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At least 1,189 records · Page 66Linked to original sources
PubMed1999

Montelukast versus salmeterol in patients with asthma and exercise-induced bronchoconstriction. Montelukast/Salmeterol Exercise Study Group.

BACKGROUND: Montelukast, a leukotriene receptor antagonist, and salmeterol, a long-acting beta(2)-receptor agonist, each have demonstrated benefits in the treatment of exercise-induced bronchoconstriction (EIB) in short-term studies. Direct comparisons between these agents in long-term studies are limited. OBJECTIVE: We sought to compare montelukast and salmeterol in the long-term treatment of EIB. METHODS: One hundred ninety-seven patients with mild asthma and a postexercise fall in FEV(1) of at least 18% were randomized (double-blind) to receive montelukast 10 mg once daily or salmeterol 50 microg twice daily for 8 weeks. Exercise challenge was repeated at day 3, week 4, and week 8 after randomization near the end of the dosing interval for both drugs. The primary efficacy endpoint was the maximal percent fall in postexercise FEV(1) at week 8. RESULTS: Montelukast was effective in treating EIB without inducing tolerance and provided superior (P </=.001) protection than salmeterol at weeks 4 and 8, with comparable protection at day 3. The frequency of respiratory clinical adverse events (P =.046) and discontinuations because of clinical adverse events (P =.052) were less with montelukast. CONCLUSION: The effect of montelukast was greater than that of salmeterol in the chronic treatment of EIB over a period of 8 weeks in patients with mild asthma as demonstrated by effect size, maintenance of effect, and fewer respiratory clinical adverse events during the study period. Montelukast may be a better alternative to salmeterol as a controller agent for the chronic treatment of EIB.

Acetates↗
PubMed1984

Wheelchair exercise testing: comparison of continuous and discontinuous exercise.

We have compared wheelchair exercise performed at submaximal levels in a continuous versus discontinuous format. There was a positive linear relationship between heart rate, systolic blood pressure, and VO2 with increasing workload. This was true for both modes of testing with no significant difference in heart rate, systolic blood pressure, VO2, Ve, or Ve/VO2. We conclude that clinical wheelchair exercise testing can be performed in a continuous format without sacrificing physiological data.

Adult↗
PubMedDate not supplied

Anatomy of a meta-analysis: a critical review of "exercise echocardiography or exercise SPECT imaging? A meta-analysis of diagnostic test performance".

BACKGROUND: Accurate diagnosis of coronary heart disease has the potential to contribute substantially to cost-effective delivery of health services. Recent work by Fleischmann et al (JAMA 1998;280:913-20) represents an effort to summarize the accuracy of exercise echocardiography and exercise single photon emission computed tomography (SPECT). METHODS AND RESULTS: A critique of the previous work was constructed, obtaining the 44 articles used. These articles were reviewed and summarized with established techniques for meta-analysis. The studies summarized by Fleischmann et al were found to be significantly heterogeneous (echocardiography and SPECT, both P<.001). In the SPECT cohort, combination of different radioisotopes and reading techniques, and inclusion of reports using experimental techniques, were sources of heterogeneity. In the echocardiography cohort, experimental techniques and an individual series were identified. When the sample was stratified for sources of heterogeneity, it was found that there was no significant difference in diagnostic accuracy between the echocardiography and SPECT techniques used in current clinical practice. Meta-regression with summary receiver operating characteristic curve techniques, after adjustment of the model for multicolinearity and outliers, revealed that there were no significant differences between SPECT as used in current clinical practice and echocardiography. CONCLUSION: The report by Fleischmann et al contains serious flaws that limit its validity and generalizability.

Echocardiography↗
PubMed1999

'Finding a good thing': the use of quantitative and qualitative methods to evaluate an exercise class and promote exercise for adults with mobility impairments.

PURPOSE: Physical inactivity in people with severe disabilities is common and has severe consequences. Conditioning classes are one way to increase activity and promote its health related outcomes. This paper reports the results of an evaluation of a community based conditioning class for adults with mobility impairments. METHOD: The study uses two methods with two samples: a quantitative self-report methodology and a quantitative interview. RESULTS: The quantitative evaluation found no significant increases in standard self-report measures of physical activity, functional status, quality of life, depression, or exercise self-efficacy. The lack of significant quantitative results may be due to limits in study design. The open-ended qualitative interviews with 16 class participants show important physical, social and psychological improvements. The juxtaposition of these two perspectives allows researchers to recognize the limitations in their choice of methods and the challenges faced by researchers evaluating small community based programmes for this limited population. CONCLUSION: In this case, the qualitative evaluation captured the positive experiences of the exercise class participants.

Adult↗
PubMed1993

Effects of a 10-week exercise intervention programme on exercise and work capacities in Belfast's ambulance-men.

The objective of the present study was to investigate the occupational benefits of an exercise intervention programme, including changes in physical working capacity and other physical fitness measures on a group of Belfast ambulancemen. Physical training was performed twice weekly for 10 weeks and consisted primarily of indoor soccer and circuit-training sessions. Both experimental (n = 8) and control subjects (n = 6) were assessed for height (HT), weight (WT), body composition (percentage fat), standing broad jump (SBJ), flexibility (Flex), and sit-up performance (SU). The experimental group was further assessed for blood pressure (BP), hand grip strength (HGS), maximal oxygen consumption (VO2 max), end lactate concentration (EL), anaerobic threshold (AT) and leg strength (LS). Working capacity was also assessed during a staged emergency incident, using a portable telemetric gas analyser. Significant changes in the experimental group were found following training for Flex, SU, SBJ, VO2 max (all P < 0.05), EL and AT (P < 0.01). A significant drop in the metabolic cost of the simulated emergency incident was also noted following training. No significant differences were found for the control group over the experimental period. The present study indicated that a twice-weekly exercise intervention programme was effective in improving the physical fitness of Belfast's ambulancemen. Such a programme could prove cost-effective by increasing work capacity and decreasing absenteeism related to musculoskeletal injury.

Ambulances↗
PubMed1992

Aerobic exercise, anaerobic exercise and the lactate threshold.

All exercise draws first on intramuscular stores of ATP and creatine phosphate; initially these are replenished by anaerobic glycolysis. The lactic acid produced contributes to the rapid development of fatigue in high intensity exercise. Aerobic metabolism (at first mainly of glycogen, later increasingly of fat) is the principal route of ATP resynthesis in activities lasting longer than 2 min, but can only maintain work-rates about 1/4 of those possible in very brief bursts. Blood lactate rises at the higher aerobic work rates. 'Lactate threshold' (LT: approximately 2 mmol/l) is almost exactly the speed at which endurance races are won, and close to those apparently providing optimal aerobic training. This training, predominantly of muscle aerobic capacity, elevates LT more than maximum oxygen consumption. LT is not now thought to indicate oxygen-deprivation, but intracellular adjustments driving oxidative phosphorylation faster. Ventilatory breakpoints, formerly considered to indicate LT, correlate more closely with the accumulation of potassium than lactate.

Adenosine Triphosphate↗
PubMed1986

Exercise thallium stress testing compared with coronary angiography in patients without exclusions for suboptimal exercise or cardioactive medications.

From 1293 patients who underwent thallium stress testing and 1099 patients who had coronary angiography, a consecutive series of 122 who had both studies is evaluated. This group includes suboptimally exercised patients and those receiving one or several cardiovascular drugs that were not discontinued prior to exercise. When compared with the EKG stress test, thallium stress imaging was superior in sensitivity (80% vs 68%), specificity (84% vs 49%), accuracy (81% vs 62%), positive predictive value, (92% vs 75%), and negative predictive value (65% vs 45%) in this group, with 71% prevalence of angiographically significant coronary artery disease.

Angiography↗
PubMed2000

Special feature for the Olympics: effects of exercise on the immune system: overview of the epidemiology of exercise immunology.

The application of epidemiological methods to exercise immunology is reviewed briefly, with particular reference to the possible influences of physical activity, exercise and training on susceptibility to upper respiratory infections. Available reports are arbitrarily rated in terms of limiting factors: the quality of the assessment of physical activity, the precision of diagnosis of upper respiratory infection and overall methodology. The pattern of physical activity has often been clearly established but, in part because of the problems associated with the competitive environment, assessments of infection and overall methodology have often been less than optimal. Although there is some evidence that susceptibility to infection is increased by either a single bout of very heavy activity or a period of heavy training, reports are far from unanimous, and in certain respects fail to meet the classical epidemiological criteria of a causal relationship. The issue is important to both the health and the success of the international competitor, and merits definitive investigation, using optimal methods to assess both activity patterns and infection.

Adolescent↗
PubMed2000

Special feature for the Olympics: effects of exercise on the immune system: infections and exercise in high-performance athletes.

The elite athlete has a potentially increased sensitivity to respiratory infections, rendering protective measures particularly important. Some other infections that may appear in clusters in the sports setting, such as gastroenteritis, leptospirosis, herpes simplex and viral hepatitis, also require special precautionary attention. Strenuous exercise during ongoing infection and fever may be hazardous and should always be avoided. In addition, early symptoms of infection warrant caution until the nature and severity of the infection become apparent. Because myocarditis may or may not be accompanied by fever, malaise or catarrhal symptoms, athletes should be informed about the symptoms suggestive of this disease. Although sudden unexpected death resulting from myocarditis is rare, exercise should be avoided whenever myocarditis is suspected. Guidelines are suggested for the management and counselling of athletes suffering from infections, including recommendations on when to resume training. Acute febrile infections are associated with decreased performance resulting from muscle wasting, circulatory deregulation and impaired motor coordination, which require variable amounts of time to become normalized once the infection is over.

Adult↗
PubMed1993

Carbohydrate ingestion during exercise: effects on muscle glycogen resynthesis after exercise.

To determine the effect of carbohydrate feeding on muscle glycogen resynthesis, 8 male cyclists pedaled for 2 hrs on a cycle ergometer at 70% of VO2max while consuming either a 10% carbohydrate solution (CHO) or a nonnutritive sweet placebo (No CHO). Muscle biopsies were obtained from the vastus lateralis prior to, immediately postexercise, and at 2, 4, and 24 hrs of recovery. Blood samples were taken before and at the end of exercise, and at specified times during recovery. During both trials food intake was withheld for the first 2 hrs of recovery, but at 2 hrs postexercise a 24% carbohydrate solution was ingested. The rate of muscle glycogen resynthesis during the first 2 hrs of recovery was similar for the CHO and No CHO trials. Following ingestion of the 24% carbohydrate supplement, the rates of muscle glycogen resynthesis increased similarly in both trials. These similar rates of resynthesis following ingestion of the carbohydrate supplement were obtained despite significantly greater serum glucose and insulin levels during the No CHO trial. The results indicate that the carbohydrate feedings taken during exercise had little effect on postexercise muscle glycogen resynthesis.

Adult↗
PubMed2003

The influence of exercise test protocol on perceived exertion at submaximal exercise intensities in children.

This study examined ratings of perceived exertion (RPE) using Borg's 6-20 scale at 50 W, 80 W, and ventilatory threshold (VT) in 10-year-old children (n = 15) during two different graded exercise tests. Power output was increased by 10 W.min(-1) in one protocol and by 30 W.3 min(-1) in the other. The cardiorespiratory responses at VT and peak exercise were similar between protocols. At 50 W and 80 W the cardiorespiratory responses were generally lower (P < 0.05) in the 10W trial. However, RPE was 11.5 +/- 2.9 and 12.1 +/- 3.2 at 50 W and 15.1 +/- 2.7 and 15.3 +/- 2.8 at 80 W in the 10-W and 30-W trials, respectively (P > 0.05). The RPE at VT was 13.9 +/- 2.4 in the 10-W trial and 12.4 +/- 2.4 in the 30-W trial (P < 0.05). In that variations in submaximal RPE did not coincide with variations in central mediators of exertion, locals cues of exertion may have provided the dominate sensory signal.

Analysis of Variance↗
PubMed1978

The National Exercise and Heart Disease Project. The pre-randomization exercise program. Report number 2.

The National Exercise and Heart Disease Project (NEHDP) was funded by the Rehabilitation Services Administration (RSA) of the Department of Health, Education and Welfare, to determine the effects of regular physical activity on the rehabilitation, morbidity and mortality of patients with healed myocardial infarctions. Planning and development lasted from June 1972 through September 1974. Since 1974, 932 subjects were referred for evaluation. At randomization, 651 subjects were assigned to exercise treatment (323) or control (328) groups. Those who qualified for randomization had to complete an initial evaluation, attend 14 of 18 consecutively scheduled, low-level physical activity sessions during a period of 6 weeks, and complete a second evaluation. This prerandomization phase was accompanied by significant alterations in work capacity, heart rate levels at rest and during three levels of physical stress, systolic blood pressure reductions during stress but not at rest, and by changes in the level of anxiety and depression. The subjects will be followed for a minimum of 2 years at regular intervals to determine if regularly performed physical activity is beneficial to the rehabilitation of myocardial infarction survivors.

Adult↗
PubMed1980

Adjusted single load exercise test. A new exercise test for improved diagnosis of coronary heart disease.

A new adjusted single load exercise test (ASLET) is presented. The test is aimed to improve diagnosis of coronary heart disease and should not be used in patients with a well-established diagnosis. 60--120 min after a multistage near-maximal ergometric test with a negative electrocardiographic outcome ASLET is performed. The single load used in ASLET is based on the last load reached at the multistage procedure. If for example a heart rate of 150 beats/min (end point parameter of the multistage test for the age group above 40 years) is reached at 100 W (after performing 25, 75, and 100 W) the ASLET will be a sudden load of 100 W. This procedure has proved to increase the sensitivity of our exercise test. In about one third of false negative results at the multistage procedure the ASLET test was positive in symptomatic patients.

Adult↗
PubMed1983

Comparison of rest and exercise radionuclide angiocardiography and exercise treadmill testing for diagnosis of anatomically extensive coronary artery disease.

The accuracy of rest and exercise radionuclide angiocardiography (RNA) and exercise treadmill testing (ETT) for diagnosis of three-vessel or left main coronary artery disease (extensive CAD) was determined in 544 patients. ETT and RNA sensitivities were similar (88% vs 92%, NS), but ETT was more specific than RNA (46% vs 34%, p less than 0.01). The prevalence of extensive CAD in patients with a positive treadmill (41%) increased only 3% when the RNA was also positive. However, in the 292 patients with a negative or indeterminate ETT, a positive RNA increased this prevalence from 16% to 23%, while a negative RNA decreased this prevalence to 5%. These results support the initial use of ETT followed by RNA if the treadmill is negative or indeterminate for diagnosis in a population with a high prevalence of extensive CAD. This approach separates patients into subgroups with a high or low probability of extensive CAD.

Adult↗
PubMed1988

Improvement in exercise capacity and exercise hemodynamics 3 months after double-balloon, catheter balloon valvuloplasty treatment of patients with symptomatic mitral stenosis.

Clinical status, exercise treadmill performance, and hemodynamics were determined in 24 patients with symptomatic mitral stenosis before catheter balloon valvuloplasty (CBV) and at 3 months follow-up. Hemodynamic determinations at rest showed that mitral CBV performed by the double-balloon technique resulted in significant immediate decreases in mean pulmonary arterial wedge pressure (28 +/- 7 to 16 +/- 5 mm Hg, p less than .01), mean pulmonary arterial pressure (41 +/- 11 to 33 +/- 10 mm Hg, p less than .05), and mitral valve gradient (16 +/- 7 to 6 +/- 3 mm Hg, p less than .01), and significant increases in cardiac output (4.3 +/- 1.1 to 5.0 +/- 1.4 liters/min, p less than .01). Mitral valve area increased from 1.0 +/- 0.3 to 2.2 +/- 0.7 cm2 (p less than .01). The mitral valve area was unchanged (2.0 +/- 0.7 cm2, p = NS) at 3 months. The lower pulmonary arterial wedge pressure, pulmonary arterial pressure, and mitral valve gradient persisted at 3 month follow-up catheterization. Clinical examinations showed that before CBV, 21 of 24 patients were in New York Heart Association functional class III or IV; 3 months after CBV, 22 patients were in class I or II. Before CBV, the mean exercise treadmill time was 5.9 +/- 3.2 min and it had increased to 9.8 +/- 2.9 min (p less than .01) by the 3 month follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

Oxygen-assisted exercise in chronic obstructive lung disease. The effect on exercise capacity and arterial blood gas tensions.

Twenty-six patients with severe chronic obstructive lung disease exercised on a treadmill while breathing either room air, supplementary compressed air, or O2. Endurance was significantly increased by O2, but there was no improvement in maximal work rate. No relation was found between increased endurance and the degree of hypoxia, hypercarbia, or acidosis during exercise or the changes in these while breathing O2.

Acidosis, Respiratory↗
PubMed1993

[Relation of habitual exercise to basal metabolic rate and energy expenditure during exercise in older people].

The relation between habitual exercise and the basal metabolic rate, energy expenditure during exercise (lactic threshold and maximal oxygen uptake) was examined in 291 older people. Metabolic rate was highest in old players of gatebowl (a form of croquet) (male; 23.3 +/- 2.3, female; 22.7 +/- 3.0 kcal/kg/day), higher in old untrained people (male; 21.9 +/- 2.5, female; 20.8 +/- 2.4 kcal/kg/day), and lower in old people in a home for the aged (male; 20.6 +/- 3.5, female; 20.8 +/- 3.7 kcal/kg/day). Energy expenditure while walking at a speed of less than 100 m/min was similar in trained and untrained old people aged 60-69 years. However, lactic threshold was higher in trained (30.2 +/- 4.8 ml/kg/min) than in untrained (20.9 +/- 2.8 ml/kg/min) females aged 60-69 years. Maximal oxygen uptake was higher in trained (male; 50.4 +/- 4.1, female; 36.6 +/- 3.9) than in untrained (male; 30.9 +/- 3.7, female; 26.8 +/- 2.8) old people aged 60-69 years. It was suggested that a higher basal metabolic rate, lactic threshold and maximal oxygen uptake resulted in higher daily physical activity and larger daily energy consumption in trained old people.

Aged↗