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PubMed1988

The effect of exercise duration on the exercise and post-exercise oxygen consumption.

This study was designed to determine the effect of duration (30, 45, 60 min) of exercise at 70% VO2 max on oxygen consumption during the exercise and post-exercise periods and if the post-exercise oxygen consumption (EPOC) is related to elevated tympanic temperature. Two male and three female volunteer subjects cycled at 70% VO2 max for 30, 45 and 60 min. The EPOC increased 2.35 and 5.3 fold when exercise duration was increased from 30 to 45 min and from 30 to 60 min respectively. The time for VO2 to return to resting levels following exercise was 128 +/- 4.4 min, 204 +/- 15.9 min and 455 +/- 30.0 min after the 30, 45 and 60 min exercise bouts. Tympanic temperatures were stable at 38.6 degrees C after approximately 30 min of exercise, but all had fallen to resting conditions approximately two hours post-exercise. The correlation between core temperature and EPOC, and RER and EPOC, was r = 0.64-0.75 and r = 0.86-0.89, respectively. These data emphasize the importance of extending the work time for elevating the energy cost during and post-exercise, and suggest that the EPOC can be explained in part by the effects of elevated temperature and metabolic substrate.

Adult↗
PubMed2004

Supplementing a home exercise programme with a class-based exercise programme is more effective than home exercise alone in the treatment of knee osteoarthritis.

OBJECTIVE: The study aimed to compare the relative effectiveness of providing a home-based exercise programme versus home-based exercise supplemented with an 8-week class-based exercise programme in reducing pain and improving function in patients with knee osteoarthritis. METHODS: Patients (n = 214) with radiologically confirmed knee osteoarthritis were selected. Patients were randomly allocated to either home or home supplemented with class-based exercise programmes. Both groups were given a home exercise programme whilst the supplemented group also attended for 8 weeks of twice weekly knee classes. Assessments of locomotor function, walking pain and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were made. Assessments were made pre- and post-treatment and also at 6- and 12-month follow-ups. Statistical analysis involved the use of a longitudinal linear model ANCOVA with baseline values entered as a covariate. RESULTS: Patients from the class-based group demonstrated significantly greater improvement in locomotor function (-3.7 seconds; 95% C.I. -4.9 to -2.5) and decrease in walking pain (-15 mm; 95% C.I. -20 to -11) than the home-based group, at 12-months follow-up. CONCLUSIONS: The supplementation of a home based exercise programme with a class-based exercise programme led to clinically significant superior improvement. These improvements were still evident at 12-month review. This is the first trial to evaluate this common physiotherapeutic practice, and based on this evidence, supplementation of home exercises with a class-based exercise programme can be recommended to patients, clinicians and service providers.

Analysis of Variance↗
PubMed1991

Inadequate exercise leads to suboptimal imaging. Thallium-201 myocardial perfusion imaging after dipyridamole combined with low-level exercise unmasks ischemia in symptomatic patients with non-diagnostic thallium-201 scans who exercise submaximally.

This study was undertaken to establish the additional value of 201TI imaging after dipyridamole in combination with low-level exercise in 15 symptomatic patients with non-diagnostic 201TI scans, who exercised submaximally. Most patients had angina, ST-segment depression and even exertional hypotension and were referred for stress 201TI testing for determining the functional significance of known coronary artery disease. Six patients with a normal exercise 201TI test and one patient with an apical defect only were found to have 37 segments (of 105 segments) with reversible perfusion defects after dipyridamole infusion. One patient showing two reversible defects after exercise had five reversible segments after dipyridamole. Seven patients with fixed defects in 28 segments after exercise and two with small areas of border zone ischemia in seven additional (sub)segments, demonstrated fixed in defects in only nine segments but reversible defects in 40 segments after dipyridamole. Quantitative analysis resulted in 24.8 +/- 28.5 (mean value) sample points below -2 s.d. of the mean normal uptake after exercise, which increased to 72 +/- 26.5 after dipyridamole infusion (p less than 0.005). The washout analysis resulted in a mean value of 5.5 +/- 8.1 sample points below -2 s.d. after exercise, increasing to 33.3 +/- 22.1 after dipyridamole (p less than 0.005). Thallium-201 myocardial perfusion imaging after dipyridamole combined with low-level upright bicycle exercise may unmask scintigraphic evidence for ischemia in symptomatic patients who would otherwise have non-diagnostic imaging studies during submaximal exercise.

Coronary Disease↗
PubMed1993

[Effects of aerosol oxitropium bromide and fenoterol on maximal exercise capacity in chronic obstructive pulmonary disease and their correlation with air flow during exercise and with parameters of maximal exercise].

To examine the effects of bronchodilators on maximal exercise capacity and their correlation with airflow during exercise in patients with chronic obstructive pulmonary disease (COPD), we conducted a double-blind, randomized comparison between inhaled fenoterol (beta 2-agonist) and oxitropium bromide (anticholinergic agent) in 8 patients with stable COPD (mean age 73 years, mean FEV1 1.1 L, mean FEV1% 50%). Only oxitropium bromide resulted in statistically significant improvement in FEV1 40 min after inhalation. On maximal exercise, fenoterol did not affect oxygen uptake (VO2 max), minute ventilation (VEmax), respiratory frequency (Rfmax), ventilatory efficacy (VEmax/VO2 max), peak expiratory flow during exercise (PEFmax), heart rate (HRmax) and dyspnea (Borg Scale Slope). After oxitropium bromide, dyspnea during exercise and HRmax decreased significantly, but PEFmax and other parameters did not change significantly compared with control. There was no correlation between changes in dyspnea during exercise and changes in FEV1 and PEFmax after oxitropium bromide inhalation. We conclude that inhaled oxitropium bromide, an anticholinergic agent, reduces dyspnea during exercise in patients with COPD. This favorable effect was not due to change of airflow limitation during exercise, and other factors can thus influence reduction of dyspnea during exercise in these patients.

Administration, Inhalation↗
PubMed2006

Effect of prior exercise on the VO2/work rate relationship during incremental exercise and constant work rate exercise.

The disproportionate increase in VO2 ("extra VO2) reported at elevated intensity during incremental exercise (IE) might result from the same physiological mechanisms as the VO2 slow component observed during heavy constant work rate exercise (CWRE). Moreover, it has been demonstrated that prior heavy exercise can diminish the VO2 slow component. The aim of this study was to evaluate whether prior heavy exercise also alters the "extra VO2" during IE. Ten trained sprinters performed three tests on a cycle ergometer: Test 1 was an IE; Test 2 consisted of six minutes of a CWRE (90% of VO2max) followed by six minutes at 35 W and by an IE and Test 3 was composed of two CWRE of six minutes separated by six minutes of exercise at 35 W. For each IE, the slope and the intercept of the VO2/work rate relationship were calculated by linear regression using data before the first Ventilatory Threshold (pre-VT1 slope). The difference between VO2max measured and VO2max expected using the pre-LT slope was calculated (deltaVO2). We also calculated the difference between VO2 at min five and VO2 at min three during CWRE of Test 3 (deltaVO2(5' - 3')). VO2max was significantly higher than VO2exp during IE of Test 1 and Test 2. deltaVO2 during IE did not differ between Test 1 and Test 2 (+ 259 +/- 229 ml x min(-1) vs. + 222 +/- 221 ml x min(-1)). During Test 3, six subjects achieved five minutes of exercise during the second CWRE and deltaVO2(5' - 3') was significantly decreased during the second CWRE (338 +/- 65 ml x min(-1) vs. 68 +/- 98 ml x min(-1), n = 6). These results demonstrate that the amplitude of the "extra VO2"during IE was not affected by prior exercise, whereas the slow component of VO2 evaluated by deltaVO2(5' - 3') during CWRE was lowered. This implies that prior exercise does not have the same effect on the slow component of VO2 and on the "extra VO2". Therefore we were unable to demonstrate a relationship between the VO2 slow component and the extra-VO2 phenomenon during IE.

Adult↗
PubMed1991

Pre-exercise feeding does not affect endurance cycle exercise but attenuates post-exercise starvation-like response.

The effects of ingesting a mixed-snack food (CB), fructose (FRU), or placebo (PBO) prior to exercise (70% peak VO2) on the metabolic response during and after cycle exercise were studied in eight normal healthy volunteers with a wide range of peak VO2 (30-70 cc.kg-1.min-1). The study was designed to minimize the impact of confounding factors by using various strategies. First, the volunteers were grouped in teams with stratification by peak VO2, and the tests were randomized by a Latin-square design. Second, subjects received two acclimation trials in the cycle ergometer to diminish the effect of learning experiences and allow them to get used to the room and equipment. In addition, financial incentives were offered for team and individual endurance times. The test meals were administered 30 min prior to the beginning of exercise, and the subjects exercised to exhaustion, which was defined with clear-cut endpoints. Gas and blood samples were taken at regular intervals before, during, and for 60 min after each exercise bout. CB and FRU induced higher pre-exercise glucose and insulin concentrations. Blood lactate increased 100% with FRU ingestion. Despite these differences; endurance time, substrate, and hormone concentrations as well as rates of substrate oxidation during exercise were identical among the three conditions. During the post-exercise recovery period, PBO was associated with a starvation-like pattern of substrate utilization in which lipid oxidation was 60% greater and carbohydrate oxidation 50% less than following either CB (75 +/- 11, 248 +/- 27 mg.min-1, P less than 0.05) or F ingestion (93 +/- 4, 221 +/- 14 mg.min-1).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2006

Youth exercise intention and past exercise behavior: examining the moderating influences of sex and meeting exercise recommendations.

The study purposes were to examine: (a) the determinants of exercise intention and past exercise behavior (PEB) using the theories of reasoned action and planned behavior, and (b) the moderating influences of sex and exercise group (meeting or not meeting exercise guidelines). Participants (n = 676 adolescents) completed self-reported measures of their exercise attitude, subjective norm, perceived behavioral control (PBC), intention, and PEB. We found that attitude, subjective norm, and PBC explained 55% of the variance in intention, and intention and PBC explained 51% of the variance in PEB. While we found sex and exercise group differences across the study measures, we did not find evidence of significant moderation. Thus, the theory constructs predicted intention and PEB similarly across sex and exercise groups.

Adolescent↗
PubMed1994

VO2 and cardiac output during rest-exercise and exercise-exercise transients.

The dynamics of external gas exchange during exercise is influenced by pulmonary, cardiovascular, and metabolic factors. During rest-exercise transitions the interaction of these factors is more complex than during exercise-exercise transients. In the present study, we directly compared oxygen uptake (VO2) and cardiac output (CO) responses to step changes in exercise intensity. Nine students performed the following step changes on a bicycle ergometer in upright body position: rest-20W, 20W-80W, 20-140W. VO2 was measured breath-by-breath while CO was determined beat-by-beat by means of a Doppler device. The probe was positioned in the suprasternal notch and directed towards the aortic root. When starting from the 20 W baseline the VO2 responses showed a first, mainly cardio-vascular component over the first 30 s, followed by a second, metabolic component at constant CO. The rest-exercise transients displayed two additional early features. First, there was a very rapid VO2 increase during the initial breathing cycles of the on-transient. This was probably caused by events in the lungs or the pulmonary circulation. Second, the CO attained its steady-state level in about 10 s. This suggests a sudden increase in venous return. The present results generally show that both the VO2 and CO kinetics are faster when exercise in the upright body position is started from rest.

Adult↗
PubMed1989

Evaluation of spatial R maximum cardiac vector changes in exercise testing: pre-exercise versus post-exercise measurements.

R wave amplitude changes during exercise have been a controversial issue as both increase and decrease in amplitude have been reported in patients with coronary arterial disease. This variability in response is attributed to change in position and heart axis on exercise. In view of this limitation, this study evaluated the change in spatial R maximum amplitude on exercise, which should not be affected by the above factors. Twenty patients with ischaemic heart disease (male 20, age 38-61 years) and 9 control subjects (male 9, age 32-65 years) were studied. Orthogonal leads, X, Y, Z were recorded using corrected Frank lead system on a stereokinematic vectorcardiograph (Tonnies). The magnitude of spatial R maximum cardiac vector increased from 0.1 to 0.6 mV in 8/9 control subjects and decreased or showed no change in 18 of the 20 patients with coronary arterial disease. In the control group, the mean value at the end of exercise (0.98 +/- 0.34 mV) was significantly less (P less than 0.01) as compared to pre-exercise value (1.09 +/- 0.2 mV). Our preliminary observations thus indicate that, with exercise, the magnitude of spatial R maximum cardiac vector decreases or shows no alteration in height in patients with coronary arterial disease whereas it increases in normal subjects.

Adult↗
PubMed1995

Exercise pad testing in continent exercisers: reproducibility and correlation with voided volume, pyridium staining, and type of exercise.

This study was undertaken to determine normal values for a modified pad test to be used for testing outcomes of studies addressing therapy for exercise incontinence. Fourteen asymptomatic volunteers who were continent by history completed three similar exercise sessions wearing pre-weighed pads after ingesting phenazopyridine hydrochloride (Pyridium, Parke-Davis, Sandy, UT). The mean pad weight gain for all exercise sessions combined was 3.19 +/- 3.16 g (range 0.1-12.4). The mean area of pyridium staining was 2.66 +/- 3.14 mm. Mean volume voided after the exercise sessions was 193 +/- 108 cc (range 10-625). The Kendall coefficient of concordance used to test the interest reliability was 0.96 for pad weight gain, 0.76 for area of stain, and 0.60 for volume voided. All but one of the subjects had at least one spot of pyridium stain on at least one of the three pads. The increase in pad weight attributable to sweat and vaginal moisture is reproducible in a given individual performing the same exercise routine, but due to the large variation between subjects, we were unable to establish a cut-off value separating continence from incontinence. Adding pyridium did not improve the specificity of the test, despite instructing subjects to milk the urethra and blot before applying the pad.

Adult↗
PubMed1984

Exercise-induced pulmonary hemorrhage in exercising Thoroughbreds: preliminary results with pre-exercise medication.

Thoroughbreds with a confirmed history of exercise-induced pulmonary hemorrhage (EIPH) were treated pre-exercise with atropine sulfate, cromolyn, ipratropium or furosemide. Atropine prevented EIPH in 3 of 3 trials in 1 horse, while having no significant effect on bleeding status in the other 2 horses. Pre-exercise treatment with cromolyn had no significant effects in the 3 horses. Pre-exercise treatment of ipratropium was apparently responsible for preventing EIPH in 17 out of 18 trials in 2 horses. The pharmacologic properties of ipratropium in the horse have not been studied, but based on human investigation it seems most probable that its bronchodilator effects are responsible for preventing EIPH in the 2 horses. Furosemide administered in different dosages and time intervals prior to exercise did not prevent EIPH in these 3 horses.

Animals↗
PubMed1999

Effects of pre-exercise frusemide administration and post exercise anaesthesia on cardiopulmonary and acid-base parameters and blood and plasma volumes in horses exercised supramaximally to fatigue.

Six horses were randomly assigned to receive either frusemide (F) (0.5 mg/kg i.v.) or an equivalent volume of saline (S) i.v., 4 h prior to treadmill exercise. Horses were instrumented to enable measurement of heart rate (HR), systolic (SAP), mean (MAP), and diastolic (DAP) carotid arterial pressures, pulmonary artery pressure (PAP), central venous pressure (CVP), pulmonary arterial temperature (TEMP), blood gases, and cardiac output (CO). Plasma (PV) and blood volumes (BV) were measured using 2 injections of Evan's Blue dye. Baseline parameters were recorded while the horse stood quietly. Horses were then administered F or S. Four hours later, they were warmed up for 3 min at 4 m/s and then exercised to the point of fatigue at 115% VO2max. Horses were anaesthetised immediately following exercise by administration of detomidine (0.04 mg/kg bwt i.v.) followed 5 min later by tiletamine-zolazepam (1.25 mg/kg bwt i.v.). After transporting the horse to a recovery stall, anaesthesia was maintained with isoflurane in 100% O2. Data were analysed using a 2-way ANOVA with repeated measures with post hoc differences identified using the Student-Newman-Keul's procedure. Exercise was associated with increases in HR, SAP, MAP, DAP, PAP, CVP, TEMP, PCV, and BV, and decreases in PV, pH, arterial bicarbonate and base excess. Anaesthesia was associated with marked hypercapnia, a decrease in HR following detomidine administration, and persistent pulmonary hypertension despite carotid arterial pressure which returned to baseline. No effects attributable to F were identified at any time during the study.

Acid-Base Equilibrium↗
PubMed1995

Additional weight-bearing during exercise is more important than duration of exercise for anabolic stimulus of bone: a study of running exercise in female rats.

Mechanical loading is necessary for maintenance of skeletal integrity, but the most effective type, intensity, and duration of exercise are not known. In vivo experiments have indicated that the strain generated by the stimulus is more important than the duration of the stimulus. To elucidate this question, we studied 5-month-old female Wistar rats exercised on a motor-driven exercise belt for 17 weeks, 5 days per week (average velocity 20 m/min). Group 1 served as controls, group 2 was trained for 30 min, group 3 was trained for 30 min with a 50-g backpack, and group 4 was trained for 15 min with a 50-g backpack. Total body bone mineral content (BMC), bone mass of the lower extremities (LEBMC), total body lean soft-tissue mass (LSTM), and total body fat-tissue mass (FTM) were measured by dual-energy absorptiometry (DXA) at 0, 6, and 17 weeks. The BMC increased more in group 4 than in controls (15% vs. 8%, p < 0.03). In the other two intervention groups, no significant increases of total body BMC occurred compared with controls, although a trend was observed (12%). The LEBMC increased significantly in all exercising groups after 17 weeks, being 16% in group 2, 15% in group 3, and 20% in group 4, compared with 6% in controls (p < 0.05). The increase in LSTM after 6 weeks was most pronounced in group 3, at 20%, compared with 10% in the control group (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1986

Functional translation of exercise responses from graded exercise testing to exercise training.

This study attempts to develop a quantitative approach to the prescription of absolute exercise intensity during level ground ambulation (min/mile) or cycle ergometry (kpm) from responses observed during GXT. A total of 345 subjects performed GXT and exercise training sessions with either the Bruce treadmill protocol and level ground ambulation (N = 154) or cycle ergometry (N = 191). Responses from 90% of each group were used to generate equations for predicting training pace (or power output) from the time (or power output) during the GXT when target HR was achieved. FAI was also included in the prediction of training pace (or power output). The remaining 10% of subjects in each group were used to cross-validate the prediction equations. The correlation between the time (or power output) during GXT when the training HR was observed and the pace of ambulation (or power output) was 0.70 for treadmill walking and 0.88 for cycle-cycle. Correlations were increased by the addition of FAI to the prediction equation. The results of this investigation suggest that the absolute intensity of exercise for training can be predicted accurately from GXT results.

Cardiac Rehabilitation↗
PubMed2001

Aerobic exercise interventions for people with HIV/AIDS.

BACKGROUND: The profile of HIV infection is constantly changing. Although once viewed as an illness progressing to death, HIV infection now presents as a chronic infection characterized by unpredictable cycles of wellness and illness. Thus, the needs of this population have increasingly included management of impairments, disabilities and handicaps. Exercise is a key management strategy employed by rehabilitation professionals to address these issues. Exercise has been shown to improve strength, cardiovascular function, and psychological status in seronegative populations (see Eds., Bouchard, C., Shephard, R.J., & Stephens, T. (1993). Physical Activity, Fitness, and Health. Champaign, IL: Human Kinetics Publishers.) But what are the effects of exercise for people living with HIV infection? If the risks and benefits of exercise for people living with HIV infection are better understood, appropriate exercise prescription may be practiced by health care providers. Improved exercise prescription may enhance the effectiveness of HIV management, thus improving overall outcomes for people living with HIV infection. OBJECTIVES: To examine the effect of aerobic exercise interventions on cardiopulmonary, immunologic and psychological parameters in adults living with HIV infection. SEARCH STRATEGY: Studies were identified using MEDLINE, EMBASE, SCIENCE CITATION INDEX, AIDSLINE CINAHL, HEALTHSTAR, PSYCHLIT, SOCIOFILE, SCI, SSCI, ERIC, DIA and abstracts from international AIDS meetings, ICAAC, and other major meetings. Reference lists from pertinent articles and books and personal contact with authors were also used, as were Collaborative Review Group databases and results of hand searching of targeted journals. All languages were included. Searches covered the period from 1980 to July 1999. SELECTION CRITERIA: For inclusion, studies had to be randomized control trials involving HIV+ adults 18 years of age or older and had to include at least one group randomized to receive aerobic exercise performed at least three times/week for at least four weeks. DATA COLLECTION AND ANALYSIS: Data on study design, participants, interventions, and outcomes were extracted from the reports onto specifically designed data collection forms by at least two reviewers. MAIN RESULTS: Six studies satisfied the eligibility criteria. The main results indicated that performing constant or interval aerobic exercise for at least 20 minutes, at least three times per week for four weeks may lead to increased CD4 count, improved cardiopulmonary fitness, and improved psychological status. These findings are limited to those who continued to exercise and for whom there was adequate follow-up data. REVIEWER'S CONCLUSIONS: Aerobic exercise appears to be safe and may be beneficial for adults living with HIV/AIDS. These findings are limited by the small sample sizes and large drop-out rates of the included studies. Further research is required to determine the optimal parameters of aerobic exercise and stage of disease in which aerobic exercise may be most beneficial for adults living with HIV infection.

CD4 Lymphocyte Count↗
PubMed1991

Effect of exercise intensity and duration on regional function during and after exercise-induced ischemia.

BACKGROUND: Transient reversible myocardial dysfunction has been documented after episodes of exercise-induced ischemia. This study was undertaken to determine whether the duration or intensity of exercise affects the severity of postischemic dysfunction in this setting. METHODS AND RESULTS: Ten dogs were instrumented with ultrasonic microcrystals for measurement of wall thickening, with circumflex coronary artery flow probes, and with hydraulic occluders. Dogs performed low-intensity exercise, which was sufficient to increase coronary perfusion 50% above control, and high-intensity exercise, which was sufficient to double coronary blood flow. To investigate the effects of exercise intensity on postischemic dysfunction, we had dogs perform high-intensity exercise for 5 minutes in the presence of a stenosis. On the alternate day, dogs performed low-intensity exercise for 10 minutes in the presence of a stenosis. These two protocols provide equivalent coronary flow debts. Mean transmural blood flow during high-intensity exercise without stenosis (2.61 +/- 0.54 ml/min/g) was significantly higher than that during low-intensity exercise (1.74 +/- 0.61 ml/min/g, p less than 0.002). During high-intensity exercise with coronary artery stenosis, subendocardial blood flow was significantly lower than that during low-intensity exercise with stenosis (0.64 +/- 0.40 versus 1.08 +/- 0.28 ml/min/g, p less than 0.02). This difference in subendocardial perfusion was associated with greater degrees of regional dysfunction during exercise (circumflex wall thickening was 44 +/- 23% of control for high-intensity exercise versus 60 +/- 18% of control for low-intensity exercise, p less than 0.01). In addition, from 10 to 30 minutes after exercise, wall thickening in myocardium perfused by the circumflex coronary artery remained significantly lower after high-intensity exercise than that after low-intensity exercise. To assess the effects of exercise duration on the severity of postischemic dysfunction, we had dogs perform low-intensity exercise in the presence of a coronary stenosis for 10 minutes and low-intensity exercise for only 5 minutes on alternate days. Systolic wall thickening was significantly lower after low-intensity exercise for 10 minutes than after low-intensity exercise for 5 minutes. CONCLUSIONS: High-intensity exercise results in greater degrees of subendocardial hypoperfusion and greater degrees of regional dysfunction both during and after exercise-induced ischemia than does low-intensity exercise. Second, exercise duration also exerts an effect on the severity of postischemic dysfunction, although the magnitude of this effect is less important than the effect of exercise intensity.

Animals↗
PubMed2002

Exercise-induced hypoalgesia and intensity of exercise.

Pain sensitivity has been found to be altered following exercise. A number of investigators have found diminished sensitivity to pain (hypoalgesia) during and following exercise. However, currently it is unknown whether there is a specific intensity of exercise that is required to produce this hypoalgesia response. Aerobic exercise, such as cycling and running, have been studied most often, and a number of different exercise protocols have been used in this research including: (i) increasing exercise intensity by progressively increasing the workloads; (ii) prescribing a particular exercise intensity based on a percentage of maximum; and (iii) having participants self-select the exercise intensity. Results indicate that hypoalgesia occurred consistently following high-intensity exercise. In the studies in which exercise intensity was increased by increasing workloads, hypoalgesia was found most consistently with a workload of 200 W and above. Hypoalgesia was also found following exercise prescribed at a percentage of maximal oxygen uptake (e.g. 60 to 75%). Results are less consistent for studies that prescribed exercise based on percentage of heart rate maximum, as well as for studies that let participants self-select the exercise intensity. However, there has not been a systematic manipulation of exercise intensity in most of the studies conducted in this area. In addition, the interaction between exercise intensity and exercise duration, more than likely influences whether hypoalgesia occurs following exercise. There is a need for research to be conducted in which both intensity and duration of exercise are manipulated in a systematic manner to determine the 'optimal dose' of exercise that is required to produce hypoalgesia. In addition, there is a need for more research with other modes of exercise (e.g. resistance exercise, isometric exercise) to determine the optimal dose of exercise required to produce hypoalgesia.

Exercise↗