PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Exercise”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources

What are the dietary protein requirements of physically active individuals? New evidence on the effects of exercise on protein utilization during post-exercise recovery.

Exercise and physical activity increase energy expenditure up to 10-fold. This brief review will focus on the effect of exercise on protein requirements. Evidence has accumulated that amino acids are oxidized as substrates during prolonged submaximal exercise. In addition, studies have determined that both endurance and resistance training exercise increase skeletal muscle protein synthesis and breakdown in the post-exercise recovery period. Studies using nitrogen balance have further confirmed that protein requirements for individuals engaged in regular exercise are increased. The current recommended intakes of protein for strength and endurance athletes are 1.6 to 1.7 g/kg and 1.2 to 1.4 g/kg per day, respectively. Presently, most athletes consume an adequate amount of protein in their diet. The timing and nutritional content of the post-exercise meal, although often overlooked, are known to have synergistic effects on protein accretion after exercise. New evidence suggests that individuals engaging in strenuous activity consume a meal rich in amino acids and carbohydrate soon after the exercise bout or training session.

Dietary Proteins↗

Pre-exercise glucose ingestion at different time periods and blood glucose concentration during exercise.

The purpose of this study was to investigate the effects of glucose ingestion (GI) at different time periods prior to exercise on blood glucose (BG) levels during prolonged treadmill running. Eight subjects (X+/-SD), age 20+/-0.5yr, bodymass 70.7+/-4.1 kg, height 177+/-4 cm, VO2max 52.8+/-7.8 ml x kg(-1) x min(-1) who underwent different experimental conditions ingested a glucose solution (1 g/kg at 350 ml) 30 min (gl-30), 60 min (gl-60), 90 min (gl-90), and a placebo one 60 min (pl-60) prior to exercise in a counterbalanced design. Afterwards they ran at 65% of VO2max for 1 hour and then at 75 % of VO2max till exhaustion. Fingertip blood samples (10 microl) were drawn every 15 min before and during exercise for the determination of BG levels. Oxygen uptake (VO2), heart rate (HR), and blood lactate (La) were also measured every 15 min during exercise. Peak BG values were reached within 30 min after GI but were different (p < 0.01) at the onset of exercise (gl-30: 147+/-22, gl-60: 118+/-25, gl-90: 109+/-22, pl-60: 79+/-5mg/dl). The two-way ANOVA repeated measures and the Tukey post-hoc test revealed a higher BG concentration (p < 0.05) for the gl-30 and the pl-60 as compared to the gl-60 and gl-90 during running (e.g. 15min run: 82+/-11, 68+/-5, 64+/-3, 78+/-7, and 60min run: 98+/-12, 85+/-12, 83+/-11, 94+/-11 mg/dl for gl-30, gl-60, gl-90, and pl-60, respectively). However, this did not significantly affect the duration of treadmill running. The La levels were higher (p < 0.05) after GI as compared to placebo throughout exercise (values at exhaustion: 4.6+/-0.2, 5.0+/-1.5, 4.8+/- 1.7 mmol/l for gl-30, gl-60, gl-90, and 3.5+/-0.8 mmol/l for placebo). The gl-30 and the placebo fluctuated closer to normoglycaemic levels. The glucose ingestion (60 to 90 min) prior to exercise lowered the blood glucose levels without affecting the duration of running performance at 75% VO2max. Thus, in order to maintain normoglycaemic levels, pre-exercise glucose supplementation should be given 30 min before the onset of exercise.

Administration, Oral↗

Acute effect of physical exercise on serum insulin-like growth factor-binding protein 2 and 3 in healthy men: role of exercise-linked growth hormone secretion.

The purpose of this study was to delineate the role of GH on serum IGF-I, IGFBP-2 and -3 responses to exercise. Hormones were evaluated in six trained male subjects before (-30, -15, 0), during (+15) and after (+30, +45, + 60, +90 min) a thirty-minutes treadmill exercise (60% VO2max), both after a single administration of a somatostatin analog (i.e., octreotide, 0.1 mg sc) and after saline. The same evaluations were performed without exercise with similar treatments. The results showed that: 1) octreotide significantly inhibited the GH response to exercise, 2) exercise increased IGFBP-3 concentration (+37.4% at +90, p < 0.05), whereas no modification of IGFBP-2 and of IGF-I/ IGFBP-2 and IGFBP-3/IGFBP-2 ratios were observed, 3) octreotide amplified the IGFBP-3 increase after exercise (p < 0.01 vs. exercise, from + 30 to + 60, or octreotide alone) and, without exercise, slightly increased IGFBP-3 (+15% at +75, p < 0.05) and decreased IGF-I (-14.8% at +75, p < 0.01). We concluded that GH has a reduced role, as a stimulating factor, in the serum acute IGFBP-3 increase after exercise and that octreotide is probably able to directly amplify this response. Unfortunately, we can only speculate on the physiological pathways involved.

Animals↗

Lower body negative pressure treadmill exercise is more comfortable and produces similar physiological responses as weighted vest exercise.

Lower body negative pressure (LBNP) treadmill exercise can generate a hypergravity load on the lower body that may improve athlete performance by mechanical and cardiovascular adaptations. This study compared the cardiovascular responses, subjective exertion and discomfort levels produced by LBNP exercise with those generated by a weighted vest (WV). We hypothesized that LBNP exercise is more comfortable than WV exercise at comparable levels of exercise. Nine subjects exercised on a treadmill at nine conditions, at 5.5 mph for 15 minutes, in which they ran in random order to avoid confounding effects: 100 %, 110 %, 120 %, 130 %, and 140 % body weight (BW), the latter four conditions were achieved by either LBNP chamber or WV. Heart rate (HR) and oxygen consumption (.VO(2)) were monitored continuously using ECG and open circuit spirometry. At the end of each test, subjects were asked to give discomfort and exertion scores using a ten-point visual analog scale (10 = maximal discomfort and exertion). For both HR and .VO(2), no significant differences were observed between LBNP and WV. Subjects reported significantly higher discomfort levels when exercising with the WV than with the LBNP at 120 % BW (5.1 +/- 0.55 vs. 3.1 +/- 0.64; p < 0.05), 130 % BW (6.2 +/- 0.42 vs. 2.3 +/- 0.44; p < 0.01) and 140 % BW (6.9 +/- 0.27 vs. 4.7 +/- 0.60; p < 0.01), while maintaining similar exertions at all conditions. Based on these results, LBNP exercise is more comfortable than standard WV exercise, while maintaining similar exertion, HR and .VO(2) values.

Adult↗

Exercise referral: the public health panacea for physical activity promotion? A critical perspective of exercise referral schemes; their development and evaluation.

This review critically explores the development, impact and evaluation of exercise referral schemes (ERS) in the UK. A rapid expansion in the use of such ERSs has been recorded throughout leisure and primary care settings, but the evidence underpinning their implementation has been sparse and predominantly limited to randomized control trial (RCT) research design. Consequently, understanding of exercise referral as a 'real world' intervention has been limited. Considering the increasing importance being placed on evidence-based practice and clinical effectiveness, it is no longer sufficient for service providers of exercise referral to ignore the need to evaluate schemes. The guidelines on evaluation provided by the National Quality Assurance Framework for Exercise Referral are limited, hence practitioners are often unsure of the best measures to use when assessing effectiveness. Predominantly, exercise professionals focus on the collection of physiological data but tend to ignore relevant psychological and environmental parameters. Also, few UK studies have followed participants up in the long term, to see if physical activity behaviour is sustained over time. Here, evidence from two on-going, large-scale (n = 1600/annum) evaluation studies of exercise referral schemes, based in urban localities in the northwest of England, are described. A participatory action research framework for evaluation was utilized and incorporated multi-method research approaches for the assessment of both ERS participants and health professionals involved in intervention delivery. This framework is an appropriate methodology for the evaluation and development of complex interventions, and here incorporates case study, focus groups, interviews and survey questionnaires. Included was a 12-month tracking study of a cohort of exercise referral participants (n = 342), which measured leisure-time physical activity levels (Godin leisure time score), at baseline (entry to exercise referral) and at 3 monthly intervals thereafter. Adherence to the ERS was approximately 35-45%, with the older participants more likely to complete. Physiological changes during the ERS, although statistically significant, were not of a magnitude to convey any real health benefit to an individual's health status. Although small in scale, physiological changes were all in a positive direction (e.g. reduction in blood pressure) and, if maintained over time, could bring about population-level benefits in health. Participants referred from cardiac and practice nurses had higher levels of adherence than participants referred by general practitioners. Scheme B showed that the participants who adhered (n = 103) until the end of the ERS (12 weeks) were able to sustain a small increase in physical activity at the end of 12 months (increase of 21 min moderate activity/week compared with baseline). In conclusion, this research shows that the process of exercise referral benefits certain segments of the population, but not necessarily all.

Evaluation Studies as Topic↗

Dietary salt alters pulmonary function during exercise in exercise-induced asthmatics.

Epidemiological and experimental studies have suggested that dietary salt may play a role in airway responsiveness. We have previously shown that a low salt diet improves and a high salt diet exacerbates post-exercise pulmonary function in individuals with exercise-induced asthma. The aim of this study was to determine the influence of both elevated and restricted salt diets on pulmonary function during exercise in individuals with exercise-induced asthma. Nine men and six women participated in this double-blind, crossover study. The participants entered the study on their normal salt diet and were placed on either a low or high salt diet for 2 weeks. Each diet was randomized, with a 1 week washout period between diets before crossing over to the alternative diet for 2 weeks. The participants underwent treadmill testing at 85% of their age-predicted heart rate on the normal salt diet and at the end of each treatment period. Pulmonary function was assessed during exercise by arterial saturation (ear oximetry) and indirect calorimetry. Twenty-four hour urine collections confirmed compliance with the diets. Arterial saturation was reduced on the high and improved on the low salt diet at higher exercise intensities. Tidal volume and frequency selection during exercise varied with the diets, with a higher tidal volume and lower frequency on the high salt diet, but a lower tidal volume and higher frequency on the low salt diet. This suggested greater airway resistance during the high salt diet. In conclusion, the low salt diet improved and the high salt diet exacerbated pulmonary function during exercise in individuals with exercise-induced asthma. The mechanism of action remains unclear.

Adult↗

Influence of previous concentric exercise on eccentric exercise-induced muscle damage.

This study investigated whether a fatiguing concentric exercise performed immediately before eccentric exercise would exacerbate eccentric exercise-induced muscle damage. One arm of nine female subjects (mean +/- s: 23.3 +/- 6.7 years) performed 12 maximal eccentric actions of the elbow flexors (ECC), and the other arm performed 100 repetitions of isokinetic concentric actions of the elbow flexors followed by the same eccentric exercise (CON-ECC). The two exercise regimens (ECC and CON-ECC) were separated by 2 weeks and presented in a counterbalanced order. Changes in muscle soreness level, maximal isometric force generation, relaxed and flexed elbow joint angle, upper arm circumference and plasma creatine kinase activity were compared between the ECC and CON-ECC conditions. All measures changed significantly after both ECC and CON-ECC; however, there were significant differences in the changes between the conditions. A lower level of soreness, a faster recovery of maximal isometric force generation, a smaller decrease in relaxed elbow joint angle and a smaller increase in upper arm circumference and creatine kinase activity were evident after the CON-ECC condition compared to the ECC condition. Thus, it would seem that muscle damage was attenuated by performance of previous concentric exercise. An additional experiment using a different group of subjects (n = 5) showed that warm-up exercise before the eccentric exercise also attenuated eccentric exercise-induced muscle damage.

Adult↗

The influence of age and gender of an exercise model on self-efficacy and quality of therapeutic exercise performance in the elderly.

This study examined whether self-efficacy and quality of exercise performance in healthy elderly adults was influenced by the age and gender of the model who demonstrated the exercises to them. Twenty men and 20 women over 60 years of age were randomly assigned to one of four groups who viewed a videotape of a model of similar or different age and gender. The participants imitated three different exercises performed by the model. Participants rated their self-efficacy for performing the exercises before observing the model and again after imitation with the model. Analysis of variance revealed that the gender of the model influenced self-efficacy ratings of women but not men (p = .041). Elderly women who observed young or old male models provided significantly lower ratings of self-efficacy (p < .05) about correctly performing the exercises than did elderly women who observed female models of either age category. Gender and age of the model did not influence self-efficacy ratings of elderly men. Two raters blinded to group membership rated the quality of the participants' exercise form. When participants performed the exercises following modeling, analysis of variance revealed that the gender of the model previously viewed did not affect form ratings. It was concluded that matching the gender of model and observer when the observer is an elderly woman may support the observer's belief that she can perform the exercises well. In turn, this may benefit adherence to an exercise program.

Age Factors↗

Psychological consequences of exercise deprivation in habitual exercisers.

Psychological consequences of exercise deprivation in habitual exercisers. The purpose of this investigation was to evaluate the influence of 3 d of exercise deprivation on selected psychological variables. Ten volunteers (4 female and 6 male) who regularly exercised 6-7 d.wk-1 for at least 45 min at a time participated in a 5-d study. Participants completed their regular workout on the first day of the study, refrained from physical activity for the next 3 d, and then resumed their regular exercise on the 5th d of the study. Participants reported to the lab on Monday following their regular workout and completed a series of questionnaires, and these same questionnaires were completed at the same time of day on the next 4 d. The dependent variables consisted of state and trait anxiety (STAI), and tension, depression, anger, vigor, fatigue, confusion, and overall mood (POMS). Increases in total mood disturbance, state anxiety, tension, depression, and confusion across days were significant (P < 0.05), and vigor decreased. The pattern of increasing mood disturbance with exercise deprivation was followed by mood improvement to baseline levels when exercise was resumed. We concluded that a brief period of exercise deprivation in habitual exercisers results in mood disturbance within 24-48 h.

Adult↗

Gas exchange and neurohumoral response to exercise: influence of the exercise protocol.

Maximal oxygen uptake varies with the exercise protocol, but the extent to which hormonal and metabolic responses to exercise are influenced by the exercise protocol has not been precisely defined. Twelve healthy subjects underwent maximal exercise testing using two incremental bicycle tests with individualized, identical work rate increments between 40 and 70 W. One protocol employed a 1-min and the other a 3-min duration per stage. Expiratory gas and venous blood were sampled at regular intervals for metabolic and hormonal analysis. Exercise duration for the 1-min and 3-min protocols was 6.0 +/- 0.1 and 14.3 +/- 0.3 min, respectively (P < 0.001). Significantly higher values were observed for peak VO2 and maximal ventilation during the 3-min protocol compared with the 1-min protocol (41.1 +/- 1.8 vs 38.3 +/- 1.6 ml.kg-1.min-1, P < 0.001; and 104.9 +/- 8.0 vs 97.2 + 5.7 l.min-1, P < 0.05, for peak VO2 and peak ventilation, respectively). However, the maximal workload achieved was higher during the 1-min versus the 3-min protocol (330 + 24 vs 280 + 21 W, P < 0.01). No differences were observed for maximal heart rate or blood pressure, whereas maximal plasma lactate was roughly twice as high during the 3-min compared with the 1-min protocol (7.5 +/- 0.8 vs 3.8 +/- 0.5 mmol.l-1, P < 0.001). Norepinephrine, epinephrine, dopamine, and growth hormone levels were generally higher throughout exercise during the 3-min compared with the 1-min protocol. When expressed as a percentage of peak VO2, however, differences in catecholamine levels were not observed. Endothelin levels did not change. We conclude that the exercise protocol profoundly influences exercise capacity as well as the metabolic and hormonal response to exercise and should be considered when using these variables to evaluate an intervention.

Adult↗

Exercise and aspirin increase levels of circulating gliadin peptides in patients with wheat-dependent exercise-induced anaphylaxis.

BACKGROUND: Food-dependent exercise-induced anaphylaxis (FDEIA) is an allergic reaction characteristically induced by intense exercise combined with the ingestion of causative food. Recent reports have shown that aspirin intake is a contributing factor in some patients with FDEIA. Wheat is known to be the most frequent causative food, and the IgE-binding epitopes of a major wheat allergen (omega-5 gliadin) in wheat-dependent exercise induced anaphylaxis (WDEIA) have already been clarified. However, the mechanism of eliciting the symptom in WDEIA remains not fully understood. OBJECTIVES: The aim of this study was to examine the relationship of serum gliadin levels and allergic symptoms induced by exercise or aspirin in patients with WDEIA. METHODS: Six patients with a history of recurrent anaphylaxis associated with wheat ingestion were diagnosed as having WDEIA by the provocation test, which included wheat ingestion, exercise, aspirin intake and a combination of these challenges. During the tests, serum levels of gliadins were monitored by gliadin-specific sandwich ELISA. The effects of exercise and aspirin on serum gliadin levels were also investigated in four healthy subjects. RESULTS: Immunoreactive gliadins appeared in the sera of patients during the provocation test with both wheat-exercise and wheat-aspirin challenges in parallel with allergic symptoms. Serum gliadin levels also increased under the two same challenge conditions in the healthy subjects, although they exhibited no allergic symptoms. However, low levels of gliadin were detected in the sera of both patients and healthy subjects when challenged with wheat alone. CONCLUSION: We demonstrated for the first time that blood gliadin levels correlate with clinical symptoms induced by exercise and aspirin in patients with WDEIA. These findings suggest that exercise and aspirin facilitate allergen absorption from the gastrointestinal tract.

Adolescent↗

Body image and psychological well-being in pregnancy. A comparison of exercisers and non-exercisers.

This study compared the perceptions of body image and psychological well-being between exercising and non-exercising pregnant women. A prospective longitudinal study was conducted with 65 nulliparous women (mean age years = 30.3, range = 23-39) who were allocated to 2 groups based on level of recreational exercise participation; 25 exercisers were compared with 18 non-exercisers. A self-report exercise history questionnaire and a 10 item Body Cathexis Scale were completed on two occasions during the pregnancy, at approximately 17 weeks and 30 weeks of gestation. The General Health Questionnaire (GHQ-28) was administered in late pregnancy. There was a significant difference between the exercise group and the non-exercise group in late pregnancy for some items on the Body Cathexis Scale. The exercise group had a lower level of probable caseness on the GHQ-28 with reduced frequency of somatic symptoms, anxiety and insomnia, and a higher level of psychological well-being.

Adult↗

Exercise-induced tendon hypertrophy: cross-sectional area changes during growth are influenced by exercise.

Most skeletal tissues are thought to adapt to the mechanical environment they experience. While this has been demonstrated for muscle and bone, previous studies in the mature horse have failed to demonstrate adaptation in the superficial digital flexor tendon (SDFT), which suffers a high frequency of injury. This study tested the hypothesis that imposed exercise during growth would result in an increase in SDFT cross-sectional area (CSA). Fourteen Thoroughbred foals were divided into 2 sex-matched groups. A control group received 4 h pasture exercise and an exercise group had the same amount of pasture exercise with an additional short period of treadmill exercise daily from age 2-15 months. Activity at pasture was assessed objectively using a visual system. There was no significant difference in pasture activity between groups, although males were more active than females. The exercise programme resulted in a significantly larger tendon CSA in the exercise group at several, but not all, timepoints, which may be attributed to levels of variance. However, there was a significantly greater rate of increase in tendon CSA as a function of time in the exercised compared to the control group. This is the first evidence to suggest that tendon development can be modulated by exercise during growth in the horse, potentially increasing the ability of tendon to withstand the rigours of later athletic activity.

Adaptation, Physiological↗

Effects of prior arm exercise on pulmonary gas exchange kinetics during high-intensity leg exercise in humans.

For moderate work rates (i.e. below the lactate threshold, theta), oxygen uptake (Vo2) approaches the steady state mono-exponentially. At higher work rates, the Vo2 kinetics are more complex, reflecting the delayed superimposition of an additional, slow component. The mechanisms of this 'slow' component are poorly understood. It has been demonstrated, however, that while a prior bout of supra theta L cycling (with a 6 min recovery) does not significantly affect the V02 time course for a subsequent sub-theta L bout, it significantly speeds the V02 response to a subsequent supra-theta L bout (Gausche, Harmon, Lamarra & Whipp, 1989; Gerbino, Ward & Whipp, 1996). These investigators proposed that this speeding was a result of improved muscle perfusion during the exercise transient, possibly related to the residual metabolic acidaemia still present at the start of the subsequent exercise bout. To determine whether speeding of the V02 kinetics could also be induced by a bout of prior high-intensity exercise performed at a remote site (e.g. the arms), subjects each performed two 6 min bouts of high-intensity cycling (leg exercise: LE) at a work rate equivalent to 50% of lambda le' (the difference between maximum V02,LE and theta L,LE). On one occasion this was preceded by a 6 min period of cycling at 50% lambda LE and, on another, by a similar period of arm-crank exercise (arm exercise: AE) at 50% lambda LE in each case, the work bouts were separated by 6 min of unloaded pedalling. Pulmonary gas exchange variables were derived breath-by-breath. During unloaded pedalling and at minute 6 of each work bout, arterialized venous blood samples were drawn from the dorsum of the heated hand or at the wrist for analysis of PH, lactate, pyruvate, noradrenaline (NAdr), adrenaline (Adr), and potassium (K+). The difference in V02 between minute 6 and 3 of each work bout (lambda V02 ¿6-3] and the 'partial' O2 deficit (O2 Def) provided indices of the slow phase of V02 kinetics. The initial AE and LE bouts resulted in similar degrees of metabolic (lactic) acidaemia; the residual acidaemia at the end of the subsequent 6 min recovery phase was also similar for the two protocols, as were [K+], [Adr¿ and [NAdr]. The subsequent LE bouts were associated with reductions in both lambda V02[6-3] and O2 Def, relative to control, with the effect being more marked when the work was preceded by a prior LE bout than a prior AE bout: lambda V02[6-3] averaging 32 and 56% of control, respectively, and O2 Def 71 and 81%. Consequently, the increase in [lactate] and decrease in PH induced in this second LE bout were smaller when preceded by prior leg exercise than prior arm exercise. It is therefore concluded that while metabolic acidaemia induced at a site remote from the legs is associated with a less prominent slow phase of the V02 kinetics for high-intensity leg exercise, a component specific to the involved contractile units appears to exert the dominant effect. The mechanisms underlying this response are, however, presently uncertain.

Adult↗

Effect of carbohydrate ingestion during exercise on post-exercise substrate oxidation and energy intake.

Thirteen physically active, eumenorrheic, normal-weight (BMI < 25 kg/m2) females, aged 18-30 years, completed 4 experimental conditions, with the order based on a Latin Square Design: (a). CHO/Ex: moderate-intensity exercise (65% VO2peak) with a net energy cost of approximately 500 kcals, during which time the subject consumed a carbohydrate beverage (45 g CHO) at specific time intervals; (b). CHO/NoEx: a period of time identical to (a). but with subjects consuming the carbohydrate while sitting quietly rather than exercising; (c). NoCHO/Ex: same exercise protocol as condition (a.) during which time subjects consumed a non-caloric placebo beverage; and (d). NoCHO/NoEx: same as the no-exercise condition (b). but with subjects consuming a non-caloric placebo beverage. Energy expenditure, and fat and carbohydrate oxidation rates for the entire exercise/sitting period plus a 90-min recovery period were determined by continuous indirect calorimetry. Following recovery, subjects ate ad libitum amounts of food from a buffet and were asked to record dietary intake during the remainder of the day. Total fat oxidation (exercise plus recovery) was attenuated by carbohydrate compared to placebo ingestion by only approximately 4.5 g. There was a trend (p =.08) for a carbohydrate effect on buffet energy intake such that the CHO/Ex and CHO/NoEx energy intakes were lower than the NoCHO/Ex and NoCHO/NoEx energy intakes, respectively (mean for CHO conditions: 683 kcal; NoCHO conditions: 777 kcal). Average total energy intake (buffet plus remainder of the day) was significantly lower (p <.05) following the conditions when carbohydrate was consumed (CHO/Ex = 1470 kcal; CHO/NoEx = 1285 kcal) compared to the noncaloric placebo (NoCHO/Ex =1767 kcal; NoCHO/NoEx = 1660 kcal). In conclusion, in young women engaging in regular exercise, ingestion of 45 g of carbohydrate during exercise only modestly suppresses total fat oxidation during exercise. Furthermore, the ingestion of carbohydrate with or without exercise resulted in a lower energy intake for the remainder of the day.

Adolescent↗

Oxygen uptake versus exercise intensity: a new concept in assessing cardiovascular exercise function in patients with congenital heart disease.

OBJECTIVE: To assess the relation between exercise intensity and oxygen uptake during graded exercise in paediatric patients who underwent surgical repair of congenital heart disease, and to compare it with conventional measures of aerobic exercise function. DESIGN: Cross sectional study. Exercise testing was performed on a treadmill and gas exchange was measured on a breath by breath basis. PATIENTS: 29 patients who underwent an atrial switch operation for transposition of the great arteries (TGA) (mean (SD) age at testing 10.3 (2.5) years) and 30 patients who underwent total repair of tetralogy of Fallot (TF) (age 12.1 (3.3) years) performed graded exercise testing. Exercise responses were compared with data obtained in 24 normal controls (age 11.4 (2.6) years). RESULTS: The slope of oxygen uptake versus exercise intensity averaged 1.50 (0. 64) ml O(2)/min(2)/kg in the patients with TGA and 1.68 (0.75) ml O(2)/min(2)/kg after TF repair, both lower (p < 0.005) than in normal controls (2.42 (0.68) ml O(2)/min(2)/kg). The lower slope of oxygen uptake was correlated with a subnormal value for ventilatory anaerobic threshold, which averaged 78.0 (13.3)% of normal in TGA and 85.1 (10.6)% in TF. This was associated with a steeper slope (p = 0.001) of carbon dioxide output versus oxygen uptake above the ventilatory anaerobic threshold in TGA (1.26 (0.20)) and TF (1.20 (0. 18)) compared with the normal controls (1.05 (0.13)), and also a steeper slope of ventilation versus carbon dioxide in TGA (47.0 (15. 4)) and TF (41.5 (13.7)) than in the controls (30.3 (8.5)). CONCLUSIONS: Calculation of the steepness of the slope of oxygen uptake versus exercise intensity is a valid measurement of oxygen flow to the exercising tissues, which may be limited in congenital heart disease.

Adolescent↗

The nasal response to exercise and exercise induced bronchoconstriction in normal and asthmatic subjects.

Two studies were carried out to test the hypothesis that the fall and recovery of nasal resistance after exercise in asthmatic and non-asthmatic subjects are related to the development of bronchoconstriction after exercise. In study 1 nasal resistance (posterior rhinomanometry) and specific airway resistance (sRaw) were measured before challenge and one, five, 10 and 30 minutes after four minutes of exhausting legwork exercise in nine asthmatic subjects and nine age matched healthy subjects. One minute after exercise there was a reduction in nasal resistance of 49% (SD 15%) from baseline in the healthy subjects and of 66% (17%) in the asthmatic subjects. This response and the subsequent return of nasal resistance to baseline values did not differ significantly between the two groups despite a substantial difference in the change in sRaw, an increase of 74% (45%) in the asthmatic subjects 10 minutes after exercise, and no change in the non-asthmatic subjects. In study 2, nasal and specific airway resistances were monitored according to the same measurement protocol in six subjects with increased airway reactivity. Subjects exercised on two occasions, wearing a noseclip, once while breathing cold, dry air and once while breathing warm, humid air. The fall in nasal resistance was similar under both conditions (to 47% and 39% of baseline), through sRaw rose only after cold air inhalation (to 172% of baseline). The results indicate that the nasal response to exercise is not related to bronchial obstruction in asthmatic subjects after exercise or to the temperature or humidity of the air inspired through the mouth during exercise.

Adult↗

ATP production and efficiency of human skeletal muscle during intense exercise: effect of previous exercise.

The aim of the present study was to examine whether ATP production increases and mechanical efficiency decreases during intense exercise and to evaluate how previous exercise affects ATP turnover during intense exercise. Six subjects performed two (EX1 and EX2) 3-min one-legged knee-extensor exercise bouts [66.2 +/- 3.9 and 66.1 +/- 3.9 (+/-SE) W] separated by a 6-min rest period. Anaerobic ATP production, estimated from net changes in and release of metabolites from the active muscle, was 3.5 +/- 1.2, 2.4 +/- 0.6, and 1.4 +/- 0.2 mmol ATP x kg dry wt(-1) x s(-1) during the first 5, next 10, and remaining 165 s of EX1, respectively. The corresponding aerobic ATP production, determined from muscle oxygen uptake, was 0.7 +/- 0.1, 1.4 +/- 0.2, and 4.7 +/- 0.4 mmol ATP x kg dry wt(-1) x s(-1), respectively. The mean rate of ATP production during the first 5 s and next 10 s was lower (P < 0.05) than during the rest of the exercise (4.2 +/- 1.2 and 3.8 +/- 0.7 vs. 6.1 +/- 0.3 mmol ATP x kg dry wt(-1) x s(-1)). Thus mechanical efficiency, expressed as work per ATP produced, was lowered (P < 0.05) in the last phase of exercise (39.6 +/- 6.1 and 40.7 +/- 5.8 vs. 25.0 +/- 1.3 J/mmol ATP). The anaerobic ATP production was lower (P < 0.05) in EX2 than in EX1, but the aerobic ATP turnover was higher (P < 0.05) in EX2 than in EX1, resulting in the same muscle ATP production in EX1 and EX2. The present data suggest that the rate of ATP turnover increases during intense exercise at a constant work rate. Thus mechanical efficiency declines as intense exercise is continued. Furthermore, when intense exercise is repeated, there is a shift toward greater aerobic energy contribution, but the total ATP turnover is not significantly altered.

Adenosine Triphosphate↗