Biomedical subjects

C X Bryant

Publications and source records attributed to C X Bryant.

6 recordsLinked to original sources

PubMed1998

Stepping as an exercise modality for improving fitness and function.

This article describes three stepping modes, summarizes research on stepping in healthy adults and patients with peripheral vascular disease, and discusses clinical implications and directions for future research. Stepping exercise has been shown to increase cardiorespiratory fitness in healthy adults and increase physical function in patients with peripheral vascular disease. Although further research is warranted, stepping exercise has potential value as a nursing intervention to correct alterations in physical mobility in selected populations. Stepping is proposed as an alternative exercise strategy; one which adds variety to exercise routines and may enhance long-term exercise adherence.

Activities of Daily Living↗

PubMed1993

Comparison of treadmill walking and stair climbing over a range of exercise intensities in peripheral vascular occlusive disease.

Although claudication pain and hemodynamic responses to exercise are related to the degree of arterial narrowing in the lower extremities, the nature of these responses to different exercise tasks and intensities is less clear. Thus, the purpose of this study was to compare claudication and hemodynamic responses to graded walking, level walking, and stair climbing over a range of exercise intensities. Ten patients with peripheral vascular occlusive disease performed five tests within each of the three exercise tasks. Similar values of oxygen consumption were obtained among exercise tasks at each intensity (p = ns). Time to onset of claudication pain and to maximal pain were similar among exercise tasks (p = ns), and both demonstrated a curvilinear decrease as intensity increased (p < 0.05). Foot transcutaneous oxygen tension, ankle systolic blood pressure, and ankle/brachial systolic pressure index were also similar among the three exercise tasks (p = ns); however, each decreased linearly as exercise intensity increased (p < 0.05). Thus, in peripheral vascular occlusive disease, the imbalance between oxygen delivery to the exercising lower extremity musculature and the local metabolic demand is similar during different weight-bearing activities. Second, even though the peripheral circulation is progressively impaired with increased exercise intensity, anaerobic metabolism in the ischemic lower extremity musculature may prevent a continual decline in claudication times. The clinical implication is that a more thorough assessment of the functional limitations imposed by claudication pain is not obtained by using different types of weight-bearing exercise tests as opposed to using on ly one type.

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PubMed1993

State anxiety and ambulatory blood pressure following resistance exercise in females.

The purpose of this investigation was to examine state anxiety and blood pressure responses during ambulatory recovery from resistance exercise. Fourteen females completed three separate bouts of resistance exercise in which the sets (N = 3), repetitions (N = 10), exercise type (knee extension, knee flexion, arm pull down, chest press, shoulder press, and abdominal curl), and time (30 min) were held constant, but the intensity was manipulated to equal 40%, 60%, and 80% of the 10-repetition maximum for each exercise. Immediately before as well as 1, 15, 30, 45, 60, 75, 90, 105, and 120 min following the cessation of exercise blood pressure and heart rate were assessed. State anxiety assessments were initiated immediately following blood pressure measurements. The subjects were ambulatory during the post-exercise period, and information about body posture during the cardiovascular assessments was obtained. MANOVAs, ANOVAs, and Tukey tests revealed that post-exercise state anxiety levels were reduced compared with pre-exercise values from 90 to 120 min following exercise. Systolic blood pressure was elevated at 1 and 15 min following the 80% intensity condition, and at 1 min following the 60% intensity condition. It is concluded that during ambulatory recovery from resistance exercise: 1) reductions in state anxiety are realized; and 2) systolic blood pressure, in contrast to what has been shown to occur following aerobic exercise, is not reduced.

Anxiety↗

PubMed1992

Comparison of three progressive exercise protocols in peripheral vascular occlusive disease.

Although claudication pain and hemodynamic responses to exercise are usually clinically assessed via graded treadmill walking, measuring these responses to other commonly performed tasks may yield a more nearly complete evaluation of peripheral vascular occlusive disease. Thus, the purpose of this study was twofold: (1) to determine the reliability of claudication and hemodynamic responses to level walking and stairclimbing and (2) to compare these responses with those obtained with graded walking at similar oxygen consumption. Ten patients with stable claudication symptoms performed graded walking, level walking, and stairclimbing progressive protocols with respective increases in grade, walking speed, and stepping rate on a modified stairclimbing device every two minutes. Similar peak oxygen consumption (13.60 to 14.18 mL/kg/min) was attained with the three protocols (P = NS). Reliability coefficients for the times to onset and to maximal claudication pain during level walking (R = 0.95 and 0.95, respectively) and during stairclimbing (R = 0.92 and 0.82, respectively) were similar to those previously obtained during graded walking. Reliability coefficients for foot transcutaneous oxygen tension during and following level walking (R = 0.78 to 0.96) and stairclimbing (R = 0.65 to 0.98) and for ankle systolic blood pressure following level walking (R = 0.95 to 0.97) and stairclimbing (R = 0.90 to 0.98) were also similar to those previously found with graded walking. Additionally, claudication and hemodynamic measurements were similar among the three exercise protocols. Thus, because graded walking, level walking, and stairclimbing progressive exercise protocols yield reliable and similar information about the hemodynamic severity of peripheral vascular occlusive disease, only one is needed for evaluation.

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PubMedDate not supplied

Stair climbing elicits a lower cardiovascular demand than walking in claudication patients.

PURPOSE: Peripheral arterial disease patients limited by claudication pain frequently have concomitant-cardiovascular problems during exercise, such as hypertension and myocardial ischemia. Thus, for testing and rehabilitation purposes, exercise which elicits lower heart rate and blood pressure at a given metabolic intensity would be preferred over a more demanding task. The purpose of this study was to compare the cardiovascular responses of claudication patients during walking and stair climbing at a similar level of oxygen uptake. METHODS: Ten patients limited by claudication pain performed treadmill walking and stair climbing tests. RESULTS: Oxygen uptake was similar (P > .05) during walking and stair climbing (13.7 vs. 13.5 mL/kg/min, respectively). The times to onset and to maximal claudication pain, as well as the peripheral hemodynamic measurements of ankle systolic pressure, ankle-to-brachial systolic pressure index, and foot transcutaneous oxygen tension were also similar between the two tests (P > .05). However, heart rate, systolic pressure, diastolic pressure, mean arterial pressure, and rate-pressure product values were lower during and following stair climbing than compared to walking (P < .05). CONCLUSION: Stair climbing may offer an advantage over treadmill walking for claudication patients because similar metabolic, claudication, and peripheral hemodynamic measurements are obtained with concomitantly less demand placed on the cardiovascular system. The stair climbing test was well tolerated and safely performed by each patient.

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PubMedDate not supplied

Functional improvements following StairMaster vs. treadmill exercise training for patients with intermittent claudication.

BACKGROUND: Although there have been many studies showing that exercise training is beneficial for patients with peripheral vascular occlusive disease (PVOD), there is little research comparing various modes of training. Previous studies showed that exercise tests performed on a StairMaster (StairMaster Sports/Medical Products, Kirkland, WA) produce responses similar to those elicited by treadmill tests. The purpose of this study was to compare these modes of exercise in a training program for patients with PVOD. METHODS: Of the 23 eligible individuals who began the exercise program, 11 did not complete the regimen due to various complications. Thus, 12 patients were randomly assigned to train for 12 weeks on either a StairMaster (n = 6) or a treadmill (n = 6). Patients underwent progressive and single-stage exercise tests on both exercise modalities before and after training. RESULTS: Mean exercise time before the onset of claudication pain for all tests rose significantly after training (P <.01), but greater improvements were seen on the specific training apparatus (i.e., treadmill training resulted in improvement in treadmill exercise performance with less improvement noted when tested on the StairMaster, and vice versa). Exercise time to maximal pain increased for the training apparatus only (P <.01). There were no changes in foot transcutaneous oxygen tension or the ankle-brachial blood pressure index. CONCLUSIONS: Both StairMaster and treadmill training improve the exercise capacity of PVOD patients. The training effect is most apparent for the specific training apparatus, but there is some cross-over improvement to the other exercise modality. Thus, StairMaster training is appropriate and can be part of the exercise prescription for treatment of these patients.

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