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Exercise Time (exercise + time)
Selected AbstractsThe Effect of Erythropoietin on Exercise Capacity, Left Ventricular Remodeling, Pressure-Volume Relationships, and Quality of Life in Older Patients With Anemia and Heart Failure With Preserved Ejection FractionCONGESTIVE HEART FAILURE, Issue 3 2010Rose S. Cohen MD A prospective, open-label, 3-month study was conducted to evaluate the feasibility and short-term clinical effect of subcutaneous erythropoietin injections in patients with anemia and heart failure with preserved ejection fraction (ejection fraction, 55%±2%). Using a dose-adjusted algorithm to effect a rate of rise in hemoglobin not to exceed 0.4 g/dL,/wk, hemoglobin (10.8±0.3 to 12.2±0.3 g/dL) and red blood cell volume (1187±55 to 1333±38 mL) increased with an average weekly dose of 3926 units. Functional measures increased from baseline (6-minute walk test [289±24 to 331±22 m], exercise time [432±62 to 571±51 s], and peak oxygen consumption [8.2±0.7 to 9.4±0.9 mL/kg/min], all P<.05). End-diastolic volume declined significantly (8% volumetric decrease, 108±3 to 100±3 mL, P =.03), but there were no significant changes in left ventricular mass or estimated left ventricular end-diastolic pressure. Pressure-volume analysis demonstrated a reduction in ventricular capacitance at an end-diastolic pressure of 30 mm Hg without significant changes in contractile state. Congest Heart Fail. 2010;16:96,103. © 2009 Wiley Periodicals, Inc. [source] The impact of state physical education requirements on youth physical activity and overweightHEALTH ECONOMICS, Issue 12 2007John Cawley Abstract To combat childhood overweight in the US, which has risen dramatically in the past three decades, many medical and public health organizations have called for students to spend more time in physical education (PE) classes. This paper is the first to examine the impact of state PE requirements on student PE exercise time. It also exploits variation in state laws as quasi-natural experiments in order to estimate the causal impact of PE on overall student physical activity and weight. We study nationwide data from the Youth Risk Behavior Surveillance System for 1999, 2001, and 2003 merged with data on state minimum PE requirements from the 2001 Shape of the Nation Report. We find that high school students with a binding PE requirement report an average of 31 additional minutes per week spent physically active in PE class. Our results also indicate that additional PE time raises the number of days per week that girls report having exercised vigorously or having engaged in strength-building activity. We find no evidence that PE lowers BMI or the probability that a student is overweight. We conclude that raising PE credit requirements may make girls more physically active overall but there is not yet the scientific base to declare raising PE requirements an anti-obesity initiative for either boys or girls. Copyright © 2007 John Wiley & Sons, Ltd. [source] Endurance Exercise Training in Older Patients with Heart Failure: Results from a Randomized, Controlled, Single-Blind TrialJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2009Peter H. Brubaker PhD OBJECTIVES: To test the hypothesis that exercise training (ET) improves exercise capacity and other clinical outcomes in older persons with heart failure with reduced ejection fraction (HfrEF). DESIGN: Randomized, controlled, single-blind trial. SETTING: Outpatient cardiac rehabilitation program. PARTICIPANTS: Fifty-nine patients aged 60 and older with HFrEF recruited from hospital records and referring physicians were randomly assigned to a 16-week supervised ET program (n=30) or an attention-control, nonexercise, usual care control group (n=29). INTERVENTION: Sixteen-week supervised ET program of endurance exercise (walking and stationary cycling) three times per week for 30 to 40 minutes at moderate intensity regulated according to heart rate and perceived exertion. MEASUREMENTS: Individuals blinded to group assignment assessed four domains pivotal to HFrEF pathophysiology: exercise performance, left ventricular (LV) function, neuroendocrine activation, and health-related quality of life (QOL). RESULTS: At follow-up, the ET group had significantly greater exercise time and workload than the control group, but there were no significant differences between the groups for the primary outcomes: peak exercise oxygen consumption (VO2 peak), ventilatory anaerobic threshold (VAT), 6-minute walk distance, QOL, LV volumes, EF, or diastolic filling. Other than serum aldosterone, there were no significant differences after ET in other neuroendocrine measurements. Despite a lack of a group "training" effect, a subset (26%) of individuals increased VO2 peak by 10% or more and improved other clinical variables as well. CONCLUSION: In older patients with HFrEF, ET failed to produce consistent benefits in any of the four pivotal domains of HF that were examined, although the heterogeneous response of older patients with HFrEF to ET requires further investigation to better determine which patients with HFrEF will respond favorably to ET. [source] Physical activity and exercise performance predict long-term prognosis in middle-aged women surviving acute coronary syndromeJOURNAL OF INTERNAL MEDICINE, Issue 2 2007F. Al-Khalili Abstract. Aim., To evaluate the importance of exercise testing (ET) parameters and leisure time physical activity in predicting long-term prognosis in middle-aged women hospitalized for acute coronary syndrome (ACS). Methods and results., Women aged <66 years recently hospitalized for ACS in the Greater Stockholm area in Sweden were recruited. All underwent baseline clinical examinations including ET and then were followed up for 9 years. Nonparticipation in ET had a hazard ratio of 4.26 (95% confidence interval 2.02,8.95) for total mortality and 3.03 (1.03,8.91) for cardiovascular mortality. All ET parameters were significantly different between survivors than nonsurvivors, except for chest pain and ST-segment depression during ET. Sedentary lifestyle and ET parameters were related to total mortality and cardiovascular mortality in a multivariate analysis adjusting for potential confounders. Predictors of total mortality were sedentary lifestyle 2.94 (1.31,6.62), exercise time 1.75 (1.07,2.87) and inadequate haemodynamic responses: low increase in pulse rate 2.04 (1.16,3.60) and systolic blood pressure (SBP) 1.88 (1.19,2.95) from rest to peak exercise. Parameters that predicted cardiovascular mortality were sedentary lifestyle 3.15 (1.13,8.74) and poor increase in SBP 2.76 (1.30,5.86) from rest to peak exercise. The relation of sedentary lifestyle to survival was substantially weakened when exercise parameters were added to the multivariate analysis model. Conclusion., In female patients <66 years surviving ACS, important independent predictors of long-term all-cause mortality were sedentary lifestyle, low physical fitness and inadequate pulse rate and SBP increase during exercise. Predictors of cardiovascular mortality were sedentary lifestyle and inadequate blood pressure response during exercise. [source] Impact of Right Ventricular Pacing Sites on Exercise Capacity during Ventricular Rate Regularization in Patients with Permanent Atrial FibrillationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 12 2009HUNG-FAT TSE M.D., Ph.D. Background:The deleterious effects of right ventricular apical (RVA) pacing may offset the potential benefit of ventricular rate (VR) regularization and rate adaptation during an exercise in patient's atrial fibrillation (AF). Methods:We studied 30 patients with permanent AF and symptomatic bradycardia who receive pacemaker implantation with RVA (n = 15) or right ventricular septal (RVS, n = 15) pacing. All the patients underwent an acute cardiopulmonary exercise testing using VVI-mode (VVI-OFF) and VVI-mode with VR regularization (VRR) algorithm on (VVI-ON). Results:There were no significant differences in the baseline characteristics between the two groups, except pacing QRS duration was significantly shorter during RVS pacing than RVA pacing (138.9 ± 5 vs 158.4 ± 6.1 ms, P = 0.035). Overall, VVI-ON mode increased the peak exercise VR, exercise time, metabolic equivalents (METs), and peak oxygen consumption (VO2max), and decreased the VR variability compared with VVI-OFF mode during exercise (P < 0.05), suggesting that VRR pacing improved exercise capacity during exercise. However, further analysis on the impact of VRR pacing with different pacing sites revealed that only patients with RVS pacing but not patients with RVA pacing had significant increased exercise time, METs, and VO2max during VVI-ON compared with VVI-OFF, despite similar changes in peaked exercise VR and VR variability. Conclusion:In patients with permanent AF, VRR pacing at RVS, but not at RVA, improved exercise capacity during exercise. [source] The repeatability of submaximal endurance exercise testing in cystic fibrosis,PEDIATRIC PULMONOLOGY, Issue 1 2007MB BCh BAO, Sinead C. Barry BSc Abstract Submaximal endurance cycle ergometer exercise tests are used to measure the efficacy of an exercise intervention, but the repeatability of these tests in patients with cystic fibrosis (CF) has not been established. The purpose of this study was to examine the repeatability of submaximal endurance testing in stable CF. Fifteen adults with CF underwent two submaximal endurance tests carried out over a 7-day period. A subset of six subjects returned 28 days later for a third submaximal endurance test. Workload was set at 80% of maximum workload and exercise was performed to exhaustion. Oxygen consumption, minute ventilation, tidal volume, carbon dioxide output, respiratory rate, heart rate, and oxygen saturation were measured at rest, at end exercise and at four matched times during the submaximal endurance tests (20, 40, 60, and 80% of exercise duration calculated from the first endurance test). Submaximal endurance test time was highly repeatable with no significant learning effect identified on multiple testing. Submaximal endurance exercise time demonstrated a variability of 5.7% which is consistent with high levels of repeatability. Metabolic, ventilatory and cardiac variables were all also highly reproducible between test days. Submaximal endurance testing is repeatable in stable CF, confirming that submaximal endurance tests are a reliable tool for assessment of therapeutic benefit in patients with CF. Pediatr Pulmonol. 2007; 42:75,82. © 2006 Wiley-Liss, Inc. [source] Does the addition of non-invasive ventilation during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease augment patient outcome in exercise tolerance?PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2010A literature review Abstract Background.,Non-invasive ventilation (NIV) during exercise in patients with chronic obstructive pulmonary disease (COPD) has been shown to increase exercise time and intensity. Feasibly then, NIV during pulmonary rehabilitation will enhance post-rehabilitation training effects. The purpose of this review is to systematically consider and critique the literature concerning the effects of NIV, when used during an exercise programme in COPD patients on exercise tolerance.,Method.,An electronic literature search was completed and the reference lists of the articles that fitted the following inclusion criteria were screened. Studies that used any mode of NIV during an exercise programme with a primary outcome measure focusing on exercise tolerance and were written after the year 2000 to reflect current practice. Studies that were not written in English or had been included in previous literature reviews were excluded. The studies were then critically appraised and assigned a level of evidence based upon Scottish Intercollegiate Guidelines Network.,Results.,Twenty-eight articles were screened, of which six fitted the inclusion criteria. The methodological quality ranged from level 1, to 1+. All but one study by Bianchi et al. (2002) demonstrated a statistically significant improvement in exercise tolerance with the addition of some form of NIV during pulmonary rehabilitation. The benefits may be greater in patients with more severe airway obstruction as determined by Forced Expiration Volume (FEV), (%pred).,Conclusion.,This review would suggest that NIV may allow an increased exercise intensity and duration during pulmonary rehabilitation in patients with moderate to very severe COPD, (according to the American Thoracic Society guidelines), resulting in a greater training effect and a prolonged exercise capacity. Further research looking at long-term follow-up is recommended. Copyright © 2009 John Wiley & Sons, Ltd. [source] The Difference of Heart Rate Recovery between Males with and without Erectile DysfunctionANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 3 2010M. Tolga Dogru M.D. Aim: In this study, we aimed to investigate the relationship between heart rate recovery (HRR) time and Chronotropic Index (CHIND) parameters, which also reflect autonomic function, after exercise stress test (EST) in males with or without erectile dysfunction (ED), and we investigated the relationship between HRR and CHIND and serum steroid hormone levels. Material and Methods: A total of 135 participants (mean age: 45.0 ± 11.8 years) were enrolled into the study. Detailed biochemical and hormonal analyses, 12-lead electrocardiography and EST (Treadmill) were performed in all participants. Erectile function was assessed using the International Index of Erectile Function (IIEF) questionnaire form. Patients were categorized into two groups according to their IIEF scores as ED (+) (IIEF < 26) and ED (,) (IIEF , 26). Afterward, statistical analyses were performed to evaluate the correlations between ED and HRR and CHIND. Results: A total of 65 patients were ED (+) (mean age 44.9 ± 6.4 years), while 70 patients (mean age 43.7 ± 7.7 years) had normal erectile status. There were statistically significant differences in CHIND (P = 0.015) and HRR time (P = 0.037) between ED (+) and ED (,) patients. In correlation analysis, IIEF score was found positively correlated with HRR and metabolic equivalent (MET) values (rHRR= 0.293, P = 0.037; rMETs= 0.388, P = 0.011, respectively). Linear regression analysis revealed that METs value and total exercise time had a more linear relationship with IIEF score compared to the other EST parameters (pMETs= 0.002 and pTET= 0.015, respectively). Conclusion: Chronotropic incompetence and dynamic postexercise autonomic dysfunction are present in ED patients. This condition may reflect decreased functional capacity and exercise intolerance in these patients. Ann Noninvasive Electrocardiol 2010;15(3):223,229 [source] A review of enhanced external counterpulsation clinical trialsCLINICAL CARDIOLOGY, Issue S2 2002George A. Beller M.D., MACC Chief Abstract A variety of clinical trials of enhanced external counterpulsation (EECP) have been conducted since the 1960s. The vast majority of these studies have investigated the use of EECP in patients with angina pectoris. Only one of these trials was randomized. These clinical trials have demonstrated the benefits of EECP in terms of reduction in anginal episodes, increased exercise times, and improvement in health-related quality of life scores. The International EECP Patient Registry, through its phase I and II enrollment, is expanding the data set on outcomes after EECP treatment. [source] | ||||||||||