[Physiotherapy in severe respiratory insufficiency].
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Breathing Exercises↗
Biomedical subjects
E Servera
Publications and source records attributed to E Servera.
VO2 max during progressive and constant bicycle exercise in patients with chronic obstructive lung disease.
Oxygen consumption (VO2) was studied during two maximal exercise tests (MET) performed on a cycle ergometer: one progressive (P-MET), the other constant (C-MET) in 6 normal men and in 21 male outpatients with chronic obstructive lung disease (COLD) from 34 to 64 years old. All of them were working. Clinical, spirographic (VC, FEV1) and cardiorespiratory parameters (VE, VO2, VCO2, f and RR) were measured. Arterial lactate was measured in the P-MET. In all patients the FEV1/VC ratio was lower than 60%. No adverse clinical effects were observed in both MET. In 19% of patients (n = 4) the VO2 was lower in the P-MET by about 20% than that observed in the C-MET. The execution of a second P-MET in these 4 patients showed values superimposed on those obtained with C-MET. Although the range of interindividual variability was considerable (VO2 0.95-2.5 l X min-1, and VE from 24 to 104 l X min-1), the comparison between the two MET showed a high correlation for VO2 (r = 0.989), VE (r = 0.969) and HR (r = 0.983) on the two occasions. A 'leveling off' of VO2 was observed in 15 patients in the P-MET. In 81% of patients VO2 max was obtained by the criteria of maximal HR (220 - age), respiratory quotient greater than 1.0, and arterial lactate greater than 8 mEq X l-1. In patients in which these criteria were not met only the reproducibility of the VO2 obtained in both the P-MET and the C-MET indicated that the maximal VO2 for these 4 patients had been reached.
Adult↗
Square-wave endurance exercise test (SWEET) for training and assessment in trained and untrained subjects. I. Description and cardiorespiratory responses.
A new 45 min Square-Wave Endurance Exercise Test (SWEET) performed on a cycle ergometer and designed for endurance training was studied in 43 normal subjects: Untrained (U), twelve women and seven men and Trained (T), eight women and 16 men. Among them seven were elite sportsmen (E). Preliminary measurements were made of VO2 max by constant power and Maximal Tolerated Power (MTP) in a progressive test (+ 30 W/3 min). To the SWEET's base, established as a % of individual MTP, a peak of 1 min at MTP was added every 5 minutes. Maximum Intensity of Endurance during the SWEET (MIE45) is defined by both maximal heart rate (HR) at the end of the test and the impossibility of maintaining 5% above the percent MTP of the MIE45 for 45 min. Exhaustion was reached at the end of the MIE45, which could be expressed as % MTP, as total energy expenditure (TEE) in liters of O2, or as total mechanical work (TMW) in kiloJoules per kg of weight (kJ . kg-1). VE, VCO2, VO2 and HR were continuously measured. VO2 max, TMW and % MTP were significantly higher in T than in U subjects. The E subjects show the highest values of those parameters. TMW and TEE were well correlated (r = 0.992, p less than 0.001, n = 43) indicating good efficiency. TMW in T (r = 0.453) and in E men (r = 0.442) were however less well correlated to the VO2 max. MIE45 therefore gives different information in the evaluation of "endurance capacity" at the time of measurement than that provided by VO2 max. Because of the high TEE per session it could be useful for endurance training of T and U subjects.
Carbon Dioxide↗
Square-wave endurance exercise test (SWEET) for training and assessment in trained and untrained subjects. II. Blood gases and acid-base balance.
In order to obtain information about physiological and homeostasic responses at the maximal Intensity of Endurance of the 45 min "Square-Wave Endurance Exercise Test" (MIE45), three arterial blood samples were taken: (a) at rest; (b) at the 45th min of the SWEET; (c) after 15 min of recovery, to measure paO2, paCO2, [H+], [Hb], and [lactate] in 14 normal male subjects: four trained (T) six well trained (WT) and four others untrained (U). Total mechanical work (TMW) corresponding to MIE45 was significantly higher (mean +/- SEM) respectively in WT (9.22 +/- 0.65 kJ . kg-1, p less than 0.001), than in T (7.17 +/- 0.18 kJ . kg-1, p less than 0.01) and U subjects (4.44 +/- 0.36, p less than 0.001). Because of this the lactate level, which rose significantly during exercise, differed between U and WT subjects (p less than 0.05). In spite of the exhaustive character of the MIE45, [H+] and paO2 remained within the range of normal values. These results suggest that trained and untrained subjects can be trained with the exhausting MIE45 exercise while maintaining a constant [H+] and paO2 at the 45th min of exercise.
Acid-Base Equilibrium↗
VO2 max during progressive and constant bicycle exercise in sedentary men and women.
VO2 max, as obtained by five cycloergometric test protocols, was studied in 14 normal sedentary subjects: seven women (from 21--35 years) and seven men (from 21--48 years) who carried out four (n = 14) or five (n = 8) of the following exercise programmes: triangular tests, which consist of increasing the load (1) 20 W/min; (2) 30 W/3 min, rectangular tests at constant load; (3) the highest load which the subject could maintain for about 10 min (MSP + 20 W); (4) maximal supported power (MSP) during 20 min; (5) trapezoidal test, consisting of a rectangular exercise of 40 W (10 min), followed test no. 2. Exercises were performed on a cycle ergometer, while VE, VO2, VCO2, f and fH were continuously measured with an open circuit system. In women, the VO2 max (mean +/- SEM) was lower (36.5 +/- 2.1 ml . kg-1 . min-1) than in men (48.7 +/- 3.6 ml . kg-1 . min-1). The highest ventilation rate observed during exercise for the whole group (VE = 101 + 13 l . min-1) was always lower than the maximal voluntary ventilation (MVV = 144 +/- 131 . min-1, p less than 0.001). VO2 max strongly correlated with lean body weight, VC, FEV1, and MVV. In spite of the significant differences between the maximal load level sustained with the first three tests, the VO2 max values were not significantly different. Moreover, there exists an excellent correlation between them. It appears that neither the absolute load sustained in the tests, nor the duration nor intensity of the submaximal load which preceded the maximal level (tests 1, 2, and 5), influence the value of VO2 max.
Adult↗
Hypercapnia during maximal exercise in patients with chronic airflow obstruction.
The pattern of breathing during maximal oxygen uptake (Vo2max) was studied in 26 patients with chronic airflow obstruction (CAO), in whom the vital capacity (VC), forced expiratory volume in 1 s (FEV1) and residual volume (RV) were measured. The patients performed, on a cycle ergometer, in a sitting position, a submaximal (A) and a maximal (B) exercise in a single session during which three arterial blood samples (pH, PaCO2, PaO2, lactate) were taken: the first at rest, the second at the 10th min of steady-state 40 W exercise, and the third at maximal VO2. VE, VCO2, VO2, respiratory rate (RR) and VT were measured with an open circuit. Physiological dead space (VD) and alveolar to arterial O2 pressure differences (A-aPO2) were computed. According to the measured value of PaCO2 at maximal exercise, the patients were divided in non-hypercapnic (NH; PaCO2 less than 44 mmHg; n = 17) and hypercapnic (H; PaCO2 greater than 44 mmHg; n = 9) groups, and were compared with a group of normal subjects (N; n = 11). At rest, VC, FEV1, FEV1/VC ratio, TLC and PaO2 were more decreased in H than in NH patients. However, RV, VE, RR and VT did not differ between H and NH patients. PaCO2 at rest was comparable in N and H subjects but was significantly lower in NH patients. During B exercise, VE, VO2 and PaO2 were lower in H patients. With both A and B exercises, the H patients showed a lower VT and VT/VC ratio with a higher VD/VT ratio, while A-aPO2 were the same in NH and H patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Oxygen uptake at maximal exercises in chronic airflow obstruction.
In order to gain a better understanding of maximal oxygen uptake in patients with chronic airflow obstruction, we compared the results of three different cyclo-ergospirometric protocols: progressive (30 W/3 min), constant and trapezoidal (10 min of 40 W + 30 W/3 min), in 26 male chronic bronchitis from 30 to 65 years of age. Eleven normal subjects of similar ages served as a control group. VE, VCO2, VO2, respiratory rate (RR) and VT were measured with an open circuit. The electrocardiogram was continuously monitored. Arterial lactate was measured at the end of the trapezoidal test in 20 patients. There were excellent correlations between the individual values of VO2 during the three maximal exercises and a low coefficient of variation of the differences between each paired measurement. There was great variability in VO2 between individuals, with values ranging from 14.7 to 46.2 ml X kg-1 X min-1 (control group : 29.5 to 54.4 ml X kg-1). A "levelling-off" in VO2 was observed in 22 patients who carried out, for 1 or 2 min, the exercise level immediately above the last step maintained for the full 3 min of the progressive test, i.e. the increase in VO2 was smaller than the average one for the preceding levels. In 14 patients, VO2 max was obtained as evidenced by the following criteria : heart rate = 220- age, respiratory quotient greater than 1.1 and arterial lactate greater than 7 mmol X l-1. In the remaining 12 patients, all these criteria were not achieved. After the progressive test, 61% of the patients said they could have performed better. However, in the subsequent maximal tests, these patients reached the same maximal VO2 values. All patients complained of pain in the legs at the end of the exercises, but only 8 of the 26 complained of breathlessness.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Maximal ventilation in healthy subjects of different age, sex and physical condition.
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Adolescent↗