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Biomedical subjects

W L Mosterd

Publications and source records attributed to W L Mosterd.

At least 19 recordsLinked to original sources
PubMed1999

Safety and effects of physical training in chronic heart failure. Results of the Chronic Heart Failure and Graded Exercise study (CHANGE)

AIMS: Physical training is considered to be safe and beneficial as part of the treatment in heart failure patients. Prospective, sufficiently large studies are still needed to confirm this hypothesis. METHODS: In a prospective study, 80 patients with chronic heart failure class II and III (age, 56.6+/-8.3 years; left ventricular ejection fraction, 26.5+/-9.6%) were randomized to an endurance training group or to a control group with continuation of optimal pharmacological treatment. RESULTS: No training-related adverse event was reported, implying that the training programme was safe for these groups of chronic heart failure patients. Between-group comparison of changes revealed that training increased exercise time (from 608+/-35 to 738+/-40 s, P<0.0001), anaerobic threshold (from 10.5+/-0.4 to 11.8+/-0.3 ml x kg-1 min-1, P<0.05), and decreased the ventilatory equivalent for carbon dioxide at submaximal exercise level (from 2.8+/-0.1 to 2.7+/-0.1, P<0.05). Training did not increase peak oxygen consumption (15.2+/-0.5 to 16. 6+/-0.5 ml x kg-1 min-1, ns). An improvement in patients' assessment of quality of life was observed. There was a significant correlation between physiological and psychological improvements. Training was not effective in patients whose exercise test at entry had a duration of less than 7 min. None of the other baseline data could predict an effective training response. CONCLUSION: Physical training in chronic heart failure patients class II and III is safe and results in significant improvements in exercise time, anaerobic threshold, ventilatory equivalent for carbon dioxide at submaximal exercise level and quality of life.

Adult↗
PubMed1999

Gastrointestinal symptoms during long-distance walking.

PURPOSE: Gastrointestinal (GI) symptoms are common during prolonged intense exercise. To examine whether GI symptoms are also common during prolonged exercise of lower intensity, we obtained data on incidence, duration, and severity of GI symptoms during four consecutive days walking with a total distance of 203 km for men and 164 km for women. METHODS: The research population consisted of 79 men and 76 women, aged 30-49 yr, who responded to a questionnaire and a diary concerning anthropometric data, activity pattern, dietary intake, and GI symptoms. RESULTS: The results show that 24% of the subjects experienced one or more symptoms. Nausea, headache, and flatulence were the most frequent symptoms. Nine subjects dropped out during the race, two of whom indicated that they stopped as a result of one or more GI symptoms. Logistic regression analysis revealed that the occurrence of GI symptoms was a significant exercise-limiting factor. Univariate analysis showed that incidence and duration of GI symptoms were significantly related to the subjects' experience (number of prior participations to the event), body weight loss during walking, and several components of the diet before and during the event. A significant relationship between GI symptoms and age, gender, training status, and walking speed could not be found. CONCLUSIONS: We conclude that GI symptoms during long-distance walking can impair exercise performance, although these symptoms occur less frequently and are less severe in comparison with prolonged intense exercise.

Adult↗
PubMed1999

Gastrointestinal symptoms in long-distance runners, cyclists, and triathletes: prevalence, medication, and etiology.

OBJECTIVE: The aim of this study was to determine the prevalence of exercise-related gastrointestinal (GI) symptoms and the use of medication for these symptoms among long-distance runners, cyclists, and triathletes, and to determine the relationship of different variables to GI symptoms. METHODS: A mail questionnaire covering the preceding 12 months was sent to 606 well-trained endurance type athletes: 199 runners (114 men and 85 women), 197 cyclists (98 men and 99 women), and 210 triathletes (110 men and 100 women) and sent back by 93%, 88%, and 71% of these groups, respectively. Symptoms were evaluated with respect to the upper (nausea, vomiting, belching, heartburn, chest pain) or lower part of the GI tract (bloating, GI cramps, side ache, urge to defecate, defecation, diarrhea). For statistical analysis, Mann-Whitney U test, Fisher exact test, or Student t test were used. RESULTS: Runners experienced more lower (prevalence 71%) than upper (36%) GI symptoms during exercise. Cyclists experienced both upper (67%) and lower (64%) symptoms. Triathletes experienced during cycling both upper (52%) and lower (45%) symptoms, and during running more lower (79%) than upper (54%) symptoms. Bloating, diarrhea, and flatulence occurred more at rest than during exercise among all subjects. In general, exercise-related GI symptoms were significantly related to the occurrence of GI symptoms during nonexercise periods, age, gender, diet, and years of training. The prevalence of medication for exercise-related GI symptoms was 5%, 6%, and 3% for runners, cyclists, and triathletes, respectively. CONCLUSIONS: Long-distance running is mainly associated with lower GI symptoms, whereas cycling is associated with both upper and lower symptoms. Triathletes confirm this pattern during cycling and running. The prevalence of medication for exercise-related GI symptoms is lower in the Netherlands in comparison with other countries, in which a prevalence of 10-18% was reported. More research on the possible predisposition of athletes for GI symptoms during exercise is needed.

Adult↗
PubMed1998

Physical activity and 10-year mortality from cardiovascular diseases and all causes: The Zutphen Elderly Study.

BACKGROUND: Little is known about physical activity and mortality risk in the elderly. Therefore, we describe the associations between the physical activity pattern of elderly men and the mortality from cardiovascular diseases (CVDs), particularly coronary heart disease (CHD) and stroke, and all causes. METHODS: Self-reported physical activity was assessed with a validated questionnaire for retired men in a population-based sample of 802 Dutch men, aged 64 to 84 years at baseline. Relative risks were estimated for 10-year mortality from CVD (199 deaths), CHD (90), stroke (47), and all causes (373) for tertiles of time spent on physical activity (reference, lowest tertile). Adjustments were made for baseline age, relevant major chronic diseases, cigarette smoking, and alcohol consumption. RESULTS: Mortality risks from CVD and all causes decreased with increasing physical activity (P for trend = .04) with adjusted relative risks of 0.70 (95% confidence interval, 0.48-1.01) and 0.77 (95% confidence interval, 0.59-1.00) in the highest tertile of total physical activity, respectively. Except for CHD, time spent in more intense activities (> or = 4 kcal/kg per hour) was more strongly associated with all mortality outcomes than less intense activities, but no single type of activity was particularly protective. Walking or cycling at least 3 times per week for 20 minutes (our definition of activity based on general health recommendations) was associated with reduced mortality from CVD (adjusted relative risk, 0.69; 95% confidence interval, 0.50-0.88) and all causes (relative risk, 0.71; 95% confidence interval, 0.58-0.88). Additional adjustment for biological cardiovascular risk factors did not affect the strength of any association. CONCLUSION: In a general population of elderly men, physical activity may protect against mortality from CVDs and all causes.

Aged↗
PubMed1998

Effect of exercise training on quality of life in patients with chronic heart failure.

The effect of exercise training on quality of life and exercise capacity was studied in 67 patients with mild to moderate chronic heart failure (CHF; age: 65.6+/-8.3 years; left ventricular ejection fraction: 26.5+/-9.6%). Patients were randomly allocated to either a training group or to a control group. After intervention a significantly larger decrease in Feelings of Being Disabled (a subscale of the Heart Patients Psychological Questionnaire) and a significantly larger increase in the Self-Assessment of General Well-Being (SAGWB) were observed in the training group. Exercise time and anaerobic threshold were increased in the training group only. The increase in exercise time was related to both Feelings of Being Disabled and SAGWB. We conclude that supervised exercise training improves both quality of life and exercise capacity and can be safely performed by chronic heart failure patients.

Aged↗
PubMed1998

Age, period, and cohort effects on physical activity among elderly men during 10 years of follow-up: the Zutphen Elderly Study.

BACKGROUND: Data regarding the nature of change in physical activity as elderly people become progressively older are scarce. The present study describes changes in the physical activity pattern of a cohort of elderly Dutch men between 1985 and 1995. METHODS: Self-reported physical activity was assessed with a reliable and valid questionnaire designed for retired men. In 1985, 863 men (aged 65-84 years) were examined, in 1990, 520 surviving men, and in 1995, 343 men. Three analytical perspectives (cross-sectional, longitudinal, and time-series) were used concurrently to untangle effects of aging, period, and birth cohort on the 10-year change in physical activity. RESULTS: Mean total time spent on physical activity decreased by 33% (28 min/day) during 10 years of follow-up. Time spent on bicycling, gardening, and total activity decreased with aging. A period effect was observed for time spent on bicycling and total activity in 1990 (increase) and gardening in 1995 (decrease). No differences in physical activity between birth cohorts were observed. Time spent on walking remained stable during follow-up, but its relative contribution to total time spent on physical activity increased with aging. The pattern of change in total activity was not affected by functional status. CONCLUSIONS: Mean total time spent on physical activity by elderly men clearly decreased during follow-up. This could not be fully explained by declining functional status, but was partly explained by aging. In contrast to other physical activity parameters, time spent on walking was not affected by aging. These results suggest an increasingly restrictive physical activity pattern with aging.

Activities of Daily Living↗
PubMed1998

Exercise training in elderly patients with chronic heart failure.

BACKGROUND: Physical training currently constitutes an important part of treatment of heart failure patients. So far, no data are available on the effects of regular exercise in elderly (aged > 65 years) heart failure patients. METHODS: In a prospective trial, patients with chronic heart failure (New York Heart Association class II and III) were randomly assigned to a training group and a control group. Patients in the training group performed additional exercises three times a week, while patients in the control group continued regular treatment. To analyse the influence of age, both groups were subdivided into subjects younger than and older than 65 years. The effect of training on exercise parameters was evaluated by means of a treadmill test. Quality of life aspects were evaluated with the help of the Heart Patients Psychological Questionnaire and a single-question Self Awareness of General Well-Being test. RESULTS: Comparison of changes between groups revealed that training increased the duration of the exercise test and improved aspects of quality of life in the trained patients aged both younger than and older than 65 years. CONCLUSION: Exercise training is equally effective in patients aged younger than and older than 65 years.

Adult↗
PubMed1997

Aortic and peripheral blood pressure during isometric and dynamic exercise.

The purpose of this study was to compare aortic blood pressure (AOR) to peripheral measurements by the Riva-Rocci/Korotkov (RRK) and Finapres continuous finger pressure (FIN) methods during dynamic and static exercise. A tip manometer was introduced in the ascending aorta after coronary angiography in 7 cardiac patients with good exercise capability. Static exercise was of moderate intensity and led to an increase of average diastolic and systolic AOR of 20 and 18 mmHg, respectively. The corresponding RKK values were 20 and 30 mmHg and the FIN values were 16 and 14 mmHg, respectively. In maximal cycle ergometry the discrepancies were larger, especially in the 4 subjects who reached 80% or more of predicted maximal work load. Diastolic and systolic increases in AOR in these 4 subjects were 12 and 38 mmHg, respectively. The RRK values were 17 and 76 mmHg. Increases in FIN values of 17 and 74 mmHg for diastolic and systolic measurements, respectively, were found. The peripheral FIN and RRK measurements give a systolic increase that is twice as large as that for AOR. It is concluded that RRK and FIN greatly overestimate the load to the cardiovascular system in dynamic exercise. When the cardiovascular load is estimated by the rate-pressure product, RRK produces an increase of 197%, FIN of 181%, while AOR gives an increase of only 133%. This suggests that the present criteria for blood pressure in exercise testing should be critically examined.

Adult↗
PubMed1997

Effect of endurance training and seasonal fluctuation on coagulation and fibrinolysis in young sedentary men.

The effect of 12 wk of submaximal training on hemostatic variables was studied in 20 young sedentary men (Tr) and 19 nontraining matched controls (Con). After training, a more pronounced increase in factor VIII coagulant activity (P < 0.01), reflected in a decrease in activated partial thromboplastin time (P < 0.01) during maximal exercise, was seen. Both basal plasminogen activator inhibitor 1 antigen (PAI-1 Ag) and activity (PAI-1 Act; P < 0.05), as well as basal and exercise-induced tissue-type plasminogen activator antigen (t-PA Ag; P < 0.05), were decreased after training. The overall effect on fibrinolysis was reflected in an increase in the t-PA Act/t-PA Ag ratio in the Tr group. In contrast, during the same period (February-June), the Con group demonstrated an increase in basal PAI-1 Ag and PAI-1 Act (P < 0.05), together with an increase in basal and exercise-induced t-PA Ag (P < 0.05). Both basal and exercise-induced t-PA Act were unchanged, but t-PA Act/t-PA Ag was decreased (P < 0.05) in the Con group. We conclude that physical training promotes both coagulation and fibrinolytic potential during exercise and may reverse unfavorable seasonal effects on fibrinolysis.

Adult↗
PubMed1996

[Outpatient sports clinic, first impressions].

OBJECTIVE: To review the first year of the outpatient sports clinic in Utrecht University Hospital (AZU), and to demonstrate the feasibility of such a sports clinic. DESIGN: Retrospective study (period: April 1993-March 1994). SETTING: University Hospital Utrecht, the Netherlands. METHODS: The patients attended the sports clinic either on referral or on their own initiative. The specialist directly entered the patients' data onto a registration form. RESULTS: Over a period of one year 461 consultations where given to 271 patients. The patients' average age was 31 years. The commonest sports were soccer, running and tennis. The lower limb was the commonest site of injury (79%) and overuse injuries predominated. For 57% of the patients therapy was instituted, which consisted in 67% of the cases of physiotherapy and in 13% of operative intervention. CONCLUSION: The outpatient sports clinic appears to be visited in particular by senior athletes with chronic complaints caused by surmenage injuries or with residual complaints following acute injuries. Future intramural sports medicine will have to deal not only with treatment of injuries as presented at the sports clinic, but also with prevention of chronic complaints resulting from acute injuries in this group of athletes.

Adult↗
PubMed1996

Physical activity and cardiovascular risk factors among elderly men in Finland, Italy, and the Netherlands.

Physical activity pattern and its relation with cardiovascular risk factors was investigated in 1,402 men aged 69-90 years who participated in the 30-year follow-up survey of the Finnish (Eastern and Western Finland), Italian (Montegiorgio and Crevalcore), and Dutch (Zutphen) cohorts of the Seven Countries Study. Physical activity was assessed with a validated self-administered questionnaire designed for retired men. Total physical activity varied largely within cohorts. Median total reported physical activity ranged from 50 minutes/day in Montegiorgio to 89 minutes/day in Crevalcore. Walking, gardening, and bicycling together contributed more than 70% of total physical activity in all cohorts. Depending on the definition of physical inactivity, the estimated prevalence of inactivity varied between 5% and 33% in Zutphen and between 18% and 68% in Montegiorgio. Total physical activity was inversely associated with resting heart rate (r= -0.11, p < 0.001) and was positively associated with high density lipoprotein (HDL) cholesterol (r = 0.08, p < 0.01) in pooled data. These associations remained statistically significant after adjustment for age, cohort, smoking, body mass index, and alcohol intake. Total activity was not associated with total cholesterol, non-HDL cholesterol, blood pressure, or body mass index. The authors conclude that physical activity may have a beneficial effect on HDL cholesterol levels in elderly men. Walking, gardening, and bicycling contribute substantially to their physical activity pattern.

Aged↗
PubMed1996

Injuries in male soccer players: team risk analysis.

Selection may be responsible for different characteristics of subgroups (teams) of soccer players resulting in different risks of injury and different injury patterns. In the present study injury rates of teams were analysed with respect to the factors age and level of play. In two Dutch non-professional soccer clubs 477 male players, active in teams of different age groups and at different levels of play, were prospectively followed during the second half of the 1986/1987 competitive season. Teams in the 17/18 years age group showed the highest incidence of injury per 1000 players hours in games. At a high level of play teams have a significantly (p < 0.01) higher risk of injury than teams at a low level of play. This difference is noticed within every age group with exception of the 15/16 years age group. At a high level of play teams of senior players have significantly (p < 0.005) more prevalent injuries than teams of junior players. Senior players, active at a high level of play, have significantly (p < 0.05) more overuse injuries than senior players of a low level of play. At a high level of play significantly (p < 0.05) more upper leg injuries are reported. In the total population of soccer players relatively more sprains are located in the ankle joint and relatively more strains are located on the upper leg. It is concluded that prevention of soccer injuries primarily should be aimed at teams and their environment and not at the individual soccer player.

Adolescent↗
PubMed1996

Haemostatic parameters and lifestyle factors in elderly men in Italy and The Netherlands.

The association between plasma fibrinogen, factor VII, factor X, activated partial thromboplastin time, antithrombin III and the lifestyle factors cigarette smoking, alcohol use, fat intake and physical activity was assessed in 802 men aged 70-90 years in Zutphen (The Netherlands), Montegiorgio and Crevalcore (Italy). Smoking was positively associated with fibrinogen, also after adjustment for other lifestyle factors, age, use of anticoagulants and aspirin like drugs, body mass index, and history of myocardial infarction. Alcohol use was associated with increased levels of factor X and decreased levels of antithrombin III. Fat intake was positively associated with antithrombin III. Between cohorts, considerable differences were observed in levels of haemostatic parameters and the lifestyle factors. Compared to the mediterranean cohorts the Zutphen cohort showed the highest levels of fibrinogen and factor VII. Differences in lifestyle factors could, however, not explain differences between cohorts in levels of any of the haemostatic parameters, despite the observed associations between lifestyle factors and haemostatic parameters.

Aged↗
PubMed1995

Hemorheological response to prolonged exercise--no effects of different kinds of feedings.

Thirty-one male triathletes performed three experimental trials at one week intervals, with either a semi-solid or liquid carbohydrate feeding, or a liquid placebo. Exercise consisted of three hours of alternately cycling, running, cycling, and running at 75% VO2 max. Venous blood samples were taken before and immediately after the exercise. Viscometry was performed with a Contraves LS-30 viscometer and erythrocyte deformability was measured with the LORCA, a laser diffractometric system. Exercise caused a significant increase in whole blood and plasma viscosity, hematocrit, and osmolality, and a very small, but significant decrease in erythrocyte deformability, irrespective of the feedings consumed. Changes were not related to exercise performance, as defined by the maximal test time, probably due to a large fluid intake. The intake of different amounts of carbohydrate had no influence on the hemorheological parameters, probably since water content was equal among feedings. Erythrocyte deformability changes were small in comparison with the other hemorheological changes and a correlation between erythrocyte deformability and other parameters was absent. This may be due to erythrocyte properties to counterbalance volume shifts to ensure an optimal oxygen delivery in the microcirculation.

Adult↗
PubMed1995

Unbalanced haemostatic changes following strenuous physical exercise. A study in young sedentary males.

During acute exercise both coagulant and fibrinolytic potential increase. Since strenuous exertion is associated with an enhanced risk for cardiac events, especially in untrained individuals, it is important to determine whether the initial haemostatic balance is maintained during exercise. Twenty-nine sedentary males (20-30 years) were subjected to a standardized cycle ergometer test. Blood samples were obtained at two exercise levels, 70% VO2max (submaximal), 100% VO2max (maximal) and during 25 min recovery. Both during submaximal and maximal performance, tissue type plasminogen activator antigen, urokinase plasminogen activator antigen and tissue type plasminogen activator activity were increased. A concomitant enhancement of clotting activity of factors VII, VIII, IX, XII and fibrinogen resulted in a shortening of clotting times. Following correction for changes in plasma volume, the results for factor VII:c were reversed, and factor XII:c and fibrinogen no longer demonstrated exercise-related changes. Increases in coagulant (activated partial thromboplastin time) and fibrinolytic (tissue type plasminogen activator activity) potential proceeded in parallel during exercise. However, during recovery while there was a sustained increase in coagulant potential, fibrinolytic potential demonstrated a sharp fall. We conclude that during physical activity, while parallel changes in coagulant and fibrinolytic activity occur, this haemostatic balance is not maintained during recovery. This phenomenon could constitute an enhanced risk for coronary artery thrombosis which may contribute to exercise-related cardiovascular events.

Blood Coagulation Factors↗
PubMed1995

Changes in haemostatic factors and activation products after exercise in healthy subjects with different ages.

We studied exercise-induced changes in coagulation and fibrinolytic factors and activation products in different age categories. Thirty-eight sedentary males, divided in three age categories (cats I-III; 20-30, 35-45 and 50-60 y) were subjected to a standardized exercise test. Pre-exercise levels (cats I-III resp) of FVII:c (105 +/- 5, 121 +/- 6 and 123 +/- 7% NP), fibrinogen (2.35 +/- 0.12, 2.55 +/- 0.10 and 2.66 +/- 0.09 mg/ml), prothrombin activation fragment F1 + 2 (0.80 +/- 0.10, 0.80 +/- 0.11 and 1.22 +/- 0.16 nM), t-PA (5.2 +/- 0.6, 9.2 +/- 1.0, 8.6 +/- 1.2 ng/ml) and PAI-I (42.8 +/- 7.5, 67.6 +/- 7.6, 62.2 +/- 10.9 ng/ml) showed differences that seemed related to age. Regression analysis revealed associations with anthropometry (FVII:c, fibrinogen, F1+2, t-PA, PAI-1) rather than with age. Exercise-induced changes in coagulation (increase in von Willebrand factor and FVIII:c and a shortening of APTT) and fibrinolytic potential (increase in t-PA and u-PA) were of comparable magnitude for the three age categories. Hardly any change in F1 + 2 (6%) was observed, while thrombin-antithrombin complexes (93%), plasmin-antiplasmin complexes (79%) and D-dimer (77%) almost doubled during maximal exercise. We conclude that anthropometric differences play a more significant role than age on constitutive levels of haemostatic factors in participants up to 60 years of age. The magnitude of exercise-induced changes is comparable in the age categories under study, and simply super-imposed on constitutive (pre-exercise) levels. Clear evidence for prothrombin activation is lacking, but plasmin formation is enhanced during exercise.

Adult↗