Biomedical subjects

L M Sheldahl

Publications and source records attributed to L M Sheldahl.

26 records · Page 2Linked to original sources

PubMed1987

Safety of graded symptom-limited exercise testing in patients with congestive heart failure.

The safety and end points of graded symptom-limited bicycle exercise were assessed in 607 patients before they were randomized to vasodilator or placebo in the Veterans Administration Cooperative Study-Vasodilator Heart Failure Trial. Their mean age was 58 years and left ventricular ejection fraction averaged 30%. The peak exercise responses were as follows: oxygen consumption, 14.5 +/- 3.9 ml/kg/min; heart rate, 132 +/- 24 beats/min; systolic blood pressure, 154 +/- 29 mm Hg. No major complications occurred with the baseline tests. The initial baseline test was stopped in only 10 patients (1.6%) for arrhythmias and in one patient for hypotension. Ventricular tachycardia assessed by ambulatory electrocardiographic monitoring during the second exercise test (before exercise, during exercise, and 4 hr after the test) revealed a prevalence of 5.7% during exercise and 28.8% during the rest of the monitoring period. This study has demonstrated that stable male patients with congestive heart failure can safely exercise on a bicycle ergometer to their peak effort in a well-supervised setting. In addition, we have demonstrated that ambulatory electrocardiographic monitoring is a better method than exercise testing to evaluate presence and extent of ventricular arrhythmias in patients with congestive heart failure.

Adolescent↗

PubMed1986

Effect of head-out water immersion on response to exercise training.

During spaceflight and head-out water immersion (WI) there is a cephalad shift in blood volume. We have recently shown that left ventricular end-diastolic dimension is significantly greater during moderate cycling exercise with WI compared with on land. The purpose of this study was to determine whether the cephalad shift in blood volume and accompanying increase in cardiac preload with WI alters the normal cardiovascular adaptations to aerobic exercise training. Nine middle-aged healthy men trained on cycle ergometers in water, nine trained on land, and four served as controls for 12 wk. Following training, both training groups showed similar increase (P less than 0.05) in stroke volume and similar decreases in heart rate (P less than 0.01) and blood pressure (P less than 0.05) at a given submaximal exercise O2 consumption (VO2). Maximal VO2 increased (P less than 0.01) similarly for both training groups. The control group did not demonstrate any significant changes in submaximal or maximal exercise responses. We conclude that the cephalad shift in blood volume with WI does not alter the normal cardiovascular adaptation to aerobic exercise training.

Adult↗

PubMed1986

Special ergometric techniques and weight reduction.

Several physiological and psychological benefits can be achieved with exercise training provided an adequate exercise threshold is reached. In recommending exercise regimens to obese individuals, it is important to consider the exercise intensity, frequency, and duration that is most likely to lead to the desired benefits of exercise training. The special problems that some obese individuals may encounter with exercise training should also be considered. Walk/jog and stationary cycling are the two most commonly recommended modes of exercise. Aquatic exercise, due to the buoyancy and thermal properties of water, may be especially suitable as a method of exercise for obese individuals. In addition to swimming, cycling exercise and aerobic dance can be performed in a water environment.

Body Weight↗

PubMed1985

The safety of static-dynamic effort soon after myocardial infarction.

Many activities of daily living require static-dynamic effort. To evaluate the safety of such effort 3 weeks after myocardial infarction, 27 male patients underwent a weight-carrying test requiring 5 minutes of treadmill ambulation with graded weight loads of 10 to 30 pounds. The hemodynamic responses with weight carrying were compared to that of a predischarge graded dynamic exercise test. The peak heart rate was significantly lower (p less than 0.01) with weight carrying, the peak systolic blood pressure did not differ, and the diastolic pressure was significantly higher (P less than 0.01). ST segment depression and angina pectoris occurred less frequently with weight carrying. The type and frequency of ventricular arrhythmias were similar between the two tests. We conclude that many men are capable of performing static-dynamic activity equivalent to carrying up to 30 pounds by 3 weeks after myocardial infarction.

Adult↗

PubMed1985

Use of simulated work testing in cardiac rehabilitation: a case report.

A significant percentage of patients do not return to work after myocardial infarction or coronary artery bypass surgery for nonmedical reasons. These reasons include unwarranted medical restrictions, patient anxiety concerning ability to meet job demands, apprehensive family members, and fearful employers. A case study is presented to illustrate how occupational therapists can enhance a patient's work potential by using skills in activity analysis to develop simulated work evaluations. Satisfactory performance on a test that closely simulates work demands can help the physician, patient, family, and employer gain confidence in the patient's ability to return to work.

Coronary Artery Bypass↗

PubMed1984

Effect of central hypervolemia on cardiac performance during exercise.

To investigate the effect of different levels of central blood volume on cardiac performance during exercise, M-mode echocardiography was utilized to determine left ventricular size and performance during cycling exercise in the upright posture (UP), supine posture (SP), and head-out water immersion (WI). At submaximal work loads requiring a mean O2 consumption (Vo2) of 1.2 1/min and 1.5 1/min, mean left ventricular end-diastolic and end-systolic dimensions were significantly greater (P less than 0.05) with WI than UP. In the SP during exercise, left ventricular dimensions were intermediate between UP and WI. Heart rate did not differ significantly among the three conditions at rest and at submaximal exercise up to a mean Vo2 of 1.8 1/min. However, at a mean Vo2 of 2.4 1/min, heart rate in the UP was significantly greater than WI (P less than 0.01) and the SP (P less than 0.05). Maximal Vo2 did not differ statistically in the three conditions. These data indicate that a change in central blood volume results in alterations in left ventricular end-diastolic and end-systolic dimensions during moderate levels of exercise and a change in heart rate at heavy levels of exercise.

Adult↗

PubMed1983

Response of patients after myocardial infarction to carrying a graded series of weight loads.

Cardiovascular responses to carrying graded weight loads of 20 to 50 pounds were determined in 52 patients after myocardial infarction (MI) (greater than or equal to 2 months). Sixty percent of the patients were stopped before completing the heaviest weight load (50 pounds for 2 minutes) because of an increase in diastolic blood pressure (BP) to 120 mm Hg (end point) or arm fatigue. Compared with symptom-limited graded dynamic exercise, peak systolic and diastolic BP were significantly greater (p less than 0.05 and p less than 0.01, respectively) with weight carrying, while peak heart rate, pressure-rate product, ventilation and oxygen consumption were significantly lower (p less than 0.01). Ischemic responses were less frequent with weight carrying. Patients with severely reduced resting left ventricular ejection fraction (LVEF) (less than 35%) tolerated the weight carrying test as well as patients with normal resting LVEFs (greater than 50%). We conclude that (1) ischemic responses occur less frequently while carrying up to 50 pounds for 2 minutes than with symptom-limited dynamic exercise, (2) a significant number of patients have an increase in diastolic BP greater than or equal to 120 mm Hg while carrying objects that weigh 30 to 50 pounds for 2 minutes, and (3) a poor correlation exists between resting LVEF and tolerance for weight carrying.

Adult↗

PubMed1982

Effects of exercise in cool water on body weight loss.

Seven obese women (greater than 30 per cent body fat, mean = 43 per cent) performed moderate exercise (30 to 40 per cent of maximal oxygen consumption) for 90 min during head-out immersion in cool water (17 to 22 degrees C) five times per week for eight weeks to determine if cold exposure and the attendant caloric deficit in body heat stores would lead to body weight loss. Exercise was on a cycle ergometer that was modified for underwater use. Body weight, body fat, fat-free body weight, and caloric intake did not change significantly as a result of the exercise program in cool water. The significant heat debts incurred were presumably repaid without an increase in energy expenditure. The caloric balance and the thermal data obtained suggest that body heat stores were slowly repaid during recovery by resting metabolic heat production associated with a reduced rate of body heat loss. Maximal oxygen uptake did not increase significantly. No metabolic or thermal evidence was found to support cold adaptation in the obese women. Ergometer exercise in water as well-tolerated, as evidenced by no exercise-related injuries and an adherence rate of 93 per cent. It was concluded that, while cold exposure does not increase caloric expenditure significantly in obese individuals, exercising regularly in cool water may be beneficial as it may motivate obese people to exercise at higher intensity for thermal comfort and the water environment may help prevent injuries.

Adipose Tissue↗