Physical Fitness and Self-Image: An Evaluation of the Exercise Self-Schema Questionnaire Using Direct Measures of Physical Fitness

International Journal of Exercise Science 9(4): 445-459, 2016. The purpose of this study was to perform a construct validity assessment of Kendzierski’s exercise self-schema theory questionnaire using objective measures of health-related physical fitness. This study tested the hypothesis that individuals with an exercise self-schema would possess significantly greater physical fitness than those who did not across three domains of health-related physical fitness: Body composition, cardiovascular fitness, and upper-body muscular endurance. Undergraduate student participants from one private university on the west coast of the United States completed informed consent forms and the exercise self-schema questionnaire within a classroom setting or at an on-campus outside tabling session. Participants not meeting inclusion criteria for Kendzierski’s three original schema groups were categorized as “unschematic,” and were included within MANCOVA/ANCOVA analyses, where gender served as the covariate. Participants underwent lab-based fitness assessments administered in accordance with the 2013 American College of Sports Medicine Guidelines for Exercise Testing and Prescription. The hypothesis of this study was partially supported. Specifically, exerciser schematics were significantly leaner than aschematics (p = .002) and they had greater levels of upper-body muscular endurance compared to both aschematic and nonexerciser schematics (p = .002). However, no differences were observed for cardiovascular fitness (i.e., predicted V02Max p = .410). The findings of this study help to establish the construct validity of Kendizerski’s self-report exercise self-schema categorization scheme. Visual inspection of the data, as well as computed effect size measures suggest exercise self-schema is associated with dimensions of one’s physical fitness

Chronotropic Intolerance: An Overlooked Determinant of Symptoms and Activity Limitation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?

Post-exertional malaise (PEM) is the hallmark clinical feature of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). PEM involves a constellation of substantially disabling signs and symptoms that occur in response to physical, mental, emotional, and spiritual over-exertion. Because PEM occurs in response to over-exertion, physiological measurements obtained during standardized exertional paradigms hold promise to contribute greatly to our understanding of the cardiovascular, pulmonary, and metabolic states underlying PEM. In turn, information from standardized exertional paradigms can inform patho-etiologic studies and analeptic management strategies in people with ME/CFS. Several studies have been published that describe physiologic responses to exercise in people with ME/CFS, using maximal cardiopulmonary testing (CPET) as a standardized physiologic stressor. In both non-disabled people and people with a wide range of health conditions, the relationship between exercise heart rate (HR) and exercise workload during maximal CPET are repeatable and demonstrate a positive linear relationship. However, smaller or reduced increases in heart rate during CPET are consistently observed in ME/CFS. This blunted rise in heart rate is called chronotropic intolerance (CI). CI reflects an inability to appropriately increase cardiac output because of smaller than expected increases in heart rate. The purposes of this review are to (1) define CI and discuss its applications to clinical populations; (2) summarize existing data regarding heart rate responses to exercise obtained during maximal CPET in people with ME/CFS that have been published in the peer-reviewed literature through systematic review and meta-analysis; and (3) discuss how trends related to CI in ME/CFS observed in the literature should influence future patho-etiological research designs and clinical practice

Cardiopulmonary Exercise Test Methodology for Assessing Exertion Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Background: Concise methodological directions for administration of serial cardiopulmonary exercise testing (CPET) are needed for testing of patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Maximal CPET is used to evaluate the coordinated metabolic, muscular, respiratory and cardiac contributions to energy production in patients with ME/CFS. In this patient population, CPET also elicits a robust post-exertional symptom flare (termed, post-exertional malaise); a cardinal symptom of the disease. CPET measures are highly reliable and reproducible in both healthy and diseased populations. However, evidence to date indicates that ME/CFS patients are uniquely unable to reproduce CPET measures during a second test, despite giving maximal effort during both tests, due to the effects of PEM on energy production.Methodology: To document and assess functional impairment due to the effects of post-exertional malaise in ME/CFS, a 2-day CPET procedure (2-day CPET) has been used to first measure baseline functional capacity (CPET1) and provoke post-exertional malaise, then assess changes in CPET variables 24 h later with a second CPET to assess the effects of post-exertional malaise on functional capacity. The second CPET measures changes in energy production and physiological function, objectively documenting the effects of post-exertional malaise. Use of CPET as a standardized stressor to induce post-exertional malaise and quantify impairment associated with post-exertional malaise has been employed to examine ME/CFS pathology in several studies. This article discusses the results of those studies, as well as the standardized techniques and procedures for use of the 2-day CPET in ME/CFS patients, and potentially other fatiguing illnesses.Conclusions: Basic concepts of CPET are summarized, and special considerations for performing CPET on ME/CFS patients are detailed to ensure a valid outcome. The 2-day CPET methodology is outlined, and the utility of the procedure is discussed for assessment of functional capacity and exertion intolerance in ME/CFS

Alzheimer’s Therapy Aide: Golden Haven Assisted Living for Elderly

My IGNITE project gave me the opportunity to shadow Dr. Rowena Ramirez and her staff at Golden Haven. Golden Haven is an Alzheimer\u27s assisted living that allows families whose loved ones diagnosed with Alzheimer\u27s seek treatment and specialized care with the help of nurses, physical and occupational therapists, psychiatrists, and other medical help. Through this opportunity I learned how to diagnose the stages of Alzheimer\u27s along with the psychological components that may effect a patient with the disease

Alzheimer’s Therapy Aide: Golden Haven Assisted Living for Elderly

My IGNITE project gave me the opportunity to shadow Dr. Rowena Ramirez and her staff at Golden Haven. Golden Haven is an Alzheimer\u27s assisted living that allows families whose loved ones diagnosed with Alzheimer\u27s seek treatment and specialized care with the help of nurses, physical and occupational therapists, psychiatrists, and other medical help. Through this opportunity I learned how to diagnose the stages of Alzheimer\u27s along with the psychological components that may effect a patient with the disease

Diminished Ventilatory Responses During Post-Exertional Malaise Contributes to Exercise Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Reduced functional capacity and post-exertional malaise following physical activity are hallmark symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The mechanisms producing exercise intolerance in the post-exertional state have not been adequately described. Purpose: To compare the ventilatory response to repeated exercise stress in control and ME/CFS subjects. Methods: 40 female subjects were recruited for the study, 20 ME/CFS patients and 20 age and weight matched controls. All underwent two maximal exercise tests 24 hours apart. Oxygen consumption, ventilation (VE), tidal volume (TV), respiratory rate (RR), end-tidal oxygen and carbon dioxide (ET02/ETCO2) were measured at rest, at the anaerobic threshold, and at maximal exercise. Multivariate analysis was performed for group (ME/CFS vs control), test (exercise test 1 vs test 2), and condition (rest vs anaerobic threshold vs maximal exertion) with univariate follow up. Results: 15 ME/CFS subjects and 18 control subject reached criteria for maximal effort. The overall multivariate was significant for group and condition. Follow up univariate and post-hoc showed VO2, VE and TV were lower in the ME/CFS group only on exercise test 2. Post hoc for condition was significant for ventilation at maximal exercise only. Respiratory rate, ETO2, and ETCO2 were not different between tests or groups. Conclusion: In the absence of a second exercise test, the lack of any significant differences for the first test would appear to suggest no functional impairment in ME/CFS patients. However, the results from the second test indicate the presence of exercise intolerance and post-exertional malaise. Diminished ventilatory responses accompany reductions in work output and oxygen consumption during post exertional malaise

Diminished Ventilatory Responses During Post-Exertional Malaise Contributes to Exercise Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Reduced functional capacity and post-exertional malaise following physical activity are hallmark symptoms of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). The mechanisms producing exercise intolerance in the post-exertional state have not been adequately described. Purpose: To compare the ventilatory response to repeated exercise stress in control and ME/CFS subjects. Methods: 40 female subjects were recruited for the study, 20 ME/CFS patients and 20 age and weight matched controls. All underwent two maximal exercise tests 24 hours apart. Oxygen consumption, ventilation (VE), tidal volume (TV), respiratory rate (RR), end-tidal oxygen and carbon dioxide (ET02/ETCO2) were measured at rest, at the anaerobic threshold, and at maximal exercise. Multivariate analysis was performed for group (ME/CFS vs control), test (exercise test 1 vs test 2), and condition (rest vs anaerobic threshold vs maximal exertion) with univariate follow up. Results: 15 ME/CFS subjects and 18 control subject reached criteria for maximal effort. The overall multivariate was significant for group and condition. Follow up univariate and post-hoc showed VO2, VE and TV were lower in the ME/CFS group only on exercise test 2. Post hoc for condition was significant for ventilation at maximal exercise only. Respiratory rate, ETO2, and ETCO2 were not different between tests or groups. Conclusion: In the absence of a second exercise test, the lack of any significant differences for the first test would appear to suggest no functional impairment in ME/CFS patients. However, the results from the second test indicate the presence of exercise intolerance and post-exertional malaise. Diminished ventilatory responses accompany reductions in work output and oxygen consumption during post exertional malaise

Blood lactate and metabolic responses to controlled frequency breathing during graded swimming

Controlled frequency breathing (CFB) is a training technique used by swimmers in an effort to simulate high-intensity workloads by limiting oxygen availability to the body and stimulating anaerobic metabolism. During CFB, a swimmer voluntarily restricts breathing, which, theoretically, limits oxygen availability and stimulates anaerobic metabolism. The purpose of this study was to determine the influence of CFB on blood lactate and metabolic responses during graded increases in swimming intensity. A free swimming (FS) protocol was used to determine blood lactate and heart rate (HR) responses to CFB, while a tethered swimming (TS) protocol was used to determine blood lactate, HR, and ventilatory responses to CFB. The subjects swam four 3-minute trials at workloads of 55, 65, 75, and 85% of peak intensity during both protocols. A total of 46 competitive collegiate swimmers participated in the study. Thirty-four subjects (14 men and 20 women) completed the FS protocol, and 12 subjects (7 men and 5 women) completed the TS protocol. CFB reduced ventilation and VO2 (p \u3c 0.05) during the TS protocol and reduced HR (p \u3c 0.05) during the FS protocol when compared to normal breathing. However, CFB did not alter blood lactate concentrations for either protocol (p \u3e 0.05). Our findings demonstrate that although CFB does not alter the blood lactate response to graded increases in swimming intensity, it appears to reduce the ventilatory and HR responses to exercise. Thus, swim coaches can use CFB at moderate intensities to simulate high-intensity training but should consider adjusting HR training zones to reflect the reduction in HR associated with reduced ventilation

Cardiopulmonary exercise test methodology for assessing exertion intolerance in myalgic encephalomyelitis/chronic fatigue syndrome

Background: Concise methodological directions for administration of serial cardiopulmonary exercise testing (CPET) are needed for testing of patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Maximal CPET is used to evaluate the coordinated metabolic, muscular, respiratory and cardiac contributions to energy production in patients with ME/CFS. In this patient population, CPET also elicits a robust post-exertional symptom flare (termed, post-exertional malaise); a cardinal symptom of the disease. CPET measures are highly reliable and reproducible in both healthy and diseased populations. However, evidence to date indicates that ME/CFS patients are uniquely unable to reproduce CPET measures during a second test, despite giving maximal effort during both tests, due to the effects of PEM on energy production. Methodology: To document and assess functional impairment due to the effects of post-exertional malaise in ME/CFS, a 2-day CPET procedure (2-day CPET) has been used to first measure baseline functional capacity (CPET1) and provoke post-exertional malaise, then assess changes in CPET variables 24 h later with a second CPET to assess the effects of post-exertional malaise on functional capacity. The second CPET measures changes in energy production and physiological function, objectively documenting the effects of post-exertional malaise. Use of CPET as a standardized stressor to induce post-exertional malaise and quantify impairment associated with post-exertional malaise has been employed to examine ME/CFS pathology in several studies. This article discusses the results of those studies, as well as the standardized techniques and procedures for use of the 2-day CPET in ME/CFS patients, and potentially other fatiguing illnesses. Conclusions: Basic concepts of CPET are summarized, and special considerations for performing CPET on ME/CFS patients are detailed to ensure a valid outcome. The 2-day CPET methodology is outlined, and the utility of the procedure is discussed for assessment of functional capacity and exertion intolerance in ME/CFS

Discriminative validity of metabolic and workload measurements for identifying people with chronic fatigue syndrome

Background: Reduced functional capacity and postexertion fatigue after physical activity are hallmark symptoms of chronic fatigue syndrome (CFS) and may even qualify for biomarker status. That these symptoms are often delayed may explain the equivocal results for clinical cardiopulmonary exercise testing in people with CFS. Test reproducibility in people who are healthy is well documented. Test reproducibility may not be achievable in people with CFS because of delayed symptoms. OBJECTIVE: The objective of this study was to determine the discriminative validity of objective measurements obtained during cardiopulmonary exercise testing to distinguish participants with CFS from participants who did not have a disability but were sedentary. DESIGN: A prospective cohort study was conducted. METHODS: Gas exchange data, workloads, and related physiological parameters were compared in 51 participants with CFS and 10 control participants, all women, for 2 maximal exercise tests separated by 24 hours. RESULTS: Multivariate analysis showed no significant differences between control participants and participants with CFS for test 1. However, for test 2, participants with CFS achieved significantly lower values for oxygen consumption and workload at peak exercise and at the ventilatory or anaerobic threshold. Follow-up classification analysis differentiated between groups with an overall accuracy of 95.1%. LIMITATIONS: Only individuals with CFS who were able to undergo exercise testing were included in this study. Individuals who were unable to meet the criteria for maximal effort during both tests, were unable to complete the 2-day protocol, or displayed overt cardiovascular abnormalities were excluded from the analysis. CONCLUSIONS: The lack of any significant differences between groups for the first exercise test would appear to support a deconditioning hypothesis for CFS symptoms. However, the results from the second test indicated the presence of CFS-related postexertion fatigue. It might be concluded that a single exercise test is insufficient to reliably demonstrate functional impairment in people with CFS. A second test might be necessary to document the atypical recovery response and protracted fatigue possibly unique to CFS, which can severely limit productivity in the home and workplace