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Humid air increases airway resistance in asthmatic subjects.

Eight persons with asthma were exposed to seven air conditions varying in temperature (37 degrees C to 49 degrees C [98.6 degrees F to 120.2 degrees F]) and water content (44 mg H2O per liter to 79 mg H2Oper liter) . Normocapnic hyperventilation for three minutes at 40% maximal voluntary ventilation was carried out for each condition. A constant-volume body plethysmograph measured the functional residual capacity and specific airway conductance (SGaw), followed by two forced expiratory manuevers. Measurements were taken before and 1, 5, 10, and 20 minutes after each challenge. Air conditions with 100% relative humidity caused a fall in the SGaw that was maximal in 1 minute. Air conditions at 100% relative humidity caused a greater fall in both the forced expiratory volume in 1 second (FEV1) (P<.05) and the SGaw (P<.005) than did conditions of the same temperature but less water content. At 44 degrees C and 100% relative humidity, the mean percent change in FEV1 and SGaw was -2% and -40%, respectively, at 1 minute after challenge. Of the conditions examined, the optimal temperature was 44 degrees C, and we speculate that the optimal water content is less than 44 mg H2O per liter. Inhaled water concentrations exceeding 44 mg H2O per liter should probably not be used in patients with asthma.

Adult↗

Effects of breathing a normoxic helium mixture on exercise tolerance of patients with cystic fibrosis.

Breathing helium-oxygen (He-O2) mixtures of 20.9% O2/79.1% He has been shown to increase exercise ventilation and peak oxygen uptake in healthy subjects. The improved exercise performance is thought to be due to the reduced density of He-O2 compared to air and the resulting increases in ventilation. Patients with cystic fibrosis (CF) frequently have abnormal pulmonary function test results, low exercise ventilations and diminished exercise tolerance. This led to the hypothesis that in CF the exercise tolerance of patients might improve when breathing He-O2. To test this hypothesis, 11 patients with CF or mild to severe airway obstruction performed spirometry and progressive maximal exercise tests while breathing air or He-O2. The He-O2 mixture significantly increased (P < 0.05) forced expiratory volume in 1 sec (FEV1) by 8.2%, peak expired flow by 39%, and maximal voluntary ventilation (MVV) by 17.9% compared to air, while forced vital capacity (FVC) and forced mid-expiratory flow rate (FEF25-75%) were unchanged by breathing He-O2. Ventilation and oxygen uptake at matched submaximal power outputs were not increased while breathing He-O2, nor were peak exercise ventilation (VEpeak) or peak exercise oxygen uptake (VO2peak). Estimated hemoglobin saturation and total exercise time were also unchanged during He-O2 breathing. However, there was a trend for the subjects with the better FEV1 to increase VO2peak. Increases in VO2peak when breathing He-O2 and air were correlated (r = 0.67, P < 0.05) with the percent of predicted FEV1 values. Still, in the 11 patients as a group, breathing He-O2 did not significantly improve VO2peak, VEpeak, or exercise tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Sternomastoid muscle function and fatigue in normal subjects and in patients with chronic obstructive pulmonary disease.

Four normal subjects and 5 patients with chronic obstructive pulmonary disease (COPD) (mean FEV1, 1.03 L) had frequency:force curves of their sternomastoid muscle measured before and 5 min after a 12-min walk on a flat treadmill, a progressive exercise test (normal subjects only), and a 10-min period of sustained maximal voluntary ventilation (SMVV). Before each test, all subjects had a normal frequency:force curve, and the ratio of the force response at 20 Hz to that at 50 Hz was normal. After SMVV, all the normal subjects and 4 of the 5 patients developed a greater than 15% fall in 20:50 ratio, and this was taken to indicate the presence of low frequency fatigue (LFF). During SMVV, all the subjects achieved minute ventilation greater than 70% of predicted maximal breathing capacity (MBC). During the 12-min walk, all the patients exceeded 70% MBC, and 4 developed LFF. The normal subjects performing progressive exercise also exceeded 70% MBC, and all showed LFF. The 12-min walk did not cause LFF in the normal subjects, but no subject reached 70% of MBC. Despite the presence of LFF in the sternomastoid muscle, the patients were all able to walk the same distance during a second 12-min walk. In both the normal and patient groups, the ventilatory response to CO2 was not changed by the presence of LFF. There were no changes in maximal inspiratory and expiratory mouth pressures or spirometry with LFF. High, sustained levels of minute ventilation cause sternomastoid LFF, but the clinical significance of this phenomenon is not yet certain.

Adult↗

Arm exercise capacity and dyspnea ratings in subjects with chronic obstructive pulmonary disease.

PURPOSE: This study aimed to compare the metabolic, ventilatory, and dyspnea responses to unsupported arm exercise, supported arm exercise and leg exercise between subjects with chronic obstructive pulmonary disease (COPD) and healthy age-matched controls. METHODS: For this study, 21 subjects with COPD (mean age, 62 +/- 2 years; predicted forced expiratory volume in 1 second [FEV(1)], 37 +/- 3%) and 7 healthy age-matched control subjects (% pred FEV(1) = 109 +/- 5%) were included in the analyses of three incremental exercise tests to peak work capacity: unsupported arm exercise, supported arm exercise (arm ergometry), and leg exercise (cycle ergometry). Work level, oxygen consumption (VO(2)), minute ventilation (V(E)), dyspnea, and rate of perceived exertion were measured each minute. RESULTS: Peak work level and peak VO(2) were significantly reduced in the subjects with COPD for all exercise tests (P <.01 for all), as compared with the control subjects. Within the COPD group, the VO(2) and V(E) at peak exercise were significantly lower for unsupported arm exercise than for both the leg and supported arm exercises (both P <.001). The ratio of V(E) to maximal voluntary ventilation was high for leg exercise (96%), supported arm exercise (91%), and unsupported arm exercise (77%) among the subjects with COPD. At a given percentage of VO(2) peak, dyspnea scores were similar for all the exercise tests. CONCLUSIONS: Ventilatory constraints limit exercise performance in COPD. The lowest amount of work, in terms of VO(2,), was during unsupported arm exercise. Because the subjects with COPD had scores showing similar levels of dyspnea at the same percentage of VO(2) peak, it is suggested that patients be encouraged to reach equivalent dyspnea levels when performing unsupported and supported arm exercise training and leg training.

Arm↗

Mechanisms of improvement in exercise capacity using a rollator in patients with COPD.

STUDY OBJECTIVE: We analyzed the effects of the use of a rollator on walking distance and physiologic variables: pulmonary gas exchange, heart rate, minute ventilation (Ve), oxygen saturation, and symptoms during the 6-min walk test (6MWT) in patients with COPD. SETTING: Outpatient clinic at university hospital. PATIENTS: Fourteen patients with COPD in stable clinical condition. One patient had mild COPD, five patients had moderate COPD, six patients had severe COPD, and two patients had very severe COPD. INTERVENTIONS: Two 6MWTs were performed with a portable metabolic system (VmaxST 1.0; Viasys Healthcare; MEDA; Aartselaar, Belgium) with a rollator and without a rollator, in random order. In addition, maximal voluntary ventilation (MVV) was measured with and without a rollator, randomly. RESULTS: The median 6MWT distance increased significantly with a rollator: 416 m without a rollator (interquartile range [IQR], 396 to 435 m), vs 462 m with a rollator (IQR, 424 to 477 m) [p = 0.04]. Significant increases were also seen in oxygen uptake (0.04 L/min [IQR, - 0.002 to 0.09 L/min]); tidal volume (0.06 L/min [IQR, - 0.001 to 0.11 L/min]); and Ve (0.95 L/min [IQR, - 0.67 to 7.1 L/min]), recorded in the last minute of the 6MWT; as well as in MVV (3 L/min [IQR, 0 to 12 L/min]) [p < 0.05 for all]. Borg dyspnea scores tended to be lower with a rollator: 6 (IQR, 4 to 7) without a rollator, vs 5 (IQR, 4 to 7) with a rollator (p = 0.10). The variation in the 6MWT was explained by individual changes in walking efficiency (partial R(2) = 0.31) and changes in Ve (partial R(2) = 0.36) [p model < 0.04]. CONCLUSION: The use of a rollator improves walking distance of patients with COPD through an increased ventilatory capacity and/or better walking efficiency.

Aged↗

Regulation of ventilatory capacity during exercise in asthmatics.

In asthmatic and control subjects, we examined the changes in ventilatory capacity (VECap), end-expiratory lung volume (EELV), and degree of flow limitation during three types of exercise: 1) incremental, 2) constant load (50% of maximal exercise capacity; 36 min), and 3) interval (alternating between 60 and 40% of maximal exercise capacity; 6-min workloads for 36 min). The VECap and degree of flow limitation at rest and during the various stages of exercise were estimated by aligning the tidal breathing flow-volume (F-V) loops within the maximal expiratory F-V (MEFV) envelope using the measured EELV. In contrast to more usual estimates of VECap (i.e., maximal voluntary ventilation and forced expiratory volume in 1 s x 40), the calculated VECap depended on the existing bronchomotor tone, the lung volume at which the subjects breathed (i.e., EELV), and the tidal volume. During interval and constant-load exercise, asthmatic subjects experienced reduced ventilatory reserve, higher degrees of flow limitation, and had higher EELVs compared with nonasthmatic subjects. During interval exercise, the VECap of the asthmatic subjects increased and decreased with variations in minute ventilation, due in part to alterations in their MEFV curve as exercise intensity varied between 60 and 49% of maximal capacity. In conclusion, asthmatic subjects have a more variable VECap and reduced ventilatory reserve during exercise compared with nonasthmatic subjects. The variations in VECap are due in part to a more labile MEFV curve secondary to changes in bronchomotor tone. Asthmatics defend VECap and minimize flow limitation by increasing EELV.

Adult↗

Effect of aerobic training on forced expiratory airflow in exercising asthmatic humans.

Pulmonary function after exercise was evaluated in 22 asthmatic subjects before and after a 36-session training sequence of aerobic exercise. Training did not change pulmonary function values, except for a small increase in maximal voluntary ventilation (P less than 0.02), which was attributed to respiratory muscle training. After aerobic training, both external work at a given heart rate and peak O2 consumption increased by 30 and 15%, respectively. At the same minute ventilation (VE), immediate postexercise forced expiratory airflow was higher after training (P less than 0.02), and reduction in forced expiratory airflow during the first 9 min postexercise was less after training (P less than 0.01). The posttraining airflow response to the pretraining work load was, as expected, less than the pretraining response (P less than 0.02). Although the difference in maximal-to-minimal airflow at the same VE was similar before and after training, the airflow increase accounted for 50% of the response after training compared with 16% of the pretraining response. Furthermore the strong negative correlation (P less than 0.01) between maximal and minimal airflow both pre- and posttraining indicates that exercise-induced bronchospasm (EIB) severity is, in part, determined by the degree of exercise-induced bronchodilation. We conclude that aerobic training significantly increases exercise-induced bronchodilation and diminishes EIB.

Aerobiosis↗

Long-term change in exercise capacity, body mass, and pulmonary function in adults with cystic fibrosis.

STUDY OBJECTIVES: Cross-sectional studies in patients with cystic fibrosis (CF) have shown that exercise capacity is correlated with pulmonary function and body mass. We have examined whether the same relationships are seen longitudinally in adults with CF. DESIGN: Subjects who first performed progressive maximal cycle ergometry between 1986 and 1989 were retested using an identical protocol a mean of 6.3 years later. PARTICIPANTS AND SETTING: Adults with CF attending a regional center. MEASUREMENTS AND RESULTS: The principal exercise measures were peak oxygen uptake (VO2peak), ventilation (VEpeak), oxygen saturation, and heart rate. Spirometry, weight, and height were also recorded at each time point. At baseline, subjects had a mean age of 19.8 years, body mass index (BMI) of 19.0, FEV1 of 69% predicted, VO2peak of 1.56 L/min, and VEpeak of 48.9 L/min. At repeated testing after a mean interval of 6.3 years, the FEV1 had fallen significantly to 54% predicted (p < 0.001) and the BMI had risen significantly to a mean of 20.9 (p < 0.001). There were no significant differences in VO2peak or VEpeak, although VEpeak was a significantly higher proportion (72% vs 61%) of predicted maximal voluntary ventilation. CONCLUSIONS: Adults with mild to moderate pulmonary dysfunction were able to increase body mass and maintain VO2peak despite a declining FEV1. VO2peak was not reduced by the decrease in FEV1 because VEpeak was unaffected. Improved nutrition may have contributed to maintaining fitness.

Adolescent↗

Evaluation of pulmonary function and bicycle ergometry tests in patients with Behçet's disease.

Behçet's disease (BD) has well-defined pulmonary complications, but cardiopulmonary exercise testing and the strength of the respiratory muscles have not been studied in detail. We aimed to investigate the pulmonary functions tests, inspiratory and expiratory muscle strength and endurance, cardiopulmonary exercise test response, and the relationship of these parameters in patients with BD. Forty BD patients and 20 healthy control subjects were recruited for this study. Mean age was 32.95 +/- 7.66 years for the BD group and 33.85 +/- 6.63 years for the control group with no statistically significant difference. The ratios of slight obstructive ventilatory impairment were 32.5% for the BD group. When the values of pulmonary function tests were compared, no statistically significant difference was found in FEV(1)/FVC (Forced expiratory volume during the first second/forced vital capacity), or maximal midexpiratory flow rate (all in percent) values between patient and control groups. Maximal inspiratory and expiratory pressures, peak expiratory flow rate (in percent) and maximal voluntary ventilation (in percent) values were significantly lower than those of the control group. Body's consumption of peak oxygen (VO(2peak)), oxygen consumption (milliliters per kilogram per minute), anaerobic threshold (AT), maximum exercise ventilation (VE(max)), work load values, and exercise test time in the bicycle exercise test were significantly higher in control groups than in patients with BD. The values of heart rate reserve, breathing reserve, and VE/VCO(2) at the AT of BD patients were within normal limits We conclude that respiratory and aerobic exercise may be recommended to improve respiratory muscle strength and endurance as well as the aerobic capacity and maximal ventilatory capacity in patients with BD.

Adult↗

Pulmonary function survey in spinal cord injury: influences of smoking and level and completeness of injury.

Spirometry was performed on 165 subjects with spinal cord injury (84 with quadriplegia and 81 with paraplegia). Subjects were characterized by level of lesion as: high quadriplegia (HQ, C4 and above not requiring mechanical ventilation), low quadriplegia (LQ, C5-8), high paraplegia (HP, T1-7), and low paraplegia (LP, T8-L3). Thirty-nine subjects had complete motor lesions, and 126 had incomplete motor lesions. Nonsmokers (54 with quadriplegia and 53 with paraplegia) were defined as those who had never smoked or those who had stopped smoking for 1 year. Current smokers (28 with quadriplegia and 28 with paraplegia) were defined as those who currently smoked cigarettes, cigars, and/or pipe or those who had quit for < or = 1 year. We found by linear regression analysis that forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal voluntary ventilation (MVV) were inversely correlated with the level of injury (i.e., the higher the level of injury, the lower the parameter). In the HQ group, those with complete injury had significantly lower pulmonary function parameters than those with incomplete lesions. In contrast, there were no significant differences in pulmonary function parameters between complete and incomplete lesions in subjects in the LQ, HP, and LP groups. In the LQ, HP, and LP groups, the FEV1 and PEF were significantly lower in smokers than in nonsmokers. Thus, this study demonstrates the effects of completeness of injury and smoking on pulmonary function in a large group of subjects with spinal cord injury.

Adolescent↗

Megestrol acetate stimulates weight gain and ventilation in underweight COPD patients.

STUDY OBJECTIVES: To assess the effect of megestrol acetate (MA), a progestational appetite stimulant commonly used in patients with AIDS and cancer, on body weight and composition, respiratory muscle strength, arterial blood gas levels, and subjective perceptions in COPD patients. DESIGN AND SETTING: Prospective, double-blind, randomized, placebo-controlled trial conducted on an outpatient basis at 18 sites. PATIENTS: Underweight (< 95% ideal body weight) COPD patients > or = 40 years old. INTERVENTIONS: Either MA, 800 mg/d oral suspension, or placebo at a 1:1 ratio for 8 weeks. RESULTS: Of 145 randomized patients (63% men), 128 patients completed the trial. Body weight increased by 3.2 kg in the MA group and 0.7 kg in the placebo group (p < 0.001). Anthropometric and dual-energy radiograph absorptiometry assessments confirmed that weight gain was mainly fat. Spirometry and maximal voluntary ventilation showed no significant changes from baseline in either group, and the difference in the change in maximum inspiratory pressure between groups was not significant. The 6-min walk distances did not differ statistically between groups at week 2 and week 4, but were greater in the placebo group at week 8 (p = 0.012). Consistent with the known ability of MA to stimulate ventilation, PaCO(2) decreased (4.6 mm Hg, p < 0.001) and PaO(2) increased (2.8 mm Hg, p < 0.04) in the MA group. Questionnaires revealed that body image and appetite improved in the MA group but not the placebo group. Adverse event frequency and type were similar in both groups, but cortisol and testosterone (in men) levels decreased substantially in the MA group. CONCLUSIONS: We conclude that MA safely increased appetite and body weight, stimulated ventilation, and improved body image in underweight COPD patients, but did not improve respiratory muscle function or exercise tolerance.

Aged↗

Interpretation of changes in spirographic and flow-volume variables after operative treatment in bilateral vocal cord paralysis.

In 13 patients, who underwent a superolateralization of a vocal cord after bilateral vocal cord paralysis, we studied pre- and postoperatively spirometric dynamic and static lung volumes and variables from maximal expiratory and maximal inspiratory flow-volume (MEFV and MIFV) curves. The effects of surgical treatment on these variables have been established by comparing the statistical significance of the changes post- versus preoperative. A significant increase was found in the vital capacity and a significant decrease in the indices associated with the dynamic variability of the obstruction. The most significant changes were found in peak inspiratory flow and peak expiratory flow, and in the inspiratory defined dynamic estimates, as forced inspiratory volume in 1 second and maximal voluntary ventilation at a frequency of 30 c X min-1. Significant correlations, however, were found to exist only for the changes within the group of flow-volume indices and for those within the group of spirographic variables. This led us to the conclusion that for the diagnosis of this type of upper airway obstruction these measurements are additive, reflecting different aspects of airway mechanics.

Adult↗

Cardiorespiratory responses to submaximal incremental exercise are not affected by one night's sleep deprivation during the follicular and luteal phases of the menstrual cycle.

The purpose of the study was to investigate the effects of one night's sleep deprivation on the cardiorespiratory responses to exercise during the follicular and luteal phases of the menstrual cycle. We have studied nine, healthy females aged 24-35 years with regular menstrual cycles. Each subject performed spirometric tests at rest and then an incremental exercise testing during 11-13 days of follicular phase and 22-24 days of luteal phase following one normal night's sleep or one night's sleep loss. Compared with resting values exercise produced significant increases in cardiorespiratory variables including oxygen uptake (VO2), carbon dioxide production (VCO2), tidal volume (VT), respiratory rate (RR), minute ventilation (VE), systolic blood pressure, heart rate (HR) and respiratory quotient (R). However, it did not alter significantly diastolic blood pressure, end-tidal PO2 (PETO2), end-tidal PCO2 (PETCO2) and arterial oxygen saturation (SaO2). Spirometric variables which include forced vital capacity (FVC), forced expiratory volume in one s (FEV1), FEV1/FVC%, forced expiratory volume in three s (FEV3), forced expired flow from 25-75% of FVC (FEF 25-75%), forced expired flow at 25% of FVC (FEF 25%), forced expired flow at 50% of FVC (FEF 50%), forced expired flow at 75% of FVC (FEF 75%), forced expired flow from 75-85% of FVC (FEF 75-85%), peak expiratory flow (PEF), expiratory reserve volume (ERV), inspiratory capacity (IC) and maximal voluntary ventilation (MVV) and cardiorespiratory variables were not different between the cycle phases after one normal night's sleep or one night's sleep deprivation. Neither menstrual cycle phase nor sleep deprivation affected spirometric and cardiorespiratory parameters. We suggest that one night's sleep deprivation does not produce alterations in spirometric parameters and cardiorespiratory responses to submaximal incremental exercise during the follicular and luteal phases.

Adult↗

Pulmonary function tests, respiratory muscle strength, and endurance of patients with osteoporosis.

BACKGROUND: It has been shown that patients with thoracic kyphosis due to osteoporosis have diminished pulmonary function. The aim of this study was to determine the pulmonary function, respiratory muscle strength, and endurance of patients with osteoporosis who did not have compression fractures. METHODS: The patient group consisted of 88 recently diagnosed postmenopausal osteoporotic women without spinal fractures. They were matched for age and body mass index with 54 healthy women, who formed the control group. Bone mineral density, pulmonary function test (PFT), maximum voluntary ventilation (MVV), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) measurements of both groups were performed. RESULTS: There were no significant differences between the two groups regarding PFT parameters and MIP and MEP. However, osteoporotic patients had significantly lower MW values. CONCLUSION: Women with postmenopausal osteoporosis without spinal compression fractures have normal PFT, MIP, and MEP values, but they have reduced respiratory muscle endurance.

Aged↗

Cardiopulmonary exercise testing in congestive heart failure.

Cardiopulmonary exercise testing includes the monitoring of respiratory gases and airflow to determine oxygen uptake, carbon dioxide (CO2) production, respiratory rate, tidal volume, and minute ventilation during a graded maximal exercise test. A plateau in oxygen uptake, which occurs despite an increase in work load, and which is termed maximal oxygen uptake (VO2 max), correlates with the maximal exercise cardiac output and can therefore be used to grade the severity of heart failure. The anaerobic threshold occurs at 60 to 70% of VO2 max and is another indicator of the severity of heart failure and, when attained, indicates that the patient is close to performing a maximal test. We have found VO2 max and anaerobic threshold to be objective measures of efficacy of both investigational and noninvestigational therapy in patients with heart failure. A pulmonary limitation to exercise can be identified by the failure to attain anaerobic threshold or VO2 max, as well as exhaustion of the ventilatory reserve, as estimated by maximal voluntary ventilation. Thus, cardiopulmonary exercise testing can be used to (1) grade the severity of heart failure, (2) objectively follow the response to therapy, and (3) differentiate a cardiac from a pulmonary limitation to exercise.

Carbon Dioxide↗

Metabolic acidosis during exercise in patients with chronic obstructive pulmonary disease. Use of the V-slope method for anaerobic threshold determination.

Patients with chronic obstructive pulmonary disease (COPD) usually have limited exercise tolerance owing to low ventilatory capacity. Because metabolic acidosis induced by exercise increases ventilatory drive, decreasing the hydrogen ion stimulus may improve exercise capacity. However, in those with mechanical limitation to ventilation or chemoreceptor insensitivity, identifying metabolic acidosis may be difficult using gas exchange methods that depend on the ventilatory response to the acidosis. We compared a modification of a gas exchange method (V-slope) for determining the lactate (anaerobic) threshold (AT), which is independent of ventilatory response with a method using the change in blood standard bicarbonate (HCO3-) level in COPD and normal subjects during cycle incremental exercise. In 43 normal subjects, the VO2 at which metabolic acidosis was identified using the two method correlated (r = 0.75), although mean values differed. In 22 patients with moderately severe to severe COPD, eight who had a change in standard HCO3- less than 2.0 mEq/L between rest and 2 min of recovery from exercise (group 1) were contrasted with 14 whose blood standard HCO3- fell by greater than 2.5 mEq/L (group 2). Mean VC was higher and FEV1/VC was lower in group 2, but mean FEV1, maximal voluntary ventilation, and diffusing capacity for carbon monoxide were not different. The degree of obstruction did not correlate strongly with the degree of exercise metabolic acidosis. The AT determined by the V-slope method was compared with that from standard HCO3-; good correlation between these methods was found (r = 0.98), although mean values were different. The V-slope method predicted metabolic acidosis in 10/14 who had a fall in HCO3- more than 2.5 mEq/L. A significant proportion of patients with COPD seem to develop metabolic acidosis during exercise. The V-slope gas exchange method may be useful in selecting those patients with COPD who develop exercise metabolic acidosis and might therefore benefit from exercise training.

Acidosis↗

Square-wave endurance exercise test (SWEET) for training and assessment in trained and untrained subjects. III. Effect on VO2 max and maximal ventilation.

The effect of training on VO2 max, endurance capacity (EC) and ventilation during maximal exercise (VE max) were studied in 17 normal subjects aged 21--51 years. At the beginning of the study 11 of the subjects (eight women and three men) were untrained (U) and six others (three women and three men) trained regulatory (T). A maximal intensity exercise (on a cycle ergometer) which could be sustained for 45 min (MIE45) was performed three times per week for 6 weeks; the total mechanical work (TMW) corresponding to the MIE45 per session varied between 3.14 and 9.24 kJ . kg-1. Before training, VO2 max (a), VEmax (b), and TMW (c) were higher in T than in U subjects. Training increased these variables in most of the subjects; the increase being significantly higher (mean +/- SEM) in U (a = +29.9 +/- 3.8%; b = 49.6 +/- 6.5%; c = 47 +/- 6.9%) than in T subjects (a = 6.6 +/- 3.8%; b = 17.5 +/- 3.6+; c = 19.1 +/- 2.8%). In all but three cases the % increase of TMW was higher than that of VO2 max, suggesting a higher sensitivity of TMW in measuring EC. The significant increase in VE max, maximal voluntary ventilation, peak flows (inspiratory and expiratory) and static maximum voluntary ventilation, peak flows (inspiratory and expiratory) and static maximum pressures indicate that this training protocol improves in healthy subjects the performance of respiratory muscles as well.

Adult↗

Pulmonary and ventilatory responses to pregnancy, immersion, and exercise.

To examine the effects of pregnancy, immersion, and exercise during immersion on pulmonary function and ventilation, 12 women were studied at 15, 25, and 35 wk of pregnancy and 8-10 wk postpartum. Pulmonary function and ventilation were measured under three experimental conditions: after 20 min of rest on land (LR), after 20 min of rest during immersion to the level of the xiphoid (IR), and after 20 min of exercise during immersion at 60% of predicted maximal capacity (IE). Forced vital capacity remained relatively constant, except for a decrease at 15 wk, for the duration of pregnancy. Expiratory reserve volume decreased with a change in the pregnancy status and with the duration of pregnancy. However, the forced vital capacity was maintained by an increase in the inspiratory capacity during pregnancy. Forced expiratory volume for 1 s, expressed as percent of forced vital capacity, did not differ significantly between conditions or as a result of pregnancy. Forced vital capacity was lower during the IR trial compared with LR and IE trials. The decreased forced vital capacity of the IR trials was mediated by a decrease in the expiratory reserve volume. Whereas the inspiratory capacity increased during IR and IE compared with LR, the increase was not large enough to offset the decrease in the expiratory reserve volume. Resting immersion resulted in a significant decrease in maximal voluntary ventilation as did pregnancy. Pregnancy resulted in significant increases in minute ventilation (VE), which were related to increases in the O2 consumption.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗