scholarly journals Metabolic Equivalents of Safe Physical Activity Levels at Anaerobic Threshold in Anorexia Nervosa Patients

2021 ◽  
Author(s):  
Yamashita Makoto ◽  
Kawai Keisuke ◽  
Toda Kenta ◽  
Aso Suzuyama Chie ◽  
Suematsu Takafumi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Rate ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Anaerobic Threshold ◽  
Exercise Tolerance ◽  
Treatment Guidelines ◽  
Cardiopulmonary Exercise Testing ◽  
Level Of Evidence ◽  
Metabolic Equivalents

Abstract Purpose Patients with anorexia nervosa (AN) require appropriate nutrient therapy and physical activity management. Eating disorder treatment guidelines do not include safe, evidence-based intensity criteria for exercise. This study used cardiopulmonary exercise testing (CPX) to evaluate the exercise tolerance of patients with AN and develop treatment guidelines to optimize their physical activity. Methods CPX was done with 14 female AN patients admitted to a specialized eating disorder unit between 2015 and 2019. Their anaerobic threshold (AT) was determined by assessing their exercise tolerance using CPX and compared with 14 healthy controls (HC). The metabolic equivalents (AT-METS) were compared when AT was reached. We examined factors related to AT (AN-AT) in the AN group, including age, body mass index (BMI), previous lowest weight, minimum BMI, past duration of BMI < 15, exercise history, and ΔHR (heart rate at the AT - resting heart rate). Results The AT of the AN group (BMI: 15.7 [Mean] ± 1.8 [SD]) was significantly lower than the HC group (BMI: 19.7 ± 1.8) (AN: 10.0 ± 1.8 vs HC: 15.2 ± 3.0 ml/kg/min, P<0.001). AT-METS was also significantly lower in the AN than the HC group (AN: 2.9 ± 0.52 vs HC: 4.4 ± 0.91, P<0.001). AN-AT was highly influenced by ΔHR. Conclusion The AT-METS level for these AN patients was 2.5-3.3 METS, and this index can be used by clinicians to teach AN patients a safe exercise intensity. CPX and AT-METS are useful tools for clinicians to manage physical activity in AN patients. Level of evidence III: Evidence obtained from case-control analytic studies

scholarly journals Can wearable technology be used to approximate cardiopulmonary exercise testing metrics?

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Laura Jones ◽  
Laura Tan ◽  
Suzanne Carey-Jones ◽  
Nathan Riddell ◽  
Richard Davies ◽  
...  
Keyword(s):  
Physical Activity ◽  
High Risk ◽  
Oxygen Uptake ◽  
Anaerobic Threshold ◽  
Exercise Testing ◽  
Low Cost ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Wearable Device ◽  
Cardiopulmonary Exercise

Abstract Background Consumer wrist-worn wearable activity monitors are widely available, low cost and are able to provide a direct measurement of several markers of physical activity. Despite this, there is limited data on their use in perioperative risk prediction. We explored whether these wearables could accurately approximate metrics (anaerobic threshold, peak oxygen uptake and peak work) derived using formalised cardiopulmonary exercise testing (CPET) in patients undergoing high-risk surgery. Methods Patients scheduled for major elective intra-abdominal surgery and undergoing CPET were included. Physical activity levels were estimated through direct measures (step count, floors climbed and total distance travelled) obtained through continuous wear of a wrist worn activity monitor (Garmin Vivosmart HR+) for 7 days prior to surgery and self-report through completion of the short International Physical Activity Questionnaire (IPAQ). Correlations and receiver operating characteristic (ROC) curve analysis explored the relationships between parameters provided by CPET and physical activity. Device selection Our choice of consumer wearable device was made to maximise feasibility outcomes for this study. The Garmin Vivosmart HR+ had the longest battery life and best waterproof characteristics of the available low-cost devices. Results Of 55 patients invited to participate, 49 (mean age 65.3 ± 13.6 years; 32 males) were enrolled; 37 provided complete wearable data for analyses and 36 patients provided full IPAQ data. Floors climbed, total steps and total travelled as measured by the wearable device all showed moderate correlation with CPET parameters of peak oxygen uptake (peak VO2) (R = 0.57 (CI 0.29–0.76), R = 0.59 (CI 0.31–0.77) and R = 0.62 (CI 0.35–0.79) respectively), anaerobic threshold (R = 0.37 (CI 0.01–0.64), R = 0.39 (CI 0.04–0.66) and R = 0.42 (CI 0.07–0.68) respectively) and peak work (R = 0.56 (CI 0.27–0.75), R = 0.48 (CI 0.17–0.70) and R = 0.50 (CI 0.2–0.72) respectively). Receiver operator curve (ROC) analysis for direct and self-reported measures of 7-day physical activity could accurately approximate the ventilatory equivalent for carbon dioxide (VE/VCO2) and the anaerobic threshold. The area under these curves was 0.89 for VE/VCO2 and 0.91 for the anaerobic threshold. For peak VO2 and peak work, models fitted using just the wearable data were 0.93 for peak VO2 and 1.00 for peak work. Conclusions Data recorded by the wearable device was able to consistently approximate CPET results, both with and without the addition of patient reported activity measures via IPAQ scores. This highlights the potential utility of wearable devices in formal assessment of physical functioning and suggests they could play a larger role in pre-operative risk assessment. Ethics This study entitled “uSing wearable TEchnology to Predict perioperative high-riSk patient outcomes (STEPS)” gained favourable ethical opinion on 24 January 2017 from the Welsh Research Ethics Committee 3 reference number 17/WA/0006. It was registered on ClinicalTrials.gov with identifier NCT03328039.

scholarly journals Autonomic Nervous System Response during Light Physical Activity in Adolescents with Anorexia Nervosa Measured by Wearable Devices

Sensors ◽  
2019 ◽  
Vol 19 (12) ◽  
pp. 2820 ◽  
Author(s):  
Lucia Billeci ◽  
Alessandro Tonacci ◽  
Elena Brunori ◽  
Rossella Raso ◽  
Sara Calderoni ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Rate ◽  
Nervous System ◽  
Anorexia Nervosa ◽  
Autonomic Nervous System ◽  
System Response ◽  
Light Physical Activity ◽  
Autonomic Nervous ◽  
Wide Range ◽  
Low Energy Availability

Anorexia nervosa (AN) is associated with a wide range of disturbances of the autonomic nervous system. The aim of the present study was to monitor the heart rate (HR) and the heart rate variability (HRV) during light physical activity in a group of adolescent girls with AN and in age-matched controls using a wearable, minimally obtrusive device. For the study, we enrolled a sample of 23 adolescents with AN and 17 controls. After performing a 12-lead electrocardiogram and echocardiography, we used a wearable device to record a one-lead electrocardiogram for 5 min at baseline for 5 min during light physical exercise (Task) and for 5 min during recovery. From the recording, we extracted HR and HRV indices. Among subjects with AN, the HR increased at task and decreased at recovery, whereas among controls it did not change between the test phases. HRV features showed a different trend between the two groups, with an increased low-to-high frequency ratio (LF/HF) in the AN group due to increased LF and decreased HF, differently from controls that, otherwise, slightly increased their standard deviation of NN intervals (SDNN) and the root mean square of successive differences (RMSSD). The response in the AN group during the task as compared to that of healthy adolescents suggests a possible sympathetic activation or parasympathetic withdrawal, differently from controls. This result could be related to the low energy availability associated to the excessive loss of fat and lean mass in subjects with AN, that could drive to autonomic imbalance even during light physical activity.

scholarly journals Can wearable technology be used to approximate cardiopulmonary exercise testing metrics?

2020 ◽  
Author(s):  
Matt Morgan ◽  
Laura Jones ◽  
Laura Tan ◽  
Suzanne Carey-Jones ◽  
Nathan Riddell ◽  
...  
Keyword(s):  
Physical Activity ◽  
High Risk ◽  
Oxygen Uptake ◽  
Anaerobic Threshold ◽  
Low Cost ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Wearable Device ◽  
Cardiopulmonary Exercise ◽  
Peak Vo2

Abstract Background Consumer wrist-worn wearable activity monitors are widely available, low cost and are able to provide a direct measurement of several markers of physical activity. Despite this, there is limited data on their use in perioperative risk prediction. We explored whether these wearables could accurately approximate metrics (anaerobic threshold, peak oxygen uptake and peak work) derived using formalised cardiopulmonary exercise testing (CPET) in patients undergoing high-risk surgery. Methods Patients scheduled for major elective intra-abdominal surgery and undergoing CPET were included. Physical activity levels were estimated through direct measures (step count, floors climbed and total distance travelled) obtained through continuous wear of a wrist worn activity monitor (Garmin Vivosmart HR+) for 7 days prior to surgery and self-report through completion of the short International Physical Activity Questionnaire (IPAQ). Correlations and receiver operating characteristic (ROC) curve analysis explored the relationships between parameters provided by CPET and physical activity. Device selection Our choice of consumer wearable device was made to maximise feasibility outcomes for this study. The Garmin Vivosmart HR+ had the longest battery life and best waterproof characteristics of the available low-cost devices. Results Of 55 patients invited to participate, 49 (mean age 65.3 ± 13.6 years; 32 male) were enrolled; 37 provided complete wearable data for analyses and 36 patients provided full IPAQ data. Floors climbed, total steps and total travelled as measured by the wearable device all showed moderate correlation with CPET parameters of peak oxygen uptake (peak VO2) (R=0.57 (CI 0.29-0.76), R=0.59 (CI 0.31-0.77) and R=0.62 (CI 0.35-0.79) respectively), anaerobic threshold (R = 0.37 (CI 0.01-0.64), R = 0.39 (CI 0.04-0.66) and R = 0.42 (CI 0.07-0.68) respectively) and peak work (R = 0.56 (CI 0.27-0.75), R = 0.48 (CI 0.17-0.70) and R = 0.50 (CI 0.2-0.72) respectively). Receiver Operator Curve (ROC) analysis for direct and self-reported measures of 7 day physical activity could accurately approximate the ventilatory equivalent for carbon dioxide (VE/VCO2) and the anaerobic threshold. The area under these curves was 0.89 for VE/VCO2 and 0.91 for the anaerobic threshold. For peak VO2 and peak work, models fitted using just the wearable data were 0.93 for peak VO2 and 1.00 for peak work. Conclusions Data recorded by the wearable device was able to consistently approximate CPET results, both with and without the addition of patient reported activity measures via IPAQ scores. This highlights the potential utility of wearable devices in formal assessment of physical functioning and suggests they could play a larger role in pre-operative risk assessment. Ethics This study entitled “uSing wearable TEchnology to Predict perioperative high-riSk patient outcomes (STEPS)” gained favourable ethical opinion on 24/1/2017 from the Welsh Research Ethics Committee 3 reference number 17/WA/0006. It was registered on ClinicalTrials.gov with identifier NCT03328039.

scholarly journals Relationship between blood pressure response during hemodialysis and exercise tolerance or heart rate recovery measured using cardio-pulmonary exercise testing in maintenance hemodialysis patients

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Hiroki Yabe ◽  
Kenichi Kono ◽  
Ryota Shiraki ◽  
Akiho Masuda ◽  
Yoshifumi Moriyama ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Uptake ◽  
Exercise Testing ◽  
Exercise Tolerance ◽  
Blood Pressure Response ◽  
Heart Rate Recovery ◽  
Cardiopulmonary Exercise Testing ◽  
Pressure Response ◽  
Exercise Intolerance

Abstract Background This study investigated the association between the blood pressure response during hemodialysis (HD) and exercise tolerance or heart rate recovery (HRR) measured with cardiopulmonary exercise testing (CPX). Methods The study enrolled 23 patients who had been undergoing 4-h regular maintenance HD. The maximum workload (Loadpeak), peak oxygen uptake (VO2peak), workload and oxygen uptake at the anaerobic threshold (LoadAT and VO2AT, respectively), and HRR were measured with CPX. The average systolic blood pressure during HD (SBPav) was measured, and the number of times the SBP was less than 100 mmHg was determined in the 2-week period after CPX. Results The SBPav showed a significant correlation with LoadAT (r = 0.46) and Loadpeak (r = 0.43, p < 0.05). The number of times the SBP was less than 100 mmHg showed a significant correlation with the HRR (r = − 0.44, p < 0.05). Conclusion Exercise intolerance and HRR in HD patients may be associated with blood pressure instability during HD.

scholarly journals Exercise for Sport-Related Concussion and Persistent Postconcussive Symptoms

2020 ◽  
pp. 194173812094601
Author(s):  
Mohammad Nadir Haider ◽  
Itai Bezherano ◽  
Alex Wertheimer ◽  
Akas H. Siddiqui ◽  
Emily C. Horn ◽  
...  
Keyword(s):  
Physical Activity ◽  
Aerobic Exercise ◽  
Exercise Tolerance ◽  
Standard Of Care ◽  
Current Standard ◽  
Level Of Evidence ◽  
Early Exercise ◽  
Postconcussive Symptoms ◽  
Specific Search ◽  
Diagnostic And Prognostic Value

Context: Emerging research supports the use of mild to moderate aerobic exercise for treating sport-related concussion (SRC) and persistent postconcussive symptoms (PPCS), yet the current standard of care remains to be strict rest. The purpose of this review is to summarize the existing literature on physical activity and prescribed exercise for SRC and PPCS. Evidence Acquisition: PubMed and Embase were searched in April of 2019 for studies assessing rest or prescribed exercise for SRC and PPCS. No specific search syntax was used. Study Design: Clinical review. Level of Evidence: Level 4. Results: A majority of studies show that spontaneous physical activity is safe after SRC and that subsymptom threshold aerobic exercise safely speeds up recovery after SRC and reduces symptoms in those with PPCS. Exercise tolerance can safely be assessed using graded exertion test protocols within days of injury, and the degree of early exercise tolerance has diagnostic and prognostic value. Conclusion: Subsymptom threshold aerobic exercise is safe and effective for the treatment of SRC as well as in athletes with PPCS. Further research is warranted to establish the most effective method and dose of aerobic exercise for the active treatment of SRC and whether early exercise treatment can prevent PPCS in athletes. Strength of Recommendation Taxonomy: 2.

Physiological Demand, Metabolic Requirements, and User-Perceived Exertion of Immersive Virtual Reality Exergaming Incorporating an Adaptive Cable Resistance System: An Exploratory Study (Preprint)

2021 ◽  
Author(s):  
Jonathan Hu ◽  
Jonathan D Browne ◽  
Michael T Arnold ◽  
Anthony Robinson ◽  
Marin F Heacock ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Rate ◽  
Virtual Reality ◽  
Energy Expenditure ◽  
Perceived Exertion ◽  
Rating Of Perceived Exertion ◽  
Immersive Virtual Reality ◽  
Metabolic Equivalents ◽  
Physiological Demand ◽  
Resistance System

BACKGROUND The intersection of games and exercise has sparked the growth of novel training systems with the potential to promote quality physical activity. Innovations in Immersive Virtual Reality (IVR) have propelled “exergaming” to the forefront of the fitness landscape. Researchers have yet to fully explore the physiological and metabolic efficacy and applications of the immersive environment and interactive programming. OBJECTIVE This study aimed to measure metabolic (i.e., energy expenditure (EE)) and physiological (i.e., heart rate (HR)) demands and subjective fatigue and enjoyment scores during a signature 30-minute IVR adaptive cable resistance exergaming session. METHODS Fourteen healthy, college-aged individuals (7 females) were initially acquainted with the equipment and acclimated to the virtual reality and gameplay dynamics. Participants then completed a signature 30-minute exergaming session using an IVR adaptive cable resistance system (Black Box VR ®) that incorporated chest press, squat, row, lat pulldown, overhead press, and stiff leg deadlift. During the session, a portable metabolic gas exchange analysis system assessed energy expenditure by indirect calorimetry and a chest-worn monitor captured heart rate. Immediately following the session, participants completed questionnaires including the Borg scale for Rating of Perceived Exertion (RPE), the Physical Activity Enjoyment Scale (PACES), and the Simulator Sickness Questionnaire (SSQ). RESULTS EE was greater in males compared to females in terms of kcal/min (P = 0.001), total kcal (P = 0.001), and metabolic equivalents (P = 0.029). Females demonstrated a higher average HR (P = 0.020) and HR as a percentage of theoretical HRmax (P = 0.018). The overall mean metabolic equivalent (MET) during the session was 12.9 (0.5). Men achieved greater volume of total weight lifted during the session (P < 0.001) and with chest press (P = 0.005), overhead press (P = 0.001), stiff-leg deadlift (P = 0.002), and squat (P = 0.015). For the questionnaires, the mean (SD) of RPE, PACES and SSQ was 14 (1), 4.31 (0.36) and 24.04 (24.13), respectively. CONCLUSIONS IVR exergaming with resistance cable training elicits substantial EE and very high physiological demand while attenuating perceived psychological and physical fatigue. Further investigations of IVR utility should explore nuanced muscle recruitment patterns during training and long-term regimen adherence.

Physical activity in anorexia nervosa: How relevant is it to therapy response?

2015 ◽  
Vol 30 (8) ◽  
pp. 924-931 ◽  
Author(s):  
S. Sauchelli ◽  
J. Arcelus ◽  
I. Sánchez ◽  
N. Riesco ◽  
S. Jiménez-Murcia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Anorexia Nervosa ◽  
Treatment Outcome ◽  
Eating Disorder ◽  
Treatment Program ◽  
Therapy Response ◽  
Hospital Treatment ◽  
Depression Symptoms ◽  
Healthy Weight ◽  
Activity Profile

AbstractObjectiveElevated physical activity has been observed in some patients with anorexia nervosa (AN) despite their emaciated condition. However, its effects on treatment outcome remain unclear. This study aimed to examine objectively measured physical activity in this clinical population and how it might be related to a partial hospitalization therapy response, after considering potential confounders.MethodThe sample comprised 88 AN patients consecutively enrolled in a day hospital treatment program, and 116 healthy-weight controls. All participants were female and a baseline assessment took place using an accelerometer (Actiwatch AW7) to measure physical activity, the Eating Disorders Inventory-2 and the Depression subscale of the Symptom Checklist-Revised. Outcome was evaluated upon the termination of the treatment program by expert clinicians.ResultsAlthough AN patients and controls did not differ in the average time spent in moderate-to-vigorous physical activity (MVPA) (P = .21), nor daytime physical activity (P = .34), fewer AN patients presented a high physical activity profile compared to the controls (37% vs. 61%, respectively; P = .014). Both lower levels of MVPA and greater eating disorder severity had a direct effect on a poor treatment outcome. Depression symptoms in the patients were associated with lower MVPA, as well as with an older age, a shorter duration of the disorder and greater eating disorder psychopathology.ConclusionsThere is a notable variation in the physical activity profile of AN patients, characterized by either low or very high patterns. Physical activity is a highly relevant issue in AN that must be taken into account during the treatment process.

Eating Disorders and Hyperactivity: A Psychobiological Perspective

1997 ◽  
Vol 42 (2) ◽  
pp. 168-175 ◽  
Author(s):  
Caroline Davis
Keyword(s):  
Physical Activity ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Field Studies ◽  
Animal Experimentation ◽  
Severe Malnutrition ◽  
Biological Factors ◽  
Eating Disordered ◽  
High Level

Objective: To review the eating disorder research investigating the psychobiological connections between self-starvation and high-level exercising, including both animal experimentation and clinical field studies. In recent years it has been proposed that physical activity plays a central role in the pathogenesis and progression of the eating disorders—in particular, anorexia nervosa. Method: A review of research from animal experimentation and from clinical field studies investigating the biological and psychological implications of physical activity and starvation in the pathogenesis of eating disorders. Results: Animal research indicates that physical activity and starvation seem to potentiate one another and that alterations in the serotonergic system may underlie this process. Similar behavioural results have been found in recent clinical studies with eating-disordered patients, which suggests that physical activity plays a more central role in the development and maintenance of the eating disorders than had previously been thought. Conclusions: The emerging picture is that psychosocial factors seem to provide the most compelling factors in the etiology and onset of the disorder, while biological factors—in most cases induced by severe malnutrition and strenuous overexercising—predominate in the maintenance of the disorder.

scholarly journals Anomalous self-experience, body image disturbance, and eating disorder symptomatology in first-onset anorexia nervosa

2021 ◽  
Author(s):  
Lorenzo Moccia ◽  
Eliana Conte ◽  
Marianna Ambrosecchia ◽  
Delfina Janiri ◽  
Salvatore Di Pietro ◽  
...  
Keyword(s):  
Body Image ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Distribution Patterns ◽  
The Body ◽  
Body Image Disturbance ◽  
Level Of Evidence ◽  
Eating Disorder Examination ◽  
First Onset ◽  
The Impact

Abstract Purpose Anorexia nervosa-restrictive subtype (AN-R) is a life-threatening disorder relying on behavioural abnormalities, such as excessive food restriction or exercise. Such abnormalities may be secondary to an “objectified” attitude toward body image and self. This is the first study exploring the impact of anomalous self-experience (ASEs) on abnormal body image attitude and eating disorder (ED) symptomatology in individuals with AN-R at onset. Methods We recruited Italian female participants, 40 with AN-R (mean age 18.3 ± 2.3) and 45 age and educational level-matched healthy controls (HCs) (mean age 18.2 ± 2.6). ASEs, body image attitude, and ED symptom severity were assessed through the examination of anomalous self-experience (EASE), the body uneasiness test (BUT), and the eating disorder examination questionnaire (EDE-Q), respectively. We conducted multivariate analysis of variance to investigate distribution patterns of variables of interest, and mediation analysis to test the effect of ASEs and body image on ED symptomatology. Results Individuals with AN-R scored higher than HCs on the EASE (p < .0001). A direct effect of ASEs on ED severity (p = 0.009; bootstrapped LLCI = 0.067, ULCI = 0.240) was found in AN-R. After modelling the effect of abnormal body image attitude, the relationship between EASE total score and ED symptomatology was significantly mediated by BUT (p = 0.002; bootstrapped LLCI = 0.001, ULCI = 0.172). Conclusion Although the exact pathways linking AN-R to self-disorder remain to be identified, a broader exploration of transdiagnostic features in AN, including explorations of different dimensions of self-experience and intersubjectivity, may shed further light on the clinical phenomenology of the disorder. Level of evidence Level III, case–control analytic study.

scholarly journals Heart rate recovery as a sensitive indicator of physical activity changes in perimenopausal and postmenopausal women

2018 ◽  
Vol 22 (2) ◽  
pp. 11-19
Author(s):  
Beata Zimak ◽  
Anna Tobiasz ◽  
Joanna Majerczak
Keyword(s):  
Physical Activity ◽  
Heart Rate ◽  
Postmenopausal Women ◽  
Exercise Test ◽  
Exercise Tolerance ◽  
Heart Rate Recovery ◽  
Sensitive Indicator ◽  
Exercise Heart Rate ◽  
Slight Reduction ◽  
Before And After

Heart rate recovery (HRR), which is defined as the rate of heart rate decline after cessation of exercise, is an important indicator of exercise tolerance. The aim of this study was to investigate the effect of a 4-month moderate reduction in physical activity on pre-exercise and exercise heart rate (HR) as well as HRR after exercise cessation in perimenopausal and postmenopausal women. 10 physically active females, 62.5±3.0 years old, participated in this study. They performed an 8-min constant power output (~50W) cycling exercise at an intensity corresponding to about 65% of maximal heart rate. Heart rate was measured continuously starting from 1 minute before exercise, during the exercise test and 3 min after exercise cessation. Furthermore, before and after exercise, blood pressure (BP) and tympanic temperature (Tt) were measured. The exercise test was performed twice, before and after a 4-month reduction in physical activity. 4 months of the slight reduction in physical activity (by ~16%) did not cause any changes in pre-exercise and exercise HR, however, significantly higher HR during the 1st min after exercise (p=0.03), as well slower HRR (p=0.03), were reported. No effects of the reduction in physical activity were observed in resting and post-exercise BP and Tt. Even a slight reduction in physical activity is accompanied by a lower rate of HRR , which indicates a decrease in exercise tolerance. These results indicate that HRR is a sensitive indicator of physical capacity also in peri- and postmenopausal women, since the changes in HRR in response to physical activity level occur earlier than changes in pre-exercise and exercise heart rate. heart rate, heart rate recovery, physical activity in the elderly

Sign in / Sign up

Export Citation Format

Share Document