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Sensory cues for perceived exertion: a review.

A variety of physiological responses, classified as local or central factors, have been suggested as providing the primary input for perception of effort during exercise. The potency of these responses as perceptual cues, however, has seldom been addressed in terms of relevant modifying variables such as exercise intensity, exercise duration, exercise modality, and steady-state vs progressive exercise. This paper provides a critical review of the most relevant perceived exertion literature in terms of these considerations. It has been proposed that the impact of physiological responses as perceptual cues is dependent on their availability to conscious monitoring during exercise. The viability of this suggestion as a criterion for determining the importance of local and central cues for perceived exertion is also examined.

Body Temperature↗

[Electrocardiography in women with angina pectoris during physical exertion].

Comparative study was conducted of ECG changes during an attack of angina pectoris induced by physical exertion on a bicycle ergometer in 74 females and 100 males suffering from angina pectoris. It is shown that with a similar clinically determined severity of angina pectoris, tolerance to physical exertion is significantly lower in females than in males. Essential differences were also revealed in the ECG changes during an anginose attack. The data obtained are evidence that the approach to the appraisal of the results of load tests in ischemic disease of the heart in females should evidently differ from that in males.

Aged↗

Intracompartmental pressure increase on exertion in patients with chronic compartment syndrome in the leg.

Intracompartmental pressure in the leg was measured continuously during running in thirty-two patients who had either a medial or an anterior chronic compartment syndrome. It was found that on exertion the patients had significantly higher increases in pressure compared with the pressures in a control group. There were no remarkable differences between the two groups in terms of pressure at rest before exertion. After fasciotomy, the pressure returned to normal. The method that we employed to measure pressure can be use in diagnosing painful conditions of the leg.

Adolescent↗

[The relationship between perceived exertion of daily activities and aging of physical function (author's transl)].

The purpose of this study was to investigate the relationship between the perceived exertion and fatigue of daily activities and the age-related decline of physical functions. Eighty-five male job applicants aged from 55 to 65 years old were asked to answer the questionnaire inquiring about perceptual effort and fatigue of daily activities, and then were examined on more than ten kinds of physical functions. The significance of the correlation coefficients between factors extracted from 35 subjective variables and those from 38 objective variables were tested. Main findings were as follows: (a) The perceived exertion of daily activities using lower limbs seems to be influenced by the decline of muscle strength. (b) The perceptual effort of daily activities using upper limbs seems to be connected with the obesity rate and also with the decline of hearing. (c) The subjective fatigue seems to be related with the level of blood pressure and also with the decline of hearing.

Activities of Daily Living↗

Exercise intensity: subjective regulation by perceived exertion.

The primary purpose of this investigation was to determine if a safe and effective physical conditioning heart rate (HR) could prescribed by perception of exertion. Ratings of perceived exertion (RPE) were requested from 10 normal adult men during treadmill exercise trials at 4.7, 6.5, 9.7, 11.3, and 12.9km/hr (T1). Subjects were then requested to subjectively regulate their own treadmill speed during 2 separate trials (T2 and T3) at the RPE reported for each speed during T1. Speed and HR at equivalent RPE were compared during T1, T2, and T3. Regression analyses revealed that there was no difference in speed across all RPE between the 3 trials; however, HR was seen to become progressively higher during T2 and T3 than during T1 as speed and RPE decreased. HR reliability was significant (p < 0.05) during running but not significant (p > 0.05) during walking. It is concluded that prescription of exercise by RPE can produce safe, effective, and reliable conditioning HR above 150bpm (80% HRmax) and running speeds above 9km/hr. Use of RPE for exercise prescription below these levels can result in inaccurate and unreliable conditioning heart rates. This method of exercise prescription has limitations and could result in dangerously high HR is used in cardiac rehabilitation programs, in which strict adherence to target HR is essential.

Adult↗

[Role of apo B-containing lipoproteins in the development of exertional diabetes in humans under Arctic and Antarctic conditions].

Under extreme conditions of the Arctic and Antarctic, man develops exertional diabetes, which is characterized by (1) decreases in blood insulin levels and in responses of the insular apparatus to glucose load; (2) a reduction in blood sugar; (3) a drop in glucose uptake; (4) lowering of the renal barrier for blood sugar and other low-molecular weight compounds; (5) appearance of urinary sugar and an increase in its nocturnal resting concentration. Exertional diabetes lies in the basis of switching energy metabolism from the carbohydrate to lipid types at high latitudes. The mechanism of this phenomenon is associated with the contra-insular effect of LDL and VLDL. There is a common epitope in the beta-chain of insulin and LDL and VLDL apoprotein B. The existence of the common epitope leads to competition of insulin and apoprotein B for an insulin receptor and reduces tissue glucose uptake.

Adult↗

Influence of tobacco smoking on serum free fatty acid, triglyceride and glucose levels during physical training and post-exertional restitution.

Studies were carried out on 60 healthy men aged 20--24 years, divided into three groups. Group A (30 persons) performed work on bicycle ergometer in three phases: 420 +/- 90 kpm/min during 6 minutes, 840 +/- 180 kpm/min during 6 minutes and 1260 +/- 270 kpm/min during 6 minutes. Group B (20 persons) performed the same work after smoking 4 cigarettes. In group C (10 persons) the tests were carried out after they had smoked 4 cigarettes, without work load. In each group the serum FFA, TG and glucose levels were determined. It was found that just after the termination of physical exertion preceded by tobacco smoking (group B) FFA and TG concentrations decreased and glucose concentration increased more than in the control group (P less than 0.05, P less than 0.001 and P less than 0.001, respectively). During restitution, the FFA and TG concentrations were significantly lower (P less than 0.001) and the glucose level was higher (P less than 0.05) than in the group of non-smokers. After tobacco smoking, FFA concentration increased transiently in group C (P less than 0.001); the TG level did not change whereas the glucose level persistently increased (P less than 0.001). The results indicate the better utilization of FFA during physical exertion after previous tobacco smoking.

Adult↗

Determination of carbonic anhydrase III isoenzyme concentration in sera of racehorses with exertional rhabdomyolysis.

The concentration of carbonic anhydrase III isoenzyme (CA-III) in serum samples from 216 clinically normal Thoroughbreds was determined by use of an enzyme immunoassay. The concentration range of CA-III was from 16.0 to 254.5 ng/ml (mean, 56.5 +/- 11.9 ng/ml). Significant differences were not detected according to age or sex. To confirm whether serum CA-III concentration was high in horses with muscle disease, serum samples of 11 horses with exertional rhabdomyolysis were analyzed by enzyme immunoassay. Their serum CA-III concentration was about 56 times (3,136 +/- 2,610 ng/ml) that of healthy Thoroughbreds. Concentration of CA-III was higher in horses with rhabdomyolysis that had been transiently recumbent than in horses with mild disease that were reluctant to move. Blood samples obtained serially from 6 horses with exertional rhabdomyolysis were studied. Serum activities of aldolase, creatine kinase, aspartate transaminase, and lactate dehydrogenase were high. Increases and decreases in concentration of CA-III were more rapid than that for aldolase, creatine kinase, aspartate transaminase, and lactate dehydrogenase activities; thus, CA-III may be clinically applicable as a diagnostic marker for muscle disease in horses.

Animals↗

Clinical evaluation of exertional dyspnea.

The medical history is the first step in the clinical evaluation of exertional dyspnea. It should include pertinent questions about the characteristics of dyspnea, especially descriptive qualities, onset, frequency, severity, and activities that provoke the symptom. Based on this information, along with the physical examination, the health care provider should be able to categorize the cause of exertional dyspnea as suspected cardiac disease, suspected respiratory disease, or as unexplained. Laboratory testing is ordered using a logical approach to diagnose the most probable cause of dyspnea. Cardiopulmonary exercise testing is indicated to differentiate cardiac and respiratory limitation, to document deconditioning, and to identify psychogenic dyspnea. The measurement of dyspnea and leg discomfort during exercise testing can be performed using the Borg 0 to 10 category-ratio scale or the visual analog scale. These perceptual responses can provide useful information about symptom limitation, which is complementary to physiologic data.

Adult↗

[Exertion-related disorders in body temperature regulation in 8 participants in the Dam-to-Dam run 1993].

In eight recreational runners (seven men and one woman, aged 16 to 50 years) participating in a 16 kilometer run, disturbances in thermoregulation were diagnosed. Six experienced sudden collapse without any prodromal signs, two were exhausted and had muscle spasms. Heat exhaustion was diagnosed in four runners, exertion-related hyperthermia in three and exertion-related heat stroke in one. As a complication the latter patient developed rhabdomyolysis with low grade intravascular coagulation and acute renal insufficiency. The most important therapy consists of cooling the patient, the most important preventive measures are wearing light clothing and drinking regularly during the run.

Adolescent↗

[Myocardial ischemia caused by the injection of dipyridamole followed by low level exertion on an exercise bicycle].

The purpose of this study was the feasibility, safety and analysis of the ischemic nature of the association of an injection of dipyridamole and an exercise test at low level exertion on an exercise bicycle for 4 minutes. The ischemic nature of this combination was assessed on the basis of three criteria: the onset of angina-type pain, electrical changes and scintigraphic abnormalities. The test could be carried out by all patients and the most common adverse events were headache (6.5%) and heartburn (3.5%). The 17 patients in this study who had one or more stenoses in excess of 70% presented with angina-type pain (3/17); electrical abnormalities (9/17) and scintigraphic abnormalities in all cases. Of the six patients who had lesions between 50 and 70%, 1 presented with angina symptoms, 2 with electrical abnormalities and 5 with scintigraphic abnormalities. Seven patients in this study showed no significant lesions when subjected to coronary artery angiography. However, angina-type pain and electrical signs were observed in 2 cases and one false positive result by scintigraphy. This study shows that it is possible to combine the injection of dipyridamole with an exercise test involving a low level of exertion on an exercise bicycle which gives a good diagnostic value to the CT scan. The frequency of clinical and electrical signs of ischemia makes it necessary to take the same precautions as for a peak exercise test.

Aged↗

Perceived exertion during hypobaric hypoxia in low- and moderate-altitude natives.

Ratings of perceived exertion (RPE) were examined in six low- (LAN) and eight moderate- (MAN) altitude natives during exercise at their residence (home) altitude (366 m and 2,200 m, respectively) and 1-4 wk later following 2-d decompression to 4,270 m (447 mm Hg). Cardiorespiratory, plasma lactate, and differentiated RPE measures were obtained at exercise intensities representing 35, 55, 75, 85, and 100% VO2peak. In general, cardiorespiratory and plasma lactate values were similar in LAN and MAN at their residence altitudes and during hypobaric hypoxia. However, the decrease in VCO2 was greater (P < 0.05) in LAN than MAN. At their residence altitudes, both LAN and MAN reported local RPE values that were greater (P < 0.05) than central ratings at the moderate to high exercise intensities. At 447 mm Hg, central and local RPE were similar in LAN. However, there was a significant correlation between acute mountain sickness (AMS) symptoms and central RPE (r = 0.875) across the five exercise intensities in LAN. The differences between the central and local RPE noted in MAN during their residence testing also persisted at 447 mm Hg. Thus, differentiated ratings of perceived exertion were similar in MAN at their residence altitude and at 4,270 m, but not in LAN subjects. Several factors, including AMS, may have contributed to this group difference in the RPE response.

Adult↗

[The effect of physical exercise on the response to exertion in the elderly].

BACKGROUND: A decrease in adaptation to exertion has been observed as age progresses. Although this decline may also be affected by factors such as health conditions and age, physical inactivity related to sedentary behaviour plays a dominant role. METHODS: In order to evaluate the influence of physical activity on cardiovascular response to exertion in the elderly, 4 groups of 22 subjects each were submitted to maximal electrocardiographic exercise test on a cycloergometer (multistage program with 30 Watts x 3 min. steps). All subjects were male. The composition of the groups was as follows: 1) veteran long distance runners (mean age: 71 +/- 5.4); 2) sedentary veterans (mean age: 69.8 +/- 3.9); 3) young long distance runners (mean age: 25.4 +/- 4.3); 4) sedentary young adults (mean age: 25.8 +/- 3.9). The endurance athletes, well fitted to competition, had been practicing sport activity for at least 3 years. RESULTS: Heart rate, arterial systolic and diastolic blood pressure were recorded; mean blood pressure and double product were calculated at baseline and at the climax of the stress test; furthermore, total and maximal watts were recorded. For each of the parameters, Student's t test for non-paired observations were used to evaluate statistical differences amongst the four groups. The most interesting result arises in the comparison between veteran long distance runners and sedentary young adults: between the two groups no statistically significant differences in workload, expressed as total watts (1649.55 +/- 296.32 vs 1650.00 +/- 446.32; p = NS) and maximal watts (175.91 +/- 19.19 vs 173.18 +/- 24.38; p = N.S.), were observed. On the contrary, highly significant differences in both total (p < 0.01) and maximal (p < 0.01) watts were noticed by comparing long distance runners and sedentary subjects of the same age. CONCLUSIONS: These data support the hypothesis that the progressive reduction in physical activity, which is usually observed in aging, is the major determinant of exercise deconditioning in the elderly.

Adolescent↗

Familial basis of exertional rhabdomyolysis in quarter horse-related breeds.

OBJECTIVES: To trace pedigrees from affected horses, identify likely contributing founder horses, and determine the conditional probability of founder genotypes. DESIGN: Muscle biopsy records from the Neuromuscular Disease Laboratory at the University of California-Davis and the University of Minnesota were searched to identify horses with a polysaccharide storage myopathy and exercise intolerance/rhabdomyolysis. Pedigrees containing 5 to 6 generations were obtained where possible. ANIMALS: 13 Quarter Horses, 4 American Paint Horses, 3 Appaloosas, and 3 Quarter Horse crossbreds (16 mares, 4 geldings, and 3 stallions) were identified with polysaccharide storage myopathy. Pedigrees were available for 18 horses. PROCEDURE: Inbreeding coefficients, founder contributions, and conditional probability of founder genotypes were calculated. RESULTS: Three stallions (A, B, and C) were featured prominently in the pedigrees. Stallions A and B descended from a common sire. On average, A contributed 8.8% (range, 0 to 23%) of the genes in affected horses, B contributed 4.2% (range, 0 to 14%), and C contributed 3.0% (range, 0 to 14%). The sire and dam of 4 horses were descendants of stallion A, the sire and dam of 1 horse were descendants of stallion B, and the sire and dam of 11 horses were descendants of a combination of stallions A and B. The pattern of inheritance resembled an autosomal recessive disorder. Assuming this pattern of inheritance, the conditional probability that these founders were carriers or recessive for the trait was > 99.29% for stallions A and B and 92% for stallion C. CONCLUSIONS: Results support a familial basis for polysaccharide storage myopathy and associated exertional rhabdomyolysis in Quarter Horse-related breeds. The strong contribution of particular founder stallions to the gene pool in some lines of Quarter Horses may explain the high incidence of exertional rhabdomyolysis in these horses.

Animals↗

Exertional collapse and sudden death associated with sickle cell trait.

The most serious complication of sickle cell trait (SCT) is sudden death during exertion. SCT often remains unrecognized in the 2.5 million African Americans affected. Exertional collapse and sudden death associated with SCT is characterized by rhabdomyolysis, heat stroke, and cardiac arrhythmia. There is a 40-fold increased risk of sudden death in affected soldiers during military basic training and there are many cases reported in athletes during preseason training. There have been no cases reported in soldiers beyond basic training. In the case presented, a soldier with 3 years of military service succumbed to SCT-associated sudden death during physical fitness testing.

Adult↗

[Use of subjective perception of exertion in the evaluation of the tolerance to repetitive lifting: a pilot study].

This preliminary study was conducted to validate subjective perception of effort as indicator of the tolerable workload for prolonged lifting tasks. Three healthy male subjects underwent endurance and incremental lifting tests. Cardiorespiratory parameters (HR, VO2) were monitored with a portable telemetric oxygen uptake analyzer, mechanical parameters were calculated from a lift dynamometer. Rating of perceived exertion was given on Borg's CR-10 scale. Individual fitness profiles for lifting tasks were obtained from the individual relationships between oxygen consumption and heart rate at different lifting frequencies. Physiological responses to repetitive lifting were matched with subjective perceptions. The relationship between perception of exertion and time was described by power functions, Y = a.Xn, in which 0 < n < 1. A single-variable statistical regression for power functions was performed to obtain the individual "iso-perception" curves. The iso-perception curve corresponding to a "moderate effort" (CR3) identified the individual tolerable threshold for prolonged lifting tasks. The individually tolerable power output over time for lifting tasks was calculated.

Adult↗

Pharmacological treatment of exertional dyspnoea in stable COPD patients.

Exertional dyspnoea is one of the most common and disabling symptoms in patients with stable chronic obstructive pulmonary disease (COPD). Because little can be done for its resolution, the idea of its symptomatic treatment is attractive. There is no gold standard for the pharmacological management of exertional dyspnoea in stable COPD. A reassessment of the available literature shows the current perspectives and limits.

Adrenal Cortex Hormones↗

Exertional chest pain in child due to gastroesophageal reflux with a family history of rumination.

A child affected by exertional chest pain secondary to gastroesophageal reflux (GER) disease is reported. Family history revealed the presence of rumination in two members. In our patient, heart diseases as well as other causes of chest pain were excluded. An ultrasound examination of the gastro-esophageal junction, performed in the first 15 minute of the post-prandial period, showed a pathological number of GER episodes. The patient was treated with cisapride (0.2 mg/kg t.i.d. per os). At follow-up, after three months, he was symptom-free. We repeated an ultrasound examination, which resulted normal. Ours is the first paediatric case characterized by exertional chest pain secondary to GER disease.

Chest Pain↗