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PubMed2004

Reliability and validity of the self-efficacy for exercise and outcome expectations for exercise scales with minority older adults.

Older African Americans and Latinos tend to exercise less than older Whites and are more likely to have chronic diseases that could benefit from exercise. Measurement of self-efficacy of exercise and exercise outcome expectations in this older population is required if exercise is to be monitored carefully and enhanced in this population. The purpose of this study was to test the reliability and validity of the Self-Efficacy for Exercise Scale (SEE) and Outcome Expectations for Exercise Scale (OEE) in a sample of African American and Latino older adults. A total of 166 individuals, 32 males (19%) and 134 females (81%) with an average age of 72.8 +/- 8.4 years participated in the study. The SEE and OEE scales were completed using face-to-face interviews. There was evidence of internal consistency for both scales with alphas of .89 and .90 for the SEE scale and .72 and .88 for the OEE scale. There was some evidence of validity for both scales based on confirmatory factor analysis and hypothesis testing, because factor loadings were greater than .50 in all but two items in the OEE, and there were significant relationships between self-efficacy and outcome expectations and exercise behavior at all testing time-points. The measurement models showed a fair fit of the data to the models. The study provided some evidence for the reliability and validity of the SEE and OEE when used with minority older adults, and it provides some guidelines for future scale revisions and use.

Black or African American↗

PubMed2005

[The effects of exercise program on knowledge and attitude of exercise and depression in low-income elderly women].

PURPOSE: The purpose of this research was to examine the effects of exercise program on knowledge and attitude of exercise, and depression in low-income elderly women. METHOD: The research design was a nonequivalent control group pretest-posttest design. The subjects were 26 in the experimental group and 22 in the control group among 46 low-income women over age 65. The independent variable is the exercise program, and the dependent variables are knowledge and attitude of exercise and depression. The exercise program was performed for 45-50 minutes, twice a week for 8 weeks. Data was collected from March 12. to May 8. 2004. RESULT: Participants were given a pre-test and post-test for the selected variables. The experimental group reported significant improvements in their knowledge and attitude of exercise and depression scores compared with the control group. CONCLUSION: The results indicated that the exercise program had the potential to manage low-income elderly women's health promotion. Furthermore, the exercise program can enhance life satisfaction in low-income elderly women.

Aged↗

PubMed1981

Exercise left ventricular performance in patients with chest pain, ischemic-appearing exercise electrocardiograms, and angiographically normal coronary arteries.

Left ventricular performance was evaluated using first-pass radionuclide angiocardiography in 31 patients with chest pain, an ischemic-appearing exercise electrocardiogram, and angiographically normal coronary arteries at rest and during maximal upright bicycle exercise. Thallium-201 (201 TI) imaging was done in all patients after treadmill exercise and in selected patients after ergonovine provocation. Resting left ventricular performance was normal in all patients. An abnormal ejection fraction response to exercise was detected in 12 of 31 patients. Regional dysfunction was present during exercise in four patients, all of whom also had abnormal global responses. Three of these 12 patients and two additional patients had exercise-induced 201 TI perfusion defects. In all nine patients who underwent ergonovine testing, there was no suggestion of coronary arterial spasm. Thus, left ventricular dysfunction during exercise, in the presence of normal resting performance, was found in a substantial number of patients with chest pain, an ischemic-appearing exercise electrocardiogram, and normal coronary arteries.

Adult↗

PubMed1999

[Usefulness of exercise echocardiography in ischemic heart disease: comparison with exercise cardiac scintigraphy].

Exercise echocardiography and exercise thallium-201 (201Tl) single photon emission computed tomography (SPECT) were performed in 152 patients with suspected coronary artery disease, including 61 patients with old myocardial infarction. All patients underwent coronary arteriography, and coronary artery disease was defined as > or = 75% diameter stenosis. Digital two-dimensional echocardiography was performed before and after the treadmill exercise test, and wall motion abnormality was evaluated using quad-screen. Sensitivity and specificity for the diagnosis of coronary artery disease were similar for the 2 exercise tests (77% and 80% for echocardiography and 75%, and 83% for SPECT, respectively). Diagnoses for one-vessel disease, 2-vessel disease and 3-vessel disease were similar for echocardiography (79%, 72% and 77%, respectively) and SPECT (74%, 75% and 77%, respectively). Sensitivity for the diagnosis of ischemia at the area remote from infarct area was low for both exercise echocardiography and exercise SPECT (45% and 48%, respectively). Exercise echocardiography has comparable diagnostic value to SPECT for the detection of coronary artery disease. However, both exercise tests have limitations for the diagnosis of ischemia at the area remote from infarct area.

Echocardiography↗

PubMed1999

Exercise-induced muscle damage: absence of adaptive effect after a single session of eccentric isokinetic heavy resistance exercise.

BACKGROUND: Unaccustomed eccentric exercise induces muscle damage. A single session of eccentric exercise can induce an "adaptive effect" protecting exercised muscles during several weeks. Our aim was to verify this phenomenon in isokinetic exercise. Tested hypothesis was: the progressive muscle rise in tension due to isokinetic eccentric actions would be insufficient to induce the adaptive effect. METHODS EXPERIMENTAL DESIGN: prospective study. SETTING: general community. PARTICIPANTS: six healthy and moderately active (untrained) males (29.1 yr +/- 1.5 SEM). INTERVENTIONS: subjects performed two isokinetic eccentric exercises (EE1 and EE2) of the quadriceps femoris of both legs (120 degrees.s-1; 8 sets of 15 repetitions) separated by 4 weeks. MEASURES: type I serum myosin heavy chains (MHC) and creatine kinase concentrations (CK), and rate of perceived soreness (DOMS) were collected before each exercise and on days 1, 2, 4, 6 and 9. RESULTS: Both exercises induced significant (p < 0.01) increases in MHC and CK concentrations, and DOMS score. There was no significant difference between EE1 and EE2, at any measurement time for any parameter. Mean peak values (SEM) were respectively (EE1; EE2): MHC (microU.l-1): 308 (192); 285 (191). CK (U.l-1): 1217 (760); 1297 (1039). DOMS score: 2.67 (0.52); 2.33 (0.52). CONCLUSIONS: The first session of eccentric isokinetic exercise (EE1) had no adaptive effect against muscle damage when an identical session was performed 4 weeks later (EE2). Muscle adaptation could have resulted in increased work production (+10.2%; p < 0.05; from EE1 to EE2).

Adaptation, Physiological↗

PubMed2001

[Study of blood pressure, hemodynamic, ventilatory and metabolic responses to isometric exercise performed during dynamic exercise in health subjects].

The object of this study was to study the blood pressure, haemodynamic, ventilatory and metabolic changes on isometric exercise during a dynamic effort in healthy subjects. Twelve healthy subjects underwent isometric exercise by manual prehension at 40% maximal capacity under these conditions: isolated (A), five minutes after the onset of rectangular dynamic exercise on a cycle at 60% of ventilatory threshold (B) and at the fourth minute of the recovery phase of dynamic exercise (C). The blood pressure, heart rate, stroke volume and cardiac index measured by Doppler echocardiography, systemic arterial resistances, respiratory flow and respiratory rate, were measured before and after each isometric exercise. The results showed blood pressure and heart rate to increase in a similar manner during isometric exercise under all conditions. The cardiac index increased by 29.5% +/- 8.3% (p < 0.01) under condition A and by 38.1% +/- 10% (p < 0.01) under conditions C but did not change significantly under conditions B. On the other hand, the systemic arterial resistances increased by 15.5% +/- 6.5% (p < 0.05) under conditions B, decreased by 8.8% +/- 3.9% (p < 0.05) under conditions C but did not change significantly under conditions A. The respiratory flow increased under all three conditions although the respiratory rate was only increased under conditions B. The authors conclude that, in healthy subjects, the increase in blood pressure during isometric and dynamic exercise is the result of an increase in systemic resistances whereas, during isometric exercise, it is flow-dependant.

Adult↗

PubMed2002

[Prevalence and clinical background of exercise-induced ventricular tachycardia during exercise testing].

OBJECTIVES: This study assessed the prevalence and clinical background of exercise-induced ventricular tachycardia during exercise testing. METHODS: Complications during exercise testing were reviewed in 25,075 consecutive patients, 14,037 men and 11,038 women, who underwent a total of 47,656 maximal treadmill or bicycle exercise tests between April 1985 and March 1999. The mean age of the patients was 53.3 +/- 8.8 (mean +/- SD) years. Non-sustained ventricular tachycardia was defined as 8 or more consecutive ventricular ectopic beats at > 100 beats/min. A total of 126 patients undergoing exercise testing to evaluate the efficacy of pharmacotherapy for ventricular tachycardia were excluded. RESULTS: The major reasons for the exercise test were chest pain (27.0%) and screening (20.3%). Twenty patients (0.08%) had exercise-induced ventricular tachycardia. Six patients had ischemic heart disease, two had cardiomyopathy, five had other cardiac diseases, and seven patients showed no clinical evidence of heart disease. The incidence of ventricular tachycardia in patients with cardiomyopathy (2/109) was higher than in other patients, but the number of patients with ventricular tachycardia was small. Ventricular tachycardia was documented at heart rates of more than 80% of predicted maximal heart rate in 12 of the 20 patients. CONCLUSIONS: These results suggest that the exercise testing can be done safely when the end-point criteria are properly applied.

Adult↗

PubMed2002

[Clinical significance of exercise-induced ST segment depression in patients with lateral myocardial infarction involving the left circumflex artery: evaluation by exercise 99mTc-MIBI myocardial scintigraphy].

PURPOSE: The aim of this study is to clarify the causes of exercise-induced ST-segment depression in patients with broad lateral old myocardial infraction involving LCX (LCX-OMI) without ischemia on exercise scintigraphy. METHOD: Twenty one patients (M/F = 11/10, age = 62 +/- 19 years) with myocardial infraction involving LCX (LCX-MI), but without fill-in on exercise and rest MIBI quantitative gated SPECT (QGS), were selected. They were divided into two groups of Group ST(+) (n = 11, with significant ST depression (max -2.8 +/- 0.4 mm), Group ST(-) (n = 10) without ST depression. On 20 SPECT segments of both exercise and rest SPECT, we scored uptake score as DS (0 = normal to 3 = defect) and wall motion as WMS (0 = normal to -5 = dyskinesis) and summed DS (TDS) and WMS (TWMS) in LCX region, furthermore, calculated the difference of TWMS (delta TWMS [exercise-rest]), end diastolic volume (EDV) and ejection fraction (EF) during exercise were compared between the two groups. RESULT: Group ST(+) showed significantly (p < 0.01) lower EF (35.4 +/- 9.2% vs. 60.2 +/- 6.2%), larger EDV (146 +/- 53 ml vs. 93 +/- 15 ml), higher TDS (5 vs. 7 +/- 3), lower TWMS (-25 +/- 9 vs. -6 +/- 5), furthermore lower delta TWMS (-6.9 +/- 4.0 vs. -2.0 +/- 0.8) than Group ST(-). CONCLUSION: Exercise-induced significant ST depression in V2-4 without ischema in LCX-MI was observed in patients with broad LCX-MI, low EF, and was related to impaired wall motion in LCX region. ST depression in V2-4 was considered to appear as miller image of ST elevation at postero-inferior wall due to disturbed wall motion on exercise.

Adult↗

PubMed2003

[Stages of change for exercise behavior and self-efficacy for exercise among middle-aged adults].

The transtheoretical model of behavior change (TTM) has been used to account for how people change their health behavior. It was originally developed to explain or predict change in unhealthy addictive behavior (e.g., smoking), but recently the use of the TTM within the physical activity and exercise behavior domain has been proposed. In the present study, we examined its structure in this regard among middle-aged Japanese adults. In particular, the relationship between the stages of change for exercise behavior and self-efficacy was investigated. Firstly, a scale was developed to assess self-efficacy for exercise. Four hundred and sixty seven middle-aged adults completed questionnaires. As a result of stepwise variable selection procedure in exploratory factor analysis, a scale comprising 1 factor with 5 items was developed. Psychometric analyses revealed that this scale had high reliability and validity. Secondly, a cross-sectional investigation was conducted to examine the relationship between stage of change and self-efficacy among middle-aged adults (n = 808) using a questionnaire approach. Significant associations were found between stage of change for exercise behavior classification and self-efficacy for exercise. Specifically, scores on self-efficacy of the subjects in the present study were less for those in a precontemplation stage and greater for those in maintenance compared to all other stages, and generally followed a linear pattern of change across the stages. Although the use of a cross-sectional research design and nonrandom sampling methods in the present study limit interpretation, the similarity of these results to those in the previous literature suggests that the relationship between stages of change for exercise behavior and self-efficacy for exercise holds across different age groups and cultures. By accurately understanding these relationships, health promotion professionals may be able to improve physical activity and exercise promotion efforts.

Exercise↗

PubMedDate not supplied

Exercising for two: examining pregnant women's second trimester exercise intention and behavior using the framework of the theory of planned behavior.

Research examining the motivational determinants of exercising during pregnancy is mostly atheoretical, despite the need for theory-based designs. The study's main objective was to prospectively examine women's exercise intention and behavior from their second to third pregnancy trimester using the theory of planned behavior (TPB). Participants were 89 pregnant women who completed self-reported measures of their exercise attitude, subjective norm, perceived behavioral control, intention, and behavior. Hierarchical regression analyses indicated: 1) intention and not perceived behavioral control significantly predicted exercise behavior; and 2) attitude was the strongest determinant of exercise intention, followed by perceived behavioral control, and subjective norm. The study findings provide preliminary support for the TPB as an effective framework for examining exercising during pregnancy. Understanding women's thoughts, feelings, and beliefs about exercise can assist intervention specialists with developing and implementing effective programs promoting exercise during pregnancy.

Adult↗

PubMed2005

Exercise training and 3-day head down bed rest deconditioning: exercise thermoregulation.

UNLABELLED: Bed rest (BR) deconditioning causes excessive increase of exercise core body tempera-ture, while aerobic training improves exercise thermoregulation. The study was designed to determine whether 3 days of 6 degrees head-down bed rest (HDBR) affects body temperature and sweating dynamics during exercise and, if so, whether endurance training before HDBR modifies these responses. Twelve healthy men (20.7+/-0.9 yrs, VO2max: 46+/-4 ml x kg(-1) x min(-1) ) underwent HDBR twice: before and after 6 weeks of endurance training. Before and after HDBR, the subjects performed 45 min sitting cycle exercise at the same workload equal to 60% of VO2max determined before training. During exercise the VO2, HR, tympanic (Ttymp) and skin (Tsk) temperatures were recorded; sweating dynamics was assayed from a ventilated capsule on chest. Training increased VO2max by 12.1% (p<0.001). Resting Ttymp increased only after first HDBR (by 0.22 +/- 0.08 degrees C, p<0.05), while exercise equilibrium levels of Ttymp were increased (p<0.05) by 0.21 +/- 0.07 and 0.26 +/- 0.08 degrees C after first and second HDBR, respectively. Exercise mean Tsk tended to be lower after both HDBR periods. Total sweat loss and time-course of sweating responses were similar in all exercise tests. The sweating threshold related to Ttymp was elevated (p<0.05) only after first HDBR. IN CONCLUSION: six-week training regimen prevents HDBR-induced elevation of core temperature (Ttymp) at rest but not during ex-ercise. The post-HDBR increases of Ttymp without changes in sweating rate and the tendency for lower Tsk suggest an early (<3d) influence of BR on skin blood flow.

Adult↗

PubMed2006

Reproducibility of automated pulse wave velocity measurement during exercise. Running head: pulse wave velocity during exercise.

Pulse wave velocity measurement is used as an index of arterial stiffness. The purpose was to evaluate the reproducibility of pulse wave velocity measurement at rest, during exercise and recovery from exercise, using an automated device. Twelve healthy young adults (mean age 22.0 +/- 3.1 yrs) underwent an upright submaximal cycle test on two separate occasions, one week apart. Pulse wave velocity, systolic and diastolic blood pressures and heart rate were assessed at rest, during the last 2 min of exercise and 10 min later. Pulse wave velocity was measured on the upper limb and the forearm by the cross-correlation function of photoplethysmography and Doppler signals. Brachial artery pulse wave velocity was calculated from upper limb and forearm pulse wave velocities. No significant difference was found on duplicate measurements of heart rate, systolic and diastolic blood pressures at rest, during exercise and recovery, showing that pulse wave velocity was measured under similar conditions. Coefficient of variation for upper limb and forearm pulse wave velocities ranged from 2.9 to 5.9% at rest and during recovery, and were respectively 2.9% and 8.3% during exercise. However, coefficient of variation for brachial pulse wave velocity was 7.7 and 10.3% at rest, 15.7% during exercise, and 5.8% during recovery. During exercise, pulse wave velocity measurements were satisfying, but indirect assessment of brachial artery pulse wave velocity showed poor reproducibility. Thus, upper limb and forearm pulse wave velocities may be used during exercise to assess the effect of training or drugs on arterial wall mechanical properties.

Adult↗

PubMed2006

Assessment of functional capacity in patients with chronic obstructive pulmonary disease: correlation between cardiopulmonary exercise, 6 minute walk and 15 step exercise oximetry test.

BACKGROUND: Different exercise tests are used to evaluate the functional capacity in chronic obstructive pulmonary disease. The cardiopulmonary exercise test is considered the gold standard, but the 6 minute walk and the 15 step exercise oximetry test are considerably less expensive. OBJECTIVES: To determine whether reliable data could be obtained at lower cost. METHODS: The study sample consisted of 50 patients with mild to severe stable COPD. All underwent pulmonary function test and the cardiopulmonary exercise test, 6 minute walk and 15 step exercise oximetry test as part of their regular follow-up visit. Functional capacity was graded according to each test separately and the functional capacities obtained were correlated. RESULTS: The results showed that most of the patients had severe COPD according to pulmonary function tests (mean forced expiratory volume in the first second 46.3 +/- 19.9% of predicted value). There was a good correlation between the cardiopulmonary exercise test and the 6 minute walk functional capacity classes (r = 0.44, P = 0.0013). We did not find such correlation between the 15 step exercise oximetry test and the cardiopulmonary exercise test (r = 0.07, P = 0.64). CONCLUSIONS: The study shows that the 6 minute walk is a reliable and accurate test in the evaluation of functional capacity in COPD patients.

Adult↗

PubMed1979

Reduced heart rate response to exercise in ischemic heart disease: the fallacy of the target heart rate in exercise testing.

When exercise testing 159 patients with prior myocardial infarction, we identified 39 who were limited by fatigue. This group was all in sinus rhythm; none were taking drugs likely to impair the chronotropic response of the heart; none experienced chest pain or developed ischemic ECG changes. In 18 of this group, maximal heart rate achieved with exercise was 2SD or more below the age predicted value, and their heart rate response to exercise was reduced compared to that of the other 21 whose maximal exercise heart rates were within 2SD of age predicted values. A subgroup of 8 subjects with reduced exercise heart rates was studied before and after vagal blockade. In the 4 subjects whose infarction was inferior, the reduction in heart rate response was more profound and persisted after vagal blockade, suggesting either reduced pacemaker responsivness, due to ischemia or infarction, or autonomic imbalance as possible mechanisms. All 8 showed alinear increases in ventilation at higher power outputs and mean blood lactate postexercise was 7.5 mM/I without vagal blockade. Our findings suggest that a reduced heart rate response to exercise, already shown to imply added coronary risk, may be subdivided aetiologically and possibly prognostically. The use of a "Target Heart Rate" in such patients offers no safety margin, and maximal exercise capacity will be grossly over-estimated if extrapolated from the submaximal heart rate response. A cardiovascular limitation to exercise may be detected by an alinear increase in ventilation.

Adult↗

PubMedDate not supplied

Changes in functional residual capacity during exercise in patients with exercise-induced asthma.

Forty-eight patients with a history of exercise-induced asthma were exercised on ambient breathing (T = 18-20 degrees C, relative humidity = 45-55%). There were 19 responders and 29 non-responders according to post-exercise spirometry. During the first minutes of exercise at a workload of 25-50 W, the functional residual capacity (FRC) was measured by a rebreathing technique. There was a significant increase in FRC in responders (p less than 0.025). A loose though significant correlation was found between the rise in FRC during exercise and the fall in forced expiratory volume in one second (FEV1) after exercise (r = -0.429, p less than 0.005). The effects of a sympathomimetic drug were studied in five responders submitted to a second exercise test 4 h after the first one. Spirometry returned to normal but FRC remained high between both tests. During the second test neither spirometry nor FRC changed. The results suggest that different mechanisms may be responsible for changes in FRC and in maximal expiratory flow in exercise-induced broncho constriction.

Adolescent↗

PubMed2006

[Exercise training in cardiac patients: usefulness of the cardiopulmonary exercise test].

Exercise training is currently including in the treatment of coronary arterial disease patients, in patients with left ventricular dysfunction as well as in patients who underwent cardiac transplantation or cardiac surgery. However methods of prescribing exercise-training programs are difficult to determine and must be adapted for each patient Exercise test with gas analysis through the determination of anaerobic threshold may help to understand the physiopathological mechanism related to exercise limitation in these patients. Exercise test may help to precise exercise intensity during cardiac rehabilitation and may assess the benefits on exercise tolerance.

Exercise Test↗

PubMed2006

Exercise capacity and impact of exercise training in patients after a Fontan procedure: a review.

After a successful Fontan procedure, children and adolescents should improve their exercise capacity. However, several studies have shown that these children have a reduced maximal oxygen consumption compared with healthy children. The lower exercise performance in these patients was mainly explained by a reduced cardiorespiratory functional capacity. However, it has recently been reported that the lower exercise performance may also be related to altered skeletal muscle function. Moreover, exercise training had a beneficial impact on several parameters related to exercise tolerance in these patients. The main studies supporting these observations are reviewed, with a focus on the physiological adaptation and limitation of the exercise performance as well as the benefits of exercise training in patients after a Fontan procedure.

Adaptation, Physiological↗

PubMed1997

Effect of exercise intensity on free tryptophan to branched-chain amino acids ratio and plasma prolactin during endurance exercise.

The potential of exercise-induced changes in peripheral amino acids to alter blood prolactin levels through a serotonergic system modification was investigated in 8 male athletes. In two trials, subjects (N = 8) exercised on a cycle ergometer for 5 hr. The intensity of exercise corresponded to 55% VO2max (T55) or 75% VO2max (T75), respectively. In each trial, each subject received a 25-g energy bar (111 kcal) every 60 min, as well as 300 ml of a 6% carbohydrate solution (90 kcal) every 30 min of exercise duration. Plasma glucose and insulin declined (p < or = .05) in both trials during exercise. Ammonia was augmented (p < or = .05) above the baseline concentration after 120 min in both trials. During the last 2 hr of exercise, plasma free fatty acids were higher (p < or = .05) in T75 than in T55. During this time, the plasma free TRP/BCAA ratio was also augmented (p < or = .05) in T75, while no change was induced in T55. Plasma prolactin did not change in T55, while an increase (p < or = .05) was found in T75. The findings may further support the hypothesis that during endurance exercise changes in peripheral amino acid concentration may influence prolactin response via serotonergic system modifications.

Adult↗