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PubMed2004

fMRI signal changes in response to forced expiratory loading in congenital central hypoventilation syndrome.

Congenital central hypoventilation syndrome (CCHS) patients show impaired ventilatory responses to CO2 and hypoxia and reduced drive to breathe during sleep but retain appropriate breathing patterns in response to volition or increased exercise. Breath-by-breath influences on heart rate are also deficient. Using functional magnetic resonance imaging techniques, we examined responses over the brain to voluntary forced expiratory loading, a task that CCHS patients can perform but that results in impaired rapid heart rate variation patterns normally associated with the loading challenge. Increased signals emerged in control (n = 14) over CCHS (n = 13; ventilator dependent during sleep but not waking) subjects in the cingulate and right parietal cortex, cerebellar cortex and fastigial nucleus, and basal ganglia, whereas anterior cerebellar cortical sites and deep nuclei, dorsal midbrain, and dorsal pons showed increased signals in the patient group. The dorsal and ventral medulla showed delayed responses in CCHS patients. Primary motor and sensory areas bordering the central sulcus showed comparable responses in both groups. The delayed responses in medullary sensory and output regions and the aberrant reactions in cerebellar and pontine sensorimotor coordination areas suggest that rapid cardiorespiratory integration deficits in CCHS may stem from defects in these sites. Additional autonomic and perceptual motor deficits may derive from cingulate and parietal cortex aberrations.

Adolescent↗
PubMed1999

Exercise self-efficacy and its correlates among socioeconomically disadvantaged older adults.

Self-efficacy has been shown to be one of the strongest, mutable predictors of exercise behavior. This report presents data on exercise self-efficacy and outcome expectations and their correlates within a stratified random sample of 729 urban, lower-income primary-care patients age 55 and older. Exercise self-efficacy scores were greater among persons with current exercise, no pain of fear of shortness of breath with exercise, and good self-rated health. Higher outcome expectations scores were associated with verbal persuasion from a doctor or from family and friends and positive attitudes and knowledge of exercise. Sociodemographic characteristics, environmental factors, and intrapersonal factors accounted for 31% of the variance in self-efficacy, but just 13% of the variance in outcome expectations. Further work on potential correlates and their measurement is needed to identify determinants of both outcome expectations and self-efficacy.

Adult↗
PubMed2004

Assessment of immunological parameters following a qigong training program.

BACKGROUND: Qigong is a type of Chinese psychosomatic exercise that integrates meditation, slow physical movements, and breathing, and to which numerous physical as well as mental benefits have been classically ascribed. The aim of the present study was to analyze the effects of a qigong program on various immunological parameters. MATERIAL/METHODS: 29 naive subjects participated in the study, of whom 16 were allocated to the experimental group and the rest to the control group. The experimental subjects underwent a qigong training program, conducted by a qualified instructor, consisting of half an hour of daily practice for one month. The day before the experiment commenced and the day after it finished, blood samples were drawn from all subjects for the quantification of immunological parameters (leukocytes, immunoglobulins, and complement). As statistical analysis, analysis of covariance (ANCOVA) was carried out. RESULTS: Statistically significant differences were found between the control and experimental groups, with the experimental group showing lower numbers of total leukocytes and eosinophils, number and percentage of monocytes, as well as complement C3 concentration. In addition, a similar result with a trend towards significance was observed in the number of eosinophils. CONCLUSIONS: These findings demonstrate that after one month of practicing qigong, significant immunological changes occurred between the experimental and control groups, with a consistently lower and broadly significant profile of these measures within the qigong practitioner group.

Adolescent↗
PubMed2005

[The application of qi-gong therapy to health care].

A great number of clinical studies merging traditional Chinese medicine (TCM) and Western medicine have proved the complementary healing effects of qi-gong in medical science. Traditional Chinese respiration exercises help to regulate our mind, body and breathing and coordinate our internal organs, remove toxins and enhance immunity. Domestic and foreign studies indicate that qi-gong can relieve chronic pain, reduce tension, increase activities of phagocytes in coenocytes, improve cardiopulmonary function, improve eyesight, influence the index of blood biochemistry, etc. Due to the obvious healing effects of qi-qong therapy, through introducing qi-gone concepts and related medical research, this paper aims to inspire health care workers to integrate qi-qong therapy into medical treatments and nursing care, or to carry out further studies in order to make good the shortfall in provision of holistic medicine and nursing in the interests of the quality of patient care.

Breathing Exercises↗
PubMed1991

The work-rate-dependent effect of carbon monoxide on ventilatory control during exercise.

The effect of low levels of carbon monoxide (CO) was studied during exercise in order to determine the work-rate dependent effect of CO breathing on exercise ventilation (VE). Ten normal subjects (aged 32.8 +/- 7.1 years) were studied during air breathing and air with added CO to bring carboxyhemoglobin (COHb) to approximately 11% and 20%. During the incremental exercise test, VE was not affected by CO breathing at work rates below the lactic acidosis threshold (LAT), defined as the O2 uptake above which CO2 is excreted by the lungs consequent to buffering of metabolic acid (not hyperventilation) (Beaver et al. (1986) J. Appl. Physiol. 60: 2020-2027). However, VE was increased above the LAT as work rate and COHb saturation were increased. At the end of constant work rate exercise, the increase in VE caused by increased COHb was positively correlated (r = 0.83, P less than 0.0001) with the increase in venous lactate sampled 2 min into recovery. This was complemented by a decrease in end-tidal PCO2 versus lactate (r = 0.76, P less than 0.0001). We conclude that the increase in exercise VE resulting from COHb levels up to 20%, is restricted to work rates above the LAT, and is proportionately higher, the greater the lactic acidosis.

Adolescent↗
PubMed2005

Canadian Association of Neuroscience Review: Respiratory control and behavior in humans: lessons from imaging and experiments of nature.

The purpose of this review is to demonstrate that respiration is a complex behavior comprising both brainstem autonomic control and supramedullary influences, including volition. Whereas some fundamental mechanisms had to be established using animal models, this review focuses on clinical cases and physiological studies in humans to illustrate normal and abnormal respiratory behavior. To summarize, central respiratory drive is generated in the rostroventrolateral medulla, and transmitted to both the upper airway and to the main and accessory respiratory muscles. Afferent feedback is provided from lung and muscle mechnoreceptors, peripheral carotid and aortic chemoreceptors, and multiple central chemoreceptors. Supramedullary regions, including cortex and subcortex, modulate or initiate breathing with volition, emotion and at the onset of exercise. Autonomic breathing control can be perturbed by brainstem pathology including space occupying lesions, compression, congenital central hypoventilation syndrome and sudden infant death syndrome. Sleep-wake states are important in regulating breathing. Thus, respiratory control abnormalities are most often evident during sleep, or during transition from sleep to wakefulness. Previously undiagnosed structural brainstem pathology may be revealed by abnormal breathing during sleep. Ondine's curse and 'the locked-in syndrome' serve to distinguish brainstem from supramedullary regulatory mechanisms in humans: The former comprises loss of autonomic respiratory control and requires volitional breathing for survival, and the latter entails loss of corticospinal or corticobulbar tracts required for volitional breathing, but preserves autonomic respiratory control.

Behavior↗
PubMed2005

Cold weather exercise and airway cytokine expression.

Athletes who perform repeated exercise while breathing cold air have a high prevalence of asthmalike chronic airway disease, but the mechanism linking such activity to airway inflammation is unknown. We used a novel animal model (exercising horses) to test the hypothesis that exercise-induced chronic airway disease is caused by exposure of intrapulmonary airways to unconditioned air, resulting in the upregulation of cytokine expression. Bronchoalveolar lavage fluid (BALF) was obtained from eight horses 5 h after submaximal exercise while they breathed room temperature or subfreezing air in a random crossover design. BALF total and differential nucleated cell counts were determined, and relative cytokine mRNA expression in BALF nucleated cells was quantified by real-time RT-PCR using primer and probe sequences specific for equine targets. There were no significant changes in total or differential cell concentrations between BALF recovered after warm and cold air exercise, although there was a strong trend toward increased concentrations of airway epithelial cells after cold air exercise (P = 0.0625). T(H)2 cytokines IL-4, IL-5, and IL-10 were preferentially upregulated after cold air exercise 12-, 9-, and 10-fold, respectively, compared with warm air exercise. Other cytokines (IL-2 and IL-6) were upregulated to a lesser extent (6- and 3-fold, respectively) or not at all (IL-1, IL-8, IFN-gamma, and TNF-alpha). These results suggest that cold weather exercise can lead to asthmalike airway disease through the local induction of cytokines typical of the T(H)2 phenotype.

Animals↗
PubMed1984

Relationship between ventilation and breathlessness during exercise in chronic obstructive airways disease is not altered by prevention of hypoxaemia.

We have examined the hypothesis that hypoxaemia contributes to breathlessness by a mechanism distinct from its action as a ventilatory stimulant. Five patients who developed arterial oxygen desaturation during incremental exercise were studied. Exercise tests were performed on a cycle-ergometer. Breathlessness was measured by using a visual analogue scale technique. All five patients had considerable previous experience of these procedures. Two identical exercise tests were performed by each patient, breathing either room air or 60% oxygen in a blind randomized study. Breathing air, arterial saturation at rest was 93% and fell by 7% during exercise. Breathing 60% oxygen, resting saturation was 98% and there was no fall during exercise. Breathing oxygen, ventilation for a given work load was reduced and exercise duration was increased when compared with air breathing. In each of the five patients the relationship between breathlessness and minute ventilation was the same whether breathing air or 60% oxygen, despite the reduction in ventilation for a given work rate.

Aged↗
PubMed2005

Cardiorespiratory synchronization during Zen meditation.

The impact of meditation on cardiorespiratory synchronization with respect to breathing oscillations and the modulations of heart rate induced by respiration (respiratory sinus arrhythmia, RSA) was investigated in this study. Four different exercises (spontaneous breathing, mental task, Zen meditation, and Kinhin meditation) were consecutively performed by nine subjects mainly without any experience in meditation. An electrocardiogram and a respiratory trace were recorded simultaneously. On this basis the degree of cardiorespiratory synchronization was quantified by a technique which has been adopted from the analysis of weakly coupled chaotic oscillators. Both types of meditation showed a high degree of synchronization, whereas heartbeat and respiration were hardly synchronized during spontaneous breathing. During the mental task exercise the extent of synchronization was slightly higher than during spontaneous breathing. These results were largely determined by the breathing frequency because the two types of meditation induce low breathing frequencies which led to a pronounced and in-phase RSA. During the meditation the low breathing frequencies led to a decrease in the high frequency of heart rate variability, whereas the low frequency and the extent of RSA increased. The heart rate primarily reflected the degree of physical effort. The high degree of cardiorespiratory synchronization during meditation in unexperienced meditators suggests that the physiological implications of meditation does not require prior experience in meditation.

Adaptation, Physiological↗
PubMed1993

Breath 13CO2 background enrichment during exercise: diet-related differences between Europe and America.

A traditional North American diet contains a high percentage of carbohydrates (CHO) derived from C4 plants (maize, sugar cane), whereas a European diet contains primarily CHO derived from C3 plants (potato, sugar beet). The natural 13C enrichment of the first type of CHO is higher than that of the latter type. 13CO2 production from orally ingested C4 plant-derived CHO can, therefore, be used to quantify oxidation rates of orally ingested CHO at rest and during exercise. Recently it has been shown that oxidation rates assessed this way in North Americans should be corrected for an increase in breath background 13CO2 during exercise. We hypothesized that the indicated difference in metabolic origin of CHO would imply that no such correction is required for subjects on a European diet. We therefore studied changes from rest in breath 13CO2 enrichment in Dutch volunteers during cycle ergometry at 65% maximal work load (experiment 1, 2h, 6 subjects) and 70% maximal oxygen uptake (experiment 2, 90 min, 8 subjects) while ingesting water (experiments 1 and 2) and potato starch-derived glucose (experiment 2). Experiment 1 was done before and after careful instruction of the subjects to refrain from nutrient sources potentially containing CHO of C4 metabolic origin. No significant changes from rest 13CO2 enrichment were observed in tests with water and potato-derived glucose ingestion in subjects who excluded CHO of C4 metabolic origin from their diet.

Adipose Tissue↗
PubMed1999

Effects of sodium bicarbonate administration on the exercise tolerance of normal subjects breathing through dead space.

STUDY OBJECTIVE: The purpose of this study was to determine whether the administration of sodium bicarbonate to normal individuals would increase their PaCO2 and thereby decrease the ventilatory requirements at a given workload. DESIGN: In this double-blind crossover study, six normal men ingested either 3 mEq/kg NaHCO3 or 1 mEq/kg NaCl once a day for 5 days, in addition to 40 mg of furosemide and 40 mEq KCl. After each 5-day treatment, the subjects underwent a symptom-limited maximal bicycle ergometer exercise test while breathing through external dead space (with a volume of approximately 50% of their FEV1), a second exercise test without any external dead space, and an assessment of their respiratory response to hypercapnia. RESULTS: The administration of the NaHCO3 resulted in a significant increase in the arterial HCO3- from 20.8 to 24.0 mEq/L and a significant increase in the PaCO2 from 31.7 to 36.9 mm Hg at rest that persisted during exercise. During exercise periods with the added dead space, the Borg scores were significantly lower at each workload after the subjects received bicarbonate, but the maximal exercise level did not increase. The mean (+/-SD) slope of the mouth occlusion pressure response to hypercapnia was significantly lower after the administration of NaHCO3 than after NaCl, respectively: 0.73+/-0.41 vs 1.27+/-0.97 cm H2O/mm Hg. CONCLUSION: From this study we conclude that the administration of NaHCO3 results in a significant increase in the PaCO2, decreases the ventilation and the Borg score at equivalent workloads, and decreases the hypercapnic response in normal individuals.

Adult↗
PubMed1988

Role of lungs and inactive muscle in acid-base control after maximal exercise.

The pulmonary responses and changes in plasma acid-base status occurring across the inactive forearm muscle were examined after 30 s of intense exercise in six male subjects exercising on an isokinetic cycle ergometer. Arterial and deep forearm venous blood were sampled at rest and during 10 min after exercise; ventilation and pulmonary gas exchange variables were measured breath by breath during exercise and recovery. Immediately after exercise, ventilation and CO2 output increased to 124 +/- 17 1/min and 3.24 +/- 0.195 l/min, respectively. The subsequent decrease in CO2 output was slower than the decrease in O2 intake (half time of 105 +/- 15 and 47 +/- 4 s, respectively); the respiratory exchange ratio was greater than 1.0 throughout the 10 min of recovery. Arterial plasma concentrations of Na+, K+, and Ca2+ increased transiently after exercise. Arterial lactate ion concentration ([La-]) increased to 14-15 meq/l within 1.5 min and remained at this level for the rest of the study. Throughout recovery there was a positive arteriovenous [La-] difference of 4-5 meq/l, associated with an increase in the arteriovenous strong ion difference ([SID]) and by a large increase in the venous Pco2 and [HCO3-]. These findings were interpreted as indicating uptake of La- by the inactive muscle, leading to a fall in the muscle [SID] and increase in plasma [SID], associated with an increase in muscle PCO2. The venoarterial CO2 content difference was 38% greater than could be accounted for by metabolism of La- alone, suggesting liberation of CO2 stored in muscle, possibly as carbamate.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗