Is there a beneficial effect difference between age, gender, and different cardiac pathology groups of exercise training at ventilatory threshold in cardiac patients?

Background: Research on cardiac rehabilitation has raised interesting methods and effects without however establishing the share of the profits according to age, sex and cardiac pathology. Yet today, this disease with various pathologies strikes people of all ages and both sexes, and the recommended rehabilitation exercise intensity is often the ventilatory threshold. The aim of this study was to compare benefits of a training program at ventilatory threshold according to age, gender and cardiac pathology. Methods: One hundred and eighty eight cardiac patients, of whom 62 had coronary artery bypass surgery, 22 artery angioplasty, 54 myocardial infarction and 50 valve replacements, aged 31–82 years, performed spirometric and cardiopulmonary exercise tests before and after a training program. This program consisted of exercise on a cycloergometer for three sessions of 45 min per week for eight weeks at heart rates attenuated at ventilatory threshold (VTh) obtained during a cardiopulmonary exercise test conducted before the training period. Results: Peak heart rate, peak aerobic power, and peak oxygen uptake determined at VTh increased during the training period in all groups of subjects. Men and adult groups had higher absolute values compared to women and elderly groups. No difference was observed in cardiac pathology groups. Similar improvements of aerobic capacities were observed in age, gender and cardiac pathology groups. Conclusions: A training program conducted at personalised VTh significantly improves the aerobic physical capacities of all cardiac patients, and inducessimilar benefits whatever the age, gender or cardiac pathology. (Cardiol J 2011; 18, 6: 632–638

Effects of Walking Football During Ramadan Fasting on Heart Rate Variability and Physical Fitness in Healthy Middle-Aged Males

This study aimed to investigate the effect of a walking football (WF) program during Ramadan fasting (RF) on heart rate variability (HRV) indices, body composition, and physical fitness in middle-aged males. Thirty-one healthy sedentary men were randomized to WF ( n = 18) and control ( n = 13) groups. Both groups participated in RF. The WF group were involved in a training program (small-sided games) of three sessions a week during RF. The time and frequency domains of HRV, body composition, handgrip, lumbar strength, Modified Agility Test (MAT), and 6-minute walk test (6MWT) were measured before Ramadan (BR), during Ramadan (DR), and after Ramadan (AR). We reported that RF has significantly altered some parameters of HRV DR; the mean HR decreased while the mean RR, LF, and HF increased. WF had a significant effect on HRV and mean HR DR compared with BR and AR decreased while mean RR, HF and LF increased. DR, body mass decreased in both groups, while body mass index (BMI) decreased and lean mass increased only in WF group. Lower body mass and BMI levels were reported AR only in WF group. Physical capacity improved AR, compared with BR, only in the WF group with longer distance in 6MWT, shorter time(s) in MAT, and higher lumbar strength levels. We conclude that RF increases parasympathetic system activity. WF practice during RF is safe and might improve body composition, physical fitness, autonomic cardiac function, and physical fitness in middle-aged males

Mechanism of Dyspnea during Exercise in Children with Corrected Congenital Heart Disease

This study will evaluate cardiorespiratory and peripheral muscle function and their relationship with subjective dyspnea threshold after the surgical correction of congenital heart disease in children. Thirteen children with surgically repaired congenital heart disease were recruited. Each participant performed an incremental exercise test on a cycle ergometer until exhaustion. Gas exchanges were continuously sampled to measure the maximal aerobic parameters and ventilatory thresholds. The functional capacity of the subjects was assessed with a 6 min walk test. At the end of the exercise test, isokinetic Cybex Norm was used to evaluate the strength and endurance of the knee extensor muscle in the leg. Dyspnea was subjectively scored with a visual analog scale during the last 15 s of each exercise step. Oxygen consumption measured at the dyspnea score/VO2 relationship located at the dyspnea threshold, at which dyspnea suddenly increased. Results: The maximal and submaximal values of the parameters describing the exercise and the peripheral muscular performances were: VO2 Peak: 33.8 ± 8.9 mL·min−1·kg−1; HR: 174 ± 9 b·min−1; VEmax: 65.68 ± 15.9 L·min−1; P max: 117 ± 27 W; maximal voluntary isometric force MVIF: 120.8 ± 41.9 N/m; and time to exhaustion Tlim: 53 ± 21 s. Oxygen consumption measured at the dyspnea threshold was related to VO2 Peak (R2 = 0.74; p < 0.01), Tlim (R2 = 0.78; p < 0.01), and the distance achieved during the 6MWT (R2 = 0.57; p < 0.05). Compared to the theoretical maximal values for the power output, VO2, and HR, the surgical correction did not repair the exercise performance. After the surgical correction of congenital heart disease, exercise performance was impeded by alterations of the cardiorespiratory function and peripheral local factors. A subjective evaluation of the dyspnea threshold is a reliable criterion that allows the prediction of exercise capacity in subjects suffering from congenital heart disease

Contraintes ventilatoires à l'exercice chez l'obèse (effets de l'entraînement)

Les principales complications respiratoires de l obésité sont une demande accrue de ventilation, une augmentation du travail respiratoire, l inefficacité des muscles respiratoires et une diminution de la compliance respiratoire. Ces personnes présentent également une aggravation de la dyspnée et une diminution de la capacité d effort, éléments essentiels à la qualité de vie. Notre étude montre une que l exercice physique induit l installation de contraintes ventilatoires caractérisé par une augmentation du travail respiratoire, diminution de la force des muscles inspiratoires, altération de la performance des muscles inspiratoire, une dyspnée d effort et une distension pulmonaire dynamique à l exercice physique. Ces résultats sont donc en faveur de l existence d un cercle vicieux du déconditionnement chez ces sujets et ce d autant plus que leur activité physique était corrélé à leur tolérance à l effort. Ces observations justifient ainsi la prescription d un réentraînement pour améliorer la tolérance à l effort et la qualité de vie des sujets obèses. Nous avons montrés que le réentraînement à l effort améliore la tolérance à l effort, la performance des muscles inspiratoires et diminue la dyspnée d effort. En conclusion, les sujets obèses présentent des contraintes ventilatoires à l exercice constituant un facteur limitant à l exercice, le réentraînement à l effort chez les obèses constitue un traitement pertinent pour améliorer la tolérance à l effort et la qualité de vie des sujets obèses et permettre ainsi de freiner l évolution de la maladie vers l invalidité et le handicap psychosocialThe major respiratory complications of obesity include a heightened demand for ventilation, elevated work of breathing, respiratory muscle inefficiency and diminished respiratory compliance. Obese patients have increased dyspnoea and decreased exercise capacity, which are vital to quality of life. Our study shows that physical exercise is accompanied by an increased work of breathing, weakness of the inspiratory muscles, alteration of the inspiratory muscle performance, dyspnea of and a dynamic hyperinflation. Thus, these results are in favor of the existence of a vicious circle of deconditioning in these subjects and particularly as their physical activity were correlated with their exercise tolerance. These observations justify the prescription of endurance training to obese subjects to improve the exercise tolerance and the quality of life. Our results demonstrate that training improves exercise tolerance, performance of the inspiratory muscles and decrease dyspnoea. In conclusion, the obese subject present ventilatory constraints during exercise constituting a limitant factor to exercise, training improve exercise tolerance and the quality of life inducing a possible slow down to the evolution of the disease towards disability and psychosocial handicap in obese subjectsAMIENS-BU Lettres (800212104) / SudocSudocFranceF

Relationship between Electromyogram Spectrum Parameters and the Tension-Time Index during Incremental Exercise in Trained Subjects

International audienceThe inspiratory muscle tension-time index TT0.1 (given by P0.1/PI-max x TI/TTOT) could be used to reliably assess inspiratory muscle activity during exercise. So far, the correlation between the TT0.1 and diaphragmatic activity has not been measured and the TT0.1 has not been compared with other measurements of the inspiratory muscle load such as the transdiaphragmatic pressure index or TTdi. In this study we hypothesize that the TT0.1 measuring the mouth is a noninvasive reflection of the electromyographic activity of the diaphragm. We simultaneously measured TT0.1 and surface EMG (SEMG) of 8 trained subjects at rest and during incremental exercise. The curvature of TT0.1 and the root mean square (RMS) follow the same trend during the incremental exercise with a significant correlation between TT0.1 and surface EMG parameters (RMS; r = 0.81 p < 0.001 and MPF; r = 0.80 p < 0.001 respectively). We conclude that TT0.1 measured as s an adequate noninvasive method reflects the diaphragmatic activity during incremental exercise in healthy subjects. \textcopyright Journal of Sports Science and Medicine (2018)

Effect of Six-Minute Walk Test and Incremental Exercise on Inspiratory Capacity, Ventilatory Constraints, Breathlessness and Exercise Performance in Sedentary Male Smokers without Airway Obstruction

We investigated physiological responses and exercise capacity in sedentary young smokers during sub-maximal and maximal test and its impact on dyspnea and exercise intolerance. Fifty sedentary male smokers and non-smokers (age: 24 ± 1 years., weight: 71 ± 9 kg, height: 177.3 ± 4.8 cm, body mass index: 22.6 ± 2.5 kg/m2) underwent two visits with pulmonary function tests, breathing pattern, and inspiratory capacity measurement at rest and during sub-maximal and maximal exercise. Smokers show reduced exercise capacity during six minutes walk test (6-MWT) with decreased walked distance (p < 0.001) and inspiratory capacity (p < 0.05). During cardiopulmonary exercise test (CPET), smokers had higher minute ventilation VE for a given submaximal intensity (p < 0.05) and lower minute ventilation at maximal exercise (p < 0.001). End expiratory lung volume was significantly lower in sedentary smokers at rest (p < 0.05), at ventilatory threshold during exercise (p < 0.05), but not during peak exercise. End inspiratory lung volume was significantly lower in smokers at rest (p < 0.05) and ventilatory threshold (p < 0.05). Cigarette smoking alters lung function during submaximal and maximal exercise. This alteration is manifested by the development of dynamic hyperinflation contributing to exercise capacity limitation

Impact of Urinary Incontinence on Physical Function and Respiratory Muscle Strength in Incontinent Women: A Comparative Study between Urinary Incontinent and Apparently Healthy Women

Patients with stress urinary incontinence (SUI) may be afraid to increase intra-abdominal pressure to avoid incontinence. This could lead to weak expiratory muscles. The aim of this study was to investigate the association between respiratory muscle strength, physical function, and SUI in patients with SUI. A cross-sectional study was conducted in the Physical Medicine and Functional Rehabilitation Department. Thirty-one incontinent women (IG) and twenty-nine women in a control group (CG) were enrolled in this study. Anthropometric data, respiratory muscle strength (maximal inspiratory pressure; maximal expiratory pressure), SUI (Urogenital Distress Inventory-6; Incontinence Impact Questionnaire-7; Pad test), and physical function (waist circumference; timed-up-and-go test; abdominal muscle strength) were assessed. Body fat, body mass index, body weight, and waist circumference were higher in IG than CG (p < 0.01), while postural gait and abdominal muscles were lower (p < 0.001). Respiratory muscle strength displayed moderate correlations with SUI severity, especially for maximal expiratory pressure (p < 0.01). Maximal expiratory pressure was moderately associated with physical function. Deterioration in respiratory muscle strength is a characteristic of women with SUI. In this population, pelvic floor muscle training may be prescribed to improve continence. By feeling more confident about increasing intra-abdominal pressure, women with SUI would strengthen their expiratory muscles and eventually improve their physical function

Impact of Urinary Incontinence on Physical Function and Respiratory Muscle Strength in Incontinent Women : A Comparative Study between Urinary Incontinent and Apparently Healthy Women

Patients with stress urinary incontinence (SUI) may be afraid to increase intra-abdominal pressure to avoid incontinence. This could lead to weak expiratory muscles. The aim of this study was to investigate the association between respiratory muscle strength, physical function, and SUI in patients with SUI. A cross-sectional study was conducted in the Physical Medicine and Functional Rehabilitation Department. Thirty-one incontinent women (IG) and twenty-nine women in a control group (CG) were enrolled in this study. Anthropometric data, respiratory muscle strength (maximal inspiratory pressure; maximal expiratory pressure), SUI (Urogenital Distress Inventory-6; Incontinence Impact Questionnaire-7; Pad test), and physical function (waist circumference; timed-up-and-go test; abdominal muscle strength) were assessed. Body fat, body mass index, body weight, and waist circumference were higher in IG than CG (p < 0.01), while postural gait and abdominal muscles were lower (p < 0.001). Respiratory muscle strength displayed moderate correlations with SUI severity, especially for maximal expiratory pressure (p < 0.01). Maximal expiratory pressure was moderately associated with physical function. Deterioration in respiratory muscle strength is a characteristic of women with SUI. In this population, pelvic floor muscle training may be prescribed to improve continence. By feeling more confident about increasing intra-abdominal pressure, women with SUI would strengthen their expiratory muscles and eventually improve their physical function.peerReviewe