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N McCartney

Publications and source records attributed to N McCartney.

At least 37 records · Page 2Linked to original sources
PubMed1995

Effects of exercise training in patients with congestive heart failure: a critical review.

Congestive heart failure is a potentially debilitating disorder that affects a significant number of patients. The age-adjusted death rate has doubled over the past decade. Patients live an average of 4 to 5 years, and nearly all suffer from fatigue and breathlessness, which limits exercise capacity and produces a poor quality of life. Patients have usually been advised to avoid exercise because of concerns that they would experience a further decline in cardiac function. However, it has been demonstrated that exercise capacity is not related to the degree of left ventricular systolic dysfunction. This has led to the suggestion that peripheral changes in skeletal muscle and blood supply may play a major role in determining the exercise capacity of patients with congestive heart failure. Studies have demonstrated abnormalities of skeletal muscle blood flow, metabolism and structure, all of which are consistent with the impaired performance observed in these patients. Although the effects of exercise training have been examined in only a relatively few number of patients, the results have been promising. Exercise training has been found to improve exercise capacity and reduce symptoms. However, to our knowledge no data exist as to the impact of exercise training on left ventricular function, hospital stay or mortality in this population. Even though the early results are promising, they require confirmation of feasibility, clinical benefit and safety in larger, long-term randomized trials. It should be determined whether training has a long-term beneficial impact on measures more closely related to daily activities and quality of life. Ultimately, it would be important to determine whether training has an impact on mortality and morbidity.

Clinical Trials as Topic↗
PubMed1995

Long-term resistance training in the elderly: effects on dynamic strength, exercise capacity, muscle, and bone.

We examined the effects of 42 weeks of progressive weight-lifting training on dynamic muscle strength, peak power output in cycle ergometry, symptom limited endurance during progressive treadmill walking and stair climbing, knee extensor cross-sectional areas, and bone mineral density and content in healthy males and females aged 60-80 years, currently enrolled in a 2-year resistance training program. Subjects were randomized into either exercise (EX) or control (CON) groups (60-70 years: 38 males and 36 females; 70-80 years: 25 males and 43 females). EX trained several muscle groups twice per week for 42 weeks at intensities ranging from 50-80% of the load that they could lift once only (1 RM); CON did usual daily activities. After the 10 months there was no change in 1 RM strength in CON, but significant gains (mean increases up to 65%) in EX (no independent age or gender effects); 30% and 47% of the increase in 1 RM had occurred by 6 and 12 weeks, respectively. In EX, the 7.1% increase in peak cycling power output was significantly greater than in CON (+1.1%). The 17.8% improvement in symptom limited treadmill walking endurance was also greater than in CON (+3.4%), but the difference between groups during stair climbing was not significant (EX + 57%, CON + 33%). The cross-sectional areas of the knee extensors increased significantly by 5.5% in EX but were unchanged in CON. There were no changes in bone mineral density or content in either group. We conclude that long-term resistance training in older people is feasible and results in increases in dynamic muscle strength, muscle size, and functional capacity.

Aged↗
PubMed1994

An evaluation of the length-tension relationship in elderly human ankle dorsiflexors.

Aging is thought to be associated with a decreased elasticity of skeletal muscle, which may be predicted to affect the optimal length at which peak tension is developed. This was assessed in the present study, in which we examined the effect of aging on the muscle length-tension relationship in the right ankle dorsiflexors of 60 subjects aged 20-40 years (M = 25.3; 15 males, 15 females) and 60-80 years (M = 68.8; 15 males, 15 females). Evoked contractile properties, 1-sec tetanic contractions (at 20, 50, and 80 Hz), and maximal voluntary contractions (MVC) were measured at 10 joint angles (15 degrees dorsiflexion to 30 degrees plantarflexion, in 5 degrees increments). Peak twitch torque occurred at the extreme of plantarflexion (30 degrees P) in both elderly and young adults, and although males had significantly greater twitch torques than females, there was no difference between the elderly and young adults. Maximum tetanic torque and MVC torque occurred at 30 degrees P and 20 degrees P, respectively, but in this case the young adults were significantly stronger than the elderly adults, and the males stronger than the females at all joint angles. There was no difference in the torque-angle relationship between elderly and young adults in any of the evoked or voluntary measures. At each of the three frequencies, the rise time of tetanic torque was also similar between elderly and young adults. These results suggest that any age-related change in the elastic properties of the ankle dorsiflexors does not affect the length (as inferred by joint angle)-tension relationship in this muscle group.

Adult↗
PubMed1994

Effect of training on the blood pressure response to weight lifting.

Six young men weight trained 3 days.week-1 for 19 weeks, on each day doing 3 warm-up sets of 20 repetitions followed by 1 set each at 15-20, 10-15, and 7-10 RM (Day 1), 3 sets at 15-20 RM (Day 2), and 1 set at 15-20 and 2 sets at 10-15 RM (Day 3) of a seated bilateral leg press exercise. Training increased (P < 0.05) the maximal single leg press lift (1-RM, 26%) and knee extensor cross-sectional area (12%). Arterial (brachial artery catheter) and esophageal (probe) pressure responses were measured before and after training as subjects did sets of as many repetitions as possible up to 20 reps with 50, 70, 80, 85 and 87.5% 1-RM. After training, peak values of systolic pressure attained during a set (M pre/post, mm Hg) were significantly (P < 0.05) increased at 85% (325/360, 10.8%) 1-RM. Peak diastolic pressure increased significantly at 50 (136/151, 11.0%), 70 (185/200, 8.1%), and 80% (215/234, 8.8%). Peak esophageal pressure increased significantly at 80% (71/91, 28.2%) 1-RM. For a given absolute weight lifted, all responses were markedly reduced after training. It is concluded that weight training can (a) increase the peak arterial and esophageal pressure responses attained during maximal weight lifting exercise, and (b) reduce the arterial and esophageal pressure responses to lifting the same absolute weight.

Adaptation, Physiological↗
PubMed1993

Comparison of blood pressure response to isokinetic and weight-lifting exercise.

Brachial arterial pressure, oesophageal pressure, and knee joint angle were monitored in eight untrained young men as they performed bilateral leg-press actions (simultaneous hip and knee extension and ankle plantarflexion) against resistance. Single maximal leg-press actions on an isokinetic device evoked mean peak arterial (systolic/diastolic) pressures of 35.4/26.2 and 34.0/23.4 kPa at lever arm velocities of 0.262 and 1.31 rad.s-1, respectively. The corresponding oesophageal pressures were 13.2 and 10.4 kPa, respectively. Although the peak force was 30% greater, and duration of the action 3-4 times longer at 0.262 than 1.31 rad.s-1, the arterial and oesophageal pressure responses did not differ. On a weight-lifting machine, a set of repetitions [mean (SEM): 11 (3)] to failure at 80-90% one repetition maximum evoked peak arterial pressures of 45.5/32.8 kPa; the corresponding oesophageal pressure was 15.7 kPa. The peak systolic and diastolic pressures observed during weight-lifting were significantly (P < 0.05) higher than during isokinetic actions at both velocities, whereas oesophageal pressure was more elevated only in relation to isokinetic actions at the higher velocity. These data indicate that resisted leg-press actions cause extreme elevations in arterial blood pressure. The degree of voluntary effort is the major determinant of the blood pressure response, rather than the resistance mode or the type (concentric, eccentric, isometric) of muscle action. Repetitive resistance exercise (e.g. a set of repetitions to failure in weight-lifting) tends to produce greater pressure elevations than isolated, single maximal effort actions.

Adult↗
PubMed1993

Weight-training-induced attenuation of the circulatory response of older males to weight lifting.

We examined the effects of 12 wk of dynamic strength training on the heart rate (HR) and blood pressure of older male subjects during 10 repetitions of single-arm curl and single- and double-leg press at 60 and 80% of both the pre- and posttraining maximum capacities and during single maximum lifts (1 RM). The circulatory responses were greater at 80% of 1 RM than at 60% and increased with active muscle mass. After training, the 1 RMs increased by 24 (legs) to 54% (arms) and there was a marked attenuation of HR and arterial pressure during exercise when subjects lifted the same absolute load. Greatest reductions in HR (108 +/- 4 to 94 +/- 2 beats/min), systolic blood pressure (BPs, 247 +/- 14 to 206 +/- 9 Torr), diastolic pressure (156 +/- 9 to 116 +/- 5 Torr), mean arterial pressure (143 +/- 6 to 131 +/- 5 Torr), and rate-pressure product (268 +/- 22 to 196 +/- 12 HR.BPs/100) occurred during double-leg press at 80% of the pretraining 1 RM. After training, during lifting at 60, 80, and 100% of the posttraining 1 RMs, the HRs and arterial pressures were the same as those during pretraining testing when the same relative, but lighter, absolute loads were used. These observations are consistent with a significant part of the circulatory response to weight lifting being mediated by a feedforward "central command" mechanism coupled to the relative intensity rather than to the absolute level of force.

Aged↗
PubMed1993

Left ventricular response in healthy young men during heavy-intensity weight-lifting exercise.

We examined cardiac volumes (using echocardiography), intra-arterial blood pressure (BP), and intrathoracic pressure (ITP) in healthy males performing leg press exercise to failure at 95% of their maximum dynamic strength. Compared with preexercise, during the lifting phase of exercise, end-diastolic volume (EDV; 147 +/- 8 to 103 +/- 7 ml) and end-systolic volume (ESV; 54 +/- 5 to 27 +/- 4 ml) decreased (P < 0.05); heart rate (82 +/- 6 to 143 +/- 5 beats/min), systolic BP (160 +/- 6 to 270 +/- 21 Torr), diastolic BP (91 +/- 2 to 183 +/- 18 Torr), ITP (0.8 +/- 0.8 to 57.8 +/- 24 Torr), and peak systolic BP/ESV (SBP/ESV; 3.0 +/- 0.3 to 11.0 +/- 1.5 Torr/ml) increased (P < 0.05); and stroke volume decreased (94 +/- 3 to 77 +/- 4 ml; P > 0.05). Full knee extension was associated with most values returning to preexercise levels except for ESV (38 +/- 7 ml), heart rate (130 +/- 9 beats/min), and ITP (-12.5 +/- 2.1 Torr). During the lowering phase, significant decreases in EDV to 105 +/- 14 ml and ESV to 27 +/- 7 ml were observed with increases in systolic BP to 207 +/- 23 Torr, diastolic BP to 116 +/- 8 Torr, and SBP/ESV to 10.0 +/- 2.5 Torr/ml. Stroke volume decreased to 78 +/- 9 ml (P > 0.05). Thus rapid changes in cardiac volumes, contractility, and pressure occur during weight lifting that are related to different phases of the lift.

Adult↗
PubMed1992

Neural regulation of heart rate variability in endurance athletes and sedentary controls.

OBJECTIVE: The aim was to examine the cardiac autonomic responses to orthostatic stress and recovery from steady state exercise in endurance trained athletes and sedentary subjects. METHODS: The power spectrum of heart rate variability was measured before and after exercise in 10 male long distance runners and 14 male sedentary control subjects. Both groups were comparable in sex, age, and body mass index. Continuous ECG recordings were obtained during the following physiological manoeuvres: 45 min supine rest state; 10 min standing; 15 min steady state exercise at 50% maximum workload, and 15 min while supine during post-exercise recovery. The resting heart rate of athletes was lower than controls, at 52(SD 4.9) v 67(8.7) beats.min-1, p < 0.001. Power spectrum analysis was performed using autoregressive modelling. RESULTS: The resting high frequency (HF) vagal component was higher in athletes than controls, at 62 (10.7) v 44(22.4) beats.min-1.Hz-1, p < 0.05. The resting low frequency (LF) peak power was significantly reduced in athletes, at 54(9.9) v 70(19.5) in control, p < 0.05. Although no group differences were observed during upright posture or exercise, the LF:HF area ratio had already returned to pre-exercise levels within 5 min of recovery in athletes. Conversely, it required up to 15 min of recovery before a noticeable decrease in the LF:HF area ratio was seen in controls. CONCLUSIONS: These data support the hypothesis that endurance training modifies heart rate control in whole or in part through neurocardiac mechanisms.

Adult↗
PubMed1992

Randomised controlled trial of weightlifting exercise in patients with chronic airflow limitation.

UNLABELLED: BACKGROUND PATIENTS: with chronic airflow obstruction are often limited by muscle fatigue and weakness. As exercise rehabilitation programmes have produced modest improvements at best a study was designed to determine whether specific muscle training techniques are helpful. METHODS: Thirty four patients with chronic airflow limitation (forced expiratory volume in one second (FEV1) 38% of predicted values) were stratified for FEV1 to vital capacity (VC) ratio less than 40% and arterial oxygen desaturation during exercise and randomised to a control or weightlifting training group. In the experimental group training was prescribed for upper and lower limb muscles as a percentage of the maximum weight that could be lifted once only. It was carried out three times a week for eight weeks. RESULTS: Three subjects dropped out of each group; results in the remaining 14 patients in each group were analysed. Adherence in the training group was 90%. In the trained subjects muscle strength and endurance time during cycling at 80% of maximum power output increased by 73% from 518 (SE69) to 898 (95) s, with control subjects showing no change (506 (86) s before training and 479 (89) s after training). No significant changes in maximum cycle ergometer exercise capacity or distance walked in six minutes were found in either group. Responses to a chronic respiratory questionnaire showed significant improvements in dyspnoea and mastery of daily living activities in the trained group. CONCLUSIONS: Weightlifting training may be successfully used in patients with chronic airflow limitation, with benefits in muscle strength, exercise endurance, and subjective responses to some of the demands of daily living.

Aged↗
PubMed1992

Factors affecting blood pressure during heavy weight lifting and static contractions.

Brachial arterial pressure was directly recorded in 31 healthy male volunteers through protocols examining the effects of the Valsalva maneuver, muscle size and strength, contraction force, contraction type (concentric, isometric, eccentric), changes in joint angle, and muscle fatigue on the blood pressure response to resistance exercise. Weight lifting at the same relative intensity produced similar increases in blood pressure, regardless of individual differences in muscle size or strength. Concentric, isometric, or eccentric exercise at the same relative intensity caused similar increases despite differences in force production. In weight lifting, the greatest increase in blood pressure occurred at the joint angle corresponding to the weakest point in the strength curve and the least at the angle corresponding to the strongest point. Isometric contractions of the same relative intensity at different joint angles produced identical blood pressures despite differences in absolute force production. When subjects attempted to maintain a maximum isometric contraction for 45 s, the blood pressure increase remained the same despite a marked diminution in force. Thus the magnitude of the blood pressure response depends on the degree of effort or central command and not actual force production. A brief Valsalva maneuver, which exaggerates the increase in blood pressure, is unavoidable when desired force production exceeds approximately 80% maximum voluntary contraction.

Adult↗
PubMed1991

Usefulness of weightlifting training in improving strength and maximal power output in coronary artery disease.

The effects of 10 weeks (20 sessions) of combined weightlifting and aerobic training (n = 10) were compared with the effects of aerobic training alone (n = 8) on indexes of strength and aerobic exercise capacity in 18 men with coronary artery disease (CAD). Initial test performance was similar between groups. After aerobic training, the maximal load that could be lifted once only (1-repetition maximum) in single-arm curl, single-leg press and single-knee extension exercises increased by 13% (11.8 to 13.3 kg; p less than 0.01), 4% (97.0 to 101.0 kg; difference not significant) and 5% (28.2 to 29.7 kg; difference not significant), respectively; corresponding gains with combined weightlifting and aerobic training were 43% (12.2 to 17.4 kg; p less than 0.01), 21% (99.0 to 120.0 kg; p less than 0.01) and 24% (29.0 to 36.0 kg; p less than 0.01). After aerobic training, the initial 1-repetition maximum could be lifted an average of 4 times, compared with 14 times after combined training. Maximal progressive incremental cycle ergometer power output increased by 2% in the aerobic control group (1,088 to 1,113 kpm/min; difference not significant) and by 15% (1,030 to 1,180 kpm/min; p less than 0.05) in the experimental group. Cycling time at 80% of initial maximal power before attaining a Borg (0 to 10) rating of perceived exertion of 7 (very severe) increased by 11% (604 to 672 seconds; difference not significant) and by 109% (541 to 1,128 seconds; p less than 0.05) in the control and weight-trained patients, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Disease↗
PubMed1990

Comparison of direct and indirect measures of systemic arterial pressure during weightlifting in coronary artery disease.

Based on auscultation measurements after exercise, circuit weight training in cardiac patients has been reported to provoke minimal increases in systolic pressure. Direct (brachial artery catheter) and indirect (sphygmomanometry) measures of blood pressure were compared at rest, during lifting with the legs (approximately the fourth, ninth and fourteenth repetition) and during 2 minutes of recovery after lifting with the arms and legs. Subjects performed 15 repetitions of single-arm curl, single-arm military press and single- and double-leg press exercises at 40 and 60% of the maximum load that could be lifted once on a multistation weightlifting apparatus. Indirect measures of systolic pressure at rest were 13% less than those recorded directly (130 +/- 7 vs 149 +/- 8 torr; p less than 0.01); diastolic pressures were similar using either method. This pattern was maintained during lifting with the legs at both intensities, and after exercise with both the legs and the arms. The mean systolic pressure recorded indirectly immediately after exercise was 63 torr (31%) and 76 torr (34%) less than the average peak intraarterial value recorded during leg and arm exercises, respectively. The highest intraarterial pressures were generated during the final repetitions of the set; immediately after the last repetition, both systolic and diastolic pressures rapidly decreased. It is concluded that indirect estimates of systolic pressure are significantly less than true arterial values at rest, and during and after lifting. Moreover, indirect measurements after lifting do not allow accurate conclusions to be drawn about the arterial pressures generated during lifting because of the rapid decrease in pressure that occurs after exercise.

Blood Pressure↗
PubMed1990

Measuring quality of life in cardiac spouses.

The purpose of this study was to develop an objective instrument to measure changes in quality of life of spouses of post-myocardial infarction (MI) patients, and to determine its responsiveness and validity. A 70-item list of potential areas of concern was compiled; the 25 most frequent and important concerns comprised the framework of the final questionnaire. The questions on the Quality of Life Questionnaire for Cardiac Spouses (QL-SP) were categorized into the Emotional Function Dimension (EFD), and the Physical and Social Function Dimension (PSFD). Subjects (n = 39) completed the QL-SP and a battery of established questionnaires at home, 1-2 weeks post-hospital discharge for the patient, and 8 weeks later. Scores on the QL-SP between visits were improved for both the EFD (t = 5.56, p less than 0.001), and the PSFD (t = 6.11, p less than 0.001). The agreement between predicted and observed relationships between the dimension changes and other index changes, as measured statistically by a kappa with Cicchetti weights, was significant (kappa w = 0.43, p = 0.0012). The QL-SP appears to be responsive and valid, and may be useful in evaluating clinical and research intervention strategies.

Activities of Daily Living↗
PubMed1990

Positive adaptations to weight-lifting training in the elderly.

Maximal weight-lifting performance, isometric strength, isokinetic torque, whole muscle and individual fiber cross-sectional areas, and muscle evoked contractile properties were assessed in 14 elderly males before and after 12 wk of weight-lifting training. Dynamic elbow flexion training of one arm resulted in a significant 48% mean increase in the maximal load that could be lifted once (1 RM) and a smaller improvement in isokinetic torque (8.8%) but no change in isometric strength. In the contralateral control arm, 1 RM and isokinetic torque increased by 12.7 and 6.5%, respectively, but isometric strength did not change. The interpolated twitch technique confirmed complete motor unit activation during a maximal isometric contraction of the elbow flexors before and after the training. Bilateral leg press training effected mean increases of 17 and 23% in isokinetic torque and dynamic lifting capacity, respectively. The mean maximal cross-sectional area of the elbow flexors (biceps brachii and brachialis) increased by 17.4% in the trained arm but did not change the control arm. The increase in the mean area of type II fibers in the biceps brachii muscle in the trained arm (30.2%) was greater than the corresponding change in the control arm (10.7%, P less than 0.05). The most significant change in the evoked contractile properties of the trained elbow flexors was the increase in twitch half-relaxation time. It is concluded that older individuals retain the potential for significant increases in strength performance and upper limb muscle hypertrophy in response to overload training.

Adaptation, Physiological↗
PubMed1990

Weightlifting training in cardiac patients. Considerations.

Cardiovascular disease is the leading cause of morbidity and mortality in most of the industrialised nations in the world. Many treatment strategies are used for patients with coronary artery disease. One of these strategies is the use of cardiac exercise rehabilitation. The traditional approach to cardiac exercise rehabilitation has been the training of large muscle groups using aerobic activities such as cycling or walking. These types of activities have been demonstrated to improve maximal exercise performance and endurance. However, although aerobic performance is improved it does not address another very important component of exercise rehabilitation--namely muscular strength. Weightlifting training has been demonstrated to improve muscular strength in healthy individuals. Until recently this form of exercise training of patients with cardiac disease has been avoided due to the haemodynamic response observed during isometric (static) exercise. Weightlifting has recently been demonstrated not to be a pure isometric exercise and a different haemodynamic response has been found even in patients with cardiac disease. For this reason studies of weightlifting training have been performed in selected groups of patients with coronary artery disease. The results of these studies in this limited group of patients have demonstrated the activity is safe and beneficial in terms of improving the patient's functional capacity. Weightlifting training may also favourably affect the risk factors for coronary artery disease. Based on studies reviewed in this paper, recommendations can be made for the weightlifting training of patients with coronary artery disease. These include restriction to patients who are asymptomatic or only mildly symptomatic; initiation of training only after a period of aerobic training; the use of single limb activities; a maximum intensity no greater than 60% of 1 repetition maximum; patients train at their own rate; initially performed in a medically supervised programme; periodic reassessment of the exercise prescription; and patients should record their heart rate and response to exercise.

Coronary Disease↗
PubMed1989

Maximal isokinetic cycle ergometry in patients with coronary artery disease.

We assessed the utility of short-term (30 s) maximal isokinetic cycle ergometry as an additional method of investigating the limitations to exercise in 33 carefully selected patients with documented coronary artery disease. The technique proved safe and reproducible in these patients. In relation to normal standards, performance was better in the maximal isokinetic cycle ergometer test (peak power = 819 +/- 116 W; average power = 532 +/- 72 W; total work = 13.1 +/- 2.1 kJ; 95-101% of predicted) than in the progressive incremental exercise test (VO2 = 1.80 +/- 0.37 l.min-1; power output = 919 +/- 165 kpm.min-1; 70-80% of predicted). Beta blockade did not affect maximal performance during either isokinetic or progressive incremental cycling, although maximal heart rate was significantly lower during both tests in patients on beta blockade. Power output in the progressive exercise was not as strongly related to the indices measured during the 30 s isokinetic test (r = 0.59-0.63) as it was in previous studies of healthy individuals (r = 0.89). The ability to detect individual variations in short-term exercise capacity measured with maximal isokinetic cycle ergometry may have significant potential value 1) as an additional method of determining the limitations to exercise and 2) when executing an exercise prescription in patients with coronary artery disease.

Adrenergic beta-Antagonists↗
PubMed1989

Improvement in maximal isokinetic cycle ergometry with cardiac rehabilitation.

It is unclear whether improvements in short-term (30 s) exercise capacity are associated with the increased aerobic exercise tolerance frequently observed in cardiac patients following training. Carefully selected patients with documented coronary artery disease were randomly allocated either to a control group (N = 10) or to 12 wk of endurance exercise training (N = 12); both progressive incremental cycle ergometer testing (maximal power output and peak VO2) and 30 s maximal isokinetic cycle ergometry (peak power, total work, and fatigue index) were measured on entry into the study and 12 wk later. Initial maximum performance measures in progressive incremental exercise and in maximal short-term isokinetic cycling were similar in both groups. Following the training program, maximum power output measured during progressive incremental exercise increased by 21% (P less than 0.005) and peak VO2 increased by 18% (P less than 0.005) in the exercise group, but they were unchanged in the control group. Isokinetic peak power and total work improved by 14% (P less than 0.001) and 11%, respectively, in the exercise group, whereas there were corresponding reductions of 6 and 8% in the control subjects, with little change in fatigue index in either group. The similar relative increases in isokinetic peak power and peak VO2 suggest that improvement in short-term exercise capacity may be an important contributor to the improvement in aerobic exercise tolerance frequently observed in cardiac patients undergoing an endurance exercise program.

Coronary Disease↗