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Biomedical subjects

L R Zohman

Publications and source records attributed to L R Zohman.

28 records · Page 2Linked to original sources
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A simple walk test to guide exercise programming of the elderly.

Exercise training programs are usually based on a maximal exercise stress test; however, this test is often difficult and sometimes frightening to older persons. This preliminary study reports on a fixed-distance, submaximal walk test and compares its usefulness for exercise prescription to that of the traditional maximal stress test. Ten cardiac patients, with an average age of 72 years (4 men), had recently clinically indicated maximal graded stress tests. Within one week, each had the walk test, which consisted of walking three times up and back 100 feet in the hospital corridor (total of 600 feet) as rapidly as possible, with a blood pressure cuff on their arm and carrying the electrocardiogram cable. Resting and peak heart rate, blood pressure, symptoms, and exercise electrocardiograms were compared for the walk test v the maximal stress test. Oxygen consumption was calculated from the peak workload on the maximal stress test and from walking speed on the walk test. The peak heart rates after the walk test were within the target heart rate zone (70-85%) for exercise programming, as obtained from the maximal stress test, in all patients except one. The calculated peak oxygen consumption from the walk test was also within the training zone (60-80%) obtained from the maximal stress test in all patients except one. This pilot study shows that a submaximal, steady state timed walk of 600 feet can be a feasible method of providing the information for exercise programming, possibly avoiding the need for a maximal stress test. This walk test can be performed easily by health-related staff without sophisticated facilities in an inpatient rehabilitation unit or nursing home; however, further study with a larger number of patients is necessary before this method of exercise prescription can be recommended.

Aged↗
PubMedDate not supplied

Exercise stress testing and risk factor assessment among offspring of cardiac patients.

As we learn more about the origins of coronary artery disease, research has begun to focus on its prevention. The purpose of this study was to determine if exercise stress testing of the offspring of our cardiac rehabilitation patients would be a useful adjunct to their general cardiac risk factor assessment. In addition, we sought to quantitate the number of cardiac risk factors they might have already accumulated. We determined the lifestyle and lipid profiles of 22 young, healthy subjects. Subjects underwent maximal multistage exercise stress tests. Eighty-six percent of subjects had two or more major risk factors for CAD, and 73% had contributory risk factors. Seventy-three percent of subjects also demonstrated hypercholesterolemia. Exercise testing did not induce ischemic changes on electrocardiography of any subject. Our research revealed that these offspring demonstrate an alarming number of coronary artery disease risk factors, even though exercise stress tests were negative.

Adult↗
PubMedDate not supplied

Intravenous dipyridamole thallium imaging V combined arm-leg cycle stress testing of patients unable to exercise on the treadmill.

UNLABELLED: Rehabilitation patients who will undergo noncardiac surgery or strenuous rehabilitation programs often cannot exercise to greater than 85% of predicted maximal heart rate as required for valid treadmill testing. Because many patients have known or suspected coronary artery disease, greatly increasing their risk for a cardiac event, dipyridamole thallium scans are usually performed, despite a cost of approximately $1400, patient radiation exposure, and the need for a gamma camera. Instead, arm-leg cycle stress testing can be continued to an appropriately high heart rate, is done in the physician's office with an electrocardiograph machine and a blood pressure cuff, and costs $250. This study describes nine patients who had both dipyridamole thallium scans and arm-leg cycle ergometry. Four awaited peripheral vascular surgery, one needed bilateral knee replacements, one was an amputee, and three had claudication. Six had documented and three had suspected coronary disease. RESULTS: In eight of nine patients, the electrocardiograms during both dipyridamole thallium imaging and ergometry were in agreement as to the presence or absence of ischemia (kappa statistic, 0.7273; P = 0.0117). In seven of nine patients, thallium images and ergometry agreed (78% concurrence). To achieve 90% agreement between dipyridamole thallium scans and cycle results, however, 68 patients would have to be studied. CONCLUSION: In this preliminary study, arm-leg ergometry was feasible in all patients and seemed cost-effective and useful for detecting myocardial ischemia. Clinically, if the ergometry were inconclusive, dipyridamole thallium scans could be performed subsequently to obtain the needed information.

Aged↗
PubMedDate not supplied

Reduction of physiological, behavioral, and self-report responses in type A behavior: a preliminary report.

Recent reports indicate that Type A Behavior may be reducible by behavioral and other psychotherapeutic methods. To date, however, there has been virtually no demonstration of reduction of the actual, observed behavior. Furthermore, the physiologic hyperresponsiveness that seems to characterize many Type A individuals when under stress, has received relatively little therapeutic attention. This preliminary, uncontrolled report describes a cognitive-behavioral group intervention program, before and after which patients underwent assessment on physiologic, behavioral, and self-report assessments. These included heart rate and blood pressure responsiveness under stressful conditions, trained observer ratings of Type A Behavior, and a variety of subjective measures of Type A Behavior and psychological distress and symptoms. Results showed limited improvement on most behavioral and self-report indices. Relatively greater reduction of Type A Behavior was associated with higher pre-treatment levels of Type A Behavior, with the absence of coronary artery disease and with male gender.

Adult↗