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PubMed1999

Thermoregulatory and physiological responses of wheelchair athletes to prolonged arm crank and wheelchair exercise.

Seven wheelchair athletes participated in this study. On separate occasions all athletes performed 60 min of arm crank ergometry and wheelchair ergometry at 60% of the ergometer specific VO2peak in cool conditions (21.5+/-1.3 degrees C; 54.2+/-6.3% relative humidity, 21.2+/-1.9 degrees C; 55.5+/-11.9% relative humidity, respectively). The order of testing was randomised. Aural and skin temperatures were continually measured throughout the 60 min test. Expired air was collected at 5, 15, 30, 45, and 60 min during the exercise period. Oxygen consumption was similar for both trials (1.09+/-0.21 and 1.16+/-0.331 x min-(-1), for the ACE and WCE trials, respectively). Heat storage was calculated at these time-points. Aural temperature was elevated from rest between 25 to 45 min of wheelchair ergometry (0.5+/-0.3 degrees C; P < 0.05) when compared to between 20 min of exercise and 5 min of recovery (0.6+/-0.3 degrees C; P<0.05) during the arm crank ergometry trial. On the cessation of arm crank ergometry, heat storage was elevated above values observed at 5 min of exercise (P < 0.05). On the cessation of wheelchair ergometry, heat storage was not elevated above values at 5 minutes of exercise. Upper arm skin temperature was cooler during wheelchair ergometry when compared to arm crank ergometry (P<0.05). All other skin temperature responses were similar during both exercise modes. The efficiency of arm crank ergometry was greater than wheelchair ergometry throughout the exercise period (18.5+/-3.5 % and 8.9+/-3.7% at 60 minutes of exercise, respectively; P < 0.05). The results of this study suggest that although ACE demonstrates greater efficiency than WCE prolonged arm crank ergometry elicited greater thermal and physiological strain when compared with prolonged wheelchair ergometry. The lower thermal strain during WCE was suggested to be related to the propulsion biomechanics which may result in some degree of local cooling, and consequently heat dissipation, when compared to ACE. Due to the greater thermal strain during arm crank ergometry, it is recommended that for studies examining the exercise responses of wheelchair users wheel-chair ergometry should be employed.

Adult↗
PubMed2005

Development of an exercise testing protocol for patients with a lower limb amputation: results of a pilot study.

Due to a decrease in physical activity, lower limb amputees experience a decline in physical fitness. This causes problems in walking with a prosthesis because energy expenditure in walking with a prosthesis is much higher than in walking with two sound legs. Exercise training may therefore increase the functional walking ability of these patients. To generate a safe and effective aerobic training program, exercise testing of amputees is recommended. The objectives of this study were to develop a maximal exercise testing protocol for lower limb amputees and to compare two different testing methods: combined arm-leg ergometry and arm ergometry. The protocols were tested in five amputee patients. Combined ergometry elicited a higher oxygen uptake and heart rate than arm ergometry. Electrocardiography during combined ergometry was easier to read. Combined ergometry was judged most comfortable by the amputees. The exercise testing protocol was useful in lower limb amputees to determine their maximal aerobic capacity and their main exercise limitation. Future exercise training programs may be based on this testing protocol. Combined arm-leg ergometry is appropriate for unilateral amputees without significant claudication of the remaining leg. Continuous arm ergometry is suitable for unilateral amputees with significant claudication of the remaining limb or bilateral amputees.

Adolescent↗
PubMed1989

[Experience with the dipyridamole test in the diagnosis of coronary insufficiency].

In 1980-86 263 dipyridamole tests were made before or after ergometry on account of the diagnosis of coronary insufficiency and possible indication for coronarography. The sensitivity and specificity was evaluated in a group of 101 subjects where both examinations had been made. As a reference method the authors used ergometry with more strict criteria of positivity of the two tests (deviations of segment ST 0.2 mV, incl. stenocardia) which are in good agreement with coronarography. The sensitivity was 58.2 and the specificity 96% (in men 61.4 and 100%). On combination of 98 dipyridamole tests with immediately following ergometry of 39 negative ergometries 23 (58.6%) changed to positive. Of 38 coronarographies the dipyridamole test was positive in 73% and in some patients with affections of the three main branches it was negative. There was also one serious complication: a new myocardial infarction. Because of lower sensitivity the dipyridamole test does not replace ergometry, except when the latter cannot be performed. The combination of the two tests sensitizes ergometry. On account of the high specificity ergometry can be omitted when the test is positive, in particular in men. For diagnostic purposes the stricter variant of criteria for evaluation of the test is more reliable and almost specific.

Adult↗
PubMed1995

Neutrophil hyper-reactivity after exercise-induced angina pectoris.

BACKGROUND: Previous studies have suggested an increased risk of myocardial infarction associated with physical exercise. Activated neutrophils may contribute to the triggering mechanisms. METHODS: Fifteen patients with stable angina pectoris underwent symptom-limited bicycle ergometry. In neutrophils obtained from serial blood samples, superoxide anion production (SOP) was determined by superoxide dismutase-inhibited reduction of cytochrome C and chemotactic mobility in the microchemotaxis chamber. The same ergometry was repeated after successful balloon angioplasty [percutaneous transluminal coronary angioplasty (PTCA)]. RESULTS: Rate-pressure products and systemic lactate concentrations were similar in both ergometries. Angina was induced in all exercise tests before PTCA, but in none after PTCA. Before the ergometries, systemic neutrophil counts, SOP and chemotactic mobility were essentially the same. Compared with baseline, exercise-induced angina immediately after the first ergometry was associated with an increase in neutrophil count by 0.8 +/- 0.1 nl-7 (P < 0.01), an increase in N-formyl-methionyl-leucyl-phenylalanine (FMLP)-stimulated SOP by 2.44 +/- 0.49 nmol/15 min/5000 cells (P < 0.01) and an increase in chemotaxis by 10.28 +/- 1.65 cells per vision field (P < 0.01). In the ergometry after PTCA this increase in SOP and in chemotaxis disappeared (0.26 +/- 0.39 nmol/15 min/5000 cells and 2.15 +/- 1.52 cells per vision field; NS), whereas the increase in neutrophil count was not significantly different from that in the ergometry before PTCA. CONCLUSION: This study reveals that neutrophil hyper-reactivity after exercise-induced angina can be attributed to myocardial ischaemia.

Aged↗
PubMed1989

Effects of active muscle mass size on cardiopulmonary responses to exercise in congestive heart failure.

Previous studies from this laboratory demonstrated that in healthy young men, cardiac output is closely coupled to oxygen uptake during dynamic exercise, regardless of its mode or relative intensity, whereas other physiologic responses such as heart rate, blood pressure and ventilation are inversely related to the size of the active muscle mass when expressed as functions of oxygen uptake. The purpose of the current investigation was to determine whether congestive heart failure alters the pattern of physiologic responses to various modes of arm and leg exercise in proportion to the size of the active muscle mass. Cardiopulmonary responses to four modes of dynamic work (one arm curl, one arm cycle ergometry, one leg cycle ergometry and two leg cycle ergometry) were characterized in terms of absolute and relative intensities (oxygen uptake and mode-specific percent of peak oxygen uptake, respectively) in middle-aged men with congestive heart failure and control groups of healthy subjects and patients after myocardial infarction without heart failure. Peak oxygen uptake was reduced to the greatest extent in patients with heart failure for large muscle mass work (-13% for curl, -32% for one arm and one leg cycle ergometry and -37% for two leg cycle ergometry; p less than 0.05 versus the normal group for the three modes of ergometry). This finding was paralleled by a markedly blunted slope for the cardiac output-oxygen uptake relation for leg but not arm exercise that was only partially compensated for by a widened arteriovenous oxygen difference. Blood pressure expressed as a function of oxygen uptake remained inversely related to active muscle mass size in all groups of subjects despite attenuation of systolic pressure for heavy large muscle mass effort in the group with heart failure. Pulmonary ventilation at a given metabolic rate was not influenced by active muscle mass size. Thus, saturation of capacity for systemic oxygen transport occurs in conjunction with blunted cardiac output reserve in patients with heart failure during exercise involving a smaller muscle mass than in healthy subjects. The basic inverse relation between size of the active muscle mass and blood pressure at a given metabolic rate is not altered by aging or reduced cardiac reserve. The muscle mass effect on ventilation seen in young healthy subjects disappears with aging.

Blood Pressure↗
PubMed1999

The validity of ratings of perceived exertion for cross-modal regulation of swimming intensity.

BACKGROUND: This study examined the use of Borg's category Ratings of Perceived Exertion (RPE) scale for prescribing and self-regulating swimming intensity. Subjects were males and females (n = 19) ages nineteen to fifty-eight who regularly swam for fitness. EXPERIMENTAL DESIGNS: Subjects completed six trials. Each trial was separated by a minimum of forty-eight hours. Mean cycle ergometry heart rates at estimated RPE-overall 12 and 16 were compared to mean swimming heart rates at produced RPE-overall 12 and 16. Also, mean arm ergometry heart rates at estimated RPE-arms 12 and 16 were compared to mean swimming heart rates at produced RPE-arms 12 and 16. Cycling and arm ergometry anchor trials familiarized subjects with testing protocol and Borg's scale prior to estimation and production trials. Comparisons were made using a one-way ANOVA (alpha 0.05). RESULTS: Mean cycling heart rate at RPE-overall 16 was not significantly different from mean swimming heart rate at RPE-overall 16. Mean swimming heart rate was significantly greater than cycling heart rate at RPE-overall 12. Mean swimming heart rates at RPE-arms 12 and 16 were significantly greater than arm ergometry heart rates at RPE-arms 12 and 16. CONCLUSIONS: Results suggest that RPE-overall 16 may be useful in prescribing a higher exercise intensity for swimmers. However, adjustments from RPE-overall 12 are needed for establishing a lower intensity. Additionally, arm ergometry-based RPEs may require adjustments to be effective in prescribing and regulating swimming intensity. Results suggest that cycling and arm ergometry anchored RPE responses should be used with discretion when prescribing and regulating swimming intensity.

Adult↗
PubMed1991

[Clinical and epidemiologic aspects of ecologically induced bronchial asthma].

After prosthetics of the aortal valve 30 patients underwent bicycle ergometry training at the sanatorial stage of rehabilitation. 10 patients who did not undergo bicycle ergometry training made up the control group. The efficacy of bicycle ergometry training was assessed according to the time-course of changes in pump and contractile functions of the heart and oxygen consumption at rest and during bicycle ergometry. Transfer of the patients to a higher functional class, a decrease in the number of threshold reactions, attainment of a higher heart rate and a higher oxygen consumption, capacity for an increase of the stroke index up to the load of 1.0 W/kg and of the level of the myocardial reserve up to 1.5-2.0 W/kg were used as criteria for the effectiveness of bicycle ergometry training. The effectiveness of bicycle ergometry training is also supported by the data obtained on comparison of the findings in the main and control groups.

Asthma↗
PubMed1997

[Usefulness of exercise electro-cardiography in a THP (Total Health Promotion Plan)].

We conducted ergometer exercise electrocardiography (ergometry) on 3,477 subjects in a THP (Total Health Promotion Plan). One hundred cases in which abnormal findings were detected by ergometry were analyzed. In the hundred cases there were 3 patterns: abnormal ST change, 50 cases; abnormal reaction, 22 cases; and extreme increase in blood pressure, 28 cases. Electrocardiograms (ECG) in 78 of these 100 cases indicated no abnormalities. Of the 31 subjects who underwent further examinations, in 18 cases abnormal findings were detected, and further observation or treatment was necessary. They were over two thirds of the 26 cases requiring observation or treatment on further examination. In other words, exercise electrocardiography revealed more than 3 times as many problem cases as electrocardiography only. One hundred and four cases were analyzed, and among them abnormal findings on ECG made further examination or treatment necessary. Of 68 subjects with an abnormal ECG and who needed to undergo exercise electrocardiography, 51 (75%) had no need to undergo further examinations, because there were no abnormal findings on ergometry in the THP. Of the 104 subjects who underwent ECG examination at rest, 51 no longer needed to waste time, effort and expense on further medical evaluation. Ergometry in a THP serves as a medical check and as a means to decide the strength of exercise before the initiation of exercise training, which is very important in preventing coronary artery disease, rather than in detecting the disease. Ergometry is expensive and it takes a lot of time and labor, but it is necessary in ensuring the safety of exercise training and in prescribing proper exercise. This analysis has shown that ergometry in THP is very useful and cost effective in improving the accuracy of health examinations.

Adult↗
PubMed2000

Transcranial doppler sonography-ergometer test for the non-invasive assessment of cerebrovascular autoregulation in humans.

Cerebrovascular hemodynamics during physical stress have been sparsely investigated, mostly through risky invasive techniques. The aim of this study was to determine the effect of ergometer stress on cerebrovascular hemodynamics in humans using the non-invasive and thus clinically-applicable method of transcranial Doppler sonography (TCD) combined with simultaneous non-invasive measurements of cardiovascular parameters. In eighteen healthy subjects (six women, twelve men; 29.3+/-4.6 years old) left midcerebral artery blood flow velocities (CBFVs) were continuously monitored using TCD during 3 min at rest, 3 min during ergometry and 3 min recovery. Simultaneously, systolic, diastolic, mean CBFVs, pulsatility index (PI), heart rate, beat-to-beat blood pressure (BP) and transcutaneous p(CO(2)) were measured. The subjects were supine with elevated trunk. Ergometry was performed by pedalling a Mühe-ergometer. In eight volunteers, the procedure was repeated within the next day to test the repeatability of the results. Heart rate increased significantly during ergometry (from 65.2+/-11 to 105. 3+/-12.3/min; P<0.05). The systolic BP increased significantly slightly later during ergometry (from 118.9+/-8.6 to 141.6+17.9 mmHg; P<0.05). Transcutaneous p(CO(2)) was initially within physiological ranges, but increased significantly after a delay during the 3rd min of cycling (from 39.7+/-3.7 to 41.1+/-4.7 mmHg; P<0.05). MFV started to rise significantly after 1 min of the exercise period (from 59.6+10.9 to 68.3+13.9 cm/s; P<0.05). PI increased immediately and significantly at the start of exercise (PI at rest 0.93+0.11; PI ergometry 1.1+0.13; P<0.05). The results were found to be reproducible in the eight volunteers. The cerebrovascular changes during ergometer exercise may reflect the combined activation of the cerebrovascular autoregulative mechanisms (neurogenic, myogenic and metabolic). The TCD-ergometer test presented here is non-invasive and would seem to present a low risk for patients who are judged fit enough for mild exercise. The test may contribute to the detection of cerebrovascular abnormalities in various diseases.

Adult↗
PubMed1998

Restoration of peak vascular conductance after simulated microgravity by maximal exercise.

We sought to determine if (i) peak vascular conductance of the calf was reduced following prolonged exposure to simulated microgravity, and (ii) if maximal cycle ergometry performed at the end of microgravity exposure stimulated a restoration of peak calf vascular conductance. To do this, peak vascular conductance of the calf was recorded following ischaemic plantar flexion exercise to fatigue in seven men after 16 days of head-down tilt (HDT) under two conditions: (i) after one bout of maximal supine cycle ergometry completed 24 h prior to performance of ischaemic plantar flexion exercise, and (ii) in a control (no cycle ergometry) condition. Following HDT, peak vascular conductance was reduced in the control condition (0.38 +/- 0.02 to 0.24 +/- 0.02 ml 100 ml-1 min-1 mmHg-1; P = 0.04), but was restored when subjects performed cycle ergometry (0.33 +/- 0.05 to 0.28 +/- 0.04 ml 100 ml-1 min-1 mmHg-1; P = 0.46). After HDT, time to fatigue during ischaemic plantar flexion exercise was not different from pre-HDT 24 h after performance of exhaustive cycle ergometry (120 +/- 24 vs. 122 +/- 19 s), but was decreased in the control condition (116 +/- 11 vs. 95 +/- 8 s; P = 0.07). These data suggest that a single bout of maximal exercise can provide a stimulus to restore peak vascular conductance and maintain time to fatigue during performance of ischaemic plantar flexion exercise.

Blood Pressure↗
PubMed1993

[The effect of captopril in nitrate tolerance].

To test whether angiotensin-converting-enzyme (ACE) inhibitor can counteract nitrate tolerance, 15 men (mean age 65 [55-69] years) were studied. They all had an at least 75% stenosis of a main coronary artery branch, proven by coronary angiography no longer than 6 months previously. Each patient underwent six ergometric tests (two each per day on alternate days) at constant exercise level and duration: the sum of S-T segment depressions was measured during the recovery and exercise minutes. The initial ergometry test was done without medication, when the S-T segment sum was 1.15 +/- 0.20 mV. After 25 mg captopril (2nd ergometry period) this sum fell to 0.80 +/- 0.18 mV. Two hours after application of a nitrate plaster the S-T segment sum was 0.55 +/- 0.12 mV (3rd ergometry period). Adding 25 mg captopril a further reduction to 0.35 +/- 0.10 was achieved (4th ergometry period). Subsequently, continuous nitrate application brought about nitrate tolerance. The 5th ergometry period then produced a sum of S-T segment depressions of 0.85 +/- 0.18 mV. Renewed captopril administration reduced this value to 0.50 +/- 0.13 mV (57% of the initial value). The effect of captopril in nitrate tolerance is apparently due to an addition of the anti-ischaemic action of the ACE inhibitor (31%) and the residual effect of the nitrate (26%).

Aged↗
PubMedDate not supplied

Intravenous dipyridamole thallium imaging V combined arm-leg cycle stress testing of patients unable to exercise on the treadmill.

UNLABELLED: Rehabilitation patients who will undergo noncardiac surgery or strenuous rehabilitation programs often cannot exercise to greater than 85% of predicted maximal heart rate as required for valid treadmill testing. Because many patients have known or suspected coronary artery disease, greatly increasing their risk for a cardiac event, dipyridamole thallium scans are usually performed, despite a cost of approximately $1400, patient radiation exposure, and the need for a gamma camera. Instead, arm-leg cycle stress testing can be continued to an appropriately high heart rate, is done in the physician's office with an electrocardiograph machine and a blood pressure cuff, and costs $250. This study describes nine patients who had both dipyridamole thallium scans and arm-leg cycle ergometry. Four awaited peripheral vascular surgery, one needed bilateral knee replacements, one was an amputee, and three had claudication. Six had documented and three had suspected coronary disease. RESULTS: In eight of nine patients, the electrocardiograms during both dipyridamole thallium imaging and ergometry were in agreement as to the presence or absence of ischemia (kappa statistic, 0.7273; P = 0.0117). In seven of nine patients, thallium images and ergometry agreed (78% concurrence). To achieve 90% agreement between dipyridamole thallium scans and cycle results, however, 68 patients would have to be studied. CONCLUSION: In this preliminary study, arm-leg ergometry was feasible in all patients and seemed cost-effective and useful for detecting myocardial ischemia. Clinically, if the ergometry were inconclusive, dipyridamole thallium scans could be performed subsequently to obtain the needed information.

Aged↗
PubMed1990

Arm exercise training in the rehabilitation of patients with impaired ventricular function and heart failure.

Although exercise training is an accepted part of comprehensive coronary care programs in patients with coronary artery disease, it still remains to be demonstrated whether or not exercise training should also be applied to patients with impaired ventricular function. Circumstantial evidence exists that patients with impaired ventricular function may eventually benefit from an individually adapted exercise training program provided that contraindications for acceptance of cardiac patients to such a program are well observed. Our study is based on 22 patients with impaired ventricular function, of which 18 were at least 6 months after a Q-wave myocardial infarction and the remaining 4 after coronary artery bypass grafting. Eleven patients with impaired left ventricular function performing upper extremity (arm) ergometry were followed up for 36 months. These patients were trained twice weekly with exercise periods of 30 min duration. The reason for choosing arm ergometry training was that the peak heart rate obtained in arm ergometry is higher when compared to leg ergometry. Rate-pressure product and heart rate were higher for given submaximal work tasks in arm ergometry, while maximal work aerobic capacity was found to be lower in comparison to leg work. The assessment of our patients was based on cardiopulmonary testing, continuous electrocardiographic monitoring (48 h), two-dimensional echocardiography and equilibrium multigated radionuclide ventriculography (99mTc). Group 1, consisting of 11 patients with left ventricular ejection fraction (LVEF) 30.1 +/- 9.5%, were trained by arm exercise for 3 years with a significant increase in work capacity and LVEF. Group 2 consisted of 11 patients with LVEF 25.5 +/- 6.8% who underwent a 12 months' calisthenic program. Peak work capacity and LVEF remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Output↗
PubMed2004

Measuring energy expenditure in cardiac patients using the Body Media Armband versus indirect calorimetry. A validation study.

AIM: The purpose of this study was to compare differences in energy expenditure using the newly developed SenseWear Armband body monitor to indirect calorimetry in cardiac rehabilitation patients. METHODS: Twenty-four (62+/-8.1 years) patients completed steady state exercise for 8 minutes on 4 modes of exercise (arm ergometry, treadmill walking, recumbent stepping and rowing ergometry). Total cumulative kilojoules were recorded simultaneously by indirect calorimetry and the SenseWear Armband. Statistical analyses assessed the degree of agreement between the 2 measurement methods and 3 different versions of the SenseWear software. RESULTS: The correlations between indirect calorimetry and version 2.2 of the SenseWear armband for arm and rowing ergometry, the treadmill and recumbent stepper were r=0.90, r=0.67, r=0 .80 and r=0.74, respectively. There were no between method differences during arm ergometry (p<1.000) and the recumbent stepper (p<0.102). Bland and Altman plots revealed the greatest spread of scores for the rower and the treadmill. Between method differences were minimal when using the preliminary cardiac software. The correlations for arm and rowing ergometry, the treadmill and recumbent stepper were r=0.90, r=0.84, r=0.78 and r=0.82, respectively. CONCLUSIONS: The accuracy of the BodyMedia SenseWear Armband appears to be exercise modality dependent in those with heart disease when using software developed for the general population. Therefore, the information should be interpreted cautiously, particularly during treadmill walking and rowing. Initial experiments with cardiac-focused software are promising, but preliminary.

Calorimetry, Indirect↗
PubMed1998

[Is the stress test useful in the detection of post-angioplasty restenosis?].

Restetenosis is still the greatest limitation of coronary angioplasty (PTCA). The systematic use of ergometry (PE) with the objective of identifying restenosis is controversial and, namely, the ACC/AHA does not recommend its routine use. Our objective was to conduct a retrospective study of the use of PE when performed late (3 to 6 months) for the detection of restenosis. As a protocol, our group performed "late" PE on all the patients without contraindications, the patients with positive ergometry or CCS class II-IV angor submitted to angiographic control. Between January 1996 and July 1997, 121 patients (pts) were submitted to PTCA. Our study population was composed of patients submitted to complete revascularisation with follow-up in our centre: 59 pts (49%) with an average age of 58 +/- 12 years, 82% male. Eighty-three percent of the pts had revascularisation in a context of unstable angina, 10% in the acute phase of myocardial infarction and 7% due to chronic angina. Stents were implanted in 42% of the pts. In the follow-up after six months, 7 pts complained of CCS class II or III angor. The ergometry showed positive electrocardiographic criteria in 11 pts (18.6%). All pts with angor had positive PE. All these pts were submitted to angiographic control; restenosis (residual stenosis equal to or above 50%) was observed in all the patients who complained of angor (100% positive predictive value); restenosis occurred in 9 pts with positive ergometry (82% positive predictive value). In asymptomatic pts, PE indicated 2 pts with restenosis (2/59-3.4%) and two false positive (2/11-18%). At six months, PE detected 22% of the pts with restenosis. In conclusion, complete post-revascularisation angor due to coronary angioplasty has a higher positive predictive value than ergometry. However, the stress test, performed systematically, can identify an additional percentage of pts with restenosis with an acceptable percentage of false positives.

Angioplasty, Balloon, Coronary↗
PubMed2003

New algorithm to control a cycle ergometer using electrical stimulation.

Data were collected from four male subjects to determine the relationships between load, speed and muscle use during cycle ergometry. These data were then used to construct equations to govern the stimulation of muscle in paralysed individuals, during cycle ergometry induced by functional electrical stimulation (FES) of the quadriceps, gluteus maximus and hamstring muscles. The algorithm was tested on four subjects who were paralysed owing to a complete spinal cord injury between T4 and T11. Using the multivariate equation, the control of movement was improved, and work was accomplished that was double (2940 Nm min(-1) compared with 5880 Nm min(-1)) that of traditional FES cycle ergometry, when muscle stimulation was also controlled by electrical stimulation. Stress on the body, assessed by cardiac output, was increased almost two-fold during maximum work with the new algorithm (81 min(-1) compared with 15 l min(-1) with the new algorithm). These data support the concept that the limitation to workload that a person can achieve on FES cycle ergometry is in the control equations and not in the paralysed muscle.

Adult↗
PubMed1993

Detection and evaluation of persisting stress-induced hormonal disturbances by a post stress provocation test in humans.

Eighteen healthy army officers were subjected after prolonged rest to exhaustive ergometric work for about 15 minutes. Before and afterwards blood was taken from the cannulated antecubital vein for determination of free and sulfoconjugated catecholamines, cortisol, glucose, and white blood cell count. One week later, the same procedure was repeated with the same subjects with the difference that the probands underwent about 2.5 hours of difficult mountain climbing and a subsequent rest of 1.5 hours before ergometry. The most important results were: 1) total and bound fractions of catecholamines showed some significant differences between the first and second ergometry due to the previous mountain climbing stress; 2) serum cortisol did not increase after the first ergometry but did so significantly after the second ergometry due to the previous stress; low cortisol is not always indicative of the absence of stress; 3) the absolute number of white blood cells increased in both situations, correlated significantly with the severity of the stress and the individual increases were more person than situation specific and; 4) blood glucose remained unaffected in both situations. We conclude that a previous stress experience can affect a second stress response and that such a post stress provocation test can uncover persistent hormonal alterations. This procedure may be useful for the evaluation of inaccessible stress situations from subsequent stress measures.

Adult↗
PubMed2004

Comparison of different exercise tests in assessing outcomes of pulmonary rehabilitation.

INTRODUCTION: Common modalities of clinical exercise testing for outcome measurement after pulmonary rehabilitation (PR) include walk tests, progressive cycle ergometry, and cycle endurance testing. We hypothesized that patients' responses to PR, as measured by those 3 tests, are differentially correlated, and we designed a study to investigate the tests' capacity to detect changes after PR. METHODS: We prospectively tested 37 male patients with stable chronic obstructive pulmonary disease who completed a comprehensive 6-week PR program that included supervised exercise training that emphasized steady-state lower-limb aerobic exercise. Before and after the PR program the patients underwent 6-minute walk test, progressive cycle ergometry, and cycle endurance testing (at 80% of the peak work rate achieved during progressive cycle ergometry). The exercise performance indices of interest were the peak oxygen uptake (VO2max) and maximum work-rate (Wmax) during progressive cycle ergometry, the cycling endurance time, and the 6-minute walk distance (6MWD). RESULTS: After PR there were statistically significant improvements in 6MWD (16%, p <0.001), VO2max (53%, p=0.004), Wmax (30%, p=0.001), and cycling endurance time (144%, p <0.001). The changes in VO2max and Wmax were significantly correlated (r=0.362, p=0.027), as were the changes in endurance time and Wmax (r=0.406, p=0.013). There was no significant correlation between changes in any other exercise index. CONCLUSIONS: Among the frequently used exercise tests in PR, the most responsive index is the endurance time. The correlation between the post-PR changes in the various exercise indices is poor.

Aged↗