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Biomedical subjects

R J Shephard

Publications and source records attributed to R J Shephard.

At least 415 records · Page 23Linked to original sources

Conditioning of postcoronary patients: comparison of continuous and interval training.

Interval training is theoretically attractive as a means of training the postcoronary patient, since by appropriate choice of exercise and recovery intervals substantial cardiac training can be achieved without the accumulation of anaerobic metabolities and associated increases of blood pressure and cardiac work load. Six patients with frequent exercise-induced anginal attacks coped well with a program based upon running or jogging (1/2 to 1 minute) followed by 1 to 1-1/2 minutes of slow walking. Despite a poor previous response to several months of continuous training, they showed a substantial gain of aerobic power with one year on the interval regimen. The ST segmental response to a fixed increment of pulse rate remained unimproved, but probably because of the enhanced cardiorespiratory fitness, the ST depression at a fixed work load was lessended. Twenty other patients who had also followed a continuous exercise regimen for up to one year were switched to interval-type work. Over the next year they failed to progress as fast as a group of 15 patientswho persisted with continuous effort training. While interval work is helpful to the severely disabled anginal patient, it apparently leads to slower progress in the average postcoronary patient.

Adult↗

The influences of race and environment on ischemic heart disease.

Certain "primitive" peoples such as traditional-living nomadic Eskimos have as yet been spared from the current epidemic of ischemic heart disease. A review of risk factors for underdeveloped populations suggests that environment rather than constitution is responsible. Favourable factors include the absence of overeating, a substantial level of of physical activity, only recent acquisition of the cigarette habit and absence of competitiveness. However, risk factors generally operate as in the "white" community, and where a Western lifestyle is embraced through either migration or acculturation the prevalence of ischemic heart disease rapidly increases to the levels encountered in "civilized" groups.

Age Factors↗

A current view of Canadian cardiorespiratory fitness.

A standard Astrand bicycle ergometer test was used to predict the maximum oxygen intake of 672 female and 558 male volunteers ranging in age from 15 to 69 years. In terms of this index of cardiorespiratory performance Canadians were unfit relative to Swedish norms. Also, some 47% of women and 40% of men achieved only low or fair fitness categories when evaluated relative to American Heart Association recommendations. These results are poorer than those reported for Torontonians in 1966. Men perceive their cardiorespiratory fitness accurately but women do not. In both sexes adequate recreational activity apparently leads to maintenance of cardiorespiratory fitness.

Adolescent↗

The dimensions of sports medicine.

The history of sports medicine is reviewed in terms of European, United States and Canadian traditions. An orientation towards treatment, particularly the treatment of injuries in elite athletes, is noted. Encouragement is found in the trend to discussion between the several Canadian groups interested in sports medicine. It is suggested that in the leisured society of the future, sports medicine will form an increasing part of family practice. It is to be hoped that emphasis will be placed on a broad-based approach to prevention of accidents and disease, coupled with the effective promotion of positive health measures, particularly increased physical activity.

Athletic Injuries↗

The athlete at high altitude.

Track times at moderate altitudes (7000 to 8000 feet) are modified by decreased wind resistance and by systemic disturbances such as mountain sickness, disruption of training, and a decrease of maximum oxygen intake. The optimum period of acclimatization is probably two to three days. This permits adjustment of cerebrospinal fluid acid-base balance, but minimizes disturbances of plasma volume and stroke volume. Further study is needed to establish whether altitude training can improve performance in sea-level competitions.

Acclimatization↗

The immediate antecedents of myocardial infarction in active men.

The antecedents of myocardial infarction have been reviewed in 102 patients (117 episodes) undergoing a program of rehabilitation. The year prior to the first attack was characterized by business and social problems, with some weight gain; in the week before the attach there was added tiredness, poor general health and, in some cases, increasing anginal pain. Heavy lifting and/or unusual exercise were common immediately before or during an attack; five attacks were related to the shovelling of wet snow.Both bed and the normal place of work were uncommon sites for an attack. More than 50% of patients had 30 minutes' warning of infarction. The relevance of these findings to a safe program of therapeutic exercise is discussed.

Activities of Daily Living↗