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PubMed2002

Exercise in pregnancy: physiological basis of exercise prescription for the pregnant woman.

A pregnant woman participated in cycling events in the 2000 Olympics. Recently there was concern about the participation of a pregnant woman in the Australian netball team. More and more women are anxious to pursue sports during their pregnancies and to maintain condition. For the clinician or sports physician caring for women who want to maintain a high-level of physical activity there is no simple exercise prescription. It is probable that continuing exercise by women who are already conditioned will not result in foetal compromise, unless there are hidden or unknown complications of pregnancy. Pregnant women should probably exercise within limits that do not cause severe discomfort and should, as pregnancy progresses, be prepared to moderate the intensity and duration of their exercise programs to avoid risks and injury. It is probably not advisable for women to begin high intensity exercise programs when pregnant, although moderate exercise is beneficial to both mother and baby. The type of activity that is undertaken has to be taken into consideration and in particular the adverse effects of supine activity in late gestation recognised.

Body Temperature Regulation↗

PubMed1997

Perceived benefits of and barriers to exercise and stage of exercise adoption in young adults.

College students (N = 432) completed questionnaires assessing current exercise participation, intention to become more active, perceived benefits of exercise, and perceived barriers to exercise. Confirmatory factor analyses of the benefit and barrier items suggested that a model containing 4 benefit factors (social, psychological, body image, and health) and 4 barrier factors (time-effort, social, physical effects, and specific obstacles) fit better than other models with fewer factors. Subscales derived from these factors revealed specific differences across participants who were categorized into 1 of 4 stages of exercise adoption. These findings confirm the multidimensional nature of perceived benefits of and barriers to exercise. Implications for the promotion and maintenance of exercise are discussed.

Adult↗

PubMed2002

Pre-exercise administration of yohimbine may enhance the efficacy of exercise training as a fat loss strategy by boosting lipolysis.

The natural alpha-2 antagonist yohimbine promotes sympathetic activity by central as well as peripheral mechanisms, and yet in moderate doses dose not usually raise heart rate, increase blood pressure, or induce anxiety (in contrast to sympathomimetic drugs such as ephedrine). Administered prior to exercise, it boosts lipolysis and serum FFA levels both during and following exercise; blockade of adipocyte alpha-2 adrenoreceptors makes at least a modest contribution to this pro-lipolytic activity. These considerations suggest that pre-exercise administration of yohimbine will lower the respiratory quotient during and following exercise, thus promoting fat loss. Since yohimbine can potentiate postprandial insulin secretion, its bariatric benefits should be greatest if administered on a schedule that minimizes postprandial yohimbine activity. A possible synergism of yohimbine and caffeine should be explored. Pre-exercise yohimbine administration has the potential to down-regulate the lipoprotein lipase activity of visceral adipocytes, increase lipolysis in refractory gynoid fat depots, and improve the impaired lipolytic response to exercise in the elderly.

Adrenergic alpha-2 Receptor Antagonists↗

PubMedDate not supplied

Influence of exercise duration and hydration status on cognitive function during prolonged cycling exercise.

The purpose of the present study was to examine the influence of submaximal aerobic exercise duration on simple and complex cognitive performance. Eight well-trained male subjects agreed to participate in this study (trial group). A control group of eight regularly trained male subjects was included for comparative purposes. For the trial group, the experiment involved a critical flicker fusion test (CFF) and a map recognition task performed before, every 20 min during, and immediately after, a 3-h cycling task at an intensity corresponding to approximately 60 % of VO2max. Data were obtained over two experimental sessions with fluid ingestion (F) or no fluid (NF) ingestion. For the control group the experiment was the same but without exercise and fluid ingestion. In the trial group, a significant effect of hydration status was observed on physiological parameters (p <0.05). No effect was found on cognitive performance. A significant decrease in CFF performance was observed after 120 min of exercise when compared with the first 20 min (respectively for CFFmdi: 2.6 vs. 3.8 Hz), irrespective of experimental condition. A significant improvement in speed of response (respectively: 3291 vs. 3062 msec for 20 and 120 min, respectively) and a decrease in error number (21.5 % vs. 6.0 % for 20 and 120 min, respectively) during the map recognition task were recorded between 80 min and 120 min when compared with the first 20 min of exercise. After 120 min the number of recorded errors was significantly greater indicating a shift in the accuracy-speed trade-off (6.0 % vs. 14.1 % for 120 and 180 min, respectively). These results provide some evidence for exercise-induced facilitation of cognitive function. However this positive effect disappears during prolonged exercise--as evidenced within our study by an increase in errors during the complex task and an alteration in perceptual response (i.e. the appearance of symptoms of central fatigue).

Adult↗

PubMed2005

Massive insulin secretion in response to anaerobic exercise in exercise-induced hyperinsulinism.

Exercise-induced hyperinsulinism (EIHI) is a recently described entity characterised by recurrent episodes of hypoglycaemia induced by physical exercise. The index patient for this disorder and a matched control were subjected to aerobic and anaerobic exercise tests on a cycle ergometer. Aerobic exercise was performed at an intensity of 60% of the respective 4 mmol/l lactate threshold (40 min). Anaerobic exercise with an intensity corresponding to 130% VO2max lead to exertion within 2-3 min and elicited comparable maximal lactate levels in both subjects (10-11 mmol/l). The patient experienced a massive increase in insulin from 34 to 649 mU/l after the anaerobic test, and a lower increase in insulin from 27 to 79 mU/l during the aerobic test. Insulin concentration remained unchanged during both tests in the control. Epinephrine increased in the EIHI patient, which was probably a counterregulatory response to hypoglycaemia. The activity of lactate dehydrogenase of the index patient in isolated leukocytes as well as the response to inhibition of oxamate was normal. The hypothesis of abnormal transport or metabolism of lactate/pyruvate in the beta-cells of patients with EIHI was further supported by the parallel increase of lactate and insulin in this study elicited in particular by anaerobic exercise.

Adult↗

PubMed1998

Responsiveness of plasma 2- and 4-hydroxycatecholestrogens to training and to graduate submaximal and maximal exercise in an untrained woman. Interuniversity Project on Reproductive Endocrinology in Women and Exercise.

A single-subject experimental design was used to obtain some preliminary findings on the plasma responses of catecholestrogens (CE) to acute exercise and brief, but exhaustive training on a cycle ergometer. One previously untrained eumenorrheic female (body fat: 26% VO2max: 43.3 ml x kg(-1) x min[-1]) participated in this study. Resting CE levels were for "total" (unconjugated + conjugated) 2-hydroxyestrogens (2-OHE) 162pg/ ml and 350 pg/ml in the follicular (FPh) and luteal phase (LPh), respectively. Plasma total 4-hydroxyestrogen (4-OHE) levels were 41 pg/ml in the FPh and 66 pg/ml in the LPh. For "total" 2-methoxyestrogens (2-MeOE), we found 257 pgl/ml in the FPh and 374 pg/ml in the LPh. Resting levels of 2-hydroxy CE following a period of brief, intensive training were decreased during the LPh (2-OHE: -38%; 2-MeOE: -19%), whereas 4-hydroxy CE were unaffected. After training, the formation of CE as expressed by the 2-OHE:E and 4-OHE:E ratios, was increased by 75% and 200% at rest, respectively. CE activity or O-methylation, as estimated from the 2-MeOE:2-OHE ratio, was higher following training (FPh: +22%; LPh: +30%). During acute exercise before training, we observed a small rise proportional to the exercise intensity in the plasma "total" primary estrogen concentrations (FPh: +28%; LPh: +16%), and no changes in either 2-OHE or 2 MeOE levels. Plasma concentrations of 4-OHE, however, doubled during maximal exercise intensity. The 2-OHE:E and 2-MeOE:2-OHE ratios did not alter during incremental exercise. Training effects on acute exercise responses were only noticed for 4-OHE, which contrary to pre-training conditions, now progressively decreased. The major findings of this study are that in response to training: a) during rest, a greater proportion of CE are formed from a lower amount of precursor hormone, b) the rate of O-methylation of CE increases.

Adult↗

PubMed2003

Antioxidant supplementation and tapering exercise improve exercise-induced antioxidant response.

OBJECTIVE AND METHODS: The present controlled-training, double-blind study (supplemented, n = 7; placebo, n = 9) investigated whether taper training (TT) and antioxidant supplementation, i.e., 150 micro g of selenium, 2000 IU of retinol, 120 mg of ascorbic acid and 30 IU of alpha-tocopherol, modulates antioxidant potential, redox status and oxidative damage occurrence both at rest and in response to exercise. Two weeks of TT followed four weeks of overloaded training. Dietary intakes were recorded. Before and after TT, triathletes did a duathlon consisting of 5-km run, 20-km bike and 5-km run. Biological studies were conducted at rest and after exercise. RESULTS: Whatever the nutritional status, TT induced a decrease in resting blood reduced glutathione (GSH) concentration (p < 0.001), erythrocyte superoxide dismutase (SOD) activity (p < 0.0001) and plasma total antioxidant status (TAS) (p < 0.05). Only in the supplemented group (Su) with TT, did plasma glutathione peroxidase (GSH-Px) activity decrease (p < 0.05) and CD4(+) cell concentration increase (p < 0.05). However, antioxidant supplementation increased plasma TAS increase in response to exercise and TT (p < 0.05). After exercise, TT also induced a lower decrease in blood reduced and oxidized (GSSG) glutathione (p < 0.01) in both groups, but TT had no effect on lipoperoxidation as estimated by plasma thiobarbituric reactive substances or on muscular damage occurrence estimated by plasma creatine kinase isoenzyme MB mass. CONCLUSION: During TT, antioxidant supplementation at nutritional doses reinforces antioxidant status response to exercise, with an effect on exercise-induced oxidative stress, and no effect on oxidative damage.

Adult↗

PubMed2002

Aerobic exercise attenuates an exaggerated exercise blood pressure response in normotensive young adult African-American men.

An exaggerated exercise blood pressure response (EEBPR) may be associated with an increased risk of hypertension. We hypothesized that aerobic exercise training can decrease EEBPR and the risk for hypertension by decreasing arterial resistance. We studied the effects of aerobic training on the submaximal exercise blood pressure (BP) of eight normotensive young adult African-American men with an EEBPR. Subjects were trained on a stationary bicycle at an intensity of 70% peak oxygen uptake (VO2peak), for 30 min, three times per week, for 8 weeks. BP, heart rate, cardiac output (CO), stroke volume (SV) and total peripheral vascular resistance (TPR) were measured at rest and during submaximal exercise at a work intensity of 50% VO2peak. Significance of the training effects were evaluated by comparing the pre- and post-training measures (t-test, p < 0.05). A 15% post-training increase in VO2peak (34.6 +/- 1.4 to 40 +/- 1.4 ml/kg/min) and a 9.5 ml post-training increase in mean resting stroke volume were found. A 16.2 mmHg decrement in mean systolic BP, an 11.5 mmHg decrement in mean diastolic BP, a 120 dyne/s/cm5 decrement in TPR and a 1.2 l/min increase in CO were detected during the post-training submaximal exercise tests. These results suggest that reductions in TPR may attenuate the EEBPR of normotensive African-American males following an 8-week training regimen of stationary bicycling at 70% VO2peak. Aerobic exercise training may, therefore, reduce the risk of hypertension in normotensive African-American males by the mechanism of a reduction in TPR. Because of the limited number of subjects, the results of this study should be interpreted cautiously pending confirmation by a larger controlled trial.

Adolescent↗

PubMed2003

Effects of 16 mo of verified, supervised aerobic exercise on macronutrient intake in overweight men and women: the Midwest Exercise Trial.

BACKGROUND: It is commonly believed that moderate aerobic exercise leads to changes in diet composition, specifically, an increase in carbohydrate intake at the expense of fat intake. OBJECTIVE: The goal was to determine the effects of a supervised, long-term program of exercise on the macronutrient intake of previously sedentary, overweight and moderately obese men and women. DESIGN: Participants (n = 74) were recruited from the university and surrounding communities and were randomly assigned to the exercise or control group. Exercise of moderate intensity was performed for 45 min/d, 5 d/wk, under supervision. Diet intake was ad libitum and was measured for energy and macronutrient composition at baseline and at 5 other occasions across the 16-mo study by use of weighing and measuring techniques. Each measurement consisted of a 2-wk period of direct measurement in the university cafeteria. Food consumption outside the cafeteria during the 2-wk periods (ie, snacks) was measured by multiple-pass 24-h dietary recall procedures. RESULTS: There were no significant differences for men or women between the exercise and control groups from baseline to 16 mo in fat, carbohydrate, or protein intake expressed as grams or as percentages of total energy intake. CONCLUSION: Sixteen months of exercise of moderate intensity does not measurably alter the macronutrient intake of young adults.

Adolescent↗

PubMed2005

Predictors of functional and exercise amenorrhoea among eating and exercise disordered patients.

BACKGROUND: The aim of this study was to investigate the predictors of amenorrhoea self-reported by patients who are suffering or recovering from eating or exercise disorders. METHODS: Menstrual status, eating and exercise behaviours and feelings, and weight history of 268 female patients, 16-40 years old and not taking oral contraception or hormone replacement, were assessed on admission to hospital or 12 months later. RESULTS: Most (134) had secondary amenorrhoea, 39 had oligomenorrhoea and 95 regular spontaneous menses. Amenorrhoea occurs in women with all types of eating disorder diagnoses including EDNOS (eating disorder not otherwise classified). The predictors of secondary amenorrhoea were: lower current BMI [odds ratio (OR) 0.59, confidence interval (CI) 0.50-0.68); a greater amount of body weight lost (OR 1.19, CI 1.06-1.33); exercising for mood, to burn up energy or for body image reasons (OR 1.50, CI 1.14-1.97); and younger age (OR 0.93, CI 0.87-1.00). Eating disorder patients with an exercise disorder were significantly more likely to report trying to reduce their food intake, to feel compelled to exercise and to have amenorrhoea/ oligomenorrhoea than eating disorder patients without an exercise disorder. CONCLUSION: The greater the self-report behaviours and feelings associated with energy debt, the more likely menstruation is to be disturbed. Energy balance needs to be assessed in all amenorrhoeic patients.

Adolescent↗

PubMed2004

Exercise promotes BCAA catabolism: effects of BCAA supplementation on skeletal muscle during exercise.

Branched-chain amino acids (BCAAs) are essential amino acids that can be oxidized in skeletal muscle. It is known that BCAA oxidation is promoted by exercise. The mechanism responsible for this phenomenon is attributed to activation of the branched-chain alpha-keto acid dehydrogenase (BCKDH) complex, which catalyzes the second-step reaction of the BCAA catabolic pathway and is the rate-limiting enzyme in the pathway. This enzyme complex is regulated by a phosphorylation-dephosphorylation cycle. The BCKDH kinase is responsible for inactivation of the complex by phosphorylation, and the activity of the kinase is inversely correlated with the activity state of the BCKDH complex, which suggests that the kinase is the primary regulator of the complex. We found recently that administration of ligands for peroxisome proliferator-activated receptor-alpha (PPARalpha) in rats caused activation of the hepatic BCKDH complex in association with a decrease in the kinase activity, which suggests that promotion of fatty acid oxidation upregulates the BCAA catabolism. Long-chain fatty acids are ligands for PPARalpha, and the fatty acid oxidation is promoted by several physiological conditions including exercise. These findings suggest that fatty acids may be one of the regulators of BCAA catabolism and that the BCAA requirement is increased by exercise. Furthermore, BCAA supplementation before and after exercise has beneficial effects for decreasing exercise-induced muscle damage and promoting muscle-protein synthesis; this suggests the possibility that BCAAs are a useful supplement in relation to exercise and sports.

Amino Acids, Branched-Chain↗

PubMed1990

Inheritance of heart structure and physical exercise capacity: a study of left ventricular structure and exercise capacity in 7-year-old twins.

The maximal aerobic power of endurance athletes is high and their heart is characterized by a larger left ventricular internal dimension than in non-athletes, and a proportional increase of wall thickness; these traits may be inherited and/or the consequence of intense physical training. To assess the influence of inheritance on physical exercise capacity and on echocardiographically determined cardiac structure, and to limit the effect of environmental factors as much as possible, we studied 15 monozygotic and 19 dizygotic 6- to 8-year-old twin pairs. Exercise capacity was expressed as the times at which the heart rates of, respectively, 150 and 170 beats min-1 were reached during a progressive exercise test on the treadmill. For these exercise times the within-pair variance was significantly larger in dizygotic compared with monozygotic twins. Therefore significant genetic variance was inferred, both when the exercise times were expressed as absolute values and after adjustment for body weight and gender. As for cardiac structure at rest, the results did not suggest a significant influence of genetic endowment on left ventricular internal diameter or on wall thickness; genetic variance was significant, however, for calculated left ventricular mass (P less than 0.05) and left ventricular mass adjusted for body weight and gender. The results are compatible with the notion that the high aerobic power of endurance athletes is at least partly inherited. Left ventricular internal dimension and wall thickness, which distinguish an athlete's heart at rest from the heart of a non-athlete, do not show a significant genetic component, suggesting that the qualities characteristic of an athlete's heart, at least as assessed at rest, are not inherited. The inheritance of aerobic power may be due to inheritance of non-cardiac factors or to cardiac features which are only expressed during exercise.

Blood Pressure↗

PubMed1983

Prognostic significance of the ST-segment response during exercise test shortly after acute myocardial infarction. Comparison with other exercise variables.

An exercise test was made in 317 patients in the third week after acute myocardial infarction. The following types of exercise associated ST-segment responses were registered in patients less than 70-years-old. I: no ST-deviation (33.6%), II: ST-depression (42.9%), III: ST-elevation (13.4%) and IV: inconclusive ST-response (10.1%). The 5-year mortality was significantly lower in group III than in groups II and IV. Group IV had a significantly higher 5-year mortality than all the other groups. Patients with ST-depression had an increased late mortality compared to that of the patients without ST-deviation, but the total mortality did not differ between these two groups. A highly increased risk of dying was found in groups I, II and IV in patients with exercise associated major ventricular arrhythmias and/or with a small increase of the pressure-rate-product (PRP) during exercise. Patients without arrhythmias and with a high increase of the PRP had a low mortality rate irrespective of their ST-response. In the older patients (70-years-old or more) the ST-response was of no prognostic value at all. The ST-segment response was thus generally of limited value in the prognostic management of the present patients. Their survival was mainly determined by the other exercise variables-the magnitude of an exercise index of left ventricular function and the occurrence of ventricular arrhythmias.

Adult↗

PubMed1985

The ability of a submaximal exercise test to predict maximal exercise capacity in patients with heart failure.

We investigated the ability of a submaximal exercise test to predict the maximal aerobic potential and hence exercise capacity of patients with chronic heart failure. Heart rate, oxygen consumption and carbon dioxide production were measured continuously during treadmill exercise in 29 patients with chronic heart failure (NYHA Class II-III). The anaerobic threshold was determined as the oxygen consumption at which carbon dioxide production increased non-linearly relative to oxygen consumption. Maximal oxygen consumption could not be predicted from the heart rate response to submaximal exercise. Oxygen consumption at the anaerobic threshold (28 patients) and at a respiratory quotient of 1 (23 patients) did predict maximal oxygen consumption (r = 0.93, r = 0.88, respectively). Measurement of oxygen consumption during submaximal exercise can be used to assess maximal exercise capacity in patients with heart failure.

Adult↗

PubMed2005

Exercise training to improve motor performance in chronic stroke: effects of a community-based exercise program.

The purpose of this study was to investigate the feasibility and efficacy of an exercise program offered by a community organization on motor performance in individuals with chronic stroke. Twenty hemiparetic individuals at least 6 months after a stroke and discharged from all rehabilitation services enrolled in the study. They took part in an 8-week group program (two times per week) aimed at improving balance, mobility, coordination, walking endurance and strength on the hemiparetic side through various functional exercises. Pre- and post-exercise assessments included the stroke impairment assessment set, the Berg balance scale, the step test, the timed-up-and-go and the 6 min walk. Results showed significant improvements (P<0.008) in all of the above tests, excluding the 6 min walk, after completion of the exercise training. Correlation analyses revealed that the individuals' age and time since injury were poorly related to the improvement in performance. It is concluded that an exercise program offered by a community organization can lead to improvement in motor performance of individuals with chronic stroke. To prevent decline in motor performance, community-based exercise programs should thus be made available for stroke patients discharged from rehabilitation services.

Age Factors↗

PubMed1999

Exercise and recovery responses of adrenal medullary neurohormones to heavy resistance exercise.

PURPOSE: The purpose of this study was to examine the effect of dynamic resistance exercise on the response patterns of adrenal medullary neurohormones in strength-trained men. METHODS: Ten strength-trained men (21.7+/-0.58 yr) gave informed consent and performed two resistance exercise protocols, high force and high power, of equal total work in a randomized order separated by 1 wk. Blood samples were obtained pre-exercise (baseline), 0 (R-0), 15 (R-15), and 240 (R-240) min postexercise and under resting control conditions for each time point. RESULTS: There were no significant differences in control concentrations for each time point and no difference in pre-exercise values between the two resistance exercise protocols for plasma lactate, epinephrine, plasma peptide F (P-F), or norepinephrine (NE). Plasma lactate significantly (P< or = 0.05) increased from baseline for both protocols; however, concentrations were higher in response to the high force protocol. Plasma epinephrine was significantly increased from baseline at R-0 and returned to baseline at R-15 for both protocols. In contrast, plasma P-F was significantly decreased at R-0 from baseline; however, at R-240 P-F had significantly increased to >80% baseline for both protocols. CONCLUSIONS: These results indicate that the adrenal medulla was activated in response to the acute stress of both types of heavy resistance exercise. Furthermore, during longer recovery periods, the adrenal medulla was also active above baseline conditions as increased concentrations of proenkephalin fragments (i.e., P-F) were detected in the circulation.

Adrenal Medulla↗

PubMed1987

Normal trunk muscle strength and endurance in women and the effect of exercises and electrical stimulation. Part 2: Comparative analysis of electrical stimulation and exercises to increase trunk muscle strength and endurance.

Several studies have shown positive correlations between muscle strength, flexibility, and the frequency of low-back pain. Weak trunk musculature and decreased endurance have thereby come to be identified as significant risk factors in the development of occupational back problems. Because it is widely accepted that exercise plays an important role in the conservative treatment and prevention of low-back pain, the goals of most rehabilitative programs involves improving the strength and endurance of the low-back pain patient. Whereas electrical stimulation has been shown to increase the muscle strength of the lower extremities, this effect has not been demonstrated for the trunk muscles. Part 2 is a prospective controlled study designed to document and to compare objectively the effects of electrical stimulation and exercise on trunk muscle strength. A total of 117 healthy women were divided randomly into four groups. Two groups received electrical stimulation with different electrical parameters, one group received exercises, and one group acted as a control group. The results showed that low-frequency electrical stimulation and exercises significantly (P less than .05) increased isokinetic back-muscle strength compared to the control and medium-high-frequency electrical stimulation groups. Both types of electrical stimulation, however, significantly increased (P less than .05) the endurance in the back muscles compared with the control and the exercise groups. This study showed that electrical stimulation may be a valuable treatment in the early care of low-back pain patients in maintaining and increasing strength and endurance of back muscles when a more active exercise program is too painful to perform.

Adolescent↗

PubMedDate not supplied

The acute effects of noninvasive ventilatory support during exercise on exercise endurance and dyspnea in patients with chronic obstructive pulmonary disease: a systematic review.

PURPOSE: The objective of this study was to review studies systematically, in which the acute effects of noninvasive ventilatory support (NIVS) during exercise were evaluated in patients with chronic obstructive pulmonary disease (COPD). In addition, a quantitative analysis was performed on the effects of NIVS on exertional dyspnea and exercise endurance. METHODS: Literature was searched in electronic databases, and by scanning lists of references of studies and abstract books of annual congresses of the American Thoracic Society and European Respiratory Society. Preliminary data of a study by our own group into the effects of NIVS on exercise endurance in patients with COPD were added. The systematic review was carried out on the basis of a validated methodological screening list. For the quantitative analysis, Glass delta of individual studies were pooled to aggregate a summary effect size. RESULTS: Fifteen studies were identified. Seven of these studies met the inclusion criteria, including a total of 65 patients with COPD. The methodological quality of the included studies varied from 31% to 54% of the maximum score of 13 points. Statistically significant summary effect sizes were found in the analysis of exertional dyspnea (P <.05) as well as in the analysis of exercise endurance (P <.001), indicating improvements in these outcomes in favor of NIVS. CONCLUSIONS: The present systematic review suggests that NIVS during exercise may acutely reduce exertional dyspnea and improve exercise endurance, in patients with COPD.

Chi-Square Distribution↗