Energy cost of sport rock climbing in elite performers.
OBJECTIVES: To assess oxygen uptake (VO2), blood lactate concentration ([La(b)]), and heart rate (HR) response during indoor and outdoor sport climbing. METHODS: Seven climbers aged 25 (SE 1) years, with a personal best ascent without preview or fall (on sight) ranging from 6b to 7a were assessed using an indoor vertical treadmill with artificial rock hand/foot holds and a discontinuous protocol with climbing velocity incremented until voluntary fatigue. On a separate occasion the subjects performed a 23.4 m outdoor rock climb graded 5c and taking 7 min 36 s (SE 33 s) to complete. Cardiorespiratory parameters were measured using a telemetry system and [La(b)] collected at rest and after climbing. RESULTS: Indoor climbing elicited a peak oxygen uptake (VO2climb-peak) and peak HR (HRpeak) of 43.8 (SE 2.2) ml/kg/min and 190 (SE 4) bpm, respectively and increased blood lactate concentration [La(b)] from 1.4 (0.1) to 10.2 (0.6) mmol/l (p < 0.05). During outdoor climbing VO2 and HR increased to about 75% and 83% of VO2climb-peak and HRpeak, respectively. [La(b)] increased from 1.3 (0.1) at rest to 4.5 mmol/l (p < 0.05) at 2 min 32 s (8 s) after completion of the climb. CONCLUSIONS: The results suggest that for elite climbers outdoor sport rock climbs of five to 10 minutes' duration and moderate difficulty require a significant portion of the VO2climb-peak. The higher HR and VO2 for outdoor climbing and the increased [La(b)] could be the result of repeated isometric contractions, particularly from the arm and forearm muscles. (+info)
Prognostic value of myocardial perfusion imaging in patients with high exercise tolerance.
BACKGROUND: Although high exercise tolerance is associated with an excellent prognosis, the significance of abnormal myocardial perfusion imaging (MPI) in patients with high exercise tolerance has not been established. This study retrospectively compares the utility of MPI and exercise ECG (EECG) in these patients. METHODS AND RESULTS: Of 388 consecutive patients who underwent exercise MPI and reached at least Bruce stage IV, 157 (40.5%) had abnormal results and 231 (59.5%) had normal results. Follow-up was performed at 18+/-2.7 months. Adverse events, including revascularization, myocardial infarction, and cardiac death, occurred in 40 patients. Nineteen patients had revascularization related to the MPI results or the patient's condition at the time of MPI and were not included in further analysis. Seventeen patients (12.2%) with abnormal MPI and 4 (1.7%) with normal MPI had adverse cardiac events (P<0.001). Cox proportional-hazards regression analysis showed that MPI was an excellent predictor of cardiac events (global chi2=13.2; P<0.001; relative risk=8; 95% CI=3 to 23) but EECG had no predictive power (global chi2=0.05; P=0.8; relative risk=1; 95% CI=0.4 to 3.0). The addition of Duke's treadmill score risk categories did not improve the predictive power of EECG (global chi2=0.17). The predictive power of the combination of EECG (including Duke score categories) and MPI was no better than that of MPI alone (global chi2=13.5). CONCLUSIONS: Unlike EECG, MPI is an excellent prognostic indicator for adverse cardiac events in patients with known or suspected CAD and high exercise tolerance. (+info)
Energy cost of propulsion in standard and ultralight wheelchairs in people with spinal cord injuries.
BACKGROUND AND PURPOSE: Wheelchair- and subject-related factors influence the efficiency of wheelchair propulsion. The purpose of this study was to compare wheelchair propulsion in ultralight and standard wheelchairs in people with different levels of spinal cord injury. SUBJECTS: Seventy-four subjects (mean age=26.2 years, SD=7.14, range=17-50) with spinal cord injury resulting in motor loss (30 with tetraplegia and 44 with paraplegia) were studied. METHOD: Each subject propelled standard and ultralight wheelchairs around an outdoor track at self-selected speeds, while data were collected at 4 predetermined intervals. Speed, distance traveled, and oxygen cost (VO2 mL/kg/m) were compared by wheelchair, group, and over time, using a Bonferroni correction. RESULTS: In the ultralight wheelchair, speed and distance traveled were greater for both subjects with paraplegia and subjects with tetraplegia, whereas VO2 was less only for subjects with paraplegia. Subjects with paraplegia propelled faster and farther than did subjects with tetraplegia. CONCLUSION AND DISCUSSION: The ultralight wheelchair improved the efficiency of propulsion in the tested subjects. Subjects with tetraplegia, especially at the C6 level, are limited in their ability to propel a wheelchair. (+info)
Phase reversal of biomechanical functions and muscle activity in backward pedaling.
Computer simulations of pedaling have shown that a wide range of pedaling tasks can be performed if each limb has the capability of executing six biomechanical functions, which are arranged into three pairs of alternating antagonistic functions. An Ext/Flex pair accelerates the limb into extension or flexion, a Plant/Dorsi pair accelerates the foot into plantarflexion or dorsiflexion, and an Ant/Post pair accelerates the foot anteriorly or posteriorly relative to the pelvis. Because each biomechanical function (i.e., Ext, Flex, Plant, Dorsi, Ant, or Post) contributes to crank propulsion during a specific region in the cycle, phasing of a muscle is hypothesized to be a consequence of its ability to contribute to one or more of the biomechanical functions. Analysis of electromyogram (EMG) patterns has shown that this biomechanical framework assists in the interpretation of muscle activity in healthy and hemiparetic subjects during forward pedaling. Simulations show that backward pedaling can be produced with a phase shift of 180 degrees in the Ant/Post pair. No phase shifts in the Ext/Flex and Plant/Dorsi pairs are then necessary. To further test whether this simple yet biomechanically viable strategy may be used by the nervous system, EMGs from 7 muscles in 16 subjects were measured during backward as well as forward pedaling. As predicted, phasing in vastus medialis (VM), tibialis anterior (TA), medial gastrocnemius (MG), and soleus (SL) were unaffected by pedaling direction, with VM and SL contributing to Ext, MG to Plant, and TA to Dorsi. In contrast, phasing in biceps femoris (BF) and semimembranosus (SM) were affected by pedaling direction, as predicted, compatible with their contribution to the directionally sensitive Post function. Phasing of rectus femoris (RF) was also affected by pedaling direction; however, its ability to contribute to the directionally sensitive Ant function may only be expressed in forward pedaling. RF also contributed significantly to the directionally insensitive Ext function in both forward and backward pedaling. Other muscles also appear to have contributed to more than one function, which was especially evident in backward pedaling (i.e. , BF, SM, MG, and TA to Flex). We conclude that the phasing of only the Ant and Post biomechanical functions are directionally sensitive. Further, we suggest that task-dependent modulation of the expression of the functions in the motor output provides this biomechanics-based neural control scheme with the capability to execute a variety of lower limb tasks, including walking. (+info)
Development of a 12-min treadmill walk test at a self-selected pace for the evaluation of cardiorespiratory fitness in adult men.
The direct measurement of true maximal oxygen uptake (VO2max) and oxygen uptake corresponding to anaerobic threshold (VO2AT) is not always practical, especially in middle age and older populations. Therefore, the purpose of this study was to develop a simple test that could accurately estimate cardiorespiratory fitness using a submaximal treadmill walking protocol for middle age, older, sedentary individuals and patients with chronic disease. Subjects for this study were 42 men (44.9 +/- 15.7 years), which included 17 patients with coronary heart disease (57.0 +/- 9.6 years). VO2peak and VO2AT were measured using a treadmill protocol (VO2peak; 38.4 +/- 11.6 ml/kg/min, VO2AT; 22.9 +/- 7.4 ml/kg/min). This simple test assessed the total distance covered in 12 minutes on the treadmill at an intensity corresponding to either 1) 11 on the Borg scale of ratings of perceived exertion (RPE11), 2) 13 on the Borg scale of ratings of perceived exertion (RPE13), or 3) "Optimal" by subjective judgment. The correlation coefficients between VO2peak or VO2AT and total distance at the three intensities (RPE11; 950 +/- 100 m, RPE13; 1080 +/- 140 m Optimal; 1050 +/- 110 m) were statistically significant, ranging from 0.72 to 0.85. The test-retest reliability coefficient on 12 subjects was 0.98. The oxygen uptake (VO2) was measured during the three walk tests on 15 subjects. There were no significant changes in submaximal VO2 values from min 4 to min 12 (RPE11; 19.8 +/- 4.7 ml/kg/min, RPE13; 24.1 +/- 4.9 ml/kg/min, Optimal; 23.1 +/- 4.8 ml/kg/min) in any of the three tests. Similarly, the three submaximal VO2 values did not differ from the VO2AT value (21.2 +/- 8.3 ml/kg/min) obtained in the initial maximal test. These results suggest that the 12-min submaximal treadmill walk test (STWT) is a valid method for the assessment of VO2peak and VO2AT. Therefore, the STWT could be a useful performance test for evaluating cardiorespiratory fitness in middle age, older, sedentary individuals and patients with chronic disease. (+info)
Echo derived variables predicting exercise tolerance in patients with dilated and poorly functioning left ventricle.
OBJECTIVE: To determine whether resting echo derived measurements predict exercise tolerance and its interrelation with heart rate response and ventilation drive in patients with systolic left ventricular disease. DESIGN: Prospective echocardiographic examination followed by cardiopulmonary exercise testing. SETTING: A tertiary referral centre for cardiac diseases. SUBJECTS: 21 patients (11 with coronary artery disease, 10 with idiopathic dilated cardiomyopathy) with end diastolic dimension > 6.4 cm, shortening fraction < 25%, and in sinus rhythm. There were 11 age matched normal controls. RESULTS: In the patients, peak oxygen consumption (mVo2) correlated with right ventricular long axis excursion (r = 0.62); 65% of the variance in mVo2 was predictable using a multivariate model with right ventricular long axis excursion and peak lengthening rate, and peak mitral atrial filling velocity as independent variables. Aetiology was not an independent predictor, although the right ventricular long axis excursion (mean (SD)) was greater in patients with idiopathic dilated cardiomyopathy than in those with coronary artery disease (2.4 (0.5) cm v 1.6 (0.5) cm, p < 0.001). Peak heart rate correlated with duration of mitral regurgitation (r = -0.52) and the slope of ventilation against CO2 production correlated with M mode isovolumic relaxation time (r = 0.61). CONCLUSIONS: In patients with systolic left ventricular dysfunction, more than half the variance in exercise tolerance can be predicted by factors measured on echocardiography at rest, particularly right ventricular long axis excursion. (+info)
Expression of the cell adhesion molecules on leukocytes that demarginate during acute maximal exercise.
The pulmonary vascular bed is an important reservoir for the marginated pool of leukocytes that can be mobilized by exercise or catecholamines. This study was designed to determine the phenotypic characteristics of leukocytes that are mobilized into the circulation during exercise. Twenty healthy volunteers performed incremental exercise to exhaustion [maximal O2 consumption (VO2 max)] on a cycle ergometer. Blood was collected at baseline, at 3-min intervals during exercise, at VO2 max, and 30 min after exercise. Total white cell, polymorphonuclear leukocyte (PMN), and lymphocyte counts increased with exercise to VO2 max (P < 0.05). Flow cytometric analysis showed that the mean fluorescence intensity of L-selectin on PMN (from 14.9 +/- 1 at baseline to 9.5 +/- 1.6 at VO2 max, P < 0.05) and lymphocytes (from 11.7 +/- 1.2 at baseline to 8 +/- 0.8 at VO2 max, P < 0.05) decreased with exercise. Mean fluorescence intensity of CD11b on PMN increased with exercise (from 10.2 +/- 0.6 at baseline to 25 +/- 2.5 at VO2 max, P < 0.002) but remained unchanged on lymphocytes. Myeloperoxidase levels in PMN did not change with exercise. In vitro studies showed that neither catecholamines nor plasma collected at VO2 max during exercise changed leukocyte L-selectin or CD11b levels. We conclude that PMN released from the marginated pool during exercise express low levels of L-selectin and high levels of CD11b. (+info)
Influence of body temperature on the development of fatigue during prolonged exercise in the heat.
We investigated whether fatigue during prolonged exercise in uncompensable hot environments occurred at the same critical level of hyperthermia when the initial value and the rate of increase in body temperature are altered. To examine the effect of initial body temperature [esophageal temperature (Tes) = 35.9 +/- 0.2, 37.4 +/- 0. 1, or 38.2 +/- 0.1 (SE) degrees C induced by 30 min of water immersion], seven cyclists (maximal O2 uptake = 5.1 +/- 0.1 l/min) performed three randomly assigned bouts of cycle ergometer exercise (60% maximal O2 uptake) in the heat (40 degrees C) until volitional exhaustion. To determine the influence of rate of heat storage (0.10 vs. 0.05 degrees C/min induced by a water-perfused jacket), four cyclists performed two additional exercise bouts, starting with Tes of 37.0 degrees C. Despite different initial temperatures, all subjects fatigued at an identical level of hyperthermia (Tes = 40. 1-40.2 degrees C, muscle temperature = 40.7-40.9 degrees C, skin temperature = 37.0-37.2 degrees C) and cardiovascular strain (heart rate = 196-198 beats/min, cardiac output = 19.9-20.8 l/min). Time to exhaustion was inversely related to the initial body temperature: 63 +/- 3, 46 +/- 3, and 28 +/- 2 min with initial Tes of approximately 36, 37, and 38 degrees C, respectively (all P < 0.05). Similarly, with different rates of heat storage, all subjects reached exhaustion at similar Tes and muscle temperature (40.1-40.3 and 40. 7-40.9 degrees C, respectively), but with significantly different skin temperature (38.4 +/- 0.4 vs. 35.6 +/- 0.2 degrees C during high vs. low rate of heat storage, respectively, P < 0.05). Time to exhaustion was significantly shorter at the high than at the lower rate of heat storage (31 +/- 4 vs. 56 +/- 11 min, respectively, P < 0.05). Increases in heart rate and reductions in stroke volume paralleled the rise in core temperature (36-40 degrees C), with skin blood flow plateauing at Tes of approximately 38 degrees C. These results demonstrate that high internal body temperature per se causes fatigue in trained subjects during prolonged exercise in uncompensable hot environments. Furthermore, time to exhaustion in hot environments is inversely related to the initial temperature and directly related to the rate of heat storage. (+info)