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PubMed1993

Effect on exercise performance of enalapril therapy initiated early after myocardial infarction. Nordic Enalapril exercise Trial.

OBJECTIVES: The Nordic Enalapril Exercise Trial was a multicenter subtrial of the Cooperative New Scandinavian Enalapril Survival Study (CONSENSUS II) designed to evaluate the effect on maximal exercise performance of a 6-month period of enalapril treatment initiated early after myocardial infarction. BACKGROUND: When begun early after myocardial infarction, converting enzyme inhibition therapy has been shown to attenuate infarct expansion and reduce left ventricular volume. Therapy has been associated with improved exercise performance. METHODS: Three hundred twenty-seven men (mean age 63.3 +/- 10.9 years) with documented acute myocardial infarction were randomized to treatment with enalapril or placebo on a double-blind basis. Intravenous enalaprilat or placebo therapy was initiated within 24 h after the onset of symptoms. Oral therapy was continued at a target dose of 20 mg/day. Patients exercised maximally at 1 month and 6 months after infarction to symptom-limited end points on a cycle ergometer with a 20 W/min incremental protocol. RESULTS: The treatment and control groups were comparable in patient age, concurrent therapy and type and site of infarction. At 1 month, for all patients, mean total work performed was 34.9 +/- 20.9 kJ in the enalapril group (n = 169) versus 28.5 +/- 20.6 kJ in the placebo group (n = 158) (difference = 18.4%, p < 0.01). This between-group difference in favor of enalapril was greatest in patients > 70 years old (difference = 41.4%, p < 0.01, n = 105) and those with clinical evidence of heart failure (difference = 33.0%, p < 0.01, n = 122). At 6 months for all patients, mean total work performed was 35.4 +/- 23.8 kJ in the enalapril group versus 34.0 +/- 23.9 kJ in the placebo group (difference = 4.1%, NS). CONCLUSIONS: This trial found that chronic converting enzyme inhibition initiated early after myocardial infarction was associated with significantly greater exercise capacity in men tested at 1 month. This difference was independent of type or site of infarction, patient age or the presence of clinical heart failure. The difference between the treatment and control groups was not significant at 6 months because of improvement in the placebo group. Further research is needed to elucidate the potential mechanisms involved, profile those patients most likely to profit from early therapy and establish the optimal timing and duration for intervention.

Administration, Oral↗

PubMed2006

Aerobic exercise, but not flexibility/resistance exercise, reduces serum IL-18, CRP, and IL-6 independent of beta-blockers, BMI, and psychosocial factors in older adults.

Increased serum levels of inflammatory mediators have been associated with numerous disease states including atherosclerosis, Type II diabetes, hypertension, depression, and overall mortality. We hypothesized that a long-term exercise intervention among older adults would reduce serum inflammatory cytokines, and this reduction would be mediated, in part, by improvements in psychosocial factors and/or by beta-adrenergic receptor mechanisms. Adults age 64 were randomly assigned to either an aerobic exercise treatment (CARDIO) or a flexibility/strength exercise treatment (FLEX) 3 days/week, 45 min/day for 10 months. A subgroup of subjects treated with non-selective beta(1)beta(2) adrenergic antagonists were included to evaluate the potential role of beta-adrenergic receptor adaptations as mediators of an exercise-induced change in inflammation. The inflammatory mediators [C-reactive protein (CRP), IL-6, tumor necrosis factor (TNF)-alpha, and IL-18] and the psychosocial factors (depression, perceived stress, optimism, sense of coherence, and social support) were measured pre- and post-intervention. The CARDIO treatment resulted in significant reductions in serum CRP, IL-6, and IL-18 compared to the FLEX treatment (significant treatment x time interaction, p<.05), whereas TNFalpha declined in both groups (main effect of time, p=.001). However, several psychosocial factors (depression, optimism, and sense of coherence) improved in both groups suggesting that the reduction of CRP, IL-6, and IL-18 in the CARDIO group was not mediated by improvements in psychosocial scores. With respect to the potential role of beta-adrenergic receptors, both CARDIO subjects treated with beta-adrenergic antagonists and those who were not treated with those medications demonstrated similar reductions in serum CRP, IL-6, IL-18, and TNFalpha. In summary, we have observed that an aerobic exercise intervention can significantly reduce serum inflammatory mediators, but beta-adrenergic receptors and psychosocial factors do not appear to be involved.

Adaptation, Physiological↗

PubMedDate not supplied

Comparative study of hands-on therapy with active exercises vs education with active exercises for the management of upper back pain.

OBJECTIVE: The aim of this study was to compare hands-on therapy, including heat, massage, and active exercises with postural education that emphasized increased self-efficacy and postural self-awareness along with education about the physiology of the disorder, and prescribed daily active exercises. SUBJECTS: Twenty-four randomly selected women, 12 custodians and 12 students, with neck and shoulder pain and stiffness. METHODS: All subjects received a medical examination and x-ray before the study to rule out any pre-existing neurologic deficits and an evaluation that included history taking and self-reporting of pain according to a numeric pain scale. Student participants received education and exercise instructions to be continued daily. The custodial workers received once-per-week hands-on treatment. RESULTS: Data were compared using a nonparametric analysis (Wilcoxon signed rank test) and showed evidence of statistically significant reductions in neck, shoulder, and back stiffness and shoulder muscle tension for most of the study subjects. CONCLUSION: Treatment of repetitive stress injuries that combines maintenance of daily active exercises prescribed and modeled by a professional therapist, which emphasize postural awareness to correct poor posture and provide a basic physiological understanding of the disorder, is as crucial to reducing upper back and neck pain and stiffness as hands-on therapy with active exercise provided in a clinical setting.

Adult↗

PubMed2004

Practical markers of the transition from aerobic to anaerobic metabolism during exercise: rationale and a case for affect-based exercise prescription.

BACKGROUND: The high rates of dropout from exercise programs may be attributed in part to the poor ability of most individuals to accurately self-monitor and self-regulate their exercise intensity. The point of transition from aerobic to anaerobic metabolism may be an appropriate level of exercise training intensity as it appears to be effective and safe for a variety of populations. Possible practical markers of this event were compared. METHODS: Two samples of 30 young and healthy volunteers each participated in incremental treadmill tests until volitional exhaustion. The ventilatory threshold, a noninvasive estimate of the aerobic-anaerobic transition, was identified from gas exchange data. Heart rate, self-ratings of affective valence (pleasure-displeasure), perceived activation, and perceived exertion were recorded every minute. RESULTS: In both samples, heart rate, perceived activation, and perceived exertion rose continuously, whereas the ratings of affective valence showed a pattern of quadratic decline, initiated once the ventilatory threshold was exceeded. CONCLUSIONS: Exercise intensity that exceeds the point of transition from aerobic to anaerobic metabolism is accompanied by a quadratic decline in affective valence. This marker may be useful in aiding exercisers to recognize the transition to anaerobic metabolism and, thus, more effectively self-monitor and self-regulate the intensity of their efforts.

Adult↗

PubMed1997

Effects of cardiac rehabilitation, exercise training, and weight reduction on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in obese coronary patients.

Obesity is strongly associated with coronary artery disease (CAD) and may be an independent risk factor; however, limited data are available on obesity intervention in patients with CAD. We studied 588 consecutive patients, including 235 (40%) who were obese by body mass index criteria (body mass index > or = 27.3 kg/m2 in women and > or = 27.8 kg/m2 in men) before and after out-patient phase II cardiac rehabilitation to determine the effects of this therapy and weight reduction on exercise capacity, CAD risk factors, behavioral characteristics, and quality of life in obese patients with CAD. At baseline, obese patients were younger (p < 0.0001) and had more systemic hypertension (p < 0.01), and diabetes mellitus (p < 0.05) and higher percent body fat (p < 0.0001), total cholesterol (p = 0.02), triglycerides (p < 0.0001), fasting glucose (p = 0.04), and low-density lipoprotein (LDL)-high-density lipoprotein (HDL) cholesterol (p < 0.0001), but had lower HDL cholesterol (p < 0.01) and exercise capacity (p = 0.07) than patients not classified as obese. After rehabilitation, obese patients had significant improvements in body mass index (-2%; p < 0.0001), percent body fat (-5%; p < 0.0001), exercise capacity (+27%; p < 0.0001), HDL cholesterol (+4%; p < 0.01), LDL/HDL ratio (-6%; p < 0.01), as well as scores for anxiety (p < 0.0001), depression (p < 0.01), somatization (p < 0.0001) and quality of life (p < 0.0001); nonobese patients, however, had significantly greater improvements in exercise capacity (+39% vs +27%; p < 0.001). In a subgroup of 45 obese patients with > or = 5% weight reduction, improvements in exercise capacity (p < 0.001), total cholesterol (p = 0.03), triglycerides (p < 0.01), HDL cholesterol (p < 0.001), LDL cholesterol (p = 0.02), and LDL/HDL ratio (p < 0.0001) were greater than improvements in 81 obese patients who did not lose weight. These data indicate that greater emphasis on more successful weight reduction programs is needed to further enhance CAD risk reduction in the 40% CAD patients with obesity.

Aged↗

PubMed1995

Effects of cardiac rehabilitation and exercise training on exercise capacity, coronary risk factors, behavioral characteristics, and quality of life in women.

Despite the known benefits of cardiac rehabilitation, limited data are available on the outcome of this treatment in women, and this secondary prevention strategy may be underutilized. To assess the gender differences in baseline exercise capacity, indexes of obesity, lipid profiles, behavior characteristics, and components of quality of life, as well as the improvements in these components after a secondary prevention program, we retrospectively reviewed data from 458 patients (83 women and 375 men) enrolled in a phase II cardiac rehabilitation and exercise program after a major cardiac event. At baseline (6 weeks after the cardiac event and before rehabilitation), exercise capacity (-9%, p = 0.08) and ratio of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (-14%, p < 0.01) were lower, but total cholesterol (+7%, p < 0.01), high-density lipoprotein cholesterol (+25%, p < 0.0001), low-density lipoprotein cholesterol (+8%, p < 0.01), and percent body fat (+15%, p < 0.0001) were higher in women than in men with coronary artery disease. In addition, with regard to quality of life, women had lower scores for energy (p = 0.06), function (p < 0.01), and total quality of life (p < 0.05) than men. After cardiac rehabilitation and exercise training, women had significant improvements in exercise capacity (+33%, p < 0.0001) and percent body fat (-7%, p < 0.001), which compared favorably with the improvements (+40% and -5%, respectively) seen in men, but improvements in body mass index and lipids were not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed2001

Gender differences in exercise-induced changes in sex hormone levels and lipid peroxidation in athletes participating in the Hawaii Ironman triathlon. Ginsburg-gender and exercise-induced lipid peroxidation.

BACKGROUND: Exercise reduces the risk of coronary heart disease in men and women but paradoxically, may promote free-radical formation, lipid peroxidation and vascular tissue injury. In this study, we assessed whether exercise-induced oxidative stress similarly affected men and women who participated in the Hawaii Ironman triathlon. METHODS AND RESULTS: Fifty-seven athletes (38 males) who completed the triathlon (3.9 km swim, 180.2 km bike, 42.2 km run) participated in this study. Blood samples were obtained 2 days before and immediately after the triathlon for the measurement of lipids, antioxidants and sex hormones and for the assessment of the susceptibility of plasma lipids to peroxidation. Lipid changes after exercise were similar for men and women. However, the susceptibility of plasma lipids to peroxidation was reduced by 61% (P < 0.001) in men and only 14% (P = NS) in women postrace. These changes were not associated with the supplemental use or levels of antioxidants. In addition, in men there was an increase of 58% in the antioxidant sex hormone estradiol and a decrease of 58% in testosterone (P < 0.001) postrace. No significant changes were noted for these two hormones in women. CONCLUSIONS: There are significant gender-specific differences in the susceptibility of lipids to peroxidation and in changes in estradiol and testosterone levels as a result of ultra-endurance exercise. These changes may in part explain the salutary effect of exercise on the development of vascular disease.

Adult↗

PubMed1998

Percent achieved of predicted peak exercise oxygen uptake and kinetics of recovery of oxygen uptake after exercise for risk stratification in chronic heart failure.

To investigate whether percent achieved of predicted peak exercise oxygen uptake (%VO2max) and recovery of oxygen consumption after exercise may provide prognostic information in chronic heart failure (CHF), we prospectively studied 196 patients with mild to moderate CHF. The following variables were examined: age, etiology of CHF, functional class, ejection fraction (EF), peak exercise oxygen uptake normalized for body weight (VO2max), %VO2max, time to reach 50% of the peak oxygen uptake after exercise (T1/2VO2max), presence of nonsustained ventricular tachycardia (NSVT) and inability to take ACE-inhibitors. VO2max was the most powerful predictor of cardiac death (P<0.0001). Other independent predictors of death were EF, T1/2VO2max, NSVT and inability to take ACE-inhibitors. The discriminatory accuracy of VO2max for cardiac death was not significantly greater than that of %VO2max. In conclusion, the determination of %VO2max does not enhance risk stratification in CHF whereas the kinetics of oxygen consumption after exercise can provide prognostic information.

Exercise Test↗

PubMed2000

Exercise BP response in subjects with high-normal BP: exaggerated blood pressure response to exercise and risk of future hypertension in subjects with high-normal blood pressure.

OBJECTIVES: This study was designed to assess the clinical usefulness of an exaggerated blood pressure (BP) response to exercise (EBPR) in predicting the development of hypertension from a high-normal state. BACKGROUND: Exaggerated BP response during both dynamic and isometric exercises are associated with increased risk of future hypertension, while the significance of these responses concerning the identification of individuals with high-normal BP who are prone to develop hypertension is unknown. METHODS: The study population comprised a sample of 239 men with high-normal BP (aged 42.3 +/- 5.9 years) who underwent a symptom-limited bicycle ergometer exercise testing at baseline and then were followed for 5.1 years. RESULTS: The Kaplan-Meier survival analysis showed that the subjects in the upper quartile of BP response to exercise had a significantly higher cumulative incidence of hypertension on follow-up than those in the middle two and lower quartiles (log-rank test, p < 0.05). Multivariate analysis using the Cox proportional hazards survival model showed that the EBPR was significantly and independently associated with the risk of developing hypertension after adjustment for some traditional risk factors for hypertension (RR = 2.31, 95% confidence interval = 1.45 to 6.25). CONCLUSIONS: These findings suggest that an EBPR is an important risk factor for new-onset hypertension from a high-normal state and, thus, exercise testing can provide valid information that may help identify individuals with high-normal BP at a greater risk of future hypertension.

Adult↗

PubMed1988

Exercise testing after myocardial infarction: relative values of the low level predischarge and the postdischarge exercise test.

This study was undertaken to compare the relative values of the low level predischarge exercise test and the postdischarge (6 weeks) symptom-limited test in 518 consecutive patients admitted with an acute myocardial infarction. Of the patients who did not develop significant ST segment depression or angina during the predischarge test, the symptom-limited test also remained negative in 91.5 and 91.9% of the patients, respectively. Similar results were obtained with ST segment elevation and the systolic blood pressure response during the two exercise tests with only 2.1 and 11.4% changing from normal to abnormal, respectively. Discriminant function analysis was done to predict the occurrence of coronary events (unstable angina, reinfarction, cardiac failure, cardiac death) with use of the data from the exercise tests together with other clinical and investigational data. The jackknife method correctly classified 71.9 and 71.4% of the patients with the data from the predischarge exercise test and symptom-limited test, respectively. Combining the data from the two tests improved the overall predictive accuracy to only 75.0%. It is concluded that the routine performance of a symptom-limited test 6 to 8 weeks after infarction does not reveal any significant additional information in those patients who have undergone a predischarge low level exercise test. Thus the 6 to 8 week test should be restricted to selected patients after myocardial infarction.

Adult↗

PubMedDate not supplied

The Canadian exercise technetium 99m-labeled teboroxime single-photon emission computed tomographic study. Canadian Exercise Teboroxime SPECT Study Investigators.

BACKGROUND: 99mTc-labeled teboroxime undergoes rapid washout from the myocardium. For this reason, its use has been favored in conjunction with pharmacologic stress, which enables patient positioning before tracer administration, and multidetector single-photon emission computed tomography (SPECT), which enables rapid acquisition. We evaluated treadmill exercise 99mTc-labeled teboroxime SPECT with single-detector systems for the detection of coronary artery disease. METHODS AND RESULTS: Treadmill exercise 99mTc-labeled teboroxime SPECT was compared with analogous 201Tl-labeled imaging in 108 patients. Teboroxime was injected first during exercise and then at rest. Nine myocardial segments per study were scored with respect to uptake of activity during stress and at rest (teboroxime) or after redistribution (201Tl). Perfusion was defined as normal, reversible, or fixed. Overall agreement of 201Tl versus teboroxime segmental perfusion (normal vs abnormal) was 772/961 (80.3%; chi 2 = 258; p < 0.001; kappa = 0.51) or (normal vs reversible vs fixed) 711/961 (74.0%; chi 2 = 296; p < 0.001; kappa = 0.42). Fifty-six patients also underwent selective coronary angiography. Stenoses greater than 50% of lumenal diameter were drawn on individualized coronary artery diagrams applied to polar plots of scintigraphic segments to compare detection of coronary artery disease. Sensitivity and accuracy of teboroxime were 0.80 and 0.79, respectively, compared with 0.84 and 0.82 for 201Tl (difference not significant). Mean imaging procedure time was 113.6 minutes for teboroxime and 240.5 minutes for 201Tl (p < 0.001). CONCLUSIONS: 99mTc-labeled teboroxime is amenable to simple modifications of routine treadmill exercise SPECT myocardial perfusion imaging protocols with widely available single-detector SPECT systems. This modality provides results similar to those of exercise 201Tl SPECT and is significantly faster.

Adult↗

PubMed2002

A study of the association between exercise-induced wheeze and exercise versus methacholine-induced bronchoconstriction in adolescents.

Among asthmatics, exercise-induced wheeze (EIW) is a frequent symptom, and 40-77% of asthmatics demonstrate exercise-induced bronchoconstriction (EIB). In the North-Trøndelag population-based survey of 8,571 adolescents (YOUNG-HUNT), 26% reported wheeze during the previous 12 months (current wheeze). Of those subjects, 50% reported EIW. The aim of the present study was to investigate the association between EIW and EIB in randomly selected adolescents with EIW as the only or predominant asthma-like symptom, and to relate our findings to results from methacholine bronchoprovocation tests (MT) and measurements of exhaled nitric oxide (ENO). Sixty-three subjects with current wheeze induced by exercise, but not by allergen exposure, were investigated using a treadmill exercise test (ET) and measurements of ENO. Fifty-eight subjects completed a MT on a separate study day. EIB was defined as a fall of >or= 10% in the forced expiratory volume in 1 second (FEV1) after exercise (DeltaFEV1%ex). Twenty-one subjects (33%) had EIB and 33 (57%) had a positive MT. The degree of reported dyspnea during the ET was not correlated to the DeltaFEV1%ex. The correlation between EIB and methacholine-induced bronchoconstriction (MIB) was poor, and the DeltaFEV1%ex was more pronounced in smokers than in non-smokers. Moreover, ENO was not increased in subjects with positive vs. negative ET. Hence, EIW, when reported as the only or predominant asthma-like symptom, was linked to EIB in only one-third of the patients. We conclude that EIW is a poor predictor of EIB in epidemiological studies. The poor correlation between EIB and MIB indicates that these two tests measure different mechanisms of bronchial hyper-responsiveness.

Adolescent↗

PubMed2003

Acute changes in neuromuscular excitability after exhaustive whole body vibration exercise as compared to exhaustion by squatting exercise.

The effects of hard squatting exercise with (VbX+) and without (VbX-) vibration on neuromuscular function were tested in 19 healthy young volunteers. Before and after the exercise, three different tests were performed: maximum serial jumping for 30 s, electromyography during isometric knee extension at 70% of the maximum voluntary torque, and the quantitative analysis of the patellar tendon reflex. Between VbX+ and VbX- values, there was no difference found under baseline conditions. Time to exhaustion was significantly shorter in VbX+ than in VbX- (349 +/- 338 s versus 515 +/- 338 s), but blood lactate (5.49 +/- 2.73 mmol l-1 versus 5.00 +/- 2.26 mmol l-1) and subjectively perceived exertion (rate of perceived exertion values 18.1 +/- 1.2 versus 18.6 +/- 1.6) at the termination of exercise indicate comparable levels of fatigue. After the exercise, comparable effects were observed on jump height, ground contact time, and isometric torque. The vastus lateralis mean frequency during isometric torque, however, was higher after VbX+ than after VbX-. Likewise, the tendon reflex amplitude was significantly greater after VbX+ than after VbX- (4.34 +/- 3.63 Nm versus 1.68 +/- 1.32 Nm). It is followed that in exercise unto comparable degrees of exhaustion and muscular fatigue, superimposed 26 Hz vibration appears to elicit an alteration in neuromuscular recruitment patterns, which apparently enhance neuromuscular excitability. Possibly, this effect may be exploited for the design of future training regimes.

Adult↗

PubMed2006

Exercise mode affects the time to achieve VO2max without influencing maximal exercise time at the intensity associated with VO2max in triathletes.

The objective of this study was to analyze, in triathletes, the possible influence of the exercise mode (running x cycling) on time to exhaustion (TTE) and oxygen uptake (VO2) response during exercise performed at the intensity associated with the achievement of maximal oxygen uptake (IVO2max). Eleven male triathletes (21.8 +/- 3.8 yr) performed the following tests on different days on a motorized treadmill and on a cycle ergometer: 1) incremental tests in order to determine VO2max and IVO2max and, 2) constant work rate tests to exhaustion at IVO2max to determine TTE and to describe VO2 response (time to achieve VO2max - TAVO2max, and time maintained at VO2max-TMVO2max). No differences were found in VO2max, TTE and TMVO2max obtained on the treadmill tests (63.7 +/- 4.7 ml . kg (-1) . min (-1); 324.6 +/- 109.1 s; 178.9 +/- 93.6 s) and cycle ergometer tests (61.4 +/- 4.5 ml . kg (- 1) . min (-1); 390.4 +/- 114.4 s; 213.5 +/- 102.4 s). However, TAVO2max was influenced by exercise mode (145.7 +/- 25.3 vs. 176.8 +/- 20.1 s; in treadmill and cycle ergometer, respectively; p = 0.006). It is concluded that exercise modality affects the TAVO2max, without influencing TTE and TMVO2max during exercise at IVO2max in triathletes.

Adult↗

PubMed1999

Pre-exercise ingestion of carbohydrate and transient hypoglycemia during exercise.

To study the occurrence and contributing factors of transient hypoglycemia after pre-exercise ingestion of glucose after a 4-hour fast, 19 well-trained cyclists ingested 50 grams of glucose dissolved in water around noon after having a normal breakfast. The ingestion of the glucose solution was followed by 30 minutes rest after which the subjects cycled for 40 minutes at 60% of the predetermined maximal power output. Every 10 minutes blood was sampled for determination of glucose, catecholamines, and insulin concentrations. In 6 subjects (hypo-group) plasma glucose levels dropped transiently below 3.0 mmol/l, while in the other 13 subjects (non-hypo group) plasma glucose level remained above this level. Although at the onset of exercise the plasma glucose levels were lower in the hypo-group, insulin levels were similar in both groups, suggesting a higher insulin sensitivity in the hypo-group. During exercise, norepinephrine was lower in the hypo-group, indicating a lower sympathetic activity in the hypo-group. The lowest plasma glucose levels in both groups were observed after 20 minutes of exercise, after which plasma glucose concentration returned to normal levels. It is concluded that pre-exercise carbohydrate ingestion after a 4-hour fast is sufficient to induce a transient hypoglycemia. The data suggest that the occurrence of hypoglycemia is determined by a combination of a high insulin sensitivity, a small amount of ingested glucose, and a low sympathetic activity.

Adult↗

PubMed1996

The effect of upper body exercise intensity and duration on post-exercise oxygen consumption.

This study assessed excess post-exercise oxygen consumption (EPOC) following upper body exercise (UBE) of different intensity and duration. Ten subjects, 5 male and 5 female (age: 26.7 +/- 4.9 yr; peak UBE oxygen uptake [VO2peak]: 1.78 +/- 0.57 l. min-1, 25.6 +/- 5.8 ml.kg-1. min-1) performed three randomized tests on an arm crank ergometer: 1) low intensity, short duration (LS) = 35% VO2peak for 15 min; 2) low intensity, long duration (LL) = 35% VO2peak for 30 min; 3) high intensity, short duration (HS) = 70% VO2peak for 15 min. Subjects reported for all tests in the morning and in a fasted and rested state. Exercise was preceded by a 30 min seated baseline. Recovery VO2 was continuously monitored until baseline was re-established. EPOC duration (p < 0.01) and magnitude (p < 0.01) were significantly greater following HS, while LL and LS did not differ in response (duration and magnitude: HS = 14.0 +/- 6.5 min, 32.5 +/- 24.6 kJ; LL = 5.5 +/- 4.4 min, 12.3 +/- 8.6 kJ; LS = 5.7 +/- 4.9 min, 10.3 +/- 5.3 kJ). HS also had higher HR (73 +/- 10 b.min-1, p < 0.01) at end-EPOC compared to LL (64 +/- 8 b.min-1) and LS (66 +/- 8 b.min-1), and baseline HS values (63 +/- 8 b. min-1). Results from this study indicate that UBE intensity has a greater effect on EPOC than exercise duration under these conditions. UBE appears to have similar EPOC patterns as lower body exercise.

Adult↗

PubMed2002

Effects of exercise training in patients with heart failure: the Exercise Rehabilitation Trial (EXERT).

BACKGROUND: The purpose of this study was to examine the effects of exercise training on functional capacity in patients with heart failure. METHODS: One hundred eighty-one patients in New York Heart Association class I to III, with ejection fraction <40% and 6-minute walk distance <500 meters, were recruited into a randomized, controlled, single-blind trial comparing 3 months of supervised training, then 9 months of home-based training with usual care. RESULTS: There was a significant increase in 6-minute walk distance at 3 and 12 months but no between-group differences. Incremental peak oxygen uptake increased in the exercise group compared with the control group at 3 months (0.104 +/- 0.026 L/min vs 0.025 +/- 0.023 L/min; P =.026) and 12 months (0.154 +/- 0.074 L/min vs 0.024 +/- 0.027 L/min; P =.081). Compared with the control group, significant increases were observed in the exercise group for arm and leg strength. No significant changes were observed in cardiac function or quality of life. Adherence to exercise was good during supervised training but reduced during home-based training. CONCLUSIONS: Exercise training improves peak oxygen uptake and strength during supervised training. Over the final 9 months of the study, there was little further improvement, suggesting that some supervision is required for these patients. There were no adverse effects on cardiac function or clinical events.

Aged↗

PubMed2004

The metabolic role of IL-6 produced during exercise: is IL-6 an exercise factor?

For most of the last century, researchers have searched for a muscle contraction-induced factor that mediates some of the exercise effects in other tissues such as the liver and the adipose tissue. It has been called the 'work stimulus', the 'work factor' or the 'exercise factor'. In the search for such a factor, a cytokine, IL-6, was found to be produced by contracting muscles and released into the blood. It has been demonstrated that IL-6 has many biological roles such as: (1) induction of lipolysis; (2) suppression of TNF production; (3) stimulation of cortisol production. The IL-6 gene is rapidly activated during exercise, and the activation of this gene is further enhanced when muscle glycogen content is low. In addition, carbohydrate supplementation during exercise has been shown to inhibit the release of IL-6 from contracting muscle. Thus, it is suggested that muscle-derived IL-6 fulfils the criteria of an exercise factor and that such classes of cytokines could be termed 'myokines'.

Energy Metabolism↗