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At least 613 records · Page 34Linked to original sources
PubMed2003

The LEGS score: a proposed grading system to direct treatment of chronic lower extremity ischemia.

OBJECTIVE: To prospectively compare the Lower Extremity Grading System (LEGS)-derived "recommended treatment" to the actual treatment performed and to analyze LEGS intergrader scoring consistency by comparing blinded scoring results between physician graders. SUMMARY BACKGROUND DATA: Due to technical advances and the increased medical complexity of the aging population, the most appropriate treatment for chronic lower extremity ischemia-open surgery versus endovascular-is again in flux. In an attempt to standardize management, the LEGS score, based on the best available outcomes data, was devised by the physicians of an established vascular service. METHODS: From March to June 2002, all chronically ischemic lower extremities that met standard indications for revascularization were prospectively enrolled and independently graded with the LEGS score by an "endovascular surgeon" and an "open surgeon" for comparative analysis. The results were then blindly evaluated to determine whether the LEGS-derived "recommended treatment" agreed with the actual treatment rendered and to assess for intergrader consistency. Agreement was assessed using kappa statistical analysis. RESULTS: Of the 137 presenting limbs (mean patient age 66.4 yo; 43% claudication, 57% limb-threatening ischemia), 107 were treated (65% endovascular, 30% open surgery, 5% amputation), 16 were pending treatment, and 14 were not treated because of patient refusal (n = 13) or death (n = 1). The LEGS score predicted the actual or offered clinical treatment in 90% of cases. The LEGS score comparison between physician graders resulted in identical "recommended treatment" in 116 of 128 cases for a 90.6% agreement. CONCLUSIONS: A reproducible scoring system to guide the treatment of patients with chronic lower extremity ischemia is possible. While systems like the LEGS score may have potential clinical application, their use as a treatment standardization tool for future prospective outcomes comparisons between open and endovascular surgery will be essential.

Adult↗
PubMed1996

Matrix metalloproteinases, gelatinase and collagenase, in chronic leg ulcers.

Although extracellular proteolysis is a prerequisite for normal wound healing, uncontrolled proteolytic tissue destruction appears to be a pathogenic factor in non-healing wounds. The aim of our study was to compare the activities of the serine proteinases of polymorphonuclear origin, elastase and cathepsin G, and the metalloproteinases, gelatinase and collagenase, in chronic leg ulcer exudate (10 patients) and acute wound fluid (6 patients). Serine proteinase activities were low in leg ulcer exudates but very high in some but not all acute wound fluids. Total collagenase activity, measured as activity against type I collagen monitored by SDS-PAGE and densitometry, was higher in chronic leg ulcer exudate than in acute wound fluid and its degree of autoactivation was relatively high. Doxycycline inhibition studies suggested that the collagenase activity in chronic leg ulcer exudate was MMP-1 ("fibroblast-type") and not MMP-8 ("neutrophil-type"). Zymographic analysis of the gelatinolytic enzymes in acute wound fluid showed a progressive increase from the day of operation to postoperative day 5, but the degree of activity was lower than in chronic leg ulcer exudate and the low molecular mass activation products were faint. The leg ulcer gelatinase profiles were characterized by high expression of 92/82- and 72/62-kDa duplex bands and by the presence of low molecular mass activation products. Leg ulcer collagenase seems to be derived from mononuclear rather than polymorphonuclear cells, which are known to be involved in acute wound healing. In conclusion, the present study shows that gelatinase and collagenase, but not elastase and cathepsin G are found in chronic leg ulcer exudate.

Aged↗
PubMed2005

Are there changes in leg vascular resistance during laparoscopic cholecystectomy with CO2 pneumoperitoneum?

BACKGROUND: The prompt haemodynamic response to carbon dioxide insufflation during laparoscopic cholecystectomy suggests involvement of the sympathetic system. The aim of the present study was to examine if a change in vascular resistance in leg skeletal muscle could be an important mechanism behind the increased afterload. Furthermore, the arterio-venous differences of the catecholamines were measured in the leg before and during insufflation of carbon dioxide into the peritoneal cavity. METHODS: Ten patients (ASA I) scheduled for laparoscopic cholecystectomy were included. After induction of anaesthesia, catheters were introduced percutaneously into the radial artery, the femoral vein and the cubital vein for pressure monitoring and blood sampling. The arterial blood flow in the legs was measured by mercury-in-Silastic strain gauge venous occlusion plethysmography. Vascular resistance in the right leg (LVR) was calculated from the formula: (MAP-FVP)/calf blood flow. Measurements were made before and 5 min after insufflation of pneumoperitoneum. RESULTS: Induction of pneumoperitoneum increased the heart rate (P < 0.05) and also increased mean arterial pressure and femoral vein pressure as well as the calculated leg vascular resistance (P < 0.01). Calf blood flow did not change significantly in either leg. Both arterial and venous noradrenaline concentrations were higher after insufflation (P < 0.01). CONCLUSION: In patients without heart or lung disease, pneumoperitoneum at an intra-abdominal pressure level of 11-13 mmHg increased the peripheral vascular resistance in the leg while the arterial blood flow in the leg was unaffected. Catecholamine levels increased, but were still low. Therefore, we suggest that the increase in peripheral vascular resistance is caused by increased myogenic activity in the resistance vessels secondary to increased arterial and transmural pressure rather than by increased neurogenic sympathetic activity.

Adolescent↗
PubMed1986

Effect of adrenaline on exchange of glucose in leg tissues and splanchnic area. A comparison with the metabolic response to surgical stress.

Surgical trauma is accompanied by increased energy expenditure and raised arterial concentrations of adrenaline and glucose. In order to study the acute effects of an adrenaline infusion on glucose metabolism and oxygen uptake in the leg and splanchnic bed, adrenaline was administered at a rate giving plasma concentrations of adrenaline similar to those in connection with abdominal surgery. Seven healthy males participated in the study. Adrenaline 40 ng/(min X kg body weight) (0.22 nmol/(min X kg body weight] was infused producing a plasma concentration of 2.77 +/- 0.42 nmol/l (mean +/- SEM). Leg and splanchnic blood flows and the femoral and hepatic arterio-venous differences for oxygen, glucose, lactate and other metabolites were determined. Measurements were made before and between 30 and 40 min after the start of the adrenaline infusion. Following the infusion of adrenaline the leg blood flow increased by 140% and hepatic blood flow by 25%. The leg oxygen uptake increased by 30%, but no significant increase in splanchnic oxygen uptake was observed. The arterial glucose concentration rose by 35%. Splanchnic glucose output increased X 2.5, but no significant increase in leg glucose uptake was observed. Leg release of gluconeogenic substrates increased but only lactate and glycerol uptake increased in the splanchnic bed. Leg blood flow increased more than that usually seen after surgery, whereas leg oxygen uptake and splanchnic oxygen uptake was higher in the immediate postoperative period. Splanchnic glucose release increased more during the infusion than in connection with surgery. It is concluded that adrenaline at a plasma concentration similar to that during and immediately after surgery can induce changes in glucose metabolism which are of the same order or more pronounced than those seen in connection with abdominal surgery.

Adult↗
PubMed1990

Influence of local beta-adrenoceptor blockade on exchange of fat and glucose in the human leg after surgery.

The metabolic effects of the local administration of propranolol were determined in seven patients undergoing cholecystectomy. Measurements were carried out in the early postoperative period before and after infusion of 2 mg of intraarterial propranolol into the femoral artery of one leg using the other leg as control. Blood flow and arterio-venous concentration differences for oxygen, glucose, lactate, alanine, glycerol and total FFAs were determined. Uptake and release of FFAs were determined by using a tracer technique. The statistical analyses were based on differences between the test and the control leg in changes following the blockade. Glycerol release was significantly more suppressed in the test leg than in the control leg. No difference between the legs was seen in the uptake of oxygen, FFA and glucose or the release of lactate and alanine. The arterial concentration of propranolol was 6.07 +/- 0.72 ng ml-1 (mean +/- SEM). This study indicates that a local beta-blockade by intra-arterial propranolol infusion after surgery slightly reduces the postoperative lipolysis in leg tissues but does not influence or only marginally influences leg blood flow and oxygen uptake or the exchange of glucose, lactate and alanine after moderate surgical trauma.

Adult↗
PubMed1977

Central and regional circulatory effects of adding arm exercise to leg exercise.

7 young, healthy, male subjects performed exercise on bicycle ergometers in two 20 min periods with an interval of 1 h. The first 10 min of each 20 min period consisted of arm exercise (38--62% of Vo2 max for arm exercise) or leg exercise (58--78% of Vo2 max for leg exercise). During the last 10 min the subjects performed combined arm and leg exercise (71--83% of Vo2 max for this type of exercise). The following variables were measured during each type of exercise: oxygen uptake, heart rate, mean arterial blood pressure, cardiac output, leg blood flow (only during leg exercise and combined exercise), arterio-venous concentration differences for O2 and lactate at the levels of the axillary and the external iliac vessels. Superimposing a sufficiently strenuous arm exercise (oxygen uptake for arm exercise greater than 40% of oxygen uptake for combined exercise) on leg exercise caused a reduction in blood flow and oxygen uptake in the exercising legs with unchanged mean arterial blood pressure. Superimposing leg exercise on arm exercise caused a decrease in mean arterial blood pressure and an increased axillary arterio-venous oxygen difference. These findings indicate that the oxygen supply to one large group of exercising muscles may be limited by vasoconstriction or by a fall in arterial pressure, when another large group of muscles is exercising simultaneously.

Adult↗
PubMed1992

Effects of graded restriction of perfusion on circulation and metabolism in the working leg; quantification of a human ischaemia-model.

An experimental model used with the intention of mimicking the ischaemic condition in patients with arterial obliterative disease was evaluated. The influence of reduced effective perfusion pressure by increased external pressure on leg blood flow and metabolism was determined during exercise in 10 healthy subjects. Catheters were inserted into the right femoral artery and vein and into the left femoral vein. Supine one-legged (n = 5) or two-legged (n = 5) cycle exercise was performed with the subject's legs in a pressure chamber. Zero and three different levels of local supra-atmospheric pressure were applied over the legs: 30, 50 and 60 mmHg. Three submaximal work loads were used: 24, 48 and 72 W/leg. Leg blood flow was measured by the constant-infusion dye-dilution technique. Samples were also drawn from the femoral artery and vein for oxygen saturation and lactate determinations and arterial pressure was recorded. Exercise blood flow decreased progressively with increasing chamber pressure (P less than 0.001). Exposure to 50 mmHg over the working leg led to a mean reduction of blood flow by 16% and venous oxygen saturation by 12 percentage units (P less than 0.05). Lactate release increased with increasing pressure (P less than 0.05). In summary, local application of moderate positive external pressure over the working leg reduces blood flow in a 'dose-dependent' manner, and as a consequence, femoral venous oxygen saturation decreases and lactate release increases. Thus, this method makes it possible to induce graded ischaemia in human skeletal muscle during exercise in a controlled fashion.

Adult↗
PubMed1994

Cardiovascular responses during one- and two-legged exercise in middle-aged men.

Eight healthy and regularly physically active men, 44-69 years old, performed one- and two-legged dynamic knee extension exercise at increasing work intensities, including one leading to exhaustion. Leg blood flow increased linearly in relation to work rate, reaching a peak value of 5.1 +/- 0.4 l min-1. With a mean weight of quadriceps femoris of 2.2 +/- 0.1 kg, a peak perfusion of 2.3 +/- 0.1 l kg-1 min-1 was attained. The maximal leg oxygen uptake was 0.72 +/- 0.07 l min-1 (0.33 +/- 0.03 l kg-1 min-1). At submaximal work the elevation in limb oxygen uptake accounted for between 70 and 100% of the rise in pulmonary oxygen uptake. Comparing two- with one-legged knee extension the cardiac output was 1.5 l min-1 higher at each work level, reaching 13.7 +/- 0.7 and 12.3 +/- 1.0, respectively at exhaustion, leaving 3.5 and 7.2 l min-1 of blood flow to the remaining body (cardiac output--leg blood flow). The mean arterial pressure was 119 +/- 5 mmHg at rest and increased to 155 mmHg for both test modes at the maximal work rate. The femoral arterial and venous plasma concentrations of lactate, ammonia and noradrenaline were significantly higher for two-legged as compared with one-legged exercise at the maximal load performed. However, the rate of release per leg, for both lactate and ammonia, did not differ between the two test conditions. It is concluded that physically active middle-aged men, with a well-retained muscle mass, can maintain a high skeletal muscle perfusion, similar to that of young males. However, the blood flow is achieved with a higher mean arterial pressure and an elevated sympathetic activity, as reflected by noradrenaline in plasma and spillover from the exercising limb.

Adult↗
PubMed1994

Ventilatory responses at the onset of passive movement and voluntary exercise with arms and legs.

This study was undertaken to elucidate whether phase I appeared at the onset of voluntary and passive arm movements and to compare these results with those of similar leg movements. Instead of the conventional cranking exercise, seven male subjects performed alternately flexion-relaxation of both arms, extension-relaxation of both legs, and combined arm and leg exercise at the rate of about 60 min-1 for four breaths in a sitting position. Similar movements were accomplished passively by the experimenters. In all experiments, minute ventilation increased rapidly within the first breath after the onset of exercise. The difference of ventilation (delta value) between the mean of the first two breaths at the onset of voluntary exercise and that of five breaths during rest was significantly (P < 0.05) greater in arm (7.75 l min-1) than in leg (5.19 l min-1). Passive movement showed a similar tendency. Arm delta ventilation correlated highly (r = 0.74-0.91) with leg delta ventilation and the slope of the regression lines was about 1.2. Heart rate increased abruptly while cardiac output did not always increase rapidly at the onset of locomotion. Oxygen uptake in the voluntary leg exercise continued for 3 min was slightly but nonsignificantly higher than in the arm exercise, indicating the equality of the exercise intensity. In conclusion, ventilatory responses at the onset of the arm exercise are larger than those of the leg in both voluntary and passive conditions regardless of the muscle mass, suggesting the different neurogenic mechanism between arm and leg.

Adult↗
PubMed2002

Obstacle avoidance during human walking: transfer of motor skill from one leg to the other.

The aim of this study was to evaluate whether a newly acquired locomotor skill can be transferred to the mirror condition. Subjects were trained to step over an obstacle on a treadmill, the appearance of which was signalled by an acoustic stimulus, while visual information was prevented. Feedback information about foot clearance was provided by acoustic signals. During two successive runs (each consisting of 100 steps over the obstacle) the same leg was leading (i.e. the leg crossing the obstacle first). In the following third run, the leading and trailing legs were changed. During each of the three successive runs the adaptational changes were analysed by recording leg muscle electromyographic (EMG) activity, joint angle trajectories and foot clearance over the obstacle. The training effect gained between the first and second runs and the transfer to the mirror condition (third run) were evaluated. Adaptational changes of all measures, except ankle joint trajectory, could to a significant extent be transferred to the mirror condition. No side-specific differences in the amount of transfer were found, neither from the right to the left side, nor vice versa. These observations are at variance with adaptational changes observed during split-belt walking or one-legged hopping on a treadmill, where no transfer to the mirror condition occurred. It is assumed that this might be due to the specific requirements of the tasks and the leg muscles involved. While in the split-belt and hopping experiments leg extensor muscles are mainly involved, leg flexors predominate in the performance of the present task. It is hypothesised that the learning effects observed in the present experiments are mediated at a higher level (e.g. brainstem) of locomotor control.

Adaptation, Physiological↗
PubMed2004

Different vasodilator responses of human arms and legs.

Forearm vascular responses to intra-arterial infusions of endothelium-dependent and -independent vasodilators have been thoroughly characterized in humans. While the forearm is a well-established experimental model for studying human vascular function, it is of limited consequence to systemic cardiovascular control owing to its small muscle mass and blood flow requirements. In the present study we determined whether these responses could be generalized to the leg. Based upon blood pressure differences between the leg and arm during upright posture, we hypothesized that the responsiveness to endothelium-dependent vasodilators would be greater in the forearm than the leg. Brachial and femoral artery blood flow (Q, ultrasound Doppler) at rest and during intra-arterial infusions of endothelium-dependent (acetylcholine and substance P) and -independent (sodium nitroprusside) vasodilators were measured in eight healthy men (22-27 years old). Resting blood flows in the forearm before infusion of acetylcholine, substance P or sodium nitroprusside were 25 +/- 4, 30 +/- 7 and 29 +/- 5 ml min(-1), respectively, and in the leg were 370 +/- 32, 409 +/- 62 and 330 +/- 30 ml min(-1), respectively. At the highest infusion rate of acetylcholine (16 microg (100 ml tissue)(-1) min(-1)) there was a greater (P < 0.05) increase in Q to the forearm (1864 +/- 476%) than to the leg (569 +/- 86%). Similarly, at the highest infusion rate of substance P (125 pg (100 ml tissue)(-1) min(-1)) there was a greater (P < 0.05) increase in Q to the forearm (911 +/- 286%) than to the leg (243 +/- 58%). The responses to sodium nitroprusside (1 microg (100 ml tissue)(-1) min(-1)) were also greater (P < 0.05) in the forearm (925 +/- 164%) than in the leg (326 +/- 65%). These data indicate that vascular responses to both endothelium-dependent and -independent vasodilator agents are blunted in the leg compared to the forearm.

Acetylcholine↗
PubMed2005

Glucose clearance is higher in arm than leg muscle in type 2 diabetes.

Insulin-mediated glucose clearance (GC) is diminished in type 2 diabetes. Skeletal muscle has been estimated to account for essentially all of the impairment. Such estimations were based on leg muscle and extrapolated to whole body muscle mass. However, skeletal muscle is not a uniform tissue and insulin resistance may not be evenly distributed. We measured basal and insulin-mediated (1 pmol min-1 kg-1) GC simultaneously in the arm and leg in type 2 diabetes patients (TYPE 2) and controls (CON) (n=6 for both). During the clamp arterio-venous glucose extraction was higher in CON versus TYPE 2 in the arm (6.9+/-1.0 versus 4.7+/-0.8%; mean+/-s.e.m.; P=0.029), but not in the leg (4.2+/-0.8 versus 3.1+/-0.6%). Blood flow was not different between CON and TYPE 2 but was higher (P<0.05) in arm versus leg (CON: 74+/-8 versus 56+/-5; TYPE 2: 87+/-9 versus 43+/-6 ml min-1 kg-1 muscle, respectively). At basal, CON had 84% higher arm GC (P=0.012) and 87% higher leg GC (P=0.016) compared with TYPE 2. During clamp, the difference between CON and TYPE 2 in arm GC was diminished to 54% but maintained at 80% in the leg. In conclusion, this study shows that glucose clearance is higher in arm than leg muscles, regardless of insulin resistance, which may indicate better preserved insulin sensitivity in arm than leg muscle in type 2 diabetes.

Arm↗
PubMedDate not supplied

Human leg heating using a mini-annular phased array.

The energy deposition pattern within an isolated human leg heated with a mini-annular phased array (MAPA) hyperthermia applicator has been determined. The non-tumor-bearing lower portion of a human leg amputated at the hip due to the presence of a large tumor in the thigh was "fixed" in a 50% ethanol in 0.9% saline solution. Subsequent to this fixation process, the leg was rehydrated in 0.9% saline and heated four times using a MAPA operating at 122 MHz. Specific absorption rates and electric field strengths were calculated from the rates of change of temperature with time measured at 143 different anatomical locations within the leg. When the leg was coaxial with the MAPA and the MAPA was axially positioned midway between the knee and the ankle, the points of maximum heating were skewed away from the center of the MAPA, towards the ankle of the leg and along the central axis of the MAPA. Significant temperature rise was measured inside the bone and the fat as well as inside the muscle of the leg. Bone heating was reduced when the leg was shifted away from the MAPA axis.

Amputation, Surgical↗
PubMed1999

Risk factors for erysipelas of the leg (cellulitis): case-control study.

OBJECTIVE: To assess risk factors for erysipelas of the leg (cellulitis). DESIGN: Case-control study. SETTING: 7 hospital centres in France. SUBJECTS: 167 patients admitted to hospital for erysipelas of the leg and 294 controls. RESULTS: In multivariate analysis, a disruption of the cutaneous barrier (leg ulcer, wound, fissurated toe-web intertrigo, pressure ulcer, or leg dermatosis) (odds ratio 23.8, 95% confidence interval 10.7 to 52.5), lymphoedema (71.2, 5.6 to 908), venous insufficiency (2.9, 1.0 to 8.7), leg oedema (2.5, 1.2 to 5.1) and being overweight (2.0, 1.1 to 3.7) were independently associated with erysipelas of the leg. No association was observed with diabetes, alcohol, or smoking. Population attributable risk for toe-web intertrigo was 61%. CONCLUSION: This first case-control study highlights the major role of local risk factors (mainly lymphoedema and site of entry) in erysipelas of the leg. From a public health perspective, detecting and treating toe-web intertrigo should be evaluated in the secondary prevention of erysipelas of the leg.

Analysis of Variance↗
PubMed1988

Comparison of arm and leg ergometry in patients with moderate chronic obstructive lung disease.

Exercise testing is traditionally performed with leg exercise on either a treadmill or a bicycle ergometer. Many of these tests are terminated before dyspnoea occurs because of leg fatigue, arthritic pain, or claudication. A study was carried out to determine whether arm ergometry testing might serve as an alternative method to leg testing in eight patients with chronic obstructive lung disease. The patients had mild to moderate dyspnoea on exertion and required bronchodilator treatment. They had smoked an average of 62 pack years and had a mean FEV1 of 1.88 l. Arm and leg ergometry yielded similar levels of maximum ventilation (arm 47.2, leg 48.6 l/min), maximum heart rates (126 v 124 beats/min), maximum tidal volume (1.5 v 1.6 l), and respiratory rate (30 v 29 breaths/min); but maximum oxygen consumption (1120 v 966 ml/min), maximum power output (62 v 26 w), and oxygen pulse (9.1 v 7.8 ml/beat) were all higher with leg than with arm ergometry. In addition, ventilation and heart rate at a given level of oxygen consumption were higher for arm than for leg work during both submaximal and maximal exercise. It is concluded that arm ergometry offers an alternative testing method to leg testing in patients with moderate chronic obstructive lung disease.

Arm↗
PubMed1991

Effect of systemic hyperinsulinemia on amino acid flux across human legs in postabsorptive state.

The effect of physiological hyperinsulinemia (approximately 110 mU/l) on leg tissue protein balance was investigated in eight weight-stable healthy individuals. A primed constant infusion of L-[U-14C]tyrosine was used to measure the disposal and release of tyrosine across the leg before and during 2 h of euglycemic clamp studies. The leg exchange of 3-methyl-L-histidine (3-MH) and all amino acids in blood were measured before and during insulinization, including the muscle tissue content of amino acids. Hyperinsulinemia decreased whole body tyrosine flux from 52 +/- 2 to 35 +/- 1 mumol/min (P less than 0.0001), whereas neither disposal (53 +/- 9 vs. 45 +/- 9 nmol.min-1.100 g-1) nor release of tyrosine across the leg (76 +/- 11 vs. 66 +/- 10 nmol X min-1 X 100 g-1) was significantly influenced. The arterial concentration and the leg exchange of 3-MH were not significantly affected by 2 h of hyperinsulinemia, but the sum of all amino acids declined significantly. The net leg balance of tyrosine was not affected at all by hyperinsulinemia, whereas the balance of the branched-chain amino acids and methionine were switched from efflux toward influx. Phenylalanine efflux from the leg only showed a trend to a significant effect by insulin. The muscle tissue concentration of six individual amino acids decreased significantly during hyperinsulinemia, particularly the branched-chain amino acids. The leg exchange of glucose, free fatty acids, and glycerol immediately changed significantly, as expected in response to insulinization.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acids↗
PubMed1975

Effects of training on the physiological responses to one- and two-leg work.

The effects of training resulting from one-leg exercise on a stationary bicycle ergometer have been studied. Seven subjects were habituated to one- and two-leg progressive exercise tests on 11 successive days and were then trained for 60 min-day-1 (30 min each leg) 3 times per wk for 5-6 wk at approximately 80% of their one-leg VO2 max. VE max increased (P less than 0.05) by approximately 14 1-min-1 and VO2 max by approximately 0.34 1-min-1 (+14%; P less than 0.05) in one-leg exercise. This latter increase was not, however, reflected in the two-leg VO2 max which only increased 145 ml-min-1 (4.7%). It was concluded that training is specific and in one-leg work the phenomenon is mainly peripheral in origin, but in two-leg work the limitation to maximal exercise is still provided by the capacity of the central cardiovascular system to transport oxygen to a given effective muscle mass.

Adult↗
PubMed1990

Muscle oxidative capacity and work performance after training under local leg ischemia.

Healthy young men executed supine one-legged cycle training four times per week for 4 wk with legs and the cycle ergometer inside a pressure chamber, the opening of which was sealed by a rubber membrane at the level of the crotch. Each training session started by training one leg under ischemic conditions induced by increased chamber pressure (50 mmHg) at the highest intensity tolerable for 45 min. Then the other leg was trained with the same power profile but normal atmospheric chamber pressure. Before and after the training period, both legs executed one-legged exercise tests under both normal and increased chamber pressure and muscle biopsies were taken from the vastus lateralis. Ischemic training increased performance more than normal training, the difference being greater for exercise executed under ischemic conditions. The difference in performance increase between the legs was paralleled by a greater muscle citrate synthase activity in the ischemically than in the normally trained leg.

Adult↗