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PubMed1989

Exercise-related changes in serum catecholamines and potassium: effect of sustained exercise above and below lactate threshold.

Plasma potassium and catecholamines exhibit rapid shifts during exercise testing, particularly when exercise intensity exceeds lactate threshold. To assess changes that may occur during sustained exercise, we studied 10 healthy men to determine the effect of 20 minutes of exercise at 25 W above lactate threshold (ALT) and 20 minutes of exercise at 25 W below lactate threshold (BLT). Both conditions showed elevation of catecholamines at end exercise compared to baseline, but catecholamine levels ALT were significantly higher than the levels BLT (2270 +/- 190 versus 900 +/- 230 pg/ml norepinephrine, p less than 0.001; 509 +/- 69 versus 150 +/- 18 pg/ml epinephrine, p less than 0.001). This difference persisted at 2 minutes of recovery (1620 +/- 130 versus 590 +/- 60 pg/ml norepinephrine, p less than 0.001; 216 +/- 31 versus 98 +/- 16 pg/ml epinephrine, p less than 0.001). Both conditions resulted in a significant elevation in potassium at end exercise compared to baseline, but the potassium levels ALT were significantly higher than the levels BLT (1.1 +/- 0.1 mEq/L versus 0.5 +/- 0.1 mEq/L, p less than 0.001. The fall in potassium in the immediate post-exercise period was significantly greater following exercise ALT (-0.8 +/- 0.1 mEq/L versus -0.2 +/- 0.1 mEq/L, p less than 0.001). Thus sustained exercise slightly ALT resulted in a significant potassium flux and very elevated catecholamine levels. Avoiding these metabolic stresses by exercising BLT may decrease chances for exercise-related arrhythmia or other cardiac dysfunction in susceptible patients.

Adult↗

PubMed1989

Reduced exercise capacity of chronic obstructive pulmonary disease patients exercising with noseclip/mouthpiece.

A noseclip and low resistance mouthpiece are often used to monitor exhaled gases during exercise. Because otolaryngologic studies suggest that 50% of airway resistance is in the nose and mouth, it was hypothesized that patients with advanced chronic obstructive pulmonary disease might be artifactually limited by exercise testing with a noseclip and mouthpiece. Accordingly, 12 patients with stable chronic obstructive pulmonary disease performed identical symptom-limited supine bicycle exercise tests with and without noseclip and mouthpiece. Right-sided cardiac hemodynamic measurements, radionuclide ventriculography and arterial and mixed venous gas sampling were performed during each exercise test. Exhaled gases were analyzed during the noseclip/mouthpiece exercise. The order of exercise tests was alternated. Comparing exercises with and without a noseclip, there were significant reductions in exercise duration (397 +/- 270 vs 300 +/- 230 seconds, p less than 0.01), exercise oxygen consumption (780 +/- 279 vs 638 +/- 200 ml/min, p less than 0.01) and exercise cardiac output (8.4 +/- 2.7 vs 7.3 +/- 2.0 liters/min, p less than 0.05), an increase in right ventricular ejection fraction (0.39 +/- 0.08 vs 0.43 +/- 0.08, p less than 0.01) and no change in exercise heart rate (106 +/- 14 vs 106 +/- 14), right-sided cardiac pressures or arterial and mixed venous blood gases. These data suggest that a noseclip/mouthpiece can limit exercise tolerance in advanced chronic obstructive pulmonary disease patients. This limitation may result from decreased right-sided cardiac preload (venous return).

Adult↗

PubMed2003

Changes in body image satisfaction during pregnancy: a comparison of high exercising and low exercising women.

OBJECTIVE: This study aimed to compare ratings of body image satisfaction (BIS) from 6 months prepregnancy to 23-30 weeks' gestation for high exercising and low exercising pregnant women. The authors also aimed to assess and compare expectations of BIS for the post-partum period in high and low exercising women. DESIGN: A partial prospective approach was implemented. SAMPLE: A total of 71 healthy pregnant women (40 high exercisers and 31 low exercisers) participated. METHODS: Participants completed a series of questionnaires at 15-22 weeks' gestation and 23-30 weeks' gestation. MAIN OUTCOME MEASURES: There were two main outcome measures. At 15-22 weeks' gestation there was an exercise inventory and two versions of the Body Cathexis Scale (BCS) (retrospective prepregnancy BIS and current BIS). At 23-30 weeks' gestation there was an exercise inventory and two versions of the BCS (current BIS and projected post-partum BIS). RESULTS: At 15-22 weeks' gestation, high exercisers demonstrated significantly higher levels of BIS compared to low exercisers. There were no other significant differences between groups. Within groups, high exercisers were significantly more satisfied with their bodies at 15-22 weeks' gestation compared to 6 months prepregnancy, and expected to be less satisfied with their bodies at 6 weeks' post-partum than they were during pregnancy. Low exercisers demonstrated no significant changes over time. CONCLUSIONS: The findings suggest that women are able to assimilate the bodily changes of pregnancy without a negative shift in BIS. However, women who exercise during pregnancy may respond more favourably to changes in their bodies at early pregnancy compared to women who remain sedentary.

Adult↗

PubMed1998

Pre-exercise carbohydrate ingestion: effect of the glycemic index on endurance exercise performance.

PURPOSE: This study aimed to examine the effect of glycemic index of pre-exercise carbohydrate (CHO) ingestion on exercise metabolism and performance. METHODS: Eight endurance trained men ingested a high glycemic index (HGI), low glycemic index (LGI), or a placebo (CON) meal 45 min before exercise and then cycled for 50 min at 67% VO2max. Subjects subsequently performed a 15-min self-paced performance ride in which total work (kJ) was recorded. RESULTS: Plasma glucose concentrations were higher (P < 0.01) after ingestion in HGI compared with LGI and CON (7.53 +/- 0.64 vs 5.55 +/- 0.21 and 4.65 +/- 0.14 mmol.L-1 for HGI, LGI, and CON, respectively, 30 min postprandial; mean +/- SE) but declined at the onset of exercise and were lower (P < 0.01) compared with LGI and CON (4.03 +/- 0.31 vs 4.64 +/- 0.24 and 5.09 +/- 0.16 mmol.L-1 for HGI, LGI, and CON respectively; mean +/- SE) at 10 min of exercise. Plasma glucose remained depressed (P < 0.01) until 30 min into exercise in HGI compared with other trials. Plasma insulin concentrations were higher (P < 0.01) following ingestion during rest and exercise in HGI compared with LGI and CON. Plasma FFA concentrations were lower (P < 0.05) following ingestion in HGI and LGI compared with CON and higher (P < 0.05) in LGI compared with HGI at the start and end of exercise. RER and CHO oxidation was higher (P < 0.01) in HGI compared with LGI and CON during submaximal exercise. There were no differences in work output during the performance cycle. CONCLUSIONS: These data indicate that pre-exercise CHO feedings with varying glycemic indexes do not affect exercise performance following short term submaximal exercise despite alterations in metabolism.

Adult↗

PubMed2000

Effects of prior exercise on eccentric exercise-induced neutrophilia and enzyme release.

PURPOSE: The purpose of this study was to determine the effects of prior exercise on changes in circulating neutrophils, neutrophil activation, and myocellular enzymes following a standardized bout of eccentric exercise. METHODS: Twenty-four male volunteers were randomized into three groups (N = 8). Group C performed 10 sets of 10 eccentric contractions of the quadriceps muscles with both legs (100% of the concentric IRM). Group D and Group F exercised for 2 h at 56%VO2max on a cycle ergometer followed by a similar bout of eccentric contractions. Group F also received 7.5 mL x kg(-1) of a carbohydrate-electrolyte beverage every 30 min during the submaximal exercise, whereas group D received no fluid. RESULTS: Body weight remained unchanged in groups C and F and decreased in group D by 1.56 +/- 0.34 kg. Ultrastructural Z-Band damage increased three-fold following exercise and remained elevated 3 d after exercise but was not different among groups. Circulating neutrophils were elevated more in group D compared with those in group C immediately after the exercise or rest period, and this difference persisted 3 h after the eccentric exercise. Serum lactoferrin concentrations increased 3.3-fold after exercise in all groups (P < 0.01). Creatine kinase levels (CK) rose in all subjects, with subjects in Group F and D having a significantly greater rise in CK after exercise compared with those in group C. CONCLUSIONS: These data indicate that submaximal exercise followed by a bout of eccentric exercise results in similar amounts of myofibrillar injury with a larger neutrophil response and CK release.

Adult↗

PubMed1999

Norepinephrine response to exercise at the same relative intensity before and after endurance exercise training.

It is well documented that endurance exercise training results in a blunted norepinephrine (NE) response to exercise of a given absolute exercise intensity. However, it is not clear what effect training has on the catecholamine response to exercise of the same relative intensity because previous studies have provided conflicting results. The purpose of the present study was, therefore, to determine the catecholamine response to exercise of the same relative exercise intensity before and after endurance exercise training. Six women and three men [age 28 +/- 8 (SD) yr] performed 10 wk of training. Maximal O2 uptake (VO2 max) was determined during treadmill exercise. Fifteen-minute treadmill exercise bouts were performed at 60, 65, 70, 75, 80, and 85% of VO2 max before and after training. VO2 max was increased by 20% (from 39.2 +/- 7.7 to 46.9 +/- 8.1 ml. kg-1. min-1; P < 0.05) in response to training. Plasma NE concentrations were higher (P < 0.05) during exercise at the same relative intensity after, compared with before, training at 65-85% of VO2 max. Differences between heart rates and plasma epinephrine concentrations after, compared with before, training were not statistically significant. These results provide evidence that the NE response to exercise is dependent on the absolute as well as the relative intensity of the exercise.

Adult↗

PubMed2000

Effects of exercise intensity on the sweating response to a sustained static exercise.

To investigate how the sweating response to a sustained handgrip exercise depends on changes in the exercise intensity, the sweating response to exercise was measured in eight healthy male subjects. Each subject lay in the supine position in a climatic chamber (35 degrees C and 50% relative humidity) for approximately 60 min. This exposure caused sudomotor activation by increasing skin temperature without a marked change in internal temperature. After this period, each subject performed isometric handgrip exercise [15, 30, 45, and 60% maximal voluntary contraction (MVC)] for 60 s. Although esophageal and mean skin temperatures did not change with a rise in exercise intensity and were similar at all exercise intensities, the sweating rate (SR) on the forearm increased significantly (P < 0.05) from baseline (0.094 +/- 0.021 mg. cm(-2). min(-1) at 30% MVC, 0.102 +/- 0.022 mg. cm(-2). min(-1) at 45% MVC, 0.059 +/- 0.009 mg. cm(-2). min(-1) at 60% MVC) in parallel with exercise intensity above exercise intensity at 30% MVC (0.121 +/- 0.023 mg. cm(-2). min(-1) at 30% MVC, 0.242 +/- 0.051 mg. cm(-2). min(-1) at 45% MVC, 0.290 +/- 0.056 mg. cm(-2). min(-1) at 60% MVC). Above 45% MVC, SR on the palm increased significantly from baseline (P < 0.05). Although SR on the forearm and palm tended to increase with a rise in exercise intensity, there was a difference in the time courses of SR between sites. SR on the palm showed a plateau after abrupt increase, whereas SR on the forearm increased progressively during exercise. These results suggest that the increase in SR with the increase in sustained handgrip exercise intensity is due to nonthermal factors and that the magnitude of these factors during the exercise may be responsible for the magnitude of SR.

Adult↗

PubMed2000

Supine lower body negative pressure exercise simulates metabolic and kinetic features of upright exercise.

Exercise within an artificial gravity environment may help prevent microgravity-induced deconditioning. We hypothesized that supine lower body negative pressure (LBNP) exercise simulates physiological and biomechanical features of upright exercise. Walking (4.5 +/- 0.3 km/h) and running (8.0 +/- 1.0 km/h) while supine within a LBNP exerciser were compared with walking and running while upright. Eight healthy subjects exercised for 5 min at each of the four posture/gait conditions. LBNP of 52 +/- 4 mmHg generated one body weight of supine ground reaction force (GRF). Gait parameters and GRFs were measured during the third minute of exercise, and heart rate and oxygen consumption were measured during the fifth minute. Oxygen consumption during supine LBNP treadmill exercise [walking: 14.6 +/- 0.9; running: 32.2 +/- 1.6 (SE) ml. min(-1). kg(-1)] was similar to that during upright treadmill exercise (walking: 15.1 +/- 0.9; running: 34.0 +/- 1.9 ml. min(-1). kg(-1)). Heart rate for supine LBNP exercise (grand mean: 133 +/- 11 beats/min) was also similar to that for upright exercise (136 +/- 11 beats/min). Footward forces integrated over each stride (330.5 +/- 34.4 vs. 319. 1 +/- 29.6 N. s) and rate of force generation (26,483 +/- 4,310 vs. 25,634 +/- 4,434 N/s) were similar for upright and LBNP exercise, respectively. Our collective results indicate that supine exercise within LBNP can simulate the physiological stress and GRFs that are generated during upright gait.

Adult↗

PubMed2002

Oxygen uptake kinetics for moderate exercise are speeded in older humans by prior heavy exercise.

This study examined the effect of heavy-intensity warm-up exercise on O(2) uptake (VO(2)) kinetics at the onset of moderate-intensity (80% ventilation threshold), constant-work rate exercise in eight older (65 +/- 2 yr) and seven younger adults (26 +/- 1 yr). Step increases in work rate from loadless cycling to moderate exercise (Mod(1)), heavy exercise, and moderate exercise (Mod(2)) were performed. Each exercise bout was 6 min in duration and separated by 6 min of loadless cycling. VO(2) kinetics were modeled from the onset of exercise by use of a two-component exponential model. Heart rate (HR) kinetics were modeled from the onset of exercise using a single exponential model. During Mod(1), the time constant (tau) for the predominant rise in VO(2) (tau VO(2)) was slower (P < 0.05) in the older adults (50 +/- 10 s) than in young adults (19 +/- 5 s). The older adults demonstrated a speeding (P < 0.05) of VO(2) kinetics when moderate-intensity exercise (Mod(2)) was preceded by high-intensity warm-up exercise (tau VO(2), 27 +/- 3 s), whereas young adults showed no speeding of VO(2) kinetics (tau VO(2), 17 +/- 3 s). In the older and younger adults, baseline HR preceding Mod(2) was elevated compared with Mod(1), but the tau for HR kinetics was slowed (P < 0.05) in Mod(2) only for the older adults. Prior heavy-intensity exercise in old, but not young, adults speeded VO(2) kinetics during Mod(2). Despite slowed HR kinetics in Mod(2) in the older adults, an elevated baseline HR before the onset of Mod(2) may have led to sufficient muscle perfusion and O(2) delivery. These results suggest that, when muscle blood flow and O(2) delivery are adequate, muscle O(2) consumption in both old and young adults is limited by intracellular processes within the exercising muscle.

Adult↗

PubMed1998

Long-term prognostic value of exercise echocardiography compared with exercise 201Tl, ECG, and clinical variables in patients evaluated for coronary artery disease.

BACKGROUND: The accuracy of exercise echocardiography and 201Tl single photon emission computed tomography (SPECT) is similar in the diagnosis of coronary artery disease (CAD). However, comparative data on long-term prognosis are lacking. METHODS AND RESULTS: Clinical variables and exercise, echocardiographic, and 201Tl tomographic parameters were studied in 248 patients (age, 56+/-12 years [mean+/-SD]; 189 men) who underwent simultaneous treadmill exercise 201Tl SPECT and echocardiography. Follow-up was obtained in 225 patients (91%) at a mean of 3.7+/-2.0 years. A total of 64 cardiac events occurred. With the use of stepwise logistic regression, 4 models simulating clinical stress testing scenarios were evaluated in the prediction of all cardiac events, ischemic events, and/or cardiac death. The best clinical models were exercise echocardiography with exercise ECG and exercise 201Tl SPECT with exercise ECG. Both models were comparable in the prediction of cardiac events. For the exercise echocardiography model, exercise wall motion score index and induction of ischemia were the strongest predictors of events with ORs of 2.63 per unit increment (95% CI, 1. 34 to 5.17; P=0.005) and 4.1 (95% CI, 1.32 to 12.79; P=0.015), respectively. For the model with exercise 201Tl SPECT, the strongest predictor was ischemic perfusion defect (OR, 4.93; 95% CI, 1.72 to 14.08; P=0.003). The absence of ST changes during exercise decreased the risk of events. For the prediction of ischemic events and/or cardiac death, echocardiographic and 201Tl parameters were the only predictive variables. CONCLUSIONS: In patients evaluated for CAD, exercise echocardiography and 201Tl combined with ECG variables provide comparable prognostic information and can be used interchangeably for risk stratification.

Adult↗

PubMedDate not supplied

Exercise habits and exercise relapse in persons with non-insulin-dependent diabetes mellitus.

Exercise is widely recognized as a crucial component in the management of non-insulin-dependent diabetes mellitus (NIDDM), but little is known about actual exercise practices in this group. This study investigated exercise habits in 60 persons with NIDDM and 60 nondiabetic significant others. Despite the importance of exercise, most of the persons with NIDDM in our study were not exercising regularly, and the percent of persons exercising regularly was no greater in the diabetic group than in the group of significant others. Although those with NIDDM reported more frequent discussion about exercise with health care professionals, only 25% reported receiving specific guidelines for exercise. Diabetic respondents reported a greater number of relapse or dropout episodes than did the nondiabetic significant others, and relapse was associated with increased guilt. Persons with NIDDM appear to receive recommendations to exercise without instruction on exercise maintenance strategies, resulting in more failed attempts to exercise, and increased guilt. Interventions shown to be effective for increasing exercise maintenance need to be incorporated into the diabetic regimen.

Diabetes Mellitus, Type 2↗

PubMed2004

Effects of an oncologist's recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial.

BACKGROUND: Increased attention has focused on exercise as a quality of life intervention for breast cancer survivors during and after adjuvant therapy. PURPOSE: Our objective was to examine the effects of an oncologist's recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors attending their first adjuvant therapy consultation. METHODS: Using a single-blinded, 3-armed, randomized controlled trial, 450 breast cancer survivors were randomly assigned to receive an oncologist exercise recommendation only, an oncologist exercise recommendation plus referral to an exercise specialist, or usual care. The primary outcome was self-reported total exercise (in metabolic equivalent [MET] hours per week) at 5 weeks postconsultation. RESULTS: The follow-up assessment rate was 73% (329 of 450). Intention-to-treat analysis based on participants with follow-up data indicated a significant difference in total exercise in favor of the recommendation-only group over the usual care group (mean difference, 3.4 MET hr per week; 95% confidence interval [CI], 0.7-6.1 MET hr per week; p = .011). There was no significant difference between the recommendation-plus-referral group and the usual care group (mean difference, 1.5 MET hr per week; 95% CI, -1.0 to 4.0 MET hr per week; p = .244). Ancillary "on-treatment" analyzes showed that participants who recalled an exercise recommendation reported significantly more total exercise than participants who did not recall an exercise recommendation (mean difference, 4.1 MET hr per week: 95% CI, 1.9-6.4 MET hr per week; p < .001). CONCLUSIONS: Our findings suggest that an oncologist recommendation may increase exercise behavior in newly diagnosed breast cancer survivors, particularly if it is recalled 1 week after the recommendation.

Adult↗

PubMed1998

[Effect of exercise duration on the magnitude and duration of post-exercise hypotension].

PURPOSE: Considering that exercise duration may play a role in post-exercise hypotension, we tested the hypothesis that a prolonged submaximal exercise would lead to a greater and longer blood pressure fall after exercise than a shorter exercise bout. METHODS: Experimental protocol-10 subjects were submitted to two cycle ergometer exercise trials (25 and 45 min) at 50% of VO2 peak. Control protocol-12 subjects rested in the sitting position for 45 min. Blood pressure (BP) was measured before (20 min) and after (90 min) rest or exercise bouts. RESULTS: Systolic BP decreased significantly after exercise and this reduction was greater and lasted longer after 45 min of exercise. Mean and diastolic BP decreased after exercise and they were significantly lower during the 45 min session. Control protocol--no change in BP was observed after resting condition. CONCLUSION: A longer exercise bout leads to a greater and longer post-exercise hypotension.

Adult↗

PubMed2004

Exercise-induced changes in insulin and glucagon are not required for enhanced hepatic glucose uptake after exercise but influence the fate of glucose within the liver.

To test whether pancreatic hormonal changes that occur during exercise are necessary for the postexercise enhancement of insulin-stimulated net hepatic glucose uptake, chronically catheterized dogs were exercised on a treadmill or rested for 150 min. At the onset of exercise, somatostatin was infused into a peripheral vein, and insulin and glucagon were infused in the portal vein to maintain basal levels (EX-Basal) or simulate the response to exercise (EX-Sim). Glucose was infused as needed to maintain euglycemia during exercise. After exercise or rest, somatostatin infusion was continued in exercised dogs and initiated in dogs that had remained sedentary. In addition, basal glucagon, glucose, and insulin were infused in the portal vein for 150 min to create a hyperinsulinemic-hyperglycemic clamp in EX-Basal, EX-Sim, and sedentary dogs. Steady-state measurements were made during the final 50 min of the clamp. During exercise, net hepatic glucose output (mg x kg(-1) x min(-1)) rose in EX-Sim (7.6 +/- 2.8) but not EX-Basal (1.9 +/- 0.3) dogs. During the hyperinsulinemic-hyperglycemic clamp that followed either exercise or rest, net hepatic glucose uptake (mg x kg(-1) x min(-1)) was elevated in both EX-Basal (4.0 +/- 0.7) and EX-Sim (4.6 +/- 0.5) dogs compared with sedentary dogs (2.0 +/- 0.3). Despite this elevation in net hepatic glucose uptake after exercise, glucose incorporation into hepatic glycogen, determined using [3-3H]glucose, was not different in EX-Basal and sedentary dogs, but was 50 +/- 30% greater in EX-Sim dogs. Exercise-induced changes in insulin and glucagon, and consequent glycogen depletion, are not required for the increase in net hepatic glucose uptake after exercise but result in a greater fraction of the glucose consumed by the liver being directed to glycogen.

Alanine↗

PubMed2006

A comparison of serratus anterior muscle activation during a wall slide exercise and other traditional exercises.

STUDY DESIGN: Single-group repeated-measures design. OBJECTIVES: To investigate the ability of the wall slide exercise to activate the serratus anterior muscle (SA) at and above 90 degrees of humeral elevation. BACKGROUND: Strengthening of the SA is a critical component of rehabilitation for patients with shoulder impingement syndromes. Traditional SA exercises have included scapular protraction exercises such as the push-up plus. These exercises promote activation of the SA near 90 degrees of humeral elevation, but not in positions above 90 degrees where patients typically experience pain. METHODS AND MEASURES: Twenty healthy subjects were studied performing 3 exercises: (1) wall slide, (2) plus phase of a wall push-up plus, and (3) scapular plane shoulder elevation. Three-dimensional position of the thorax, scapula, and humerus and muscle activity from the SA, upper and lower trapezius, and latissimus dorsi were recorded. The magnitudes of activation for each muscle at 90 degrees, 120 degrees, and 140 degrees of humeral elevation were quantified from EMG records. Repeated-measures analyses of variance were used to determine the degree to which the different exercises activated the SA at the 3 humeral positions. RESULTS: The intensity of SA activity was not significantly different between the 3 exercises at 90 degrees of humeral elevation (P = .40). For the wall slide and scapular plane shoulder elevation exercises, SA activity increased with increasing humeral elevation angle (P = .001), with no significant differences between the 2 exercises (P = .36). CONCLUSION: The wall slide is an effective exercise to activate the SA muscle at and above 90 degrees of shoulder elevation. During this exercise, SA activation is not significantly different from SA activation during the push-up plus and scapular plane shoulder elevation, 2 exercises previously validated in the literature.

Adult↗

PubMed1992

[Hypertensive reaction to exercise. Retrospective studies of 1363 consecutive exercise tests].

OBJECTIVE: To study exercise hypertensive reaction and its relation with rest blood pressure, hypertension type and hypertensive cardiac disease. DESIGN: Retrospective study of treadmill exercise testes (ET) performed from January/89 to June/91: (n: 1703). SETTING: Stress tests Laboratory of Cardiology Service of a Military Hospital. METHODS: 1363 consecutive ET of male subjects, performing at least the 3rd stage of the Bruce protocol, were studied. From each ET record were obtained general data, including the reason for test, medication and the rest and exercise blood pressure. Exercise hypertensive reaction was defined as a Bruce protocol 3rd stage systolic blood pressure above 187 mmHg, which corresponds to mean +2SD of 130 normal male subjects previously studied. The Echocardiograms of non-treated hypertensives, obtained less than a month from ET, were reviewed. The diagnosis of borderline or moderate hypertension was base on the clinical records. RESULTS: 1) The 1363 ET included 132 (9.7%) ET to study hypertensive subjects, and 68 of these had hypertensive reaction. 86 ET were performed by non-treated hypertensive subjects, of whom 73 had Echocardiogram. 43 (3.5%) from 1231 ET performed by non-hypertensive subjects also had exercise hypertensive reaction. 2) The left ventricular (LV) mass index of non-treated hypertensive patients had a positive correlation with exercise systolic pressure (r: 0.45; p < 0.001), more important than with rest blood pressure or exercise systolic pressure response; there was a relation with LV wall thickness, but not with internal ventricular dimensions, that was only observed in hypertensive subjects that also had hypertensive reaction to exercise. 3) Exercise systolic blood pressure was usually normal in borderline and elevated in moderate hypertensives (Qui2: 27.249; p < 0.001). 4) Subjects with exercise hypertensive reaction, but not previously diagnosed as hypertensives, were usually true hypertensives. CONCLUSIONS: 1) Hypertensive peaks seem to be an important determinant factor in LV hypertrophy of hypertension, but its influence is felt only above a certain blood pressure threshold; it results on LV concentric type hypertrophy. 2) Exercise systolic blood pressure had a discrimination power of about 80% to separate borderline and moderate hypertensive subjects. 3) All subjects having an exercise hypertensive reaction must be carefully observed, even if their blood pressure at rest is normal, because most of them are true hypertensive patients.

Adult↗

PubMed2003

Exercise counseling and personal exercise habits of US women physicians.

OBJECTIVES: This paper examines the personal exercise habits of women physicians and the effect of those habits on how they counsel their patients on exercise. METHODS: Using the Women Physicians' Health Study (WPHS), a national questionnaire-based survey (n=4501), we analyzed responses of women physicians regarding personal and clinical exercise-related practices. RESULTS: Nearly all (96%) women physicians reported exercising. Forty-nine percent exercised enough to meet the American College of Sports Medicine (ACSM) recommendations, and these physicians were more likely to be unmarried, to be white, to have light stress at home and work, to have female physicians, to be in good health, and to not feel overweight. Physicians complying with ACSM recommendations also were more likely to counsel patients on exercise, to counsel confidently, and to be trained in counseling. Those having a high priority to exercise more were more likely to counsel on exercise. Fifty-nine percent of female primary care practitioners and 33% of female specialists counseled typical patients at least yearly on exercise. CONCLUSION: Women physicians are relatively good exercise role models for their patients. However, many (especially those not regularly exercising themselves) could more frequently counsel their patients regarding exercise.

Adult↗

PubMed2005

Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain.

BACKGROUND AND PURPOSE: The purpose of this randomized controlled trial was to examine the usefulness of the addition of specific stabilization exercises to a general back and abdominal muscle exercise approach for patients with subacute or chronic nonspecific back pain by comparing a specific muscle stabilization-enhanced general exercise approach with a general exercise-only approach. SUBJECTS: Fifty-five patients with recurrent, nonspecific back pain (stabilization-enhanced exercise group: n=29, general exercise-only group: n=26) and no clinical signs suggesting spinal instability were recruited. METHODS: Both groups received an 8-week exercise intervention and written advice (The Back Book). Outcome was based on self-reported pain (Short-Form McGill Pain Questionnaire), disability (Roland-Morris Disability Questionnaire), and cognitive status (Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia, Pain Locus of Control Scale) measured immediately before and after intervention and 3 months after the end of the intervention period. RESULTS: Outcome measures for both groups improved. Furthermore, self-reported disability improved more in the general exercise-only group immediately after intervention but not at the 3-month follow-up. There were generally no differences between the 2 exercise approaches for any of the other outcomes. DISCUSSION AND CONCLUSION: A general exercise program reduced disability in the short term to a greater extent than a stabilization-enhanced exercise approach in patients with recurrent nonspecific low back pain. Stabilization exercises do not appear to provide additional benefit to patients with subacute or chronic low back pain who have no clinical signs suggesting the presence of spinal instability.

Abdominal Muscles↗