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Neil McCartney

Publications and source records attributed to Neil McCartney.

18 recordsLinked to original sources

Isometric handgrip training does not improve flow-mediated dilation in subjects with normal blood pressure.

Isometric HG (handgrip) training lowers resting arterial BP (blood pressure), yet the mechanisms are elusive. In the present study, we investigated improved systemic endothelial function as a mechanism of arterial BP modification following isometric HG training in normotensive individuals. This study employed a within-subject repeated measures design primarily to assess improvements in BA FMD (brachial artery flow-mediated dilation; an index of endothelium-dependent vasodilation), with the non-exercising limb acting as an internal control. Eleven subjects performed four 2-min unilateral isometric HG contractions at 30% of maximal effort, three times per week for 8 weeks. Pre-, mid- and post-training resting ABP and BA FMD (exercised arm and non-exercised arm) were measured via automated brachial oscillometry and ultrasound respectively. BA FMD (normalized to the peak shear rate experienced in response to the reactive hyperaemic stimulus) remained unchanged [exercised arm, 0.029+/-0.003 to 0.026+/-0.003 to 0.029+/-0.004%/s(-1) (pre- to mid- to post-training respectively); non-exercised arm, 0.023+/-0.003 to 0.023+/-0.003 to 0.024+/-0.003%/s(-1) (pre- to mid- to post-training respectively); P=0.22]. In conclusion, improved systemic endothelial function is unlikely to be responsible for lowering arterial BP in this population.

Adult↗

Isometric handgrip training improves local flow-mediated dilation in medicated hypertensives.

Bilateral isometric handgrip (IHG) training lowers resting arterial blood pressure (BP) in medicated hypertensives. Numerous mechanisms have been suggested, but have yet to be investigated. One such mechanism is that of improved systemic endothelial-dependent vasodilation. The purpose of this investigation was twofold: (1) to determine if bilateral IHG training had any beneficial effects on endothelial-dependent vasodilation, and (2) to see if improved systemic endothelial-dependent vasodilation was responsible for lowering BP. Sixteen participants performed four, 2 min IHG contractions at 30% of their maximal voluntary effort, using either a bilateral (n = 7) or a unilateral IHG protocol (n = 9), three times per week for 8 weeks. Brachial artery (BA) flow-mediated dilation (FMD, an index of endothelial-dependent vasodilation, measured in both arms) was assessed pre- and post-training. Following bilateral IHG training, BA FMD improved in both arms (normalized to peak shear rate 0.005 +/- 0.001 to 0.02 +/- 0.002 s(-1), P < 0.01). Following unilateral IHG training, BA FMD improved in the trained arm only (normalized 0.009 +/- 0.002 to 0.02 +/- 0.005 s(-1), P < 0.01). These findings suggest that although IHG training improves endothelial-dependent vasodilation, the improvements only occur locally in the trained limbs. This suggests that enhanced systemic endothelial-dependent vasodilation is not the mechanism responsible for the observed post-IHG training reductions in BP in medicated hypertensives.

Aged↗

Isometric handgrip training improves local flow-mediated dilation in medicated hypertensives.

Bilateral isometric handgrip (IHG) training lowers resting arterial blood pressure (BP) in medicated hypertensives. Numerous mechanisms have been suggested, but have yet to be investigated. One such mechanism is that of improved systemic endothelial-dependent vasodilation. The purpose of this investigation was twofold: (1) to determine if Bilateral IHG training had any beneficial effects on endothelial-dependent vasodilation, and (2) to see if improved systemic endothelial-dependent vasodilation was responsible for lowering BP. Sixteen participants performed four, 2 min IHG contractions at 30% of their maximal voluntary effort, using either a Bilateral (n = 7) or a Unilateral IHG protocol (n = 9), three times per week for 8 weeks. Brachial artery (BA) flow-mediated dilation (FMD, an index of endothelial-dependent vasodilation, measured in both arms) was assessed pre-and post-training. Following Bilateral IHG training, BA FMD improved in both arms (normalized to peak shear rate, 0.005 +/- 0.001 to 0.02 +/- 0.002 s(-1), P < 0.01). Following Unilateral IHG training, BA FMD improved in the trained arm only (normalized: 0.009 +/- 0.002 to 0.02 +/- 0.005 s(-1), P < 0.01). These findings suggest that although IHG training improves endothelial-dependent vasodilation, the improvements occur only locally in the trained limbs. This suggests that enhanced systemic endothelial-dependent vasodilation is not the mechanism responsible for the observed post-IHG training reductions in BP in medicated hypertensives.

Aged↗

Acute vascular responses to isometric handgrip exercise and effects of training in persons medicated for hypertension.

Previous work from our laboratory demonstrated that isometric handgrip (IHG) training improved local, endothelium-dependent vasodilation in medicated hypertensives [McGowan CL (PhD Thesis), 2006; McGowan et al. Physiologist 47: 285, 2004]. We investigated whether changes in the capacity of smooth muscle to dilate (regardless of endothelial factors) influenced this training-induced change, and we examined the acute vascular responses to a single bout of IHG. Seventeen subjects performed four 2-min unilateral IHG contractions at 30% of maximal voluntary effort, three times a week for 8 wk. Pre- and posttraining, brachial artery flow-mediated dilation (FMD, an index of endothelium-dependent vasodilation) and nitroglycerin-mediated maximal vasodilation (an index of endothelium-independent vasodilation) were measured in the exercised arm by using ultrasound before and immediately after acute IHG exercise. IHG training resulted in improved resting brachial FMD (P < 0.01) and no change in nitroglycerin-mediated maximal vasodilation. Pre- and posttraining, brachial artery FMD decreased following an acute bout of IHG exercise (normalized to peak shear rate, pre-, before IHG exercise: 0.01 +/- 0.002, after IHG exercise: 0.008 +/- 0.002%/s(-1); post-, before IHG exercise: 0.020 +/- 0.003, after IHG exercise: 0.010 +/- 0.003%/s(-1); P < 0.01). Posttraining, resting brachial artery FMD improved yet nitroglycerin-mediated maximal vasodilation was unchanged in persons medicated for hypertension. This suggests that the training-induced improvements in the resting brachial artery FMD were not due to underlying changes in the forearm vasculature. Acute IHG exercise attenuated brachial artery FMD, and although this impairment may be interpreted as hazardous to medicated hypertensives with already dysfunctional endothelium, the effects appear transient as repeated exposure to the IHG stimulus improved resting endothelium-dependent vasodilation.

Aged↗

The effect of body weight-supported treadmill training on muscle morphology in an individual with chronic, motor-complete spinal cord injury: A case study.

OBJECTIVE: The purpose of this pilot study was to examine the effects of 4 months of thrice-weekly body weight-supported treadmill training (BWSTT) on skeletal muscle morphology in a woman (age 27 y) with chronic, motor-complete (ASIA B) spinal cord injury (SCI). METHODS: The participant performed passive thrice-weekly BWSTT for 4 months (48 total sessions) with manual assistance from therapists. Muscle biopsies of the vastus lateralis were taken prior to the beginning of the training program as well as following the completion of 4 months of training. Histochemical analysis was utilized to evaluate changes in muscle fiber size and type following training. RESULTS: At baseline, vastus lateralis muscle biopsies showed evidence of fiber atrophy and fiber type redistribution typical of persons with SCI, with mean fiber areas (and % distributions) of type I, type IIa and type IIx fibers being 3474 microm2 (1.3%), 3146 microm2 (30.8%) and 1284 microm2 (68.0%), respectively. Following training, there were increases in treadmill walking speed (pre: 1.0km/h; post: 2.5km/h) and distance walked/session (pre: 500m; post: 1875m). Vastus lateralis mean fiber area increased by 27.1% and type I fiber % distribution increased to 24.6%, whereas type IIa and type IIx fiber % distributions both decreased following training. CONCLUSION: These data indicate that 4 months of thrice-weekly BWSTT improved muscle morphology in an individual with chronic, motor-complete SCI.

Adult↗

Can body weight supported treadmill training increase bone mass and reverse muscle atrophy in individuals with chronic incomplete spinal cord injury?

This study evaluates the impact of 12 months of body weight supported treadmill training (BWSTT) on muscle and bone in individuals with spinal cord injury (SCI). Fourteen individuals who sustained an incomplete SCI at least 12 months before the study were recruited to participate in BWSTT 3 times/week for a total of 144 sessions. Thirteen individuals completed the study. The average age of subjects was 29 y, average time post-injury was 7.70 y (range: 1-24 y). Areal bone densities of the proximal and distal femur, proximal tibia, spine, and whole body were measured using dual-energy X-ray absorptiometry. Muscle cross-sectional area (CSA), volumetric bone density, and bone geometry at mid-femur and proximal tibia were measured using computed tomography. Serum osteocalcin and urinary deoxypyridinoline were measured at baseline and after 6 and 12 months of training. All other measures were made before and after training. Participants experienced significant increases in whole-body lean mass, from 45.9 +/- 8.7 kg to 47.8 +/- 8.9 kg (mean +/- SD; p < 0.003). Muscle CSAs increased by an average of 4.9% and 8.2% at the thigh and lower leg sites, respectively. No significant changes occurred in bone density or bone geometry at any site, or in bone biochemical markers. Whole-body bone density exhibited a small but statistically significant decrease (p < 0.006). BWSTT may therefore be a promising intervention for increasing muscle mass. Although 12 months of BWSTT did not increase bone density in individuals with chronic incomplete SCI, it did not appear to decrease bone density at fracture-prone sites.

Adult↗

Reproducibility of heart rate variability and blood pressure variability in individuals with spinal cord injury.

Individuals with spinal cord injury (SCI) are prone to orthostatic intolerance and an increased risk of cardiovascular disease. The use of heart rate variability (HRV) and blood pressure variability (BPV) as indices of cardiovascular regulation would be valuable in this population; however, their reproducibility has yet to be tested in those with SCI. The purpose of this study was to examine the day-to-day reproducibility of resting HRV and BPV in individuals with SCI. Ten individuals (age 35.9 +/- 13.2 yrs) with chronic (5.4 +/- 7.7 years post injury) SCI (C4-T12; ASIA A-C) participated. On two occasions within a two-week period, 10-minute supine electrocardiogram and Finapres blood pressure recordings were obtained during spontaneous breathing. Computer software calculated frequency domain measures of HRV and BPV (Low frequency (LF) power, High frequency (HF) power, and LF:HF ratio). Intraclass correlations coefficients (R) were used as an index of day-to-day reproducibility, and analyses were conducted on all participants and only those with tetraplegia. For HRV, measures of heart rate, LF, and LF:HF were found to be highly reproducible (R = 0.82-0.88); however, the reproducibility of HF was found to be poor (all participants: R = 0.53, tetraplegia: R = 0.66). Measures of blood pressure as well as systolic BPV also showed high reproducibility (R = 0.72-0.93). Measures of diastolic BPV were less reproducible but still acceptable (R = 0.71-0.89) with the exception of LF:HF(DBP) (R = 0.51). In conclusion, despite the autonomic dysfunction associated with SCI, measures of HRV and BPV may still be used as reproducible indices of autonomic cardiovascular regulation in this population.

Adult↗

Effects of body weight-supported treadmill training on heart rate variability and blood pressure variability in individuals with spinal cord injury.

Individuals with spinal cord injury are prone to cardiovascular dysfunction and an increased risk of cardiovascular disease. Body weight-supported treadmill training (BWSTT) may enhance ambulation in individuals with incomplete spinal cord injury; however, its effects on cardiovascular regulation have not been investigated. The purpose of this study was to examine the effects of 6-mo of BWSTT on the autonomic regulation of heart rate (HR) and blood pressure (BP) in individuals with incomplete tetraplegia. Eight individuals [age 27.6 yr (SD 5.2)] with spinal cord injury [C4-C5; American Spinal Injury Association B-C; 9.6 yr (SD 7.5) postinjury] participated. Ten-minute HR and finger arterial pressure (Finapres) recordings were collected during 1) supine rest and 2) an orthostatic stress (60 degrees head-up tilt) before and after 6 mo of BWSTT. Frequency domain measures of HR variability [low-frequency (LF) power, high-frequency (HF) power, and LF-to-HF ratio] and BP variability (systolic and diastolic LF power) were used as clinically valuable indexes of neurocardiac and neurovascular control, respectively. There was a significant reduction in HR [61.9 (SD 6.9) vs. 55.7 beats/min (SD 7.7); P=0.05] and LF-to-HF ratio [1.23 (SD 0.47) vs. 0.99 (SD 0.40); P < 0.05] after BWSTT. There was a significant reduction in LF systolic BP [183.1 (SD 46.8) vs. 158.4 mmHg2 (SD 45.2); P < 0.01] but no change in BP. There were no significant effects of training on HR variability or BP variability during 60 degrees head-up tilt. In conclusion, individuals with incomplete tetraplegia retain the ability to make positive changes in cardiovascular autonomic regulation with BWSTT without worsening orthostatic intolerance.

Adult↗

Body-weight-support treadmill training improves blood glucose regulation in persons with incomplete spinal cord injury.

The impact of a 6-mo body-weight-supported treadmill training program on glucose homeostasis and muscle metabolic characteristics was investigated. Nine individuals (31 +/- 3 yr, 8.1 +/- 2.5 yr postinjury; means +/- SE) with incomplete spinal cord injury trained three times weekly for a total of 6 mo. Training session duration and intensity (velocity) increased by 54 +/- 10% (P < 0.01) and 135 +/- 20%, respectively. Muscle biopsies and a modified glucose tolerance test (100 g glucose with [U-(13)C]glucose) were performed before (Pre) and after training (Post). Training resulted in a reduction in area under the curve of glucose x time (-15 +/- 4%) and insulin x time (-33 +/- 8%; both P < 0.05). Oxidation of exogenous (ingested) glucose increased as a result of training (Pre = 4.4 +/- 0.7 g/h, Post = 7.4 +/- 0.6 g/h; P < 0.05), as did oxidation of endogenous (liver) glucose (Pre = 3.8 +/- 0.3 g/h, Post = 5.2 +/- 0.3 g/h; P < 0.05). Training resulted in increased muscle glycogen (80 +/- 23%; P < 0.05) and GLUT-4 content and hexokinase II enzyme activity (126 +/- 34 and 49 +/- 4%, respectively, both P < 0.01). Resting muscle phosphocreatine content also increased after training (Pre = 62.1 +/- 4.3, Post = 78.7 +/- 3.8, both mmol/kg dry wt and P < 0.05). Six months of thrice-weekly body-weight-supported treadmill training in persons with an incomplete spinal cord injury improved blood glucose regulation by increasing oxidation and storage of an oral glucose load. Increases in the capacity for transport and phosphorylation glucose in skeletal muscle likely play a role in these adaptations.

Adult↗

Treadmill training-induced adaptations in muscle phenotype in persons with incomplete spinal cord injury.

Body weight-supported treadmill (BWST) training has been shown to improve ambulatory capacity in persons with a spinal cord injury (SCI); however, the effect that BWST training has on skeletal muscle phenotype is unknown. We aimed to determine whether 6 months (three sessions/week) of BWST training in neurologically stable persons with a traumatic spinal cord injury (ASIA C) alters skeletal muscle phenotype, ambulatory capacity, and blood lipid profile. Externally supported body weight decreased, and walking velocity and duration of the training sessions increased (all P < 0.05) as a result of training. Muscle biopsies revealed increases in the mean muscle-fiber area of type I and IIa fibers. Training induced a reduction in type IIax/IIx fibers, as well as a decrease in IIX myosin heavy chain, and an increase in type IIa fibers. Maximal citrate synthase and 3-hydroxy-acyl-CoA dehydrogenase activity also increased following training. BWST training brought about reductions in plasma total (-11%) and low-density lipoprotein (-13%) cholesterol. We conclude that, in patients with a spinal cord injury, BWST training is able to induce an increase in muscle fiber size and bring about increases in muscle oxidative capacity. In addition, BWST training can bring about improvements in ambulatory capacity and antiatherogenic changes in blood lipid profile.

Adaptation, Physiological↗

An examination of the mechanisms of exercise-induced change in psychological well-being among people with spinal cord injury.

For individuals with a spinal cord injury (SCI), regular exercise training leads to significant improvements in pain, stress, and depression. The mechanisms by which exercise effects change in these variables are poorly understood. To address this issue, we examined the mediated effects of exercise on the psychological well-being of individuals with SCI according to the relationships described in the Chronic Pain Process Model. Twenty-one individuals with traumatic SCI either participated in a 9-month, twice-weekly exercise program (n = 11), or participated as nonexercising controls (n = 10). Measures of pain, stress, and depression were administered at the baseline and 3, 6, and 9 months into the intervention. Change in pain mediated exercise-induced change in stress, F(4,17) = 7.72, p < 0.01. Change in stress mediated exercise-induced change in depression, F(4,17) = 7.68, p < 0.01. With the identification of these factors as mediators of exercise-related changes in pain and well-being, exercise interventions can be designed that specifically target these mediators and possibly maximize intervention efficacy.

Adult↗

Canadian Cardiovascular Society Consensus Conference 2002: Management of heart disease in the elderly patient.

Cardiovascular disease is a major health issue for the elderly patient. Many diagnostic, therapeutic and ethical issues are specific for the the older adult with heart disease. The Canadian Cardiovascular Society 2002 Consensus Conference provides recommendations for the most frequently encountered cardiac problems in the elderly patient. A common theme of the recommendations is the need to apply the best evidence based medicine together with an assessment of frailty, comorbidity and quality of life. A major goal of the conference was to identify treatments that are not optimally used in the older patient.

Aged↗

Training for muscle power in older adults: effects on functional abilities.

The purpose of this study was to determine the influence of simple, progressive lower body exercise training, focusing on strength and power, on functional abilities in frail older adults. Twenty-five residents of a long-term care facility (75-94 yrs) participated in this randomized controlled trial of 10-wks duration. The exercise group (Ex, n = 18) underwent simple, progressive lower body resistance exercises, specifically aimed at improving muscle power, 3 times/wk; the control subjects (Con, n = 7) maintained their usual daily activities. Knee extensor strength and power were measured on an isokinetic dynamometer (180 degrees/s), and functional performance was assessed from a 6-m walk timed test, a 30-s chair stand, and an 8-ft up-and-go timed test, before and after the 10-wk intervention period. Significant increases were found in the Ex group for eccentric (44%) and concentric (60%) average power (p < 0.05), and improvements were seen on each functional test: the 8-foot up-and-go, chair stand, and walk time improved by 31%, 66%, and 33%, respectively (p < 0.05). No significant change occurred in the Con group. In conclusion, simple progressive exercise training, even in the 10th decade, increases muscle power and is associated with an improved performance of functional activities using the trained muscles.

Activities of Daily Living↗

Two years of resistance training in older men and women: the effects of three years of detraining on the retention of dynamic strength.

Dynamic muscle strength (1-RM) and symptom-limited treadmill endurance were compared among three groups (5 M and 5 F per group) of older adults (mean age 72.5 yrs) who had either weight-trained continuously twice per week for 5 years (Tr), ceased to weight train after 2 years (Detr), or acted as controls throughout (Con). The Tr and Detr trained hard (progressing up to 3 sets at up to 80% of 1-RM) for 2 years; the Tr continued training for an additional 3 years at a maintenance level (2 to 3 sets at 60-70% 1-RM), whereas the Detr stopped training for those 3 years. The Con subjects did not train for the duration of the study but took part in identical testing procedures. After 2 years of resistance training, dynamic strength in the Tr and Detr groups increased significantly above baseline and Con values for all exercises, p < 0.0001. Following 3 years of maintenance level training, arm curl, leg press, and bench press 1-RM (sum of both limbs) in the Tr remained significantly above baseline values (21.6 kg = 17%; 15.7 kg = 82%; 8.3 kg = 34%, respectively). The 1-RM in Detr were 18.4 kg (14%), 5.3 kg (24%), and 1.4 kg (9%) above baseline for leg press, arm curl, and bench press after 5 years, whereas the Con declined over the 5-yr period by 18.4 kg (-9.7%), 4.4 kg (-19%), and 3.5 kg (-6%), respectively. There were nonsignificant improvements in treadmill performance in the Tr and Detr, and a decline in the Con after 2 years. Treadmill performance declined between Years 2 and 5 in all groups despite continued training (ns). We conclude that: (1) dynamic strength gains from 2 years of resistance training in older individuals are not entirely lost even after 3 years of detering; (2) these effects may be specific to the exercises performed in the training program; (3) adoption of maintenance-level moderate-intensity training significantly attenuates the decline in dynamic strength of previously trained muscles.

Aged↗

Isometric training lowers resting blood pressure and modulates autonomic control.

PURPOSE: This study examined the effects of isometric handgrip training on resting arterial blood pressure, heart rate variability, and blood pressure variability in older adults with hypertension. METHODS: Nine subjects performed four 2-min isometric handgrip contractions at 30% of the maximum voluntary contraction force, 3 d.wk(-1) for 10 wk, and eight subjects served as controls. RESULTS: After training, there was a significant reduction in resting systolic pressure and mean arterial pressure. In addition, power spectral analysis of heart rate variability demonstrated that the low frequency: high frequency area ratio tended to decrease. CONCLUSIONS: It is concluded that isometric training at a moderate intensity elicits a hypotensive response and a simultaneous increase in vagal modulation in older adults with hypertension.

Aged↗

A 6-mo home-based exercise program may slow vertebral height loss.

Twenty-one of 46 postmenopausal women were assigned to a home-based exercise program consisting of 60 min of exercise, 3 d/wk. The 25 nonexercisers continued usual daily activities. Each woman had at least one prevalent vertebral fracture and suffered from osteoporosis as defined by the application of WHO criteria to lumbar spine bone mineral density. Vertebral heights were measured using bone densitometry at baseline and 12 mo later. Vertebrae T9 to L4 were all identified for each of the 46 subjects in both the baseline and end-of-study lateral scans. The change in mean vertebral height over the course of the study was -0.3 mm anteriorly, -0.7 mm at the mid-location, and -0.4 mm posteriorly for the nonexercisers. For the exercisers, the corresponding changes were +0.1 mm anteriorly, -0.3 mm at the mid-location, and +0.2 mm posteriorly. The benefit of exercise in preserving vertebral morphometry in patients with osteoporosis deserves further investigation.

Aged↗

Effects of exercise training in patients with heart failure: the Exercise Rehabilitation Trial (EXERT).

BACKGROUND: The purpose of this study was to examine the effects of exercise training on functional capacity in patients with heart failure. METHODS: One hundred eighty-one patients in New York Heart Association class I to III, with ejection fraction <40% and 6-minute walk distance <500 meters, were recruited into a randomized, controlled, single-blind trial comparing 3 months of supervised training, then 9 months of home-based training with usual care. RESULTS: There was a significant increase in 6-minute walk distance at 3 and 12 months but no between-group differences. Incremental peak oxygen uptake increased in the exercise group compared with the control group at 3 months (0.104 +/- 0.026 L/min vs 0.025 +/- 0.023 L/min; P =.026) and 12 months (0.154 +/- 0.074 L/min vs 0.024 +/- 0.027 L/min; P =.081). Compared with the control group, significant increases were observed in the exercise group for arm and leg strength. No significant changes were observed in cardiac function or quality of life. Adherence to exercise was good during supervised training but reduced during home-based training. CONCLUSIONS: Exercise training improves peak oxygen uptake and strength during supervised training. Over the final 9 months of the study, there was little further improvement, suggesting that some supervision is required for these patients. There were no adverse effects on cardiac function or clinical events.

Aged↗

Body image and depressive symptoms as correlates of self-reported versus clinician-reported physiologic function.

PURPOSE: This study examined the relationships between physiologic function, depressive symptoms, and body image among maintenance cardiac rehabilitation participants. Physiologic function was operationalized as both functional status and functional capacity. METHODS: Participants were 72 men (mean age = 67.3 years) all of whom had experienced a traumatic cardiac event (ie, myocardial infarction, valve replacement surgery, coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty), and had completed some type of physician-supervised acute cardiac rehabilitation (ie, phase I and phase II). Measures of body image (social physique anxiety and body appearance satisfaction), self-reported functional status, clinician-reported functional capacity (ie, V0(2) and peak power), and depressive symptoms were collected. RESULTS: Hierarchic multiple regression analyses revealed that both functional capacity and functional status explained significant variance in social physique anxiety (R(2) = 0.11, P<.05 and R(2) = 0.18, P<.05, respectively), whereas only functional status was a significant predictor of body appearance satisfaction (R(2) = 0.37, P<.01). Contrary to our hypotheses, depressive symptoms were not significantly related to either psychosocial or physiologic indices of functional well-being. CONCLUSIONS: Both patient perceptions of functional status and clinical measures of functional capacity are important aspects of psychosocial well-being among cardiac patients.

Aged↗