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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↗

[Computer-assisted evaluation of bicycle ergometry].

The pedal ergometry is a reliable method for testing the functional capacity of patients with organic arterial obstructive diseases of the lower extremities. In order to lower the loss of time for evaluation pedal work and performance were calculated by means of a microcomputer KC 85/1 with the help of a basic programme using Hall switch circuits. The connection between working ability of the pedal, type of obstruction and pressure values of the posterior tibial artery is documented in the light of the measuring results of 61 patients with arterial obstructive disease of the lower extremities and of 32 test persons with healthy vessels.

Exercise Test↗

[Pedal ergometry--an efficient method of angiologic functional diagnosis].

In 61 patients with peripheral arterial obstructive disease (stages I and II after Fontaine) oscillographic, haemodynamic and ergometric functional examinations were performed. The pedal-ergometric charge maximum correlated with haemodynamic parameters. Informations were obtained which transgressed the exclusive pressure and flow measurement, for which reason the pedal ergometry is particularly suitable for the judgement of the function and control of therapy in arterial obstructive disease.

Arterial Occlusive Diseases↗

[Clinical importance of 99mTc-pyrophosphate scintigraphy in the bicycle ergometry test].

The clinical value of myocardial scintigraphy with 99mTc-pyrophosphate in conjunction with bicycle ergometry was assessed through the correlation of the latter's results with the clinical course of coronary heart disease over 1 year in 21 patients with first myocardial infarction during its early healing stage and 17 anginal patients without a history of myocardial infarction. The disease ran a stable course at the time of the testing in all the patients; later on, 11 of those developed various complications associated with coronary heart disease, or died. Three scintigraphic recordings were made: prior to, at the peak of, and after the exercise. Thirteen scintigraphic patterns were identified. They are interpreted on the basis of presumed variation in the degree of myocardial damage and blood supply to affected areas under the effect of exercise; a relation is also noted with predicted risk of complications. The method has proved reliable in identifying patients at low risk for complications. Providing indirect evidence of the quality of blood supply to damaged myocardial areas during rationed exercise, it furnishes additional criteria for the assessment of the patients' working capacity.

Adult↗

Metabolic and heart rate responses to submaximal arm lever and arm crank ergometry.

Previous studies have shown that arm cranks and arm levers, working as propulsion mechanisms for nonambulatory individuals, may have mechanical and physiologic advantages over standard handrim wheelchairs. This study evaluated physiologic responses to arm lever and arm crank ergometry using identical workloads. An arm lever ergometer (ALE) was constructed and adapted to an arm crank ergometer (ACE) so that equal workloads could be applied with both ergometers. Fifteen able-bodied men and 15 able-bodied women exercised at a low (15 watts) and a high (45 watts) workload, with a three-minute rest interval. While exercising at each level, oxygen consumption (VO2), minute ventilation (VE), and heart rate (HR) were monitored. When low workloads with ALE and ACE were compared, no significant differences (p greater than 0.05) were demonstrated in any of the variables for men or women. For the men, at the high workload, the ALE elicited significantly lower (p less than 0.05) VO2 (by 9.8%), HR (by 6.3%), and VE (by 7.5%), than did the ACE. For the women, at the high workload, VO2 was significantly lower (p less than 0.05) (by 7.6%) with the ALE, as was VE (by 7.5%), but HR, although 3.3% lower with the ALE, was not significantly different (p greater than 0.05) from the ACE. These data suggest that the ALE is physiologically less stressful than the ACE at high workloads. Arm levers may, therefore, provide an advantage for handicapped persons when they propel themselves in wheelchairs.

Arm↗

Cardiorespiratory and subjective responses to incremental and constant load ergometry with arms and legs.

Aerobic exercises in which both arm and legs are used are becoming more popular for conditioning and rehabilitation. In order to clarify our understanding of physiologic and subjective responses to work of this type, two experiments were conducted using legs and/or arms. In the first, incremental cycle ergometry was done with the arms (A), legs (L), and combined, in which either 10% (A-10) or 25% (A-25) of the power output (PO) was done by the arms. Peak rate of oxygen consumption (VO2) and heart rate (HR) were significantly lower for A, but the other three conditions did not differ significantly. Ventilatory breakpoint (VB) was significantly higher for A-10 than for L. The second study used 60 minutes of constant-load work at a PO of approximately 115% of the PO at which the VB occurred in the L incremental test, to stimulate an aerobic training session. During the 60 minutes, VO2 and cardiac output were significantly higher, and systolic blood pressure (SBP) significantly lower for A-25 than for L, with A-10 values generally failing between the two. The HR-SBP products and ratings of perceived exertion were quite similar for the three modes. Thus, assigning some of the PO to the arms allowed a greater metabolic load to be maintained with no greater cardiovascular or subjective strain, suggesting that this type of exercise might be valuable for aerobic conditioning, cardiorespiratory rehabilitation, and weight control.

Adult↗

[Effect of the bicycle ergometry test on lipid peroxidation processes in patients with ischemic heart disease].

The effect of bicycle ergometry on lipid peroxidation was examined in 43 coronary patients. An increase in malonic dialdehyde, a secondary product of lipid peroxidation, was detected in patients with post-infarction cardiosclerosis, an evidence of intensified lipid peroxidation in systemic tissues. It is proposed that natural antioxidants be used to prevent myocardial metabolic disorders in coronary patients.

Adult↗

[Comparative evaluation of the results of the bicycle ergometry test in patients with stress stenocardia after treatment with propranolol and nifedipine].

The results of bicycle ergometry (BE) following administration of placebo, 80 mg propranolol (anaprilin), 30 mg nifedipine (corinfar) and a combination of 60 mg propranolol and 20 mg nifedipine were reviewed in coronary patients with angina pectoris of functional classes (FC) II-IV. Patients with FC-II angina showed the greatest increment in stress tolerance after nifedipine administration, and patients with FC-IV angina, after propranolol, apparently due to a predominance of the functional (coronaro-spastic) pathogenetic factor in the FC-II angina, and the organic factor, in angina of more severe functional classes. In patients belonging to FC-III, the two drugs had similar antianginal efficiency. Stress tolerance increased considerably after simultaneous administration of both drugs in all patients with angina of effort, irrespective of functional class.

Adult↗

[Metabolic responses to ergometry and their role in the development of physical work capacity in patients with ischemic heart disease and different types of hemodynamics].

Blood coagulation and fibrinolysis, lipid and lactate levels and some enzyme activities were measured in 283 coronary patients during bicycle ergometry. Hemodynamic type was established on the basis of the cardiac index. A negative correlation is demonstrated between the cardiac output and blood lipids. Fibrinolytic reserve was intact in 32.3% of patients with eu- and hyperkinetic hemodynamic types and in just 9.3% of patients with hypokinetic hemodynamics. The latter type was associated with the greatest disturbance of aerobic/anaerobic metabolism ratios. The extent of disturbance in lipid metabolism and blood coagulation is closely correlated with hemodynamic types that reflect the state of myocardial contractility.

Blood Coagulation↗

[Value of the treadmill test, bicycle ergometry test and the isometric test in evaluating the severity of coronary insufficiency].

Possibilities of the treadmill test, bicycle ergometry and the isometric test are reviewed with respect to the diagnosis and assessment of the severity of coronary heart disease (CHD). A study of 40 normal males and 95 coronary patients (including 57 aneurysm-free ones and 38 with left ventricular postinfarction aneurysm) demonstrated low diagnostic value of standard dynamic load programs for the assessment of coronary insufficiency. An original treadmill test program has been developed where each new step carries a 1 MET increment of the load, allowing to assess the severity of CHD within a wide range of clinical manifestations, and group patients according to the involvement of 1 or 2 coronary arteries. The isometric test is of little value for the diagnosis of CHD, yet it can be useful in the assessment of the severity of coronary insufficiency and identification of patients with the involvement of 2 and 3 coronary arteries.

Adult↗

[Changes in ECG indices and hemodynamics during bicycle ergometry of patients following aortic valve prosthesis].

Correlated electrocardiographic and hemodynamic changes have been demonstrated in 60 convalescent patients within 3 years after aortic valve replacement by means of bicycle ergometry (BEM) and simultaneous Kubicek's impedance rheoplethysmography. As electrocardiographic ischemic changes are more frequent during recovery, while their hemodynamic causes are different during and after exercise, BEM load increment should be intermittent in patients with aortic valve prosthesis. Exercise-induced increase of R voltage that was mostly combined with inadequate hemodynamic response and accompanied by ischemic ST depression may be an additional criterion of threshold stress.

Adult↗

[Dynamics of the indices of spirometry and bicycle ergometry in stenocardia patients undergoing repeated studies].

A study of reproducibility and patterns of change in 7 control bicycle and respiration ergometric tests in 14 coronary anginal patients demonstrated consistent change in stress tolerance and gaseous exchange: a rapid adaptation period (first 2 or 4 tests) when stress tolerance, ventilation and maximum oxygen uptake increased significantly, and a slow adaptation period (most later tests) when tolerance grew gradually, while oxygen consumption first dropped and then stabilized above the baseline. Accidental stress tolerance variation exceeded 1 step in 20% of patients, obviously due to their inability to adapt to the testing procedure. It is suggested that pharmacodynamic studies of antianginal drugs, making use of bicycle and respiration ergometry can only be conducted in the slow adaptation period, provided the individuals showing wide spontaneous variability are excluded from the study.

Adult↗

[Dynamics of respiratory function and and bicycle ergometry in the treatment of patients with chronic circulatory failure].

Data are presented on external respiration at rest and during exercise (bicycle ergometry) in 20 patients with chronic circulatory insufficiency due to a variety of heart diseases, as well as variation in the above in the course of treatment with digoxin and calcium antagonist corinfar. External respiration parameters of the examined patients were compared with those of 40 apparently normal controls. Some mechanisms of action and the effects of digoxin, corinfar and combined use of the two on external respiration parameters are discussed. Evidence is obtained that digoxin and corinfar improve these parameters, particularly when used in combination, therefore combined digoxin/corinfar therapy is certainly advisable as part of combined treatment for chronic circulatory insufficiency.

Adult↗

[ECG and hemodynamic changes during the bicycle ergometry of patients following aortic valve prosthesis].

Interrelated ECG and hemodynamic changes were revealed in an analysis of the results of a bicycle ergometry test (BET) with the recording of ECG in 12 accepted leads and simultaneous impedance rheoplethysmography after Kubichek in 60 patients during rehabilitation for 3 yrs after aortic valve replacement. Impedance-measuring investigation of hemodynamics after physical exercise provided valuable information on causes of ECG changes. More frequent development of ischemic changes during rehabilitation and a variety of hemodynamic causes of changes in physical exercise and in the period of restitution necessitated intermittent BET in patients with a prosthesis of the aortic valve. An increase in voltage of the R wave during BET was combined in most cases with other inadequate hemodynamic reactions and was accompanied by an "ischemic" decrease in ST, and could serve as an additional criterion of threshold exercise.

Adult↗

[Methodological approaches to assessing the effectiveness of anti-angina preparations in stenocardia patients using paired bicycle ergometry loads].

Paired bicycle ergometry was used in 24 anginal patients to compare the efficiency of 10-20 mg isosorbide dinitrate, 20-30 mg corinfar and 40-80 mg propranolol. Isosorbide dinitrate showed maximum efficiency in half of the patients, corinfar in 1/4, propranolol in 1/6. Isosorbide dinitrate produced an effect with the very first dose more frequently, as compared to other drugs. Heart rate patterns at rest and under the action of corinfar and isosorbide dinitrate varied in different individuals and were related to the time of onset of an exercise-induced anginal attack.

Angina Pectoris↗

[Importance of the bicycle ergometry test indices for predicting the outcome of stenocardia].

The predictive value of initial bicycle ergometry was assessed on the basis of long-term follow-up (averaging 5.4 years) of 272 patients with stable angina pectoris. The prognosis for anginal patients was shown to be basically worse where the threshold capacity, operation volume at the final stage of exercise and the double product at the time of an anginal attack were at low levels. It was also unfavorable in cases where electrocardiograms showed combinations of horizontal ST depression and frequent extrasystoles or ambidirectional ischemic displacements in individual leads, during an anginal attack provoked by rationed exercise. These parameters are suggested as criteria for dividing anginal patients into high and relatively low risk groups with respect to the fatal outcome.

Adult↗

[Use of graded bicycle ergometry as a method for the objective evaluation of the efficacy of reflexotherapy in the early stages of hypertension].

Graded bicycle ergometry was used to evaluate the efficacy of pathogenetic auriculo-paravertebral reflexotherapy (RT) in 24 patients with stages IB and IIA of essential hypertension (EH). After RT was completed the subjective symptomatology, central hemodynamics, and heart work improved. The increment of the minute volume of the circulation in response to graded exercise decreased, especially in patients with stage IB of EH. These patients also showed a reduction in the heart rate. The total peripheral vascular resistance dropped both at rest and after exercise. After RT the patients with stages IB and IIA of EH manifested a decrease in the loading heart index and intensity of the functioning of the structures, with that decrease being more demonstrable in patients with stage IIA EH, which attested to the lowering of heart muscle oxygen consumption. The decreased intensity of the functioning of the structures in patients with stage IB EH points to the diminution of myocardial hyperfunction marking the hyperkinetic circulatory pattern in these patients.

Acupuncture Therapy↗