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PubMed2000

Regular aerobic exercise during pregnancy.

BACKGROUND: Physiological responses of the fetus (especially increase in heart rate) to single, brief bouts of maternal exercise have been documented frequently. OBJECTIVES: The objective of this review was to assess the effects of advising healthy pregnant women to engage in regular (at least two to three times per week) aerobic exercise on physical fitness, labour and delivery, and the outcome of pregnancy. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register was searched. SELECTION CRITERIA: Acceptably controlled comparisons of prescribed aerobic exercise programmes. DATA COLLECTION AND ANALYSIS: One reviewer assessed trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS: Five trials involving 142 women were included. The trials were not of high methodologic quality. Three trials reported significant improvement in physical fitness in the exercise group, although differences in measures used to assess fetuses prevent a quantitative pooling of results. Two small trials reported nonsignificant results on pregnancy outcomes, but apart from a reassurring absence of effect on mean gestational age [+0.3 (-0.2 to +0.9) weeks], these results allow exclusion of only extremely large effects. REVIEWER'S CONCLUSIONS: Regular aerobic exercise during pregnancy appears to improve (or maintain) physical fitness. Available data are insufficient to exclude important risks or benefits for the mother or infant.

Exercise↗
PubMed2000

Worsening of left ventricular diastolic dysfunction during exercise causes decreased exercise tolerance in hypertension.

BACKGROUND: Exercise tolerance is reduced in hypertension. Hypertension affects left ventricular (LV) diastolic filling by causing abnormal relaxation and decreasing compliance. HYPOTHESIS: This study was designed to determine whether worsening of LV diastolic dysfunction during exercise causes decreased exercise tolerance in hypertension. METHODS: Left ventricular diastolic filling parameters were examined at mitral valve by Doppler echocardiography at rest and at peak exercise in hypertensive patients and were compared with those of age- and gender-matched normotensive individuals. Treadmill exercise stress test was performed according to the Bruce protocol and the exercise time was recorded. RESULTS: Exercise time was significantly shorter in the hypertensive group than that in the normotensive group (320 +/- 29 vs. 446 +/- 38 s, p 0.03). The hypertensive group demonstrated abnormal relaxation pattern of diastolic mitral inflow at rest, which became pseudonormal at peak exercise (E/A velocity ratio, rest 0.86 +/- 0.06 vs. exercise 1.19 +/- 0.09, p < 0.001). The diastolic mitral inflow pattern remained normal at peak exercise in the normotensive group. The deceleration time and the pressure half time of early mitral inflow at peak exercise were significantly shorter in the hypertensive group than those in the normotensive group (deceleration time, 182 +/- 20 vs. 238 +/- 22 ms, p 0.02: pressure half time, 54 +/- 5 vs. 70 +/- 12 ms, p 0.01). CONCLUSIONS: This study demonstrates that reduced exercise tolerance in hypertension is associated with worsening of diastolic dysfunction during exercise consistent with an increase in left atrial pressure.

Compliance↗
PubMed2005

Protective effect of high diastolic blood pressure during exercise against exercise-induced myocardial ischemia.

BACKGROUND: Hypertension is one of the risk factors for coronary artery disease. However, because most coronary blood flow to the left ventricle occurs during diastole, high diastolic blood pressure during exercise may have a protective effect against exercise-induced myocardial ischemia. The aim of the present study was to test this hypothesis. METHODS AND RESULTS: We identified 469 patients with sinus rhythm and known or suspected coronary artery disease who underwent exercise thallium-201 myocardial single-photon emission computed tomography and coronary arteriography. High diastolic blood pressure during exercise was defined as diastolic blood pressure at peak exercise > or = 90 mm Hg. There was no significant difference in medications, number of diseased vessels, or Gensini score between patients with high (n = 228) and normal (n = 241) diastolic blood pressure during exercise, whereas patients with high diastolic blood pressure during exercise exhibited a higher pressure-rate product during exercise than patients with normal diastolic blood pressure during exercise. The reversibility score on thallium-201 myocardial scan was significantly smaller in patients with high diastolic blood pressure during exercise than in patients with normal diastolic blood pressure during exercise (P = .021). CONCLUSIONS: High diastolic blood pressure during exercise has a potential protective effect against exercise-induced ischemia, although the mechanism of such effects remains to be determined.

Adult↗
PubMed1997

Relation of changes in left ventricular peak filling rate during exercise to exercise performance in systemic hypertension and in healed myocardial infarction.

Patients with systemic hypertension and coronary artery disease (CAD) often manifest abnormalities at rest in left ventricular (LV) diastolic function and reduced exercise tolerance. It is possible that abnormalities in filling persist during exercise and are partially related to abnormal exercise tolerance. We examined rest and exercise peak filling rate (PFR) to determine if changes in PFR during exercise influence exercise performance. We studied 20 patients with systemic hypertension who had no evidence of CAD (negative thallium-201 stress imaging) and 15 patients with prior myocardial infarction, preserved ejection fraction, and no ischemia by thallium-201 stress imaging. Results were compared with 20 normal subjects. All 55 subjects had rest and exercise radionuclide angiograms Peak workload, exercise time, and LV ejection fraction were reduced in subjects with CAD (57 +/- 24 W, 7.41 +/- 2.91 min, and 60 +/- 9%) compared with subjects with hypertension (72 +/- 21 W, 9.69 +/- 3.03 min, and 70 +/- 6%, p <0.05) and controls (80 +/- 30 W, 10.82 +/- 3.50 min, and 67 +/- 6%, p <0.05). PFR at rest was reduced in CAD subjects (2.40 +/- 0.70 end-diastolic volume per second [EDV/s]) compared with those with hypertension (2.89 +/- 0.70 EDV/s, p <0.02) and controls (3.23 +/- 0.52 EDV/s, p <0.0002). The increments in PFR during exercise were reduced in CAD patients (+1.76 +/- 0.95 EDV/s) compared with hypertensive subjects (+2.93 +/- 1.7 EDV/s) and controls (+3.22 +/- 1.4 EDV/s, p <0.05). The increment in PFR during exercise was related to exercise performance (r = 0.49, p <0.0002). These findings suggest that alterations in LV diastolic filling during exercise are important determinants of exercise performance.

Case-Control Studies↗
PubMed1989

Exercise tolerance and cardiorespiratory response to exercise before and after the Fontan operation.

To determine the effect of the Fontan operation on exercise tolerance and cardiorespiratory response to exercise, we compared the preoperative and postoperative responses to graded exercise to maximal effort in 20 patients who underwent a modified Fontan procedure. The mean interval between preoperative and postoperative exercise testing was 1.8 years. Postoperatively, total work performed, duration of exercise, and maximal oxygen uptake were significantly increased. Although cardiac output increased during exercise, the response was subnormal, and stroke volume was unchanged. The heart rate and systolic blood pressure during maximal exercise were not significantly changed from preoperative values, but the diastolic blood pressures during rest and maximal exercise were significantly increased postoperatively. Systemic arterial blood oxygen saturation increased after the modified Fontan operation, but during exercise, a mild but significant desaturation occurred (93% compared with 90%). The ventilatory equivalent for oxygen decreased toward normal during exercise. The respiratory rate and oxygen consumption during resting remained unchanged from preoperative values. For this subset of patients, these data indicate that exercise tolerance improves, cardiac output and stroke volume responses to exercise are subnormal, and ventilatory response to exercise decreases toward normal after the modified Fontan operation.

Adolescent↗
PubMed1997

Pre-exercise carbohydrate meal and endurance running capacity when carbohydrates are ingested during exercise.

This study examined whether combining a pre-exercise carbohydrate meal with the ingestion of a carbohydrate-electrolyte solution during exercise is better in improving endurance running capacity than a carbohydrate-electrolyte solution alone. Ten men completed three treadmill runs at 70% VO2max to exhaustion. They consumed 1.) a carbohydrate meal three hours before exercise and a carbohydrate-electrolyte solution during exercise (M + C), or 2.) a liquid placebo three hours before exercise and the carbohydrate-electrolyte solution during exercise (P + C), or 3.) a placebo three hours before exercise and placebo during exercise (P + P). When the meal was consumed (M + C) serum insulin concentrations were higher at the start of exercise, and carbohydrate oxidation rates were higher during the first 60 min of exercise compared with the values found in the P + C and P + P trials (p < 0.01). Exercise time was longer in the M + C (147.4+/-9.6 min) compared with the P + C (125.3+/-7 min) (p < 0.01). Also, exercise time was longer in M + C and P + C compared with the P + P (115.1+/-7.6 min) (p < 0.01 and p < 0.05 respectively). These results indicate that the combination of a pre-exercise carbohydrate meal and a carbohydrate-electrolyte solution further improves endurance running capacity than the carbohydrate-electrolyte solution alone.

Adult↗
PubMed2006

Effects of physical exercise on quality of life, exercise capacity and pulmonary function in children with asthma.

OBJECTIVE: To investigate the effects of regular submaximal exercise on quality of life, exercise capacity and pulmonary function in asthmatic children. PATIENTS AND METHODS: Sixty-two children with mild-moderate asthma (mean age 10.4 (SD 2.1) years) were randomly allocated into exercise and control groups. The exercise group underwent a moderately intensive basketball training program for 8 weeks. A home respiratory exercise program was advised to both groups. Pediatric Asthma Quality of Life Questionnaire (PAQLQ) was used for the evaluation of activity limitation, symptoms and emotional functions. Exercise capacity was evaluated through the physical work capacity (PWC 170 test) on a cycle ergometer and 6-minute walk test. Spirometric tests were also performed and medication and symptom scores were recorded. RESULTS: Although PAQLQ scores improved in both groups, the improvement in the exercise group was significantly higher. The exercise group performed better in the PWC 170 and 6-minute walk tests, whereas no improvement was detected in the control group at the end of the trial. Medication scores improved in both groups, but symptom scores improved only in the exercise group. No significant changes were detected in pulmonary function in either group, except for peak expiratory flow values in the exercise group. CONCLUSION: Eight weeks of regular submaximal exercise has beneficial effects on quality of life and exercise capacity in children with asthma. Submaximal basketball training is an effective alternative exercise program for asthmatic children.

Adolescent↗
PubMed2006

Effects of home-based cardiac exercise program on the exercise tolerance, serum lipid values and self-efficacy of coronary patients.

BACKGROUND: Exercise-based cardiac rehabilitation improves exercise capacity and reduces cardiac risk factors. The purpose of this pilot study was to examine the effects of a home-based cardiac exercise program (HBCEP) on exercise tolerance, serum lipids, and self-efficacy in coronary heart disease patients in Turkey. Self-efficacy theory provided the framework for this study's intervention. DESIGN: The study design was a pre-test and post-test experimental, randomized assignment. METHOD: The study included 30 participants in a home-based cardiac exercise program (HBCEP; mean age=54.7+/-7.8) and 30 in control (C; mean age=52.7+/-6.5). The Phase II cardiac exercise program included three 45-60-min sessions per week for 12 weeks, and the enhancement of self-efficacy through educational sessions and the use of goal setting, modelling, and physiological feedback strategies. Both groups were comparable in their medical regimen, exercise capacity, and other measured variables pre-intervention. At baseline and after 12 weeks, exercise capacity was evaluated by exercise testing using the Bruce Protocol, self-efficacy was measured with the Cardiac Exercise Self Efficacy Index, and serum lipid values were measured. RESULTS: At the completion of the 12-week exercise program, the exercise capacity (P<0.001), total cholesterol (P=0.004), triglycerides (P=0.048), high-density lipoprotein-cholesterol (P=0.001), low-density lipoprotein-cholesterol (P=0.039), and self-efficacy (P<0.001) of the HBCEP Group were significantly improved compared to the control group. CONCLUSION: These results suggest that a first-time HBCEP in Turkey can be successful in having patients adhere to a prescribed exercise program and reduce risk factors. Enhanced self-efficacy may have mediated the improved behavioural outcomes.

Coronary Disease↗
PubMed2005

How should COPD patients exercise during respiratory rehabilitation? Comparison of exercise modalities and intensities to treat skeletal muscle dysfunction.

BACKGROUND: Physical exercise is an important component of respiratory rehabilitation because it reverses skeletal muscle dysfunction, a clinically important manifestation of COPD associated with reduced health-related quality of life (HRQL) and survival. However, there is controversy regarding the components of the optimal exercise protocol. A study was undertaken to systematically evaluate and summarise randomised controlled trials (RCTs) comparing different exercise protocols for COPD patients. METHODS: Six electronic databases, congress proceedings and bibliographies of included studies were searched without imposing language restrictions. Two reviewers independently screened all records and extracted data on study samples, interventions and methodological characteristics of included studies. RESULTS: The methodological quality of the 15 included RCTs was low to moderate. Strength exercise led to larger improvements of HRQL than endurance exercise (weighted mean difference for Chronic Respiratory Questionnaire 0.27, 95% CI 0.02 to 0.52). Interval exercise seems to be of similar effectiveness as continuous exercise, but there are few data on clinically relevant outcomes. One small RCT which included patients with mild COPD compared the effect of high and low intensity exercise (at 80% and 40% of the maximum exercise capacity, respectively) and found larger physiological training effects from high intensity exercise. CONCLUSIONS: Strength exercise should be routinely incorporated in respiratory rehabilitation. There is insufficient evidence to recommend high intensity exercise for COPD patients and investigators should conduct larger high quality trials to evaluate exercise intensities in patients with moderate to severe COPD.

Exercise Therapy↗
PubMedDate not supplied

Effects of enalapril on the exercise capacity and neurohumoral factors during exercise in patients with chronic heart failure.

The effects of enalapril on exercise capacity and neurohumoral factors during exercise were evaluated in 10 patients with heart failure. Echocardiograms and exercise testing with expired gas analysis were performed before and after enalapril. Blood samples were obtained before and after exercise. Both ejection fraction and percent fractional shortening increased with enalapril (p < 0.05). The anaerobic threshold and peak VO2 did not change with enalapril. Epinephrine and norepinephrine levels at peak exercise decreased with enalapril (p < 0.1). Plasma renin both at rest and at peak exercise increased with enalapril (p < 0.1). Angiotensin II was lower after enalapril both at rest and at peak exercise (p < 0.1 and p < 0.05, respectively). Aldosterone was lower after enalapril both at rest and at peak exercise (p < 0.05). Atrial natriuretic peptide (ANP) was lower after enalapril both at rest and at peak exercise. There was no significant correlations between peak VO2 and changes in neurohumoral factors before and after enalapril during exercise. In conclusion, neurohumoral changes with enalapril occurred during exercise even if exercise capacity did not improve. Moreover, the improvement of cardiac function at rest and neurohumoral factors with enalapril did not lead to a change of exercise capacity.

Aged↗
PubMed2004

3-min step test and treadmill exercise for evaluating exercise-induced asthma.

A simple exercise test would be useful for detecting exercise-induced asthma, a common problem in asthmatic children. The current study compared the 3-min step test with treadmill exercise for evaluating exercise-induced asthma in asthmatic children and assessed whether responses to both tests are influenced by baseline lung function and habitual physical activity. A series of 154 asthmatic children (84 male children; mean age 12.9 +/- 0.9 yrs) underwent a 3-min step-test and treadmill testing on different days within a week at least 24 h apart. Before both tests each subject did spirometry to obtain the baseline forced expiratory volume in one second (FEV1). After both exercise challenges all subjects did serial spirometry and the lowest FEV1 recorded over time was used to calculate the fall in FEV1 expressed as a percentage of the measured pre-exercise (baseline) value (% fall in FEV1) and the area above the FEV1 curve (AAC0-30 min) expressed as a percentage of the pre-exercise value. Changes in both exercise variables were also analysed in percentile subgroups defined by questionnaire answers on habitual physical activity in hours. The mean % fall in FEV1 was significantly higher for treadmill exercise than for the step test (15.0 +/- 7.5 versus 11.7 +/- 5.9); and the AAC0-30 min was larger for treadmill than for the step test (-261.6 +/- 139.9% versus -197.3 +/- 105.0% min). In all subgroups defined by habitual physical activity the mean % fall in FEV1 decreased more after treadmill exercise than after the step test. After step test and treadmill exercise no significant correlation was found between % fall in FEV1 and baseline lung function, or between % fall in FEV1 among groups defined by habitual physical activity. Although the 3-min step test yields a lower % fall in forced expiratory volume in one second (FEV1) and a lower value of the area above the FEV1 curve than treadmill testing, it is a quick, economical, reproducible and portable alternative procedure for identifying exercise-induced asthma in outpatients and epidemiological studies. Baseline lung function and habitual physical activity have no influence on the amount or duration of exercise-induced asthma.

Adolescent↗
PubMed1999

Significance of exercise QT dispersion in patients with coronary artery disease who do not have exercise-induced ischemic ST-segment changes.

The poor sensitivity and the poor predictive value of ST-segment depression have limited the usefulness of the exercise electrocardiogram (ECG) in the diagnosis and evaluation of coronary artery disease (CAD). The QT dispersion (QTD), recorded as the difference between maximal and minimal QT intervals on a 12-lead exercise ECG, is sensitive to myocardial ischemia and may improve the accuracy of exercise testing in patients with CAD who do not show an ST-segment depression. Exercise ECGs were analyzed in 50 subjects who had undergone coronary angiography for clinical indications. None of them showed an ST-segment depression during or after exercise: There were 25 patients with significant coronary artery stenosis and 25 without significant stenosis. The QTD measured before, immediately after, and 1 min after exercise was similar in the 2 groups. The QTD at 3 and 5 min after exercise was significantly greater in patients with CAD than in the controls, and the most marked difference in QTD was observed at 3 min after exercise. A QTD at 3 min after exercise of >60 ms had a sensitivity of 80% and specificity of 88% regarding the diagnosis of CAD. When a deltaQTD (post-exercise QTD minus QTD at rest) at 3 min after exercise of >0 ms was added to a QTD of >60 ms as a condition for positivity, the specificity increased to 96%. QTD measured at 3 min after exercise increases the accuracy of exercise testing in patients with CAD who do not show an ST-segment depression.

Adult↗
PubMed2003

Effects of prior exercise on metabolic and gas exchange responses to exercise.

'Warm-up' activity is almost universally performed by athletes prior to their participation in training or competition. However, relatively little is known about the optimal intensity and duration for such exercise, or about the potential mechanisms primed by warm-up that might enhance performance. Recent studies demonstrate that vigorous warm-up exercise that normally results in an elevated blood and presumably muscle lactate concentration has the potential to increase the aerobic energy turnover in subsequent high-intensity exercise. The reduced oxygen deficit is associated with a reduction in both the depletion of the intramuscular phosphocreatine stores and the rate at which lactic acid is produced. Furthermore, the oxygen uptake 'slow component' that develops during high-intensity, ostensibly submaximal, exercise is attenuated. These factors would be hypothesised to predispose to increased exercise tolerance. Interestingly, the elevation of muscle temperature by prior exercise does not appear to be implicated in the altered metabolic and gas exchange responses observed during subsequent exercise. The physiological mechanism(s) that limit the rate and the extent to which muscle oxygen uptake increases following the onset of exercise, and which are apparently altered by the performance of prior heavy exercise, are debated. However, these mechanisms could include oxygen availability, enzyme activity and/or availability of metabolic substrate, and motor unit recruitment patterns. Irrespective of the nature of the control mechanisms that are influenced, 'priming' exercise has the potential to significantly enhance exercise tolerance and athletic performance. The optimal combination of the intensity, duration and mode of 'warm-up' exercise, and the recovery period allowed before the criterion exercise challenge, remain to be determined.

Acidosis, Lactic↗
PubMed1996

Effects of exercise training on left ventricular filling at rest and during exercise in patients with ischemic cardiomyopathy and severe left ventricular systolic dysfunction.

The aim of our study was to determine whether exercise training can augment left ventricular diastolic filling at rest and during exercise in patients with ischemic cardiomyopathy and whether any correlation exists between changes in diastolic filling and changes in exercise tolerance. Forty-three consecutive patients (mean age, 54 +/- 8 years) with ischemic cardiomyopathy and severe left ventricular systolic dysfunction (election fraction <30%) were studied. Group T (29 patients) was exercised on a cycle ergometer 3 times a week for 8 weeks at 60% of peak oxygen uptake. Group C (14 patients) was not exercised. All patients underwent an exercise test and a radionuclide ventriculography at baseline and after 8 weeks. At the end, no changes were found in group C. In group T, exercise training increased peak oxygen uptake (1 5%; p < 0.0001), work rate (1 5%; p < 0.005), peak early filling rate (10%; p < 0.02), and peak filling rate (1 1%; p < 0.03). At submaximal exercise, peak filling rate increased at all matched heart rates. The increase in peak filling rate was correlated with the increase in cardiac index (r= 0.72; p < 0.0001) at peak exercise. The independent predictors of the increase in peak oxygen uptake were changes in work capacity and peak early filling rate. The data demonstrate that exercise training can improve the exercise capacity of patients with ischemic cardiomyopathy and severe systolic-dysfunction. The increase in early diastolic filling at rest and during exercise may contribute to the improvement in peak oxygen uptake.

Cardiac Output↗
PubMed1990

Exercise in type 1 (insulin-dependent) diabetic patients treated with continuous subcutaneous insulin infusion. Prevention of exercise induced hypoglycaemia.

The study was performed to investigate the effects of mild to moderate exercise on blood glucose levels, metabolite concentrations and responses of counterregulatory hormones in tightly controlled Type 1 (insulin-dependent) diabetic patients treated by continuous subcutaneous insulin infusion, and to quantify the measures necessary to prevent acute and late exercise-induced hypoglycaemia. Seven male patients started a 60 min exercise period 90 min after an insulin bolus and a standard breakfast; they were monitored during a post-exercise resting period of 5 h 30 min. Different basal and premeal insulin infusion rates were applied. (Near)normoglycaemia prevailed throughout the study during the control protocol when the subjects did not exercise and received their usual insulin dose. When they exercised without changing the insulin dose, four patients were forced to stop due to hypoglycaemia. This effect of exercise could be attenuated but not completely avoided if the basal infusion rate of insulin was discontinued during the exercise period. The pronounced increase in catecholamine and growth hormone concentrations during exercise were not sufficient to prevent hypoglycaemic reactions. Hypoglycaemia during exercise could only be prevented when the premeal insulin bolus was reduced by 50% in addition to the discontinuation of the basal insulin infusion during exercise. In order to reduce late hypoglycaemic reactions after exercise the best measure proved to be a reduction of the basal insulin infusion rate by 25% during post-exercise hours. Administration of only 50% of the basal insulin infusion rate during this time was associated with blood glucose levels being raised up to 8 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Heart rate and oxygen uptake response to exercise in children with low peak exercise heart rate.

Normal children achieve the same increase of oxygen uptake (VO2) in response to exercise even though resting and submaximal exercise heart rates vary greatly as a function of age, body size and physical conditioning. To determine whether the VO2 response to exercise is altered when heart rate is significantly reduced by heart disease, we compared 78 children who achieved a peak exercise heart rate of less than or equal to 150 beats/min to 201 controls of similar body size and normal peak exercise heart rates of greater than or equal to 180 beats/min. All performed incremental (16.4 Watts/min) maximal cycle exercise. Separate analysis of males and females included heart rate, power (kg-m/min, Watts/kg), VO2 (ml/min, ml/min per kg), O2 pulse (VO2/heart beat), VE (l/min) and R (VCO2/VO2) at rest and during the 1st, 4th and last minute of exercise. Patients with low peak exercise heart rates had also lower resting submaximal exercise heart rates than controls. VO2 at comparable exercise levels did not differ from controls and consequently O2 pulse was greater in the patients than controls at rest and at all levels of exercise. A consistent gender difference was only found in controls where males achieved a higher VO2 and lower heart rates at comparable levels of exercise. The data show a normal exercise VO2 despite significantly lower heart rates. These findings cannot be explained by an increased arteriovenous difference alone and suggest that the patients retained the ability to effectively modulate stroke volume.

Adolescent↗
PubMed1998

Effect of exercise-induced muscle damage on the blood lactate response to incremental exercise in humans.

Eccentric muscle actions are known to induce temporary muscle damage, delayed onset muscle soreness (DOMS) and muscle weakness that may persist for several days. The purpose of the present study was to determine whether DOMS-inducing exercise affects blood lactate responses to subsequent incremental dynamic exercise. Physiological and metabolic responses to a standardised incremental exercise task were measured two days after the performance of an eccentric exercise bout or in a control (no prior exercise) condition. Ten healthy recreationally active subjects (9 male, 1 female), aged 20 (SD 1) years performed repeated eccentric muscle actions during 40 min of bench stepping (knee high step; 15 steps x min[-1]). Two days after the eccentric exercise, while the subjects experienced DOMS, they cycled on a basket loaded cycle ergometer at a starting work rate of 150 W, with increments of 50 W every 2 min until fatigue. The order of the preceding treatments (eccentric exercise or control) was randomised and the treatments were carried out 2 weeks apart. Two days after the eccentric exercise, all subjects reported leg muscle soreness and exhibited elevated levels of plasma creatine kinase activity (P < 0.05). Endurance time and peak VO2 during cycling were unaffected by the prior eccentric exercise. Minute volume, respiratory exchange ratio and heart rate responses were similar but venous blood lactate concentration was higher (P < 0.05) during cycling after eccentric exercise compared with the control condition. Peak blood lactate concentration, observed at 2 min post-exercise was also higher [12.6 (SD 1.4) vs 10.9 SD (1.3) mM; P < 0.01]. The higher blood lactate concentration during cycling exercise after prior eccentric exercise may be attributable to an increased rate of glycogenolysis possibly arising from an increased recruitment of Type II muscle fibres. It follows that determination of lactate thresholds for the purpose of fitness assessment in subjects experiencing DOMS is not appropriate.

Adult↗
PubMed2004

Functional tasks exercise versus resistance exercise to improve daily function in older women: a feasibility study.

OBJECTIVE: To evaluate the feasibility of a new functional tasks exercise program, designed to improve functional performance of community-dwelling older women, by comparing it with a resistance exercise program. DESIGN: A 12-week, randomized, single-blind pilot study. SETTING: A community leisure center. PARTICIPANTS: Twenty-four community-dwelling, medically stable women (mean age, 74.6+/-4.8 y) were randomized to the functional tasks exercises (function group) or the resistance exercises (resistance group). Three participants withdrew from the study. INTERVENTIONS: Exercises were given 3 times weekly for 12 weeks. The functional tasks exercise program aimed to improve daily tasks in the domains first affected in older adults, whereas the resistance exercise program focused on strengthening the muscle groups that are important for functional performance. MAIN OUTCOME MEASURES: Participant satisfaction with the exercises, Assessment of Daily Activity Performance (ADAP), and, as a secondary outcome, muscle strength and power. RESULTS: Exercise adherence was 81% in the function group and 90% in the resistance group. Participants reported greater satisfaction with the resistance exercises than with the functional exercises. The ADAP total score improved with time (P =.001; mean change function group, 7.5 U; 95% confidence interval [CI], 2.1-12.8; resistance group, 2.8 U, 95% CI, -0.4 to 5.9), as did isometric knee extensor strength (P =.001; mean change function group, 6.4%; 95% CI, -1.6 to 14.5; resistance group, 14.4%; 95% CI, 6.4-22.2). Testing for differences in outcomes between the 2 groups showed no statistically significant differences. CONCLUSIONS: The functional tasks exercise program is feasible and shows promise of being more effective for functional performance than a resistance exercise program. A randomized controlled trial with a larger sample size is needed to test the difference between the 2 programs.

Activities of Daily Living↗