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Biomedical subjects

T Kavanagh

Publications and source records attributed to T Kavanagh.

At least 37 records · Page 2Linked to original sources
PubMed1977

Sexual activity after myocardial infarction.

Questionnaires on sexual activity were completed by 161 patients attending an exercise-centred rehabilitation program an average of some 3 years after a myocardial infarction. In almost half the group, sexual activity was unchanged or increased compared with the period before the infarction. In the remainder it was reduced; this group included 29 men who had adopted a more passive sexual role and 26 who were now having angina or ventricular premature beats during intercourse. Although the patients with diminished activity could not be distinguished by means of formal personality test, questionnaires completed by their wives suggested that they were less willing to assume responsibility, had increased difficulty in adjusting to life at home and at work and were more neurotic and depressed than those with normal or increased activity. Furthermore, those with decreased sexual activity had a poorer response to training in terms of attendance, final average jogging distance and gains in physiologic status. Since the frequency of angina and ventricular premature beats was less during intercourse than during standard laboratory exercise, it was concluded that normal sexual relations carry no special risk for the average postcoronary patient; indeed, by enhancing self-esteem and encouraging effective participation in an exercise programm, acceptance of normal sexual activity may improve the prognosis.

Blood Pressure↗
PubMed1977

Depression following myocardial infarction: the effects of distance running.

A proportion of postcoronary patients seen 16 to 18 months after infarction are seriously depressed (high D score on Minnesota Multiphasic Personality Inventory). A follow-up of 44 such depressed patients showed a significant (p less than 0.001) decrease of standardized D scores, from 80 to 72 units over 4 years of exercise-based rehabilitation. There were associated decreases in scores for hysteria, hypochondriasis, and psychasthenia. A decrease of D score was associated with exercise compliance. An increase of D score was associated with a significant (p less than 0.05) worsening of ST segmental sagging, suggesting that progression of the disease process had contributed to the increase of depression. All of the patients had high (feminine) scores on the masculinity/femininity scale of the MMPI test. This finding was unrelated to the daily running distance or medication; it could represent a "feminine" personality, or be a typical response in a well-educated white collar group. Evidence of successful group interaction may be indicated by reduction in scores for social introversion and schizophrenic traits.

Adult↗
PubMed1977

On the choice of fluid for the hydration of middle-aged marathon runners.

Nine subjects (five well-trained post-coronary patients and four other middle-aged joggers) paticipated in a 42 km "Marathon" race. The course was covered in an average of 212 minutes under pleasantly warm conditions (Maximum 21.7 degree C, 69% relative humidity). Subjects were given initial hyperhydration and repeated subsequent doses of water, "Erg" (Na+ 19mE/l K+ 10.7mE/l, glucose 5.3g/100 ml) or a "Special Solution" (during the race Na+ 21mE/1 glucose 4.1g/100 ml; after the race Na+ 20 mE/l, K+ 4.7mE/l., glucose 4.1 g/100 ml). Weight loss averaged 2.2 kg and sweat production 3.3l taking account of water liberated from the hydration of glycogen and the oxidation of food stuffs, it was estimated that most subjects suffered relatively little dehydration over the race (0.4--0.8l). This was confirmed by a sustained urine production of greater than 100ml/hr. Nevertheless, rectal temperatures showed substantial elevation over the race (final readings 38.3 - 40.2 degree C). In terms of fluid balance and stability of plasma mineral composition, the runners drinking water performed slightly better than those receiving the other two solutions. Nevertheless, there may be merit in giving potassium solutions during recovery from vigorous effort.

Adult↗
PubMed1976

Maximum exercise tests on "postcoronary" patients.

The maximum oxygen intake has been measured directly (uphill treadmill walking) in 36 patients following recovery from myocardial infarction. These were selected as follows: 15 consecutive new entrants to an exercise program that is currently accepting about one-sixth of the total reported myocardial infarction hospital admissions in metropolitan Toronto (group A), 12 patients not responding well to training (group B), and 9 patients now running substantial distances (group C). The only clinical complications were two episodes of ventricular tachycardia. Twenty patients reached an oxygen plateau, and in group C, the maximum heart rate (170/min) reached Scandinavian norms, with a maximum oxygen intake (2.63 +/- 0.35 1/min STPD, 36.9 +/- 4.8 ml/kg-min STPD) as in healthy men of the same age. The rate of adaptation to a progressive submaximum test was such that comparable Astrand nomogram predictions of VO2max were obtained from data in the 3rd and 5th min at the third load. Predictions generally agreed closely with directly measured values. It may be concluded that in patients who have recovered sufficiently to enter an exercise rehabilitation program 1) predictions of VO2max have about the same accuracy (+/-10) as in healthy subjects, and 2) direct measurements can often be pursued to an "oxygen plateau" without due risk.

Adult↗
PubMed1975

Depression after myocardial infarction.

The Minnesota Multiphasic Personality Inventory was completed by 101 patients 16 to 18 months after a proved myocardial infarction. The data suggested a bimodal distribution of patients. One class of patients had a relatively "normal" personality score apart from a tendency to hypomania. The second class had severe depression, with associated hysteria, hypochondriasis and psychasthenia. The severely depressed patients were older, with a greater tendency to hypertension and angina, and a tendency to smaller gains in aerobic power despite an equal intensity of endurance training. The distinction between "normal" and "depressed" postinfarction patients seems of some clinical importance, for the two classes of patients require opposite supportive techniques--restraint and encouragement, respectively.

Age Factors↗
PubMed1975

A controlled prospective study of the effect of endurance training on the recurrence rate of myocardial infarction. A description of the experimental design.

A multicenter prospective study has been designed to determine whether participation in an exercise program which produces a significant training effect will affect the recurrence rate in men who have survived an initial myocardial infarction. The control group consists of subjects who participate in a program involving low intensity activities designed to avoid a significant training effect. The subjects will be followed for a period of 4 years and a reduction of 50 per cent in the risk of recurrence will be considered clinically significant. The criteria for entry, the method of allocation, the structure of the exercise program and method of assessing cardiorespiratory fitness are described.

Angina Pectoris↗
PubMed1975

Conditioning of postcoronary patients: comparison of continuous and interval training.

Interval training is theoretically attractive as a means of training the postcoronary patient, since by appropriate choice of exercise and recovery intervals substantial cardiac training can be achieved without the accumulation of anaerobic metabolities and associated increases of blood pressure and cardiac work load. Six patients with frequent exercise-induced anginal attacks coped well with a program based upon running or jogging (1/2 to 1 minute) followed by 1 to 1-1/2 minutes of slow walking. Despite a poor previous response to several months of continuous training, they showed a substantial gain of aerobic power with one year on the interval regimen. The ST segmental response to a fixed increment of pulse rate remained unimproved, but probably because of the enhanced cardiorespiratory fitness, the ST depression at a fixed work load was lessended. Twenty other patients who had also followed a continuous exercise regimen for up to one year were switched to interval-type work. Over the next year they failed to progress as fast as a group of 15 patientswho persisted with continuous effort training. While interval work is helpful to the severely disabled anginal patient, it apparently leads to slower progress in the average postcoronary patient.

Adult↗
PubMed1973

The immediate antecedents of myocardial infarction in active men.

The antecedents of myocardial infarction have been reviewed in 102 patients (117 episodes) undergoing a program of rehabilitation. The year prior to the first attack was characterized by business and social problems, with some weight gain; in the week before the attach there was added tiredness, poor general health and, in some cases, increasing anginal pain. Heavy lifting and/or unusual exercise were common immediately before or during an attack; five attacks were related to the shovelling of wet snow.Both bed and the normal place of work were uncommon sites for an attack. More than 50% of patients had 30 minutes' warning of infarction. The relevance of these findings to a safe program of therapeutic exercise is discussed.

Activities of Daily Living↗
PubMed1973

The application of exercise testing to the elderly amputee.

Case histories of 62 elderly amputees with peripheral vascular disease are reviewed. Almost one half had previous infarction, heart failure or digoxin therapy. An arm ergometer test revealed myocardial ischemia in two thirds of the group. The theoretical maximum oxygen intake is low, but many patients were unable to reach the theoretical figure because of myocardial ischemia. Application of these findings to an exercise prescription for amputees is discussed, and it is questioned how many elderly amputees have the potential for useful ambulation.

Adult↗