Resistance exercise training restores bone mineral density in heart transplant recipients

AbstractObjectives. This was a prospective, randomized, controlled study designed to determine the effect of resistance exercise traning on bone metabolism in heart transplant recipients.Background. Osteoporosis frequently complicates heart transplantation. No preventative strategy is generally accepted for glucocorticoid-induced bone loss.Methods. Sixteen male heart transplant recipients were randomly assigned to a resistance exercise group that trained for 6 months (mean [±SD] age 56 ± 6 years) or a control group (mean age 52 ± 10 years) that did not perform resistance exercise. Bone mineral density (BMD) of the total body, femur neck and lumbar spine (L2 to L3) was measured by dual-energy X-ray absorptiometry before and 2 months after transplantation and after 3 and 6 months of resistance exercise or a control period. The exercise regimen consisted of lumbar extension exercise (MedX) performed 1 day/week and variable resistance exercises (Nautilus) performed 2 days/week. Each exercise consisted of one set of 10 to 15 repetitions performed to volitional fatigue.Results. Pretransplantation baseline values for regional BMD did not differ in the control and training groups. Bone mineral density of the total body, femur neck and lumbar vertebra (L2 to L3) were significantly decreased below baseline at 2 months after transplantation in both the control (−3.3 ± 1.3%, − 4.5 ± 2.8%, −12.7 ± 6.2%, respectly) and training groups (−2.9 ± 1.1%, 5.9 ± 3.2%, −14.8 ± 3.1%, respectively). Six months of resistance exercise restored BMD of the whole body, femur neck and lumbar vertebra to within 1%, 1.9% and 3.6% of pretransplantation levels, respectively. Bone mineral density of the control group remained unchanged from the 2-month posttransplantation levels.Conclusions. Within 2 months after heart transplantation, ≈ 3% of whole-body BMD is lost, mostly due to decreases in trabecular bone (−12% to −15% of lumbar vertebra). Six months of resistance exercise, consisting of low back exercise that isolates the lumbar spine and a regimen of variable resistance exercises, restores BMD toward pretransplantation levels. Our results suggest that resistance exercise is osteogenic and should be initiated early after heart transplantation

Exercise-induced hypoxemia in heart transplant recipient

AbstractObjectives. The purpose of this study was to determine whether heart transplantation has an adverse effect on pulmonary diffusion and to investigate the potentially deleterious effects of impaired pulmonary diffusion on arterial blood gas dynamics during exercise in heart transplant reciplents.Background. Abnormal pulmonary diffusing capacity is reported in patients after orthotopic heart transplantation. Abnormal diffusion may be caused by cyclosporlne or by the persistence of preexisting conditions known to adversely affect diffusion, such as congestive heart failure and chronic obstructive pulmonary disease.Methods. Eleven patients (mean age 50 ± 14 years) performed pulmonary function tests 3 ± 1 months before and 18 ± 12 (mean ± SD) months after heart transplantation. Transplant patients were assigned to groups with diffusion > 70% (n = 5) or diffusion < 70% of predicted values (n = 5). The control group and both subsets of patients performed 10 min of cycle exercise at 40% and 70% of peak power output. Arterial blood gases were drawn every 30 s during the 1st 5 min and at 6, 8 and 10 min.Results. Significant improvements in forced vital capacity (17,4%), forced expiratory volume in 1 s (11.7%) and diffusion capacity (6.6%) occurred in the patients; however, posttransplantation vital capacity, forced expiratory volume and diffusion were lower (p ≤ 0.05) compared with values in 11 control subjects. Changes in blood gases were similar among groups at 40% of peak power output. At 76% of peak power output, arterial blood gases and pH were significantly (p ≤ 0.05) lower in transplant patients with low diffusion (arterial oxygen pressure 15 to 38 mm Hg below baseline) than in patients with normal diffusion and control subjects. Cardiac index did not differ (p ≥0.05) between transplant patients with noramal and low diffusion at rest or during exercise. Posttransplantation mean pulmonary artery pressure was significantly related to exercise-induced hypoxemia (r = 0.71; p = 0.03).Conclusions. Abnormal pulmonary diffusion observed in patients before heart transplantation persists after transplantation with or without restrictive or obstructive ventilatory defects. Heart transplant recipients exprience exercise-induced hypoxemia when diffusion at rest is < 70% of predicted. Our data also suggest that abnormal pulmonary gas exchange possibly contributes to diminished peak oxygen consumption in some heart transplant recipients; however, direct testing of this hypothesis was beyond the scope of the present study. This possibility needs to be investigated further

Resistance exercise and bone turnover in elderly men and women

Etude de l'effet de six mois de musculation sur la densité osseuse et les marqueurs biochimiques de la vitesse de renouvellement osseux chez des adultes âgés de 60 à 83 ans

Measurement of acute dynamic anaerobic muscle fatigue using a novel fatigue resistance index

Développement d'un nouveau protocole de test de la fatigue isocinétique sur dynamomètre isocinétique : vitesse unique de 90 degrés par seconde, mode concentrique/excentrique, 35 répétitions

Moderate and High Intensity Exercise Lowers Blood Pressure in Normotensive Subjects 60 to 79 Years of Age

To investigate the effects of exercise intensity on resting blood pressure (BP) in normotensive elderly subjects, 44 sedentary healthy subjects aged 60 to 79 years of age were studied during 6 months of walking exercise. Subjects were ranked according to maximal oxygen consumption and randomly stratified to groups that trained at 70% (n = 19) or 80% to 85% (n = 14) of maximal heart rate reserve, or to a control group (n = 11) that did not train. Initial BP was established during a 2- to 3-week control period. During the first 3 months, both exercise groups progressed to 70% of heart rate reserve for 40 minutes 3 times each week. The moderate-intensity group continued to train at 70% (45-minute duration) for an additional 3 months, whereas the high-intensity group progressed to training at 85% of heart rate reserve (35-minute duration). Maximal oxygen consumption increased (p 0.05) -during the initial 3 months in both exercise groups (25.2 to 28.1 ml·kg−1·min−1 and 26.3 to 29.3 ml·kg−1·min−1) and continued to increase (p ≤ 0.05) after 3 additional months of training, but the increase was greater (p ≤ 0.05) in the high-intensity group (28.1 to 29.4 ml·kg−1·min−1 and 29.3 to 32.8 ml·kg−1·min−1). Systolic BP decreased (p ≤ 0.05) similarly at 6 months in both training groups (120 to 111 mm Hg and 120 to 112 mm Hg). Diastolic BP also decreased (p ≤ 0.05) similarly at 6 months in both training groups (72 to 64 mm Hg and 75 to 68 mm Hg). Resting heart rate decreased (p ≤ 0.05) to the same magnitude at 6 months in both training groups (71 to 66 beats/min and 69 to 63 beats/min). Body weight did not change in any group (p ≥ 0.05). The sum of 7 skinfold fat measures decreased (p ≤ 0.05) similarly at 6 months in both training groups (175 to 164 mm and 173 to 159 mm). Our data indicate that walking exercise between 70% and 85% of heart rate reserve lowers resting BP in normotensive elderly subjects, and produces a moderately favorable conditioning benefit similar to that observed in younger persons

Effect of Training on the Relationship between Maximal and Submaximal Strength

The purpose of this study was to evaluate the validity of a dynamic seven to 10 repetition maximum (7-10 RM) test to estimate maximal knee extension strength (1-RM) in untrained and trained subjects. Thirty-three men and 25 women (25 +/- 5 yr) were randomly assigned to a group that trained two or three times.wk-1 for 18 wk (N = 47) or a control group (N = 11). Training included one set of 7-10 repetitions to volitional fatigue on a Nautilus knee extension machine. Prior to (T1) and after training (T2) dynamic strength was evaluated by 1-RM and 7-10 RM tests. The 7-10 RM test consisted of one set of variable resistance knee extension exercise performed to volitional fatigue with a weight that allowed 7-10 repetitions. The training group improved their 1-RM and 7-10 RM strength (by 31.7 and 51.4%, respectively) (P \u3c or = 0.01) while the control group did not change. Training increased relative 7-10 RM strength (68.4% of 1-RM at T1 and 79.1% of 1-RM at T2) (P \u3c or = 0.01). The relationship between the 7-10 RM weight and 1-RM at T1 was linear: 1-RM = 1.554 (7-10 RM weight)-5.181; R2 = 0.89; SEE = 9.3 kg. Application of this equation following training resulted in a systematic overprediction (p \u3c or = 0.01) of 1-RM (21.2 kg) in trained subjects.(ABSTRACT TRUNCATED AT 250 WORDS