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PubMed2003

Effect of rest interval length on repeated 1 repetition maximum back squats.

To examine the effects of different rest intervals on the repeatability of 1 repetition maximum (1RM) efforts in the free-weight back squat exercise, 17 weight-trained men served as subjects (mean age 22.0 years). One repetition maximum was tested on each of the first 2 days of testing to establish a stable baseline (1RM = 184.9 kg). Each of the next 3 sessions involved performing 2 1RM back squats, with the rest interval between attempted lifts being either 1, 3, or 5 minutes, assigned in a counterbalanced fashion. For the 1-minute rest interval, 13 of 17 subjects successfully completed the second lift; for the 3-minute rest interval, 16 of 17 were successful; and for the 5-minute rest interval, 15 of 17 were successful. Cochran Q analysis determined no significant difference (p > 0.05) in the ability to repeat a successful maximal-effort back squat when different rest intervals were used. These findings are consistent with the literature for the bench-press exercise and indicate that 1-minute rest intervals are sufficient for recovery between attempted lifts during 1RM testing or training for the free-weight back squat when involving lifters of this caliber.

Adult↗
PubMed2006

Effect of interrepetition rest intervals on weight training repetition power output.

The purpose of this study was to determine the change in weight training repetition power output as a consequence of interrepetition rest intervals. Twenty-six elite junior male basketball and soccer players performed bench presses using a 6 repetition maximum (6RM) load. The power output for each repetition was recorded using a linear encoder sampling each 10 ms (100 Hz). Subjects were assigned to 1 of 3 intervention groups, differentiated by the arrangement of rest intervals within the 6 repetitions: 6 x 1 repetition with 20-second rest periods between each repetition (Singles); 3 x 2 repetitions with 50 seconds between each pair of repetitions (Doubles); or 2 x 3 repetitions with 100 seconds of rest between each 3 repetitions (Triples). A timer was used to ensure that the rest interval and duration to complete all interrepetition interventions was equated across groups (118 seconds). Significantly (p < 0.05) greater repetition power outputs (25-49%) were observed in the later repetitions (4-6) of the Singles, Doubles, and Triples loading schemes. Significantly greater total power output (21.6-25.1%) was observed for all interrepetition rest interventions when compared to traditional continuous 6RM total power output. No significant between-group differences were found (p = 0.96). We conclude that utilizing interrepetition rest intervals enables greater repetition and total power output in comparison to traditional loading parameters.

Adolescent↗
PubMed1995

Sulfoconjugated and free plasma catecholamine levels at rest and during exercise in patients with idiopathic dilated cardiomyopathy.

Plasma levels of sulfoconjugated (sc) catecholamines (CA) have been shown to be increased with activation of the sympathoadrenal system in a number of clinical settings. We evaluated the relation between scCA and clinical or hemodynamic parameters of patients with idiopathic dilated cardiomyopathy (IDC) at rest and during incremental exercise testing. Eleven healthy subjects, nine patients in New York Heart Association (NYHA) functional class I (IDC-A group) and 11 in NYHA functional class II and III (IDC-B group) performed a symptom-limited, graded bicycle exercise test. Resting, peak and various postexercise levels of plasma free and scCA were determined by high-pressure liquid chromatography. Resting CA levels obtained in the supine position were remarkable for elevations of free norepinephrine (NE) in IDC-B patients (355 +/- 157 ng/l) as compared to IDC-A patients (177 +/- 54, p = 0.006) or healthy controls (193 +/- 74, p = 0.007). Similarly, scNE was highest in IDC-B patients with 1856 +/- 1089 ng/l, followed by IDC-A (1028 +/- 187, p = 0.025) and control subjects (1109 +/- 440, p = 0.025). There was a highly significant correlation between free and scNE (r = 0.76, p < 0.0005). Whereas resting free dopamine (DA) levels were comparable in all three groups, scDA was found to be elevated clearly in IDC-B patients (8772 +/- 2097 ng/l) and significantly different to IDC-A (5786 +/- 2481, p = 0.01) or control subjects (4892 +/- 1575, p = 0.0005). The NYHA functional class and maximum exercise performance correlated best with resting scDA (r = 0.68, p = 0.001 and r = 0.56, p = 0.005, respectively). At peak exercise, IDC-B patients exhibited a significant decrease in scNE and sc epinephrine (E) (from 1856 +/- 1089 to 1495 +/- 932 ng/l, p < 0.005 and from 491 +/- 173 to 282 +/- 143 ng/l, p < 0.01) compared to controls (from 1109 +/- 444 to 1094 +/- 548 ng/l and from 379 +/- 200 to 329 +/- 134 ng/l). In IDC-B patients this decrease in scNE and scE at peak exercise was related inversely to the rise in free NE and E (r = -0.81, p < 0.005 and r = -0.68, p < 0.05). Resting hemodynamic indices generally were reflected better by some free CA rather than by conjugated forms or by parameters of clinical performance. These findings suggest that in addition to free or scNE levels, resting scDA is elevated in symptomatic patients with IDC.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1993

Effects of bed rest on bone metabolism in patients with femoral neck fracture.

The effect of continuous 1 week bed rest during traction on bone metabolism were studied in patients with femoral neck fracture. Bone demineralization was assessed by measuring serum calcium (Ca), phosphorus (P), and alkaline phosphatase (AlkP) before, during, and after 1 week-bed rest with skeletal traction. In addition, 24-hour urinary excretion of calcium and phosphorus were measured. Serum Ca did not change significantly before, during, and after bed rest, whereas serum P increased after 1 week bed rest and postoperatively remained significantly elevated. Serum AlkP did not increase with bed rest, but became elevated postoperatively. Urinary Ca excretion increased from 105.8 +/- 15.2 to 138.0 +/- 15.4 mg/24h after 1 week of bed rest, and remained elevated postoperatively. In contrast, urinary P excretion initially increased 495.1 +/- 65.0 to 610.8 +/- 87.7 mg/24h, and subsequently decreased to a level significantly less than the admission level. These results suggest that 1 week bed rest for the patients with femoral neck fracture resulted in bone atrophy and demineralization.

Aged↗
PubMed1981

Thallium-201 peripheral perfusion scans: feasibility of single-dose, single-day, rest and stress study.

The distribution and redistribution kinetics of thallium-201 in the lower extremities were investigated to determine the relationships among the rest, stress, and delayed-stress perfusion studies. The distribution of perfusion when the tracer was administered at rest was compared with that when administered during stress, and the distribution 5--6 hr after the stress injection. The distribution was evaluated qualitatively by scanning and quantitatively by point counting. In nine of 10 subjects without peripheral vascular disease, the 5--6 poststress redistribution pattern was unchanged from the stress pattern and was different from the rest pattern. However, in all patients with peripheral vascular disease, the delayed poststress perfusion distribution had greater similarity to the rest pattern and was substantially different from that noted immediately after stress. Using the time frame of this study, the stress and delayed-stress 201Tl perfusion study of the lower extremities cannot be used to represent true rest perfusion. However, because of the similarity of the delayed-stress to the true rest distribution in abnormals, it may be clinically useful in defining rest and stress alterations.

Humans↗
PubMed1999

Testicular adrenal rest tissue in congenital adrenal hyperplasia: serial sonographic and clinical findings.

OBJECTIVE: The purpose of this study was to describe the serial sonographic findings and clinical and laboratory data obtained during follow-up of patients with congenital adrenal hyperplasia in whom testicular adrenal rest tissue develops. MATERIALS AND METHODS: We retrospectively reviewed testicular sonography and laboratory data for 12 patients with congenital adrenal hyperplasia who also had intratesticular masses consistent with adrenal rest tissue. The studies were done during follow-up that ranged from 7 months to 10 years. RESULTS: During follow-up of 11 of the 12 patients after the initial sonographic diagnosis, the testicular adrenal rest tissue either remained stable in size (n = 1), grew larger or smaller (n = 9), disappeared (n = 4), or reappeared after disappearing (n = 3). In one patient, the testicular adrenal rest tissue grew very rapidly in a 1-month interval. Discordant changes in the testicular adrenal rest tissue were noted in 10 patients with bilateral masses. We found no relationship between the change in size of the masses and clinical control (based on 17-hydroxyprogesterone level) at the time of sonography. CONCLUSION: In patients with congenital adrenal hyperplasia who have testicular masses detected sonographically, testicular adrenal rest tissue is the most likely diagnosis. Testicular adrenal rest tissue may remain stable in size, grow larger or smaller, or disappear during sonographic follow-up. The change in size may be marked, may occur very rapidly, and, in our study cohort, was not related to short-term clinical control based on 17-hydroxyprogesterone level at the time of sonography.

Adrenal Hyperplasia, Congenital↗
PubMed2002

Resting and reactive blood pressure. Predictors of ambulatory blood pressure in older adults with hypertension.

The study examined whether reactive change scores from a short blood pressure (BP) reactivity protocol, resting BP, or resting pulse pressure (PP) would be predictors of 24-hour ambulatory BP and BP load in cardiac patients. The study used a single-group design, with both an experimental clinical component and an observational field component. Both components used repeated measurement methods. The study population consisted of 45 adult patients with a mean age of 64.6 +/- 8.5 years who were diagnosed with cardiac disease in a cardiac rehabilitation program and who were taking anti-hypertensive medication. Blood pressure reactivity was operationalized with a speech protocol. During the speech protocol, BP was measured with an automatic device (Dinamap) while patients talked about their health and about their usual day. Twenty-four-hour ambulatory BP measurement followed the speech protocol. Resting systolic BP and resting PP were significant predictors of 24-hour ambulatory systolic BP, and resting systolic BP was a significant predictor of systolic BP load. No predictors were significant of 24-hour diastolic BP or diastolic BP load. Initial resting BP and PP may be used in clinical settings to assess hypertension management. Future studies are necessary to confirm the ability of resting BP to predict ambulatory BP and BP load in older adults who are medicated and hypertensive.

Age Factors↗
PubMed2000

[Bed rest after lumbar puncture: a nation-wide survey in Austria].

BACKGROUND: Recommendations in medical textbooks concerning bed rest after lumbar puncture to prevent postpunctional headache vary between immediate mobilisation and 24 hours bed rest. AIM OF THE STUDY: The aim of the study was to evaluate the current practice in neurological departments. METHODS: We contacted all neurological departments in Austria by fax and asked about standards concerning bed rest after lumbar puncture and about the number of punctures per month. RESULTS: 28 out of 32 departments replied (88%). Fifty percent (n = 14) of the departments recommend 24 hours bed rest after lumbar puncture, recommendations of the other departments vary between immediate mobilisation (one department) and 16 hours bed rest. CONCLUSION: Current practice concerning bed rest after lumbar puncture varies widely in Austria and most patients are confined to bed for several hours. Even though there is evidence that bed rest does not prevent post lumbar puncture headache, there is so far no systematic review published in the medical literature.

Austria↗
PubMed2001

Hemodynamics of semilunar valves at rest and exercise at an average of more than two years after the Ross procedure.

BACKGROUND AND AIM OF THE STUDY: Rest, and especially exercise, hemodynamics are valuable determinants to assess outcome of the Ross procedure. In this study, the degree of insufficiency and pressure gradients at rest across the autograft and homograft, as well as the pressure gradients at exercise, were measured. METHODS: Among 115 patients operated on between February 1990 and February 1999, 67 were evaluated echocardiographically at rest and moderate exercise. The mean patient age at subcoronary implantation was 52 +/- 13 years. The mean interval between surgery and investigation was 27.3 +/- 17.4 months. The exercise level was 100 W (n = 47), 75 W (n = 14) or 50 W (n = 6). RESULTS: Fifty-two patients had no or trace aortic insufficiency, 23 were grade I/IV, and two were grade II/IV. Pulmonary insufficiency was graded as none (n = 45), mild (n = 21), and moderate (n = 1). Heart rate increased from 70 +/- 12 beats/min at rest to 108 +/- 19 beats/min at exercise. The maximal pressure gradient across the autograft increased from 6.1 +/- 2.3 mmHg at rest to 8.7 +/- 4.1 mmHg at exercise. The maximal pressure gradient across the homograft increased from 11.8 +/- 5.3 mmHg at rest to 17.7 +/- 8.2 mmHg at exercise. A pressure gradient across the homograft >25 mmHg was measured in 13 patients. CONCLUSION: In most patients, hemodynamics at rest and moderate exercise at an average of more than two years after the Ross procedure were excellent. Some homografts developed pressure gradients at exercise; this finding will form the target of future surgical and scientific investigations.

Adult↗
PubMed1997

Baroreflex during exercise in different postures before and after 20-days bed rest.

Vagal-cardiac baroreflex functions in young healthy humans (n=6) were investigated in four different conditions; supine rest, seated rest, supine and seated exercise (50 watts) before and after 20-day horizontal bed rest. By selectively stimulating carotid baroreceptors using a neck pressure and suction technique, the primary finding was that the baroreflex sensitivity tuation at which we observed a tendency for an attenuation (0.05<p<0.07) of baroreflex sensitivity. The range of decrease in heart rate during neck suction was diminished (p<0.05) after bed rest, but only during supine rest. In conclusion, an attenuation of carotid vagal baroreflex after inactivity was found to be dependent on posture, and was found only in supine rest. It was also concluded that an exaggerated exercise tachycardia found after bed rest is not due to an attenuation of vagal carotid baroreflex sensitivity in itself.

Adult↗
PubMed1997

Cardiovascular response to lower body negative pressure before and after 20 days horizontal bed rest.

To evaluate the effects of 20 days bed rest (BR) on cardiovascular system in normal subjects, left ventricular (LV) echocardiography and vascular ultrasound of the common carotid artery and abdominal aorta were performed during rest and a supine lower body negative pressure (LBNP) test in 14 healthy volunteers (mean age: 22 years) before and after BR. After BR, heart rates (HR) at rest and during LBNP (-40 mmHg) increased. In contrast, LV dimensions, stroke volume, and blood pressures decreased both at rest and during LBNP. Also LBNP tolerance time decreased after BR. Although resting cardiac output (CO) and abdominal aortic flow decreased after bed rest, CO and abdominal aortic flow were unchanged during LBNP comparing before and after BR. Common carotid artery flows both at rest and during LBNP showed no change after BR. LBNP did not increase HR before BR, but increased HR prominently after BR. In conclusion, LBNP tolerance time and LV size during LBNP decreased after BR, suggesting orthostatic intolerance due to a decreased blood volume. However, CO and flow in the abdominal aorta and common carotid artery during LBNP were similar before and after BR due to a compensatory increase after BR.

Adult↗
PubMed2000

Leg venous compliance in orthostatic intolerance before and after 14-day head-down bed rest.

To test the hypothesis that increased leg venous compliance (LVC) is one of the contributory factors to orthostatic intolerance (OI) after simulated microgravity, 28 healthy young males were exposed to a 14-day head-down bed rest, and LVC was measured by venous occlusion plethysmography. Orthostatic tolerance was evaluated by a 60 degree head-up tilt (HUT) for 15 min. Sixteen subjects suffered from OI after the bed rest. They were then divided into orthostatic tolerance (non-fainters, n=12) and intolerance (fainters, n=16) groups. We found that fainters had significantly larger LVC before bed rest (0.055 +/- 0.003 vs. 0.065 +/- 0.002 ml 100 ml-1 mm Hg-1, non-fainter vs. fainter; P < 0.05). After bed rest, LVC markedly increased in both groups. In all the subjects calf circumference was reduced on average by 4.7% and the percent change in LVC was negatively correlated with the percent change in calf circumference when all subjects' data were combined after bed rest (r = -0.42, P < 0.05). Our results did not support the hypothesis that increased LVC is the contributory factor to OI after a 14-day bed rest; however, the mechanisms behind the large LVC in the fainters before bed rest are unclear, and the initial LVC might be a predictive indicator for OI after microgravity exposure.

Adult↗
PubMed1992

Balance and gait analysis after 30 days -6 degrees bed rest: influence of lower-body negative-pressure sessions.

Five volunteers took part in -6 degrees head-down bed-rest experiments for 30 d. In the first experiment, three subjects underwent several sessions of lower-body negative-pressure (LBNP) per day, with two others serving as controls. In the second, the LBNP group of the first experiment became the control and vice versa. Two experimental protocols analyzed the bed-rest-induced modifications of balance and gait and the efficiency of LBNP in counteracting these modifications. A kymographic method allowed the measurement of walking parameters. Anteroposterior and lateral sways were successively studied with both a force platform (static condition) and a rocking platform (dynamic condition). The tests were performed 2 d before the bed-rest period, and over the 1st, 3rd and 4th days of the recovery period. When the subjects were controls, bed rest decreased step length, walking velocity, and balance stability. LBNP completely counteracted the bed-rest-induced modifications of gait and static balance and of dynamic balance for the lateral sway. As LBNP was ineffective in counteracting the modifications of the anteroposterior sway, dynamic balance deficiency was independent of the beneficial effect of LBNP on the decreased orthostatic tolerance induced by -6 degrees head-down bed rest. The results indicate that head-down bed rest, like spaceflight, induces certain sensorimotor changes involved in the decrease of gait and balance performance.

Adult↗
PubMed2003

[Enhanced prognostic stratification of cad patients with dilated left ventricle by stress and rest functional parameters and 99mTc-tetrofosmin Gated-SPECT].

PURPOSE: To evaluate whether the post-stress and rest functional parameters, measured by Gated-SPECT, have incremental prognostic value compared with perfusion parameters in predicting cardiac events (CE), in a population of CAD patients with dilated LV. MATERIALS AND METHODS: A total of 670 consecutive patients (mean age: 62; range 29-86 yrs.) underwent conventional diagnostic 2-day gated-SPECT with 99mTc-tetrofosmin (55% exercise stress test, 45% dip stress): 605 patients (mean age: 62 yrs., range: 34-86 yrs.) had known or suspected CAD, whereas 65 (mean age: 60 yrs, range: 29-80 yrs) had low pre-test likelihood of CAD (<10%), a normal post-stress perfusion scan and no hypertension. Fifty-three percent of CAD patients had a history of MI. Perfusion was analyzed on ungated images using 20 segments scored on a 5-point scale (0=normal, 4=no uptake), while wall thickening was assessed visually on stress/rest end-systolic images using a 4-point score (0=normal, 3=absence of WT). LVEF and volumes were calculated using an automatic algorithm. Post-stress and rest ratio were determined for both end-diastolic and end-systolic volume, while the post-stress LVEF change (d-LVEF) was calculated according to the following formula: (Stress LVEF-rest LVEF)/rest LVEF*100. RESULTS: By using a cutoff value of 126 ml for rest-EDV, and of 68 ml for rest-ESV we found a LV dilation in 129/605 patients (21%). These thresholds were the mean values plus two standard deviations obtained in the control group. 111/129 (86%) were followed up for a mean period of 147.0 months. 83 of 111 (75%) patients had a history of MI and forty three (39%) had undergone surgical revascularizations. During the follow-up, 21 events (5 cardiac deaths, 3 nonfatal MI, 13 late revascularizations) occurred. All post-stress perfusion and functional parameters were more compromised in patients with CE compared with patients without events, but only rest EDV, rest ESV, post-stress ESV and WT-SSS reached statistical significance (201 ml vs 176 ml; p=0.035; 137 ml vs 113 ml; p=0.047; 143 ml vs 117 ml; p=0.034, 19 vs 15; p=0.048, respectively). Multivariate Cox proportional analysis demonstrated that stress ESV added significantly prognostic information over WT-SSS in predicting CE (p=0.046). CONCLUSIONS: Stress ESV has incremental prognostic value compared with wall thickening in predicting CE, in CAD patients with dilated cardiomyopathy. Perfusion parameters failed to show prognostic information in these patients.

Adult↗
PubMed2003

Leg compression and ambulation is better than bed rest for the treatment of acute deep venous thrombosis.

AIM: Treatment of acute deep venous thrombosis (DVT) with low-molecular-weight heparin and vitamin K-antagonists reduces the risk of thrombus progression and pulmonary embolism but has no immediate effect on signs and symptoms. We addressed the question whether adding compression and walking would lead to a more rapid clinical improvement than bed rest. METHODS: Fifty-three symptomatic outpatients with proximal DVT were randomly treated, in addition to dalteparin and phenprocoumon, with either firm inelastic bandages (n=18), elastic compression stockings (n=18), both combined with immediate deliberate ambulation, or bed rest without any compression (n=17). We assessed daily walking distance, well-being, quality of life, pain, swelling and clinical scores over a period of 9 days. Lung scans and ultrasound of the leg were performed on days 0 and 9. RESULTS: In the compression groups the walking distance increased with time to 4 km/day on average. Improvement of well-being and DVT-related quality of life was significantly faster and more pronounced with compression than with bed rest (p<0.05 for stockings, p<0.001 for bandages). Pain monitored by visual analogue scale decreased with time in a linear pattern in all groups (p<0.001). There was a significant difference between the groups (p<0.01), the best effect being achieved with bandages. Pain assessed by a provocation test was reduced by half on day 3 with bed rest but remained constantly present over the subsequent 6 days. With compression it was reduced to near baseline on day 3. Swelling was almost completely removed with compression and clinical scores also improved more than with bed rest (p<0.001). Thrombus progression, as studied with ultrasound, was less frequent and less pronounced in the compression groups than with bed rest. There was no difference of new pulmonary embolism on repeat lung scans. CONCLUSION: Leg compression combined with walking is the better alternative to bed rest for the treatment of symptomatic outpatients with proximal DVT.

Acute Disease↗
PubMed2004

The role of bed rest in acute low back pain.

Acute low back pain is a common problem and clinicians from a number of different disciplines are involved in its management. Advice on daily activities constitutes an important part in the management of low back pain. In spite of evidence against its efficacy, bed rest continues to be a cornerstone of treatment. The purpose of this review is to present evidence from literature to determine the effectiveness of bed rest for patients with acute low back pain together with comparison of bed rest versus advice to stay active, bed rest versus other treatment modalities and shorter periods of bed rest (2 to 4 days) versus longer periods (more than 4 days) of bed rest. There is strong evidence to suggest that bed rest is not effective in the management of acute low back pain.

Acute Disease↗
PubMed2005

Intracranial pressure dynamics assessed by noninvasive ultrasound during 30 days of bed rest.

INTRODUCTION: Intracranial pressure (ICP) may be an important contributor to symptoms of space adaptation syndrome during the initial days of microgravity exposure. The temporary nature of these symptoms suggests that some physiologic adaptation or compensation occurs. Fluid shifts similar to those in microgravity can be simulated on Earth using head-down tilt (HDT) bed rest. This study was performed to calibrate a new noninvasive ICP instrument and to investigate ICP adaptation during 30 d of HDT bed rest. METHODS: A noninvasive ultrasound technique that measures small skull expansions with fluctuations in ICP was used to measure cranial oscillations before and near the end of 30-d HDT bed rest in eight healthy, male volunteers. Pulse phase-locked loop (PPLL) output voltage and arterial BP were continuously monitored and correlated. RESULTS: The amplitude of intracranial distance pulsation decreased during 30-d bed rest. Prior to bed rest, the PPLL amplitude was 25 +/- 9 mV and this amplitude was reduced by 60% to 9 +/- 4 mV (a value consistent with that of upright posture) at the end of HDT bed rest (p = 0.01). DISCUSSION: PPLL measurements of skull pulsations are acutely posture dependent, being significantly higher in supine and HDT as compared with upright posture. A cephalad fluid shift is probably the responsible mechanism. Our results indicate that there are adaptations to intracranial pooling of blood and tissue fluid during bed rest that reduce skull pulsation amplitudes to values similar to those obtained in normal upright posture. Detailed studies of the time course of cranial vessel and bone adaptations may provide insights into the potential adaptative mechanisms.

Aerospace Medicine↗
PubMed1991

Changes in body fluid compartments during a 28-day bed rest.

The extravascular fluid responses to real or simulated space-flight are not well-documented. In this study serial isotope measurements were used to obtain measurements of the body fluid responses of 10 22-29-year-old men during 28 d of simulated microgravity (bed rest). The subjects were maintained on a controlled metabolic diet for 7 d before the study, during 14 d of ambulatory control, 28 d of horizontal bed rest, and 14 d of ambulant recovery. Fluid compartments were measured on control days 1 and 9, bed rest days 2, 14, and 28, and recovery days 7 and 14. By day 2 of bed rest, plasma volume (PV) and extra-cellular volume (ECV) decreased significantly by an average 209 and 533 ml, respectively. Red cell volume (RCV) and total body water (TBW) decreased more slowly, with average losses of 128 and 1,316 ml, respectively, after 28 d of bed rest. Early in the bed rest, TBW loss was mostly from the ECV. Thereafter, the TBW deficit was derived from the intracellular compartment, which decreased an average of 838 ml after 28 d. These results suggest losses from all fluid compartments during bed rest, with no evidence of restoration of ECV after 1-2 weeks.

Adult↗