impaired in patients with EBPR. A total of 75 normotensive subjects who were referred for exercise treadmill test examination and experienced EBPR were included to this cross-sectional case-control study. The control group consisted of 75 age- and gender-matched normotensive subjects without EBPR. EBPR was defined as a peak exercise systolic blood pressure (BP) ≥210 mmHg in men and ≥190 mmHg in women. HRR was defined as the difference in HR from peak exercise to 1 min in recovery; abnormal HRR was defined as ≤12 beats/min. These parameters were compared with respect to occurrence of EBPR. Mean values of systolic and diastolic BP at baseline, peak exercise, and the first minute of the recovery were significantly higher in the subjects with EBPR. Mean HRR values were significantly lower (P recovery and degree of HRR in individuals without EBPR (r = 0.42, P recovery period. However, such a correlation was not found in subjects with EBPR. Our data suggest that mechanisms underlying the blunting of the HRR might be associated with the genesis of EBPR. The association between the extent of HRR and adverse cardiovascular outcomes in patients with EBPR needs to be investigated in detail in future research.

  6. THE EVALUATION OF CLONIDINE, INSULIN, L- DOPA, EXERCISE TESTS ON GROWTH HORMONE IN SHORT CHILDREN

    Directory of Open Access Journals (Sweden)

    A. Rabbani.

    1999-07-01

    Full Text Available Growth hormone stimulation tests have been used to assess the growth hormone reserve of the pituitary gland in both children and adults. We have assessed the effect of clonidine, insulin, L-Dopa and exercise on growth hormone secretion in 261 short children. The" results found in this study revealed that there are no significant differences in these stimulation tests (P=0.28 .

  7. The serum protein carbonyl content level in relation to exercise stress test

    Directory of Open Access Journals (Sweden)

    Titiporn Mekrungruangwong

    2012-01-01

    Full Text Available Background: Protein carbonyl (P is oxidatively-modified protein with diagnostic potential for acute myocardial infarction. However, many findings indicated the elevation of serum PC content level related to exercise, which could cause false positive results and limiting the specificity for acute coronary syndrome diagnosis. This study aims to evaluate the level of serum protein carbonyl content in healthy volunteers subjected to exercise stress test (EST. Materials and Methods: Serum from healthy volunteers was collected 5-10 min before performing EST and 1 hour after the EST was achieved. The serum was collected, and the serum PC content level was determined by spectrophotometric DNPH assay. Results: The serum PC content level after exercise stress test was significantly higher than that of before performing EST (0.373 ± 0.05 nM/mg vs. 0.275 ± 0.02 nM/mg, P < 0.0001. The results demonstrated that in both male and female, serum PC content level after EST was significantly higher than that of before performing EST (0.29 ± 0.03 nM/mg vs. 0.36 ± 0.05 nM/mg P < 0.0001 in male, 0.27 ± 0.02 nM/mg vs. 0.38 ± 0.06 nM/mg P < 0.0001 in female, respectively. Conclusions: This study demonstrated that exercise stress test could result in non-specificity and false positive increasing in serum PC content level in healthy subjects, which may cause misinterpretation when using PC as cardiac marker, especially in patients, who underwent exercise stress test or patients who performing heavy physical activities.

  8. Limited value of recovery phase-limited ST segment depression of treadmill exercise test

    Institute of Scientific and Technical Information of China (English)

    Yang Hongbo; Huang Zheyong; Lou Yi; Shen Yunli; Qian Juying; Ge Junbo

    2014-01-01

    Background Clinical meaning of recovery phase limited ST segment depression of a treadmill exercise test is controversial.The aim of this study was to re-assess the diagnostic and prognostic value of ST segment depression during the recovery phase with the active phase of a treadmill exercise test in suspected coronary artery disease patients.Methods Clinical,exercise and angiographic data were retrospectively collected from 602 patients in the study.Five hundred and seventy-six patients developed ST segment depression during the active phase of the treadmill exercise test (group 1) and 26 patients developed ST segment depression only during the recovery phase (group 2).Results With similar major clinical features,the prevalence of significant coronary artery stenosis and average Gensini scores were lower in the recovery phase-limited depression patients (group 2 vs.group 1,50.0% vs.66.9%,P=0.031 and group 2 vs.group 1,1.5 vs.8.5,P=0.04).At a median follow up of 50.9 months for 22 group 2 and 34.8 months for 438 group 1 patients,the prevalence of total cardiac events was higher in group 1 than in group 2 patients (RR 1.60,95% Cl 1.00-2.54,P=0.049).Conclusion The present study provides preliminary evidence that the diagnostic and prognostic value of recovery phaselimited ST segment depression of treadmill exercise test is limited.

  9. Potential neurobiological benefits of exercise in chronic pain and posttraumatic stress disorder: Pilot study.

    Science.gov (United States)

    Scioli-Salter, Erica; Forman, Daniel E; Otis, John D; Tun, Carlos; Allsup, Kelly; Marx, Christine E; Hauger, Richard L; Shipherd, Jillian C; Higgins, Diana; Tyzik, Anna; Rasmusson, Ann M

    2016-01-01

    This pilot study assessed the effects of cardiopulmonary exercise testing and cardiorespiratory fitness on plasma neuropeptide Y (NPY), allopregnanolone and pregnanolone (ALLO), cortisol, and dehydroepiandrosterone (DHEA), and their association with pain sensitivity. Medication-free trauma-exposed participants were either healthy (n = 7) or experiencing comorbid chronic pain/posttraumatic stress disorder (PTSD) (n = 5). Peak oxygen consumption (VO2) during exercise testing was used to characterize cardiorespiratory fitness. Peak VO2 correlated with baseline and peak NPY levels (r = 0.66, p exercise-induced changes in ALLO (r = 0.89, p exercise correlated with pain threshold 30 min after exercise (r = 0.65, p exercise-induced increases in ALLO correlated with pain tolerance 30 min after exercise (r = 0.64, p exercise-induced changes in cortisol and DHEA levels were inversely correlated with pain tolerance after exercise (r = -0.69, p exercise, which in turn relate to pain sensitivity. Future work will examine whether progressive exercise training increases cardiorespiratory fitness in association with increases in NPY and ALLO and reductions in pain sensitivity in chronic pain patients with PTSD.

  10. Effects of tiotropium on sympathetic activation during exercise in stable chronic obstructive pulmonary disease patients

    Directory of Open Access Journals (Sweden)

    Kitada S

    2012-05-01

    Full Text Available Kenji Yoshimura, Ryoji Maekura, Toru Hiraga, Seigo Kitada, Keisuke Miki, Mari Miki, Yoshitaka TateishiDepartment of Respiratory Medicine, Toneyama National Hospital, Osaka, JapanBackground: Tiotropium partially relieves exertional dyspnea and reduces the risk of congestive heart failure in chronic obstructive pulmonary disease (COPD patients. However, its effect on the sympathetic activation response to exercise is unknown.Aims: This study aimed to determine whether tiotropium use results in a sustained reduction in sympathetic activation during exercise.Methods: We conducted a 12-week, open-label (treatments: tiotropium 18 µg or oxitropium 0.2 mg × 3 mg, crossover study in 17 COPD patients. Treatment order was randomized across subjects. The subjects underwent a pulmonary function test and two modes of cardiopulmonary exercise (constant work rate and incremental exercise testing using a cycle ergometer, with measurement of arterial catecholamines after each treatment period.Results: Forced expiratory volume in 1 second and forced vital capacity were significantly larger in the tiotropium treatment group. In constant exercise testing, exercise endurance time was longer, with improvement in dyspnea during exercise and reduction in dynamic hyperinflation in the tiotropium treatment group. Similarly, in incremental exercise testing, exercise time, carbon dioxide production, and minute ventilation at peak exercise were significantly higher in the tiotropium treatment group. Plasma norepinephrine concentrations and dyspnea intensity were also lower during submaximal isotime exercise and throughout the incremental workload exercise in the tiotropium treatment group.Conclusion: Tiotropium suppressed the increase of sympathetic activation during exercise at the end of the 6-week treatment, as compared with the effect of oxipropium. This effect might be attributed to improvement in lung function and exercise capacity and reduction in exertional dyspnea

  11. Mechanism Development, Testing, and Lessons Learned for the Advanced Resistive Exercise Device

    Science.gov (United States)

    Lamoreaux, Christopher D.; Landeck, Mark E.

    2006-01-01

    The Advanced Resistive Exercise Device (ARED) has been developed at NASA Johnson Space Center, for the International Space Station (ISS) program. ARED is a multi-exercise, high-load resistive exercise device, designed for long duration, human space missions. ARED will enable astronauts to effectively maintain their muscle strength and bone mass in the micro-gravity environment more effectively than any other existing devices. ARED's resistance is provided via two, 20.3 cm (8 in) diameter vacuum cylinders, which provide a nearly constant resistance source. ARED also has a means to simulate the inertia that is felt during a 1-G exercise routine via the flywheel subassembly, which is directly tied to the motion of the ARED cylinders. ARED is scheduled to fly on flight ULF 2 to the ISS and will be located in Node 1. Presently, ARED is in the middle of its qualification and acceptance test program. An extensive testing program and engineering evaluation has increased the reliability of ARED by bringing potential design issues to light before flight production. Some of those design issues, resolutions, and design details will be discussed in this paper.

  12. Identification of patients at low risk of dying after acute myocardial infarction, by simple clinical and submaximal exercise test criteria.

    Science.gov (United States)

    Campbell, S; A'Hern, R; Quigley, P; Vincent, R; Jewitt, D; Chamberlain, D

    1988-09-01

    A consecutive series of 559 hospital survivors of acute myocardial infarction aged less than 66 years were studied; 93 were designated prospectively as low-risk because they were suitable for early submaximal exercise testing and had none of the following clinical or exercise test 'risk factors': (1) angina for at least one month prior to infarction; (2) symptomatic ventricular arrhythmias, or (3) recurrent ischaemic pain, both after the first 24 h of infarction; (4) cardiac failure; (5) cardiomegaly; and (6) an abnormal exercise test (angina, ST-depression or poor blood pressure response). Altogether 301 patients were exercised; their mortality over a median follow-up of 2.4 years was 10.2%, versus 24.6% in the 258 patients not exercised (P = 0.0005). Absence of clinical 'risk factors' alone, in the exercised patients, identified 156 with a mortality of 5.4% versus 15.6% in the 145 with at least one clinical 'risk factor' (P = 0.004). The fully defined low-risk group comprised 93 of the former patients who had neither clinical nor exercise test 'risk factors'. None of these patients died compared with 19 of those with at least one 'risk factor' (mortality = 14.7%; P = 0.002). Their respective rates of non-fatal reinfarction were similar and never exceeded 5% per annum. Therefore, simple clinical and exercise test criteria can positively identify low-risk patients after infarction in whom secondary prevention may be inappropriate.

  13. Effects of Obstructive Sleep Apnea and Obesity on Exercise Function in Children

    Science.gov (United States)

    Evans, Carla A.; Selvadurai, Hiran; Baur, Louise A.; Waters, Karen A.

    2014-01-01

    Study Objectives: Evaluate the relative contributions of weight status and obstructive sleep apnea (OSA) to cardiopulmonary exercise responses in children. Design: Prospective, cross-sectional study. Participants underwent anthropometric measurements, overnight polysomnography, spirometry, cardiopulmonary exercise function testing on a cycle ergometer, and cardiac doppler imaging. OSA was defined as ≥ 1 obstructive apnea or hypopnea per hour of sleep (OAHI). The effect of OSA on exercise function was evaluated after the parameters were corrected for body mass index (BMI) z-scores. Similarly, the effect of obesity on exercise function was examined when the variables were adjusted for OAHI. Setting: Tertiary pediatric hospital. Participants: Healthy weight and obese children, aged 7–12 y. Interventions: N/A. Measurements and Results: Seventy-one children were studied. In comparison with weight-matched children without OSA, children with OSA had a lower cardiac output, stroke volume index, heart rate, and oxygen consumption (VO2 peak) at peak exercise capacity. After adjusting for BMI z-score, children with OSA had 1.5 L/min (95% confidence interval -2.3 to -0.6 L/min; P = 0.001) lower cardiac output at peak exercise capacity, but minute ventilation and ventilatory responses to exercise were not affected. Obesity was only associated with physical deconditioning. Cardiac dysfunction was associated with the frequency of respiratory-related arousals, the severity of hypoxia, and heart rate during sleep. Conclusions: Children with OSA are exercise limited due to a reduced cardiac output and VO2 peak at peak exercise capacity, independent of their weight status. Comorbid OSA can further decrease exercise performance in obese children. Citation: Evans CA, Selvadurai H, Baur LA, Waters KA. Effects of obstructive sleep apnea and obesity on exercise function in children. SLEEP 2014;37(6):1103-1110. PMID:24882905

  14. Motivation contagion when instructing obese individuals: a test in exercise settings.

    Science.gov (United States)

    Ng, Johan Y Y; Thøgersen-Ntoumani, Cecilie; Ntoumanis, Nikos

    2012-08-01

    We examined motivation contagion in a hypothetical exercise setting. Exercise science students (n = 164) were provided with quotes of hypothetical male and female obese exercisers displaying different quality of motivation to start an exercise program. We used a 3 (exerciser motivation) × 2 (exerciser gender) × 2 (student gender) between-subjects experimental design to examine students' (a) motivation to instruct, (b) interpersonal style, (c) perception of barrier efficacy of the exerciser, and (d) effort to identify factors that could maximize the effectiveness of an exercise program for the exerciser. Results showed that students displayed less controlled motivation and rated the exerciser as more capable of overcoming barriers to exercise when they perceived the exerciser to be autonomously motivated. However, students, particularly females, reported more autonomy support and invested more effort toward female exercisers with controlled motivation. Our findings indicate that motivation contagion effects are plausible in exercise settings and may affect interactions between fitness instructors and obese clients.

  15. A perceptually regulated, graded exercise test predicts peak oxygen uptake during treadmill exercise in active and sedentary participants.

    Science.gov (United States)

    Eston, Roger; Evans, Harrison; Faulkner, James; Lambrick, Danielle; Al-Rahamneh, Harran; Parfitt, Gaynor

    2012-10-01

    The validity of predicting peak oxygen uptake ([Formula: see text]) in sedentary participants from a perceptually regulated exercise test (PRET) is limited to two cycle ergometry studies. We assessed the validity of a treadmill-based PRET. Active (n = 49; 40.7 ± 13.8 years) and sedentary (n = 26; 33.4 ± 13.2 y) participants completed two PRETS (PRET 1 and PRET2), requiring a change in speed or incline corresponding to ratings of perceived exertion (RPE) 9, 11, 13 and 15. Extrapolation of RPE: [Formula: see text] data to RPE 19 and 20 from the RPE 9-13 and 9-15 ranges were used to estimate [Formula: see text], and compared to [Formula: see text] from a graded exercise test (GXT). The [Formula: see text] :heart rate (HR) data (≥RPE 15) from the GXT were also extrapolated to age-predicted maximal HR (HRmax(pred)) to provide further estimation of [Formula: see text]. ANOVA revealed no significant differences between [Formula: see text] predictions from the RPE 9-15 range for PRET 1 and PRET 2 when extrapolated to RPE 19 in both active (54.3 ± 7.4; 52.9 ± 8.1 ml kg(-1) min(-1)) and sedentary participants (34.1 ± 10.2; 34.2 ± 9.6 ml kg(-1) min(-1)) and no difference between the HRmax(pred) method and measured [Formula: see text] from the GXT for active (53.3 ± 10.0; 53.9 ± 7.5 ml kg(-1) min(-1), respectively) and sedentary participants (33.6 ± 8.4, 34.4 ± 7.0 ml kg(-1) min(-1), respectively). A single treadmill-based PRET using RPE 9-15 range extrapolated to RPE 19 is a valid means of predicting [Formula: see text] in young and middle to older-aged individuals of varying activity and fitness levels.

  16. Motivation Contagion When Instructing Obese Individuals: A Test in Exercise Settings

    OpenAIRE

    Ntoumanis, Nikos; Thøgersen-Ntoumani, Cecilie; Ng, J

    2012-01-01

    We examined motivation contagion in a hypothetical exercise setting. Exercise science students (n = 164) were provided with quotes of hypothetical male and female obese exercisers displaying different quality of motivation to start an exercise program. We used a 3 (exerciser motivation) × 2 (exerciser gender) × 2 (student gender) between-subjects experimental design to examine students’ (a) motivation to instruct, (b) interpersonal style, (c) perception of barrier efficacy of the exerciser, a...

  17. History of the evolution of cardiopulmonary resuscitation

    OpenAIRE

    2013-01-01

    Cardiopulmonary resuscitation (CPR) is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, hist...

  18. Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia

    Directory of Open Access Journals (Sweden)

    Ana Carla Pereira de Araujo

    2014-11-01

    Full Text Available Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1 or positive (G2 for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%. During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016. The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022 and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p < 0. 001 and p = 0.001, respectively. Conclusion: Physical stress echocardiography provides additional prognostic information in patients with exercise test positive for myocardial ischemia.

  19. Reference value of long-time exercise test in the diagnosis of primary periodic paralysis

    Institute of Scientific and Technical Information of China (English)

    Ding Zeyu; Liu Mingsheng; Cui Liying

    2014-01-01

    Background The long-time exercise test (ET) is used to diagnose the primary periodic paralyses (PPs).However the reference values of ET are many and various.This study aimed to investigate the reference value of long-time ET in the diagnosis of PPs.Methods We recruited 108 healthy subjects,68 patients with PPs,and 72 patients with other diseases for the study.The procedure of ET was made on the basis of the McManis' method.Electrical responses were recorded from right abductor digiti minimi (ADM) muscle when stimulation of the ulnar nerve at the wrist.After the compound muscle action potential (CMAP) was monitored,subjects were then asked to contract the muscle as strongly as possible for 5 minutes.CMAPs were recorded for 2 seconds immediately after cessation of exercise,then every 5 minutes for 10 minutes,and finally every 10 minutes for 50 minutes.In general,the CMAP amplitudes will fall below the pre-exercise levels in an hour.The largest decrease was calculated and used as results of ET.Results The CMAP amplitude decreases had no significant differences between groups when the healthy adults were grouped according to age,gender,height,weight and test time.Decreases in PPs patients (57.76%) were significantly more than in healthy subjects (15.21%) and other disease patients (18.10%,P <0.001).Receiver operating characteristic (ROC) curve analysis showed that the best threshold is 35.50%.Conclusions In the long-time exercise test,threshold of 35.50% for the CMAP amplitude decrease was identified for abnormal.The result is not influenced by age,gender,height,weight,and test time.About 7.4% of healthy subjects were abnormal in ET.

  20. Exercise oscillatory ventilation:Mechanisms and prognostic significance

    Institute of Scientific and Technical Information of China (English)

    Bishnu P Dhakal; Gregory D Lewis

    2016-01-01

    Alteration in breathing patterns characterized by cyclic variation of ventilation during rest and during exercise has been recognized in patients with advanced heart failure(HF) for nearly two centuries. Periodic breathing(PB) during exercise is known as exercise oscillatory ventilation(EOV) and is characterized by the periods of hyperpnea and hypopnea without interposed apnea. EOV is a non-invasive parameter detected during submaximal cardiopulmonary exercise testing. Presence of EOV during exercise in HF patients indicates significant impairment in resting and exercise hemodynamic parameters. EOV is also an independent risk factor for poor prognosis in HF patients both with reduced and preserved ejection fraction irrespective of other gas exchange variables. Circulatory delay, increased chemosensitivity, pulmonary congestion and increased ergoreflex signaling have been proposed as the mechanisms underlying the generation of EOV in HF patients. There is no proven treatment of EOV but its reversal has been noted with phosphodiesterase inhibitors, exercise training and acetazolamide in relatively small studies. In this review, we discuss the mechanistic basis of PB during exercise and the clinical implications of recognizing PB patterns in patients with HF.

  1. Comportamento da hiperinsuflação dinâmica em teste em esteira rolante em pacientes com DPOC moderada a grave Dynamic hyperinflation during treadmill exercise testing in patients with moderate to severe COPD

    Directory of Open Access Journals (Sweden)

    Priscila Kessar Cordoni

    2012-02-01

    Full Text Available OBJETIVO: Caracterizar a presença, extensão e padrões de hiperinsuflação dinâmica (HD durante teste em esteira rolante em pacientes com DPOC moderada a grave. Métodos: Estudo transversal com 30 pacientes não hipoxêmicos (VEF1= 43 ± 14% do previsto submetidos a teste cardiopulmonar de exercício em esteira rolante em velocidade constante (70-80% da velocidade máxima até o limite da tolerância (Tlim. Manobras seriadas de capacidade inspiratória (CI foram utilizadas para avaliação da HD. RESULTADOS: Dos 30 pacientes estudados, 19 (63,3% apresentaram HD (grupo HD+, que apresentaram maior comprometimento funcional em repouso do que os pacientes sem HD (grupo HD-. Nenhuma das variáveis obtidas relacionou-se com a tolerância ao exercício no grupo HD-, enquanto Tlim, CI e percepção de dispneia ao esforço foram significativamente correlacionados no grupo HD+ (p OBJECTIVE: To characterize the presence, extent, and patterns of dynamic hyperinflation (DH during treadmill exercise testing in patients with moderate to severe COPD. METHODS: This was a cross-sectional study involving 30 non-hypoxemic patients (FEV1= 43 ± 14% of predicted who were submitted to a cardiopulmonary exercise test on a treadmill at a constant speed (70-80% of maximum speed to the tolerance limit (Tlim. Serial inspiratory capacity (IC maneuvers were used in order to assess DH. RESULTS: Of the 30 patients studied, 19 (63.3% presented with DH (DH+ group, having greater pulmonary function impairment at rest than did those without DH (DH- group. None of the variables studied correlated with exercise tolerance in the DH- group, whereas Tlim, IC, and perception of dyspnea during exercise did so correlate in the DH+ group (p < 0.05. In the DH+ group, 7 and 12 patients, respectively, presented with a progressive and a stable pattern of DH (ΔIC Tlim,2min = -0.28 ± 0.11 L vs. 0.04 ± 0.10 L; p < 0.01. Patients with a progressive pattern of DH presented with higher

  2. Clinical and pathological characteristics of mitochondrial myopathy and the screening value of simplified serum lactic acid exercise test

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    Xiao-fen ZHU

    2016-12-01

    Full Text Available Objective To analyze clinical and pathological characteristics of mitochondrial myopathy (MM in 15 patients, and to study the value of simplified serum lactic acid exercise test in the screening of mitochondrial myopathy.  Methods A total of 15 patients with mitochondrial myopathy diagnosed clinically and pathologically, 11  patients with other muscular diseases (OM, and 21 normal controls were collected. All subjects went up and down stairs for 5 min with medium effort. Blood samples for serum lactic acid detection were collected from all subjects before exercise, immediately after exercise and 10 min after exercise. Serum lactic acid levels were compared among 3 groups and among 3 time points. Results Patients with mitochondrial myopathy mainly presented as paroxysmally progressive muscular   soreness and weakness. Histopathological examination showed there were 8 cases with the proportion of ragged red fibers (RRF more than 5%. Serum lactic acid level before exercise, immediately after exercise and 10 min after exercise were (3.57 ± 1.88, (10.98 ± 4.84 and (7.87 ± 4.38 mmol/L in MM group, (1.89 ± 0.98, (6.05 ± 4.07 and (4.13 ± 3.14 mmol/L in OM group, (1.91 ± 0.53, (3.37 ± 1.22 and (2.52 ± 0.89 mmol/L in control group. Serum lactic acid level in MM group was significantly higher than that in control and OM groups before exercise (P = 0.000, 0.001, immediately after exercise (P = 0.000, 0.001, and 10 min after exercise (P = 0.000, 0.003. Serum lactic acid level in OM group was significantly higher than that in control group immediately after exercise (P = 0.042. Serum lactic acid level in 3 groups immediately after exercise (P = 0.000, 0.000, 0.003 and 10 min after exercise (P = 0.000, 0.000, 0.013 was significantly higher than that before exercise. Serum lactic acid level immediately after exercise was significantly higher than that 10 min after exercise in 3 groups (P = 0.000, 0.000, 0.003. Serum lactic acid level had most

  3. Health Evaluation for Hypertensive Population Using Exercise Testing and Health-related Quality of Life Questionnaire

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objectives This study aims to assess the impacts of hypertension on health-related quality of life (HRQOL), as well as cardiovascular functional status (CVFS). Methods An instrument was presented based on WHOQOL-BREF and SP-16 questionnaire and exercise testing. 57 normotensive and 76 hypertensive subjects aged 35-65 year-old participated the health survey using this instrument.Based on the exercise testing results of the two groups, a discriminate function was established and used to investigate cardiovascular risk factors for hypertensive population. Results The results showed that persons with hypertension rated significantly lower scores on physical health (i.e. limitation in performing daily activities and problems with work or mobility) than did normotensives (P < 0.01). The discriminant score obtained from the exercise testing results was capable of reflecting the impacts of hypertension on CVFS. Conclusions The method presented in this paper provides a more powerful tool to estimate the effects of health interventions and medical therapy for hypertensive population than just self-rated HRQOL questionnaire.

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

    Science.gov (United States)

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

    2011-12-01

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

  5. Comparing core stability and traditional trunk exercise on chronic low back pain patients using three functional lumbopelvic stability tests.

    Science.gov (United States)

    Shamsi, Mohammad Bagher; Sarrafzadeh, Javad; Jamshidi, Aliashraf

    2015-02-01

    It is a matter of controversy whether core stability exercise is preferred to other types of exercise for chronic low back pain. Lumbopelvic stability is an important element in low back pain. No study was found using lumbopelvic stability tests in comparing core stability and other exercises. The single leg squat, dip test, and runner pose test appear to be suitable as tests for lumbopelvic stability. The aim of this study was to compare "core stability" and "traditional trunk exercise" using these tests and also the Oswestry disability questionnaire and pain intensity. Twenty-nine non-specific chronic low back pain subjects were alternately allocated in one of the two exercise groups. For both groups, a 16-sessions exercise program was provided. Before and after training: (1) video was recorded while subjects performed the tests; (2) Oswestry disability questionnaire was completed; and (3) pain intensity was measured by visual analogue scale. The test videos were scored by three physiotherapists. Statistical analysis revealed a significant improvement in stability test scores (p = 0.020 and p = 0.041) and reduction in disability (p stability or equal effectiveness of TTE and CSE on improving LPS. The non-significant differences may also be attributable to the lack of sensitivity of our tests to assess stability change in two groups after training given the relatively small sample size.

  6. Effect of chronic neuromuscular electrical stimulation on primary cardiopulmonary exercise test variables in heart failure patients: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Laura Maria Tomazi Neves

    2014-11-01

    Conclusions: CPX performance has substantial prognostic and functional importance in the HF population. Our results suggest that NMES improves CPX performance and thus may be a valuable therapeutic intervention, positively altering the clinical trajectory of patients with HF.

  7. NASA's Functional Task Test: High Intensity Exercise Improves the Heart Rate Response to a Stand Test Following 70 Days of Bedrest

    Science.gov (United States)

    Laurie, Steven S.; Lee, Stuart M. C.; Phillips, Tiffany R.; Dillon, E. Lichar; Sheffield-Moore, Melinda; Urban, Randall J.; Ploutz-Snyder, Lori; Stenger, Michael B.; Bloomberg, Jacob J.

    2015-01-01

    Cardiovascular adaptations due to spaceflight are modeled with 6deg head-down tilt bed rest (BR) and result in decreased orthostatic tolerance. We investigated if high-intensity resistive and aerobic exercise with and without testosterone supplementation would improve the heart rate (HR) response to a 3.5-min stand test and how quickly these changes recovered following BR. During 70 days of BR male subjects performed no exercise (Control, n=10), high intensity supine resistive and aerobic exercise (Exercise, n=9), or supine exercise plus supplemental testosterone (Exercise+T, n=8; 100 mg i.m., weekly in 2-week on/off cycles). We measured HR for 2 min while subjects were prone and for 3 min after standing twice before and 0, 1, 6, and 11 days after BR. Mixed-effects linear regression models were used to evaluate group, time, and interaction effects. Compared to pre-bed rest, prone HR was elevated on BR+0 and BR+1 in Control, but not Exercise or Exercise+T groups, and standing HR was greater in all 3 groups. The increase in prone and standing HR in Control subjects was greater than either Exercise or Exercise+T groups and all groups recovered by BR+6. The change in HR from prone to standing more than doubled on BR+0 in all groups, but was significantly less in the Exericse+T group compared to the Control, but not Exercise group. Exercise reduces, but does not prevent the increase in HR observed in response to standing. The significantly lower HR response in the Exercise+T group requires further investigation to determine physiologic significance.

  8. Treadmill exercise testing of asymptomatic men and women without evidence of heart disease

    Directory of Open Access Journals (Sweden)

    W.A. Chalela

    2009-12-01

    Full Text Available The aim of this study was to test the hypothesis of differences in performance including differences in ST-T wave changes between healthy men and women submitted to an exercise stress test. Two hundred (45.4% men and 241 (54.6% women (mean age: 38.7 ± 11.0 years were submitted to an exercise stress test. Physiologic and electrocardiographic variables were compared by the Student t-test and the chi-square test. To test the hypothesis of differences in ST-segment changes, data were ranked with functional models based on weighted least squares. To evaluate the influence of gender and age on the diagnosis of ST-segment abnormality, a logistic model was adjusted; P < 0.05 was considered to be significant. Rate-pressure product, duration of exercise and estimated functional capacity were higher in men (P < 0.05. Sixteen (6.7% women and 9 (4.5% men demonstrated ST-segment upslope ≥0.15 mV or downslope ≥0.10 mV; the difference was not statistically significant. Age increase of one year added 4% to the chance of upsloping of segment ST ≥0.15 mV or downsloping of segment ST ≥0.1 mV (P = 0.03; risk ratio = 1.040, 95% confidence interval (CI = 1.002-1.080. Heart rate recovery was higher in women (P < 0.05. The chance of women showing an increase of systolic blood pressure ≤30 mmHg was 85% higher (P = 0.01; risk ratio = 1.85, 95%CI = 1.1-3.05. No significant difference in the frequency of ST-T wave changes was observed between men and women. Other differences may be related to different physical conditioning.

  9. [A study of cardiac dynamics during multistage exercise tests performed on a bycicle ergometer (author's transl)].

    Science.gov (United States)

    Gobbato, F; Fiorito, A; Cornelio, G

    1977-05-01

    The authors analysed the behaviour of the mechanical systole (electromechanical systole; tension time, left ventricular ejection time), as well as of the diastole (both cardiac and hemodynamic diastole) during exercise tests performed on a bycicle ergometer, with 40, 80, 120 watt workloads. The mechanical systole--as well as its components--duration is influenced, during exercise test, by both heart rate and stroke volume--pulse pressure being assumed as an indirect index of the latter. The study of the correlation between the two above mentioned parameters has a great importance in evaluating the cardiac pump efficiency both in health and disease. The study of the behaviour of diastole is likewise very important, as it provides useful information concerning: a) the length of the cardiac muscle post-exercise recovery phase; b) the coronary available perfusion time; c) the Windkessel (arterial bellows) emptying time. Moreover, the blood pressure fall rate in diastole is an useful indirect measure of the peripheral resistance changes during muscular work. A statistical analysis is made and the correlation coefficients and the regression equations between the various parameters are defined.

  10. Exercise as a provocative test in early renal disease in type 1 (insulin-dependent) diabetes

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, B; Baker, L; Deckert, T

    1985-01-01

    The value of exercise as a provocative test for early renal disease in Type 1 (insulin-dependent) diabetes was re-evaluated. Three carefully characterized groups of males were studied: 10 non-diabetic controls, 16 diabetic patients (group 1) with normal urinary albumin excretion (less than 15...... micrograms/min) and 14 Albustix-negative diabetics (group 2) with increased urinary albumin excretion (15-122 micrograms/min). Assignment to a study group was made on the basis of three 24-h urine collections, and the groups were well matched for age, weight, height, and serum creatinine concentration....... The two diabetic groups were similar with regard to duration of disease (13 +/- 6 versus 16 +/- 3 years), metabolic control (HbA1c: 8.4 +/- 1.4 versus 8.7 +/- 1.3%) and degree of diabetic complications (beat-to-beat variation and retinopathy). An exercise protocol of 450 and 600 kpm/min workloads...

  11. Exercise testing in hypertensive patients taking different angiotensin-converting enzyme inhibitors

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    Maria Angela M. Q. Carreira

    2003-02-01

    Full Text Available OBJECTIVE: To compare blood pressure response to dynamic exercise in hypertensive patients taking trandolapril or captopril. METHODS: We carried out a prospective, randomized, blinded study with 40 patients with primary hypertension and no other associated disease. The patients were divided into 2 groups (n=20, paired by age, sex, race, and body mass index, and underwent 2 symptom-limited exercise tests on a treadmill before and after 30 days of treatment with captopril (75 to 150 mg/day or trandolapril (2 to 4 mg/day. RESULTS: The groups were similar prior to treatment (p<0.05, and both drugs reduced blood pressure at rest (p<0.001. During treatment, trandolapril caused a greater increase in functional capacity (+31% than captopril (+17%; p=0.01 did, and provided better blood pressure control during exercise, observed as a reduction in the variation of systolic blood pressure/MET (trandolapril: 10.7±1.9 mmHg/U vs 7.4±1.2 mmHg/U, p=0.02; captopril: 9.1±1.4 mmHg/U vs 11.4±2.5 mmHg/U, p=0.35, a reduction in peak diastolic blood pressure (trandolapril: 116.8±3.1 mmHg vs 108.1±2.5 mmHg, p=0.003; captopril: 118.2±3.1 mmHg vs 115.8±3.3 mmHg, p=0.35, and a reduction in the interruption of the tests due to excessive elevation in blood pressure (trandolapril: 50% vs 15%, p=0.009; captopril: 50% vs 45%, p=0.32. CONCLUSION: Monotherapy with trandolapril is more effective than that with captopril to control blood pressure during exercise in hypertensive patients.

  12. The relation between BMI with exercise test in individuals with cardiac ischemic pains

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    Ravanbakhsh Esmaeili1

    2009-01-01

    Full Text Available (Received 19 Nov, 2008; Accepted 28 Jan, 2009AbstractBackground and purpose: Prevalence of over weight and obesity is increasing in the world. Those over weight are more susceptible to cardiovascular diseases than other individual's. Studies indicate that body fat distribution has a determining role in the identification of risk factors. Also, the relation between BMI, cardiac ischemic pains and exercise test condition in such patients, is in need further investigation. The aim of this study was to determine the relation between BMI with exercise tolerance test in patients with cardiac ischemic pains, who were referred to the Cardiac Center of Mazandaran Province, in Sari Township.Materials and methods: In this case control study considering the BMI in ischemic patients, 65 were selected as case and 65 persons as control using Tread mill and according to Bruce Protocol, results and tolerance test time was recorded. Independent T test was used for comparison of quantitative indexes mean, while x2 test using SPSS soft ware was used for comparison of the ratio of persons with the qualitative features.Results: Data indicated mean weight of 57.1 kg and height of 1.64m in the case group. Also, 58.5% had history of hyperlipidemia (Cholesterol higher than 200mg/dl and 78.8% with history of blood sugar (higher than 120mg/dl (P<0.001. Even 63.6% had hypertension of 140/9o mm Hg. Our findings showed that BMI in the case and control groups were (26.95±3.94 and (25.95±3.49 respectively. Moreover, a significant relationship between high BMI with cardiac ischemic pains and exercise tolerance test (P<0.001 were demonstrated.Conclusion: Cardiac ischemic pains in individuals with high BMI is common. Exercise tolerance test as one of the non invasive and less expensive procedures, can be an indicator of cardiac ischemic disease.J Mazand Univ Med Sci 2009; 19(68: 64-69 (Persian

  13. Multiple dimensions of cardiopulmonary dyspnea

    Institute of Scientific and Technical Information of China (English)

    HAN Jiang-na; XIONG Chang-ming; YAO Wei; FANG Qiu-hong; ZHU Yuan-jue; CHENG Xian-sheng; Karel P Van de Woestijne

    2011-01-01

    Background The current theory of dyspnea perception presumes a multidimensional conception of dyspnea.However,its validity in patients with cardiopulmonary dyspnea has not been investigated.Methods A respiratory symptom checklist incorporating spontaneously reported descriptors of sensory experiences of breathing discomfort,affective aspects,and behavioral items was administered to 396 patients with asthma,chronic obstructive pulmonary disease (COPD),diffuse parenchymal lung disease,pulmonary vascular disease,chronic heart failure,and medically unexplained dyspnea.Symptom factors measuring different qualitative components of dyspnea were derived by a principal component analysis.The separation of patient groups was achieved by a variance analysis on symptom factors.Results Seven factors appeared to measure three dimensions of dyspnea:sensory (difficulty breathing and phase of respiration,depth and frequency of breathing,urge to breathe,wheeze),affective (chest tightness,anxiety),and behavioral (refraining from physical activity) dimensions.Difficulty breathing and phase of respiration occurred more often in COPD,followed by asthma (R2=0.12).Urge to breathe was unique for patients with medically unexplained dyspnea (R2=0.12).Wheeze occurred most frequently in asthma,followed by COPD and heart failure (R2=0.17).Chest tightness was specifically linked to medically unexplained dyspnea and asthma (R2=0.04).Anxiety characterized medically unexplained dyspnea (R2=0.08).Refraining from physical activity appeared more often in heart failure,pulmonary vascular disease,and COPD (R2=0.15).Conclusions Three dimensions with seven qualitative components of dyspnea appeared in cardiopulmonary disease and the components under each dimension allowed separation of different patient groups.These findings may serve as a validation on the multiple dimensions of cardiopulmonary dyspnea.

  14. History of cardiopulmonary bypass (CPB).

    Science.gov (United States)

    Hessel, Eugene A

    2015-06-01

    The development of cardiopulmonary bypass (CPB), thereby permitting open-heart surgery, is one of the most important advances in medicine in the 20th century. Many currently practicing cardiac anesthesiologists, cardiac surgeons, and perfusionists are unaware of how recently it came into use (60 years) and how much the practice of CPB has changed during its short existence. In this paper, the development of CPB and the many changes and progress that has taken place over this brief period of time, making it a remarkably safe endeavor, are reviewed. The many as yet unresolved questions are also identified, which sets the stage for the other papers in this issue of this journal.

  15. Graded Maximal Exercise Testing to Assess Mouse Cardio-Metabolic Phenotypes.

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    Jennifer M Petrosino

    Full Text Available Functional assessments of cardiovascular fitness (CVF are needed to establish animal models of dysfunction, test the effects of novel therapeutics, and establish the cardio-metabolic phenotype of mice. In humans, the graded maximal exercise test (GXT is a standardized diagnostic for assessing CVF and mortality risk. These tests, which consist of concurrent staged increases in running speed and inclination, provide diagnostic cardio-metabolic parameters, such as, VO2max, anaerobic threshold, and metabolic crossover. Unlike the human-GXT, published mouse treadmill tests have set, not staged, increases in inclination as speed progress until exhaustion (PXT. Additionally, they often lack multiple cardio-metabolic parameters. Here, we developed a mouse-GXT with the intent of improving mouse-exercise testing sensitivity and developing translatable parameters to assess CVF in healthy and dysfunctional mice. The mouse-GXT, like the human-GXT, incorporated staged increases in inclination, speed, and intensity; and, was designed by considering imitations of the PXT and differences between human and mouse physiology. The mouse-GXT and PXTs were both tested in healthy mice (C57BL/6J, FVBN/J to determine their ability to identify cardio-metabolic parameters (anaerobic threshold, VO2max, metabolic crossover observed in human-GXTs. Next, theses assays were tested on established diet-induced (obese-C57BL/6J and genetic (cardiac isoform Casq2-/- models of cardiovascular dysfunction. Results showed that both tests reported VO2max and provided reproducible data about performance. Only the mouse-GXT reproducibly identified anaerobic threshold, metabolic crossover, and detected impaired CVF in dysfunctional models. Our findings demonstrated that the mouse-GXT is a sensitive, non-invasive, and cost-effective method for assessing CVF in mice. This new test can be used as a functional assessment to determine the cardio-metabolic phenotype of various animal models or

  16. Swim training does not protect mice from skeletal muscle oxidative damage following a maximum exercise test.

    Science.gov (United States)

    Barreto, Tatiane Oliveira; Cleto, Lorena Sabino; Gioda, Carolina Rosa; Silva, Renata Sabino; Campi-Azevedo, Ana Carolina; de Sousa-Franco, Junia; de Magalhães, José Carlos; Penaforte, Claudia Lopes; Pinto, Kelerson Mauro de Castro; Cruz, Jader dos Santos; Rocha-Vieira, Etel

    2012-07-01

    We investigated whether swim training protects skeletal muscle from oxidative damage in response to a maximum progressive exercise. First, we investigated the effect of swim training on the activities of the antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), in the gastrocnemius muscle of C57Bl/6 mice, 48 h after the last training session. Mice swam for 90 min, twice a day, for 5 weeks at 31°C (± 1°C). The activities of SOD and CAT were increased in trained mice (P swim test. Compared to control mice (untrained, not acutely exercised), malondialdehyde (MDA) levels were increased in the skeletal muscle of both trained and untrained mice after maximum swim. The activity of GPx was increased in the skeletal muscle of both trained and untrained mice, while SOD activity was increased only in trained mice after maximum swimming. CAT activity was increased only in the untrained compared to the control group. Although the trained mice showed increased activity of citrate synthase in skeletal muscle, swim performance was not different compared to untrained mice. Our results show an imbalance in the activities of SOD, CAT and GPx in response to swim training, which could account for the oxidative damage observed in the skeletal muscle of trained mice in response to maximum swim, resulting in the absence of improved exercise performance.

  17. Sex differences in response to maximal exercise stress test in trained adolescents

    Directory of Open Access Journals (Sweden)

    Fomin Åsa

    2012-08-01

    Full Text Available Abstract Background Sex comparisons between girls and boys in response to exercise in trained adolescents are missing and we investigated similarities and differences as a basis for clinical interpretation and guidance. Methods A total of 24 adolescent females and 27 adolescent males aged 13–19 years underwent a maximal bicycle exercise stress test with measurement of cardiovascular variables, cardiac output, lung volumes, metabolic factors/lactate concentrations and breath-by-breath monitoring of ventilation, and determination of peak VO2. Results Maximum heart rate was similar in females (191 ± 9 bpm and males (194 ± 7 bpm, cardiac index at maximum exercise was lower in females (7.0 ± 1.0 l/min/m2 than in males (8.3 ± 1.4 l/min/m2, P 2 was lower in females (2.37 ± 0.34 l/min than in males (3.38 ± 0.49 l/min, P 2 was normalized to leg muscle mass sex differences disappeared (females: 161 ± 21 ml/min/kg vs. males: 170 ± 23 ml/min/kg. The increase in cardiac index during exercise is the key factor responsible for the greater peak VO2 in adolescent boys compared to girls. Conclusions Differences in peak VO2 in adolescent boys and girls disappear when peak VO2 is normalized to estimated leg muscle mass and therefore provide a tool to conduct individual and intersex comparisons of fitness when evaluating adolescent athletes in aerobic sports.

  18. Inspiratory Capacity during Exercise: Measurement, Analysis, and Interpretation

    Directory of Open Access Journals (Sweden)

    Jordan A. Guenette

    2013-01-01

    Full Text Available Cardiopulmonary exercise testing (CPET is an established method for evaluating dyspnea and ventilatory abnormalities. Ventilatory reserve is typically assessed as the ratio of peak exercise ventilation to maximal voluntary ventilation. Unfortunately, this crude assessment provides limited data on the factors that limit the normal ventilatory response to exercise. Additional measurements can provide a more comprehensive evaluation of respiratory mechanical constraints during CPET (e.g., expiratory flow limitation and operating lung volumes. These measurements are directly dependent on an accurate assessment of inspiratory capacity (IC throughout rest and exercise. Despite the valuable insight that the IC provides, there are no established recommendations on how to perform the maneuver during exercise and how to analyze and interpret the data. Accordingly, the purpose of this manuscript is to comprehensively examine a number of methodological issues related to the measurement, analysis, and interpretation of the IC. We will also briefly discuss IC responses to exercise in health and disease and will consider how various therapeutic interventions influence the IC, particularly in patients with chronic obstructive pulmonary disease. Our main conclusion is that IC measurements are both reproducible and responsive to therapy and provide important information on the mechanisms of dyspnea and exercise limitation during CPET.

  19. Evaluation of coma patients after cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    SU Ying-ying; YANG Qing-lin; PANG Ying; LV Xiang-ping

    2005-01-01

    Background Coma after cardiopulmonary resuscitation (CPR) is commonly seen in daily clinical practice. How to objectively evaluate brain function after CPR is essential to the following treatment. Coma patients after CPR had been studied prospectively at the Neuro-Intensive Care Unit of Xuanwu Hospital since 2002. In this study, we focused on the topic of how to evaluate the severity of coma after CPR .Methods From April 2002 to November 2004, patients in coma 24 hours after CPR were monitored, the evaluation methods included Glasgow coma score (GCS),brain stem reflection, and spinal reflection. Laboratory evaluation included electroencephalography (EEG),brainstem auditory evoked potential (BAEP), short latency somatosensory evoked potential (SLSEP), and transcranial Doppler (TCD) .Results Twenty-four of 35 patients(68.57%)were in deep coma. The GCS was 3 except for 2 patients;EEG was evaluated not less than grade Ⅳ except for 4 patients, BAEP was evaluated as grade Ⅲ except for 3 patients, and SLSEP was evaluated as grade Ⅲ except for 1 patient.Twenty-four patients died within 1 month and 11 of them(45.83%)were determined as brain death. Glasgow outcome score (GOS) was evaluated as grade Ⅰ. Eleven of the 35 patients survived and their consciousness changed from deep coma to coma vigil. EEG was evaluated as gradeⅠin 5 patients, BAEP and SLSEP were evaluated as grade Ⅰ in 3 patients, and GOS was all evaluated as grade Ⅱ among the 11 patients.Two patients(18.18%)regained consciousness in 35 and 90 days after cardiopulmonary resuscitation and GOS was evaluated as grade Ⅳ and Ⅲ, respectively.Conclusion Combined or continuous evaluation of clinical examinations and laboratory tests can accurately and objectively determine brain function after CPR.

  20. Dimensions of Compulsive Exercise across Eating Disorder Diagnostic Subtypes and the Validation of the Spanish Version of the Compulsive Exercise Test

    Science.gov (United States)

    Sauchelli, Sarah; Arcelus, Jon; Granero, Roser; Jiménez-Murcia, Susana; Agüera, Zaida; Del Pino-Gutiérrez, Amparo; Fernández-Aranda, Fernando

    2016-01-01

    Objectives: Compulsive exercise in eating disorders has been traditionally considered as a behavior that serves the purpose of weight/shape control. More recently, it has been postulated that there may be other factors that drive the compulsive need to exercise. This has led to the development of the Compulsive Exercise Test (CET); a self-reported questionnaire that aims to explore the cognitive-behavioral underpinnings of compulsive exercise from a multi-faceted perspective. The objectives of this study were threefold: (1) to validate the Spanish version of the CET; (2) to compare eating disorder diagnostic subtypes and a healthy control group in terms of the factors that drive compulsive exercise as defined by the CET; (3) to explore how the dimensions evaluated in the CET are associated with eating disorder symptoms and general psychopathology. Methods: The CET was administered to a total of 157 patients with an eating disorder [40 anorexia nervosa, 56 bulimia nervosa (BN), and 61 eating disorder not-otherwise-specified (EDNOS)] and 128 healthy weight/eating controls. Patients were assessed via a semi-structured interview to reach a DSM-IV-TR diagnosis. Additionally, all participants completed the Symptom Checklist-90-Revised (SCL-90R) and the Eating Disorders Inventory-2 (EDI-2). Results: Confirmatory factor analysis demonstrated adequate goodness-of-fit to the original five-factor model of the CET. BN and EDNOS patients scored higher in the avoidance and rule-driven behavior, weight control, and total CET scales in comparison to the healthy controls, and higher across all scales apart from the exercise rigidity scale compared to the anorexia nervosa patients. Mean scores of the anorexia nervosa patients did not differ to those of the control participants, except for the mood improvement scale where the anorexia nervosa patients obtained a lower mean score. Mean scores between the BN and EDNOS patients were equivalent. The CET scales avoidance and rule

  1. DIMENSIONS OF COMPULSIVE EXERCISE ACROSS EATING DISORDER DIAGNOSTIC SUBTYPES AND THE VALIDATION OF THE SPANISH VERSION OF THE COMPULSIVE EXERCISE TEST.

    Directory of Open Access Journals (Sweden)

    Sarah Sauchelli

    2016-11-01

    Full Text Available Objectives: Compulsive exercise in eating disorders has been traditionally considered as a behavior that serves the purpose of weight/shape control. More recently, it has been postulated that there may be other factors that drive the compulsive need to exercise. This has led to the development of the Compulsive Exercise Test (CET; a self-reported questionnaire that aims to explore the cognitive-behavioral underpinnings of compulsive exercise from a multi-faceted perspective. The objectives of this study were threefold: 1 To validate the Spanish version of the CET; 2 To compare eating disorder diagnostic subtypes and a healthy control group in terms of the factors that drive compulsive exercise as defined by the CET; 3 To explore how the dimensions evaluated in the CET are associated with eating disorder symptoms and general psychopathology. Methods: The CET was administered to a total of 157 patients with an eating disorder (40 anorexia nervosa, 56 bulimia nervosa, 61 eating disorder not-otherwise-specified (EDNOS and 128 healthy weight/eating controls. Patients were assessed via a semi-structured interview to reach a DSM-IV-TR diagnosis. Additionally, all participants completed the Symptom Checklist-90-Revised (SCL-90R and the Eating Disorders Inventory-2 (EDI-2. Results: Confirmatory factor analysis demonstrated adequate goodness-of-fit to the original five-factor model of the CET. Bulimia nervosa and EDNOS patients scored higher in the avoidance and rule-driven behavior, weight control and total CET scales in comparison to the healthy controls, and higher across all scales apart from the exercise rigidity scale compared to the anorexia nervosa patients. Mean scores of the anorexia nervosa patients did not differ to those of the control participants, except for the mood improvement scale where the anorexia nervosa patients obtained a lower mean score. Mean scores between the bulimia nervosa and EDNOS patients were equivalent. The CET scales

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

    Science.gov (United States)

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

    2017-01-01

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

  3. EFFECTS OF MAXIMAL SQUAT EXERCISE TESTING ON VERTICAL JUMP PERFORMANCE IN AMERICAN COLLEGE FOOTBALL PLAYERS

    Directory of Open Access Journals (Sweden)

    Jay R. Hoffman

    2007-03-01

    Full Text Available Maximal strength and power testing are common assessments that are used to evaluate strength/power athletes. The validity and reliability of these tests have been well established (Hoffman, 2006, however the order of testing may have a profound effect on test performance outcome. It is generally recommended that the least fatiguing and highly-skilled tests are performed first, while highly fatiguing tests are performed last (Hoffman, 2006. Recent research has demonstrated that maximal isometric contractions and maximal or near- maximal dynamic exercise can augment the rate of force development, increase jump height and enhance sprint cycle performance (Chiu et al., 2003; French et al., 2003. The use of a maximal or near-maximal activity to enhance strength and power performance has been termed "muscle postactivation potentiation", and appears to be more common in the experienced resistance-trained athletes than in the recreationally-trained population (Chiu et al., 2003. It is believed that postactivation potentiation can enhance muscle performance by increasing the neural signal that activates the muscle (Hamada et al., 2000. Since heavy loading in a similar movement pattern of exercise appears to enhance maximal strength and power performance in the experienced resistance-trained athlete, it may be hypothesized that the postactivation potentiation associated with heavy loading has the potential to augment subsequent performance of tests utilizing similar motion. Therefore, consideration of an appropriate sequence of athletic performance testing in strength and power athletes is warranted. We would like to share our experience on the effect of performing a maximal lower body strength test on vertical jump performance in experienced resistance-trained strength/power athletes.We examined 64 NCAA Division III American collegiate football players (age = 20.1 ± 1.9 yr; body mass = 97.5 ± 17.8 kg; height = 1.80 ± 0.12 m. All testing was performed

  4. The Effect of Aerobic Training for Lower Limbs on the Early Cardiopulmonary Function Recovery of Racing Athletes%下肢有氧训练对竞速运动员早期心肺功能恢复的影响

    Institute of Scientific and Technical Information of China (English)

    刘伟; 王振涛

    2016-01-01

    为探讨下肢有氧训练对竞速运动员早期心肺功能恢复的影响,制定科学合理的有氧运动策略。本文基于对竞速运动员的运动特点及心肺功能情况全面了解,选取10名山东省竞速运动员作为测试对象,采用产自德国耶格公司的心肺功能测试系统,对训练对象进行下肢有氧训练,并对训练前后的心肺功能指标进行比较,利用EXCEL进行评测数据整理统计。结果表明:(1)受测运动员在心肺耐受时间、耐受负荷、肺部通气量和摄氧量等方面都得到了有效改善,加速了心肺功能的恢复;(2)适度的运动量非常重要,过小或者过大的训练量都不利于早期心肺功能的恢复;(3)男女运动员由于生理结构的差异性,机体指标存在差异,因此,在制定有氧训练策略时,应考虑性别差异。%To study the effect of aerobic training for lower limbs on the early cardiopulmonary function recovery of racing athletes, this paper selected ten athletes who were known well their profiles about the movement characteristics and cardiopulmonary function to detect them with the cardiopulmonary function detector made in Germany and compared cardiopulmonary function indexes before and after exercise with EXCEL to analyze the test data. The results showed that tested athletes effectively improved in the cardiopulmonary tolerance time, resistance load, pulmonary ventilation, oxygen uptake etc. and accelerated the cardiopulmonary function recovery. It was important for early cardiopulmonary function recovery to suitably exercise rather than an excess. In view of physiological differences between men and women, when athletes were trained, they were treated differently according to a gender.

  5. Consensus evaluation of radioactivity-in-soil reference materials in the context of an NPL Environmental Radioactivity Proficiency Test Exercise.

    Science.gov (United States)

    Dean, Julian; Collins, Sean; Garcia Miranda, Maria; Ivanov, Peter; Larijani, Cyrus; Woods, Selina

    2017-01-25

    The development of two radioactivity-in-soil reference materials is described - one for peat and one for soil with high sand content. Each bulk material was processed, subdivided and measured before being sent to participants in an NPL Environmental Radioactivity Proficiency Test Exercise. Activity concentrations of radionuclides in each material were determined by 'consensus' evaluations of participants' results using two weighted mean methods. The project demonstrated the use of such exercises in delivering reference materials to the user community.

  6. Coronary microvascular function, insulin sensitivity and body composition in predicting exercise capacity in overweight patients with coronary artery disease

    DEFF Research Database (Denmark)

    Jürs, Anders; Pedersen, Lene Rørholm; Olsen, Rasmus Huan

    2015-01-01

    BACKGROUND: Coronary artery disease (CAD) has a negative impact on exercise capacity. The aim of this study was to determine how coronary microvascular function, glucose metabolism and body composition contribute to exercise capacity in overweight patients with CAD and without diabetes. METHODS......: Sixty-five non-diabetic, overweight patients with stable CAD, BMI 28-40 kg/m(2) and left ventricular ejection fraction (LVEF) above 35 % were recruited. A 3-hour oral glucose tolerance test was used to evaluate glucose metabolism. Peak aerobic exercise capacity (VO2peak) was assessed...... by a cardiopulmonary exercise test. Body composition was determined by whole body dual-energy X-ray absorptiometry scan and magnetic resonance imaging. Coronary flow reserve (CFR) assessed by transthoracic Doppler echocardiography was used as a measure of microvascular function. RESULTS: Median BMI was 31.3 and 72...

  7. Prospective evaluation of a new protocol for the provisional use of perfusion imaging with exercise stress testing

    Energy Technology Data Exchange (ETDEWEB)

    Duvall, W.L. [Hartford Hospital, Division of Cardiology (Henry Low Heart Center), Hartford, CT (United States); Mount Sinai Medical Center, Division of Cardiology (Mount Sinai Heart), New York, NY (United States); Savino, John A.; Levine, Elliot J.; Croft, Lori B.; Henzlova, Milena J. [Mount Sinai Medical Center, Division of Cardiology (Mount Sinai Heart), New York, NY (United States); Hermann, Luke K. [Mount Sinai Medical Center, Department of Emergency Medicine, New York, NY (United States)

    2014-11-04

    Previous literature suggests that myocardial perfusion imaging (MPI) adds little to the prognosis of patients who exercise >10 metabolic equivalents (METs) during stress testing. With this in mind, we prospectively tested a provisional injection protocol in emergency department (ED) patients presenting for the evaluation of chest pain in which a patient would not receive an injection of radioisotope if adequate exercise was achieved without symptoms and a negative ECG response. All patients who presented to the ED over a 5-year period who were referred for stress testing as part of their ED evaluation were included. Patients considered for a provisional protocol were: exercise stress, age <65 years, no known coronary artery disease, and an interpretable rest ECG. Criteria for not injecting included a maximal predicted heart rate ≥85 %, ≥10 METs of exercise, no anginal symptoms during stress, and no ECG changes. Groups were compared based on stress test results, all-cause and cardiac mortality, follow-up cardiac testing, subsequent revascularization, and cost. A total of 965 patients were eligible with 192 undergoing exercise-only and 773 having perfusion imaging. After 41.6 ± 19.6 months of follow-up, all-cause mortality was similar in the exercise-only versus the exercise plus imaging group (2.6 % vs. 2.1 %, p = 0.59). There were no cardiac deaths in the exercise-only group. At 1 year there was no difference in the number of repeat functional stress tests (1.6 % vs. 2.1 %, p = 0.43), fewer angiograms (0 % vs. 4.0 %, p = 0.002), and a significantly lower cost (65 ± 332 vs 506 ± 1,991, p = 0.002; values are in US dollars) in the exercise-only group. The radiation exposure in the exercise plus imaging group was 8.4 ± 2.1 mSv. A provisional injection protocol has a very low mortality, few follow-up diagnostic tests, and lower cost compared to standard imaging protocols. If adopted it would decrease radiation exposure, save time and decrease health-care costs

  8. Effect of different oils administration on oleic and linoleic serum profile in horses during standardised exercise test on treadmill

    Directory of Open Access Journals (Sweden)

    Gian Battista Liponi

    2010-01-01

    Full Text Available Because of its energy density, fat is often added to the diet for exercising horses; however, little attention has been given to the effect of dietary fatty acid composition. The aims of this study were to compare the effect of two diets containing different oils on the fatty acids haematic profile during and after an aerobic exercise test on treadmill. Four adult trained gelding Standardbred (mean BW=481±27 kg were used in a two replicated 2x2 Latin Square design. Mixed hay-concentrate diets contained corn oil (CORN or a mix of mono-di and triglycerides of olive oil (MDTO were administrated. The horses received the diets for a period of four weeks. At the end of the adaptation period an aerobic exercise test on treadmill (30-min long was carried on. Blood samples were collected at rest, after 15’ and 30’ of exercise and during recovery period (at 10’, 30’ and 60’. Serum fatty acid concentration was determined. MDTO supplemented horses showed an higher percentage of Oleic acid during and after the exercise test; whereas Linoleic acid showed a significant difference (P<0.05 between groups with the highest value at 10’ and 30’ after exercise in the CORN supplemented group.

  9. Increased post-operative cardiopulmonary fitness in gastric bypass patients is explained by weight loss

    DEFF Research Database (Denmark)

    Lund, M. T.; Hansen, M.; Wimmelmann, C. L.

    2016-01-01

    Roux-en-Y gastric bypass (RYGB) leads to a major weight loss in obese patients. However, given that most patients remain obese after the weight loss, regular exercise should be part of a healthier lifestyle. The primary aim of this study was to investigate the cardiopulmonary fitness in obese......-perceived physical fitness increased after RYGB. Self-reported low- and high-intensity physical activity did not change. With weight loss, self-rated fitness level increased and the limitations to perform exercise decreased in RYGB patients. Nevertheless, as shown by the lower absolute VO2max, RYGB patients do...... patients before and after RYGB. Thirty-four patients had body composition and cardiopulmonary fitness (VO2max) assessed and completed questionnaires regarding physical activity and function twice before RYGB (time points A and B) and 4 and 18 months after surgery (time points C and D). Weight loss was 37...

  10. Feasibility and Validity of a Graded One-Legged Cycle Exercise Test to Determine Peak Aerobic Capacity in Older People With a Lower-Limb Amputation

    NARCIS (Netherlands)

    Wezenberg, Daphne; de Haan, Arnold; van der Woude, Lucas H.; Houdijk, Han

    2012-01-01

    Background. Information concerning exercise tolerance and aerobic capacity is imperative for generating effective and safe exercise programs. However, for older people with a lower-limb amputation, a standard exercise test is not available. Objective. The primary aim of the present study was to dete

  11. Non-invasive haemodynamic assessments using Innocor during standard graded exercise tests.

    Science.gov (United States)

    Fontana, Piero; Boutellier, Urs; Toigo, Marco

    2010-02-01

    Cardiac output (Q) and stroke volume (V(S)) represent primary determinants of cardiovascular performance and should therefore be determined for performance diagnostics purposes. Since it is unknown, whether measurements of Q and V(S) can be performed by means of Innocor during standard graded exercise tests (GXTs), and whether current GXT stages are sufficiently long for the measurements to take place, we determined Q and V(S) at an early and late point in time on submaximal 2 min GXT stages. 16 male cyclists (age 25.4 +/- 2.9 years, body mass 71.2 +/- 5.0 kg) performed three GXTs and we determined Q and V(S) after 46 and 103 s at 69, 77, and 85% peak power. We found that the rebreathings could easily be incorporated into the GXTs and that Q and V(S) remained unchanged between the two points in time on the same GXT stage (69% peak power, Q: 18.1 +/- 2.1 vs. 18.2 +/- 2.3 l min(-1), V(S): 126 +/- 18 vs. 123 +/- 21 ml; 77% peak power, Q: 20.7 +/- 2.6 vs. 21.0 +/- 2.3 l min(-1), V(S): 132 +/- 18 vs. 131 +/- 18 ml; 85% peak power, Q: 21.6 +/- 2.4 vs. 21.8 +/- 2.7 l min(-1), V(S): 131 +/- 17 vs. 131 +/- 22 ml). We conclude that Innocor may be a useful device for assessing Q and V(S) during GXTs, and that the adaptation of Q and V(S) to exercise-to-exercise transitions at moderate to high submaximal power outputs is fast enough for 1 and 2 min GXT stage durations.

  12. Safety, feasibility, and results of exercise testing for stratifying patients with chest pain in the emergency room

    Directory of Open Access Journals (Sweden)

    Renato Machado Macaciel

    2003-08-01

    Full Text Available OBJECTIVE: To assess safety, feasibility, and the results of early exercise testing in patients with chest pain admitted to the emergency room of the chest pain unit, in whom acute myocardial infarction and high-risk unstable angina had been ruled out. METHODS: A study including 1060 consecutive patients with chest pain admitted to the emergency room of the chest pain unit was carried out. Of them, 677 (64% patients were eligible for exercise testing, but only 268 (40% underwent the test. RESULTS: The mean age of the patients studied was 51.7±12.1 years, and 188 (70% were males. Twenty-eight (10% patients had a previous history of coronary artery disease, 244 (91% had a normal or unspecific electrocardiogram, and 150 (56% underwent exercise testing within a 12-hour interval. The results of the exercise test in the latter group were as follows: 34 (13% were positive, 191 (71% were negative, and 43 (16% were inconclusive. In the group of patients with a positive exercise test, 21 (62% underwent coronary angiography, 11 underwent angioplasty, and 2 underwent myocardial revascularization. In a univariate analysis, type A/B chest pain (definitely/probably anginal (p<0.0001, previous coronary artery disease (p<0.0001, and route 2 (patients at higher risk correlated with a positive or inconclusive test (p<0.0001. CONCLUSION: In patients with chest pain and in whom acute myocardial infarction and high-risk unstable angina had been ruled out, the exercise test proved to be feasible, safe, and well tolerated.

  13. The single-bout forearm critical force test: a new method to establish forearm aerobic metabolic exercise intensity and capacity.

    Directory of Open Access Journals (Sweden)

    J Mikhail Kellawan

    Full Text Available No non-invasive test exists for forearm exercise that allows identification of power-time relationship parameters (W', critical power and thereby identification of the heavy-severe exercise intensity boundary and scaling of aerobic metabolic exercise intensity. The aim of this study was to develop a maximal effort handgrip exercise test to estimate forearm critical force (fCF; force analog of power and establish its repeatability and validity. Ten healthy males (20-43 years completed two maximal effort rhythmic handgrip exercise tests (repeated maximal voluntary contractions (MVC; 1 s contraction-2 s relaxation for 600 s on separate days. Exercise intensity was quantified via peak contraction force and contraction impulse. There was no systematic difference between test 1 and 2 for fCF(peak force (p = 0.11 or fCF(impulse (p = 0.76. Typical error was small for both fCF(peak force (15.3 N, 5.5% and fCF(impulse (15.7 N ⋅ s, 6.8%, and test re-test correlations were strong (fCF(peak force, r = 0.91, ICC = 0.94, pfCF(peak force. TTE predicted by W' showed good agreement with actual TTE during the TTE tests (r = 0.97, ICC = 0.97, P<0.01; typical error 0.98 min, 12%; regression fit slope = 0.99 and y intercept not different from 0, p = 0.31. MVC did not predict fCF(peak force (p = 0.37, fCF(impulse (p = 0.49 or W' (p = 0.15. In conclusion, the poor relationship between MVC and fCF or W' illustrates the serious limitation of MVC in identifying metabolism-based exercise intensity zones. The maximal effort handgrip exercise test provides repeatable and valid estimates of fCF and should be used to normalize forearm aerobic metabolic exercise intensity instead of MVC.

  14. Cardiopulmonary helminths in foxes from the Pyrenees.

    Science.gov (United States)

    Garrido-Castañé, Ignasi; Ortuño, Anna; Marco, Ignasi; Castellà, Joaquim

    2015-12-01

    The present survey was carried out to investigate the prevalence of cardiopulmonary helminths in red foxes in Pyrenees area and to evaluate the role of foxes in the eco-epidemiology of these nematodes. Hearts and entire respiratory tracts were obtained from 87 foxes from Vall d'Aran region, Pyrenees, Catalonia, north-eastern Spain. The cardiopulmonary tracts were dissected, flushed and examined for nematodes using sedimented flushing water. Of the 87 examined foxes, 53 (61%) were positive for cardiopulmonary helminths. The identified nematodes were Crenosoma vulpis (44.8%), Eucoleus aerophilus (29.9%) and Angiostrongylus vasorum (3.4%). Statistical differences were observed only on comparing age and C.vulpis prevalence, with young foxes being more infected than adults. The high prevalence of cardiopulmonary nematodes suggested that red foxes may play an important role in their transmission and maintenance in the studied area.

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

    Science.gov (United States)

    Galen, Sujay S; Malek, Moh H

    2014-10-01

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

  16. Relationship between nutritional risk and exercise capacity in severe chronic obstructive pulmonary disease in male patients

    Directory of Open Access Journals (Sweden)

    Shan XZ

    2015-06-01

    Full Text Available Xizheng Shan,1 Jinming Liu,2 Yanrong Luo,1 Xiaowen Xu,1 Zhiqing Han,1 Hailing Li1 1Department of Respiratory Medicine, Yangpu Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Department of Pulmonary Circulation, Pulmonary Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China Objective: The nutritional status of chronic obstructive pulmonary disease (COPD patients is associated with their exercise capacity. In the present study, we have explored the relationship between nutritional risk and exercise capacity in severe male COPD patients.Methods: A total of 58 severe COPD male patients were enrolled in this study. The patients were assigned to no nutritional risk group (n=33 and nutritional risk group (n=25 according to the Nutritional Risk Screening (NRS, 2002 criteria. Blood gas analysis, conventional pulmonary function testing, and cardiopulmonary exercise testing were performed on all the patients.Results: Results showed that the weight and BMI of the patients in the nutritional risk group were significantly lower than in the no nutritional risk group (P<0.05. The pulmonary diffusing capacity for carbon monoxide of the no nutritional risk group was significantly higher than that of the nutritional risk group (P<0.05. Besides, the peak VO2 (peak oxygen uptake, peak O2 pulse (peak oxygen pulse, and peak load of the nutritional risk group were significantly lower than those of the no nutritional risk group (P<0.05 and there were significantly negative correlations between the NRS score and peak VO2, peak O2 pulse, or peak load (r<0, P<0.05.Conclusion: The association between exercise capacity and nutritional risk based on NRS 2002 in severe COPD male patients is supported by these results of this study. Keywords: nutritional risk, exercise capacity, chronic obstructive pulmonary disease, conventional pulmonary function testing, cardiopulmonary exercise testing

  17. Effect of Exercise Testing on Short-term Heart Rate Variability in Patients with Coronary Heart Disease

    DEFF Research Database (Denmark)

    Niu, Hui-Yan; Zhang, Dai-Fu; Liang, Bo

    2005-01-01

    Objective To study the effect of exercise testing on short term heart rate variability in patients with CHD.Methods In 12 patients with CHD and 12 age-and sex-matched healthy controls, short-term frequency domain analysis was performed at respective stage before, during and after ET.Results It sh......Objective To study the effect of exercise testing on short term heart rate variability in patients with CHD.Methods In 12 patients with CHD and 12 age-and sex-matched healthy controls, short-term frequency domain analysis was performed at respective stage before, during and after ET...

  18. Cardiopulmonary fitness correlates with regional cerebral grey matter perfusion and density in men with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Bradley J MacIntosh

    Full Text Available PURPOSE: Physical activity is associated with positive effects on the brain but there is a paucity of clinical neuroimaging data in patients with coronary artery disease (CAD, a cardiovascular condition associated with grey matter loss. The purpose of this study was to determine which brain regions are impacted by cardiopulmonary fitness and with the change in fitness after 6 months of exercise-based cardiac rehabilitation. METHODS: CAD patients underwent magnetic resonance imaging at baseline, and peak volume of oxygen uptake during exercise testing (VO2Peak was measured at baseline and after 6 months of training. T1-weighted structural images were used to perform grey matter (GM voxel-based morphometry (VBM. Pseudo-continuous arterial spin labeling (pcASL was used to produce cerebral blood flow (CBF images. VBM and CBF data were tested voxel-wise using VO2Peak and age as explanatory variables. RESULTS: In 30 men with CAD (mean age 65±7 years, VBM and CBF identified 7 and 5 respective regions positively associated with baseline VO2Peak. These included the pre- and post-central, paracingulate, caudate, hippocampal regions and converging findings in the putamen. VO2Peak increased by 20% at follow-up in 29 patients (t = 9.6, df = 28, p<0.0001. Baseline CBF in the left post-central gyrus and baseline GM density in the right putamen predicted greater change in VO2Peak. CONCLUSION: Perfusion and GM density were associated with fitness at baseline and with greater fitness gains with exercise. This study identifies new neurobiological correlates of fitness and demonstrates the utility of multi-modal MRI to evaluate the effects of exercise in CAD patients.

  19. Physiological responses to a tap dance choreography: comparisons with graded exercise test and prescription recommendations.

    Science.gov (United States)

    Oliveira, Samantha M L; Simões, Herbert G; Moreira, Sergio R; Lima, Ricardo M; Almeida, Jeeser A; Ribeiro, Fabiana M R; Puga, Guilherme M; Campbell, Carmen S G

    2010-07-01

    The aim of this study was to analyze the physiological responses to a tap dance choreography and to compare with those observed during a maximal treadmill exercise test, in tap dancers. Eight women (19.6 +/- 2.4 years; 162.3 +/- 4.4 cm; 54.0 +/- 2.3 kg; 20.5 +/- 1.4 kg.m; and 5.1 +/- 2.6 years of tap dance training) were submitted to the following procedures: (a) graded exercise test (GXT) on a treadmill until volitional exhaustion with 0.8 km.h of increment at each 3 and 1 minute of interval between stages and (b) tap dance choreography (TAP)-"The Shim Sham Shimmy"-consisting of 9 stages of 3 minutes with 1-minute rest between stages. Expired gas analyses were performed in all experimental sessions, providing breath-by-breath values for respiratory exchange rate (RER), oxygen uptake (VO(2)), and carbon dioxide production (CO2). Heart rate (HR) and rate of perceived exertion (RPE) were also measured. During the rest period between stages, blood samples (25 microl) were collected from the ear lobe for lactate threshold (LT) determination. It was observed that at the end of the TAP, subjects achieved an average of 83.8 +/- 6.2% of the HRmax and 68.9 +/- 11.3% of the VO(2)max, both previously identified in the GXT. The choreography demanded 204.7 +/- 31.3 kcal, an average RER of 0.88 +/- 0.05 and mean RPE of 13 +/- 2. The VO(2), HR, and RPE values did not significantly differ from those at the LT intensity identified during the GTX. Based on the present results, it was concluded that the TAP performance in the "The Shim Sham Shimmy" choreography elicited acute physiologic responses similar to those observed at the LT intensity, thus suggesting that Tap Dance constitutes a useful exercise modality for aerobic fitness and cardiovascular health improvements.

  20. Effect of chronic intermittent hypoxia on exercise adaptations in healthy subjects.

    Science.gov (United States)

    Tonini, Julia; Michallet, Anne-Sophie; Flore, Patrice; Nespoulet, Hugo; Pepin, Jean-Louis; Wuyam, Bernard; Levy, Patrick; Tamisier, Renaud

    2011-12-15

    Reduced exercise tolerance has been reported in obstructive sleep apnea syndrome (OSAS) patients, although the associated hypertension, obesity and/or metabolic disorder may underlie this reduction. Therefore, we evaluated the effects of chronic intermittent hypoxia (CIH) in 12 healthy subjects on exercise capacity, cardio-respiratory responses, and substrate oxidation during maximal and sub-maximal exercise. Subjects were exposed to 30 cycles of hypoxia-reoxygenation per hour for 14 nights. Although exercise capacity was unaltered PETCO(2) was reduced and V˙E/V˙CO(2) increased during both maximal and submaximal exercise tests, indicating a hyperventilatory response. Maximal heart rate was lower and diastolic arterial blood pressure (DBP) was higher in the 1st min of recovery after submaximal exercise. Subjects reached maximal lipid oxidation at a higher power output and had decreased blood lactate for a given power output. This suggests that although the metabolic adaptations to CIH in healthy subjects may improve exercise performance, the cardio-pulmonary modifications are similar to those observed in OSAS patients and could limit exercise capacity.

  1. Objective effect manifestation of pectus excavatum on load-stressed pulmonary function testing: a case report

    Directory of Open Access Journals (Sweden)

    Chan Jason

    2011-12-01

    Full Text Available Abstract Introduction Pectus excavatum is the most common congenital deformity of the anterior chest wall that, under certain conditions, may pose functional problems due to cardiopulmonary compromise and exercise intolerance. Case presentation We present the case of an otherwise physically-adept 21-year-old Chinese sportsman with idiopathic pectus excavatum, whose symptoms manifested only on bearing a loaded body vest and backpack during physical exercise. Corroborative objective evidence was obtained via load-stressed pulmonary function testing, which demonstrated restrictive lung function. Conclusion This report highlights the possible detrimental synergism of thoracic load stress and pectus excavatum on cardiopulmonary function. Thoracic load-stressed pulmonary function testing provides objective evidence in support of such a synergistic relationship.

  2. Assessment of Speckle-Tracking Echocardiography-Derived Global Deformation Parameters During Supine Exercise in Children.

    Science.gov (United States)

    Liu, Michael Y; Tacy, Theresa; Chin, Clifford; Obayashi, Derek Y; Punn, Rajesh

    2016-03-01

    Exercise echocardiography is an underutilized tool in pediatrics with current applications including detecting segmental wall abnormalities, assessing the utility of global ventricular function, and measuring pulmonary hemodynamics. No prior study has applied speckle-tracking echocardiography (STE) during exercise echocardiography in children. The aim of this study was to determine the feasibility of measuring speckle-tracking-derived peak systolic velocities, global longitudinal and circumferential strain, and global strain rates at various phases of exercise. Ninety-seven healthy children underwent cardiopulmonary exercise testing using supine cycle ergometry. The exercise stress test consisted of baseline pulmonary function testing, monitoring of blood pressure and heart rate responses, electrocardiographic recordings, and oxygen saturations while subjects pedaled against a ramp protocol based on body weight. Echocardiographic measurements and specifically speckle-tracking analysis were performed during exercise at baseline, at a heart rate of 160 beats per minute and at 10 min after exercise. Peak systolic velocity, peak systolic strain, and peak systolic strain rate at these three phases were compared in the subjects in which all measurements were accurately obtained. We were able to complete peak velocity, strain, and strain rate measurements in all three exercise phases for 36 out of the 97 subjects tested. There was no significant difference between the feasibility of measuring circumferential versus longitudinal strain (p = 0.25, B-corrected = 0.75). In the 36 subjects studied, the magnitude of circumferential strain values decreased from -18.3 ± 4.8 to -13.7 ± 4.0 % from baseline to HR 160 (p exercise. We studied the effects of frame rate on deformation measurements and we observed no difference between measurements taken at lower (exercising pediatric subjects with STE. The majority of subjects that were excluded from the study had inadequate

  3. Hemodynamic Changes After Static and Dynamic Exercises and Treadmill Stress Test; Different Patterns in Patients with Primary Benign Exertional Headache?

    Directory of Open Access Journals (Sweden)

    Mohsen Rostami

    2012-06-01

    Full Text Available The pathophysiology of primary benign exertional headache (EH is not still clearly defined. Some researchers have suggested an impaired vascular response as the etiology of this disorder. In this study we investigated whether there are any differences in blood pressure (BP and heart rate (HR of the subjects in course of the static and dynamic exercises and the treadmill stress test between those with and without EH. From university students, 22 patients with EH (mean age: 19.8 ± 2.10, Female to Male: 7:15 and 20 normal subjects (mean age: 19.3 ± 1.97, Female: Male: 8:12 were recruited. All the subjects performed the static and dynamic exercises at 30 and 20 percent of the maximal voluntary contraction (MVC and Bruce treadmill stress test according to the standard protocols. HR and BP of all the cases at the baseline and during and immediately after each test were measured. No significant difference was found between the mean rise of HR, systolic and diastolic BP of the subjects with and without EH in static and dynamic exercises and also treadmill stress test. It seems that between those with and without EH, there is no significant difference in rise of HR and BP response to static and dynamic exercises and treadmill stress test. Further studies are required to find the pathophysiology and risk factors of EH.

  4. Prognosis of patients with positive exercise test and normal myocardial perfusion SPECT

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    Seo, J. H.; Jeong, S. Y.; Bae, J. H.; Ahn, B. C.; Lee, J.; Lee, K. B [College of Medicine, Kyungpook National University, Daegu (Korea, Republic of)

    2004-07-01

    Exercise SPECT myocardial perfusion imaging(Ex-MPI) is regarded as a predictive technique particularly in patients with coronary artery disease(CAD) capable of performing exercise testing. In clinical practice, we encounter equivocal situations of discordant findings between exercise ECG and MPI. We evaluated the prognosis of subjects with positive ECG and normal MPI findings, and predictive factors for cardiac events. 2571 Ex-MPI studies were reviewed over a period of 3 years. Subjects were followed for more than 2 years(24-56 months, mean 35{+-}10months) for cardiac events after study. The cardiac events were defined as hard events(cardiac death and nonfatal myocardial infarction(MI)) and soft events(aggravation of CAD necessitating revascularization, congestive heart failure necessitating hospital admission). We evaluated age, sex, typical angina pain, rest ECG, hypertension, diabetes mellitus(DM), serum levels of cholesterol and LDL, smoking history, history of cerebrovascular disease(CVD) and peripheral artery disease(PAD), and rest left ventricular ejection fraction(LVEF) as clinical variables. Of 83 subjects with positive ECG and normal MPS findings, 6 were considered as false negative results confirmed with coronary angiography. There were 77 patients (mean age 52{+-}10 years, 39 males) with positive ECG and normal MPI results. During the follow-up period, of 77 there were 3 cardiac events (annual rate 1.9%), no cardiac death, 2 nonfatal MIs (annual rate 1.3%) and 1 soft event (annual rate 0.6%). 2/39 males(5.1%), and 1/38 females(2.6%) had cardiac events. All cardiac events were observed within 2 years. 1-year cardiac event rate was 0.6% and 2-year cardiac event rate was 1.9%. Among clinical factors, male sex, typical chest pain and smoking history at the time of MPI were predictive of cardiac events. Patients with positive ECG and negative EX-MPI results have low risk for cardiac events. Nevertheless, the cardiac events cannot be excluded totally in some

  5. Problematic Exercise in Anorexia Nervosa: Testing Potential Risk Factors against Different Definitions.

    Directory of Open Access Journals (Sweden)

    Melissa Rizk

    Full Text Available "Hyperactivity" has a wide prevalence range of 31% to 80% in the anorexia nervosa literature that could be partly due to the plethora of definitions provided by researchers in this field. The purpose of this study was two-fold: 1 To assess the variance across prevalence rates of problematic exercise encountered in patients with anorexia nervosa, in relation to seven different definitions found in the literature. 2 To examine how core eating disorder symptoms and the dimensions of emotional profile are associated with these different definitions and the impact of these definitions on the assessment of patients' quality of life. Exercise was evaluated in terms of duration, intensity, type and compulsion using a semi-structured questionnaire administered to 180 women suffering from severe anorexia nervosa. Seven different definitions of problematic exercise were identified in the literature: three entailing a single dimension of problematic exercise (duration, compulsion or intensity and four combining these different dimensions. Emotional profile scores, obsessive-compulsive symptoms, eating disorder symptomatology, worries and concerns about body shape, self-esteem and quality of life were assessed using several established questionnaires. The prevalence of problematic exercise varied considerably from, 5% to 54%, depending on the number of criteria used for its definition. The type and level of eating disorder symptomatology was found to be associated with several definitions of problematic exercise. Surprisingly, a better self-reported quality of life was found among problematic exercisers compared to non-problematic exercisers in three of the definitions. The different definitions of problematic exercise explain the broad prevalence ranges and the conflicting associations generally reported in the literature between problematic exercise and eating disorder-related psychological parameters. There is an urgent need for a valid consensus on the

  6. Problematic Exercise in Anorexia Nervosa: Testing Potential Risk Factors against Different Definitions.

    Science.gov (United States)

    Rizk, Melissa; Lalanne, Christophe; Berthoz, Sylvie; Kern, Laurence; Godart, Nathalie

    2015-01-01

    "Hyperactivity" has a wide prevalence range of 31% to 80% in the anorexia nervosa literature that could be partly due to the plethora of definitions provided by researchers in this field. The purpose of this study was two-fold: 1) To assess the variance across prevalence rates of problematic exercise encountered in patients with anorexia nervosa, in relation to seven different definitions found in the literature. 2) To examine how core eating disorder symptoms and the dimensions of emotional profile are associated with these different definitions and the impact of these definitions on the assessment of patients' quality of life. Exercise was evaluated in terms of duration, intensity, type and compulsion using a semi-structured questionnaire administered to 180 women suffering from severe anorexia nervosa. Seven different definitions of problematic exercise were identified in the literature: three entailing a single dimension of problematic exercise (duration, compulsion or intensity) and four combining these different dimensions. Emotional profile scores, obsessive-compulsive symptoms, eating disorder symptomatology, worries and concerns about body shape, self-esteem and quality of life were assessed using several established questionnaires. The prevalence of problematic exercise varied considerably from, 5% to 54%, depending on the number of criteria used for its definition. The type and level of eating disorder symptomatology was found to be associated with several definitions of problematic exercise. Surprisingly, a better self-reported quality of life was found among problematic exercisers compared to non-problematic exercisers in three of the definitions. The different definitions of problematic exercise explain the broad prevalence ranges and the conflicting associations generally reported in the literature between problematic exercise and eating disorder-related psychological parameters. There is an urgent need for a valid consensus on the definition of

  7. Influência da massa magra corporal nas repercussões cardiopulmonares durante o teste de caminhada de seis minutos em pacientes com DPOC Influence of lean body mass on cardiopulmonary repercussions during the six-minute walk test in patients with COPD

    Directory of Open Access Journals (Sweden)

    Nilva Regina Gelamo Pelegrino

    2009-01-01

    Full Text Available OBJETIVO: A massa magra corporal (MMC tem sido associada à mortalidade em pacientes com DPOC, mas seu impacto na limitação funcional é pouco conhecido. O objetivo deste trabalho foi analisar as variáveis cardiopulmonares em pacientes com DPOC, com ou sem depleção da MMC, antes e após a realização do teste de caminhada de seis minutos (TC6. MÉTODOS: Foram avaliados pacientes com DPOC, 36 sem depleção de MMC e 32 com depleção de MMC. Todos os pacientes foram submetidos à avaliação clínica, espirometria, avaliação da composição da massa corpórea e TC6 e responderam a questionários de qualidade de vida e de percepção de dispnéia. RESULTADOS: Não foram observadas diferenças significativas na gravidade de obstrução das vias aéreas, na percepção da dispnéia e na qualidade de vida entre os grupos. A distância percorrida no TC6 foi similar nos pacientes com DPOC com e sem depleção de MMC (470,3 ± 68,5 m vs. 448,2 ± 89,2 m. Entretanto, durante a realização do teste, os pacientes com depleção de MMC apresentaram aumento significativamente maior na diferença entre os valores final e basal da frequência cardíaca e do índice da escala de Borg para cansaço dos membros inferiores. A distância percorrida no TC6 apresentou correlação significativa positiva com o VEF1 (r = 0,381; p = 0,01. CONCLUSÕES: Não houve influência da depleção da MMC na capacidade funcional de exercício e na qualidade de vida dos pacientes estudados. Entretanto, os pacientes com depleção de MMC apresentam sintomas de fadiga dos membros inferiores mais acentuados durante o TC6, o que reforça a importância da avaliação e tratamento das manifestações sistêmicas da DPOC.OBJECTIVE: Although lean body mass (LBM has been associated with mortality in patients with COPD, its influence on functional limitation is not clear. The objective of this study was to analyze the cardiopulmonary variables in COPD patients with or without LBM

  8. Motivational change towards physical activity participation from physiological testing in cancer survivors attending rehabilitation

    OpenAIRE

    Arnesen, Ingvild

    2016-01-01

    Abstract: Aim: Stimulating physical activity (PA) participation is particularly important to cancer survivors, to reduce late effects from cancer and medical treatment and promote health. Physiological tests are procedures that aim to assess the individuals’ level of cardio-pulmonary fitness or performance, and are commonly integrated in rehabilitation programs, to specify exercise programs and motivate to PA participation. Still there is limited research to the field motivational changes fro...

  9. Relative power of clinical, exercise test, and angiographic variables in predicting clinical outcome after myocardial infarction: the Newham and Tower Hamlets study.

    Science.gov (United States)

    de Belder, M A; Pumphrey, C W; Skehan, J D; Rimington, H; al Wakeel, B; Evans, S J; Rothman, M; Mills, P G

    1988-11-01

    The interrelations of clinical, exercise test, and angiographic variables and their relative values in predicting specific clinical outcomes after myocardial infarction have not been fully established. Of 302 consecutive stable survivors of infarction, 262 performed a predischarge submaximal exercise test. In the first year after infarction patients with a "positive" exercise test were 13 times more likely to die, 2.8 times more likely to have an ischaemic event, and 2.3 times more likely to develop left ventricular failure than patients with negative tests. Patients with positive exercise tests underwent cardiac catheterization. Features of the history, 12 lead electrocardiogram, in-hospital clinical course, exercise test, and left ventricular and coronary angiograms that predicted these clinical end points were identified by univariate analysis. Then multivariable analysis was used to assess the relative powers of all variables in predicting end points. Certain features of the exercise test remained independent predictors of future ischaemic events and the development of overt left ventricular failure, but clinical and angiographic variables were more powerful predictors of mortality. Because the exercise test is also used to select patients for angiography, however, the results of this study strongly support the use of early submaximal exercise testing after infarction.

  10. N-acetylcysteine modifies the acute effects of isosorbide-5-mononitrate in angina pectoris patients evaluated by exercise testing

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Klarlund, K; Aldershvile, J

    1989-01-01

    , given together with a single oral dose of the long-acting nitrate, isosorbide-5-mononitrate (5-ISMN, 60 mg), would modify the nitrate effect evaluated by exercise testing before and after additional sublingual doses of nitroglycerin (NTG). Ten patients with angina pectoris and angiographically proven...... significant coronary artery disease were included. All patients received a baseline therapy with beta blockers. None of the patients had developed nitrate tolerance at inclusion. NAC/5-ISMN treatment significantly prolonged the total exercise time as compared with placebo/5-ISMN (7.7 +/- 2.1 min vs. 6.8 +/- 1...

  11. Hypoalgesia after exercise and the cold pressor test is reduced in chronic musculuskeletal pain patients with high pain sensitivity

    DEFF Research Database (Denmark)

    Vægter, Henrik Bjarke; Handberg, Gitte; Graven-Nielsen, Thomas

    2016-01-01

    OBJECTIVES: In chronic pain patients, impaired conditioned pain modulation (CPM) and exercise-induced hypoalgesia (EIH) have been reported. No studies have compared CPM and EIH in chronic musculoskeletal pain patients with high pain sensitivity (HPS) and low pain sensitivity (LPS). MATERIALS.......005). Pain tolerance increased after the cold pressor test and exercise in both groups (PCPM and EIH were partly impaired in chronic pain patients with high versus less pain sensitivity, suggesting that the CPM and EIH responses depend on the degree of pain sensitivity. This has clinical...

  12. Myocardial perfusion quantification in patients suspected of cardiac syndrome X with positive and negative exercise testing : A [N-13]ammonia positron emission tomography study

    NARCIS (Netherlands)

    de Vries, Jessica; DeJongste, Mike J. L.; Jessurun, Gillian A. J.; Jager, Pieter L.; Staal, Michiel J.; Slart, Riemer H. J. A.

    2006-01-01

    Background The combination of angina pectoris, angiographically normal coronary arteries, and a positive exercise stress test (EST) is referred to as cardiac syndrome X. However, a large group of patients suspected of syndrome X reveals a normal exercise stress test and weakens the diagnosis of synd

  13. How Does Exercise Benefit Performance on Cognitive Tests in Primary-School Pupils?

    Science.gov (United States)

    Hill, Liam J. B.; Williams, Justin H. G.; Aucott, Lorna; Thomson, Jenny; Mon-Williams, Mark

    2011-01-01

    Aim: We have previously demonstrated improved cognitive performance after a classroom-based exercise regime. In this study, we examined the reproducibility of this effect in a more socio-economically diverse sample and also investigated whether cognitive benefits of exercise were moderated by body mass index (BMI) or symptoms of…

  14. Relationship between Serum Levels of Metalloproteinase-8 and Tissue Inhibitor of Metalloproteinases-1 and Exercise Test Results in Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    J. Mieczkowska

    2016-01-01

    Full Text Available Physical activity as a part of the lifestyle is a significant factor influencing health condition. Exercises that require stamina are of particular importance. Oxygen metabolism, which is a significant part of all longer training processes, has an influence on cardiovascular and respiratory system functioning as well as all the processes taking part in maintenance of efficient homeostasis. Presentation of the correlation between exercise test results and MMP-8 (metalloproteinase-8 and TIMP-1 (tissue inhibitor of metalloproteinases-1 levels was attempted in this work. MMP-8 is a proteolytic enzyme taking part in progression of diseases related to process of ageing. 62 healthy women in postmenopausal period were qualified for the study (mean age: 54±3.6. There was exercise test on the treadmill according to Bruce’s protocol performed. MMP-8 and TIMP-1 serum levels were measured. There was statistically important correlation between increased level of MMP-8 and increased level of TIMP-1 with lower results of exercise test observed. The conducted study provides further biochemical arguments for prophylactic role of physical activity, which lowers the risk of noninfectious diseases, typical for middle adulthood, by influencing physical capacity.

  15. Usefulness of predischarge exercise electrocardiographic testing in detecting the late patency status of the infarct-related artery.

    Science.gov (United States)

    Kountouris, Evaggelos; Pappa, Eugenia; Korantzopoulos, Panagiotis; Pappas, Kostas; Karanikis, Paulos; Dimitroula, Vasiliki; Ntatsis, Anastasios; Siogas, Kostas

    2004-05-01

    Predischarge exercise electrocardiographic testing (PEET) represents a widely accepted clinical tool for prognostic and functional assessment of patients who experience an uncomplicated acute myocardial infarction (AMI). However, there are no data suggesting any relation between PEET results and patency status of the infarct-related artery (IRA). The aim of this study was to investigate whether ST and/or QT-dispersion (QTD) changes induced by a low-level PEET, after uncomplicated ST-elevation AMI, are related to the late patency status of the IRA. We prospectively evaluated 61 consecutive patients who had suffered a first uncomplicated ST-elevation AMI. All of them successfully carried out four stages of the modified Bruce protocol exercise testing before discharge, and thereafter were subjected to coronary angiography. Exercise-induced ST elevation and QTD shortening were found significantly more frequently in patients with persistently occluded IRA, as compared to patients with patent IRA (ST elevation 65% vs 27%, P = 0.006; QTD shortening 80% vs 29%, P positive predictive value of 75%, whereas the absence of both predicted the patency of IRA with a negative predictive value of 100%. These results indicate that ST-elevation and QT-dispersion changes induced by a predischarge exercise testing after a first ST-elevation AMI may effectively predict the late patency status of the infarct-related artery.

  16. Prognostic value of QTc interval dispersion changes during exercise testing in hypertensive men

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    Đorđević Dragan

    2008-01-01

    Full Text Available INTRODUCTION The prognostic significance of QTc dispersion changes during exercise testing (ET in patients with left ventricular hypertrophy is not clear. OBJECTIVE The aim was to study the dynamics of QTc interval dispersion (QTcd in patients (pts with left ventricular hypertrophy (LVH during the exercise testing and its prognostic significance. METHOD In the study we included 55 men (aged 53 years with hypertensive left ventricular hypertrophy and a negative ET (LVH group, 20 men (aged 58 years with a positive ET and 20 healthy men (aged 55 years. There was no statistically significant difference in the left ventricular mass index (LVMI between LVH group and ILVH group (160.9±14.9 g/m2 and 152.8±22.7 g/m2. The first ECG was done before the ET and the second one was done during the first minute of recovery, with calculation of QTc dispersion. The patients were followed during five years for new cardiovascular events. RESULTS During the ET, the QTcd significantly increased in LVH group (56.8±18.0 - 76.7±22.6 ms; p<0.001. A statistically significant correlation was found between the amount of ST segment depression at the end of ET and QTc dispersion at the beginning and at the end of ET (r=0.673 and r=0.698; p<0.01. The QTc dispersion was increased in 35 (63.6% patients and decreased in 20 (36.4% patients during the ET. Three patients (5.4% in the first group had adverse cardiovascular events during the five-year follow-up. A multiple stepwise regression model was formed by including age, LVMI, QTc interval, QTc dispersion and change of QTc dispersion during the ET. There was no prognostic significance of QTc interval and QTc dispersion during five-year follow-up in regard to adverse cardiovascular events, but prognostic value was found for LVMI (coefficient β=0.480; p<0.001. CONCLUSION The increase of QTc interval dispersion is common in men with positive ET for myocardial ischemia and there is a correlation between QTc dispersion and

  17. 21 CFR 868.6175 - Cardiopulmonary emergency cart.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary emergency cart. 868.6175 Section... (CONTINUED) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Miscellaneous § 868.6175 Cardiopulmonary emergency cart. (a) Identification. A cardiopulmonary emergency cart is a device intended to store and...

  18. Dobutamine stress echo is superior to exercise stress testing in achieving target heart rate among patients on beta blockers.

    Science.gov (United States)

    Sabbath, Adam; Pack, Michael; Markiewicz, Richard; John, Jooby; Gaballa, Mohamed; Goldman, Steven; Thai, Hoang

    2005-01-01

    Published guidelines recommend continuing beta-adrenergic receptor blockade in patients undergoing stress testing. We evaluated the role of pharmacological versus exercise stress testing in achieving target heart rate (THR) among patients on beta-adrenergic blockade. We compared data from 140 patients who underwent dobutamine stress echo (DSE) and 143 patients who underwent exercise treadmill testing (ETT). In both groups, beta-adrenergic blocker was continued at the time of stress testing. Overall, patients undergoing DSE achieved THR more frequently than ETT. With beta-adrenergic blockade, DSE patients met THR more frequently than ETT patients (p < 0.001). Without beta-adrenergic blockade, there was no difference between either modality in achieving THR. In both DSE and ETT patients, absence of beta-adrenergic blockade increased the odds of achieving THR [odds ratio (OR): 2.46, p = 0.042 and OR: 7.44, p < 0.001, respectively]. Atropine use with DSE increased the odds of achieving THR (OR: 3.76, p = 0.006). In conclusion, pharmacological stress testing appears to be superior to exercise stress testing in achieving THR among patients on beta-adrenergic blockade.

  19. Effects of presurgical exercise training on systemic inflammatory markers among patients with malignant lung lesions.

    Science.gov (United States)

    Jones, Lee W; Eves, Neil D; Peddle, Carolyn J; Courneya, Kerry S; Haykowsky, Mark; Kumar, Vikaash; Winton, Timothy W; Reiman, Tony

    2009-04-01

    Systemic inflammation plays an important role in the initiation, promotion, and progression of lung carcinogenesis. The effects of interventions to lower inflammation have not been explored. Accordingly, we conducted a pilot study to explore the effects of exercise training on changes in biomarkers of systemic inflammation among patients with malignant lung lesions. Using a single-group design, 12 patients with suspected operable lung cancer were provided with structured exercise training until surgical resection. Participants underwent cardiopulmonary exercise testing, 6 min walk testing, pulmonary function testing, and blood collection at baseline and immediately prior to surgical resection. Systemic inflammatory markers included intracellular adhesion molecule (ICAM)-1, macrophage inflammatory protein-1alpha, interleukin (IL)-6, IL-8, monocyte chemotactic protein-1, C-reactive protein, and tumor necrosis factor-alpha. The overall exercise adherence rate was 78%, with patients completing a mean of 30 +/- 25 sessions. Mean peak oxygen consumption increased 2.9 mL.kg-1.min-1 from baseline to presurgery (p = 0.016). Results indicate that exercise training resulted in a significant reduction in ICAM-1 (p = 0.041). Changes in other inflammatory markers did not reach statistical significance. Change in cardiorespiratory fitness was not associated with change in systemic inflammatory markers. This exploratory study provides an initial step for future studies to elucidate the potential role of exercise, as well as identify the underlying mechanisms of action, as a means of modulating the relationship between inflammation and cancer pathogenesis.

  20. Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test

    Energy Technology Data Exchange (ETDEWEB)

    Vaz, Humberto Andres, E-mail: humbertovaz@cardiol.br; Vanz, Ana Paula; Castro, Iran [Instituto de Cardiologia - Fundação Universitária de Cardiologia, Porto Alegre, RS (Brazil)

    2016-04-15

    The kinetics of high-sensitivity troponin T (hscTnT) release should be studied in different situations, including functional tests with transient ischemic abnormalities. To evaluate the release of hscTnT by serial measurements after exercise testing (ET), and to correlate hscTnT elevations with abnormalities suggestive of ischemia. Patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty were referred for ET 3 months after infarction. Blood samples were collected to measure basal hscTnT immediately before (TnT{sub 0h}), 2 (TnT{sub 2h}), 5 (TnT{sub 5h}), and 8 hours (TnT{sub 8h}) after ET. The outcomes were peak hscTnT, TnT{sub 5h}/TnT{sub 0h} ratio, and the area under the blood concentration-time curve (AUC) for hscTnT levels. Log-transformation was performed on hscTnT values, and comparisons were assessed with the geometric mean ratio, along with their 95% confidence intervals. Statistical significance was assessed by analysis of covariance with no adjustment, and then, adjusted for TnT{sub 0h}, age and sex, followed by additional variables (metabolic equivalents, maximum heart rate achieved, anterior wall STEMI, and creatinine clearance). This study included 95 patients. The highest geometric means were observed at 5 hours (TnT{sub 5h}). After adjustments, peak hscTnT, TnT{sub 5h}/TnT{sub 0h} and AUC were 59% (p = 0.002), 59% (p = 0.003) and 45% (p = 0.003) higher, respectively, in patients with an abnormal ET as compared to those with normal tests. Higher elevations of hscTnT may occur after an abnormal ET as compared to a normal ET in patients with STEMI.

  1. Serial High-Sensitivity Troponin T in Post-Primary Angioplasty Exercise Test

    Directory of Open Access Journals (Sweden)

    Humberto Andres Vaz

    2016-04-01

    Full Text Available Abstract Background: The kinetics of high-sensitivity troponin T (hscTnT release should be studied in different situations, including functional tests with transient ischemic abnormalities. Objective: To evaluate the release of hscTnT by serial measurements after exercise testing (ET, and to correlate hscTnT elevations with abnormalities suggestive of ischemia. Methods: Patients with acute ST-segment elevation myocardial infarction (STEMI undergoing primary angioplasty were referred for ET 3 months after infarction. Blood samples were collected to measure basal hscTnT immediately before (TnT0h, 2 (TnT2h, 5 (TnT5h, and 8 hours (TnT8h after ET. The outcomes were peak hscTnT, TnT5h/TnT0h ratio, and the area under the blood concentration-time curve (AUC for hscTnT levels. Log-transformation was performed on hscTnT values, and comparisons were assessed with the geometric mean ratio, along with their 95% confidence intervals. Statistical significance was assessed by analysis of covariance with no adjustment, and then, adjusted for TnT0h, age and sex, followed by additional variables (metabolic equivalents, maximum heart rate achieved, anterior wall STEMI, and creatinine clearance. Results: This study included 95 patients. The highest geometric means were observed at 5 hours (TnT5h. After adjustments, peak hscTnT, TnT5h/TnT0h and AUC were 59% (p = 0.002, 59% (p = 0.003 and 45% (p = 0.003 higher, respectively, in patients with an abnormal ET as compared to those with normal tests. Conclusion: Higher elevations of hscTnT may occur after an abnormal ET as compared to a normal ET in patients with STEMI.

  2. Attitudes and exercise adherence: test of the Theories of Reasoned Action and Planned Behaviour.

    Science.gov (United States)

    Smith, R A; Biddle, S J

    1999-04-01

    Three studies of exercise adherence and attitudes are reported that tested the Theory of Reasoned Action and the Theory of Planned Behaviour. In a prospective study of adherence to a private fitness club, structural equation modelling path analysis showed that attitudinal and social normative components of the Theory of Reasoned Action accounted for 13.1% of the variance in adherence 4 months later, although only social norm significantly predicted intention. In a second study, the Theory of Planned Behaviour was used to predict both physical activity and sedentary behaviour. Path analyses showed that attitude and perceived control, but not social norm, predicted total physical activity. Physical activity was predicted from intentions and control over sedentary behaviour. Finally, an intervention study with previously sedentary adults showed that intentions to be active measured at the start and end of a 10-week intervention were associated with the planned behaviour variables. A multivariate analysis of variance revealed no significant multivariate effects for time on the planned behaviour variables measured before and after intervention. Qualitative data provided evidence that participants had a positive experience on the intervention programme and supported the role of social normative factors in the adherence process.

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

    Science.gov (United States)

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

    2011-03-01

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

  4. ST segment elevation in lead aVR during exercise testing is associated with LAD stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Neill, Johanne; Harbinson, Mark [Royal Victoria Hospital, Regional Medical Cardiology Centre, Belfast (United Kingdom); Queens University, Belfast (United Kingdom); Shannon, Heather J.; Morton, Amanda; Muir, Alison R.; Adgey, Jennifer A. [Royal Victoria Hospital, Regional Medical Cardiology Centre, Belfast (United Kingdom)

    2007-03-15

    To evaluate, in patients with chest pain, the diagnostic value of ST elevation (STE) in lead aVR during stress testing prior to {sup 99m} Tc-sestamibi scanning correlating ischaemic territory with angiographic findings. Consecutive patients attending for {sup 99m} Tc-sestamibi myocardial perfusion imaging (MPI) completed a treadmill protocol. Peak exercise ECGs were coded. STE {>=}0.05 mV in lead aVR was considered significant. Gated perfusion images and findings at angiography were assessed. STE in lead aVR occurred in 25% (138/557) of the patients. More patients with STE in aVR had a reversible defect on imaging compared with those who had no STE in aVR (41%, 56/138 vs 27%, 114/419, p=0.003). Defects indicating a left anterior descending artery (LAD) culprit lesion were more common in the STE in aVR group (20%, 27/138 vs 9%, 39/419, p=0.001). There was a trend towards coronary artery stenosis (>70%) in a double vessel distribution involving the LAD in those patients who had STE in aVR compared with those who did not (22%, 8/37 vs 5%, 4/77, p=0.06). Logistic regression analysis demonstrated that STE in aVR (OR 1.36, p=0.233) is not an independent predictor of inducible abnormality when adjusted for STD >0.1 mV (OR 1.69, p=0.026). However, using anterior wall defect as an end-point, STE in aVR (OR 2.77, p=0.008) was a predictor even after adjustment for STD (OR 1.43, p=0.281). STE in lead aVR during exercise does not diagnose more inducible abnormalities than STD alone. However, unlike STD, which is not predictive of a territory of ischaemia, STE in aVR may indicate an anterior wall defect. (orig.)

  5. Physical Stress Echocardiography: Prediction of Mortality and Cardiac Events in Patients with Exercise Test showing Ischemia.

    Science.gov (United States)

    Araujo, Ana Carla Pereira de; Santos, Bruno F de Oliveira; Calasans, Flavia Ricci; Pinto, Ibraim M Francisco; Oliveira, Daniel Pio de; Melo, Luiza Dantas; Andrade, Stephanie Macedo; Tavares, Irlaneide da Silva; Sousa, Antonio Carlos Sobral; Oliveira, Joselina Luzia Menezes

    2014-11-01

    Background: Studies have demonstrated the diagnostic accuracy and prognostic value of physical stress echocardiography in coronary artery disease. However, the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia is limited. Objective: To evaluate the effectiveness of physical stress echocardiography in the prediction of mortality and major cardiac events in patients with exercise test positive for myocardial ischemia. Methods: This is a retrospective cohort in which 866 consecutive patients with exercise test positive for myocardial ischemia, and who underwent physical stress echocardiography were studied. Patients were divided into two groups: with physical stress echocardiography negative (G1) or positive (G2) for myocardial ischemia. The endpoints analyzed were all-cause mortality and major cardiac events, defined as cardiac death and non-fatal acute myocardial infarction. Results: G2 comprised 205 patients (23.7%). During the mean 85.6 ± 15.0-month follow-up, there were 26 deaths, of which six were cardiac deaths, and 25 non-fatal myocardial infarction cases. The independent predictors of mortality were: age, diabetes mellitus, and positive physical stress echocardiography (hazard ratio: 2.69; 95% confidence interval: 1.20 - 6.01; p = 0.016). The independent predictors of major cardiac events were: age, previous coronary artery disease, positive physical stress echocardiography (hazard ratio: 2.75; 95% confidence interval: 1.15 - 6.53; p = 0.022) and absence of a 10% increase in ejection fraction. All-cause mortality and the incidence of major cardiac events were significantly higher in G2 (p ecocardiografia com estresse físico na doença arterial coronária, mas a predição de mortalidade e de eventos cardíacos maiores, em pacientes com teste ergométrico positivo para isquemia miocárdica, é limitada. Objetivo: Avaliar a predição de mortalidade e de eventos cardíacos maiores pela

  6. Stress Echocardiography and Major Cardiac Events in Patients with Normal Exercise Test

    Science.gov (United States)

    Calasans, Flávia Ricci; Santos, Bruno Fernandes de Oliveira; Silveira, Débora Consuelo Rocha; de Araújo, Ana Carla Pereira; Melo, Luiza Dantas; Barreto-Filho, José Augusto; Sousa, Antônio Carlos Sobral; Oliveira, Joselina Luzia Menezes

    2013-01-01

    Background Exercise test (ET) is the preferred initial noninvasive test for the diagnosis and risk stratification of coronary artery disease (CAD), however, its lower sensitivity may fail to identify patients at greater risk of adverse events. Objective To assess the value of stress echocardiography (SE) for predicting all-cause mortality and major cardiac events (MACE) in patients with intermediate pretest probability of CAD and a normal ET. Methods 397 patients with intermediate CAD pretest probability, estimated by the Morise score, and normal ET who underwent SE were studied. The patients were divided into two groups according to the absence (G1) or presence (G2) of myocardial ischemia on SE .End points evaluated were all-cause mortality and MACE, defined as cardiac death and nonfatal acute myocardial infarction (AMI). Results G1 group was comprised of 329 (82.8%) patients. The mean age of the patients was 57.37 ± 11 years and 44.1% were male. During a mean follow-up of 75.94 ± 17.24 months, 13 patients died, three of them due to cardiac causes, and 13 patients suffered nonfatal AMI. Myocardial ischemia remained an independent predictor of MACE (HR 2.49; [CI] 95% 1.74-3.58). The independent predictors for all-cause mortality were male gender (HR 9.83; [CI] 95% 2.15-44.97) and age over 60 years (HR 4.57; [CI] 95% 1.39-15.23). Conclusion Positive SE for myocardial ischemia is a predictor of MACE in the studied sample, which helps to identify a subgroup of patients at higher risk of events despite having normal ET. PMID:23765384

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

    Science.gov (United States)

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

    2015-08-01

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

  8. Measurement of coronary calcium scores by electron beam computed tomography or exercise testing as initial diagnostic tool in low-risk patients with suspected coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Geluk, Christiane A.; Perik, Patrick J.; Tio, Rene A.; Goette, Marco J.W.; Hillege, Hans L.; Zijlstra, Felix [University Medical Center Groningen, Thoraxcenter, Department of Cardiology, Groningen (Netherlands); Dikkers, Riksta; Vliegenthart, Rozemarijn; Houwers, Janneke B.; Willems, Tineke P.; Oudkerk, Matthijs [University Medical Center Groningen, Department of Radiology, Groningen (Netherlands)

    2008-02-15

    We determined the efficiency of a screening protocol based on coronary calcium scores (CCS) compared with exercise testing in patients with suspected coronary artery disease (CAD), a normal ECG and troponin levels. Three-hundred-and-four patients were enrolled in a screening protocol including CCS by electron beam computed tomography (Agatston score), and exercise testing. Decision-making was based on CCS. When CCS{>=}400, coronary angiography (CAG) was recommended. When CCS<10, patients were discharged. Exercise tests were graded as positive, negative or nondiagnostic. The combined endpoint was defined as coronary event or obstructive CAD at CAG. During 12{+-}4 months, CCS{>=}400, 10-399 and <10 were found in 42, 103 and 159 patients and the combined endpoint occurred in 24 (57%), 14 (14%) and 0 patients (0%), respectively. In 22 patients (7%), myocardial perfusion scintigraphy was performed instead of exercise testing due to the inability to perform an exercise test. A positive, nondiagnostic and negative exercise test result was found in 37, 76 and 191 patients, and the combined endpoint occurred in 11 (30%), 15 (20%) and 12 patients (6%), respectively. Receiver-operator characteristics analysis showed that the area under the curve of 0.89 (95% CI: 0.85-0.93) for CCS was superior to 0.69 (95% CI: 0.61-0.78) for exercise testing (P<0.0001). In conclusion, measurement of CCS is an appropriate initial screening test in a well-defined low-risk population with suspected CAD. (orig.)

  9. Physiological consequences : Cardiopulmonary, vestibular, and sensory aspects

    NARCIS (Netherlands)

    Welsch, H.; Albery, W.; Banks, R.D.; Bles, W.

    2000-01-01

    Discussing the physiological consequences of enhanced fighter manoeuvrability (EFM), aspects of cardiopulmonary reactions will be seen during high G manoeuvres, especially the combination of negative G-load followed by high G-onset manoeuvres ("push-pull"). The aircraft's capability to reach high al

  10. Acute posthypoxic myoclonus after cardiopulmonary resuscitation

    NARCIS (Netherlands)

    Bouwes, Aline; van Poppelen, Daniel; Koelman, Johannes H. T. M.; Kuiper, Michael A.; Zandstra, Durk F.; Weinstein, Henry C.; Tromp, Selma C.; Zandbergen, Eveline G. J.; Tijssen, Marina A. J.; Horn, Janneke

    2012-01-01

    Background: Acute posthypoxic myoclonus (PHM) can occur in patients admitted after cardiopulmonary resuscitation (CPR) and is considered to have a poor prognosis. The origin can be cortical and/or subcortical and this might be an important determinant for treatment options and prognosis. The aim of

  11. Heart-rate response to sympathetic nervous stimulation, exercise, and magnesium concentration in various sleep conditions.

    Science.gov (United States)

    Omiya, Kazuto; Akashi, Yoshihiro J; Yoneyama, Kihei; Osada, Naohiko; Tanabe, Kazuhiko; Miyake, Fumihiko

    2009-04-01

    The aim of this study was to clarify the mechanism of impaired exercise tolerance in chronic sleep-restricted conditions by investigating variables related to heart-rate (HR) response to sympathetic nervous stimulation. Sixteen healthy men (mean age 21.5 years) were tested in a control state, acute sleep-loss state, and chronic sleep-restricted state. Participants underwent cardiopulmonary exercise testing in each state. Their norepinephrine (NE) concentration was measured before and immediately after exercise. Intracellular magnesium (Mg) concentration was measured in a resting state. Exercise duration was shorter and the ratio of HR response to the percentage increase in NE was higher in the chronic sleep-restricted state than in the control state. Intracellular Mg gradually decreased from control to chronic sleep restriction. There was a negative correlation between peak exercise duration and the ratios of HR response to the rate of increase in NE. Intracellular Mg was positively correlated with the ratios of HR response to the increase in NE both in control and in acute sleep loss. The authors conclude that the impaired exercise tolerance in a chronic sleep-restricted state is caused by hypersensitivity of the HR response to sympathetic nervous stimulation, which showed a compensation for decreased intracellular Mg concentration.

  12. Respiratory muscle training in healthy individuals: physiological rationale and implications for exercise performance.

    Science.gov (United States)

    Sheel, A William

    2002-01-01

    The respiratory system has traditionally been viewed to be capable of meeting the substantial demands for ventilation and gas exchange and the cardiopulmonary interactions imposed by short-term maximum exercise or long-term endurance exercise. Recent studies suggest that specific respiratory muscle (RM) training can improve the endurance and strength of the respiratory muscles in healthy humans. The effects of RM training on exercise performance remains controversial. When whole-body exercise performance is evaluated using submaximal fixed work-rate tests, significant improvements are seen and smaller, but significant improvements have also been reported in placebo-trained individuals. When performance is measured using time-trial type performance measures versus fixed workload tests, performance is increased to a much lesser extent with RM training. It appears that RM training influences relevant measures of physical performance to a limited extent at most. Interpretation of the collective literature is difficult because most studies have utilised relatively small sample sizes and very few studies have used appropriate control or placebo groups. Mechanisms to explain the purported improvements in exercise performance remain largely unknown. However, possible candidates include improved ratings of breathing perception, delay of respiratory muscle fatigue, ventilatory efficiency, or blood-flow competition between respiratory and locomotor muscles. This review summarises the current literature on the physiology of RM training in healthy individuals and critically evaluates the possible implications for exercise performance.

  13. APROTININ PRESERVES HEMOSTASIS IN ASPIRIN-TREATED PATIENTS UNDERGOING CARDIOPULMONARY BYPASS

    NARCIS (Netherlands)

    TABUCHI, N; HUET, RCG; STURK, A; EIJSMAN, L; WILDEVUUR, CRH

    1994-01-01

    Various clinical trials have shown that hemostasis is improved by the administration of aprotinin during cardiopulmonary bypass. However, this effect has not been proved for those patients treated preoperatively with aspirin. Therefore, a double-blind, placebo-controlled study was conducted to test

  14. Transient myocardial ischemia after a first acute myocardial infarction and its relation to clinical characteristics, predischarge exercise testing and cardiac events at one-year follow-up

    DEFF Research Database (Denmark)

    Mickley, H; Pless, P; Nielsen, J R

    1993-01-01

    recording 11 +/- 5 days after AMI 23 patients (19%) had 123 ischemic episodes (group 1), whereas 100 patients demonstrated no ischemia (group 2). Exercise-induced ST-segment depression was more prevalent in group 1 (83%) than in group 2 (47%) (p ... as judged from a shorter exercise duration before significant ST-segment depression (5.5 +/- 2.4 vs 7.7 +/- 4.1 minutes; p depression on exercise testing (4.1 +/- 2.6 vs 2.6 +/- 1.6 mm; p exercise test results revealed an impaired hemodynamic......The relation between early out-of-hospital ambulatory ST-segment monitoring, clinical characteristics, predischarge maximal exercise testing and cardiac events was determined in 123 consecutive men (age 55 +/- 8 years) with a first acute myocardial infarction (AMI). During 36 hours of ambulatory...

  15. Testing the recovery of stellar rotation signals from Kepler light curves using a blind hare-and-hounds exercise

    CERN Document Server

    Aigrain, S; Ceillier, T; Chagas, M L das; Davenport, J R A; Garcia, R A; Hay, K L; Lanza, A F; McQuillan, A; Mazeh, T; de Medeiros, J R; Nielsen, M B; Reinhold, T

    2015-01-01

    We present the results of a blind exercise to test the recoverability of stellar rotation and differential rotation in Kepler light curves. The simulated light curves lasted 1000 days and included activity cycles, Sun-like butterfly patterns, differential rotation and spot evolution. The range of rotation periods, activity levels and spot lifetime were chosen to be representative of the Kepler data of solar like stars. Of the 1000 simulated light curves, 770 were injected into actual quiescent Kepler light curves to simulate Kepler noise. The test also included five 1000-day segments of the Sun's total irradiance variations at different points in the Sun's activity cycle. Five teams took part in the blind exercise, plus two teams who participated after the content of the light curves had been released. The methods used included Lomb-Scargle periodograms and variants thereof, auto-correlation function, and wavelet-based analyses, plus spot modelling to search for differential rotation. The results show that th...

  16. IEA Common Exercise 4: ARX, ARMAX and grey-box models for thermal performance characterization of the test box

    DEFF Research Database (Denmark)

    Bacher, Peder; Andersen, Philip Hvidthøft Delff

    In this report results of applying time series models for assessing the thermal performance of the IEA Annex 58 test box based on data given in the Common Exercise 4 (CE4), which was measured in Almeria, Spain. Both ARX, ARMAX and grey-box models are applied. Finally, the same models are fitted...... for the Common Exercise 3b (CE3) data measured in Belgium and the results are compared. The focus in this report is on model selection and validation enabling a stable and reliable performance assessment. Basically, the challenge is to find a procedure for each type of model, which can give un...... radiation is present data), these aspects are discussed. Furthermore, new models for enhancing the description of the effect of solar radiation on the test box is presented....

  17. Identification of a core set of exercise tests for children and adolescents with cerebral palsy : a Delphi survey of researchers and clinicians

    NARCIS (Netherlands)

    Verschuren, Olaf; Ketelaar, Marjolijn; Keefer, Daniel; Wright, Virginia; Butler, Jane; Ada, Louise; Maher, Carol; Reid, Siobhan; Wright, Marilyn; Dalziel, Blythe; Wiart, Lesley; Fowler, Eileen; Unnithan, Viswanath; Maltais, Desiree B.; Van Den Berg-Emons, Rita; Takken, Tim

    2011-01-01

    AIM Evidence-based recommendations regarding which exercise tests to use in children and adolescents with cerebral palsy (CP) are lacking. This makes it very difficult for therapists and researchers to choose the appropriate exercise-related outcome measures for this group. This study aimed to ident

  18. An investigation into a contactless photoplethysmographic mobile application to record heart rate post-exercise: Implications for field testing

    Directory of Open Access Journals (Sweden)

    Peart Daniel J.

    2015-08-01

    Full Text Available Study aim: the aim of this study was to compare the accuracy of a contactless photoplethysmographic mobile application (CPA to record post-exercise heart rate and estimate maximal aerobic capacity after the Queen’s College Step Test. It was hypothesised that the CPA may present a cost effective heart rate measurement tool for educators and practitioners with limited access to specialised laboratory equipment.

  19. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... exercise can improve or maintain some aspects of cognitive function, such as your ability to shift quickly ... activity, and ignore irrelevant information. For more on cognitive function and exercise, see "Do Exercise and Physical ...

  20. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... please turn Javascript on. Exercise: Benefits of Exercise Health Benefits One of the Healthiest Things You Can ... yourself. Studies have shown that exercise provides many health benefits and that older adults can gain a ...

  1. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... A-Z > Exercise: Benefits of Exercise: Health Benefits In This Topic Health Benefits Benefits for Everyday Life ... Try Exercise: How to Stay Active The information in this topic was provided by the National Institute ...

  2. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... version of this page please turn Javascript on. Exercise: Benefits of Exercise Health Benefits One of the Healthiest Things You ... activity campaign from the National Institute on Aging. Exercise or Physical Activity? Some people may wonder what ...

  3. Parasympathetic reinnervation accompanied by improved post-exercise heart rate recovery and quality of life in heart transplant recipients.

    Science.gov (United States)

    Imamura, Teruhiko; Kinugawa, Koichiro; Okada, Ikuko; Kato, Naoko; Fujino, Takeo; Inaba, Toshiro; Maki, Hisataka; Hatano, Masaru; Kinoshita, Osamu; Nawata, Kan; Kyo, Shunei; Ono, Minoru

    2015-01-01

    Although sympathetic reinnervation is accompanied by the improvement of exercise tolerability during the first years after heart transplantation (HTx), little is known about parasympathetic reinnervation and its clinical impact. We enrolled 21 recipients (40 ± 16 years, 71% male) who had received successive cardiopulmonary exercise testing at 6 months, and 1 and 2 years after HTx. Exercise parameters such as peak oxygen consumption or achieved maximum load remained unchanged, whereas recovery parameters including heart rate (HR) recovery during 2 minutes and the delay of peak HR, which are influenced by parasympathetic activity, improved significantly during post-HTx 2 years (P recovery parameters (P recovery parameters enjoyed a better HF-specific quality of life (P recovery ability of HR and quality of life during post-HTx 2 years.

  4. Use of Geophysical and Remote Sensing Techniques During the Comprehensive Test Ban Treaty Organization's Integrated Field Exercise 2014

    Science.gov (United States)

    Labak, Peter; Sussman, Aviva; Rowlands, Aled; Chiappini, Massimo; Malich, Gregor; MacLeod, Gordon; Sankey, Peter; Sweeney, Jerry; Tuckwell, George

    2016-04-01

    The Integrated Field Exercise of 2014 (IFE14) was a field event held in the Hashemite Kingdom of Jordan (with concurrent activities in Austria) that tested the operational and technical capabilities of a Comprehensive Test Ban Treaty's (CTBT) on-site inspection (OSI). During an OSI, up to 40 inspectors search a 1000km2 inspection area for evidence of a nuclear explosion. Over 250 experts from ~50 countries were involved in IFE14 (the largest simulation of an OSI to date) and worked from a number of different directions, such as the Exercise Management and Control Teams to execute the scenario in which the exercise was played, to those participants performing as members of the Inspection Team (IT). One of the main objectives of IFE14 was to test Treaty allowed inspection techniques, including a number of geophysical and remote sensing methods. In order to develop a scenario in which the simulated exercise could be carried out, a number of physical features in the IFE14 inspection area were designed and engineered by the Scenario Task Force Group (STF) that the IT could detect by applying the geophysical and remote sensing inspection technologies, as well as other techniques allowed by the CTBT. For example, in preparation for IFE14, the STF modeled a seismic triggering event that was provided to the IT to prompt them to detect and localize aftershocks in the vicinity of a possible explosion. Similarly, the STF planted shallow targets such as borehole casings and pipes for detection by other geophysical methods. In addition, airborne technologies, which included multi-spectral imaging, were deployed such that the IT could identify freshly exposed surfaces, imported materials and other areas that had been subject to modification. This presentation will introduce the CTBT and OSI, explain the IFE14 in terms of goals specific to geophysical and remote sensing methods, and show how both the preparation for and execution of IFE14 meet those goals.

  5. History of the evolution of cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    George Karlis

    2013-04-01

    Full Text Available Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references on CPR go back to the era of Ancient Egypt (3100 B.C.. Although the technique for mouth to mouth ventilation was known in ancient times, its efficacy was demonstrated just in 1958. The ease and efficacy of chest compressions were demonstrated in 1960. Electrical defibrillation may have begun in 1775, but it was applied to a victim of cardiac arrest in the 1950s. Conclusion: CPR is currently a rapidly evolving field of medical science. According to latest data, there is evidence that high quality chest compressions, prompt defibrillation if applicable and treatment of reversible causes improve Cardiopulmonary resuscitation (CPR is as old as humankind. The evolution of CPR represents a combination of human errors and discoveries. Aim: The present study reviews the most important moments in the history of resuscitation, from the first attempts of CPR until now. Methods: The methodology followed included bibliography research from review literature, through databases PubMed, Medline, Scopus, with the use of keywords, such as cardiopulmonary arrest, cardiopulmonary resuscitation, history, evolution and combinations of them. Complementary bibliography was found through the library of the National and Kapodistrian University of Athens. Results: The first historical references

  6. Determining The Electromyographic Fatigue Threshold Following a Single Visit Exercise Test.

    Science.gov (United States)

    Galen, Sujay S; Guffey, Darren R; Coburn, Jared W; Malek, Moh H

    2015-07-27

    Theoretically, the electromyographic (EMG) fatigue threshold is the exercise intensity an individual can maintain indefinitely without the need to recruit more motor units which is associated with an increase in the EMG amplitude. Although different protocols have been used to estimate the EMG fatigue threshold they require multiple visits which are impractical for a clinical setting. Here, we present a protocol for estimating the EMG fatigue threshold for cycle ergometry which requires a single visit. This protocol is simple, convenient, and completed within 15-20 min, therefore, has the potential to be translated into a tool that clinicians can use in exercise prescription.

  7. The standardization of results on hair testing for drugs of abuse: An interlaboratory exercise in Lombardy Region, Italy.

    Science.gov (United States)

    Stramesi, C; Vignali, C; Groppi, A; Caligara, M; Lodi, F; Pichini, S; Jurado, C

    2012-05-10

    Hair testing for drugs of abuse is performed in Lombardy by eleven analytical laboratories accredited for forensic purposes, the most frequent purposes being driving license regranting and workplace drug testing. Individuals undergoing hair testing for these purposes can choose the laboratory in which the analyses have to be carried out. The aim of our study was to perform an interlaboratory exercise in order to verify the level of standardization of hair testing for drugs of abuse in these accredited laboratories; nine out of the eleven laboratories participated in this exercise. Sixteen hair strands coming from different subjects were longitudinally divided in 3-4 aliquots and distributed to participating laboratories, which were requested to apply their routine methods. All the participants analyzed opiates (morphine and 6-acetylmorphine) and cocainics (cocaine and benzoylecgonine) while only six analyzed methadone and amphetamines (amphetamine, methamphetamine, MDMA, MDA and MDEA) and five Δ(9)-tetrahydrocannabinol (THC). The majority of the participants (seven labs) performed acidic hydrolysis to extract the drugs from the hair and analysis by GC-MS, while two labs used LC-MS/MS. Eight laboratories performed initial screening tests by Enzyme Multiplied Immunoassay Technique (EMIT), Enzyme-linked Immunosorbent Assay (ELISA) or Cloned Enzyme Donor Immunoassay (CEDIA). Results demonstrated a good qualitative performance for all the participants, since no false positive results were reported by any of them. Quantitative data were quite scattered, but less in samples with low concentrations of analytes than in those with higher concentrations. Results from this first regional interlaboratory exercise show that, on the one hand, individuals undergoing hair testing would have obtained the same qualitative results in any of the nine laboratories. On the other hand, the scatter in quantitative results could cause some inequalities if any interpretation of the data is

  8. A Feasibility Study Related To Inactive Cancer Survivors Compared with Non-Cancer Controls during Aerobic Exercise Training

    Science.gov (United States)

    Drum, Scott N.; Klika, Riggs J.; Carter, Susan D.; Sprod, Lisa K.; Donath, Lars

    2016-01-01

    Cancer survivors (CA) tend to demonstrate metabolic, cardiac, and ventilatory alterations due to previous chemotherapy and radiation that may impair adaptability following aerobic exercise training. Exercise training adaptations of CA finished with primary treatment compared to non-cancer participants (NC) have not yet been extensively elucidated. Thus, the present study compared physiologic responses of CA versus NC following a low-to-moderate intensity, 8-wk aerobic training program. Thirty-seven previously sedentary participants (CA: n = 14, 12 females; NC: n = 23, 19 females) with no heart or metabolic disease did not differ in age, height, weight, and body mass index (51 ± 2 y, 1.66 ± 0.02 m, 83.8 ± 3.2 kg, and 30.5 ± 1 kg·m-2). Each participant underwent baseline, 3-, 6-, and 8-wk VO2peak treadmill testing using the USAFSAM protocol and walked on a treadmill three times per week at 80-90% of ventilatory threshold (VT) for approximately 40-min·session-1. Variables obtained on the VO2peak tests included: HR at stage 2 (HR@stage2), rating of perceived exertion at stage 2 (RPE@stage2), lactate threshold (LT), ventilatory threshold (VT), salivary cortisol at 30-min post VO2peak test (SC@30-minPost),VO2peak level, time of fatigue (TOF), and maximal heart rate (HRmax). NC had significantly (p exercise capacity during 8 weeks of aerobic training and did not show altered adaptability compared to NC. We suggest prescribing aerobic exercise training at low/moderate intensity and duration initially, with progressive increases in duration and intensity after approximately 8-weeks. If available and supported, we advise clinicians to utilize submaximal threshold concepts obtained from cardiopulmonary exercise testing to prescribe more precise aerobic exercise training parameters. Key points Cancer survivors will most likely begin an exercise program after cancer therapy with a diminished functional capacity whereby baseline cardiopulmonary testing is recommended. By

  9. ST-Segment Depression in Hyperventilation Indicates a False Positive Exercise Test in Patients with Mitral Valve Prolapse

    Directory of Open Access Journals (Sweden)

    Andreas P. Michaelides

    2010-01-01

    Full Text Available Objectives. Mitral valve prolapse (MVP is a known cause for false positive exercise test (ET. The purpose of this study was to establish additional electrocardiographic criteria to distinguish the false positive exercise results in patients with MVP. Methods. We studied 218 consecutive patients ( years, 103 males with MVP (according to echocardiographic study, and positive treadmill ET was performed due to multiple cardiovascular risk factors or angina-like symptoms. A coronary angiography was performed to detect coronary artery disease (CAD. Results. From 218 patients, 90 (group A presented with normal coronary arteries according to the angiography (false positive ET while the rest 128 (group B presented with CAD. ST-segment depression in hyperventilation phase was present in 54 patients of group A (60% while only in 14 patients of group B (11%, . Conclusions. Presence of ST-segment depression in hyperventilation phase favors a false positive ET in patients with MVP.

  10. Preoperative hypoalgesia after cold pressor test and aerobic exercise is associated with pain relief six months after total knee replacement

    DEFF Research Database (Denmark)

    Vaegter, Henrik Bjarke; Handberg, Gitte; Emmeluth, Claus

    2017-01-01

    PPT) and subsequently the pain tolerance threshold (cPTT). 2) Manual pressure pain thresholds (PPTs) at the legs, arm and shoulder. Clinical pain intensity (numerical rating scale) and psychological distress (questionnaires) were assessed. RESULTS: Clinical pain intensity, psychological distress, cPPT and PPT...... investigated the association between exercise-induced hypoalgesia (EIH) and CPM on post-TKR pain relief. METHODS: Before and six months post-TKR, 14 patients with chronic knee osteoarthritis performed the cold pressor test on the non-affected leg and two exercise conditions (bicycling and isometric knee...... post-TKR (Passociated with pain relief six months after TKR. EIH as a novel preoperative screening tool should be further investigated...

  11. Food Microbiology--Design and Testing of a Virtual Laboratory Exercise

    Science.gov (United States)

    Flint, Steve; Stewart, Terry

    2010-01-01

    A web-based virtual laboratory exercise in identifying an unknown microorganism was designed for use with a cohort of 3rd-year university food-technology students. They were presented with a food-contamination case, and then walked through a number of diagnostic steps to identify the microorganism. At each step, the students were asked to select 1…

  12. Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review

    Directory of Open Access Journals (Sweden)

    Julia Ratter

    2014-09-01

    [Ratter J, Radlinger L, Lucas C (2014 Several submaximal exercise tests are reliable, valid and acceptable in people with chronic pain, fibromyalgia or chronic fatigue: a systematic review. Journal of Physiotherapy 60: 144–150

  13. Emergent cardiopulmonary bypass during pectus excavatum repair

    Directory of Open Access Journals (Sweden)

    Ryan Craner

    2013-01-01

    Full Text Available Pectus excavatum is a chest wall deformity that produces significant cardiopulmonary disability and is typically seen in younger patients. Minimally invasive repair of pectus excavatum or Nuss procedure has become a widely accepted technique for adult and pediatric patients. Although it is carried out through a thoracoscopic approach, the procedure is associated with a number of potential intraoperative and post-operative complications. We present a case of cardiac perforation requiring emergent cardiopulmonary bypass in a 29-year-old male with Marfan syndrome and previous mitral valve repair undergoing a Nuss procedure for pectus excavatum. This case illustrates the importance of vigilance and preparation by the surgeons, anesthesia providers as well as the institution to be prepared with resources to handle the possible complications. This includes available cardiac surgical backup, perfusionist support and adequate blood product availability.

  14. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... show that people with arthritis, heart disease, or diabetes benefit from regular exercise. Exercise also helps people ... or difficulty walking. To learn about exercise and diabetes, see "Exercise and Type 2 Diabetes" from Go4Life®, ...

  15. [Clinical relevance of cardiopulmonary reflexes in anesthesiology].

    Science.gov (United States)

    Guerri-Guttenberg, R A; Siaba-Serrate, F; Cacheiro, F J

    2013-10-01

    The baroreflex, chemoreflex, pulmonary reflexes, Bezold-Jarisch and Bainbridge reflexes and their interaction with local mechanisms, are a demonstration of the richness of cardiovascular responses that occur in human beings. As well as these, the anesthesiologist must contend with other variables that interact by attenuating or accentuating cardiopulmonary reflexes such as, anesthetic drugs, surgical manipulation, and patient positioning. In the present article we review these reflexes and their clinical relevance in anesthesiology.

  16. Measurement of coronary calcium scores or exercise testing as initial screening tool in asymptomatic subjects with ST-T changes on the resting ECG: An evaluation study

    NARCIS (Netherlands)

    C.A. Geluk (Christiane); R. Dikkers (Riksta); J.A. Kors (Jan); R.A. Tio (René); R.H.J.A. Slart (Riemer); R. Vliegenthart (Rozemarijn); H.L. Hillege (Hans); T.P. Willems (Tineke); P. de Jong (Paul); W.H. van Gilst (Wiek); M. Oudkerk (Matthijs); F. Zijlstra (Felix)

    2007-01-01

    textabstractBackground: Asymptomatic subjects at intermediate coronary risk may need diagnostic testing for risk stratification. Both measurement of coronary calcium scores and exercise testing are well established tests for this purpose. However, it is not clear which test should be preferred as in

  17. Survival after in-hospital Cardiopulmonary Resuscitation

    Directory of Open Access Journals (Sweden)

    M Adib Hajbaghery

    2005-05-01

    Full Text Available Background: During recent years, cardiopulmonary resuscitation (CPR in hospital has received much attention. However, the survival rate of CPR in Iran’s hospitals is unknown. This study was designed to evaluate outcome of in-hospital CPR in Kashan. Methods: A longitudinal case registry study was conducted on all cases of in-hospital CPR during 6 months at 2002. Necessary data including; age, sex, underlying disease, working shift, time from cardiac arrest until initiating of CPR and until defibrillation, duration and result of CPR, frequency of tracheal intubations and time served for it were collected in a checklist. Results: In six months study, 206 cases of cardiopulmonary resuscitation attempted. The survival rate was similar for both sexes. Short-term survival observed in19.9% of cases and only 5.3% survived to discharge. Conclusions: Duration of CPR, time of the first defibrillation, response time and the location of cardiac arrest are the key predictors of survival to hospital discharge and in-hospital CPR strategies require improvement. This study promotes a national study on post CPR survival for accurate data on our performance in attention to chain of survival. KeyWords: Cardiopulmonary Resuscitation (CPR, Survival rate, Iran

  18. A marked increase in gastric fluid volume during cardiopulmonary bypass

    OpenAIRE

    2011-01-01

    Major physiological stress occurs during cardiac surgery with cardiopulmonary bypass. This is related to hypothermia and artificial organ perfusion. Thus, serious gastrointestinal complications, particularly upper gastrointestinal bleeding, sometimes follow cardiac surgery. We have compared the antisecretory effects of a preanesthetic H2 antagonist (roxatidine, cardiopulmonary bypass-H2 group, n = 15) and a proton pump inhibitor (rabeprazole, cardiopulmonary bypass-PPI group, n = 15) in patie...

  19. Modelos para predição da carga máxima no teste clínico de esforço cardiopulmonar Maximal workload prediction models in the clinical cardio-pulmonary effort test

    Directory of Open Access Journals (Sweden)

    Fernando dos Santos Nogueira

    2006-08-01

    Full Text Available OBJETIVO: Este estudo buscou derivar equações generalizadas para predição da carga máxima para homens e mulheres jovens. MÉTODOS: O método da ergoespirometria direta (Aerosport® TEEM 100, Estados Unidos da América do Norte foi empregado para determinar o VO2máx e a carga máxima (Wmáx, no cicloergômetro (Monark®, Brasil, de 30 homens (25 ± 5 anos, 75,0 ± 10,7 kg; 48,4 ± 8,8 mL . kg -1 . min -1 e 243 ± 51 Watts e 30 mulheres (26 ± 5 anos, 56,7 ± 5,9 kg, 39,8 ± 7,6 mL . kg -1 . min -1 e 172 ± 37 Watts. A idade e a massa corporal foram empregadas como variáveis independentes. Para todos os testes estatísticos aceitou-se o nível de significância de p OBJECTIVE: This study sought to derive generalized equations for predicting maximal workload for young men and women. METHODS: Direct ergospirometry (Aerosport® TEEM 100, USA was used to determine VO2máx and the maximal work load (Wmax on the cycle ergometer test (Monark®, Brazil of thirty men (25 ± 5 years, 75.0 ± 10.7 kg; 48.4 ± 8.8 mL . kg -1 . min -1 and 243 ± 51 Watts and thirty women (26 ± 5 years, 56.7 ± 5.9 kg, 39.8 ± 7.6 mL . kg -1 . min -1 and 172 ± 37 Watts. Age and body mass were used as independent variables. For all statistic tests, a p < 0.05 significance level was adopted. RESULTS: In the multiple linear adjustment, the maximal workload was explained by age and body mass as 54% (r = 0.73 for men, and as 76% (r = 0.87 for women, with standard errors of 0.66 W . kg -1 and 25 Watts. The proposed equations were cross-validated using another sample with similar age and VO2máx characteristics comprised of fifteen men and fifteen women. The intraclass correlation between the predicted Wmax values and those measures by ergospirometry were 0.70 and 0.69, with standard errors of 28.4 and 15.8 Watts, respectively, for men and women. CONCLUSIONS: This study exhibits valid generalized equations for determining the maximal cycle ergonometer workload for men and

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

    Science.gov (United States)

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

    2015-01-01

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

  1. Perspective: Does laboratory-based maximal incremental exercise testing elicit maximum physiological responses in highly-trained athletes with cervical spinal cord injury?

    Directory of Open Access Journals (Sweden)

    Christopher R West

    2016-01-01

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

  2. Chronic exercise prevents repeated restraint stress-provoked enhancement of immobility in forced swimming test in ovariectomized mice.

    Science.gov (United States)

    Han, Tae-Kyung; Lee, Jang-Kyu; Leem, Yea-Hyun

    2015-06-01

    We assessed whether chronic treadmill exercise attenuated the depressive phenotype induced by restraint stress in ovariectomized mice (OVX). Immobility of OVX in the forced swimming test was comparable to that of sham mice (CON) regardless of the postoperative time. Immobility was also no difference between restrained mice (exposure to periodic restraint for 21 days; RST) and control mice (CON) on post-exposure 2nd and 9th day, but not 15th day. In contrast, the immobility of ovariectomized mice with repeated stress (OVX + RST) was profoundly enhanced compared to ovariectomized mice-alone (OVX), and this effect was reversed by chronic exercise (19 m/min, 60 min/day, 5 days/week for 8 weeks; OVX + RST + Ex) or fluoxetine administration (20 mg/kg, OVX + RST + Flu). In parallel with behavioral data, the immunoreactivity of Ki-67 and doublecortin (DCX) in OVX was significantly decreased by repeated stress. However, the reduced numbers of Ki-67- and DCX-positive cells in OVX + RST were restored in response to chronic exercise (OVX + RST + Ex) and fluoxetine (OVX + RST + Flu). In addition, the expression pattern of cAMP response element-binding protein (CREB) and calcium-calmodulin-dependent kinase IV (CaMKIV) was similar to that of the hippocampal proliferation and neurogenesis markers (Ki-67 and DCX, respectively). These results suggest that menopausal depression may be induced by an interaction between repeated stress and low hormone levels, rather than a deficit in ovarian secretion alone, which can be improved by chronic exercise.

  3. Core stability for dancers - testing the effect of an exercise program

    OpenAIRE

    2014-01-01

    The purpose of this thesis was to create a targeted tool, a three-month exercise program, for an advanced group of dancers to improve their core stability. The second purpose was to increase awareness of the importance of deep abdominal activation among dancers. The thesis was implemented in cooperation with a local dance school in Pori, Tanssikoulu Tiina ja heimo, which provided the target group of research: an advanced group of dancers, called LeikistiVakavasti. The research methods of this...

  4. Functional exercise capacity and health-related quality of life in people with asbestos related pleural disease: an observational study

    Directory of Open Access Journals (Sweden)

    Dale Marita T

    2013-01-01

    Full Text Available Abstract Background Functional exercise capacity in people with asbestos related pleural disease (ARPD is unknown and there are no data on health-related quality of life (HRQoL. The primary aims were to determine whether functional exercise capacity and HRQoL were reduced in people with ARPD. The secondary aim was to determine whether functional exercise capacity was related to peak exercise capacity, HRQoL, physical activity or respiratory function. Methods In participants with ARPD, exercise capacity was measured by the six-minute walk test (6MWT and incremental cycle test (ICT; HRQoL by the St George’s Respiratory Questionnaire and physical activity by an activity monitor worn for one week. Participants also underwent lung function testing. Results 25 males completed the study with a mean (SD age of 71 (6 years, FVC 82 (19% predicted, FEV1/FVC 66 (11%, TLC 80 (19% predicted and DLCO 59 (13% predicted. Participants had reduced exercise capacity demonstrated by six-minute walk distance (6MWD of 76 (11% predicted and peak work rate of 71 (21% predicted. HRQoL was also reduced. The 6MWD correlated with peak work rate (r=0.58, p=0.002, St George’s Respiratory Questionnaire Total score (r=-0.57, p=0.003, metabolic equivalents from the activity monitor (r=0.45, p Conclusions People with ARPD have reduced exercise capacity and HRQoL. The 6MWT may be a useful surrogate measure of peak exercise capacity and physical activity levels in the absence of cardiopulmonary exercise testing and activity monitors. Trial registration ANZCTR12608000147381

  5. Angina pectoris during daily activities and exercise stress testing: The role of inducible myocardial ischemia and psychological distress.

    Science.gov (United States)

    Sullivan, Mark D; Ciechanowski, Paul S; Russo, Joan E; Spertus, John A; Soine, Laurie A; Jordan-Keith, Kier; Caldwell, James H

    2008-10-31

    Physicians often consider angina pectoris to be synonymous with myocardial ischemia. However, the relationship between angina and myocardial ischemia is highly variable and we have little insight into the sources of this variability. We investigated the relationship of inducible myocardial ischemia on SPECT stress perfusion imaging to angina reported with routine daily activities during the previous four weeks (N=788) and to angina reported during an exercise stress test (N=371) in individuals with confirmed or suspected coronary disease referred for clinical testing. We found that angina experienced during daily life is more strongly and consistently associated with psychological distress and the personal threat associated with angina than with inducible myocardial ischemia. In multivariable models, the presence of any angina during routine activities over the prior month was significantly associated with age, perceived risk of myocardial infarction, and anxiety when compared to those with no reported angina in the past month. Angina during daily life was not significantly associated with inducible myocardial ischemia on stress perfusion imaging in bivariate or multivariable models. In contrast, angina experienced during exercise stress testing was significantly related to image and ECG ischemia, though it was also significantly associated with anxiety. These results suggest that angina frequency over the previous four weeks is more strongly associated with personal threat and psychosocial distress than with inducible myocardial ischemia. These results lend support to angina treatment strategies that aim to reduce threat and distress as well as to reduce myocardial ischemia.

  6. An innovative design for cardiopulmonary resuscitation manikins based on a human-like thorax and embedded flow sensors

    Science.gov (United States)

    Thielen, Mark; Joshi, Rohan; Delbressine, Frank; Bambang Oetomo, Sidarto; Feijs, Loe

    2017-01-01

    Cardiopulmonary resuscitation manikins are used for training personnel in performing cardiopulmonary resuscitation. State-of-the-art cardiopulmonary resuscitation manikins are still anatomically and physiologically low-fidelity designs. The aim of this research was to design a manikin that offers high anatomical and physiological fidelity and has a cardiac and respiratory system along with integrated flow sensors to monitor cardiac output and air displacement in response to cardiopulmonary resuscitation. This manikin was designed in accordance with anatomical dimensions using a polyoxymethylene rib cage connected to a vertebral column from an anatomical female model. The respiratory system was composed of silicon-coated memory foam mimicking lungs, a polyvinylchloride bronchus and a latex trachea. The cardiovascular system was composed of two sets of latex tubing representing the pulmonary and aortic arteries which were connected to latex balloons mimicking the ventricles and lumped abdominal volumes, respectively. These balloons were filled with Life/form simulation blood and placed inside polyether foam. The respiratory and cardiovascular systems were equipped with flow sensors to gather data in response to chest compressions. Three non-medical professionals performed chest compressions on this manikin yielding data corresponding to force–displacement while the flow sensors provided feedback. The force–displacement tests on this manikin show a desirable nonlinear behaviour mimicking chest compressions during cardiopulmonary resuscitation in humans. In addition, the flow sensors provide valuable data on the internal effects of cardiopulmonary resuscitation. In conclusion, scientifically designed and anatomically high-fidelity designs of cardiopulmonary resuscitation manikins that embed flow sensors can improve physiological fidelity and provide useful feedback data. PMID:28290239

  7. Design and evaluation of a ubiquitous chest-worn cardiopulmonary monitoring system for healthcare application: a pilot study.

    Science.gov (United States)

    Zheng, Jiewen; Ha, Congying; Zhang, Zhengbo

    2017-02-01

    Ambulatory recording of physiological data will provide us deep insight into the physical condition of patients and athletes, and assessing treatment effects and training performances. This study presents a miniature wearable cardiopulmonary monitoring system called "Smart Chest Strap," which consists of an elastic band worn around the user's chest with integrated sensors, a physiological signals acquisition unit, and a mobile phone. The physiological signals including electrocardiogram, respiratory inductance plethysmograph, and accelerations (ACC) are sampled, digitalized, stored, and simultaneously transmitted to a mobile phone via Bluetooth. A medical validation test with participants performing discontinuous incremental treadmill (0-12 km/h) exercise was conducted. The results indicate nearly perfect correlations (0.999, 0.996, 0.994), small mean bias (0.60 BPM, 0.51 BPM, 0.05 g), and narrow limits of agreement (±2.90 BPM, ±1.81 BPM, ±0.09 g) for heart rate (HR), breathing rate (BR), and ACC represented as vector magnitude units (VMUs). There is a general trend of decrease in accuracy, precision, and correlation for HR, BR, and VMU as velocity increases, but these validity statistics are all within acceptable error limits and clinically accepted. The findings demonstrate that the Smart Chest Strap is valid and will have wider applications in healthcare, sports, and scientific research areas.

  8. Badminton Specific Testing and Development of Physical On-Court Exercise Capacity in Elite Youth Badminton Players

    DEFF Research Database (Denmark)

    Madsen, Christian Ole Møller

    in adult players only. This thesis aims to enhance the existing research within the field by also evaluating badminton-specific speed and endurance in elite youth players in both a cross-sectional and longitudinal manner, and with reference to the physiological capacities of world top-50 single players.......This thesis describes the development of two badminton-specific tests to evaluate players' maximum movement speed and the endurance capacity using game-like movement patterns and intermittent game-like conditions. The badminton speed test (B-SPEED) is used to assess maximal movements during...... specific on-court actions. It can distinguish between groups of players with different badminton skills, but similar sprint abilities The badminton-specific endurance test (B-ENDURANCE) is applicable for evaluation of badminton-specific endurance. Previous studies have tended to examine exercise capacity...

  9. Effects of eight weeks of exercise training and orlistat therapy on body composition and maximal exercise capacity in obese females.

    Science.gov (United States)

    Ozcelik, O; Dogan, H; Kelestimur, H

    2006-01-01

    A comparative assessment was made of the short-term effects of orlistat therapy and exercise training on body composition and aerobic fitness in obese females. A total of 24 obese patients were enrolled in to the study; 12 received orlistat therapy (DO) and 12 participated in a regular aerobic exercise-training programme (DE). All patients were on hypocaloric diets. Each patient performed three incremental ramp exercise tests (one at Week 0, one at the end of Week 4 and one at the end of Week 8) to exhaustion using an electromagnetically braked cycle ergometer to determine their anaerobic threshold and maximal exercise (Wmax) capacity. Patients in the DE group performed continuous exercise at a work rate that corresponded to the anaerobic threshold. Weight loss and loss of fat mass after 8 weeks were -6.4% (P=0.002) and -13.4% (DE) vs -5.8% (P=0.002) and -6.4% (P=0.008) (DO), respectively. Wmax capacity was 90.8+/-5 W (basal) vs 92.9+/-5 W (Week 4, P=0.1) and 100.4+/-6 W (Week 8, 10.5%, P=0.04) in the DO group, and 96.2+/-6 W (basal) vs 129.1+/-4 W (Week 4, 34.1%, P=0.002) and 137.5+/-5 W(Week 8, 42.9%, P=0.002) in the DE group. Despite similar decreases in body weight in both groups, patients in the DE group achieved a markedly higher level of Wmax, reflecting a better improvement in cardiopulmonary fitness, compared with patients in the DO group. Considering the improvement of aerobic fitness in the short term, an aerobic exercise-training programme should be considered for sedentary obese patients to improve their aerobic fitness and thereby reduce the negative outcomes of obesity.

  10. Correlation of heart rate recovery after exercise test with exercise capacity in patients with stable chronic obstructive pulmonary disease%运动试验后心率恢复与稳定期慢性阻塞性肺疾病患者运动耐力的相关性研究

    Institute of Scientific and Technical Information of China (English)

    刘海舰; 刘锦铭; 杨文兰; 孙兴国; 陈淑娟; 张艳; 谭晓越

    2013-01-01

    目的 研究运动试验后心率恢复与慢性阻塞性肺疾病(COPD)患者疾病严重程度的相关性,评估心率恢复对COPD患者运动耐力的影响.方法 对60例稳定期COPD患者及50例健康志愿者做动脉血气分析、常规肺功能测定和心肺运动试验,并根据运动后心率恢复情况将COPD患者分为心率恢复正常组(41例)和异常组(19例).结果 COPD患者的运动耐力(峰值摄氧量占预计值百分比)、峰值心率、心率恢复明显低于正常组,分别为66 ±15比89±11、(134 ±21)比(149±13)次/min和(18±9)比(27±10)次/min,均P<0.01,静息心率明显高于正常组[(83±13)比(77±13)次min,P<0.01].心率恢复异常组较正常组第一秒用力呼气容积占预计值百分比和峰值摄氧量占预计值的百分比下降更显著,分别为38±15比52±16(P <0.05)和57 ±12比71±14(P<0.01).心率恢复与第一秒用力呼气容积占预计值百分比和峰值摄氧量占预计值百分比呈显著性相关(r=0.422,P<0.01和r=0.523,P<0.01).多变量回归分析显示,第一秒用力呼气容积占预计值百分比和心率恢复是预测COPD患者运动耐力的独立变量(P<0.01和P=0.012).结论 运动后心率恢复不仅与COPD患者疾病严重程度相关,而且可作为预测COPD患者运动耐力的独立预测指标.%Objective To explore the correlation between heart rate recovery after exercise test and disease severity in patients with chronic obstructive pulmonary disease(COPD)and assess its impact on the exercise capacity of COPD patients.Methods Arterial blood gas analysis, pulmonary lung function test and cardiopulmonary exercise testing were performed in 60 patients with stable COPD and 50 healthy volunteers.Based on the heart rate recovery after exercise test, COPD patients were divided into normal heart rate recovery group(n =41)and abnormal heart rate recovery group(n =19).Results The COPD patients had lower exercise capacity(peak oxygen uptake as

  11. COMPARATIVE STUDY OF SUB - MAXIMAL EXERCISE TEST IN A GROUP OF 20 COLLEGE STUDENTS IN THE AGE GROUP OF 18 - 21 YEARS

    Directory of Open Access Journals (Sweden)

    Karuna Devi

    2013-10-01

    Full Text Available ABSTRACT : This study aims to compa re two widely applied tests such as step - test and bicycle ergometer. It was seen that body - weight has significant influence on the validity of sub - maximal exercise test [1]. In the development of exercise prescription knowing the actual energy expenditure with prescribed activity is essential particularly in weight loss programmes [2]. Recovery heart - rate from standardized stepping exercise, can classify people on cardiovascular fitness and VO 2 max with reasonable acceptable accuracy. Post - exercise heart - ra te is the primary parameter for estimating aerobic capacity [3], these evaluations are based on the regression among resting heart - rate, load intensity and maximum O 2 uptake. In the present study, the influence of body weight VO 2 max, BMI and speed were ta ken into consideration. The results showed the reliability & sensitivity of two tests are remarkably different. Evaluation of maximal O 2 consumption was determined by Astrand’s evaluation test on Bicycle Ergometer [4] and the step - test evaluated by Von Dob len formula, results seen were significantly different. The participants had a higher O 2 consumption rate in the step - test. The assessment of cardiovascular fitness commonly assessed by the measurements of maximum O 2 uptake can be a useful tool in promotin g health. It enables the baseline of the fitness to be established, it enables an exercise programme to be more individually prescribed, the assessment of aerobic capacity is becoming more common in medical screening.

  12. Exercise after breast cancer treatment: current perspectives

    Directory of Open Access Journals (Sweden)

    Dieli-Conwright CM

    2015-10-01

    Full Text Available Christina M Dieli-Conwright, Breanna Z Orozco Division of Biokinesiology and Physical Therapy, Women's Health and Exercise Laboratory, University of Southern California, Los Angeles, CA, USA Abstract: Over the past 2 decades, great strides have been made in the field of exercise-oncology research, particularly with breast cancer. This area of research is particularly important since there are >2.8 million breast cancer survivors who are in need of an intervention that can offset treatment-related side effects. Noticeable reductions in physical fitness (ie, cardiopulmonary fitness and muscular strength, negative changes in body composition (ie, increase in body mass, decrease in lean body mass, and increase in fat mass, increased fatigue, depression, or anxiety are some of the common side effects of cancer treatments that negatively impact overall quality of life and increase the risk for the development of comorbidities. Exercise plays a vital role in improving cardiopulmonary function, psychological events, muscular strength, and endurance in breast cancer survivors, and thus should be considered as a key factor of lifestyle intervention to reverse negative treatment-related side effects. The purpose of this review is to address current perspectives on the benefits of aerobic and resistance exercise after breast cancer treatments. This review is focused on the well-established benefits of exercise on physical and emotional well-being, bone health, lymphedema management, and the postulated benefits of exercise on risk reduction for recurrence of breast cancer. Keywords: breast cancer, exercise, physical well-being

  13. Effect of L-carnitine on exercise performance in patients with mitochondrial myopathy

    Directory of Open Access Journals (Sweden)

    A.C. Gimenes

    2015-04-01

    Full Text Available Exercise intolerance due to impaired oxidative metabolism is a prominent symptom in patients with mitochondrial myopathy (MM, but it is still uncertain whether L-carnitine supplementation is beneficial for patients with MM. The aim of our study was to investigate the effects of L-carnitine on exercise performance in MM. Twelve MM subjects (mean age±SD=35.4±10.8 years with chronic progressive external ophthalmoplegia (CPEO were first compared to 10 healthy controls (mean age±SD=29±7.8 years before they were randomly assigned to receive L-carnitine supplementation (3 g/daily or placebo in a double-blind crossover design. Clinical status, body composition, respiratory function tests, peripheral muscle strength (isokinetic and isometric torque and cardiopulmonary exercise tests (incremental to peak exercise and at 70% of maximal, constant work rate (CWR exercise test, to the limit of tolerance [Tlim] were assessed after 2 months of L-carnitine/placebo administration. Patients with MM presented with lower mean height, total body weight, fat-free mass, and peripheral muscle strength compared to controls in the pre-test evaluation. After L-carnitine supplementation, the patients with MM significantly improved their Tlim (14±1.9 vs 11±1.4 min and oxygen consumption (V˙O2 at CWR exercise, both at isotime (1151±115 vs 1049±104 mL/min and at Tlim (1223±114 vs 1060±108 mL/min. These results indicate that L-carnitine supplementation may improve aerobic capacity and exercise tolerance during high-intensity CWRs in MM patients with CPEO.

  14. Effect of L-carnitine on exercise performance in patients with mitochondrial myopathy.

    Science.gov (United States)

    Gimenes, A C; Bravo, D M; Nápolis, L M; Mello, M T; Oliveira, A S B; Neder, J A; Nery, L E

    2015-04-01

    Exercise intolerance due to impaired oxidative metabolism is a prominent symptom in patients with mitochondrial myopathy (MM), but it is still uncertain whether L-carnitine supplementation is beneficial for patients with MM. The aim of our study was to investigate the effects of L-carnitine on exercise performance in MM. Twelve MM subjects (mean age±SD=35.4±10.8 years) with chronic progressive external ophthalmoplegia (CPEO) were first compared to 10 healthy controls (mean age±SD=29±7.8 years) before they were randomly assigned to receive L-carnitine supplementation (3 g/daily) or placebo in a double-blind crossover design. Clinical status, body composition, respiratory function tests, peripheral muscle strength (isokinetic and isometric torque) and cardiopulmonary exercise tests (incremental to peak exercise and at 70% of maximal), constant work rate (CWR) exercise test, to the limit of tolerance [Tlim]) were assessed after 2 months of L-carnitine/placebo administration. Patients with MM presented with lower mean height, total body weight, fat-free mass, and peripheral muscle strength compared to controls in the pre-test evaluation. After L-carnitine supplementation, the patients with MM significantly improved their Tlim (14±1.9 vs 11±1.4 min) and oxygen consumption ( V ˙ O 2 ) at CWR exercise, both at isotime (1151±115 vs 1049±104 mL/min) and at Tlim (1223±114 vs 1060±108 mL/min). These results indicate that L-carnitine supplementation may improve aerobic capacity and exercise tolerance during high-intensity CWRs in MM patients with CPEO.

  15. Psychophysiologic effects of Hatha Yoga on musculoskeletal and cardiopulmonary function: a literature review.

    Science.gov (United States)

    Raub, James A

    2002-12-01

    Yoga has become increasingly popular in Western cultures as a means of exercise and fitness training; however, it is still depicted as trendy as evidenced by an April 2001 Time magazine cover story on "The Power of Yoga." There is a need to have yoga better recognized by the health care community as a complement to conventional medical care. Over the last 10 years, a growing number of research studies have shown that the practice of Hatha Yoga can improve strength and flexibility, and may help control such physiological variables as blood pressure, respiration and heart rate, and metabolic rate to improve overall exercise capacity. This review presents a summary of medically substantiated information about the health benefits of yoga for healthy people and for people compromised by musculoskeletal and cardiopulmonary disease.

  16. Asymptomatic ST-depression during exercise testing in children and adolescents with type 1 diabetes mellitus and autonomic dysfunction

    Directory of Open Access Journals (Sweden)

    Dmitry Nikitich Laptev

    2015-04-01

    Full Text Available Aim. The aim of this study was to investigate cardiac autonomic function as assessed by ST dynamics during and post-exercise in children and adolescents with type 1 diabetes mellitus (T1DM.Materials and methods. The study included 71 young patients with T1DM. The patients were aged 9–18 years and had no history of macrovascular disease or renal disease, including microalbuminuria. Cardiac autonomic function was assessed using cardiovascular tests and 24-h ECG monitoring with automatic calculation of QT interval and heart rate variability parameters. Each patient underwent the physical working capacity 170 test.Results. The prevalence of cardiovascular autonomic neuropathy (CAN was 30.9%. The frequency of asymptomatic ST-segment depression increased during exercise in 10 (45.5% patients with CAN (CAN+ compared with 9 (18.4% patients without CAN (CAN-; p=0.042. During the recovery period, asymptomatic ST-segment depression was present in the first minute in 8 (36.4% CAN+ patients compared with 1 (2% CAN- patient (p=0.0003 and in the second minute in 5 (22.7% CAN+ patients compared with 1 (2% CAN- patient (p=0.0095.Conclusion. Children and adolescents with T1DM and impaired autonomic function have increased prevalence of asymptomatic ST-segment depression during and post-exercise. The presence of cardiovascular risk factors in children and adolescents with T1DM and CAN may contribute to the increased cardiovascular morbidity and mortality during adulthood in patients with T1DM.

  17. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... Exercise: Benefits of Exercise Health Benefits One of the Healthiest Things You Can Do Like most people, ... active on a regular basis is one of the healthiest things you can do for yourself. Studies ...

  18. Asymptomatic cardiopulmonary changes caused by adenoid hypertrophy.

    Science.gov (United States)

    Abdel-Aziz, Mosaad

    2011-07-01

    Adenoid hypertrophy is the most common cause of pediatric upper airway obstruction, and it can lead to cardiopulmonary complications such as pulmonary hypertension, cor pulmonale, and even heart failure. The aim of this study was to detect the asymptomatic cardiopulmonary changes that could happen in children with adenoid hypertrophy.Eighty children with adenoid hypertrophy were included in this study. Chest x-ray was used to assess the cardiothoracic ratio, whereas echocardiography was used for measuring the pulmonary arterial pressures, right ventricular diastolic filling parameters, and right ventricular end-diastolic diameters. All patients underwent adenoidectomy with or without tonsillectomy, and they were subjected again to echocardiographic assessment 6 months after the operation. No patient showed an increase in the cardiothoracic ratio on x-ray. Preoperative echocardiography showed an increase in pulmonary artery pressure (22.7 [SD, 3.8] mm Hg), a decrease in right ventricular diastolic filling parameters (E/A = 1.03 [SD, 0.17]), and an increase in right ventricular end-diastolic diameters (1.89 [SD, 0.19] cm). Postoperatively, pulmonary artery pressure decreased to 17.2 [SD, 2.1] mm Hg, right ventricular diastolic filling (E/A) increased to 1.25 [SD, 0.11], and right ventricular end-diastolic diameters decreased to 1.68 [SD, 0.12] cm. The comparison between preoperative and postoperative results for each individual parameter was statistically significant. Clinically asymptomatic cardiopulmonary changes due to adenoid hypertrophy are not rare. Early diagnosis and treatment of upper airway obstruction can prevent these serious complications. Echocardiographic examination should be recommended for these patients as a part of preoperative preparation to avoid anesthetic complications.

  19. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... version of this page please turn Javascript on. Exercise: Benefits of Exercise Health Benefits One of the Healthiest Things You Can Do ... can do for yourself. Studies have shown that exercise provides many health benefits and that older adults can gain a lot ...

  20. Exercise: Benefits of Exercise

    Science.gov (United States)

    ... version of this page please turn Javascript on. Exercise: Benefits of Exercise Health Benefits One of the Healthiest Things You Can Do ... can do for yourself. Studies have shown that exercise provides many health benefits and that older adults can gain a lot ...

  1. 21 CFR 870.4240 - Cardiopulmonary bypass heat exchanger.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass heat exchanger. 870.4240... bypass heat exchanger. (a) Identification. A cardiopulmonary bypass heat exchanger is a device, consisting of a heat exchange system used in extracorporeal circulation to warm or cool the blood...

  2. Cardiopulmonary resuscitation: how far have we come?

    Science.gov (United States)

    Whitcomb, John J; Blackman, Virginia Schmied

    2007-01-01

    In the 43 years since it was first described, cardiopulmonary resuscitation (CPR) has grown from an obscure medical theory to a basic first aid skill taught to adults and is now the near-universal technique used in CPR instruction. This article provides insight into the history of CPR. We explore the phenomenon of sudden cardiac arrest, the historical roots of CPR, current practice data and recommendations, and the society's role in the development of this life-saving technique. We conclude with a review of CPR's economic impact on the healthcare system and the ethical and policy issues surrounding CPR.

  3. Effects of the oral contraceptive pill cycle on physiological responses to hypoxic exercise

    Science.gov (United States)

    Sandoval, Darleen A.; Matt, Kathleen S.

    2003-01-01

    To test whether the oral contraceptive pill cycle affects endocrine and metabolic responses to hypoxic (fraction of inspired oxygen = 13%, P(IO2): 95 mmHg; H) versus normoxic (P(IO2):153 mmHg; N) exercise, we examined eight women (28 +/- 1.2 yr) during the third (PILL) and placebo (PLA) weeks of their monthly oral contraceptive pill cycle. Cardiopulmonary, metabolic, and neuroendocrine measurements were taken before, during, and after three 5-min consecutive workloads at 30%, 45%, and 60% of normoxic V(O2peak) in H and N trials. Heart rate response to exercise was greater in H versus N, but was not different between PILL and PLA. Lactate levels were significantly greater during exercise, and both lactate and glucose levels were significantly greater for 30 min after exercise in H versus N (p PILL versus PLA, but glucose was greater in PILL versus PLA (p PILL versus PLA (p PILL phase reduces glucose and lactate responses to hypoxic exercise.

  4. Neurological complications and risk factors of cardiopulmonary failure of EV-A71-related hand, foot and mouth disease.

    Science.gov (United States)

    Long, Lili; Xu, Lin; Xiao, Zhenghui; Hu, Shixiong; Luo, Ruping; Wang, Hua; Lu, Xiulan; Xu, Zhiyue; Yao, Xu; Zhou, Luo; Long, Hongyu; Gong, Jiaoe; Song, Yanmin; Zhao, Li; Luo, Kaiwei; Zhang, Mengqi; Feng, Li; Yang, Liming; Sheng, Xiaoqi; Fan, Xuegong; Xiao, Bo

    2016-03-22

    From 2010 to 2012, large outbreaks of EV-A71-related- hand foot and mouth disease (HFMD) occurred annually in China. Some cases had neurological complications and were closely associated with fatal cardiopulmonary collapse, but not all children with central nervous system (CNS) involvement demonstrated a poor prognosis. To identify which patients and which neurological complications are more likely to progress to cardiopulmonary failure, we retrospectively studied 1,125 paediatric inpatients diagnosed with EV-A71-related HFMD in Hunan province, including 1,017 cases with CNS involvement. These patients were divided into cardiopulmonary failure (976 people) group and group without cardiopulmonary failure (149 people). A logistic regression analysis was used to compare the clinical symptoms, laboratory test results, and neurological complications between these two groups. The most significant risk factors included young age, fever duration ≥3 days, coma, limb weakness, drowsiness and ANS involvement. Patients with brainstem encephalitis and more CNS-involved regions were more likely to progress to cardiopulmonary failure. These findings can help front-line clinicians rapidly and accurately determine patient prognosis, thus rationally distributing the limited medical resources and implementing interventions as early as possible.

  5. Exercise Interventions in Children with Cancer: A Review

    Directory of Open Access Journals (Sweden)

    Tseng-Tien Huang

    2011-01-01

    Full Text Available The purpose of this review is to summarize literature that describes the impact of exercise on health and physical function among children during and after treatment for cancer. Relevant studies were identified by entering the following search terms into Pubmed: aerobic training; resistance training; stretching; pediatric; children; AND cancer. Reference lists in retrieved manuscripts were also reviewed to identify additional trials. We include fifteen intervention trials published between 1993 and 2011 that included children younger than age 21 years with cancer diagnoses. Nine included children with an acute lymphoblastic leukemia (ALL diagnosis, and six children with mixed cancer diagnoses. Generally, interventions tested were either in-hospital supervised exercise training or home based programs designed to promote physical activity. Early evidence from small studies indicates that the effects of exercise include increased cardiopulmonary fitness, improved muscle strength and flexibility, reduced fatigue and improved physical function. Generalizations to the entire childhood cancer and childhood cancer survivor populations are difficult as most of the work has been done in children during treatment for and among survivors of ALL. Additional randomized studies are needed to confirm these benefits in larger populations of children with ALL, and in populations with cancer diagnoses other than ALL.

  6. The influence of aerobic exercise training on the double product break point in low-to-moderate risk adults.

    Science.gov (United States)

    Hargens, Trent A; Griffin, Diane C; Kaminsky, Leonard A; Whaley, Mitchell H

    2011-02-01

    The double product is the product of the heart rate and systolic blood pressure. The double product break point (DPBP) is a physiologic threshold that occurs at similar exercise intensities to that of the ventilatory threshold (VT). The influence of aerobic exercise training on the DPBP has not yet been examined. The purpose of this study was to examine whether aerobic exercise training (ET) increases the exercise intensity at which the DPBP occurs, and whether it increases in a similar fashion to the VT. Seven males and 11 females, all sedentary (mean ± SD: age = 29.9 ± 10.5 years) underwent supervised cardiopulmonary exercise testing using a cycle ergometer ramp protocol at baseline and after 8 weeks of vigorous ET on a cycle ergometer. The VT was determined by gas analysis and the V-slope method. Experienced observers using standardized instructions visually determined the DPBP. Following ET, VO(2 peak), maximal workload, and body composition variables all showed significant positive changes. The VO(2) at which the DPBP and VT occurred increased significantly from baseline to follow-up (P Results suggest that the DPBP responds to ET in a similar fashion to that of the VT, and may be an easier and more useful marker of the VT for exercise training purposes.

  7. Valor del test de dobutamina comparado con la ergometría en la evaluación de riesgo coronario Comparison between electrocardiographic test with dobutamine and exercise stress testing on coronary risk stratification

    Directory of Open Access Journals (Sweden)

    José A. Martínez

    2004-08-01

    Full Text Available La ergometría es el método de elección para estratificar el riesgo de eventos luego de un infarto agudo de miocardio, pero el 20-40% de la población no puede realizarla. La utilización de dobutamina con control electrocardiográfico es una propuesta segura, fácil de realizar y reproducible. Nuestro objetivo fue evaluar la utilidad de dicho test para predecir los resultados de la ergometría en pacientes con infarto agudo de miocardio. Se incluyeron en forma prospectiva y consecutiva 210 pacientes (49 mujeres, edad: 60.5±11.7 años con primer infarto agudo de miocardio no complicado. Se realizó al quinto día el test de dobutamina con control electrocardiográfico y al sexto día la ergometría. Se consideró positiva la presencia de angor y/o infradesnivel del segmento ST > 1mV en ambas pruebas. Se determinó sensibilidad, especificidad, valor predictivo positivo y negativo del test de dobutamina, test de concordancia y valor kappa, con pThe exercise testing is still the most common test used to stratify the patients’s risk of new events following an acute myocardial infarction, but about 20 to 40% of the patients can not perform it appropriately. Since the electrocardiographic test with dobutamine has proved to be easy and safe, our aim was to evaluate its capacity to predict the results of the exercise testing on patients after an acute myocardial infarction. A total of 210 patients (average of age 60.5±11.7 years old and 23.3% females recovering from a first uncomplicated myocardial infarction, were consecutively included. An electrocardiographic test with dobutamine was performed during the fifth day of admission, and an exercise test during the sixth. The development of chest pain and/or a descending ST segment > 1 mm during a test qualified it as positive for ischemia. The sensitivity, specificity, positive and negative predictive values of both tests were determinated, as well as the congruence on their results, a p-value <0

  8. Electroencephalography during surgery with cardiopulmonary bypass and hypothermia.

    Science.gov (United States)

    Bashein, G; Nessly, M L; Bledsoe, S W; Townes, B D; Davis, K B; Coppel, D B; Hornbein, T F

    1992-06-01

    After more than 30 yr of use, electroencephalographic (EEG) monitoring during cardiopulmonary bypass has not gained wide clinical acceptance. To assess its utility to predict central nervous system injury, two-channel recordings were made from 78 patients undergoing cardiopulmonary bypass and anesthetized with fentanyl/diazepam/enflurane. The perfusion regimen included the use of high pump flow, a bubble oxygenator, and no arterial tubing filter. Target values were 28-32 degrees C for the minimum rectal temperature, 60-80 mmHg for mean arterial pressure, and 20-25% for hematocrit. Eight descriptors of the Fourier power spectra of the EEG were calculated off-line, and outcome comparisons were made with the results from neuropsychological tests. Among 58 patients yielding complete data of acceptable quality, a statistically significant reduction in total power was observed from prebypass to postbypass, accompanied by an increase in the fractional power in the theta and beta frequency bands and in the spectral edge frequency. The shifts in total and theta power were weakly associated with short-term but not with long-term changes in neuropsychological scores. Nearly 40% of the patients' EEGs were corrupted with electrical noise at some time during bypass. In 15 patients selected for having high-quality recordings and no neuropsychological deficit, an extensive statistical analysis failed to reveal any consistent variation in the EEG descriptors with hypothermia. Under the conditions studied, it appears that for other than gross signal dropout, the strong background variability in the EEG makes it have little value for detecting harbingers of brain injury.

  9. Lessons learned from the first U.S./Russian Federation joint tabletop exercise to prepare for conducting on-site inspections under the Comprehensive Nuclear Test Ban Treaty

    Energy Technology Data Exchange (ETDEWEB)

    Filarowski, C; Gough, R; Hawkins, W; Knowles, S; Kreek, S; MacLeod, G; Rockett, P; Smith, A; Sweeney, J; Wild, J; Wohletz, K

    1999-03-24

    A U.S./Russian Federation Joint Tabletop Exercise took place in Snezhinsk, Russia, from 19 to 24 October 1998, whose objectives were the following: (1) To simulate the actions of the Inspection Team (IT), including interactions with the inspected State Party (ISP), in order to examine different ways the United States and Russian Federation (RF) approach inspections and develop appropriate recommendations for the international community. (2) To identify ambiguities and contradictions in the interpretation of Treaty and Protocol provisions that might become apparent in the course of an inspection and that need clarification in connection with the development of Operational Manuals and on-site inspection (OSI) infrastructure. (3) To confirm the efficacy of using bilateral tabletop exercises to assist in developing an effective Comprehensive Test Ban Treaty (CTBT) verification regime. (4) To identify strong and weak points in the preparation and implementation methods of such exercises for the purpose of further improving possible future exercises.

  10. Can a fatigue test of the isolated lumbar extensor muscles of untrained young men predict strength progression in a resistance exercise program?

    NARCIS (Netherlands)

    Helmhout, P.; Staal, B.; Dijk, J. van; Harts, C.; Bertina, F.; Bie, R. de

    2010-01-01

    AIM: The aim of this exploratory study was to investigate the predictive value of a fatigue test of the lumbar extensor muscles for training progression in a group of 28 healthy but predominantly sedentary male students, in an 8-week resistance exercise program. METHODS: A three-phased fatigue test

  11. Graded Exercise Testing Protocols for the Determination of VO2max: Historical Perspectives, Progress, and Future Considerations

    Directory of Open Access Journals (Sweden)

    Nicholas M. Beltz

    2016-01-01

    Full Text Available Graded exercise testing (GXT is the most widely used assessment to examine the dynamic relationship between exercise and integrated physiological systems. The information from GXT can be applied across the spectrum of sport performance, occupational safety screening, research, and clinical diagnostics. The suitability of GXT to determine a valid maximal oxygen consumption (VO2max has been under investigation for decades. Although a set of recommended criteria exists to verify attainment of VO2max, the methods that originally established these criteria have been scrutinized. Many studies do not apply identical criteria or fail to consider individual variability in physiological responses. As an alternative to using traditional criteria, recent research efforts have been directed toward using a supramaximal verification protocol performed after a GXT to confirm attainment of VO2max. Furthermore, the emergence of self-paced protocols has provided a simple, yet reliable approach to designing and administering GXT. In order to develop a standardized GXT protocol, additional research should further examine the utility of self-paced protocols used in conjunction with verification protocols to elicit and confirm attainment of VO2max.

  12. Graded Exercise Testing Protocols for the Determination of VO2max: Historical Perspectives, Progress, and Future Considerations

    Science.gov (United States)

    Gibson, Ann L.; Janot, Jeffrey M.; Kravitz, Len; Dalleck, Lance C.

    2016-01-01

    Graded exercise testing (GXT) is the most widely used assessment to examine the dynamic relationship between exercise and integrated physiological systems. The information from GXT can be applied across the spectrum of sport performance, occupational safety screening, research, and clinical diagnostics. The suitability of GXT to determine a valid maximal oxygen consumption (VO2max) has been under investigation for decades. Although a set of recommended criteria exists to verify attainment of VO2max, the methods that originally established these criteria have been scrutinized. Many studies do not apply identical criteria or fail to consider individual variability in physiological responses. As an alternative to using traditional criteria, recent research efforts have been directed toward using a supramaximal verification protocol performed after a GXT to confirm attainment of VO2max. Furthermore, the emergence of self-paced protocols has provided a simple, yet reliable approach to designing and administering GXT. In order to develop a standardized GXT protocol, additional research should further examine the utility of self-paced protocols used in conjunction with verification protocols to elicit and confirm attainment of VO2max. PMID:28116349

  13. Responsiveness of the double limb lowering test and lower abdominal muscle progression to core stabilization exercise programs in healthy adults: a pilot study.

    Science.gov (United States)

    Haladay, Douglas E; Miller, Sayers J; Challis, John H; Denegar, Craig R

    2014-07-01

    Low back pain (LBP) is one of the most prevalent and expensive health care problems in the United States. Studies suggest that stabilization exercise may be effective in the management of people with LBP. To accurately assess the effect of stabilization programs on muscle performance, clinicians need an objective measure that is both valid and reliable. The purpose of this study was to determine whether the double limb lowering test (DLLT) and lower abdominal muscle progression (LAMP) can detect a change in abdominal muscle performance after stabilization exercises. Eleven healthy participants (4 men and 7 women) were randomly assigned to either a specific stabilization exercise (SSE) or general stabilization exercise (GSE) group and were evaluated by the DLLT and LAMP before, during, and at the end of 8 weeks of training. Subjects attended exercise sessions twice per week over 8 weeks. No significant difference in pretest performance existed between the 2 groups. No significant difference was detected with the DLLT for either the SSE or GSE over time or when groups were combined. The LAMP detected a significant difference for the combined groups and GSE but not SSE over time. These data indicate that the LAMP is sensitive to change after a spinal stabilization program, whereas the DLLT does not detect a change after these programs. Furthermore, the GSE was more effective in producing these changes. Additional testing of these assessments is necessary to further validate these tests and to identify specific populations for which these tests may be most appropriate.

  14. Exercise testing and thallium-201 myocardial perfusion scintigraphy in the clinical evaluation of patients with Wolff Parkinson White syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Poyatos, M.E.; Suarez, L.; Lerman, J.; Guibourg, H.; Camps, J.; Perosio, A.

    1986-10-01

    In 58 patients with Wolff Parkinson White syndrome (WPW), we performed exercise stress testing in order to investigate the incidence of normalization of the auriculo-ventricular conduction and the ST-segment changes. For a more accurate evaluation of the latter, exercise and redistribution radionuclide images with Thallium-201 were obtained in 18 cases. Forty-nine had type A and nine had type B of WPW. Forty-eight had permanent, four had alternant and six had no pre-excitation (PE) when they started the test. Mean maximal functional capacity, mean maximal heart rate and mean maximal double product were not different when compared to an age-matched control group. Of the 48 patients who began the test with PE, in 23 (48%) it disappeared while PE persisted in 25 (52%). In 16 cases the disappearance of the PE was sudden and in seven it was progressive. Pre-excitation persisted in 39.5% of patients with type A and in 88.8% with type B (p less than 0.01). ST-segment depression was observed in 76.6% of patients with PE and in 28.6% of cases without PE (p less than 0.01). ST-segment depression occurred in 44.8% of patients with type A and in 100% of cases with type B (p less than 0.05). Transient abnormal Thallium-201 scans were observed in 62.5% of patients without PE and in 20% with PE. No patients showed exertional arrhythmias. This study suggests the possibility of measuring the duration of the refractory period of the accessory pathway in those patients n which the PE disappears suddenly, at a given heart rate.

  15. Lessons learned from the first US/Russian Federation joint tabletop exercise to prepare for conducting on-site inspections under the Comprehensive Nuclear Test Ban Treaty

    Energy Technology Data Exchange (ETDEWEB)

    Filarowski, C; Kreek, S; Smith, A; Sweeney, J; Wild, J; Gough, R; Rockett, P; MacLeod, G; Hawkins, W; Wohletz, K; Knowles, S

    1999-03-24

    A U.S./Russian Federation Joint Tabletop Exercise took place in Snezhinsk, Russia, from 19 to 24 October 1998 whose objectives were to examine the functioning of an Inspection Team (IT) in a given scenario, to evaluate the strategies and techniques employed by the IT, to identify ambiguous interpretations of treaty provisions that needed clarification, and to confirm the overall utility of tabletop exercises to assist in developing an effective Comprehensive Test Ban Treaty (CTBT) verification regime. To achieve these objectives, the United States and Russian Federation (RF) agreed that two exercises would be conducted. The first would be developed by the RF, who would act as controller and as the inspected State Party (ISP), while the United States would play the role of the IT. The roles would be reversed in the second exercise; the United States would develop the scenario and play the ISP, while the RF would play the IT. A joint control team, comprised of members of both the U.S. and RF control teams, agreed on a number of ground rules for the two exercises and established a joint Evaluation Team to evaluate both of the exercises against the stated objectives. To meet time limitations, the scope of this joint exercise needed to be limited. The joint control team decided that each of the two exercises would not go beyond the first 25 days of an on-site inspection (OSI) and that the focus would be on examining the decision-making of the IT as it utilized the various technologies to clarify whether a nuclear test explosion had taken place. Hence, issues such as logistics, restricted access, and activities prior to Point of Entry (POE) would be played only to the extent needed to provide for a realistic context for the exercises' focus on inspection procedures, sensor deployments, and data interpretation. Each of the exercises began at the POE and proceeded with several iterations of negotiations between the IT and ISP, instrument deployments, and data

  16. 21 CFR 870.4210 - Cardiopulmonary bypass vascular catheter, cannula, or tubing.

    Science.gov (United States)

    2010-04-01

    ... Devices § 870.4210 Cardiopulmonary bypass vascular catheter, cannula, or tubing. (a) Identification. A cardiopulmonary bypass vascular catheter, cannula, or tubing is a device used in cardiopulmonary surgery to... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass vascular catheter,...

  17. Clinical Significance of Abnormal Heart Rate Recovery after Treadmill Exercise Test in Patients With Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    Li-feng HONG; Hao ZHANG; Ye-xin MA; He-song ZENG; Yuan WEN

    2009-01-01

    Objectives To evaluate the values of abnormal heart rate recovery (HRR) after treadmill exercise test in patients with coronary artery disease (CAD). Methods One hundred and seventy-eight consecutive cases of suspected CAD who underwent symptom-limited treadmill exercise test (TET) and coronary angiography (CAG) were enrolled and di-vided into normal and abnormal HRR group based on the status of the values of HRR one or two minutes after TET. The clinical characteristics, TET parameters and CAG results of the two groups were compared attempted to assess the value of HRR on patients with CAD. Results (1) The cases of smoking, diabetes mellitus (DM) and ST segment de-viation at rest in abnormal HRR group were more significantly than those in normal HRR group (all P < 0. 05). (2) The subjects of abnormal HRR usually had higher basal heart rate, more cases exhibited ST segment abnormality and or exercise-limited angina during or after TET(P<0.01 and P<0.05, respectively), but lower level of peak heart rate attained (P<0.05) than those in normal group. The values of metabolism equivalents and duration of TET between the two groups displayed phenomenal difference (P<0.05). There were more samples acquired moderate to high level of Duke test score and chronotropic incompetence in the group of abnormal HRR, compared to the normal HRR group (P<0.01). (3) The cases of negative CAG results in the group of normal and abnormal HRR group were 73 (66.97 % ) and 24 (34.78 %). Cases of significant coronary lesions (at least one major coronary vessel ≥ 50 % stenosis) a-mongst the subgroup of positive CAG were 36 (33.03 % ) and 45 (65.22 %), severe coronary lesions (three-vessel, left main or the equivalents of left main) were 10 (9.17 % ) and 17 (24.64 %) for normal and abnormal HRR respec-tively (P<0.01). Accordingly, the Gensini scores in the subunit of abnormal HRR increased. (4)Linear correlation analysis indicate there was a negative correlation between the values of HRR in

  18. Associates of Cardiopulmonary Arrest in the Perihemodialytic Period

    Directory of Open Access Journals (Sweden)

    Jennifer E. Flythe

    2014-01-01

    Full Text Available Cardiopulmonary arrest during and proximate to hemodialysis is rare but highly fatal. Studies have examined peridialytic sudden cardiac event risk factors, but no study has considered associates of cardiopulmonary arrests (fatal and nonfatal events including cardiac and respiratory causes. This study was designed to elucidate patient and procedural factors associated with peridialytic cardiopulmonary arrest. Data for this case-control study were taken from the hemodialysis population at Fresenius Medical Care, North America. 924 in-center cardiopulmonary events (cases and 75,538 controls were identified. Cases and controls were 1 : 5 matched on age, sex, race, and diabetes. Predictors of cardiopulmonary arrest were considered for logistic model inclusion. Missed treatments due to hospitalization, lower body mass, coronary artery disease, heart failure, lower albumin and hemoglobin, lower dialysate potassium, higher serum calcium, greater erythropoietin stimulating agent dose, and normalized protein catabolic rate (J-shaped were associated with peridialytic cardiopulmonary arrest. Of these, lower albumin, hemoglobin, and body mass index; higher erythropoietin stimulating agent dose; and greater missed sessions had the strongest associations with outcome. Patient health markers and procedural factors are associated with peridialytic cardiopulmonary arrest. In addition to optimizing nutritional status, it may be prudent to limit exposure to low dialysate potassium (<2 K bath and to use the lowest effective erythropoietin stimulating agent dose.

  19. Endothelial Function as a Possible Significant Determinant of Cardiac Function during Exercise in Patients with Structural Heart Disease

    Directory of Open Access Journals (Sweden)

    Bonpei Takase

    2009-01-01

    Full Text Available This study was investigated the role that endothelial function and systemic vascular resistance (SVR play in determining cardiac function reserve during exercise by a new ambulatory radionuclide monitoring system (VEST in patients with heart disease. The study population consisted of 32 patients. The patients had cardiopulmonary stress testing using the treadmill Ramp protocol and the VEST. The anaerobic threshold (AT was autodetermined using the V-slope method. The SVR was calculated by determining the mean blood pressure/cardiac output. Flow-mediated vasodilation (FMD was measured in the brachial artery to evaluate endotheilial function. FMD and the percent change f'rom rest to AT in SVR correlated with those from rest to AT in ejection fraction and peak ejection ratio by VEST, respectively. Our findings suggest that FMD in the brachial artery and the SVR determined by VEST in patients with heart disease can possibly reflect cardiac function reserve during aerobic exercise.

  20. The clinical translation gap in child health exercise research: a call for disruptive innovation.

    Science.gov (United States)

    Ashish, Naveen; Bamman, Marcas M; Cerny, Frank J; Cooper, Dan M; D'Hemecourt, Pierre; Eisenmann, Joey C; Ericson, Dawn; Fahey, John; Falk, Bareket; Gabriel, Davera; Kahn, Michael G; Kemper, Han C G; Leu, Szu-Yun; Liem, Robert I; McMurray, Robert; Nixon, Patricia A; Olin, J Tod; Pianosi, Paolo T; Purucker, Mary; Radom-Aizik, Shlomit; Taylor, Amy

    2015-02-01

    In children, levels of play, physical activity, and fitness are key indicators of health and disease and closely tied to optimal growth and development. Cardiopulmonary exercise testing (CPET) provides clinicians with biomarkers of disease and effectiveness of therapy, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response that is hidden when the child is at rest. Yet the growth of clinical trials utilizing CPET in pediatrics remains stunted despite the current emphasis on preventative medicine and the growing recognition that therapies used in children should be clinically tested in children. There exists a translational gap between basic discovery and clinical application in this essential component of child health. To address this gap, the NIH provided funding through the Clinical and Translational Science Award (CTSA) program to convene a panel of experts. This report summarizes our major findings and outlines next steps necessary to enhance child health exercise medicine translational research. We present specific plans to bolster data interoperability, improve child health CPET reference values, stimulate formal training in exercise medicine for child health care professionals, and outline innovative approaches through which exercise medicine can become more accessible and advance therapeutics across the broad spectrum of child health.

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

    Science.gov (United States)

    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

  2. Exercise tolerance, lung function abnormalities, anemia, and cardiothoracic ratio in sickle cell patients.

    Science.gov (United States)

    van Beers, Eduard J; van der Plas, Mart N; Nur, Erfan; Bogaard, Harm-Jan; van Steenwijk, Reindert P; Biemond, Bart J; Bresser, Paul

    2014-08-01

    Many patients with sickle cell disease (SCD) have a reduced exercise capacity and abnormal lung function. Cardiopulmonary exercise testing (CPET) can identify causes of exercise limitation. Forty-four consecutive SCD patients (27 HbSS, 11 HbSC, and 6 HbS-beta thalassemia) with a median age (interquartile range) of 26 (21-41) years underwent pulmonary function tests, CPET, chest x-ray, and echocardiography to further characterize exercise limitation in SCD. Peak oxygen uptake (V'O2 -peak), expressing maximum exercise capacity, was decreased in 83% of the studied patients. V'O2 -peak correlated with hemoglobin levels (R = 0.440, P = 0.005), forced vital capacity (FVC) (R = 0.717, P anemia (n = 17), cardiovascular dysfunction (n = 2), musculoskeletal function (n = 10), pulmonary ventilatory abnormalities (n = 1), pulmonary vascular exercise limitation (n = 1), and poor effort (n = 3). In the present study we demonstrate that anemia is the most important determinant of reduced exercise tolerance observed in SCD patients without signs of pulmonary hypertension. We found a strong correlation between various parameters of lung volume and cardiothoracic ratio and we hypothesize that cardiomegaly and relative small chest size may be important causes of the impairment in pulmonary function, that is, reduced long volumes and diffusion capacity, in SCD. Taking into account anthropomorphic differences between SCD patients and controls could help to interpret lung function studies in SCD better.

  3. Prediction values of mMRC and pulmonary function test for exercise capacity in patients with chronic obstructive pulmonary disease%改良版英国医学研究会呼吸困难量表评分及肺功能测定对慢性阻塞性肺疾病患者运动能力的预测价值研究

    Institute of Scientific and Technical Information of China (English)

    刘欣欣; 王浩彦; 张曼林; 汤兵祥

    2016-01-01

    目的:评价改良版英国医学研究会呼吸困难量表(mMRC)评分及肺功能对慢性阻塞性肺疾病(COPD)患者运动能力的预测价值。方法选择稳定期 COPD 患者66例,采用 mMRC分级行呼吸困难评分,并测定肺功能,其中31例男性患者行心肺运动测试。结果mMRC 与最大摄氧量(VO2 max)、每公斤体重最大摄氧量(VO2 max/kg)、最大功率(Wmax)及无氧阈(AT)呈较强负相关性(r =-0.413~-0.593),心肺运动能力指标与用力肺活量(FVC)、第1秒钟用力呼气量(FEV1)、1秒率(FEV1/FVC)、残气肺总量比(RV /TLC)及 CO 弥散量(DL CO)呈显著正相关(r =0.379~0.699),多元逐步回归分析结果显示,mMRC 预测 COPD 患者运动能力的价值弱于肺功能指标。结论与肺功能相比,mMRC 对 COPD 患者运动能力的预测价值有限。%Objective To evaluate the prediction values of the modified medical research council scale(mMRC)and pulmonary function test for exercise capacity of patients with chronic obstructive pulmonary disease(COPD).Methods 66 patients with stable COPD were studied.Dyspnea was assessed by the mMRC.All patients performed pulmonary function test and 31 male patients were chosen to perform cardiopulmonary exercise test.Results Dyspnea scores obtained from the mMRC significantly negatively correlated with VO2 max,VO2 max/kg,Wmax and AT(r =-0.413 ~-0.593).The index of exercise capacity significantly positively correlated with FVC,FEV1 ,RV/TLC,FEV1 /FVC and DL CO(r =0.379 ~0.699). Stepwise multiple regression analysis showed respiratory function but not mMRC was the most significant determinant for exercise performance of the patients with COPD.Conclusion The respiratory function shows more prediction values for exercise performance of the patients with COPD in cardiopulmonary exercise test than the mMRC.

  4. Partner Influence in Diet and Exercise Behaviors: Testing Behavior Modeling, Social Control, and Normative Body Size

    Science.gov (United States)

    Ciciurkaite, Gabriele; Brady, Christy Freadreacea; Garcia, Justin

    2016-01-01

    Previous research has documented social contagion in obesity and related health behaviors, but less is known about the social processes underlying these patterns. Focusing on married or cohabitating couples, we simultaneously explore three potential social mechanisms influencing obesity: normative body size, social control, and behavior modeling. We analyze the association between partner characteristics and the obesity-related health behaviors of focal respondents, comparing the effects of partners’ body type, partners’ attempts to manage respondents’ eating behaviors, and partners’ own health behaviors on respondents’ health behaviors (physical activity, fruit and vegetable consumption, and fast food consumption). Data on 215 partners are extracted from a larger study of social mechanisms of obesity in family and community contexts conducted in 2011 in the United States. Negative binomial regression models indicate that partner behavior is significantly related to respondent behavior (p obesity-related patterns of consumption and physical activity. In contrast, we find little support for the influence of normative body size or partner social control in this sample, though generalizations about the relevance of these processes may be inappropriate. These results underscore the importance of policies and interventions that target dyads and social groups, suggesting that adoption of exercise or diet modifications in one individual is likely to spread to others, creating a social environment characterized by mutual reinforcement of healthy behavior. PMID:28033428

  5. Positive end-expiratory pressure improves survival in a rodent model of cardiopulmonary resuscitation using high-dose epinephrine.

    LENUS (Irish Health Repository)

    McCaul, Conán

    2009-10-01

    Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pulmonary vascular resistance, and potentially improve cardiac output, its use during CPR would increase survival.

  6. Value of standardised exercise tests and blood biochemistry in the selection and training of breeding stallions.

    Science.gov (United States)

    Sloet van Oldruitenborgh-Oosterbaan, M M; Wensing, T; Barneveld, A; Breukink, H J

    1991-10-19

    Stallions selected by the Royal Dutch Warmblood Society were submitted to a standardised lungeing test at the beginning and at the end of a 100-day test of performance and ability. The heart rate, haematology and biochemistry values obtained in the first lungeing test showed no significant differences between the 15 stallions which were rejected by the Royal Dutch Warmblood Society during the first month of the 100-day test, the 15 stallions rejected during the last month and the 11 stallions which were approved for registration in the studbook. The 26 stallions submitted to the second lungeing test had significantly lower heart rates and blood lactate concentrations than in the first test. The standardised lungeing test had no value in predicting the rejection or approval of the stallions, and the fitness of a stallion at the beginning of the 100-day test did not influence its chance of being approved as a breeding stallion. The differences between the results of the first and the second tests suggest that the fitness of the stallions improved during the 100-day test.

  7. Relationship between exercise behavior, cardiorespiratory fitness, and cognitive function in early breast cancer patients treated with doxorubicin-containing chemotherapy: a pilot study.

    Science.gov (United States)

    Crowgey, Theresa; Peters, Katherine B; Hornsby, Whitney E; Lane, Amy; McSherry, Frances; Herndon, James E; West, Miranda J; Williams, Christina L; Jones, Lee W

    2014-06-01

    The purpose of this study was to examine the relationship between self-reported exercise behavior, cardiorespiratory fitness (CRF), and cognitive function in early breast cancer patients. Thirty-seven breast cancer patients following completion of chemotherapy (median 16 months) and 14 controls were studied. Cognitive function was assessed using the Central Nervous System (CNS) Vital Signs software (CNS Vital Signs, LLC, Morrisville, N.C., USA), a computerized test battery consisting of 9 cognitive subtests. Exercise behavior was evaluated using the Godin Leisure Time Exercise Questionnaire, and CRF was assessed via a cardiopulmonary exercise test to assess peak oxygen consumption. Patients' mean total exercise was 184 ± 141 min·week(-1) compared with 442 ± 315 min·week(-1) in controls (p exercise guidelines (i.e., ≥150 min of moderate-intensity or vigorous exercise per week) compared with 57% of controls (p = 0.014). Patients' peak oxygen consumption averaged 23.5 ± 6.3 mL·kg(-1)·min(-1) compared with 30.6 ± 7.0 mL·kg(-1)·min(-1) in controls (p exercise, peak oxygen consumption, and the majority of cognitive subdomain scores; however, there was a significant positive correlation between exercise and visual memory (r = 0.47, p = 0.004). In conclusion, breast cancer patients following the completion of primary adjuvant chemotherapy exhibit, in general, worse cognitive performance than healthy women from the general population, and such performance may be related to their level of exercise behavior.

  8. A marked increase in gastric fluid volume during cardiopulmonary bypass

    Science.gov (United States)

    Hirota, Kazuyoshi; Kudo, Mihoko; Hashimoto, Hiroshi; Kushikata, Tetsuya

    2011-01-01

    Major physiological stress occurs during cardiac surgery with cardiopulmonary bypass. This is related to hypothermia and artificial organ perfusion. Thus, serious gastrointestinal complications, particularly upper gastrointestinal bleeding, sometimes follow cardiac surgery. We have compared the antisecretory effects of a preanesthetic H2 antagonist (roxatidine, cardiopulmonary bypass-H2 group, n = 15) and a proton pump inhibitor (rabeprazole, cardiopulmonary bypass-PPI group, n = 15) in patients undergoing cardiac surgery with cardiopulmonary bypass, and also compared in patients undergoing a off-pump coronary artery bypass graft surgery (off-pump cardiopulmonary bypass-H2 group, n = 15). Gastric pH (5.14 ± 0.61) and gastric fluid volume (13.2 ± 2.4 mL) at the end of surgery in off-pump cardiopulmonary bypass-H2 groups was significantly lower and higher than those in both cardiopulmonary bypass-H2 (6.25 ± 0.54, 51.3 ± 8.0 mL) and cardiopulmonary bypass-PPI (7.29 ± 0.13, 63.5 ± 14.8 mL) groups, respectively although those variables did not differ between groups after the induction of anesthesia. Plasma gastrin (142 ± 7 pg/mL) at the end of surgery and maximal blood lactate levels (1.50 ± 0.61 mM) in off-pump cardiopulmonary bypass-H2 group were also significantly lower than those in both cardiopulmonary bypass-H2 (455 ± 96 pg/mL, 3.97 ± 0.80 mM) and cardiopulmonary bypass-PPI (525 ± 27 pg/mL, 3.15 ± 0.44 mM) groups, respectively. In addition, there was a significant correlation between gastric fluid volume and maximal blood lactate (r = 0.596). In conclusion, cardiopulmonary bypass may cause an increase in gastric fluid volume which neither H2 antagonist nor PPI suppresses. A significant correlation between gastric fluid volume and maximal blood lactate suggests that gastric fluid volume may predict degree of gastrointestinal tract hypoperfusion. PMID:21765601

  9. Unique Testing Capabilities of the NASA Langley Transonic Dynamics Tunnel, an Exercise in Aeroelastic Scaling

    Science.gov (United States)

    Ivanco, Thomas G.

    2013-01-01

    NASA Langley Research Center's Transonic Dynamics Tunnel (TDT) is the world's most capable aeroelastic test facility. Its large size, transonic speed range, variable pressure capability, and use of either air or R-134a heavy gas as a test medium enable unparalleled manipulation of flow-dependent scaling quantities. Matching these scaling quantities enables dynamic similitude of a full-scale vehicle with a sub-scale model, a requirement for proper characterization of any dynamic phenomenon, and many static elastic phenomena. Select scaling parameters are presented in order to quantify the scaling advantages of TDT and the consequence of testing in other facilities. In addition to dynamic testing, the TDT is uniquely well-suited for high risk testing or for those tests that require unusual model mount or support systems. Examples of recently conducted dynamic tests requiring unusual model support are presented. In addition to its unique dynamic test capabilities, the TDT is also evaluated in its capability to conduct aerodynamic performance tests as a result of its flow quality. Results of flow quality studies and a comparison to a many other transonic facilities are presented. Finally, the ability of the TDT to support future NASA research thrusts and likely vehicle designs is discussed.

  10. Studies on exercise physiology and performance testing of racehorses performed in Japan during the 1930s using recovery rate as an index.

    Science.gov (United States)

    Hiraga, Atsushi; Sugano, Shigeru

    2016-01-01

    The history of research on the exercise physiology of racehorses in Japan dates back to the 1930s. A research report entitled "Studies on exercise physiology and performance testing of the racehorse", published in 1933 by Shigeo Matsuba and Torao Shimamura of The University of Tokyo, was epoch-making and the most important study in the history of equine exercise physiology in Japan. Research results were reported from 92 Thoroughbred racehorses in a large-scale project during the period of 1928 to 1932 at the Shimofusa Imperial Farm and the Koiwai Farm, which were the two greatest racehorse farms at that time. A total of 20 physiological variables were measured to evaluate the fitness of Thoroughbred racehorses before exercise (Pre), just after exercise (Post), 1 hr after exercise (1 hr), 2 hr after exercise (2 hr), and 3 hr after exercise (3 hr) in order to calculate their recovery rates as an index of fitness and performance. The percentage of the Pre value at 1 hr, 2 hr, and 3 hr was calculated. When the percentage of a variable reached 95-105% of the Pre value, the variable was considered to be recovered. The percentage of the total number of variables that were recovered for each time period was calculated, and an overall average was calculated from them; Matsuba and Shimamura proposed calling this overall average the "recovery rate", which could then be applied to evaluate each horse. The effects of training on racehorses were subsequently evaluated by measuring the various physiological variables and the recovery rate.

  11. Influence of the incremental step size in work rate on exercise response and gas exchange in patients with pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    Völzke Henry

    2008-02-01

    Full Text Available Abstract Background Cardiopulmonary exercise testing (CPET has become increasingly important as a routine procedure in daily clinical work. So far, it is generally accepted that an individualized exercise protocol with exercise duration of 6 to 12 minutes is preferable to assess maximal exercise performance. The aim of this study was to compare an individualized NYHA adapted exercise protocol with a fixed standard protocol in patients with severe pulmonary arterial hypertension. Methods Twenty-two patients (17 female, 5 male; mean age 49 ± 14 yrs underwent symptom limited CPET on a bicycle. On two consecutive days each subject performed a stepwise CPET according to a modified Jones protocol (16 Watt per minute stages as well as an individualized NYHA adapted protocol with 5 or 10 Watt/min stages in a randomized order. Oxygen uptake at peak exercise (peakVO2 and anaerobic threshold (VO2AT, maximal ventilation (VE, breathing reserve (VE/MVV, ventilatory efficiency (VE vs. VCO2 slope, exercise time, maximal power and work rate were assessed and compared between both protocols. Results Comparing both, adapted NYHA protocol and standardized Jones protocol, we found significant differences in maximal power (56.7 ± 19 W vs. 74 ± 18 W; p 2, VO2AT and VE vs. VCO2 slope. Conclusion Variations of incremental step size during CPET significantly affect exercise time and maximal power, whereas relevant parameters for clinical judgement and prognosis such as oxygen uptake, ventilation and ventilatory efficiency remain unchanged. These findings have practical implications for the exercise evaluation of patients with pulmonary hypertension. To reach maximal results for ventilation, oxygen uptake and gas exchange an individualization of incremental step size appears not to be mandatory.

  12. 慢性阻塞性肺疾病患者六分钟步行试验中的心肺不良事件%The Cardiopulmonary Adverse Events of Six-Minute Walk Test in Patients with Chronic Obstructive Pulmonary Disease

    Institute of Scientific and Technical Information of China (English)

    于书雨; 张冬睿; 李月川

    2013-01-01

    目的 探讨稳定期慢性阻塞性肺疾病(COPD)患者6 min步行试验(6MWT)过程中心肺不良事件的发生情况与不同程度肺功能和心脏合并症的关系.方法 将85例完成试验的COPD患者依合并症情况分为单纯COPD组(Ⅰ组)16例、COPD合并左心舒张功能减低组(Ⅱ组)31例、COPD合并左心舒张功能减低及慢性肺源性心脏病组(Ⅲ组)38例,分别对3组患者6MWT前、试验结束时与试验结束后10 min的心率(HR)、血氧饱和度(SpO2)进行比较.结果 85 例中共27 例(31.76%)休息1~3 次后完成试验,19 例(22.35%)HR 异常;14 例(16.47%)SpO2120 次/min、SpO2120 bpm or SpO2<0.90 in 15 cases (17.65%). There were significant differences in HR before and after the tests between three groups (P < 0.05). There were significant differences in SpO2 before and after the tests between group Ⅱ and group Ⅲ(P< 0.05). Conclusion Severe COPD patients with left ventricular diastolic dysfunction and chronic pulmonary heart disease are more likely to occur cardiopulmonary adverse events during the test of 6MWT, and the HR and SpO2 are not easy to return to the level before the test.

  13. Transient Diabetes Insipidus Following Cardiopulmonary Bypass.

    Science.gov (United States)

    Ekim, Meral; Ekim, Hasan; Yilmaz, Yunus Keser; Bolat, Ali

    2015-04-01

    Diabetes insipidus (DI) results from inadequate output of Antidiuretic Hormone (ADH) from the pituitary gland (central DI) or the inability of the kidney tubules to respond to ADH (nephrogenic DI). ADH is an octapeptide produced in the supraoptic and paraventricular nuclei of the hypothalamus and stored in the posterior lobe of the pituitary gland. Cardiopulmonary Bypass (CPB) has been shown to cause a six-fold increased circulating ADH levels 12 hours after surgery. However, in some cases, ADH release may be transiently suppressed due to cardioplegia (cardiac standstill) or CPB leading to DI. We present the postoperative course of a 60-year-old man who developed transient DI after CPB. He was successfully treated by applying nasal desmopressin therapy. Relevant biochemical parameters should be monitored closely in patients who produce excessive urine after open heart surgery.

  14. Automated cardiopulmonary resuscitation: a case study.

    Science.gov (United States)

    Spiro, Jon; Theodosiou, Maria; Doshi, Sagar

    2014-02-01

    Rates of survival after cardiac arrest are low and correlate with the quality of cardiopulmonary resuscitation (CPR). Devices that deliver automated CPR (A-CPR) can provide sustained and effective chest compressions, which are especially useful during patient transfer and while simultaneous invasive procedures are being performed. The use of such devices can also release members of resuscitation teams for other work. This article presents a case study involving a man with acute myocardial infarction complicated by cardiogenic shock and pulmonary oedema. It describes how ED nursing and medical teams worked together to deliver A-CPR, discusses the use of A-CPR devices in a tertiary cardiac centre, and highlights the advantages of using such devices.

  15. Cardiopulmonary resuscitation: a review for clinicians.

    Science.gov (United States)

    Varon, J; Marik, P E; Fromm, R E

    1998-02-01

    Attempts at cardiopulmonary resuscitation (CPR) date from antiquity, but it is only in the last 50 years that a scientifically-based methodology has been developed. External chest compressions is the standard method for managing circulatory arrest, however, numerous alterations of this technique have been proposed in attempts to improve outcome from CPR. Defibrillation is the single most important therapy for the management of ventricular fibrillation or pulseless ventricular tachycardia. Adrenergic agents used to improve myocardial and cerebral perfusion are also the subject of considerable investigation with new agents entering clinical study. This paper reviews the history, current techniques and pharmacotherapy as well as controversial issues in the management of patients with cardiac arrest.

  16. Validity of COSMED's quark CPET mixing chamber system in evaluating energy metabolism during aerobic exercise in healthy male adults.

    Science.gov (United States)

    Nieman, David C; Austin, Melanie D; Dew, Dustin; Utter, Alan C

    2013-01-01

    This study validated the accuracy of COSMED's Quark cardiopulmonary exercise testing (CPET) metabolic mixing chamber system in measuring metabolic factors during maximal, graded exercise testing. Subjects included 32 physically active men between the ages of 18 and 34 years. During the first test session, subjects were measured for maximal oxygen consumption twice (15 min separation) with the CPET and Douglas bag systems (random order). During the second test session, subjects exercised through four stages of the Bruce treadmill protocol with measurement by the CPET and Douglas bag systems (random order) during steady state at the end of each 3-minute stage. Statistical analysis using a 2 (systems) x 5 (time) repeated measures ANOVA showed that the pattern of change in VO2, VCO2, VE, FeO2, FeCO2, and RER did not differ significantly between CPET and Douglas bag systems. This validation study indicates that the CPET mixing chamber system provides valid metabolic measurements that compare closely with the Douglas bag system during aerobic exercise.

  17. Residual myocardial ischaemia in first non-Q versus Q wave infarction: maximal exercise testing and ambulatory ST-segment monitoring

    DEFF Research Database (Denmark)

    Mickley, H; Pless, P; Nielsen, J R

    1993-01-01

    the infarction. The prevalence of exercise-induced ischaemic manifestations in the infarct types was similar: chest pain 14% vs 16% and ST-segment depression 54% vs 54%. The ischaemic threshold did not differ either (heart rate at 1 mm of ST-segment depression 120 +/- 27 vs 119 +/- 25 beats.min-1). During early...... in non-Q wave infarction (51%) as compared to Q wave infarction (31%) (P depression on ambulatory recording and exercise testing significantly predicted the development of future angina pectoris, whereas patients at increased risk for subsequent......In a prospective study of 123 consecutive survivors of a first myocardial infarction (43 non-Q wave, 80 Q wave), we determined the total residual ischaemic burden by use of pre-discharge maximal exercise testing and post-discharge 36 h ambulatory ST-segment monitoring initiated 11 +/- 5 days after...

  18. A 12-Week Vigorous Exercise Protocol in a Healthy Group of Persons over 65: Study of Physical Function by means of the Senior Fitness Test.

    Science.gov (United States)

    Todde, Francesco; Melis, Franco; Mura, Roberto; Pau, Massimiliano; Fois, Francesco; Magnani, Sara; Ibba, Gianfranco; Crisafulli, Antonio; Tocco, Filippo

    2016-01-01

    The aim of this study was to assess the effects of vigorous exercise on functional abilities by means of a Senior Fitness Test (SFT) in a group of elderly adults. Twenty healthy and inactive people performed vigorous exercise (VE: 12 men and 8 women, aged 69.6 ± 3.9 years). At the beginning of the study (T0) and after 3 months (T1), each subject's functional ability was tested for muscular strength, agility, cardiovascular fitness, flexibility, and balance. The VE was designed with continuous and interval exercise involving large muscle activities. Functional exercises were performed between 60% and 84% of heart rate reserve (HRR) for a duration of 65 minutes. Five out of the 6 SFTs performed were found significantly improved: Chair Stand (T0 12.4 ± 2.4, T1 13.5 ± 2.6, p exercises can improve functional mobility and muscle endurance in those over 65 years of age. SFTs are an effective method for assessing improvements in the functional capacity of elderly adults.

  19. Spatial variation in nitrogen dioxide concentrations and cardiopulmonary hospital admissions

    NARCIS (Netherlands)

    Dijkema, Marieke B A; van Strien, Robert T; van der Zee, Saskia C; Mallant, Sanne F; Fischer, Paul; Hoek, Gerard; Brunekreef, Bert; Gehring, Ulrike

    2016-01-01

    BACKGROUND: Air pollution episodes are associated with increased cardiopulmonary hospital admissions. Cohort studies showed associations of spatial variation in traffic-related air pollution with respiratory and cardiovascular mortality. Much less is known in particular about associations with cardi

  20. The influence of aetiology on the benefits of exercise training in patients with heart failure.

    Science.gov (United States)

    Antunes-Correa, Ligia M; Ueno-Pardi, Linda M; Trevizan, Patricia F; Santos, Marcelo R; da Silva, Carlos Henrique P; Franco, Fábio Gm; Alves, Maria Janieire Nn; Rondon, Maria Urbana Pb; Negrao, Carlos E

    2017-03-01

    Background Exercise training improves neurovascular control and functional capacity in heart failure (HF) patients. However, the influence of the aetiology on these benefits is unknown. We compared the effects of exercise training on neurovascular control and functional capacity in idiopathic, ischaemic and hypertensive HF patients. Design Subjects consisted of 45 exercise-trained HF patients from our database (2000-2015), aged 40-70 years old, functional class II/III and ejection fraction ≤40%, and they were divided into three groups: idiopathic ( n = 11), ischaemic ( n = 18) and hypertensive ( n = 16). Methods Functional capacity was determined by cardiopulmonary exercise testing. Muscle sympathetic nerve activity (MSNA) was recorded by microneurography. Forearm blood flow (FBF) was measured by venous occlusion plethysmography. Results Four months of exercise training significantly reduced MSNA and significantly increased FBF in all groups. However, the relative reduction in MSNA was greater in hypertensive patients compared with that in idiopathic patients (frequency: -34% vs . -15%, p = 0.01; incidence: -31% vs . -12%, p = 0.02). No differences were found between hypertensive patients and ischaemic patients. The relative increase in FBF was greater in hypertensive patients than in ischaemic and idiopathic patients (42% vs. 15% and 17%, respectively, p = 0.02). The relative increase in forearm vascular conductance was greater in hypertensive patients compared with those in ischaemic and idiopathic patients (57% vs . 13% and 26%, respectively, p = 0.001). Exercise training significantly and similarly increased peak oxygen consumption in all groups. Conclusion The exercise-induced improvement in neurovascular control is more pronounced in hypertensive HF patients than in idiopathic and ischaemic HF patients. The increase in functional capacity is independent of aetiology.

  1. Improved Left Ventricular Diastolic Function with Exercise Training in Hypertension: A Doppler Imaging Study

    Directory of Open Access Journals (Sweden)

    Huan Zheng

    2011-01-01

    Full Text Available Objective. To study the effects of 6 months’ exercise training on ventricular function in hypertensive patients. Methods. Both groups received routine anti-hypertensive pharmacological therapy and one received a 6 months’ exercise program in addition. All patients underwent incremental cardiopulmonary exercise test and echocardiography in baseline and after 6 months. Results. (1 In 6 months’ follow-up, PeakVO2, Powermax (max workload, AT (anaerobic threshold, VO2AT (VO2 at anaerobic threshold, tAT (time from beginning to anaerobic threshold (<.05, were increased in the exercise group. HRrest (Heart rate at rest was decreased (<.05. LAVI (left atrial volume index, peak mitral filling velocities during early (E and late (A diastole E/A ratio, DT(deceleration time of the mitral E wave, IVST(Interventricular septum thickness in diastole, tissue Doppler indice Mean Ea/Aa ratio (<.05 were also improved. (2 Correlation analysis: 4 variates had significant effect on change of PeakVO2 in the exercise group: age (=−0.39, change of HRrest (=0.59, change of E/A (=0.55, change of Mean Ea/Aa (=0.58; Through analyzing 2 groups patients’ baseline values, their age (=−0.32, VO2AT (=0.29, HRrest (=−0.25, LAVI (=−0.24, E/A (=0.41 were found to be independent predictors of MeanEa/Aa. -value under .05 was considered statistically significant. Conclusion. 6 months’ exercise could enhance hypertensive patients’ aerobic exercise level and diastolic function to a certain extent.

  2. Dynamic hyperinflation is associated with a poor cardiovascular response to exercise in COPD patients

    Directory of Open Access Journals (Sweden)

    Tzani Panagiota

    2011-11-01

    Full Text Available Abstract Background Pulmonary hyperinflation has the potential for significant adverse effects on cardiovascular function in COPD. The aim of this study was to investigate the relationship between dynamic hyperinflation and cardiovascular response to maximal exercise in COPD patients. Methods We studied 48 patients (16F; age 68 yrs ± 8; BMI 26 ± 4 with COPD. All patients performed spirometry, plethysmography, lung diffusion capacity for carbon monoxide (TLco measurement, and symptom-limited cardiopulmonary exercise test (CPET. The end-expiratory lung volume (EELV was evaluated during the CPET. Cardiovascular response was assessed by change during exercise in oxygen pulse (ΔO2Pulse and double product, i.e. the product of systolic blood pressure and heart rate (DP reserve, and by the oxygen uptake efficiency slope (OUES, i.e. the relation between oxygen uptake and ventilation. Results Patients with a peak exercise EELV (%TLC ≥ 75% had a significantly lower resting FEV1/VC, FEF50/FIF50 ratio and IC/TLC ratio, when compared to patients with a peak exercise EELV (%TLC 2Pulse (r = - 0.476, p = 0.001, OUES (r = - 0.452, p = 0.001 and DP reserve (r = - 0.425, p = 0.004. Furthermore, according to the ROC curve method, ΔO2Pulse and DP reserve cut-off points which maximized sensitivity and specificity, with respect to a EELV (% TLC value ≥ 75% as a threshold value, were ≤ 5.5 mL/bpm (0.640 sensitivity and 0.696 specificity and ≤ 10,000 Hg · bpm (0.720 sensitivity and 0.783 specificity, respectively. Conclusion The present study shows that COPD patients with dynamic hyperinflation have a poor cardiovascular response to exercise. This finding supports the view that in COPD patients, dynamic hyperinflation may affect exercise performance not only by affecting ventilation, but also cardiac function.

  3. Pediatric Cardiopulmonary Resuscitation: Advances in Science, Techniques, and Outcomes

    OpenAIRE

    Topjian, Alexis A.; Berg, Robert A; Nadkarni, Vinay M.

    2008-01-01

    More than 25% of children survive to hospital discharge after in-hospital cardiac arrests, and 5% to 10% survive after out-of-hospital cardiac arrests. This review of pediatric cardiopulmonary resuscitation addresses the epidemiology of pediatric cardiac arrests, mechanisms of coronary blood flow during cardiopulmonary resuscitation, the 4 phases of cardiac arrest resuscitation, appropriate interventions during each phase, special resuscitation circumstances, extracorporeal membrane oxygenati...

  4. Ventilatory efficiency during exercise in healthy subjects.

    Science.gov (United States)

    Sun, Xing-Guo; Hansen, James E; Garatachea, Nuria; Storer, Thomas W; Wasserman, Karlman

    2002-12-01

    When evaluating dyspnea in patients with heart or lung disease it is useful to measure the quantity of ventilation needed to eliminate metabolically produced CO2 (i.e., the ventilatory efficiency). Mathematically, the relationship between ventilation (VE) and CO2 output is determined by the arterial CO2 pressure and the physiologic dead space-tidal volume ratio. We decided to determine how age, sex, size, fitness, and the type of ergometer influenced ventilatory efficiency in normal subjects. Three methods were compared for expressing this relationship: (1) the VE versus CO2 output slope below the ventilatory compensation point, commonly used by cardiologists for estimating the severity of heart failure; (2) the VE/CO2 output ratio at the anaerobic threshold, commonly used by pulmonologists; and (3) the lowest VE/CO2 output ratio during exercise, the latter parameter not previously reported. We studied 474 healthy adults, between 17 and 78 years of age during incremental cycle and treadmill cardiopulmonary exercise tests at three test sites, correcting the total VE for the equipment dead space. The lowest VE/CO2 output ratio was insignificantly different from the ratio at the anaerobic threshold, less variable than that for the slope relationship, and unaffected by the site, ergometer, and gas exchange measurement systems. The regression equation for the lowest VE/CO2 output ratio was 27.94 + 0.108 x age + (0.97 = F, 0.0 = M) - 0.0376 x height, where age is in years and height is in centimeters. We conclude that the lowest VE/CO2 output ratio is the preferred noninvasive method to estimate ventilatory inefficiency.

  5. Measurement of coronary calcium scores by electron beam computed tomography or exercise testing as initial diagnostic tool in low-risk patients with suspected coronary artery disease

    NARCIS (Netherlands)

    Geluk, Christiane A.; Dikkers, Riksta; Perik, Patrick J.; Tio, Rene A.; Gotte, Marco J. W.; Hillege, Hans L.; Vliegenthart, Rozemarijn; Houwers, Janneke B.; Willems, Tineke P.; Oudkerk, Matthijs; Zijlstra, Felix

    2008-01-01

    We determined the efficiency of a screening protocol based on coronary calcium scores (CCS) compared with exercise testing in patients with suspected coronary artery disease (CAD), a normal ECG and troponin levels. Three-hundred-and-four patients were enrolled in a screening protocol including CCS b

  6. Effect of Resistance Tube Exercises on Kicking Accuracy, Vertical Jump and 40-Yard Technical Test in Competitive Football Players – An Experimental Study

    Directory of Open Access Journals (Sweden)

    Tirumala Alekhya

    2014-09-01

    Full Text Available Purpose. Kicking, jumping and agility are important skills in football. These activities require adequate lower limb strength, which can be enhanced with resistance training. The objective of the study was to evaluate the effect of resistance tube exercises on kicking accuracy, vertical jump performance and 40-yard technical test results in competitive football players. Methods. The study involved 23 competitive football players (11 males, 12 females aged from 18-20 years recruited from three different universities in Belgaum, Karnataka, India. Back heel kick accuracy, vertical jump height and 40-yard technical test time were evaluated before and after a 2-week resistance tube exercise program. Results. Significant improvements in post-intervention kicking accuracy were found when males and females were treated as a single group (p = 0.01. Vertical jump height also showed a highly significant post-intervention improvement in the males and for the combined group of males and females (p = 0.001. The 40-yard technical test values significantly improved in the females and in the combined results for males and females (p = 0.001. Conclusions. The two-week resistance tube exercise program was found to have an effect on kicking accuracy, vertical jump height and 40-yard technical test performance in competitive football players. Resistance tube exercises can thus be included as a component of a regular strength training program for such athletes.

  7. Health Locus of Control Predicts Free-living, but Not Supervised, Physical Activity: A Test of Exercise-Specific Control and Outcome-Expectancy Hypotheses.

    Science.gov (United States)

    Dishman, Rod K.; Steinhardt, Mary

    1990-01-01

    Discusses a study that compared internal health locus of control (IHLOC) with internal exercise locus of control for predicting college students' activity. Results indicate an independent influence of IHLOC on free-living physical activity and suggest that testing adjust for fitness, barriers to physical activity, and outcome-expectancy values.…

  8. Sport climbing with pre-existing cardio-pulmonary medical conditions.

    Science.gov (United States)

    Kuepper, T; Morrison, A; Gieseler, U; Schoeffl, V

    2009-06-01

    Over the past 25 years sport climbing has developed from an elite extreme sport subculture pursued by few into a mainstream recreational sport enjoyed globally by climbers of all ages, climbing abilities, and with pre-existing health conditions. As the demands and grades of climbing difficulty have increased over this period, most scientific literature on sport climbing focused on acute injuries and overuse syndromes, or performance physiology in healthy adult males. The physiological response to sport climbing is more similar to that of resistance training (i.e., body building) rather than a predominantly aerobic sport (i.e., running, cycling), so that heart rate and blood pressure during a climb will be disproportionately high relative to the 'exercise' of climbing, and breathing may be irregular. Therefore this review sought evidence-based recommendations for recreational sport climbing participation by those individuals with pre-existing cardiopulmonary medical conditions including coronary heart disease, chronic heart failure, cardiac dysrhythmia, pulmonary diseases (i.e., asthma) or hypertension. This review defines the criteria that must be fulfilled for safe sport climbing by those with pre-existing cardiopulmonary conditions or those with hypertension.

  9. Heart rate recovery in elite athletes: the impact of age and exercise capacity.

    Science.gov (United States)

    Suzic Lazic, Jelena; Dekleva, Milica; Soldatovic, Ivan; Leischik, Roman; Suzic, Slavica; Radovanovic, Dragan; Djuric, Biljana; Nesic, Dejan; Lazic, Milivoje; Mazic, Sanja

    2017-03-01

    There is compelling evidence that postexercise heart rate recovery (HRR) is a valid indicator of sympaticovagal balance. It is also used in prescription and monitoring of athletic training. The purpose of our study was to determine HRR after maximal exercise among elite athletes with respect to age. A total of 274 elite male Caucasian athletes were randomly selected from the larger sample and divided into two groups: adolescent (group Y) and adult athletes (≥18 years; group A). They performed maximal cardiopulmonary exercise testing on a treadmill. Heart rate recovery was calculated as the rate of decline of HR from peak exercise to rates 1, 2 and 3 min after cessation of exercise (HRR1, HRR2 and HRR3). A significantly higher HRR1 was found in group A (29·5 ± 15·6 versus 22·4 ± 10·8, Precovery. Higher values of HRR1 should be expected in older athletes, and HRR3 could be used as an index of aerobic capacity, irrespective of age.

  10. Influence of exercise modality on agreement between gas exchange and heart rate variability thresholds.

    Science.gov (United States)

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

    2014-08-01

    The main purpose of this study was to investigate the level of agreement between the gas exchange threshold (GET) and heart rate variability threshold (HRVT) during maximal cardiopulmonary exercise testing (CPET) using three different exercise modalities. A further aim was to establish whether there was a 1:1 relationship between the percentage heart rate reserve (%HRR) and percentage oxygen uptake reserve (%VO2 R) at intensities corresponding to GET and HRVT. Sixteen apparently healthy men 17 to 28 years of age performed three maximal CPETs (cycling, walking, and running). Mean heart rate and VO2 at GET and HRVT were 16 bpm (P0.05). There was a strong relationship between GET and HRVT, with R2 ranging from 0.69 to 0.90. A 1:1 relationship between %HRR and % VO2 R was not observed at GET and HRVT. The %HRR was higher during cycling (GET mean difference=7%; HRVT mean difference=11%; both P<0.001), walking (GET mean difference=13%; HRVT mean difference=13%; both P<0.001), or running (GET mean difference=11%; HRVT mean difference=10%; both P<0.001). Therefore, using HRVT to prescribe aerobic exercise intensity appears to be valid. However, to assume a 1:1 relationship between %HRR and % VO2 R at HRVT would probably result in overestimation of the energy expenditure during the bout of exercise.

  11. Effect of a cardiac rehabilitation program on exercise oscillatory ventilation in Japanese patients with heart failure.

    Science.gov (United States)

    Yamauchi, Fumitake; Adachi, Hitoshi; Tomono, Jun-Ichi; Toyoda, Shigeru; Iwamatsu, Koichi; Sakuma, Masashi; Nakajima, Toshiaki; Oshima, Shigeru; Inoue, Teruo

    2016-10-01

    Although exercise oscillatory ventilation has emerged as a potent independent risk factor for adverse prognosis in heart failure, it is not well known whether cardiac rehabilitation can improve oscillatory ventilation. In this study, we investigated the magnitude of oscillations in ventilation before and after cardiac rehabilitation in chronic heart failure patients with exercise oscillatory ventilation. Cardiac rehabilitation (5-month program) was performed in 26 patients with chronic heart failure who showed an oscillatory ventilation pattern during cardiopulmonary exercise testing (CPX). After the 5-month rehabilitation program was completed, the patients again underwent CPX. To determine the magnitude of oscillations in ventilation, the amplitude and cycle length of the oscillations were calculated and compared with several other parameters, including biomarkers that have established prognostic value in heart failure. At baseline before cardiac rehabilitation, both oscillation amplitude (R = 0.625, P Cardiac rehabilitation decreased oscillation amplitude (P cardiac rehabilitation program improves exercise oscillatory ventilation in chronic heart failure patients by reducing the oscillation amplitude. This effect is associated with a reduction of plasma BNP levels, potentially contributing to an improvement of heart failure.

  12. Can bronchodilators improve exercise tolerance in COPD patients without dynamic hyperinflation?

    Directory of Open Access Journals (Sweden)

    Maria Enedina Aquino Scuarcialupi

    2014-04-01

    Full Text Available OBJECTIVE: To investigate the modulatory effects that dynamic hyperinflation (DH, defined as a reduction in inspiratory capacity (IC, has on exercise tolerance after bronchodilator in patients with COPD. METHODS: An experimental, randomized study involving 30 COPD patients without severe hypoxemia. At baseline, the patients underwent clinical assessment, spirometry, and incremental cardiopulmonary exercise testing (CPET. On two subsequent visits, the patients were randomized to receive a combination of inhaled fenoterol/ipratropium or placebo. All patients then underwent spirometry and submaximal CPET at constant speed up to the limit of tolerance (Tlim. The patients who showed ΔIC(peak-rest 0.05. In addition, both groups showed similar improvements in Tlim after bronchodilator (median [interquartile range]: 22% [3-60%] vs. 10% [3-53%]; p > 0.05. CONCLUSIONS: Improvement in TLim was associated with an increase in IC at rest after bronchodilator in HD- patients with COPD. However, even without that improvement, COPD patients can present with greater exercise tolerance after bronchodilator provided that they develop DH during exercise.

  13. Aerobic exercise in adolescents with obesity: preliminary evaluation of a modular training program and the modified shuttle test

    Directory of Open Access Journals (Sweden)

    van der Baan-Slootweg Olga H

    2007-04-01

    Full Text Available Abstract Background Increasing activity levels in adolescents with obesity requires the development of exercise programs that are both attractive to adolescents and easily reproducible. The aim of this study was to develop a modular aerobic training program for adolescents with severe obesity, with a focus on variety, individual targets and acquiring physical skills. We report here the effects on aerobic fitness from a pilot study. Furthermore, we examined the feasibility of the modified shuttle test (MST as an outcome parameter for aerobic fitness in adolescents with severe obesity. Methods Fifteen adolescents from an inpatient body weight management program participated in the aerobic training study (age 14.7 ± 2.1 yrs, body mass index 37.4 ± 3.5. The subjects trained three days per week for 12 weeks, with each session lasting 30–60 minutes. The modular training program consisted of indoor, outdoor and swimming activities. Feasibility of the MST was studied by assessing construct validity, test-retest reliability and sensitivity to change. Results Comparing pretraining and end of training period showed large clinically relevant and significant improvements for all aerobic indices: e.g. VO2 peak 17.5%, effect size (ES 2.4; Wmax 8%, ES 0.8. In addition, a significant improvement was found for the efficiency of the cardiovascular system as assessed by the oxygen pulse (15.8%, ES 1.6. Construct validity, test-retest reliability and sensitivity to change of the MST were very good. MST was significantly correlated with VO2 peak (r = 0.79 and Wmax (r = 0.84 but not with anthropometric measures. The MST walking distance improved significantly by 32.5%, ES 2.5. The attendance rate at the exercise sessions was excellent. Conclusion This modular, varied aerobic training program has clinically relevant effects on aerobic performance in adolescents with severe obesity. The added value of our aerobic training program for body weight management programs

  14. Prueba de esfuerzo cardiopulmonar (PEC en el síndrome de falla cardíaca. Una propuesta basada en la evidencia Cardiopulmonary exercise testing in congestive heart failure. a proposal based on evidence

    Directory of Open Access Journals (Sweden)

    Juan Manuel Sénior Sánchez

    2008-06-01

    Full Text Available

    El objetivo de este artículo es presentar recomendaciones para la utilización clínica de la prueba de esfuerzo cardiopulmonar en el síndrome de falla cardíaca con énfasis en la medicina basada en la evidencia mediante una búsqueda sistemática de la literatura. La prueba de esfuerzo cardiopulmonar es una herramienta útil en la evaluación y seguimiento de los pacientes con falla cardíaca, pero es poco utilizada en la práctica diaria del internista general y el cardiólogo clínico. Permite establecer diagnósticos diferenciales en pacientes con disnea de causa inexplicada, evaluar la tolerancia al ejercicio, la capacidad funcional y el pronóstico, seleccionar los pacientes para trasplante cardíaco, proporcionar parámetros para la prescripción del ejercicio y monitorizar la respuesta al entrenamiento en programas de rehabilitación.

  1. Noninvasive ventilation and exercise tolerance in heart failure: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Daiana C. Bündchen

    2014-10-01

    Full Text Available Background: Patients with heart failure (HF usually develop exercise intolerance. In this context, noninvasive ventilation (NIV can help to increase physical performance. Objective: To undertake a systematic review and meta-analysis of randomized controlled trials that evaluated the effects of NIV on exercise tolerance in patients with HF. Method: Search Strategy: Articles were searched in the following databases: Physiotherapy Evidence Database (PEDro, Scientific Electronic Library Online (SciELO, and MEDLINE. Selection Criteria: This review included only randomized controlled trials involving patients with HF undergoing NIV, with or without other therapies, that used exercise tolerance as an outcome, verified by the distance travelled in the six-minute walk test (6MWT, VO2peak in the cardiopulmonary test, time spent in testing, and dyspnea. Data Collection and Analysis: The methodological quality of the studies was rated according to the PEDro scale. Data were pooled in fixed-effect meta-analysis whenever possible. Results: Four studies were selected. A meta-analysis including 18 participants showed that the use of NIV prior to the 6MWT promoted increased distance, [mean difference 65.29 m (95% CI 38.80 to 91.78]. Conclusions: The use of NIV prior to the 6MWT in patients with HF may promote increased distance. However, the limited number of studies may have compromised a more definitive conclusion on the subject.

  2. The Neuromatrix Theory of Pain and Angina during Exercise Stress Testing: Results from the PIMI Study

    Science.gov (United States)

    2011-05-27

    al., 1988; Glusman et al., 1996). In these individuals, the opioid reactivity would produce stronger analgesia of pain from most inputs, including...pain thresholds in silent ischemics might generalize to other areas as well. Pain tests in areas such as the toe, finger or dental pain thresholds...induced opioid Angina and the Neuromatrix 20 analgesia . Indeed, perhaps people who genetically have greater β-endorphin reactivity to stress

  3. Serial measurements of high-sensitivity cardiac troponin T after exercise stress test in stable coronary artery disease

    DEFF Research Database (Denmark)

    Axelsson, Anna; Ruwald, Martin Huth; Dalsgaard, Morten;

    2013-01-01

    The aim was to assess serial measurements of high-sensitivity cardiac troponin T (hs-cTNT) post-exercise in patients with stable coronary artery disease (CAD).......The aim was to assess serial measurements of high-sensitivity cardiac troponin T (hs-cTNT) post-exercise in patients with stable coronary artery disease (CAD)....

  4. Pre-discharge exercise test for evaluation of patients with complete or incomplete revascularization following primary percutaneous coronary intervention: a DANAMI-2 sub-study

    DEFF Research Database (Denmark)

    Valeur, N.; Clemmensen, P.; Grande, P.

    2008-01-01

    revascularization had lower exercise capacity [6.5 (95% CI: 1.9-12.8) vs. 7.0 (95% CI: 2.1-14.0) METs, p = 0.004] and more frequently ST depression [43 (20%) vs. 39 (13%), p = 0.02] compared to patients with complete revascularization. ST depression was not predictive of outcome in either groups, while...... with complete revascularization. CONCLUSIONS: Exercise capacity was prognostic of reinfarction and/or death in patients with incomplete revascularization, but not in completely revascularized patients. ST segment depression alone did not predict residual coronary stenosis or dismal prognosis Udgivelsesdato......OBJECTIVES: It is unclear whether the completeness of revascularization impacts on the prognostic value of an exercise test after primary percutaneous coronary intervention (PCI). METHODS: The DANAMI-2 trial included patients with ST elevation acute myocardial infarction randomized to primary PCI...

  5. Physiologic Determinants of Exercise Capacity in Pulmonary Langerhans Cell Histiocytosis: A Multidimensional Analysis

    Science.gov (United States)

    Fry, Stephanie; Giovannelli, Jonathan; Langlois, Carole; Bricout, Nicolas; Aguilaniu, Bernard; Bellocq, Agnes; Le Rouzic, Olivier; Dominique, Stephane; Delobbe, Alain; François, Geraldine; Tazi, Abdellatif; Wallaert, Benoit; Chenivesse, Cecile

    2017-01-01

    Background Reduced exercise capacity severely impacts quality of life in pulmonary Langerhans cell histiocytosis. Ascertaining mechanisms that impair exercise capacity is necessary to identify targets for symptomatic treatments. Methods Dyspnea, pulmonary function tests and cardiopulmonary exercise test were analysed in 62 study participants. Data were compared between subjects with impaired and normal aerobic capacity (V’O2 peak less than 84% versus 84% predicted or more). Data were reduced using a principal component analysis. Multivariate analysis included V’O2 peak as the dependent variable and principal components as covariates. Results V’O2 peak was reduced in 44 subjects (71%). Subjects with impaired aerobic capacity presented: (i) decreased FEV1, FVC, FEV1/FVC, DLCO and DLCO/VA and increased AaDO2, (ii) increased ventilatory equivalents at ventilatory threshold, VD/VT peak, AaDO2 peak and PaCO2 peak and decreased ventilatory reserve and PaO2 peak. There was no difference between groups in dyspnea scores. Principal component analysis extracted 4 principal components interpreted as follows: PC1: gas exchange; PC2: “pseudorestriction”; PC3: exercise-induced hyperpnea; PC4: air trapping. Multivariate analysis explained 65% of V’O2 peak. The 4 principal components were independently associated with V’O2 peak (βcoefficients: PC1: 9.3 [4.6; 14], PC2: 7.5 [3; 11.9], PC3: -5.3 [-9.6;-1.], PC4: -9.8 [-14,9;-4.7]). Conclusion Impaired exercise capacity is frequent in pulmonary Langerhans cell histiocytosis. It is mainly caused by pulmonary changes but is not associated with increased dyspnea intensity. Therefore, treating the lung represents a relevant approach for improving exercise capacity, even in patients experiencing mild dyspnea. PMID:28072848

  6. Immediate effects of active cranio-cervical flexion exercise versus passive mobilisation of the upper cervical spine on pain and performance on the cranio-cervical flexion test.

    Science.gov (United States)

    Lluch, Enrique; Schomacher, Jochen; Gizzi, Leonardo; Petzke, Frank; Seegar, Dagmar; Falla, Deborah

    2014-02-01

    This study compared the immediate effects of an assisted plus active cranio-cervical flexion exercise (exercise group) versus a passive mobilisation plus assisted cranio-cervical flexion (mobilisation group) on performance of the cranio-cervical flexion test (CCFT), cervical range of motion (ROM) and pain in patients with chronic neck pain. Eighteen volunteers with chronic idiopathic neck pain participated in the study and were randomised to one of the two intervention groups. Current level of pain, cervical ROM and pain perceived during movement, pressure pain threshold (PPT) and surface electromyography (EMG) during performance of the CCFT were measured before and immediately after the intervention. A significant reduction in resting pain and PPT measured over cervical sites was observed immediately following both interventions, although a greater change was observed for the exercise group. No change in cervical ROM was observed after either intervention. Reduced sternocleidomastoid and anterior scalene EMG amplitude were observed during stages of the CCFT but only for the participants in the active exercise group. Although both active and passive interventions offered pain relief, only the exercise group improved on a task of motor function highlighting the importance of specific active treatment for improved motor control of the cervical spine.

  7. Testing the effectiveness of a self-efficacy based exercise intervention for inactive people with type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    van der Heijden, Marion M P; Pouwer, Francois; Romeijnders, Arnold C

    2012-01-01

    BACKGROUND: Sufficient exercise is important for people with Type 2 Diabetes Mellitus (T2DM), as it can prevent future health problems. Despite, it is estimated that only 30-40% of people with T2DM are sufficiently active. One of the psychosocial constructs that is believed to influence physical...... activity behaviour, is exercise self-efficacy. The goal of this study is to evaluate a patient-tailored exercise intervention for people with T2DM that takes exercise self-efficacy into account. METHODS/DESIGN: This study is conducted as a non-randomized controlled clinical trial. Patients are eligible...... when they are diagnosed with T2DM, exercise less than advised in the ADA guideline of 150 min/week of moderate-intensity aerobic physical activity, have an BMI >25 and are between 18 and 80 years old. Recruitment takes place at a Primary care organization of general practitioners and practice nurses...

  8. The use of the standard exercise test to establish the clinical significance of mild echocardiographic changes in a Thoroughbred poor performer : clinical communication

    Directory of Open Access Journals (Sweden)

    C. Meyer

    2004-06-01

    Full Text Available A 4-year-old Thoroughbred gelding racehorse was referred to the Onderstepoort Veterinary Academic Hospital (OVAH with a history of post-race distress and collapse. In the absence of any obvious abnormalities in the preceding diagnostic work-up, a standard exercise test was performed to determine an underlying cause for the post-race distress reported. In this particular case oxygen desaturation became evident at speeds as slow as 6 m/s, where PO2 was measured at 82.3 mm Hg. Similarly at a blood pH of 7.28, PCO2 had dropped to 30.0mm Hg indicating a combined metabolic acidosis and respiratory alkalosis. The cause of the distress was attributed to a severe hypoxia, with an associated hypocapnoea, confirmed on blood gas analyses, where PO2 levels obtained were as low as 56.6 mm Hg with a mean PCO2 level of 25.4 mm Hg during strenuous exercise. Arterial oxygenation returned to normal immediately after cessation of exercise to 106.44 mm Hg, while the hypocapnoeic alkalosis, PCO2 25.67 mm Hg, persisted until the animal's breathing normalized. The results obtained were indicative of a dynamic cardiac insufficiency present during exercise. The combination of an aortic stenosis and a mitral valve insufficiency may have resulted in a condition similar to that described as high-altitude pulmonary oedema, with respiratory changes and compensation as for acute altitude disease. The results obtained were indicative of a dynamic cardiac insufficiency present during exercise and substantiate the fact that an extensive diagnostic regime may be required to establish a cause for poor performance and that the standard exercise test remains an integral part of this work-up.

  9. Exercise: Benefits of Exercise

    Medline Plus

    Full Text Available ... use of medicines for a variety of illnesses. Prevent or Delay Disease Scientists have found that staying physically active and exercising regularly can help prevent or delay many diseases and disabilities. In some ...

  10. The critical power function is dependent on the duration of the predictive exercise tests chosen.

    Science.gov (United States)

    Bishop, D; Jenkins, D G; Howard, A

    1998-02-01

    The linear relationship between work accomplished (W(lim)) and time to exhaustion (t(lim)) can be described by the equation: W(lim) = a + CP x t(lim). Critical power (CP) is the slope of this line and is thought to represent a maximum rate of ATP synthesis without exhaustion, presumably an inherent characteristic of the aerobic energy system. The present investigation determined whether the choice of predictive tests would elicit significant differences in the estimated CP. Ten female physical education students completed, in random order and on consecutive days, five all-out predictive tests at preselected constant-power outputs. Predictive tests were performed on an electrically-braked cycle ergometer and power loadings were individually chosen so as to induce fatigue within approximately 1-10 mins. CP was derived by fitting the linear W(lim)-t(lim) regression and calculated three ways: 1) using the first, third and fifth W(lim)-t(lim) coordinates (I135), 2) using coordinates from the three highest power outputs (I123; mean t(lim) = 68-193 s) and 3) using coordinates from the lowest power outputs (I345; mean t(lim) = 193-485 s). Repeated measures ANOVA revealed that CPI123 (201.0+/-37.9W) > CPI135 (176.1+/-27.6W) > CPI345 (164.0+/-22.8W) (P<0.05). When the three sets of data were used to fit the hyperbolic Power-t(lim) regression, statistically significant differences between each CP were also found (P<0.05). The shorter the predictive trials, the greater the slope of the W(lim)-t(lim) regression; possibly because of the greater influence of 'aerobic inertia' on these trials. This may explain why CP has failed to represent a maximal, sustainable work rate. The present findings suggest that if CP is to represent the highest power output that an individual can maintain "for a very long time without fatigue" then CP should be calculated over a range of predictive tests in which the influence of aerobic inertia is minimised.

  11. Comparison of usefulness of exercise testing versus coronary computed tomographic angiography for evaluation of patients suspected of having coronary artery disease

    DEFF Research Database (Denmark)

    Ovrehus, Kristian A; Jensen, Jesper K; Mickley, Hans;

    2010-01-01

    In patients suspected of having coronary artery disease (CAD), we compared the diagnostic sensitivity and specificity of exercise testing using ST-segment changes alone and ST-segment changes, angina pectoris, and hemodynamic variables compared to coronary computed tomographic angiography (CTA...... performance of CTA for the detection and exclusion of significant CAD might favor CTA as the first-line diagnostic test in patients suspected of having CAD....

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

    Science.gov (United States)

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

    2015-12-15

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

  13. Cognitive Aging and Physical Exercise.

    Science.gov (United States)

    Woo, Ellen; Sharps, Matthew J.

    2003-01-01

    Younger (n=58) and older (n=49) adults completed the Kaufman Brief Intelligence Test and recall tests of verbal and visual stimuli with maximum and minimum semantic support. Category support did not help young adults who exercised less. Older adults' exercise had no effect on use of category support; less-frequent exercisers had poorer results…

  14. Preliminary testing of the role of exercise and predator recognition for bonytail and razorback sucker

    Science.gov (United States)

    Mueller, Gordon A.; Carpenter, Jeanette; Krapfel, Robert; Figiel, Chester

    2007-01-01

    Hatchery-reared juvenile, suckers appeared curious and showed no sign of predator avoidance when initially placed with large (>45-cm TL) flathead catfish. Predator-naïve juveniles (20- to 25-cm TL) exhibited no discernable preference when provided areas with and without (52 percent and 48 percent, n = 16 observations; 46 percent and 54 percent, n = 20 observations) large flathead catfish. However, once predation occurred, use of predator-free areas nearly doubled in two trials (36 percent and 64 percent, n = 50 observations; 33 percent and 67 percent, n = 12 observations). A more stringent test examining available area indicated predator-savvy razorback suckers used predator-free areas (88 percent, n = 21) illustrating predator avoidance was a learned behavior.

  15. A panel priority rating exercise for the British Forces Germany Health Services Market test.

    Science.gov (United States)

    Jefferson, T O; Demicheli, V

    1995-02-01

    We report on the application to the BFG Health Services Market Testing (MT) study of the response to a users' questionnaire and panel discussions to determine in which priority and how services should be provided. The questionnaire served to inform lay and health care panel members on users' views on the relative importance of future health services and the way they will be provided. Based on the questionnaire results and data contained in the BAOR Report of Public Health for 1992/93 the panel assigned the highest priorities to emergency services, followed by routine General Practitioner services and essential hospital services. The lowest ranking were non-essential hospital services, health care for children with special needs and provision of designated transport. There was a high consistency in views between the lay and health care members of the panel.

  16. The Cardiopulmonary effect of passive movement

    Directory of Open Access Journals (Sweden)

    L. Loram

    2002-02-01

    Full Text Available Eleven articles were reviewed on the cardiopulmonary effects of passive movements. These included two articles on theneurological effects of passive movements. Of the eleven articles, four were considered to have level II evidence in accordance with Sackett’s rules of evidence. There was little consensus regarding the rate or duration of passive movements. There were some suggestions that upper limb movement produces a greater ventilatory response than lower limb movement. There was a statistically significant increase (p< 0.05 in minute ventilation when the movement was done at a rate of 40 repetitions per minute or more, but this change may not be clinically significant. Passive movements were not detrimental to neurosurgical patients with a normal or slightly elevated intracranial pressure, although the values of the intracranial pressure were not stated.  The studies were limited in that eight of the eleven had small sample sizes and most studies were conducted using normal subjects. Further studies with higher levels of evidence need to be  conducted to verify any results reported to date in the literature. Studies that are relevant to clinical practice also need to be conducted in populations such as sedated intensive care patients.

  17. Postoperative abdominal complications after cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Dong Guohua

    2012-10-01

    Full Text Available Abstract Background To summarize the diagnostic and therapeutic experiences on the patients who suffered abdominal complications after cardiovascular surgery with cardiopulmonary bypass(CPB. Methods A total of 2349 consecutive patients submitted to cardiovascular surgery with CPB in our hospital from Jan 2004 to Dec 2010 were involved. The clinical data of any abdominal complication, including its incidence, characters, relative risks, diagnostic measures, medical or surgical management and mortality, was retrospectively analyzed. Results Of all the patients, 33(1.4% developed abdominal complications postoperatively, including 11(33.3% cases of paralytic ileus, 9(27.3% of gastrointestinal haemorrhage, 2(6.1% of gastroduodenal ulcer perforation, 2(6.1% of acute calculus cholecystitis, 3(9.1% of acute acalculus cholecystitis, 4(12.1% of hepatic dysfunction and 2(6.1% of ischemia bowel diseases. Of the 33 patients, 26 (78.8% accepted medical treatment and 7 (21.2% underwent subsequent surgical intervention. There were 5(15.2% deaths in this series, which was significantly higher than the overall mortality (2.7%. Positive history of peptic ulcer, advanced ages, bad heart function, preoperative IABP support, prolonged CPB time, low cardiac output and prolonged mechanical ventilation are the risk factors of abdominal complications. Conclusions Abdominal complications after cardiovascular surgery with CPB have a low incidence but a higher mortality. Early detection and prompt appropriate intervention are essential for the outcome of the patients.

  18. Conflicting perspectives compromising discussions on cardiopulmonary resuscitation.

    LENUS (Irish Health Repository)

    Groarke, J

    2010-09-01

    Healthcare professionals, patients and their relatives are expected to discuss resuscitation together. This study aims to identify the differences in the knowledge base and understanding of these parties. Questionnaires examining knowledge and opinion on resuscitation matters were completed during interviews of randomly selected doctors, nurses and the general public. 70% doctors, 24% nurses and 0% of a public group correctly estimated survival to discharge following in-hospital resuscitation attempts. Deficiencies were identified in doctor and nurse knowledge of ethics governing resuscitation decisions. Public opinion often conflicts with ethical guidelines. Public understanding of the nature of cardiopulmonary arrests and resuscitation attempts; and of the implications of a \\'Do Not Attempt Resuscitation (DNAR)\\' order is poor. Television medical dramas are the primary source of resuscitation knowledge. Deficiencies in healthcare professionals\\' knowledge of resuscitation ethics and outcomes may compromise resuscitation decisions. Educational initiatives to address deficiencies are necessary. Parties involved in discussion on resuscitation do not share the same knowledge base reducing the likelihood of meaningful discussion. Public misapprehensions surrounding resuscitation must be identified and corrected during discussion.

  19. PREDICTION OF VO2PEAK USING OMNI RATINGS OF PERCEIVED EXERTION FROM A SUBMAXIMAL CYCLE EXERCISE TEST

    Science.gov (United States)

    Mays, Ryan J.; Goss, Fredric L.; Nagle-Stilley, Elizabeth F.; Gallagher, Michael; Schafer, Mark A.; Kim, Kevin H.; Robertson, Robert J.

    2015-01-01

    Summary The primary aim of this study was to develop statistical models to predict peak oxygen consumption (VO2peak) using OMNI Ratings of Perceived Exertion measured during submaximal cycle ergometry. Men (mean ± standard error: 20.90 ± 0.42 yrs) and women (21.59 ± 0.49 yrs) participants (n = 81) completed a load-incremented maximal cycle ergometer exercise test. Simultaneous multiple linear regression was used to develop separate VO2peak statistical models using submaximal ratings of perceived exertion for the overall body, legs, and chest/breathing as predictor variables. VO2peak (L·min−1) predicted for men and women from ratings of perceived exertion for the overall body (3.02 ± 0.06; 2.03 ± 0.04), legs (3.02 ± 0.06; 2.04 ± 0.04) and chest/breathing (3.02 ± 0.05; 2.03 ± 0.03) were similar with measured VO2peak (3.02 ± 0.10; 2.03 ± 0.06, ps > .05). Statistical models based on submaximal OMNI Ratings of Perceived Exertion provide an easily administered and accurate method to predict VO2peak. PMID:25068750

  20. Chronotropic incompetence can limit exercise tolerance in COPD patients with lung hyperinflation

    Directory of Open Access Journals (Sweden)

    Hulo S

    2016-10-01

    Full Text Available Sébastien Hulo,1 Jocelyn Inamo,2 Aurélie Dehon,3 Olivier Le Rouzic,4 Jean-Louis Edme,1 Remi Neviere51Université Lille, CHU Lille, EA 4483, IMPact de l’Environnement Chimique sur la Santé humaine, Lille, France; 2Département de Cardiologie – CHU Fort de France, Martinique – Faculté de Médecine – Université des Antilles, France; 3Pôle d’Anesthésie Réanimation ADRU, CHU Nîmes, Nîmes, France; 4Université Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, Center for Infection and Immunity of Lille, Lille, France; 5Université Lille, Inserm, CHU Lille, Lille Inflammation Research International Center, Lille, FrancePurpose: Metabolic-chronotropic relationship is the only concept that assesses the entire chronotropic function during exercise, as it takes into account individual fitness. To better understand interrelationships between chronotropic incompetence (CI, dynamic hyperinflation (DH and exercise limitation among Global initiative for chronic Obstructive Lung Disease (GOLD stages of chronic obstructive pulmonary disease (COPD disease severity, we evaluated cardiopulmonary responses to symptom-limited cycle exercise in stable patients.Patients and methods: We prospectively studied 47 COPD patients classified by GOLD stage severity. Pulmonary function tests and cardiopulmonary responses to symptom-limited incremental exercise were studied. CI was defined by regression line between percent heart rate (HR reserve and percent oxygen uptake (V’O2 reserve, ie, chronotropic-metabolic index (CMI. DH was defined from the knot resulting from the nonlinear regressions of inspiratory capacity changes from rest to peak (dynamic inspiratory capacity (ICdyn with percentage of maximal HR and CMI.Results: Aerobic capacity (median interquartile ranges peak V’O2, 24.3 (23.6; 25.2, 18.5 (15.5; 21.8, 17.5 (15.4; 19.1 mL·kg-1·min-1 and CMI worsened according to GOLD severity. The optimal knot of ICdyn was equal to −0.34 L. The

  1. A proximal change experiment testing two communication exercises with intimate partner violent men.

    Science.gov (United States)

    Babcock, Julia C; Graham, Katherine; Canady, Brittany; Ross, Jody M

    2011-06-01

    This study tests the immediate impact of two interventions for intimate partner violent (IPV) men in affecting behavioral and emotional change during arguments with their partners. Couples with an abusive male partner (N=100) discussed an area of conflict twice, interrupted by a brief intervention. Men were randomly assigned to receive (a) an editing-out-the-negative skills training, (b) an accepting influence skills training, or (c) a time-out. IPV men in both skills-training conditions showed greater decreases in aggressive feelings than IPV men in the time-out condition based on their self-report and observed affective behavior. Women also reported feeling less aggressive when their husbands were assigned to one of the skills-training conditions as compared to the control (time-out) condition. Results suggest that IPV men can learn to adopt new communication skills and that they do appear to have a positive impact on the emotional tone of their arguments. Clinically, communication skills training may be a useful addition to battering intervention programs, although these skills may need to be taught to both men and women involved in violent relationships.

  2. The Risks of Exercise Stress Test for Hypertensive Patients%高血压患者运动试验风险因素探讨

    Institute of Scientific and Technical Information of China (English)

    梁辰; 桑立红; 马云; 赵亮; 高璨; 宋小波

    2012-01-01

    Objective To investigate the risks of exercise stress test for hypertensive patients. Methods Data of ninety eight hypertensive patients who performed graded exercise test on treadmill were retrospectively analyzed. The patients were divided into habitual exercise group(E,n = 52) and lack of exercise group (less than 3 times per a week,NE,re = 46) according to iheir daily activity. Meanwhile the patients were categorized as SBP exaggerated response group (the SBP during exercise test >220 mmHg,n = 28) and normal SBP response group (n = 70),exaggerated DBP response group (the DBP during exercise test > 110 mmHg.n = 30) and the normal DBP response groups (n = 68) .depressed ST segment group (ST segment depression during exercise test ^1 mm,n = 20) and normal ST segment group(n = 78). Results (1 )The DBP before exercise and the maximum DBP during exercise in group E were significantly lower than in group NE (P = 0.019,P = 0.029). (2)The DBP before exercise in the SBP exaggerated response group and the DBP exaggerated response group were significantly higher than in the respective control groups (P = 0.00 and P = 0.00). The average values of the DBP before exercise in the SBP exaggerated response group and DBP exaggerated response group was abnormal (≥90 mmHg). (3)The SBP 2 minute after exercise in the group ST was significantly higher than in respective control group (P = 0.006). Conclusions (l)The hypertensive patients with habitual exercise have lower DBP at rest and the lower DBP response during exercise test. (2)The hypertensive patients with higher resting DBP could be at higher risks during exercise test. (3)The SBP 2 minutes after exercise test could be used as a risk indicator for hypertensive patients.%目的:初步探讨高血压患者运动试验中的风险因素.方法:选取国家体育总局运动医学研究所体育医院门诊高血压患者98例,进行心电图平板运动试验.将患者按照既往运动习惯分为运动组(n=52)和运

  3. Impact of aerobic exercise capacity and procedure-related factors in lung cancer surgery.

    Science.gov (United States)

    Licker, M; Schnyder, J-M; Frey, J-G; Diaper, J; Cartier, V; Inan, C; Robert, J; Bridevaux, P-O; Tschopp, J-M

    2011-05-01

    Over the past decades, major progress in patient selection, surgical techniques and anaesthetic management have largely contributed to improved outcome in lung cancer surgery. The purpose of this study was to identify predictors of post-operative cardiopulmonary morbidity in patients with a forced expiratory volume in 1 s exercise testing (CPET). In this observational study, 210 consecutive patients with lung cancer underwent CPET with completed data over a 9-yr period (2001-2009). Cardiopulmonary complications occurred in 46 (22%) patients, including four (1.9%) deaths. On logistic regression analysis, peak oxygen uptake (peak V'(O₂) and anaesthesia duration were independent risk factors of both cardiovascular and pulmonary complications; age and the extent of lung resection were additional predictors of cardiovascular complications, whereas tidal volume during one-lung ventilation was a predictor of pulmonary complications. Compared with patients with peak V'(O₂) >17 mL·kg⁻¹·min⁻¹, those with a peak V'(O₂) training can improve post-operative outcome.

  4. Effects of cardiopulmonary bypass on propofol pharmacokinetics and bispectral index during coronary surgery

    Directory of Open Access Journals (Sweden)

    Ricardo Antonio G. Barbosa

    2009-03-01

    Full Text Available PURPOSE: Cardiopulmonary bypass is known to alter propofol pharmacokinetics in patients undergoing cardiac surgery. However, few studies have evaluated the impact of these alterations on postoperative pharmacodynamics. This study was designed to test the hypothesis that changes in propofol pharmacokinetics increase hypnotic effects after cardiopulmonary bypass. METHODS: Twenty patients scheduled for on-pump coronary artery bypass graft (group, n=10 or off-pump coronary artery bypass graft (group, n=10 coronary artery bypass grafts were anesthetized with sufentanil and a propofol target controlled infusion (2.0 µg/mL. Depth of hypnosis was monitored using the bispectral index. Blood samples were collected from the induction of anesthesia up to 12 hours after the end of propofol infusion, at predetermined intervals. Plasma propofol concentrations were measured using high-performance liquid chromatography, followed by a non-compartmental propofol pharmacokinetic analysis. Data were analyzed using ANOVA, considering p<0.05 as significant. RESULTS: After cardiopulmonary bypass, despite similar plasma propofol concentrations in both groups, bispectral index values were lower in the on-pump coronary artery bypass graft group. Time to extubation after the end of propofol infusion was greater in the on-pump coronary artery bypass graft group (334 ± 117 vs. 216 ± 85 min, p = 0.04. Patients undergoing cardiopulmonary bypass had shorter biological (1.82 ± 0.5 vs. 3.67 ± 1.15h, p < 0.01 and terminal elimination (6.27 ± 1.29 vs. 10.5h ± 2.18, p < 0.01 half-life values, as well as higher total plasma clearance (28.36 ± 11.40 vs.18.29 ± 7.67 mL/kg/min, p = 0.03, compared to patients in the off-pump coronary artery bypass graft group. CONCLUSION: Aside from the increased sensitivity of the brain to anesthetics after cardiopulmonary bypass, changes in propofol pharmacokinetics may contribute to its central nervous system effects.

  5. [Prone position: effect on gas exchange and functional capacity for exercise in patients with pulmonary hypertension].

    Science.gov (United States)

    Bastidas-L, Andrea Carolina; Colina-Chourio, José A; Guevara, Jesnel M; Nunez, Alexis

    2015-03-01

    The objective of this investigation was to evaluate gas exchange and cardiopulmonary functional behavior in patients with pulmonary hypertension (PH) before, during and after the change to a prone position. Thirty patients with PH and alterations in gas exchange were included in the study. Gas exchange measurements were performed in four stages: at the baseline supine position and after 30, 120 and 240 minutes in prone position. Also, the patients were evaluated by the six minutes walking test (6MWT) after 30 days in prone position during night's sleep. After four hours in prone position, all patients showed an increase of PaO2 and arterial saturation of oxygen (SaO2), with a decrease of intrapulmonary shunts, improving the gas exchange and therefore the physiological demand imposed by exercise in patients with PH.

  6. Oxidative stress responses to a graded maximal exercise test in older adults following explosive-type resistance training

    Directory of Open Access Journals (Sweden)

    Roberta Ceci

    2014-01-01

    In conclusion, the adherence to an EMRT protocol is able to induce a cellular adaptation allowing healthy elderly trained subjects to cope with the oxidative stress induced by an acute exercise more effectively than the aged-matched sedentary subjects.

  7. Managing the Inflammatory Response after Cardiopulmonary Bypass : Review of the Studies in Animal Models

    NARCIS (Netherlands)

    Liguori, Gabriel Romero; Kanas, Alexandre Fligelman; Moreira, Luiz Felipe Pinho

    2014-01-01

    OBJECTIVE: To review studies performed in animal models that evaluated therapeutic interventions to inflammatory response and microcirculatory changes after cardiopulmonary bypass. METHODS: It was used the search strategy ("Cardiopulmonary Bypass" (MeSH)) and ("Microcirculation" (MeSH) or "Inflammat

  8. Respiratory muscle training with normocapnic hyperpnea improves ventilatory pattern and thoracoabdominal coordination, and reduces oxygen desaturation during endurance exercise testing in COPD patients

    Directory of Open Access Journals (Sweden)

    Bernardi E

    2015-09-01

    Full Text Available Eva Bernardi,1 Luca Pomidori,1 Faisy Bassal,1 Marco Contoli,2 Annalisa Cogo11Biomedical Sport Studies Center, University of Ferrara, Ferrara, 2Respiratory Section, Department of Medical Sciences, University of Ferrara, Cona (FE, ItalyBackground: Few data are available about the effects of respiratory muscle training with normocapnic hyperpnea (NH in COPD. The aim is to evaluate the effects of 4 weeks of NH (Spirotiger® on ventilatory pattern, exercise capacity, and quality of life (QoL in COPD patients.Methods: Twenty-six COPD patients (three females, ages 49–82 years, were included in this study. Spirometry and maximal inspiratory pressure, St George Respiratory Questionnaire, 6-minute walk test, and symptom-limited endurance exercise test (endurance test to the limit of tolerance [tLim] at 75%–80% of peak work rate up to a Borg Score of 8–9/10 were performed before and after NH. Patients were equipped with ambulatory inductive plethysmography (LifeShirt® to evaluate ventilatory pattern and thoracoabdominal coordination (phase angle [PhA] during tLim. After four supervised sessions, subjects trained at home for 4 weeks – 10 minutes twice a day at 50% of maximal voluntary ventilation. The workload was adjusted during the training period to maintain a Borg Score of 5–6/10.Results: Twenty subjects completed the study. After NH, maximal inspiratory pressure significantly increased (81.5±31.6 vs 91.8±30.6 cmH2O, P<0.01; exercise endurance time (+150 seconds, P=0.04, 6-minute walk test (+30 meters, P=0.03, and QoL (-8, P<0.01 all increased. During tLim, the ventilatory pattern changed significantly (lower ventilation, lower respiratory rate, higher tidal volume; oxygen desaturation, PhA, and dyspnea Borg Score were lower for the same work intensity (P<0.01, P=0.02, and P<0.01, respectively; one-way ANOVA. The improvement in tidal volume and oxygen saturation after NH were significantly related (R2=0.65, P<0.01.Conclusion: As

  9. Coronary Flow Reserve Predicts Cardiopulmonary Fitness in Patients with Coronary Artery Disease Independently of Systolic and Diastolic Function

    DEFF Research Database (Denmark)

    Snoer, Martin; Olsen, Rasmus Huan; Monk-Hansen, Tea

    2014-01-01

    Aims Despite revascularization and optimal medical treatment, patients with coronary artery disease (CAD) have reduced exercise capacity. In the absence of coronary artery stenosis, coronary flow reserve (CFR) is a measure of coronary microvascular function, and a marker of future poor outcome...... early (E) and late (A) inflow velocities, and tissue Doppler diastolic (e′) and systolic (s′) velocities. Peak coronary flow velocity (CFV) was measured in the LAD using pulse-wave Doppler. CFR was calculated as the ratio between peak CFV at rest and during vasodilator stress. Median CFR was 2.22 (1....... Conclusions Coronary flow reserve measured noninvasively predicts cardiopulmonary fitness independently of resting systolic and diastolic function in CAD patients, indicating that cardiac output during maximal exercise is dependent on the ability of the coronary circulation to adapt to the higher metabolic...

  10. 运动负荷试验在糖尿病量化运动处方中的应用%Application of Exercise Tolerance Test on Quantitative Exercise Prescription in Patients with Diabetes Mellitus

    Institute of Scientific and Technical Information of China (English)

    潘琼华; 秦映芬; 陈青云; 何涛; 周爱民; 黎莹

    2011-01-01

    Objective To investigate effect of the method of anaerobic threshold heartbeat guide exercise training which combined with the heart rate and blood lactic acid on patients with type 2 diabetes mellitus , providing a personalization exercise prescription. Methods Fifty cases of type 2 diabetes mellitus accepted electrocardiogram exercise test in power 40 r/min with uniform motion , each added 2 min 20 W exercise power, whose plasma lactic acids of every levels were detected at the end, and their 12-lead electrocardiogram and blood pressure were recorded automaticly. The exercise terminating standard accorded with type 2 diabetes mellitus based on American College of Sports Medicine Guidelines. Results The blood lactic acids of 50 cases diabetes mellitus for testing power 80 W and 100 W was( 3. 95 ± 1. 56 )mmol/L and ( 4. 43 ±2. 28 )mmol/L, respectively. The targeting heart rate ranged from ( 126. 95 ± 18. 5 )beat/min to( 125. 85 ± 19. 22 )beat/min. The subjective fatigue grade was( 15. 79 ± 1. 78 )points.There were positive correlations between blood lactic acia and exercise power, heart rate and exercise power, blood lactic acia and heart rate , their correlation coefficients of were 1. 000 ,0. 943 and 0. 983 , respectively. In ECG exercise treadmill test,there were 44cases with negative and 6 cases with positive. In the movement of the power of 100 W, the heart rate of negative group was higher than that of positive group , the difference was statistically significant( P <0. 05 ).At the end of the test, subjective fatigue grade was no statistical difference( P > 0. 05 ). The lactic acid, heart rate,systolic blood pressure, diastolic pressure of negative group increased with the the increasing power. There was a downward trend in the blood pressure of the positive group at the end of test. Conclusion Combining the heart rate and blood lactic acid to assess exercise intensity is a sensitive,feasible and safe method. It can not only overcome the actual

  11. Hydrogen sulfide improves neural function in rats following cardiopulmonary resuscitation

    Science.gov (United States)

    LIN, JI-YAN; ZHANG, MIN-WEI; WANG, JIN-GAO; LI, HUI; WEI, HONG-YAN; LIU, RONG; DAI, GANG; LIAO, XIAO-XING

    2016-01-01

    The alleviation of brain injury is a key issue following cardiopulmonary resuscitation (CPR). Hydrogen sulfide (H2S) is hypothesized to be involved in the pathophysiological process of ischemia-reperfusion injury, and exerts a protective effect on neurons. The aim of the present study was to investigate the effects of H2S on neural functions following cardiac arrest (CA) in rats. A total of 60 rats were allocated at random into three groups. CA was induced to establish the model and CPR was performed after 6 min. Subsequently, sodium hydrosulfide (NaHS), hydroxylamine or saline was administered to the rats. Serum levels of H2S, neuron-specific enolase (NSE) and S100β were determined following CPR. In addition, neurological deficit scoring (NDS), the beam walking test (BWT), prehensile traction test and Morris water maze experiment were conducted. Neuronal apoptosis rates were detected in the hippocampal region following sacrifice. After CPR, as the H2S levels increased or decreased, the serum NSE and S100β concentrations decreased or increased, respectively (P<0.0w. The NDS results of the NaHS group were improved compared with those of the hydroxylamine group at 24 h after CPR (P<0.05). In the Morris water maze experiment, BWT and prehensile traction test the animals in the NaHS group performed best and rats in the hydroxylamine group performed worst. At day 7, the apoptotic index and the expression of caspase-3 were reduced in the hippocampal CA1 region, while the expression of Bcl-2 increased in the NaHS group; and results of the hydroxylamine group were in contrast. Therefore, the results of the present study indicate that H2S is able to improve neural function in rats following CPR. PMID:26893650

  12. Teamwork and leadership in cardiopulmonary resuscitation.

    Science.gov (United States)

    Hunziker, Sabina; Johansson, Anna C; Tschan, Franziska; Semmer, Norbert K; Rock, Laura; Howell, Michael D; Marsch, Stephan

    2011-06-14

    Despite substantial efforts to make cardiopulmonary resuscitation (CPR) algorithms known to healthcare workers, the outcome of CPR has remained poor during the past decades. Resuscitation teams often deviate from algorithms of CPR. Emerging evidence suggests that in addition to technical skills of individual rescuers, human factors such as teamwork and leadership affect adherence to algorithms and hence the outcome of CPR. This review describes the state of the science linking team interactions to the performance of CPR. Because logistical barriers make controlled measurement of team interaction in the earliest moments of real-life resuscitations challenging, our review focuses mainly on high-fidelity human simulator studies. This technique allows in-depth investigation of complex human interactions using precise and reproducible methods. It also removes variability in the clinical parameters of resuscitation, thus letting researchers study human factors and team interactions without confounding by clinical variability from resuscitation to resuscitation. Research has shown that a prolonged process of team building and poor leadership behavior are associated with significant shortcomings in CPR. Teamwork and leadership training have been shown to improve subsequent team performance during resuscitation and have recently been included in guidelines for advanced life support courses. We propose that further studies on the effects of team interactions on performance of complex medical emergency interventions such as resuscitation are needed. Future efforts to better understand the influence of team factors (e.g., team member status, team hierarchy, handling of human errors), individual factors (e.g., sex differences, perceived stress), and external factors (e.g., equipment, algorithms, institutional characteristics) on team performance in resuscitation situations are critical to improve CPR performance and medical outcomes of patients.

  13. Gravity and Development of Cardiopulmonary Reflex

    Science.gov (United States)

    Nagaoka, Shunji; Eno, Yuko; Ohira, Yoshinobu

    Cardio-pulmonary reflex, which our cardiac activity is synchronized to the respiration by autonomic nervous system regulation, is called as "respiratory sinus arrhythmia" and commonly found in adult. The physiological function of the espiratory sinus arrhythmia is considered to maximize the gas exchange during respiration cycle. This respiration induced heart rate variability (RHRV) is only found in mammals and avian showing a remarkable postnatal development, whereas no RHRV in aquatic species such as fish or amphibian. To elucidate our hypothesis that gravity exposure may plays a key role in the postnatal development of RHRV as well as its evolutional origin in these ground animals, we have studied effects of hypergravity (2G) on the postnatal development of RHRV using rat. Pregnant Wister rats were kept in centrifugal cages system for 38 days from 6th days of pregnant mother to have neonates until 23 days old. Electrocardiograph was recorded from the neonates in 2 to 23 days old in 2G group with simultaneous control (1G) group. The RHRV analysis was performed by calculating a component of Fourier power spectral coincide with the respiration frequency. In both groups, averaged resting heart rate gradually increase from 2 to 23 days old. When comparing the heart rate between the two groups, the 2G group indicated significantly lower (240± 8 bpm) than 1G control (326±21 bpm, p¡0.001) in 2 days old, where as no significance in 23 days old. The RHRV of 2 days old neonates in both groups indicated very small magnitude but significantly lower in 2G group than 1G control (p¡0.01). The RHRV gradually increase during the first 2 weeks and then rapid increased to reached 45 fold of magnitude in 1G control, whereas 69 fold in 2G group. The results strongly suggested that the postnatal innervation from respiration to cardiovascular centers was gravity dependent.

  14. Exercise Headaches

    Science.gov (United States)

    ... exercise headaches if you: Exercise in hot weather Exercise at high altitude Have a personal or family history of migraine You're likely ... verify that you have the harmless variety of exercise headache, rather than the type ... images of the structures within your brain. Magnetic resonance ...

  15. Changes in Cardiopulmonary Reserve and Peripheral Arterial Function Concomitantly with Subclinical Inflammation and Oxidative Stress in Patients with Heart Failure with Preserved Ejection Fraction

    Directory of Open Access Journals (Sweden)

    Damien Vitiello

    2014-01-01

    Full Text Available Background. Changes in cardiopulmonary reserve and biomarkers related to wall stress, inflammation, and oxidative stress concomitantly with the evaluation of peripheral arterial blood flow have not been investigated in patients with heart failure with preserved ejection fraction (HFpEF compared with healthy subjects (CTL. Methods and Results. Eighteen HFpEF patients and 14 CTL were recruited. Plasma levels of inflammatory and oxidative stress biomarkers were measured at rest. Brain natriuretic peptide (BNP was measured at rest and peak exercise. Cardiopulmonary reserve was assessed using an exercise protocol with gas exchange analyses. Peripheral arterial blood flow was determined by strain gauge plethysmography. Peak VO2 (12.0±0.4 versus 19.1±1.1 mL/min/kg, P<0.001 and oxygen uptake efficiency slope (1.55±0.12 versus 2.06±0.14, P<0.05 were significantly decreased in HFpEF patients compared with CTL. BNP at rest and following stress, C-reactive-protein, interleukin-6, and TBARS were significantly elevated in HFpEF. Both basal and posthyperemic arterial blood flow were not significantly different between the HFpEF patients and CTL. Conclusions. HFpEF exhibits a severe reduction in cardiopulmonary reserve and oxygen uptake efficiency concomitantly with an elevation in a broad spectrum of biomarkers confirming an inflammatory and prooxidative status in patients with HFpEF.

  16. Hantavirus cardiopulmonary syndrome successfully treated with high-volume hemofiltration

    Science.gov (United States)

    Bugedo, Guillermo; Florez, Jorge; Ferres, Marcela; Roessler, Eric; Bruhn, Alejandro

    2016-01-01

    Hantavirus cardiopulmonary syndrome has a high mortality rate, and early connection to extracorporeal membrane oxygenation has been suggested to improve outcomes. We report the case of a patient with demonstrated Hantavirus cardiopulmonary syndrome and refractory shock who fulfilled the criteria for extracorporeal membrane oxygenation and responded successfully to high volume continuous hemofiltration. The implementation of high volume continuous hemofiltration along with protective ventilation reversed the shock within a few hours and may have prompted recovery. In patients with Hantavirus cardiopulmonary syndrome, a short course of high volume continuous hemofiltration may help differentiate patients who can be treated with conventional intensive care unit management from those who will require more complex therapies, such as extracorporeal membrane oxygenation. PMID:27410413

  17. Test-retest reliability of skeletal muscle oxygenation measurements during submaximal cycling exercise in patients with chronic heart failure.

    Science.gov (United States)

    Niemeijer, Victor M; Spee, Ruud F; Jansen, Jasper P; Buskermolen, Antonetta B C; van Dijk, Thomas; Wijn, Pieter F F; Kemps, Hareld M C

    2017-01-01

    The potential purpose of near-infrared spectroscopy (NIRS) as a clinical application in patients with chronic heart failure (CHF) is the identification of limitations in O2 delivery or utilization during exercise. The objective of this study was to evaluate absolute and relative test-retest reliability of skeletal muscle oxygenation measurements in patients with CHF. Thirty patients with systolic heart failure (left ventricular ejection fraction 31 ± 8%) performed 6-min constant-load cycling tests at 80% of the anaerobic threshold (AT) with tissue saturation index (TSI) measurement at the vastus lateralis. Tests were repeated after 10 ± 5 days to evaluate reliability. Absolute reliability was assessed with limits of agreement (LoA, expressed as bias ± random error) and coefficients of variation (CV) for absolute values (LoA range: 0·4 ± 6·2% to 0·6 ± 7·9%; CV range: 4·7-7·1%), amplitudes (LoA range -0·5 ± 5·8% to -0·7 ± 6·8%; CV range: 26·2-42·1%), onset and recovery kinetics (mean response times; LoA 0·4 ± 9·5 s, CV 23·5% and LoA -5·8 ± 50·8 s, CV 67·4% respectively) and overshoot characteristics (CV range 45·7-208·6%). Relative reliability was assessed with intraclass correlation coefficients for absolute values (range 0·74-0·90), amplitudes (range 0·85-0·92), onset and recovery kinetics (0·53 and 0·51, respectively) and overshoot characteristics (range 0·17-0·74). In conclusion, absolute reliability of absolute values and onset kinetics seems acceptable for serial within-subject comparison, and as such, for evaluation of treatment effects. Absolute reliability of amplitudes and recovery kinetics is considered unsatisfactory. Relative reliability of absolute values and amplitudes is sufficient for purposes of physiological distinction between patients with CHF. Despite lower relative reliability, kinetics may still be useful for clinical application.

  18. What the exercise of the SPICE source inversion validation BlindTest 1 did not tell you

    Science.gov (United States)

    Shao, Guangfu; Ji, Chen

    2012-04-01

    Uncertainties of earthquake finite-fault inversions based upon strong motion data are investigated using the source inversion validation BlindTest 1 exercise of the SPICE (Seismic Wave Propagation and Imaging in Complex Media: A European Network) project, motivated by previous counterintuitive results. The distribution of slip and the shapes of asymmetric slip rate functions are simultaneously inverted by matching 10 or 33 broad-band three-component velocity waveforms within the period ranging from 0.02 to 2 Hz, using a finite-fault method that carries out the waveform inversion in the wavelet domain. The effects of subfault size, data noise and the number of stations have been explored. Our results suggest: (1) Although there are inevitable discrepancies between the inverted model and the target model because of ignoring the spatial slip variations within individual subfaults, the fault slip and rise-time distributions can be well constrained even with the data including large Gaussian noise. (2) It is crucial for source studies to develop new inversion schemes that can properly honour the frequency- and time-dependent energy distribution of seismic radiation and data noise. For instance, inversions using the variance reduction function of velocity waveforms as the objective function have low sensitivities to the total seismic moment and peak slip. (3) Although the relative value of the objective function is guided in the inversion, the absolute value of the objective function cannot be used to evaluate the quality of an inverted model. (4) Because the source inversion is based on surface observations, the spatiotemporal resolution of source inversion is affected not only by the data quality but also by the earthquake itself. For vertical strike-slip faults, the along-strike resolution is better than that along the downdip direction.

  19. 21 CFR 870.4410 - Cardiopulmonary bypass in-line blood gas sensor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass in-line blood gas sensor... Cardiopulmonary bypass in-line blood gas sensor. (a) Identification. A cardiopulmonary bypass in-line blood gas sensor is a transducer that measures the level of gases in the blood. (b) Classification. Class...

  20. Idiopathic ventricular arrhythmias detected by an implantable loop recorder in a child with exercise-induced syncope.

    Science.gov (United States)

    Akdeniz, Celal; Ozyilmaz, Isa; Saygi, Murat; Ergul, Yakup; Tuzcu, Volkan

    2013-01-01

    Syncope is common in the general population. Despite extensive evaluation, including tilt-table testing and electrophysiologic studies, approximately 30% of cases of recurrent syncope remain unexplained. An implantable loop recorder can be used for diagnosis when recurrent syncope has an idiopathic cause. We present the case of a 9-year-old boy who had a history of recurrent, exercise-induced syncope. Results of physical examination and noninvasive diagnostic testing were inconclusive, and an electrophysiologic study revealed no inducible supraventricular or ventricular arrhythmias. Sixteen months after an implantable loop recorder was placed, the patient had a syncopal episode while swimming in a pool. Cardiopulmonary resuscitation was performed, and data from the loop recorder revealed polymorphic ventricular tachycardia and ventricular fibrillation. A cardioverter-defibrillator was subsequently implanted. Implantable loop recorders can play an important role in the diagnosis of life-threatening arrhythmias in children whose syncope is otherwise unexplained.

  1. Unusual Ventilatory Response to Exercise in Patient with Arnold-Chiari Type 1 Malformation after Posterior Fossa Decompression

    Directory of Open Access Journals (Sweden)

    Keely Smith

    2016-01-01

    Full Text Available We present a case of a 17-year-old Hispanic male with Arnold-Chiari Type 1 [AC-Type 1] with syringomyelia, status post decompression, who complains of exercise intolerance, headaches, and fatigue with exertion. The patient was found to have diurnal hypercapnia and nocturnal alveolar hypoventilation. Cardiopulmonary testing revealed blunting of the ventilatory response to the rise in carbon dioxide (CO2 resulting in failure of the parallel correlation between increased CO2 levels and ventilation; the expected vertical relationship between PETCO2 and minute ventilation during exercise was replaced with an almost horizontal relationship. No new pathology of the brainstem was discovered by MRI or neurological evaluation to explain this phenomenon. The patient was placed on continuous noninvasive open ventilation (NIOV during the day and CPAP at night for a period of 6 months. His pCO2 level decreased to normal limits and his symptoms improved; specifically, he experienced less headaches and fatigue during exercise. In this report, we describe the abnormal response to exercise that patients with AC-Type 1 could potentially experience, even after decompression, characterized by the impairment of ventilator response to hypercapnia during exertion, reflecting a complete loss of chemical influence on breathing with no evidence of abnormality in the corticospinal pathway.

  2. Increased Left Ventricular Stiffness Impairs Exercise Capacity in Patients with Heart Failure Symptoms Despite Normal Left Ventricular Ejection Fraction

    Directory of Open Access Journals (Sweden)

    David Sinning

    2011-01-01

    Full Text Available Aims. Several mechanisms can be involved in the development of exercise intolerance in patients with heart failure despite normal left ventricular ejection fraction (HFNEF and may include impairment of left ventricular (LV stiffness. We therefore investigated the influence of LV stiffness, determined by pressure-volume loop analysis obtained by conductance catheterization, on exercise capacity in HFNEF. Methods and Results. 27 HFNEF patients who showed LV diastolic dysfunction in pressure-volume (PV loop analysis performed symptom-limited cardiopulmonary exercise testing (CPET and were compared with 12 patients who did not show diastolic dysfunction in PV loop analysis. HFNEF patients revealed a lower peak performance (=.046, breathing reserve (=.006, and ventilation equivalent for carbon dioxide production at rest (=.002. LV stiffness correlated with peak oxygen uptake (=−0.636, <.001, peak oxygen uptake at ventilatory threshold (=−0.500, =.009, and ventilation equivalent for carbon dioxide production at ventilatory threshold (=0.529, =.005. Conclusions. CPET parameters such as peak oxygen uptake, peak oxygen uptake at ventilatory threshold, and ventilation equivalent for carbon dioxide production at ventilatory threshold correlate with LV stiffness. Increased LV stiffness impairs exercise capacity in HFNEF.

  3. Unusual Ventilatory Response to Exercise in Patient with Arnold-Chiari Type 1 Malformation after Posterior Fossa Decompression

    Science.gov (United States)

    Smith, Keely; Gomez-Rubio, Ana M.; Harris, Tomika S.; Brooks, Lauren E.

    2016-01-01

    We present a case of a 17-year-old Hispanic male with Arnold-Chiari Type 1 [AC-Type 1] with syringomyelia, status post decompression, who complains of exercise intolerance, headaches, and fatigue with exertion. The patient was found to have diurnal hypercapnia and nocturnal alveolar hypoventilation. Cardiopulmonary testing revealed blunting of the ventilatory response to the rise in carbon dioxide (CO2) resulting in failure of the parallel correlation between increased CO2 levels and ventilation; the expected vertical relationship between PETCO2 and minute ventilation during exercise was replaced with an almost horizontal relationship. No new pathology of the brainstem was discovered by MRI or neurological evaluation to explain this phenomenon. The patient was placed on continuous noninvasive open ventilation (NIOV) during the day and CPAP at night for a period of 6 months. His pCO2 level decreased to normal limits and his symptoms improved; specifically, he experienced less headaches and fatigue during exercise. In this report, we describe the abnormal response to exercise that patients with AC-Type 1 could potentially experience, even after decompression, characterized by the impairment of ventilator response to hypercapnia during exertion, reflecting a complete loss of chemical influence on breathing with no evidence of abnormality in the corticospinal pathway. PMID:27418995

  4. Attitude and skill levels of graduate health professionals in performing cardiopulmonary resuscitation

    Science.gov (United States)

    Gebreegziabher Gebremedhn, Endale; Berhe Gebregergs, Gebremedhn; Anderson, Bernard Bradley; Nagaratnam, Vidhya

    2017-01-01

    Background Cardiopulmonary resuscitation (CPR) is an emergency procedure used to treat victims following cardiopulmonary arrest. Graduate health professionals at the University of Gondar Teaching Hospital manage many trauma and critically ill patients. The chance of survival after cardiopulmonary arrest may be increased with sufficient attitude and skill levels. The study aimed to assess the attitude and skill levels of graduate health professionals in performing CPR. Methods A hospital-based cross-sectional study was conducted from May 1 to 30, 2013, at the University of Gondar Teaching Hospital. The mean attitude and skill scores were compared for sex, original residence, and department of the participants using Student’s t-test and analysis of variance (Scheffe’s test). P-values attitude scores of nurse, interns, health officer, midwifery, anesthesia, and psychiatric nursing graduates were 1.15 (standard deviation [SD] =1.67), 8.21 (SD =1.24), 7.2 (SD =1.49), 6.69 (SD =1.83), 8.19 (SD =1.77), and 7.29 (SD =2.01), respectively, and the mean skill scores were 2.34 (SD =1.95), 3.77 (SD =1.58), 1.18 (SD =1.52), 2.16 (SD =1.93), 3.88 (SD =1.36), and 1.21 (SD =1.77), respectively. Conclusion and recommendations Attitude and skill level of graduate health professionals with regard to CPR were insufficient. Training on CPR for graduate health professionals needs to be given emphasis.

  5. Excess ventilation and ventilatory constraints during exercise in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Teopompi, Elisabetta; Tzani, Panagiota; Aiello, Marina; Gioia, Maria Rosaria; Marangio, Emilio; Chetta, Alfredo

    2014-06-15

    We assessed the relationship between minute ventilation/carbon dioxide output (VE/VCO2) and ventilatory constraints during an incremental cardiopulmonary exercise testing (CPET) in patients with chronic obstructive pulmonary disease (COPD). Slope and intercept of the VE/VCO2 linear relationship, the ratios of inspiratory capacity/total lung capacity (IC/TLC) and of tidal volume (VT) over vital capacity (VTpeak/VC) and IC (VTpeak/IC) and over forced expiratory volume at 1st second (VTpeak/FEV1) at peak of exercise were measured in 52 COPD patients during a CPET. The difference peak-rest in end-tidal pressure of CO2 (PETCO2) was also measured. VE/VCO2 intercept showed a negative correlation with IC/TLC peak (pCOPD, VE/VCO2 slope and intercept provide complementary information on the ventilatory limitation to exercise, as assessed by changes in the end-expiratory lung volume and in tidal volume excursion.

  6. Oxidative stress responses to a graded maximal exercise test in older adults following explosive-type resistance training

    DEFF Research Database (Denmark)

    Ceci, R.; Beltran Valls, M.R.; Duranti, G.

    2014-01-01

    to evaluate the impact of EMRT on oxidative stress biomarkers induced in old people (70-75 years) by a single bout of acute, intense exercise. Sixteen subjects randomly assigned to either a control, not exercising group ( n=8) or a trained group performing EMRT protocol for 12-weeks ( n=8), were submitted...... as PBMCs cellular damage (Comet assay, apoptosis) and stress-protein response (Hsp70 and Hsp27 expression) were evaluated. The use of multiple biomarkers allowed us to confirm that EMRT per se neither affected redox homeostasis nor induced any cellular and oxidative damage. Following the GXT, the EMRT...

  7. Effect of repeated sauna treatment on exercise tolerance and endothelial function in patients with chronic heart failure.

    Science.gov (United States)

    Ohori, Takashi; Nozawa, Takashi; Ihori, Hiroyuki; Shida, Takuya; Sobajima, Mitsuo; Matsuki, Akira; Yasumura, Satoshi; Inoue, Hiroshi

    2012-01-01

    Repeated sauna treatment, known as Waon therapy, has been shown to improve cardiac function as well as exercise tolerance in patients with chronic heart failure. However, the underlying mechanisms of this therapy regarding these improvements remain to be elucidated. Forty-one patients with chronic heart failure (mean age 68.3 ± 13.5 years old) underwent Waon therapy 5 times a week for 3 weeks. Before and after treatment, a number of assessments were performed in all subjects: 6-minute walk test, echocardiography, determination of neurohumoral factors and number of circulating CD34(+) cells, and a flow-mediated dilation (FMD) test of endothelial function. Cardiopulmonary exercise testing was also performed in 20 patients. Waon therapy increased the left ventricular ejection fraction (from 30.4 ± 12.6% to 32.5% ± 12.8%, p = 0.023) and reduced plasma levels of norepinephrine (from 400 ± 258 to 300 ± 187 pg/ml, p = 0.015) and brain natriuretic peptide (from 550 ± 510 to 416 ± 431 pg/ml, p = 0.035). Waon therapy increased the 6-minute walk distance (from 337 ± 120 to 379 ± 126 m, p sauna therapy in patients with chronic heart failure improves exercise tolerance in association with improvement in endothelial function.

  8. Addition of atropine to submaximal exercise stress testing in patients evaluated for suspected ischaemia with SPECT imaging: a randomized, placebo-controlled trial

    Energy Technology Data Exchange (ETDEWEB)

    Manganelli, Fiore; Sauro, Rosario; Di Lorenzo, Emilio; Rosato, Giuseppe [San Giuseppe Moscati Hospital, Department of Cardiology and Heart Surgery, Avellino (Italy); Spadafora, Marco; Varrella, Paola; Peluso, Giuseppina [San Giuseppe Moscati Hospital, Nuclear Medicine Unit, Avellino (Italy); Daniele, Stefania [Institute of Diagnostic and Nuclear Development (SDN), Naples (Italy); Cuocolo, Alberto [Institute of Diagnostic and Nuclear Development (SDN), Naples (Italy); University Federico II, Department of Biomorphological and Functional Sciences, Naples (Italy); National Council of Research, Institute of Biostructures and Bioimages, Naples (Italy)

    2011-02-15

    To evaluate the effects of the addition of atropine to exercise testing in patients who failed to achieve their target heart rate (HR) during stress myocardial perfusion imaging with single-photon emission computed tomography (SPECT). The study was a prospective, randomized, placebo-controlled design. Patients with suspected or known coronary artery disease who failed to achieve a target HR ({>=}85% of maximal predicted HR) during exercise SPECT imaging were randomized to receive intravenous atropine (n = 100) or placebo (n = 101). The two groups of patients did not differ with respect to demographic or clinical characteristics. A higher proportion of patients in the atropine group achieved the target HR compared to the placebo group (60% versus 3%, p < 0.0001). SPECT imaging was abnormal in a higher proportion of patients in the atropine group as compared to the placebo group (57% versus 42%, p < 0.05). Stress-induced myocardial ischaemia was present in more patients in the atropine group as compared to placebo (47% versus 29%, p < 0.01). In both groups of patients, no major side effects occurred. The addition of atropine at the end of exercise testing is more effective than placebo in raising HR to adequate levels, without additional risks of complications. The use of atropine in patients who initially failed to achieve their maximal predicted HR is associated with a higher probability of achieving a diagnostic myocardial perfusion study. (orig.)

  9. Catsius Clay Project. Calculation and Testing of Behaviour of Unsaturated Clay as Barrier in Radioactive Waste Repositories. Stage 2: Validation Exercises at Laboratory scale

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, E. E.; Alcoverro, J.

    1999-07-01

    Stage 2 of CATSIUS CLAY Project: Validation Exercises at Laboratory Scale includes two Benchmarks, Benchmark 2.1: Oedometer Suction Controlled Tests on Samples of compacted Boom Clay and Benchmark 2.2: Small Scale Weltting-Heating Test on Compacted Bentonite. BM 2.1 had two parts: BM 2.1A (volumetric deformation upon wetting-drying cycles) and BM 2.1 B (swelling pressure test). In BM 2.1A, participants were asked to model the results of a series of five tests on samples of compacted Boom clay. In BM 2.1B, a swelling pressure test in which suction, vertical and horizontal stresses were monitored, was proposed as a blind exercise. Participants were asked to use, without further changes, the models calibrated in BM 2.1A. This exercise provides an evaluation of the capabilities of current mechanical constitutive models for unsaturated clay behaviour. It was found that, even if a calibration exercise on the basis of known experimental data is satisfactory, blind predictions of tests involving different paths may prove difficult. The test set up for BM 2.2 consisted of a stainless stell cell filled with highly expansive compacted bentonite (S2 clay from Almeria, Spain). The clay was subjected to a simultaneous central heating and a progressive water inflow through the botton plate. Temperature at various locations within the sample and the boundary radial stress were monitored throughout the test. Water content distribution was also measured at the end of the experiment. Predictions for this benchmark required the solution of field equations for flow, temperature distribution and mechanical analysis. Model parameters were derived from the extensive set of available experiments on this clay. Comparison between model predictions and measurements revealed the significance of water transport in vapour phase, the difficulties to predict boundary stresses and the general good agreement between measured and calculated temperatures. The report provides a detailed accojnt of the

  10. Neurodevelopmental outcome after cardiac surgery utilizing cardiopulmonary bypass in children

    Directory of Open Access Journals (Sweden)

    Aymen N Naguib

    2015-01-01

    Full Text Available Introduction: Modulating the stress response and perioperative factors can have a paramount impact on the neurodevelopmental outcome of infants who undergo cardiac surgery utilizing cardiopulmonary bypass. Materials and Methods: In this single center prospective follow-up study, we evaluated the impact of three different anesthetic techniques on the neurodevelopmental outcomes of 19 children who previously underwent congenital cardiac surgery within their 1 st year of life. Cases were done from May 2011 to December 2013. Children were assessed using the Stanford-Binet Intelligence Scales (5 th edition. Multiple regression analysis was used to test different parental and perioperative factors that could significantly predict the different neurodevelopmental outcomes in the entire cohort of patients. Results: When comparing the three groups regarding the major cognitive scores, a high-dose fentanyl (HDF patients scored significantly higher than the low-dose fentanyl (LDF + dexmedetomidine (DEX (LDF + DEX group in the quantitative reasoning scores (106 ± 22 vs. 82 ± 15 P = 0.046. The bispectral index (BIS value at the end of surgery for the -LDF group was significantly higher than that in LDF + DEX group (P = 0.011. For the entire cohort, a strong correlation was seen between the standard verbal intelligence quotient (IQ score and the baseline adrenocorticotropic hormone level, the interleukin-6 level at the end of surgery and the BIS value at the end of the procedure with an R 2 value of 0.67 and P < 0.04. There was an inverse correlation between the cardiac Intensive Care Unit length of stay and the full-scale IQ score (R = 0.4675 and P 0.027. Conclusions: Patients in the HDF group demonstrated overall higher neurodevelopmental scores, although it did not reach statistical significance except in fluid reasoning scores. Our results may point to a possible correlation between blunting the stress response and improvement of the neurodevelopmental

  11. 21 CFR 870.4350 - Cardiopulmonary bypass oxygenator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Cardiopulmonary bypass oxygenator. 870.4350 Section 870.4350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... gases between blood and a gaseous environment to satisfy the gas exchange needs of a patient during...

  12. Voice advisory manikin versus instructor facilitated training in cardiopulmonary resuscitation

    DEFF Research Database (Denmark)

    Isbye, Dan L; Høiby, Pernilla; Rasmussen, Maria B;

    2008-01-01

    BACKGROUND: Training of healthcare staff in cardiopulmonary resuscitation (CPR) is time-consuming and costly. It has been suggested to replace instructor facilitated (IF) training with an automated voice advisory manikin (VAM), which increases skill level by continuous verbal feedback during indi...

  13. Cardiopulmonary interactions during mechanical ventilation in critically ill patients

    NARCIS (Netherlands)

    T.G.V. Cherpanath (Thomas); W.K. Lagrand (Wim); M.J. Schultz (Marcus); A.B.J. Groeneveld (Johan)

    2013-01-01

    textabstractCardiopulmonary interactions induced by mechan-ical ventilation are complex and only partly understood. Ap-plied tidal volumes and/or airway pressures largely mediate changes in right ventricular preload and afterload. Effects on left ventricular function are mostly secondary to changes

  14. Necessity of immediate cardiopulmonary resuscitation in trauma emergency

    Directory of Open Access Journals (Sweden)

    Luciano Baitello

    2010-08-01

    Full Text Available Abstract The ability to respond quickly and effectively to a cardiac arrest situation rests on nurses being competent in the emergency life-saving procedure of cardiopulmonary resuscitation. The objective of the current study was to evaluate the types of trauma and survival of patients that require immediate cardiopulmonary resuscitation in trauma emergencies. A total of 13301 patients treated as accident victims between July 2004 and December 2006 were evaluated in a prospective study. Patients requiring immediate cardiopulmonary resuscitation at admission were identified. The type of injury and the survival of these patients were evaluated. Of the 65 patients included in the study, 30% had suffered from gunshot wounds, 19% had been run over, 18% had been involved in car crashes, 13% in motor cycle accidents, 9% stabbings, 1% by cycle accidents and 10% other types of accidents including burns, hangings and falls. In only 12 of these patients, immediate resuscitation was successful and procedure such as chest drainage, exploratory laparotomy and interventions in the surgical center were performed. However all patients evolved to death; eight within 24 hours, two between 24 and 48 hours and the other 2 after 48 hours. Immediate cardiopulmonary resuscitation after accidents is a sign of high mortality requiring further studies to review indication and the ethical aspects involved.

  15. The influence of biomaterials on inflammatory responses to cardiopulmonary bypass.

    Science.gov (United States)

    Courtney, J M; Matata, B M; Yin, H Q; Esposito, A; Mahiout, A; Taggart, D P; Lowe, G D

    1996-05-01

    The nature of cardiopulmonary bypass and the complexity of the inflammatory response make the detection and interpretation of a biomaterial influence difficult. However, if mediation of the inflammatory response is considered to be an appropriate clinical goal, alteration to the biomaterial influence merits further investigation.

  16. Gastrointestinal motility during cardiopulmonary bypass : A sonomicrometric study

    NARCIS (Netherlands)

    Gu, YJ; de Kroon, TL; Elstrodt, JM; Rakhorst, G

    2006-01-01

    Cardiopulmonary bypass (CPB) is known to impair the integrity of the gastrointestinal tract. However, little is known about the movement behavior of the gastrointestinal tract during CPB. This study was aimed to assess the gastrointestinal motility with sonomicrometry, a distance measurement using u

  17. Clinical benefit of steroid use in patients undergoing cardiopulmonary bypass

    DEFF Research Database (Denmark)

    Whitlock, Richard P; Chan, Simon; Devereaux, P J;

    2008-01-01

    We sought to establish the efficacy and safety of prophylactic steroids in adult patients undergoing cardiopulmonary bypass (CPB). We performed a meta-analysis of randomized trials reporting the effects of prophylactic steroids on clinical outcomes after CPB. Outcomes examined were mortality...

  18. Turbulent mixing in a rod bundle with vaned spacer grids: OECD/NEA–KAERI CFD benchmark exercise test

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Seok-Kyu; Kim, Seok; Song, Chul-Hwa, E-mail: chsong@kaeri.re.kr

    2014-11-15

    Highlights: • Detailed velocity profiles have been examined in a rod bundle with mixing spacer grids. • Mixing characteristics strongly depend on the type of the mixing vane on a spacer grid. • The swirl in subchannels is elliptic and the cross-flow in gaps is vigorous in the split-type. • Swirl-type vanes generate a circular swirl in a subchannel and a weak cross-flow in gaps. • Mixing performance is superior in the case of the split-type compared to the swirl-type. - Abstract: An experimental study titled the 2nd International Benchmark Exercise (IBE-2) has been conducted to provide high-precision data of detailed turbulent flow mixing in a rod bundle for validating the CFD codes being used widely in the nuclear power industry. A 5 × 5 rod bundle having mixing spacer grids was adopted as a test rig, and was contained in a square flow housing with a 170 mm side length and 4670 mm length. The 25 rods in a bundle have dimensions of 25.4 mm in outer diameter and a 3863 mm length. The benchmark experiments have been performed at the MATiS-H water loop facility in KAERI. The axial bulk velocity in a rod bundle was maintained at about 1.50 m/s (equivalent to Re ∼50,000) with loop conditions of 35 °C and 1.57 bar measured upstream of the spacer during the experiments. Detailed measurements of the turbulent flow in the subchannels were accomplished using 2-D LDA at four different distances (0.5, 1, 4 and 10 D{sub H}) from the downstream of the mixing spacer grid. The upstream flow profiles also have been measured at the inlet of the mixing spacer grid for the inlet boundary condition. Precise measurements of the lateral and axial velocities in the subchannels are presented at four downstream distances, as well as the inlet from the mixing spacer grid of two types. Turbulence intensities and vorticities in the subchannels are also evaluated from the velocity measurements.

  19. Quantitative blood flow measurements in the small animal cardiopulmonary system using digital subtraction angiography

    Energy Technology Data Exchange (ETDEWEB)

    Lin Mingde; Marshall, Craig T.; Qi, Yi; Johnston, Samuel M.; Badea, Cristian T.; Piantadosi, Claude A.; Johnson, G. Allan [Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy and Department of Biomedical Engineering, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Department of Radiology, Center for In Vivo Microscopy, Duke University Medical Center, Box 3302, Durham, North Carolina 27710 (United States); Division of Pulmonary and Critical Care Medicine and Center for Hyperbaric Medicine and Environmental Physiology, Duke University Medical Center, Box 3823, Durham, North Carolina 277