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PubMed1991

Productivity of radiologists: estimates based on analysis of relative value units.

Analysis of relative value units (RVUs) was used to quantify patient-care productivity of radiologists in 19 multispecialty group practices and to determine how productivity is affected by certain characteristics of the practices. The RVUs used in this study are the professional component RVUs developed by the American College of Radiology and the Health Care Financing Administration and published as the Radiology Relative Value Scale. An RVU workload was calculated by multiplying the number of times each procedure was performed by the procedure's corresponding RVU; the sum of these products gave the overall professional RVU workload. Five productivity indexes were calculated. The physician index denotes the ratio of the total number of physicians in the clinics to the total number of radiologists. The availability index denotes the fraction of radiologists who are available to perform clinical work after deductions are made for time away from clinical work. The difficulty index measures, in RVUs per examination, the level of complexity of the overall examination mix. The examination index measures examinations per available radiologist, and the RVU index measures RVUs per available radiologist. Altogether, the 19 clinics reported 3,234,451 examinations performed by 299 radiologists. The computed overall indexes were as follows: physician index = 20 physicians per radiologist; availability index = 0.77; difficulty index = 2.27 RVUs per examination; examination index = 14,098 examinations per year per available radiologist; RVU index = 32,065 RVUs per year per available radiologist. When the clinics were grouped according to characteristics of the practices, the RVU index was higher for single-site practices, high-prepaid practices, outpatient-only practices, and practices without radiology training programs. Fifty-two percent of the RVUs were in general radiology, 37% in sectional imaging, and 10% in special procedures. The concept of RVU workload is timely because it undoubtedly will be used to compare workloads across medical subspecialties, and these workloads are likely to be related by third-party payers to compensation.

Ambulatory Care↗

PubMed2004

Quality control pharmacy tasks: big five personality model and accuracy of error detection.

The relationships between extraversion, conscientiousness, neuroticism, and performance were examined in the context of an error detection task completed under stable and shifting workload conditions. 114 participants checked two sets of 40 fictitious prescriptions for errors. Errors were inserted at rates varying from 26% to 38%. Workload was manipulated by altering the amount of time allowed to complete each set. The stable workload group had 45 min. per set, the workload up-shift group had 60 min. for the first set and 30 min. for the second set. Performance was measured using hit rates and false alarms. Analysis indicated that extraversion and conscientiousness were correlated with hit rates, but only in the stable workload condition. Results are discussed and research directions are considered.

Adolescent↗

PubMed1995

Evaluation of work stress using psychological and physiological measures of mental activity in a paced calculating task.

With a view to developing a method of evaluating mental work stress, a paced calculating task (addition and substraction of two two-digit figures) with eight grades of workload (20%-160% of work capacity) was assigned to 21 male and 20 female students. Using a VDT, subjects performed the task and psychological and physiological measures of mental activity (intellectual activity, feeling, arousal level) were determined. Occipital midline (Oz) beta 2 (20 Hz-30 Hz) amplitudes regressed linearly against workloads, with a marked rise observed at overload levels (above 100% workload), though the number of correct responses did not increase at such levels. Error rate, subjective task difficulties, and feelings (unpleasant, tense, excited) were proportional to workload and closely correlated to each other. Blood pressures and heart rates increased slightly in proportion to workload, with a correlation between them. Feelings were presumed to be not particularly intense even at overload levels. Regression coefficients of error rate, excitement level, and Oz beta 2 amplitude were larger in females than males. Based on the results, it was inferred that females might sustain somewhat more severe work stress than males. Critical flicker frequencies decreased over time. The criteria for evaluating heavy and excessive mental work stresses were deduced from the Oz beta 2 amplitudes, which best reflected intellectual activity, and from the critical flicker frequency, which is related to arousal level.

Adult↗

PubMed2001

Small bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions.

The workload and costs of the emergency admissions and treatment of adhesive small bowel obstruction (ASBO) are unclear. This review details and costs the admission workload of ASBO. All admissions over a 2-year period for ASBO at two district general hospitals were identified through ICD10 diagnostic codes. Diagnostic investigations, treatment patterns, ward stay and outcome information for admissions were detailed from clinical records to develop mean cost estimates and assess the associated workload. Of the 298 admissions identified, 188 were not due to ASBO and were excluded from analysis. Of the 110 admissions detailed, 41 (37%) were treated surgically and 69 (63%) conservatively. Most admissions occurred through general practitioner referral (86.4%) to accident and emergency (90.0%). Mean (SD) length of stay was 16.3 days (11.0 days) for surgical treatment and 7.0 days (4.6 days) for conservative treatment. In-patient mortality was 9.8% for the surgical group and 7.2% for the conservative group. Costs were based on the mean values from both centres for surgical and conservative admissions and detailed according to the cost of referral and follow-up (100.98 Pounds surgical versus 102.61 Pounds conservative), hospital ward and ICU stay (3,327.48 Pounds versus 1,267.92 Pounds), theatre time (832.32 Pounds surgical only), investigations (282.73 Pounds versus 207.33 Pounds) and drug costs (133.90 Pounds versus 28.29 Pounds). Total treatment cost per admission for ASBO was 4,677.41 Pounds for surgically treated admissions and 1,606.15 Pounds for conservatively treated admissions. The impact of admissions for ASBO is considerable in terms of both costs and workload. Bed stay for these admissions represents the equivalent of almost one surgical bed per year and at least 2 days theatre time, impacting on surgical capacity and waiting lists. Adhesion prevention strategies may reduce the workload associated with ASBO. The review provides useful information for planning resource allocation.

Adolescent↗

PubMed2005

Profile of the cardiovascular specialist physician workforce in Canada, 2004.

The Canadian Cardiovascular Society (CCS) examined the demand for cardiovascular care, the supply of specialist physicians to provide that care and physician survey data on human resource issues, including workload, wait times, satisfaction and future intentions. The CCS used data from the National Physician Survey 2004, the CCS Cardiovascular Specialist Physician Workforce Survey 2001, the Canadian Medical Association's Physician Resource Evaluation Template and procedural volumes from the Canadian Institute for Health Information to analyze key human resource planning issues for cardiologists and cardiac surgeons. There are indications in the 2004 survey data that the average workload continues to be very heavy, with an average workweek of between 55 h (cardiologists) and 64 h (cardiac surgeons), and an additional on-call responsibility of between 106 h (cardiologists) and 196 h (cardiac surgeons) per month, of which 38 h (cardiologists) to 45 h (cardiac surgeons) are spent with patients. As a result, many patients are waiting too long for nonurgent referrals. In addition to the toll that this heavy workload exacts from the current workforce and the long wait times for nonurgent referrals, the workload may also compromise the profession's ability to attract physicians into cardiovascular care. Medical graduates, particularly female graduates, tend to consider workload flexibility and predictability when choosing a specialty area. Supply projections already show a decline in the number of cardiovascular specialists per 100,000 elderly population over the next 15 years. If cardiology and cardiac surgery are perceived by female medical graduates (which now make up over 50% of all graduates) as unattractive areas of specialization, the profession may have difficulty attracting needed new entrants in the future. The CCS Workforce Project Team endorses and supports the 2003 Canadian Medical Association's recommendation for the federal government to establish an independent institute for health human resources to foster and conduct research on the supply, mix, distribution and sustainability of Canada's health workforce. The CCS should also renew its commitment to invest in related activities to improve access to cardiovascular care. The CCS Workforce Project Team also believes that the profession's ability to recruit and retain new medical graduates will depend on how well it addresses the identified quality of work life issues.

Adult↗

PubMed1995

[Cognitive load and listener orientation in monologue instruction].

It was experimentally tested whether high mental workload adversely affects the listener-adaptation of speakers giving an instruction. Forty-five subjects were randomly assigned to one of three groups with either low or high mental workloads and gave instructions on the assembly of a small machine model. Speakers in the low workload condition had the model available while instructing, whereas speakers in the high workload condition had to recall the assembly without external aids. In a third group, speakers were given a secondary task while instructing. Only in the low load condition were instructions apparently adapted to the listener. High load and dual task conditions, on the other hand, yielded messages that were equivalent as to their contents, regardless of the different communicative tasks. Additional assessment of speech characteristics demonstrated the experimental manipulation of mental workload to be effective. Results suggest that decreased listener-adaptation reflects a dissociation of the communicative demands of listener-adapted speech and the cognitive resources to meet these demands.

Adult↗

PubMed1988

Comparison of heart rate as a non-invasive determinant of anaerobic threshold with the lactate threshold when cycling.

In 9 trained athletes and 4 sedentary subjects the anaerobic threshold was assessed on a cycle ergometer, using the deflection point of heart rate in a protocol in which the workload increased by 10 W every 45 s. The workload at which plasma lactate concentration equalled 4 mmol.l-1 was assessed under steady state conditions on separate occasions. In addition, in 3 subjects the non-invasive anaerobic threshold and the 4 mmol.l-1 lactate level under steady state conditions were assessed on a treadmill. On the cycle ergometer 6 subjects demonstrated a deflection point in the heart rate record, whereas the others failed to do so. The workload at which heart rate departed from linearity in the progressive protocol did not coincide with the steady state 4 mmol.l-1 workload but occurred at a higher workload. On the treadmill no deflection in heart rate was observed. It is concluded that in cyclists a deflection in heart rate does not always occur, and when it does, it does not coincide with the anaerobic threshold determined under steady state conditions.

Adult↗

PubMed2003

Cycle ergometry is not a sensitive diagnostic test for mitochondrial myopathy.

Cycle exercise has repeatedly been used to diagnose patients suspected of having mitochondrial myopathy (MM), in whom exercise intolerance and lactic acidosis are common. No standardized test, however, has been established. We evaluated the diagnostic value of incremental and constant workload (20 min at 65 % VO(2max)) cycle tests for the diagnosis of MM. Plasma lactate and oxidative capacity (VO(2) and workload) were measured in 15 well-characterized MM patients during cycling. Findings were compared with those in 10 myotonic dystrophy patients and 18 sedentary, healthy subjects. All MM patients had ragged red or COX-negative fibers on muscle biopsy. VO(2max) and maximal workload were lower in MM than in control groups (P < 0.02). Resting plasma lactate was higher in MM than in control groups (P < 0.005; sensitivity = 93 %; specificity = 85 %), while exercise-induced increases in plasma lactate were only higher during the constant workload protocol in MM patients vs. control groups (P < 0.05; sensitivity = 27 %; specificity = 86 %). The findings indicate that the diagnostic value of a constant workload protocol is superior to an incremental cycle test, but that the test is less sensitive for MM than simple testing of resting lactate and muscle morphology. Cycle testing of MM patients remains an important research tool, but should not be a standard diagnostic procedure for MM.

Adult↗

PubMed2004

Effects of blackcurrant anthocyanin intake on peripheral muscle circulation during typing work in humans.

This double-blind, placebo-controlled, crossover study investigated the effect of blackcurrant anthocyanin (BCA) intake on peripheral circulation during rest and during typing work by using near-infrared spectroscopy (NIRS), and it also assessed improvement in shoulder stiffness caused by poor local circulation. In a resting circulation study, nine healthy male subjects took capsules of BCA at a dosage of 17 mg kg(-1) or placebo (isoenergetic sugar). NIRS was used to measure left forearm blood flow (FBF) following venous occlusion and muscle oxygen consumption following arterial occlusion prior to and hourly for 4 h after ingestion of BCA. Plasma anthocyanin concentration was measured prior to ingestion and 1, 2, and 4 h later. FBF increased significantly 2 h after BCA ingestion [BCA 1.22 (0.13)-fold increase relative to pre-values vs placebo 0.83 (0.06) of pre-values; P < 0.05] and then tended to increase for a further 3 h after ingestion [BCA 1.26 (0.15)-fold increase relative to pre-values vs placebo 0.82 (0.07) of pre-values; P = 0.078]. There was, however, no significant difference in muscle oxygen consumption between BCA and placebo intake at any time point. In a typing work study, 11 healthy subjects took capsules of BCA (7.7 mg kg(-1)) or placebo (isoenergetic sugar) daily for 2 weeks. The subjects then performed intermittent typing workload for 30 min in order to induce acute shoulder stiffness. During the workload, total hemoglobin and oxygenated hemoglobin (oxy-Hb) were determined using NIRS and myoelectric signals measured in the right trapezius muscle using electromyography (EMG). The viscoelasticity of the trapezius muscle was also evaluated using a muscle stiffness meter before and after the typing workload. BCA intake prevented the decrease in oxy-Hb significantly (P < 0.05), and also tended to alleviate the increase in root mean square (RMS) of the EMG during the typing workload, and also muscle stiffness after the workload. There was no improvement in typing performance with BCA intake. The results of this study suggest that intake of BCA may improve shoulder stiffness caused by typing work by increasing peripheral blood flow and reducing muscle fatigue.

Administration, Oral↗

PubMed1988

Influence of exercise on plasma atrial natriuretic factor levels in patients with myocardial infarction.

The influence of dynamic exercise on plasma atrial natriuretic factor (ANF) levels was studied in a group of 10 patients with myocardial infarction (MI) and five patients with atypical chest pain (control group). Exercise protocol consisted of three fixed workloads (25, 50, and 75 watts) every 4 minutes with the use of a supine bicycle ergometer. Plasma ANF levels and hemodynamic indices were measured before, during, and 10 minutes after exercise. In the MI group, plasma ANF levels significantly increased at the 75-watt workload and significantly decreased at 10 minutes after exercise, whereas in the control group, the increase in plasma ANP levels after a 75-watt workload, compared with those at rest, was not significant. Significant correlations of pulmonary artery wedge pressure, right atrial pressure, mean arterial pressure, and heart rate to plasma ANF levels were observed at four points obtained before and during each stage of exercise in the MI group. Furthermore, a significant correlation between maximal creatine kinase levels and plasma ANF levels at a 75-watt workload and a significant inverse correlation between left ventricular ejection fraction and plasma ANF levels at a 75-watt workload were observed. These results suggest that the increase in the circulating ANF level during exercise in MI is associated with elevated atrial pressure resulting from left ventricular dysfunction and that measurement of ANF during exercise may be an indication of the severity of MI and associated left ventricular dysfunction.

Adult↗

PubMed2005

Practical method for choosing diluent that ensures the best temperature uniformity in the case of pharmaceutical microwave vacuum drying of a heat sensitive product.

Microwave vacuum drying is getting more and more popular thanks to its known advantageous and unique features, but its non-uniform electric field can cause nonhomogeneous temperature distribution in the workload. The origin and effect of a generated hot-spot is influenced by the electromagnetic and thermodynamic features of the microwave system and the workload. In the case of single/one pot technology, the geometry and the construction of the microwave cavity is primarily designed for high-shear granulation. As for the workload, its composition has first-order effect on the electric field pattern. The aim of our study is to present a rational decision procedure based on basic practical experiments and the elaborated '3D layered thermography' technique to make it possible to choose the most suitable diluent to formulate a heat sensitive active pharmaceutical ingredient given its stability due to temperature distribution within the workload. Comparing two commonly used diluents, namely microcrystalline cellulose and corn starch, it was found that in the case of different actives with different acceptable temperature limits different diluents are recommended. Drying of a composition consists of an active ingredient characterized by a temperature limit of 70 degrees C. Using corn starch is safer when the workload is less endangered than when using microcrystalline cellulose. Above this temperature limit microcrystalline cellulose becomes beneficial.

Cellulose↗

PubMed2026

Alarms and alarm management with automated versus conventional ventilation in neurocritical care patients.

INTRODUCTION: False or clinically irrelevant alarms are a major driver of ICU alarm fatigue and nursing workload. Ventilator alarms make up a large share, and although automated ventilation modes can reduce manual adjustments, their effect on alarm burden is still unclear. This issue can be particularly relevant in neurocritical care patients, where precise ventilator and alarm management is imperative for patient safety. OBJECTIVES: This explorative post hoc analysis of a randomized clinical trial compared alarm frequency and management between automated ventilation and conventional ventilation in neurocritical care patients. METHODS: Ventilator alarms and manual ventilator changes were captured continuously from the ventilator for up to 24 h per patient. The primary endpoint was a composite of workload-relevant alarms; with alarm management interventions at the ventilator as a key secondary outcome. Additional endpoints included redundant alarms, alarm duration and ventilator management. RESULTS: 13 patients received automated ventilation and 24 received conventional ventilation. No difference was observed in workload-relevant alarm frequency between automated and conventional ventilation (3.28 [2.87 to 4.30] vs 3.73 [1.66 to 7.33] alarms per hour; P = 0.81), while alarm management interventions at the ventilator were lower with automated ventilation (0.14 [0.10 to 0.15] vs 0.21 [0.17 to 0.31] interventions per hour; P = 0.01). Other alarm frequencies, duration of alarms and ventilator management were similar. CONCLUSIONS: In this exploratory post hoc analysis of a randomized clinical trial in neurocritical care patients during the early phase of mechanical ventilation, automated ventilation did not reduce the frequency of total or workload-relevant alarms, nor their duration, but was associated with fewer alarm management interventions compared to conventional ventilation. IMPLICATIONS FOR CLINICAL PRACTICE: Automated ventilation may not reduce alarm frequency in neurocritical care patients, but the observed reduction in alarm-related bedside interventions suggests a potential benefit for nursing workload.

Humans↗

PubMed2005

Kinesiological and kinematical analysis for stroke subjects with asymmetrical cycling movement patterns.

This aim of this study is to provide quantitative analyses of asymmetrical movements between affected and unaffected limbs for hemiparetic subjects in a cycling ergometer. To acquire kinesiological and kinematical data, electromyography (EMG) of quadriceps muscles in the both legs as well as crank positions under three cycling workloads were recorded. The symmetry index (SI) was designed to measure the similarity between muscle activities recorded from affected and unaffected limbs. Using kinematical information of the crank position, the cycling unsmoothness (denoted as roughness index, RI) can be derived from the curvature of the instantaneous cycling speed. Thirteen hemiparetic subjects following a cerebrovascular accident (CVA) and eight able-bodied subjects participated in this study. With total symmetry at SI=1, the average SIs of hemiparetic subjects (0.66+/-0.18) were significantly lower (p<0.01) than those of normal subjects (0.91+/-0.08) but no significant difference found among three workloads. From the average RI, subjects with hemiparesis exhibited less smooth cycling movements compared to normal group (p<0.01). Non-parametric Friedman and Wilcoxon tests of RIs further indicated that the workload factors are significantly different only for hemiparetic group (p<0.01). No significant difference between lower workloads in RIs showed that the CVA subjects' sound side alone can execute most of the cycling load with minimal involvement of the affected side under lower workload condition. When cycling at a heavier load, however, it is essential to force the affected limb to assist in the pedaling, thus accomplishing an effective cycling exercise. By combining these two quantitative indices, we can observe the kinesiological measurement of the symmetry of EMG phasic activities from SI and the kinematical cycling smoothness in a coordinated movement from RI, which could provide a clinical guideline for cycling exercises for hemiparetic subjects.

Biomechanical Phenomena↗

PubMed2004

High-energy phosphate metabolism during incremental calf exercise in humans measured by 31 phosphorus magnetic resonance spectroscopy (31P MRS).

Several previous 31 phosphorus magnetic resonance spectroscopy ((31)P MRS) studies performing incremental or progressive muscle exercises have observed that a decrease in pH is accompanied with an acceleration in phosphocreatine (PCr) hydrolysis. The purpose of this study was to investigate the relationship between PCr breakdown and pH during isotonic, exhaustive, incremental plantar flexion exercises. We included eight healthy, male volunteers into this study. Using a 1.5 Tesla MR scanner and a self-built exercise bench, we performed serial free induction decay (FID) (31)P MRS measurements with a time resolution of 1 min at rest, isotonic calf muscle exercise, and recovery. The exercise protocol consisted of 5-min intervals with 4.5, 6, 7.5, and 9 W workload followed by 9-min recovery. Changes in PCr and inorganic phosphate (Pi) were determined as percent changes in comparison to the baseline. In addition, pH values were calculated. This study obtained significant decreases in PCr corresponding to the gradual increases in workload. In each workload level that was succeeded by all volunteers, PCr hydrolysis passed into a steady state. After an early biphasic response, we detected a significant decrease in pH from the first to the second minute of the 6-W workload level followed by a further continuous decrease in pH up to the second minute of the recovery phase. The decrease in pH was not accompanied by acceleration in PCr hydrolysis. In conclusion, this study shows that PCr hydrolysis during incremental plantar flexion exercises passes into a steady state at different workload levels. The observed decrease in pH does not result in acceleration of PCr hydrolysis.

Adult↗

PubMed2000

The effect of arm and wrist supports on the load of the upper extremity during VDU work.

OBJECTIVE: To evaluate the effectiveness of arm and wrist supports in reducing the workload during computer work. DESIGN: Female subjects (n=10) performed computer work in conditions with arm or wrist supports and in a condition without supports. BACKGROUND: Sustained muscle tension in the trapezius muscle is a risk factor for trapezius myalgia. Arm and wrist supports are used at the workplace with the intention to reduce the muscle tension. The effectiveness of these aids in reducing the load is not clear. METHODS: A typing task and mouse task were performed, each with four types of supports and without support. Electromyography and subjective ratings were used to quantify the workload. RESULTS: Lower levels of trapezius muscle activation were recorded with the use of arm supports. Wrist supports did not reduce activation. The rated perceived workload did not discriminate. CONCLUSIONS: Reduction of muscle activation in the neck-shoulder region during standard visual display unit work can be achieved with arm supports. Wrist supports do not reduce the strain on the neck-shoulder region. Subjective ratings seem not of use in selecting ergonomic aids in low intensity tasks. RelevanceVisual display unit workers are at risk of developing complaints of the neck and upper extremity. Arm and wrist supports are introduced at the workplace to reduce the workload. If arm and wrist supports are effective in reducing the workload they might be of use as preventive measures to reduce the risk of neck-shoulder complaints.

Adult↗

PubMedDate not supplied

Situational factors as determinants of community pharmacists' clinical decision making behavior.

OBJECTIVE: To examine the relative contribution of two work-related pressures, workload and perceived normative beliefs of significant others, to community pharmacists' clinical decision making behavior. DESIGN: Systematic random sample design. SETTING: A large southeastern city. PARTICIPANTS: 450 independent and chain community pharmacists identified from the state board of pharmacy list of licensed community pharmacists. INTERVENTIONS: A mailed questionnaire asking about community pharmacists' workload pressures and the perceived beliefs of their patients and employers (significant others) approving or disapproving of them providing pharmaceutical care. MAIN OUTCOME MEASURES: Clinical decision making behavior, as measured using a subset of the Behavioral Pharmaceutical Care Scale. RESULTS: Response rate was 31.8%. Workload was not significantly related to clinical decision making. After controlling for social desirability and workload, perceived normative beliefs of significant others was highly significant; it accounted for 7.6% of the variance associated with clinical decision making behavior. CONCLUSION: Workload pressures did not appear to influence the provision of pharmaceutical care. Community pharmacists' perceived normative beliefs about their patients' and employer's approval or disapproval of the provision of pharmaceutical care should be further examined within the larger context of the pharmacy organization's climate.

Adult↗

PubMed1980

Utilization of energy-providing substrates in the isolated working rat heart.

1. An improved perfusion system for the isolated rat heart is described. It is based on the isolated working heart of Neely, Liebermeister, Battersby & Morgan (1967) (Am. J. Physiol. 212, 804-814) and allows the measurement of metabolic rates and cardiac performance at a near-physiological workload. The main improvements concern better oxygenation of the perfusion medium and greater versatility of the apparatus. Near-physiological performance (cardiac output and aortic pressure) was maintained for nearly 2 h as compared with 30 min or less in the preparations of earlier work. 2. The rates of energy release (O2 uptake and substrate utilization) were 40-100% higher than those obtained by previous investigators, who used hearts at subphysiological workloads. 3. Values are given for the rates of utilization of glucose, lactate, oleate, acetate and ketone bodies, for O2 consumption and for the relative contributions of various fuels to the energy supply of the heart. Glucose can be replaced to a large extent by lactate, oleate or acetate, but not by ketone bodies. 4. Apart from quantitative differences there were also major qualitative differences between the present and previous preparations. Thus insulin was not required for maximal rates of glucose consumption at near-physiological, in contrast with subphysiological, workloads when glucose was the sole added substrate. When glucose oxidation was suppressed by the addition of other oxidizable substrates (lactate, acetate or acetoacetate), insulin increased the contribution of glucose as fuel for cardiac energy production at high workload. 5. In view of the major effects of workload on cardiac metabolism, experimentation on hearts performing subphysiologically or unphysiologically is of limited value to the situation in vivo.

Acetates↗

PubMed2003

Experiment and computer-aided simulation: complementary tools to understand exercise metabolism.

During the last two decades the concept of the MLSS (maximal lactate steady state) has been established. The MLSS detects the highest level of the BLC (blood lactate concentration) and the corresponding workload (MLSS workload) that can be maintained over time without continual BLC accumulation. In spite of a lack of experimental and/or theoretical foundation, it has been speculated that the level of the MLSS may decrease with increasing performance capacity. The potential inter-relationship between performance capacity and BLC response to prolonged constant workload will be analysed based on a recent study, which provided evidence that the MLSS is independent of performance whereas MLSS workload increases with performance capacity, and by a computer-aided simulation. The simulated model modifies and combines previous theories put forward to explain the response of BLC to exercise and incorporates a theory about limiting factors of oxygen transport to the muscle cell. Simulations consider the BLC response to selected prolonged constant workloads while paying special respect to changes in body structure and substrate utilization, which are generally accepted as limiting factors of performance capacity. This complex modulation of appearance and disappearance of lactate during constant prolonged exercise seems to support the experimental results, which indicated independence between MLSS and performance capacity.

Adult↗