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Biomedical subjects

Mark Haykowsky

Publications and source records attributed to Mark Haykowsky.

14 recordsLinked to original sources
PubMed2006

Safety and feasibility of cardiopulmonary exercise testing in patients with advanced cancer.

PURPOSE: The use of cardiopulmonary exercise testing (CPET) is increasing in many areas of disease management, the clinical utility of this procedure in patients with advanced cancer remains to be determined. Accordingly, we conducted a pilot study to comprehensively evaluate the safety and feasibility of CPET in 85 patients diagnosed with inoperable non-small cell lung cancer (NSCLC) or metastatic breast cancer (MBC). METHODS: Using a cross-sectional design, consecutive patients with histologically or cytologically confirmed inoperable NSCLC or MBC were screened for eligibility by their attending oncologist. All consenting patients performed complete pulmonary function tests (NSCLC only) and a symptom-limited CPET on a cycle ergometer with gas exchange analysis. RESULTS: A total of 85 patients (NSCLC, n=46; MBC, n=39) were recruited and tested. Overall, there were a total of three (3.5%) positive exercise tests [NSCLC, n=2 (4.3%); MBC, n=1 (2.6%)]; 68 (80.0%) negative tests [NSCLC, n=33 (71.7%); MBC, n=35 (89.7%)]; and 14 (16.5%) indeterminate tests [NSCLC, n=11 (23.3%); MBC, n=3 (7.7%)]. Two patients experienced an adverse event during exercise testing. Mean VO(2peak) was 17.0mlkg(-1)min(-1) and 16.5mlkg(-1)min(-1) for NSCLC and MBC patients, respectively. The mean percentage of age and sex-predicted VO(2peak) maximum for both groups was 67%. CONCLUSION: A symptom-limited, individualized CPET appears to be a relatively safe and feasible assessment tool to objectively evaluate physical functioning in selected patients with advanced cancer. This study provides important information to future investigations examining the potential role of exercise training in this patient population.

Alberta↗
PubMed2005

Exercise training improves aerobic endurance and musculoskeletal fitness in female cardiac transplant recipients.

AIM: Female cardiac transplant recipients' aerobic capacity is 60% lower than sex and age-predicted values. The effect of exercise training on restoring the impaired aerobic endurance and muscle strength in female cardiac transplant recipients is not known. This study examined the effect that aerobic and strength training have on improving aerobic endurance and muscle strength in female cardiac transplant recipients. METHODS: 20 female cardiac transplant recipients (51 +/- 11 years) participated in this investigation. The subjects performed a baseline six-minute walk test and a leg-press strength test when they were discharged following cardiac transplantation. The subjects then participated in a 12-week exercise program consisting of aerobic and lower extremity strength training. Baseline assessments were repeated following completion of the exercise intervention. RESULTS: At baseline, the cardiac transplant recipients' aerobic endurance was 50% lower than age-matched predicted values. The training program resulted in a significant increase in aerobic endurance (pre-training: 322 +/- 104 m vs. post-training: 501 +/- 99 m, p < 0.05) and leg-press strength (pre-training: 48 +/- 16 kg. vs. post-training: 78 +/- 27 kg, p < 0.05). CONCLUSION: Aerobic and strength training are effective interventions that can partially restore the impaired aerobic endurance and strength found in female cardiac transplant recipients.

Journal Article↗
PubMed2005

Effect of exercise training on VO2peak and left ventricular systolic function in recent cardiac transplant recipients.

This study examined the effect of 12 weeks of combined aerobic and resistance training on aerobic capacity, left ventricular ejection fraction, and arterial afterload during submaximal cycle exercise in 18 recent (<1 month from transplantation) cardiac transplant recipients. The main finding of this study is that 12 weeks of combined aerobic and resistance training is an effective intervention to increase aerobic capacity in this population. However, exercise training was not associated with favorable improvements in left ventricular systolic function, because stroke volume and ejection fraction were reduced after training because of an increase in arterial afterload.

Exercise↗
PubMed2005

Effect of exercise training on peak aerobic power, left ventricular morphology, and muscle strength in healthy older women.

The effect that aerobic (AT) and/or strength training (ST) has on altering peak aerobic power (VO2peak), muscle strength, left ventricular (LV) morphology, and diastolic filling in healthy older women is not known. We assessed the effects of 12 weeks of AT, ST, combined aerobic and strength training (COMT), or no training (NT) on VO2peak, muscle strength, LV morphology, and diastolic filling in 31 healthy women (68 +/- 4 years). Relative VO2peak was significantly greater after 12 weeks of AT, ST, or COMT. Upper and lower extremity strength were significantly higher after 12 weeks of ST or COMT with no change after AT or NT. LV morphology and diastolic filling were not altered after 12 weeks of AT, ST, COMT, or NT. Twelve weeks of ST or COMT are as effective as 12 weeks of AT for increasing relative VO2peak, however, ST and COMT are more effective than AT for improving overall muscle strength.

Age Factors↗
PubMed2005

Supervised exercise training improves aerobic capacity and muscle strength in older women with heart failure.

BACKGROUND: The effect that supervised or unsupervised exercise training has on aerobic capacity (peak oxygen consumption [VO2peak]), muscle strength and quality of life in older women with heart failure remains unknown. OBJECTIVE: To examine the effect of six months (three months supervised followed by three months unsupervised) of aerobic training (AT) or combined aerobic and strength training (CAST) on VO2peak, muscle strength and quality of life in older women with heart failure. METHODS: Twenty older women (mean age +/- SD, 72+/-8 years) with clinically stable heart failure were randomly assigned to AT (n=10) or CAST (n=10). Supervised AT was performed two days per week at 60% to 70% heart rate reserve, whereas unsupervised training was performed two days per week at a rate of perceived exertion of 12 to 14 on the Borg scale. The CAST group also performed one to two sets of low-to-moderate intensity strength training two days per week. RESULTS: Supervised AT or CAST resulted in an increase in VO2peak (12%; P<0.05) and leg press strength (13%; P<0.05) that returned to baseline after unsupervised training. Vertical row strength was greater (+23%; P<0.05) after supervised CAST and remained unchanged after supervised or unsupervised AT. Supervised or unsupervised exercise training was not associated with a significant change in quality of life. CONCLUSIONS: Supervised AT or CAST are effective modes of exercise to improve VO2peak and muscle strength in older women with heart failure. However, the improvements in VO2peak and muscle strength are not maintained with unsupervised exercise training.

Age Factors↗
PubMed2004

Cardiovascular adaptations to exercise training in postmenopausal women with type 2 diabetes mellitus.

BACKGROUND: Type 2 diabetes mellitus (DM-2) is one of the most prevalent chronic diseases of the aged and contributes to a significant amount of cardiovascular disease morbidity and mortality. Exercise training may be beneficial in attenuating the cardiovascular maladaptations associated with DM-2. The purpose of this study was to examine the effects of exercise training on left ventricular (LV) and vascular function in a sample of postmenopausal women with DM-2. METHODS: Twenty-eight postmenopausal women with DM-2 (age: 59 +/- 7 yrs) were assigned to either an exercise training (ET) (n = 17) or control group (CT) (n = 7). Cardiorespiratory fitness (VO2peak), LV filling dynamics and arterial compliance were assessed at baseline in all participants. The ET group performed a supervised aerobic and resistance training intervention three days per week for a period of 10 weeks, while the CT group continued normal activities of daily living. RESULTS: Body mass index, VO2peak, age and duration of diabetes were similar between the ET and CT groups at baseline. VO2peak (21.3 +/- 3.3 to 24.5 +/- 4.2 ml.kg-1.min-1, p < 0.05) and large artery compliance (1.0 +/- 0.4 to 1.2 +/- 0.4 mL.mmHg-1, p < 0.05), increased significantly in the ET group following training despite no change in LV filling dynamics, blood pressure, lipid profile or insulin sensitivity. All variables remained unchanged in the CT group. CONCLUSIONS: Exercise training improves large artery compliance and cardiorespiratory fitness in postmenopausal women with DM-2, without any appreciable changes in LV filling dynamics or conventional risk factors for cardiovascular disease.

Journal Article↗
PubMed2004

The addition of manual lymph drainage to compression therapy for breast cancer related lymphedema: a randomized controlled trial.

PURPOSE: The purpose of this investigation was to compare the reduction in arm lymphedema volume achieved from manual lymph drainage massage (MLD) in combination with multi-layered compression bandaging (CB) to that achieved by CB alone. METHODS AND MATERIALS: Fifty women with lymphedema (mean age of 59 years +/- 13 years) were randomly assigned to 4 weeks of combined MLD/CB or CB alone. The primary study endpoint was the reduction in arm lymphedema volume, which was determined by water displacement volumetry and measurement of circumference. Independent assessors, blinded to subject treatment assignment, performed the outcome measurements. RESULTS: Arm lymphedema volume decreased significantly after 4 weeks irrespective of treatment assignment (p < 0.001). Individuals with mild lymphedema receiving combined MLD/CB had a significantly larger percentage reduction in volume compared to individuals with mild lymphedema receiving CB alone, and compared to individuals with moderate or severe lymphedema receiving either treatment. CONCLUSION: These findings indicate that CB, with or without MLD, is an effective intervention in reducing arm lymphedema volume. The findings suggest that CB on its own should be considered as a primary treatment option in reducing arm lymphedema volume. There may be an additional benefit from the application of MLD for women with mild lymphedema; however, this finding will need to be further examined in the research setting.

Adult↗
PubMed2004

Exercise training improves overall physical fitness and quality of life in older women with coronary artery disease.

BACKGROUND: Older women with coronary artery disease (CAD) have reduced peak aerobic power (Vo(2)peak), muscle strength, and quality of life (QOL). Exercise interventions that can improve Vo(2)peak and muscle strength may also result in an improvement in QOL. This study compared the effect of aerobic training (AT) or combined aerobic and strength training (COMT) on Vo(2)peak, distance walked in 6 min, upper- and lower-extremity maximal strength, and QOL in 18 women (age range, 60 to 80 years) with documented CAD. METHODS: After baseline testing, subjects were randomly assigned to AT (treadmill and cycle exercise, n = 9) or COMT (treadmill and cycle exercise plus upper- and lower-extremity strength training, n = 9), and each group exercised 3 d/wk for 8 weeks. RESULTS: Both AT and COMT resulted in a similar increase in Vo(2)peak, distance walked in 6 min, lower-extremity strength, and emotional and global QOL. COMT improved upper-extremity strength, and physical and social QOL, which was unchanged after AT. CONCLUSIONS: Older women with CAD should perform aerobic and strength training to attain optimal improvements in overall physical fitness and QOL.

Aged↗
PubMed2004

Low cardiorespiratory fitness is associated with elevated C-reactive protein levels in women with type 2 diabetes.

OBJECTIVE: The purpose of this study was to examine differences in novel markers of cardiovascular disease (CVD) in women with type 2 diabetes stratified according to cardiorespiratory fitness. RESEARCH DESIGN AND METHODS: A total of 28 women (mean age 57 +/- 6 years) with type 2 diabetes who were free from overt CVD were placed into low cardiorespiratory fitness (LCF) or average cardiorespiratory fitness (ACF) groups based on a graded exercise test to exhaustion. A group of eight women without type 2 diabetes were also examined and served as healthy control subjects. The median VO(2peak) value was used as a cutoff for group determination. We assessed both conventional CVD risk factors, including blood pressure, BMI, and lipid profile, as well as novel CVD risk factors, such as left ventricular filling dynamics, arterial stiffness, fasting insulin, and C-reactive protein (CRP). RESULTS: VO(2peak) values were 69 +/- 14 and 91 +/- 24% of predicted values for sedentary age-matched healthy individuals in the LCF and ACF groups, respectively. BMI was significantly greater in the LCF group (P < 0.05); however, no differences were observed in age, lipid profile, or resting hemodynamics. CRP was 3.3-fold higher in the LCF group (6.3 +/- 41. vs. 1.9 +/- 1.7 mg/l, P < 0.05), whereas other novel markers of CVD were not significantly different between the groups. Significant negative relationships were observed between VO(2peak) and both CRP (r = -0.49) and the homeostasis model assessment index (r = -0.48) (P < 0.05). CONCLUSIONS: The novel finding of this investigation is that low cardiorespiratory fitness is associated with elevated CRP and reduced fasting glucose control in women with type 2 diabetes.

Age of Onset↗
PubMed2003

Left ventricular systolic performance during prolonged strenuous exercise in female triathletes.

BACKGROUND: The effect of prolonged strenuous exercise (PSE) on left ventricular (LV) systolic function has not been well studied in younger female triathletes. This study examined LV systolic function prior to, during and immediately following PSE (i.e., 40 km bicycle time trial followed by a 10 km run) in 13 younger (29 PlusMinus; 6 years) female triathletes. METHODS: Two-dimensional echocardiographic images were obtained prior to, at 30-minute intervals during and immediately following PSE. Heart rate, systolic blood pressure, end-diastolic and end-systolic cavity areas were measured at each time point. Echocardiographic and hemodynamic measures were also combined to obtain LV end-systolic wall stress and myocardial contractility (i.e., systolic blood pressure - end-systolic cavity area relation). RESULTS: Subjects exercised at an intensity equivalent to 90 PlusMinus; 3% of maximal heart rate. Heart rate, systolic blood pressure, systolic blood pressure - end-systolic cavity area relation and fractional area change increased while end-diastolic and end-systolic cavity areas decreased during exertion. CONCLUSIONS: PSE is associated with enhanced LV systolic function secondary to an increase in myocardial contractility in younger female triathletes.

Journal Article↗
PubMed2003

Effects of a comprehensive cardiac rehabilitation program on quality of life and exercise tolerance in women: A retrospective analysis.

BACKGROUND: Currently, there are a lack of investigations that have examined the effect of participating in a comprehensive cardiac rehabilitation program on quality of life and physiological measures in women of different ages. The purpose of this investigation was to examine the effect of participating in a comprehensive cardiac rehabilitation program on quality of life, exercise tolerance, blood pressure and lipids in women between 33 and 82 years of age. METHODS: The 126 women participated in a 14-week cardiac rehabilitation program that consisted of 7 weeks of formal supervised exercise training and 7 weeks of unsupervised exercise and lifestyle modification. Physiologic and quality of life outcome measures obtained at the outset and after 14 weeks included: 1) exercise treadmill time; 2) resting and peak systolic and diastolic blood pressure; 3) total cholesterol, low-density lipoprotein cholesterol, high density lipoprotein cholesterol and Triglycerides; 4) Cardiac Quality of Life Index questionnaire. RESULTS: Significant improvements were found in the following quality of life measures after participating in the cardiac rehabilitation program: physical well being, psychosocial, worry, nutrition and symptoms. No significant differences were seen for any QOL variable between the different age groups. Significant improvements were seen in exercise tolerance (+21%) and high density lipoprotein (+5%). CONCLUSION: Cardiac rehabilitation may play an important role in improving quality of life, exercise tolerance and high density lipoprotein cholesterol levels in younger and older women with underlying cardiovascular disease.

Journal Article↗
PubMed2003

The effect of opioid analgesia on exercise test performance in chronic low back pain.

The effect of opioid analgesia on tests of muscular function in chronic low back pain (CLBP) is unknown. Twenty-eight subjects with CLBP of at least moderate intensity performed the Sorensen isokinetic exercise test once after receiving 1 microg/kg fentanyl intravenously and once after placebo in a randomized-order double-blind crossover design. Naloxone 3 microg/kg was administered after the fentanyl phase. Fentanyl reduced mean+/-SD pain from 4.0+/-2.1 to 3.1+/-2.2 on a 0-10 verbal rating scale (P<0.05). Mean+/-SD Sorensen test performance was 77+/-49 s in the fentanyl arm and 60+/-42 s in the placebo arm. This represents an increased performance with fentanyl of 28% (P<0.001). We conclude that in addition to relieving pain in CLBP, the administration of 1 microg/kg fentanyl is associated with an improvement in lumbar exercise test performance. We presume that the pain relief resulted in increased test performance. Our result is at odds with those of randomized trials which have failed to demonstrate increased function following the treatment of pain with opioid analgesics. This highlights the complexity of the interaction between pain, analgesia and changes in function.

Adult↗