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PubMed2005

Proposed tests for measuring the running velocity at the oxygen consumption and heart rate thresholds for treadmill exercise.

The purposes of this study were to (a) determine if the mathematical model used to estimate the physical working capacity at the oxygen consumption threshold (PWC(VO(2))) and physical working capacity at the heart rate threshold (PWC(HRT)) for cycle ergometry could be applied to treadmill running; (b) propose new fatigue thresholds called the running velocity at the oxygen uptake threshold (RV(VO(2))) and running velocity at the heart rate threshold (RV(HRT)) for treadmill exercise; and (c) statistically compare the velocities at the RV(VO(2)), RV(HRT), and ventilatory threshold (VT). Seven aerobically trained adult volunteers (mean +/- SD: age 24.0 +/- 3.9 years, Vo(2) max 56.7 +/- 7.1 ml.kg(-1).min(-1)) performed a maximal treadmill test to determine Vo(2) peak and VT as well as four 8-minute submaximal workbouts for the determination of RV(VO(2)) and RV(HRT). One-way repeated-measures analysis of variance indicated that there were no significant (p > 0.05) mean differences among the running velocities for the RV(VO(2)), RV(HRT), and VT. The results of this study indicated that the mathematical model used to estimate PWC(VO(2)) and PWC(HRT) for cycle ergometry could be applied to treadmill running. Furthermore, the RV(VO(2)) and RV(HRT) test may provide submaximal techniques for estimating the VT.

Adult↗
PubMed2003

Effects of three different types of exercise on blood leukocyte count during and following exercise.

CONTEXT: High-intensity exercise causes tissue damage, production of stress hormones, and alterations in the function and quantity of various immune cells. Many clinical-physical stressors such as surgery, trauma, burns and sepsis induce a pattern of hormonal and immunological response similar to that of exercise. It has thus been suggested that heavy exercise might be used to cause graded and well-defined amounts of muscle trauma, thereby serving as an experimental model for inflammation and sepsis. OBJECTIVE: In order to explore whether some form of strenuous exercise might provide an useful model for the inflammatory process, we studied the effects of three different exercise protocols on blood leukocyte count during and following exercise. DESIGN: Four different experimental conditions, using a randomized-block design. SETTING: Defence and Civil Institute of Environmental Medicine, North York, Ontario, Canada. PARTICIPANTS: Eight healthy and moderately fit males. PROCEDURES: Participants were each assigned to four experimental conditions. Subjects performed 5 minutes of cycle-ergometry exercise at 90%, 2 hours of cycle-ergometry exercise at 60%, a standard circuit of resistance exercises with 3 sets of 10 repetitions at 60 to 70% of one-repetition maximum (1-RM) force at each of 5 different stations; or they remained seated for 5 hours. DIAGNOSTIC TEST USED: Flow cytometric analysis. MAIN MEASUREMENTS: Blood samples were analyzed for total leukocyte counts, total T cells, T helper/inducer cells, T suppressor/cytotoxic cells, B cells, cytolytic T cells, and natural killer cells. RESULTS: The peak aerobic and prolonged submaximal exercise induced similar alterations in cell counts. These changes were generally larger than those produced by the resistance exercise, although both resistance and peak aerobic exercise resulted in a significantly longer-lasting decrease in the CD4+/CD8+ ratio than the submaximal exercise bout did. CONCLUSION: The data suggest that, of the three exercise patterns tested, prolonged aerobic exercise induced the largest and most readily measured patterns of immune response. Nevertheless, the changes provided only a partial model for the clinical inflammatory process.

Adult↗
PubMed1976

[Estimation of cardio-respiratory energy reserves by ergometric exploration].

Beyond the usual respiratory functional tests, ergometry represents a complementary test, yielding much information on the functioning of the lung-heart system. Simultaneous recording, studying and comparing different respiratory and haemodynamic functional parameters during effort, provides an objective appreciation of the cardio-respiratory energetic reserve. Such a study is necessary to estimate a functional handicap and to understand the pathophysiological alterations of the cardio-respiratory system. The estimation of energetic reserve based on the simultaneous study of multiple respiratory and circulatory parameters also provides valuable information. Ergometry is of equal value in the estimation of operating risks in pulmonary surgery. Information drawn from more than 600 ergometric tests composed of simultaneous recording of 8 parameters (heart rate, ECG, pulse volume, spirogram, ventilation per minute, SAO2, capnogram, right ventricular pressure) have confirmed the great value of this method in pulmonary medicine.

Adult↗
PubMed1978

[Coronary spasm on exercise. Demonstration of a case by coronary angiography].

We have seen a case with spasm of the right coronary artery coming on during exercise ergometry in the course of a coronary arteriogram. The patient had angina pectoris spontaneously and on exercise. Bicycle ergometry was repeated four times by the same method, and was positive in three; in two of these there was angina and ST elevation in II, III, aVF, and ST depression in I, aVL and V2 to V5. On one occasion the test was negative, the patient having taken a trinitrin tablet one hour before the test. Repeating the exercise test during coronary arteriography showed spasm of the right coronary artery and elevation of the segment ST in II, III and aVF; this disappeared after trinitrin treatment.

Adult↗
PubMed2000

[Electric stimulation in muscle training of the lower extremities in persons with spinal cord injuries].

Spinal cord injured persons have limited possibilities to perform physical training. By use of computerized, feed-back controlled electrical stimulation of the gluteal, the hamstrings and the quadriceps muscles cycle ergometry can be performed by the spinal cord injured individual. The cardiovascular demands of this training is higher than with voluntary upper body training using the intact innervated muscles. The inactivity related conditions caused by the spinal cord injury are reversed in part by regular electrically stimulated training. An increase is seen in maximal oxygen consumption, in the insulin stimulated glucose uptake and in the muscular mass and bone mineral content of the lower extremities. Electrically induced cycle ergometry is thoroughly investigated, relatively safe, but time consuming. As this training in addition results in the same well being as seen by training in able bodied individuals it can be recommended for motivated patients.

Electric Stimulation Therapy↗
PubMed1975

[Tolerance of physical stress and evaluation of work capacity of persons with functional diseases of the heart].

The examination of 112 patients with functional cardiopathies demonstrated that bicycle ergometry permits to differentiate them from ischaemic heart disease. These patients exhibit a reduced capacity for physical labour caused by several factors (among them such as lack of habit of physical labour, nervous regulation disorders, latent circulation insufficiency). Ergometry proves to be a good objective test for the efficiency of therapy of functional cardiopathies.

Adolescent↗
PubMed1990

Long-term treatment of angina pectoris with bisoprolol or atenolol in patients with chronic obstructive bronchitis: a randomized, double-blind crossover study.

Forty outpatients suffering from angina pectoris due to coronary artery disease and concomitant reversible. chronic obstructive bronchitis were treated with the beta1-selective beta-blockers atenolol (50 mg) and bisoprolol (5 mg) for 6 months in each case, following a randomized, double-blind crossover study design. Lung function tests were carried out by means of whole-body plethysmography before and then several times during treatment. 2 to 4 h after drug intake (once daily in the morning). The main target variables for the factorial analysis of variance for comparison of the two beta-blockers were the airway resistance (AWR), the forced expiratory volume in the first second (FEV1), and the peak expiratory flow rate (PEFR). Bicycle ergometry was performed before and after therapy in order to check the cardiovascular effects of the two beta-blockers. The patients were questioned as to their angina pectoris and bronchitis symptoms at the monthly check-ups. There was no difference between the two beta-blockers (p > 0.05), both causing a slight increase in AWR, which increased with therapy duration, and a small but significant decrease in FEV1 and PEFR (p < 0.01). The bronchitis symptoms were not affected; however, seasonal influences were detected. Atenolol and bisoprolol had comparably pronounced effects on the cardiovascular parameters during ergometry (blood pressure, heart rate, W x min product, and ST-segment depression) and the frequency of angina pectoris attacks. Even beta1-selective beta-blockers may cause an impairment of lung function in patients with chronic obstructive bronchitis. This may be due to the presence of beta1-adrenoceptors in the bronchial tissue. Fifty milligrams of atenolol and 5 mg of bisoprolol once per day are effective in the treatment of angina pectoris.

Adrenergic beta-1 Receptor Antagonists↗
PubMed1975

[Isosorbide dinitrate in coronary heart disease. Effects of a delayed-action preparation during acute load and in chronic use].

The antianginal effectivity of a sustained release isosorbiddinitrate Sorbidilat Retard drug was examined by the number of spontaneous attacks and by ergometry with a constant work load in a double blind trial with cross over technique. An effect on the stress duration, on the ST segment depression, on the "double product", on heart rate, and blood pressure could be proved, which is interpreted as an therapeutic advantage of serum against placebo. The number of spontaneous attacks could be reduced in the verum period significantly. Ergometry every 2 hour after drug adminstration shows an oral effectivity of about 10 hours.

Administration, Oral↗
PubMed2002

Value of exercise testing to evaluate the indication for surgery in asymptomatic patients with valvular aortic stenosis.

BACKGROUND AND AIMS OF THE STUDY: The study aim was to assess the value of exercise stress testing in identifying asymptomatic patients with moderate or severe valvular aortic stenosis (AS). These patients generally develop symptoms during follow up, and require valvular replacement surgery (VRS) at one to three years after single symptom-limited exercise stress testing. Limited data are available on predictors of outcome in asymptomatic patients with valvular AS. A single symptom-limited exercise stress test might offer more precise risk stratification of patients referred for cardiological evaluation. METHODS: The safety and diagnostic accuracy of exercise testing to predict symptom development and need for surgery was assessed prospectively in 30 asymptomatic patients (mean age 62+/-14 years) with valvular AS. Twenty patients had moderate AS (mean Doppler gradient 30-49 mmHg), and 10 severe AS (gradient > or =50 mmHg). Patients underwent a symptom-limited maximal exercise test with upright bicycle ergometry. There were no complications during and after exercise testing. All patients were followed up for at least 36 months. RESULTS: Ergometry was abnormal in 18 patients (60%); two patients had a fall in systolic blood pressure, one patient had a fall in systolic blood pressure with angina and ECG signs of myocardial ischemia, one had angina and ECG signs of myocardial ischemia, three patients had ECG signs of myocardial ischemia without symptoms, and 11 had dyspnea at low workload. During the following 12 months all patients with a normal exercise test remained asymptomatic (negative predictive value 100%). Ten of the 18 patients with abnormal exercise test experienced symptoms and required VRS, but eight did not (positive predictive value 55%). After 36 months, only two of 12 patients with a normal exercise test developed symptoms and required VRS (negative predictive value 83%); among subjects with abnormal exercise test, four of 18 required VRS. At three years after exercise testing, 10 patients with a normal exercise stress test and four with an abnormal test did not require VRS as they remained asymptomatic (positive predictive value 78%). There was no statistically significant difference in valvular aortic area, maximal and mean gradient between patients with normal and abnormal exercise tests. CONCLUSION: Exercise stress testing may be performed safely in asymptomatic patients with moderate or severe valvular AS. Tests which meet criteria for normal patients allow physicians confidently to postpone VRS and to suggest a simple, cost-effective method of follow up in such cases. An abnormal test may reveal symptoms or identify a population for closer follow up.

Adult↗
PubMed1992

[Use of loading tests to detect silent myocardial ischemia].

A total of 74 patients with postinfarct cardiosclerosis (PC) and stable angina (SA) were examined by Holter monitoring, bicycle ergometry, echocardiography and 201Tl chloride myocardial scintigraphy and loading tests (transesophageal cardiac pacing and isometric hand exercise test). The detection rate for silent myocardial ischemia (SI) was found to be 57.1% with Holter monitoring, 52.3% by bicycle ergometry, 62.5% with echocardiography, 100% with myocardial scintigraphy with loading test and 88.8% with that without the loading test. The detection rate for PC was 33.9, 32.0, 64.7, 81.8, and 56.7%, respectively. Higher SI detection rates in postinfarct patients were more frequently observed when echocardiography and myocardial scintigraphy in combination with loading tests in patients with PC without angina. The efficiency of SI detection in patients with various coronary heart disease increases when loading tests are employed. The loading tests in echocardiography and myocardial scintigraphy ensure the most complete detection of SI in postinfarct patients without angina.

Cardiac Pacing, Artificial↗
PubMed1992

[Rheoencephalography as an indicator of disorders of cerebral circulation in patients after myocardial infarction].

As many as 103 men who suffered myocardial infarction were examined for the clinical and functional manifestations of cerebral circulatory disorders as well as for the coronary heart disease at rest and during bicycle ergometry. The majority of the patients with postinfarction cardiosclerosis were found to have changes in the rheoencephalograms, augmenting with physical exercise. Those changes were most pronounced in patients with the clinical manifestations of atherosclerosis of cerebral vessels and in the presence of angina pectoris. The simultaneous recording of the rheoencephalogram and electrocardiogram during bicycle ergometry can be used for an all-round estimation of the reserves of cerebral and coronary circulation in patients suffering from coronary heart disease and elaboration of rehabilitation measures.

Adult↗
PubMed1992

[Comparison of the effects of diltiazem and isradipine in adrenergic beta receptor blockade in patients with stable angina pectoris].

In 20 patients with stable angina II-III according to NYHA by means of ergometry the effect of short-term administration of dilthiazem (90 mg in three doses), placebo and isradipine (5 mg in three doses) in block of beta-receptors of the sympathetic nerve (metipranolol 3 x 10 mg/day) was compared. As compared with placebo, dilthiazem and isradipine retarded significantly the development of stenocardia, reduced the S-T depression in lead V5 and increased the total work output during ergometry. Based on the results of this and previous work (9) it may be stated that concurrent administration of metipranolol reduced the frequency of side-effects of isradipine and prevented the reflex rise of the heart rate following its short-terms administration. The authors conclude that starting treatment of stable angina with isradipine is safer and more effective in combination with metipranolol than when monotherapy is used. Dilthiazem must be administered with metipranolol carefully with regard to possible development of severe bradycardia and its suitable dose should be established by titration.

Adult↗
PubMed1992

Free epinephrine, norepinephrine and dopamine in saliva and plasma of healthy adults.

To investigate whether salivary catecholamine levels reflect short term changes of sympathoadrenal activity, we simultaneously measured plasma and saliva epinephrine, norepinephrine and dopamine concentrations at rest, during bicycle ergometry and during epinephrine infusion in 12 healthy adults, using a radioenzymatic method. Whereas all plasma catecholamines significantly increased during bicycle ergometry and epinephrine infusion, no changes were observed in the salivary catecholamine concentrations and the salivary catecholamine flow rate after stimulation by rhythmic chewing. Moreover, salivary catecholamine concentrations were related neither to heart rate nor to blood pressure. Obviously, free catecholamines are rapidly inactivated by enzymatic degradation, neuronal reuptake or extraneuronal uptake in tissues before they diffuse through the tight junctions into the saliva. Therefore, stimulated saliva catecholamine levels do not reflect short term changes in the activity of the sympathoadrenal nervous system.

Adult↗
PubMed1992

Benefits of an exercise class for elderly women following hip surgery.

A prospective cohort study of a twice weekly exercise programme for six months was undertaken to determine the benefits of an exercise class for 28 elderly women following hip surgery. The effects of the exercise programme were monitored using cycle ergometry. Walking speed was measured on entry and at 3, 6 and 12 months. Twenty-six subjects completed the programme with an overall attendance rate of 88%. Measures of fitness, calculated from cycle ergometry, did not improve significantly apart from test duration. In contrast there was a significant improvement in mean walking speed, with a 50% increase between 0 and 3 months and a further 21% increase between 3 and 6 months. This improvement was maintained at 12 months.

Aged↗
PubMed2004

Altitude decompression sickness at 7620 m following prebreathe enhanced with exercise periods.

INTRODUCTION: Over 80% altitude decompression sickness (DCS) was reported during a 4-h exposure with mild exercise to 7620 m (25,000 ft) without prebreathe. Prebreathe for more than 1 h would be necessary to reduce the DCS risk below 40%. Use of a single period of exercise to enhance prebreathe effectiveness has been successfully tested and used during some U-2 operations. The current tests used multiple exercise sessions to enhance prebreathe (MEEP) as a means of improving denitrogenation efficiency. METHODS: Two MEEP profiles, 30 or 60 min, preceded 4-h exposures to 7620 m with mild, upper-body exercise while breathing 100% oxygen. Resting prebreathe controls were from published studies at the same laboratory. Both MEEP profiles involved 10 min of strenuous dual-cycle ergometry (75% of maximal oxygen uptake) at the beginning of prebreathe. After a 15-min rest period during the 60-min prebreathe, an additional 5 min of strenuous ergometry was performed. Mild exercise was performed during 15 of the last 20 min of both prebreathe profiles. RESULTS: The 60-min MEEP resulted in 25% DCS and the 30-min MEEP 40% DCS (N.S.). The 25% incidence of DCS following the 60-min MEEP profile was significantly less than the 63% DCS following an equal-time, resting prebreathe control. Following the 30-min MEEP, DCS incidence was not greater than the incidence following a 60-min, resting prebreathe control. There was a lower incidence of venous gas emboli during the MEEP exposures than during resting control exposures. CONCLUSION: Denitrogenation with multiple periods of exercise provides a shorter alternative to resting prebreathe for reducing DCS risk during exposure to 7620 m.

Adolescent↗
PubMed2005

Evaluation of cardiac ischaemia in cardiac asymptomatic newly diagnosed untreated patients with primary hypothyroidism.

BACKGROUND: Hypothyroidism is regarded as a risk factor for coronary artery disease. Possible factors involved in this association are hyperlipidaemia and hypertension, both occurring with increased frequency in hypothyroid patients. The aim of our study was to evaluate signs/symptoms of cardiac ischaemia in untreated hypothyroid patients without angina pectoris, since this has never been performed before. METHODS: 51 consecutive cardiac asymptomatic patients (mean age 47, range 22 to 86 years) were studied by dobutamine stress echocardiography and bicycle ergometry. RESULTS: Mean values of body mass index, resting heart rate and blood pressure were 28.5 kg/m2, 68 beats/min and 129/81 mmHg, respectively. Median TSH was 51.9 mU/l, mean FT4 7.3 +/- 2.9 pmol/l (mean +/- SD), TT3 1.6 +/- 0.6 nmol/l and total cholesterol was 5.8 +/- 1.6 mmol/l. None of the patients had symptoms of angina pectoris during dobutamine stress echocardiography or bicycle ergometry and no evidence of myocardial ischaemia was demonstrated. Exercise tolerance, assessed by dividing the maximum achieved workload by the target performance (depending on body height, sex and age), was diminished in 38% of patients, and significantly related to the degree of hypothyroidism. CONCLUSION: No angina pectoris or cardiac ischaemia at exercise or stress was found in cardiac asymptomatic hypothyroid patients. The precise role of hypothyroidism as a risk factor for coronary artery disease should be further elucidated.

Adult↗
PubMed2006

Venous bubble count declines during strenuous exercise after an open sea dive to 30 m.

INTRODUCTION: The effect of post-dive exercise on bubble formation remains controversial, although the current practice of divers and aviators is to avoid strenuous exercise after diving. Previously, we have shown that exercising 24 h before a dive, or during a decompression stop, significantly reduces bubble formation in man. The objective of this study was to determine whether a short period of strenuous post-dive exercise promotes venous bubble formation. METHODS: Seven male military divers performed an open-sea field dive to a maximum depth of 30 m for 30 min. At maximum depth, subjects performed mild underwater fin swimming, followed by standard decompression. Diving was followed by a post-dive exercise session consisting of short, strenuous incremental upright cycle ergometry, up to 85% of maximal oxygen uptake, for about 10 min. Subjects were monitored for venous gas bubbles in the right heart with an echo-imaging system starting 20 min post-dive while in the supine position, during cycle ergometry in the seated upright position, and immediately after exercise in a supine position. RESULTS: The average number of bubbles was 1.5 +/- 1.4 bubbles x cm(-2) 20 min after diving. Changes in posture from supine to seated upright resulted in significant reduction of bubbles to 0.6 +/- 1.3 bubbles x cm(-2) (p = 0.043), with further reduction to 0.2 +/- 0.3 bubbles x cm(-2) at the end of exercise (p = 0.02). No cases of DCS or intra-pulmonary shunt were observed during or following post-dive exercise. DISCUSSION: These results suggest that post-dive strenuous exercise after a single field dive reduces post-dive gas bubble formation in well-trained military divers. Additional findings are needed for normal sports divers.

Adult↗
PubMedDate not supplied

[Correlation between the stress test electrocardiogram and Holter monitoring in asymptomatic myocardial ischemia].

The author separated a group of 22 patients with ischaemic ST depression revealed by Holter-monitoring without symptoms, and compared it with the results obtained by ergonometry testing. Angina pectoris, a key symptom on which were based many epidemiological and clinical studies, could not be considered as a reliable criterion for the evaluation of patients with ischaemic heart disorder. Non-invasive diagnostic methods (ergometry testing and Holter-monitoring) used by the author in this study were particularly significant in the establishment of early diagnostic of cardiac ischaemic disorder and detection of symptomatic and asymptomatic episodes of myocardial ischaemia. Asymptomatic myocardial ischaemia during ergometry testing and Holter-monitoring has equal importance in surviving of patients as ischaemia followed with angina pectoris. For that reason, early ischaemia are of great importance for patients' fate.

Coronary Disease↗