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PubMed1993

Exercise-induced ventricular arrhythmias in patients with healed myocardial infarction.

BACKGROUND: Controversy exists about the clinical and prognostic significance of exercise-induced ventricular arrhythmias late after myocardial infarction. The aim of the study was to identify the main clinical and prognostic features of exercise-induced ventricular arrhythmias in out-patients with healed Q-wave myocardial infarction. METHODS: The study population was 777 consecutive patients who underwent a symptom-limited (Bruce protocol) treadmill test from May 1988 to January 1991 after myocardial infarction (at least 1 year). Clinical and exercise data were prospectively entered in a computerized database and retrospectively two different groups were selected: (1) 228 patients with exercise-induced ventricular arrhythmias; (2) 549 patients without. Incidence and morphology of exercise-induced ventricular arrhythmias, various exercise parameters and a follow-up were evaluated. RESULTS: Patients with exercise-induced ventricular arrhythmias were older (P < 0.001), had higher blood pressure (P < 0.03) and peak exercise rate pressure product (P < 0.00) than the others. No difference was found in the incidence of exercise-ischaemia: either symptomatic or not. When simple (< or = 2 Lown) versus complex (> or = 3 Lown) exercise-induced ventricular arrhythmias were considered, the latter were more frequent in patients with anterior myocardial infarction, shorter exercise duration (P < 0.001) and lower exercise rate pressure product, lower ejection fraction and lower incidence of exercise-induced ischaemia. In the follow-up (mean 24 +/- 13 month) there were 24 deaths: five (2.2%) in patients with exercise-induced ventricular arrhythmias and 19 (3.4%) in patients without. Cardiac event rate was similar in both groups. CONCLUSIONS: We conclude that in out-patients with healed myocardial infarction exercise-induced ventricular arrhythmias are quite frequent, but they are not associated with exercise-induced ischaemia, either symptomatic or not. Exercise-induced ventricular arrhythmias seem to be related to age or peak workload. Moreover patients with these arrhythmias have no adjunctive negative risk on prognosis.

Aged↗

PubMed2004

Korean adolescents' exercise behavior and its relationship with psychological variables based on stages of change model.

PURPOSE: To examine the exercise behavior of Korean adolescents, reveal the differences in self-efficacy and decision balance by the stages of exercise behavior, and identify the relationship between exercise behavior and psychological variables. METHODS: A total of 671 adolescents randomly selected from junior high and high schools in Seoul were surveyed. Three Korean-version questionnaires were used to identify the stage of exercise behavior and psychological attributes of adolescents: Stage of Exercise Behavior Change Questionnaire, Decision Balance Scale for Exercise, and Exercise Self-efficacy Scale. Data were analyzed by frequency analysis, chi(2) test, MANOVA, correlation analysis, and regression analysis. RESULTS: The exercise pattern of Korean adolescents was different by each stage of exercise behavior: precontemplation (17.5%), contemplation (16.6%), preparation (20.4%), action (28.3%), and maintenance (17.2%). Significant differences in exercise behavior distribution emerged as a function of gender and age. In addition, exercise efficacy, exercise benefits and exercise barriers differentiated across the stages of exercise behavior. Furthermore, the findings revealed that adolescents' exercise behavior was significantly correlated with the selected psychological variables, and that psychological variables had a statistically significant impact on the exercise behavior. CONCLUSION: This study provides information about relatively unstudied Korean adolescents and has the potential to influence the development of better exercise interventions and health promotion programs for adolescents.

Adolescent↗

PubMed1996

Effects of nifedipine and nitroglycerin on left ventricular systolic dysfunction and impaired diastolic filling after exercise-induced ischemia in humans.

OBJECTIVES: This study sought to determine whether calcium antagonist, compared with nitroglycerin, administration attenuates left ventricular dysfunction after exercise-induced ischemia in humans. BACKGROUND: Exercise-induced ischemia impairs left ventricular systolic function and diastolic filling after exercise. The mechanism of this phenomenon is unknown but may relate to intracellular calcium overload. METHODS: Echocardiography was performed in 131 patients before and 30 min, 2 h and 4 h after exercise stress test. Ischemia was defined as a reversible thallium stress defect. No medication, sublingual nitroglycerin or nifedipine was randomly given to each patient at peak exercise. RESULTS: Isovolumetric relaxation time was significantly prolonged from rest (100 +/- 19 ms [mean +/- SD]) to 30 min (118 +/- 20 ms, p < 0.0005), 2 h (117 +/- 18 ms, p < 0.0005) and 4 h (110 +/- 22 ms, p < 0.05) after exercise in 21 patients with exercise-induced ischemia who received no medication (ischemia-none group). Isovolumetric relaxation time similarly increased after exercise in 23 patients who received nitroglycerin and had exercise-induced ischemia (ischemia-NTG group) but was unchanged in 20 patients with exercise-induced ischemia who received nifedipine (ischemia-nifedipine group). Peak early filling velocity decreased in the ischemia-none and ischemia-NTG groups from rest to 30 min and 2 h after exercise, but peak early filling velocity was unchanged in the ischemia-nifedipine group. Ejection fraction decreased from rest to 30 min after exercise in the ischemia-none group (59 +/- 12% vs. 51 +/- 13%, p < 0.025) and ischemia-NTG group (59 +/- 14% vs. 49 +/- 14%, p < 0.005) but was unchanged in the ischemia-nifedipine group (60 +/- 19% vs. 64 +/- 18%, p = NS). A new regional left ventricular wall motion abnormality occurred more frequently 30 min after exercise in the ischemia-none group (11 [52%] of 21) and ischemia-NTG group (9 [39%] of 23) compared with the ischemia-nifedipine group (2 [10%] of 20, both p < 0.05). No change occurred in left ventricular systolic function and diastolic filling after exercise in the control groups. CONCLUSIONS: Exercise-induced ischemia impairs systolic function and diastolic filling after exercise. Sublingual nifedipine but not nitroglycerin attenuates this process and suggests that altered calcium homeostasis may play a role in left ventricular dysfunction that occurs after exercise-induced ischemia.

Adult↗

PubMed2003

Prophylactic tolperisone for post-exercise muscle soreness causes reduced isometric force--a double-blind randomized crossover control study.

The role of tolperisone hydrochloride, a centrally acting muscle relaxant in relieving painful muscle spasm is recently being discussed. The present study hypothesizes that the prophylactic use of tolperisone hydrochloride may effectively relieve post-exercise muscle soreness, based on the spasm theory of exercise pain. Twenty male volunteers, aged 25.2 +/- 0.82 years (mean +/- SEM) participated in 10 sessions in which they received oral treatment with placebo or the centrally acting muscle relaxant tolperisone hydrochloride (150 mg) three times daily for 8 days, in randomized crossover double-blind design. Time course assessments were made for pressure pain threshold, Likert's pain score (0-5), pain areas, range of abduction, isometric force, and electromyography (EMG) root mean square (RMS) during maximum voluntary isometric force on day 1 and 6, immediately after an eccentric exercise of first dorsal interosseous muscle, and 24 and 48 h after the exercise. Treatment with placebo or tolperisone hydrochloride was initiated immediately after the assessments on the first day baseline assessments. On the sixth day baseline investigations were repeated and then the subjects performed six bouts of standardized intense eccentric exercise of first dorsal interosseous muscle for provocation of post-exercise muscle soreness (PEMS). Perceived intensity of warmth, tiredness, soreness and pain during the exercise bouts were recorded on a 10 cm visual analogue pain scale. VAS scores and pressure pain thresholds did not differ between tolperisone and placebo treatment. All VAS scores increased during the exercise bouts 2, 3, 4, 5 and 6 as compared to bout 1. Increased pain scores and pain areas were reported immediately after, 24 and 48 h after exercise. Pressure pain thresholds were reduced at 24 and 48 h after the exercise in the exercised hand. Range of abduction of the index finger was reduced immediately after the exercise and was still reduced at 24 h as compared to the non-exercised hand. The EMG RMS amplitude was also reduced immediately after the exercise, but was increased at 24 and 48 h. Isometric force was reduced immediately after the exercise as compared to days 1, 6, and the 24 and 48 h post-exercise assessments with a greater reduction following the tolperisone hydrochloride treatment and the reduction was more in tolperisone group as compared to the placebo group. The results suggest, that the prophylactic intake of tolperisone hydrochloride provides no relief to pain in course of post-exercise muscle soreness but results in reduction in isometric force.

Adult↗

PubMed1997

The acute immune response to exercise: what does it mean?

The purpose of this article is to provide information about the exercise-induced alterations of cellular immune parameters depending on the intensity related to the individual anaerobic threshold (IAT) and duration of exercise. Immunological parameters were differential blood counts (CD14, CD45), monocyte subpopulations (CD14, CD16), lymphocyte subpopulations (CD3, CD4, CD8, CD45RO, CD19, CD16, CD56, HLA-DR) and natural killer cells (CD3, CD16, CD56), oxidative burst activity of neutrophils, and phagocytosis of neutrophils (flow cytometry). The main results were: (a) "Moderate" exercise (duration < 2h at about 85% of the IAT corresponding to a lactate steady state at about 2 mmol.l-1, < 30 min at the IAT corresponding to a lactate steady state of 4 mmol.l-1) elicits lower changes in cell concentrations and hormonal responses than strenuous exercise [exhaustive exercise at 100% IAT or above; (exhaustive) long-term (> 2-3h) endurance exercise]. Similar investigations about cell functions to decide about the positive or negative nature of these observations will have to follow in the future. (b) The neutrocytosis following exercise is more dependent on the duration than on the intensity of exercise. Especially exercise sessions that lead to a strong incline of the adrenocorticotropic hormone, beta-endorphin and cortisol are associated with this neutrocytosis. (c) Neutrophils' function during the exercise-induced neutrocytosis indicated by phagocytosis and oxidative burst activity is unchanged or reduced following strenuous endurance exercise, whereas bacterial URTI leads to similar neutrophil counts but significantly increased cell activities indicating the diverse meaning of the leukocytosis in infections (primed cells, enhanced cell activity, stimulated defense mechanism) and following exercise (impaired cell function, suppressed defense mechanism). (d) Regular monocytes (early differentiation stage) are strongly recruited into the circulation during long-term aerobic exercise, whereas mature monocyte cell counts (premacrophages) increase most with highly intensive (an)aerobic exercise above the IAT. Infections induced a maturation from regular to mature monocytes as a response to the infectious antigenic stimulus, whereas exercise does not, indicating the diversity between change of cell counts and function. (e) Long-term endurance diverse meaning leads to increases of activated CD45RO+ T cells (memory cell phenotype) but compared to the incline of cell concentrations and activation levels (% HLA-DR+ T cells) during infections like infectious mononucleosis this effect is small indicating only minor effects on T cell function by exercise. The effect of single bouts of exercise on immune cell counts is large but the effects on the cell function is - i.e. compared to bacterial URTI - relatively small.

Acute-Phase Reaction↗

PubMed2006

Comparison of the effects of acute and regular exercise on intraocular pressure in Turkish athlete and sedentarians.

The aim of this study was to investigate the changes that take place in IOP in athletes and people leading sedentary lives subjected to aerobic and anaerobic exercise and how chronic exercise could affect these changes. The study included 20 sportsmen (Group 1), and 20 people leading sedentary lives (Group 2). The intensity of the exercise for both groups was determined according to the Karvonen protocol and executed as an aerobic exercise program involving running on a treadmill for 30 min. Subjects in both groups were subjected to anaerobic exercise according to the Wingate test protocol for 30 s. The intraocular pressure of all subjects before exercise and after aerobic and anaerobic exercise were measured. The IOP before and after exercise aerobic and anaerobic were evaluated by the Willcoxon test whereas the right and left IOP before exercise and after the aerobic and anaerobic exercise programs in both groups were evaluated using the Mann Whitney U test. p values of <.05 were considered significant. Significant differences were found when the pre-exercise and post-aerobic and anaerobic exercise IOPs of the groups were compared (p < .05). Comparison of the post-anaerobic and aerobic exercise revealed a fall in the IOPs of the subjects after the aerobic exercise (p < .01). In this study, exercise was found to lead to a fall in the IOP in both sportsmen and those leading sedentary lives with the fall less apparent under anaerobic conditions than under aerobic conditions. In conclusion, therefore, it can be said that in those with an increased intraocular pressure, regular, moderately intense aerobic exercise rather than short-lived intense exercise could be more useful.

Adult↗

PubMed2005

Treadmill exercise in claudicants on aspirin results in improved antioxidant status but only minimal platelet activation.

The consequence of exercise on platelets remains controversial and adverse effects may result from repeated ischaemia reperfusion injury. We investigated platelet activation (platelet P-selectin (PS), and activated glycoprotein (Gp) IIb/IIIa), platelet-monocyte aggregates (PMA) and total plasma antioxidant status (TPAS) in claudicants after exercise. Twenty claudicants, taking 75 mg of aspirin daily, were subjected to repeated treadmill testing (3 km/h, 10% inclination). Blood was sampled before and after exercise. Activated GpIIb/IIIa, PS and PMA were quantified with flow cytometry. TPAS was quantified using a decolourisation assay. Percent positive cells for PS (pre-exercise 3.76% vs. 40 min post-exercise 4.10%; P < 0.05) and platelet-monocyte aggregates (pre-exercise: 25.31% vs. 40 min post-exercise 26.99%; P < 0.05) were significantly higher after exercise. Relative median fluorescence (RMF) for activated GpIIb/IIIa was significantly higher 40 min after exercise (pre-exercise: 3.04 vs. 40 min post-exercise: 4.01; P < 0.05). TPAS was significantly higher post-exercise (pre-exercise: 1.31 mmol/l vs. 1 min post-exercise: 1.40 mmol/l and 40 min post-exercise: 1.38 mmol/l; P < 0.01). Following moderate exercise, 'aspirin treated claudicants' show marginal platelet activation, PMA formation and a favourable improvement in antioxidant status. Further studies are required to assess the effect of additional antiplatelet agents and the significance of platelet-monocyte interactions. The possibility that aspirin contributes to the TPAS changes following exercise needs to be investigated.

Aged↗

PubMed2002

Teaching resident physicians to provide exercise counseling: a needs assessment.

PURPOSE: To determine the behaviors, knowledge, and attitudes of resident physicians regarding exercise counseling. METHOD: In 1997, a self-administered questionnaire was sent to 313 internal medicine resident physicians at six U.S. training programs. Pearson correlation coefficients examined associations between the resident physicians' practices, attitudes, and personal habits. Stepwise multiple linear regression identified predictors of exercise counseling by the resident physicians. RESULTS: A total of 251 resident physicians responded. Only 15.5% reported counseling more than 80% of the clinic patients about exercise. Over 93% understood the benefits of exercise, and almost all (96%) felt that it was a physician's responsibility to counsel patients about exercise. Only 29% felt successful at getting their patients to start exercising, and only 28% felt confident in their skills to prescribe exercise for patients. Ninety-one percent felt that training in exercise counseling would be worthwhile. The significant predictors of physician exercise counseling were perception of exercise counseling as a priority (p <.001), confidence in exercise-counseling skills (p <.001), and postgraduate year of training (p <.05) (R(2) =.18). The significant predictors of physicians' confidence in exercise-counseling skills included physician's gender (i.e., men) (p <.001), perception that exercise is important for a healthy 35-year-old (p <.01), feeling successful at exercise counseling (p <.001), perceiving less interference with counseling by barriers (p <.001), and prior training in exercise counseling (p <.05) (R(2) =.44). CONCLUSIONS: Resident physicians' perceptions of exercise counseling as a priority, confidence in counseling skills, and postgraduate year of training are important predictors of their providing exercise counseling. These factors should be addressed in future educational programs.

Adult↗

PubMed2001

The acute versus the chronic response to exercise.

PURPOSE: There is strong and consistent evidence that a single exercise session can acutely reduce triglycerides and increase high-density lipoprotein (HDL) cholesterol (HDL-C), reduce blood pressure, and improve insulin sensitivity and glucose homeostasis. Such observations suggest that at least some of the effects on atherosclerotic cardiovascular disease (ASCVD) risk factors attributed to exercise training may be the result of recent exercise. RESULTS: These acute and chronic exercise effects cannot be considered in isolation. Exercise training increases the capacity for exercise, thereby permitting more vigorous and/or more prolonged individual exercise sessions and a more significant acute effect. The intensity, duration, and energy expenditure required to produce these acute exercise effects are not clearly defined. The acute effect of exercise on triglycerides and HDL-C appears to increase with overall energy expenditure possibly because the effect maybe mediated by reductions in intramuscular triglycerides. Prolonged exercise appears necessary for an acute effect of exercise on low-density lipoprotein (LDL) cholesterol (LDL-C) levels. The acute effect of exercise on blood pressure is a low threshold phenomenon and has been observed after energy expenditures requiring only 40% maximal capacity. The acute effect of exercise on glucose metabolism appears to require exercise near 70% maximal, but this issue has not been carefully examined. CONCLUSIONS: Exercise has definite acute effects on blood lipids, blood pressure, and glucose homeostasis. Exercise also has acute effects on other factors related to atherosclerosis such as immunological function, vascular reactivity, and hemostasis. Considerable additional research is required to define the threshold of exercise required to produce these putatively beneficial effects.

Adult↗

PubMed1995

The effect of ambient temperature and saline loading on changes in plasma and urine electrolytes (Na+ and K+) following exercise.

In this study 4 Standardbred geldings (age 3-8 years, weight 431-531 kg) were used. The horses were fed a hay and oat diet and the total sodium intake was about 32 mg/kg bwt (690 mmol/day). An exercise test (ET) which contained 3 phases was performed. Phase I consisted of 23.5 min of mainly submaximal exercise, Phase 2 of 2 h of box rest and Phase 3 of 26 min of exercise including an intensive trot over 2600 m at 90% of VO2max. The ET was repeated 3 times: the first at 20 degrees C (30-40% RH), the second at 35 degrees C (30-40% RH) and the third at 35 degrees C (30-40% RH) after a nasogastric administration of 10 litres of 0.9% NaCl solution (35 degrees C and saline load [+ F]). Blood samples were taken before, during and after exercise. To measure fluid loss, horses were weighted before and after the ETs. Total urine output was determined 2 days before the ET (control), throughout the exercise day and for 2 days after (recovery days). There were an increase in blood and rectal temperatures after both exercise phases and a significant higher blood temperature was observed after exercise at 35 degrees C compared to 20 degrees C. The horses lost about 2% of their bodyweight (bwt) during the ETs. The plasma protein concentration increased during the exercise phases and remained elevated 2 h after exercise at both 20 degrees C and 35 degrees C, even though the horses had free access to water. The plasma protein concentration had returned to pre-exercise levels 26 h post exercise. After the saline load, total plasma protein concentration fell and increased only at the end of each exercise phase. The major mechanism regulating fluid balance after exercise seemed to be a lowered urinary excretion since water intake did not increase significantly. Urinary potassium excretion was positive throughout the experiment. During control days there was a positive sodium balance, shown by a urinary sodium excretion of 260 mmol/day. Post exercise urinary sodium excretion fell and remained very low until the second day of recovery, except after saline loading. In addition, plasma sodium was lowered 26 h after exercise at 35 degrees C. This study shows that with a daily salt intake of 38 g it will take several days to compensate for a sodium loss caused by sweating. Therefore, it is recommended that extra salt be given during the exercise day. In the experimental situation, pre-exercise saline supplementation was beneficial since the recovery time was shortened.

Animals↗

PubMed2004

The combined effects of exercise and food intake on adipose tissue and splanchnic metabolism.

Seven young, healthy male subjects were each studied in two separate experiments. (1) Subjects exercised for 60 min at 55% of peak oxygen consumption in the fasted state ending 30 min before a meal (60% of energy as carbohydrate, and 20% of energy as lipid and protein each) comprising 25% of the total daily energy intake, and were then studied for another 150 min postprandially during rest (E-->M). (2) One hour after a similar meal, subjects exercised for 60 min and were then studied for another 180 min postexercise during rest (M-->E). Regional adipose tissue and splanchnic tissue metabolism were measured by Fick's Principle. Food intake before exercise reduced whole-body lipid combustion during exercise to about 50% of the combustion rate found during exercise in the fasted state. The increase in subcutaneous, abdominal adipose tissue lipolysis during exercise was not influenced by preexercise food intake, while the fatty acid mobilization was increased by only 1.5-fold during postprandial exercise compared to a fourfold increase during exercise in the fasted state. During exercise, catecholamine concentrations increased similarly in the fasted and the postprandial state, while the insulin concentration was twofold higher postprandially. These results indicate that the increase in catecholamine concentrations during exercise is a more important determinant of the adipose tissue lipolytic rate than the decrease in insulin concentration. Furthermore, food intake either 30 min after or 1 h before exercise prevents the postexercise increase in adipose tissue glycerol and fatty acid release which normally takes place in fasting subjects at least up to 2.5 h postprandially. Postprandial exercise led to a faster increase in postprandial lipaemia. This could not be accounted for by changes in the regional splanchnic tissue or adipose tissue triacylglycerol metabolism. Exercise was able to increase hepatic glucose production irrespective of food intake before exercise. It is concluded that exercise performed in the fasted state shortly before a meal leads to a more favourable lipid metabolism during and after exercise than exercise performed shortly after a meal.

Adipose Tissue↗

PubMed1996

Effect of exercise intensity on glucose and insulin metabolism in obese individuals and obese NIDDM patients.

OBJECTIVE: The primary purpose of this study was to evaluate the acute effect of exercise of differing intensity on plasma glucose and insulin responses to an oral glucose challenge. RESEARCH DESIGN AND METHODS: Six obese men and six obese men with NIDDM of similar age, weight, percentage body fat, and VO2peak participated in the study. Each subject underwent two 7-day exercise programs in a counterbalanced order at 2-week intervals. During each 7-day exercise period, the subjects cycled every day at a power output corresponding to 50% VO2peak for 70 min or 70% VO2peak for 50 min. Muscle glycogen utilization was estimated during exercise on day 7 using a [3H]glucose infusion technique in conjunction with indirect calorimetry. During the day before and after each 7-day exercise period, a 3-h oral glucose tolerance test (OGTT) was administered after a 12-h overnight fast. RESULTS: The average caloric expenditure did not differ between exercise at 50 and 70% VO2peak in both obese and obese NIDDM subjects. However, the carbohydrate oxidation was higher (P < 0.05) during exercise at 70 than 50% VO2peak in obese subjects (77 +/- 5 vs. 68 +/- 6 g) and obese NIDDM subjects (70 +/- 4 vs. 58 +/- 6 g). Muscle glycogen utilization was also higher (P < 0.05) during exercise at 70 than 50% VO2peak in obese subjects (59 +/- 9 vs. 30 +/- 7 g) and in obese NIDDM subjects (48 +/- 5 vs. 24 +/- 5 g). In obese subjects, plasma glucose response area during the OGTT did not change after 7 days of exercise at either 50 or 70% VO2peak. Plasma insulin response area during the OGTT also did not change after 7 days of exercise at 50% VO2peak. However, plasma insulin response area was reduced (P < 0.05) after 7 days of exercise at 70% VO2peak (9,644 +/- 1,783 vs 7,538 +/- 1,522 microU.ml-1.180 min-1). In obese NIDDM subjects, both plasma glucose and insulin response areas during the OGTT did not decrease after 7 days of exercise at either 50 or 70% VO2peak. CONCLUSIONS: It is concluded that the exercise-induced improvement in insulin sensitivity is influenced by exercise intensity in obese individuals. The improved insulin sensitivity after 7 days of exercise at 70% VO2peak in obese individuals may be related to greater muscle glycogen utilization during exercise. The lack of improvement in glucose tolerance and insulin sensitivity after 7 days of exercise at either 50 or 70% VO2peak in obese NIDDM patients may be due to the fact that the NIDDM patients selected in the present study were relatively hypoinsulinemic.

Adipose Tissue↗

PubMed2001

The effects of exercise on mood changes: the moderating effect of depressed mood.

BACKGROUND: The present study examined the extent to which pre-exercise depressed mood moderated the influence of exercise on changes in other mood dimensions. The study was conducted in an ecologically valid setting using participants with previous experience of aerobic dance exercise. We hypothesized that (a) exercise will be associated with improved mood regardless of depressed mood, (b) the effect of exercise on mood changes would be significantly greater among individuals that reported symptoms of depressed mood before exercise, and (c) that pre-exercise depressed mood will be associated with a mood profile comprising high anger, confusion, fatigue, and tension, with low vigor. METHODS: Participants were 80 (M=27.90 years, SD=4.32 years) exercisers who had attended an exercise class on a regular basis for the previous three months. Participants completed the Profile of Mood States-A 15 minutes before exercise and then immediately after an aerobic dance exercise class. To examine the proposed moderating influence of depressed mood, participants were grouped into either a no-depression group, or a depressed mood group using pre-exercise depression scores. The exercise intervention was an aerobic dance session where participants followed the moves of the instructor. The session lasted for 60 minutes including a warm-up, main session, and cool-down. RESULTS: Repeated measures MANOVA (time x depression/no-depression group) results indicated that anger, confusion, fatigue, tension, and vigor reduced significantly. Thus supporting the notion that exercise reduces negative mood. Results indicated that the reduction in anger, confusion, fatigue, and tension, and increase in vigor was significantly greater in the depressed mood group, hence consistent with theoretical predictions. Results demonstrated that pre-exercise depressed mood was associated with a negative mood profile as hypothesized. CONCLUSIONS: Findings lend support to the notion that exercise is associated with improved mood. However, findings show that this effect was significantly greater among individuals reporting symptoms of depressed mood before exercise.

Adult↗

PubMed1992

Preoperative and postoperative right ventricular function during exercise in patients with mitral stenosis.

To elucidate the effects of mitral valve surgery on right ventricular function in 11 patients with mitral stenosis, pre- and postoperative right ventricular function were quantified using gated equilibrium blood pool radionuclide ventriculography at rest and during exercise. The preoperative right ventricular ejection fraction was 39 +/- 4% at rest and 36 +/- 9% during exercise, which during exercise was lower than control values (51 +/- 5%) (p < 0.01). When the preoperative right ventricular ejection fraction was lower during exercise than at rest, postoperative right ventricular ejection fraction during exercise was lower than normal values (42 +/- 3% versus 51 +/- 5%) (p < 0.01). When the preoperative right ventricular ejection fraction did not decrease during exercise, the postoperative right ventricular ejection fraction was within normal limits during exercise (54 +/- 5%). In addition, postoperative right ventricular ejection fraction during exercise increased to normal values in patients whose preoperative right ventricular ejection fraction during exercise had been 40% or higher. Preoperative peak ejection rate was -1.81 +/- 0.19 EDV/sec at rest and -1.72 +/- 0.39 EDV/sec during exercise, which during exercise was lower than control values (-2.44 +/- 0.53 EDV/sec) (p < 0.01). Postoperatively, peak ejection rate during exercise (-2.50 +/- 0.37 EDV/sec) increased (p < 0.05) to normal levels. Preoperative peak filling rate was 1.61 +/- 0.47 EDV/sec at rest and 1.88 +/- 0.54 EDV/sec during exercise, which during exercise was lower than control values (2.58 +/- 0.62 EDV/sec) (p < 0.01). Postoperatively, peak filling rate during exercise (2.82 +/- 0.62 EDV/sec) increased (p < 0.05) to normal values in all patients. Preoperative changes in both right ventricular ejection fraction and peak ejection rate from rest to exercise inversely correlated with the preoperative pulmonary vascular resistance at rest (right ventricular ejection fraction, r = -0.79, p < 0.005; and peak ejection rate, r = -0.67, p < 0.05). In conclusion, right ventricular systolic function improved in about half of the patients with mitral stenosis, and diastolic function improved in all patients during exercise following surgery. When the preoperative pulmonary vascular resistance was elevated, the right ventricular systolic dysfunction persisted.

Adult↗

PubMed1992

Exercise and the cutaneous circulation.

Our understanding of the control of the cutaneous circulation has increased over the past decade, but is still far from complete. There is a cutaneous vasoconstriction at the beginning of exercise that usually effectively competes with concurrent thermoregulatory drives for vasodilation. This cutaneous vasoconstrictor response, however, requires dynamic activity by a significant muscle mass as small muscle groups or isometric exercise are ineffective or nearly so. Also, exercise causes the threshold internal temperature relative to rest such that SKBF is lower during exercise than in resting conditions for a given thermal stimulus. A further influence by exercise on the cutaneous circulation is to limit the degree of cutaneous vasodilation when heat stress and exercise are combined. These three roles for exercise compete with the thermogenic role that promotes vasodilation. The previously described effects act through the adrenergic vasoconstrictor system and the separate active vasodilator system. The increase in SKBF with heat stress represents the combination of withdrawal of vasoconstrictor activity and elevation of active vasodilator activity. The vasoconstrictor effect of the initiation of exercise is accomplished strictly through enhanced vasoconstrictor activity; vasodilator withdrawal does not participate [72]. However, both the exercise-induced elevation in thermoregulatory threshold for raising SKBF and the limitation to cutaneous vasodilation during exercise are strictly functions of the active vasodilator system [69, 73, 78]. In the first case, active vasodilation is delayed until a higher (relative to rest) level of internal temperature is reached. In the second case, the plateau in SKBF during exercise in the heat is due to a similar plateau in active vasodilator activity. Exercise has also served as a tool for the study of other influences on the cutaneous circulation. The influences of alterations in body fluid volumes, osmolarity, acclimatization, hypertension, time of day, menstrual phase, and others on the control of SKBF have been assessed by using exercise as a calorigenic source. The question as to whether the nonthermoregulatory influences of exercise interact with these other influences to give a modification of the pattern of control different from what might be observed at rest is largely unanswered. Future directions for research are numerous, but several fundamental questions are outstanding. The mechanism of active cutaneous vasodilation has been elusive since its discovery and remains an exceptionally important question. Second, the sensory elements associated with exercise giving rise to the alterations in the pattern of control are unclear. This problem is made challenging by the fact that the efferent control by exercise differs between its initiation and events later in exercise.(ABSTRACT TRUNCATED AT 400 WORDS)

Acclimatization↗

PubMed2006

Factors that influence exercise among adults with arthritis in three activity levels.

INTRODUCTION: Recent public health objectives emphasize the importance of exercise for reducing disability among people with arthritis. Despite the documented benefits of exercise, people with arthritis are less active than those without arthritis. The purpose of this study was to examine the factors that influence exercise participation among insufficiently active individuals with arthritis and to compare these factors with those identified by nonexercisers and regular exercisers with arthritis. METHODS: Forty-six individuals with arthritis were recruited from various community-based organizations to participate in seven focus groups segmented by exercise status and education. Trained moderators led each discussion using a standard guide. All focus group discussions were transcribed verbatim and coded. RESULTS: Pain was the most commonly mentioned barrier to exercise and limited exercise participation for nonexercisers and insufficiently active individuals. Paradoxically, insufficiently active individuals also identified exercise-related reductions in pain as a potential motivation for increasing exercise. Likewise, exercise-related reductions in pain were a motivation to continue exercising for the exerciser groups. Nonexercisers expressed that a reduction in pain was a possible outcome of exercise but were skeptical of its occurrence. Receiving tailored advice from a health care provider was consistently identified as an exercise enabler across the groups. CONCLUSION: Findings from this study indicate that potential strategies for increasing exercise participation include incorporating pain management strategies and coping skills into exercise interventions and ensuring that health care providers provide specific exercise advice to their patients with arthritis.

Adult↗

PubMed2006

Effects of a multimodal exercise program for people with ankylosing spondylitis.

BACKGROUND AND PURPOSE: Few randomized controlled studies have examined the effects of exercise in patients with ankylosing spondylitis (AS). This study investigated the effects of a 12-week, multimodal exercise program in patients with AS. SUBJECTS: A convenience sample of 30 patients with AS (18 male, 12 female), with a mean age of 34.9 years (SD=6.28), participated in the study. Twenty-six subjects were classified as having stage I AS and 4 subjects were classified as having stage II AS according to the modified New York Criteria. METHODS: This study was a randomized controlled trial. Subjects were assigned to either a group that received an exercise program or to a control group. The exercise program consisted of 50 minutes of multimodal exercise, including aerobic, stretching, and pulmonary exercises, 3 times a week for 3 months. Subjects in both groups received medical treatment for AS, but the exercise group received the exercise program in addition to the medical treatment. All subjects received a physical examination at baseline and at 12 weeks. The examinations were conducted under the supervision of a physician who specialized in physical medicine and rehabilitation and included the assessment of spinal mobility using 2 methods: clinical measurements (chin-to-chest distance, Modified Schober Flexion Test, occiput-to-wall distance, finger-to-floor distance, and chest expansion) and inclinometer measurements (gross hip flexion, gross lumbar flexion, and gross thoracic flexion). In addition, vital capacity was measured by a physiologist, and physical work capacity was evaluated by a doctorally prepared exercise instructor. RESULTS: The measurements of the exercise group for chest expansion, chin-to-chest distance, Modified Schober Flexion Test, and occiput-to-wall distance were significantly better than those of the control group after the 3-month exercise period. The spinal movements of the exercise group improved significantly at the end of exercise program, but those of the control group showed no significant change. In addition, the results showed that the posttraining value of gross thoracic flexion of the exercise group was significantly higher than that of the control group. Physical work capacity and vital capacity values improved in the exercise group but decreased in the control group. DISCUSSION AND CONCLUSION: In this study, a multimodal exercise program including aerobic, stretching, and pulmonary exercises provided in conjunction with routine medical management yielded greater improvements in spinal mobility, work capacity, and chest expansion.

Adult↗

PubMed1991

Carbohydrate ingestion during prolonged exercise: effects on metabolism and performance.

It is well recognized that energy from CHO oxidation is required to perform prolonged strenuous (greater than 60% VO2 max) exercise. During the past 25 years, the concept has developed that muscle glycogen is the predominant source of CHO energy for strenuous exercise; as a result, the potential energy contribution of blood glucose has been somewhat overlooked. Although during the first hour of exercise at 70-75% VO2max, most of the CHO energy is derived from muscle glycogen, it is clear that the contribution of muscle glycogen decreases over time as muscle glycogen stores become depleted, and that blood glucose uptake and oxidation increase progressively to maintain CHO oxidation (Fig. 1.7). We theorize that over the course of several hours of strenuous exercise (i.e., 3-4 h), blood glucose and muscle glycogen contribute equal amounts of CHO energy, making blood glucose at least as important as muscle glycogen as a CHO source. During the latter stages of exercise, blood glucose can potentially provide all of the CHO energy needed to support exercise at 70-75% VO2max if blood glucose availability is maintained. During prolonged exercise in the fasted state, however, blood glucose concentration often decreases owing to depletion of liver glycogen stores. This relative hypoglycemia, although only occasionally severe enough to result in fatigue from neuroglucopenia, causes fatigue by limiting blood glucose (and therefore total CHO) oxidation. The primary purpose of CHO ingestion during continuous strenuous exercise is to maintain blood glucose concentration and thus CHO oxidation and exercise tolerance during the latter stages of prolonged exercise. CHO feeding throughout continuous exercise does not alter muscle glycogen use. It appears that blood glucose must be supplemented at a rate of approximately 1 g/min late in exercise. Feeding sufficient amounts of CHO 30 minutes before fatigue is as effective as ingesting CHO throughout exercise in maintaining blood glucose availability and CHO oxidation late in exercise. Most persons should not wait, however, until they are fatigued before ingesting CHO, because it appears that glucose entry into the blood does not occur rapidly enough at this time. It also may be advantageous to ingest CHO throughout intermittent or low-intensity exercise rather than toward the end of exercise because of the potential for glycogen synthesis in resting muscle fibers. Finally, CHO ingestion during prolonged strenuous exercise delays by approximately 45 minutes but does not prevent fatigue, suggesting that factors other than CHO availability eventually cause fatigue.

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