scholarly journals Cardiopulmonary exercise tests of adolescent elite sport climbers—a comparison of the German junior national team in sport climbing and nordic skiing

2020 ◽  
Author(s):  
Isabelle Schöffl ◽  
Jan Wüstenfeld ◽  
Gareth Jones ◽  
Sven Dittrich ◽  
Chris Lutter ◽  
...  

Abstract Background: All the research investigating the cardiopulmonary capacity in climbers focused on predictors for climbing performance. The effects of climbing on the cardiovascular system in adolescents climbing at an elite level (national team) have not been evaluated.A retrospective analysis of the cardiopulmonary exercise test (CPET) performed on a cycle ergometer during the yearly medical examination of the entire German Junior National climbing team on one occasion and for a selected subgroup on two occasions spaced two years apart was undertaken. The data from the subgroup was compared to an age- and gender-matched control of nordic skiers from the German Junior National nordic skiing team.Results: 47 climbers (20 girls, 27 boys) were examined once. The peak oxygen consumption (B achieved by the athletes was 41.3 mL kg-1 min-1 (boys) and 39.8 mL kg-1 min-1 (girls). 8 boys and 6 girls were tested twice over a time-frame of 27.5 months. The parameters of the exercise test measured on both occasions were significantly lower than those of the 14 nordic skiers. There was no change with respect to any variables over the examined time-frame. Conclusions: The elite climbers investigated in this study showed comparable a-values to athletes from team and combat sports. The nordic skiers to which they were compared showed significantly higher values consistant with the fact that this is an endurance sport. Even though the cardiopulmonary measurements of the nordic skiers still improved after two years of training, no adaptations could be observed in the elite climbers.

2021 ◽  
Vol 14 (1) ◽  
pp. 1-8
Author(s):  
Isabelle Schöffl ◽  
Jan Wüstenfeld ◽  
Gareth Jones ◽  
Sven Dittrich ◽  
Chris Lutter ◽  
...  

Introduction: All the research investigating the cardiopulmonary capacity in climbers is focused on predictors for climbing performance. The effects of climbing on the cardiovascular system in adolescents climbing at an elite level (national team) have not been evaluated.Material and methods: Retrospective analysis of the cardiopulmonary exercise test (CPET) performed on a cycle ergometer during the annual medical examination of the entire German Junior National climbing team on one occasion and for a selected subgroup on two occasions spaced two years apart. The data from the subgroup was compared to an age- and gender-matched control of Nordic skiers from the German Junior National Nordic skiing team. Results: 47 climbers (20 girls, 27 boys) were examined once. The VO2peak achieved by the athletes was 41.3 mL kg<sup>−1</sup> min<sup>−1</sup> (boys) and 39.8 mL kg<sup>−1</sup>min<sup>−1</sup> (girls). 8 boys and 6 girls were tested twice over a period of 27.5 months. The parameters of the exercise test measured on both occasions were significantly lower than those of the 8 male and 6 female Nordic skiers. There was no change with respect to any variables (e.g. VO<sub>2peak</sub>, peak work load, peak heart rate, peak lactate or O<sub>2</sub> pulse) over the examined period. Conclusions: The elite climbers investigated in this study showed comparable VO<sub>2peak</sub> values to athletes from team and combat sports. The Nordic skiers to which they were compared showed significantly higher values consistant with the fact that this is an endurance sport. Even though the cardiopulmonary measurements of the Nordic skiers still improved after two years of training, no adaptations could be observed in the elite climbers.


2020 ◽  
Vol 127 (Suppl_1) ◽  
Author(s):  
Ayesha Bakhtiar ◽  
Adeel Yousphi ◽  
Adnaan Sheikh ◽  
Lan Yang ◽  
Shahkar A Khan ◽  
...  

Introduction: The cardiopulmonary exercise test (CPET) helps assess exercise tolerance in patients. The CPET is a better predictor of general health status and functional capacity (fc) when compared with resting cardiac and pulmonary function testing measurements (1). The test makes use of a bicycle ergometer with the patient being fitted with ECG leads, blood pressure cuff, pulse oximeter, and a face mask which determines the amount of oxygen consumed and carbon dioxide released. The predicted peak oxygen consumption per unit body weight per unit time (VO2max) is calculated based on patient’s sex, age, weight and height (2). Fc is measured as a percentage of VO2max that was actually consumed. Objective: Our study evaluates any relationship between the CPET fc results and patient’s sense of overall well-being, which provides a subjective measure of their quality of life. Methods: In this retrospective study, we randomly selected 299 patients who visited the clinic using electronic medical records from May-June 2019. There were 260 females and 39 males, with ages between 16-82 years. Patient history was analyzed to look for “overall health rating” scores; how they felt about their overall health on a scale of 1 to 10, with 1 denoting feeling the worst and 10 indicating feeling the best of their health. Their CPET fc results were analyzed at the same time, where values <55% meant severely reduced fc, ≥55% but <70% meant moderately reduced fc, ≥70% but <80% meant mildly reduced fc, and ≥80% meant normal fc. Logistic regression was used to look for an association between the values of the overall health rating and CPET fc results, where patient’s age and sex were used as control variables. Results: With each score increase in the overall health rating, the odds of the fc value being normal than being mildly/moderately/severely reduced increases by 1.2 times, given the patient sex and age remain constant (95%CI (0.76,0.98), p = 0.019<0.05). Conclusion: The results reveal a statistically significant association between the patients' overall health rating and their CPET fc results. The higher the numerical value of the overall health rating and the better the patients feel about their health, the greater the probability that the patient will also have a better CPET fc result. Thus the CPET fc can be used as an objective value to assess a patient’s overall well being.


2016 ◽  
Vol 73 (2) ◽  
Author(s):  
A. Brunelli ◽  
C. Pompili ◽  
M. Salati

Exercise tests are increasingly used in the preoperative functional evaluation of lung resection candidates. Low-technology exercise tests include six minute walking, shuttle walking and stair climbing. Conflicting evidence has been reported regarding 6 minute walking test. This test should not be used to select patients for lung resection. An incremental shuttle walk test is easier to replicate than 6 minute walking test. Most patients achieving 25 shuttles or 400 m have a maximum oxygen consumption measured at cardiopulmonary exercise test greater than 15 l/Kg/min. Although this test tends to underestimate performance at the lower range compared to peak oxygen consumption it can be used a screening test before lung resection. Excluding patients from operation based on this test alone is however not recommended and a formal cardiopulmonary exercise test should be always used in those walking less than 400 m. Stair climbing has been extensively studied in thoracic surgery. Several studies have found that poor performance in this test is indicative of cardiopulmonary complications and mortality after lung resection. In particular, climbing less than 12 m represents very high risk, whereas climbing more than 22 m is associated with a favourable outcome. Recent guidelines recommend referring all patients climbing lower than 22 m to cardiopulmonary exercise test. Stair climbing can be used as a screening test in cases cardiopulmonary exercise test is not readily available. In general, patients climbing more than 22 m can proceed to surgery without further evaluation.


2008 ◽  
Vol 88 (10) ◽  
pp. 1188-1195 ◽  
Author(s):  
Sandra A Billinger ◽  
Benjamin Y Tseng ◽  
Patricia M Kluding

Background Assessment of peak oxygen consumption (V̇o2peak) using traditional modes of testing such as treadmill or cycle ergometer can be difficult in individuals with stroke due to balance deficits, gait impairments, or decreased coordination. Objective The purpose of this study was to quantitatively assess the validity and feasibility of a modified exercise test using a total-body recumbent stepper (mTBRS-XT) in individuals after stroke. Design A within-subject design, with a sample of convenience, was used. Participants Eleven participants (7 male, 4 female) with a mean of 40.1 months (SD=32.7) after stroke, a mean age of 60.9 years (SD=12.0), and mild to severe lower-extremity Fugl-Myer test scores (range=13–34) completed the study. Methods Participants performed 2 maximal-effort graded exercise tests on separate days using the mTBRS-XT and a cycle ergometer exercise protocol to assess cardiorespiratory fitness. Measurements of V̇o2peak and peak heart rate (peak HR) were obtained during both tests. Results A strong relationship existed between the mTBRS-XT and the cycle ergometer exercise test for V̇o2peak and peak HR (r=.91 and .89, respectively). Mean V̇o2peak was significantly higher for the mTBRS-XT (16.6 mL×kg−1×min−1[SD=4.5]) compared with the cycle ergometer exercise protocol (15.4 mL×kg−1×min−1 [SD=4.5]). All participants performed the mTBRS-XT. One individual with severe stroke was unable to pedal the cycle ergometer. No significant adverse events occurred. Conclusion The mTBRS-XT may be a safe, feasible, and valid exercise test to obtain measurements of V̇o2peak in people with stroke. Health care professionals may use the mTBRS-XT to prescribe aerobic exercise based on V̇o2peak values for individuals with mild to severe deficits after stroke.


2021 ◽  
Vol 10 (11) ◽  
pp. 2312
Author(s):  
Adrián Bayonas-Ruiz ◽  
Francisca Muñoz-Franco ◽  
Vicente Ferrer ◽  
Carlos Pérez-Caballero ◽  
María Sabater-Molina ◽  
...  

Background: Patients with chronic diseases frequently adapt their lifestyles to their functional limitations. Functional capacity in Hypertrophic Cardiomyopathy (HCM) can be assessed by stress testing. We aim to review and analyze the available data from the literature on the value of Cardiopulmonary Exercise Test (CPET) in HCM. Objective measurements from CPET are used for evaluation of patient response to traditional and new developing therapeutic measurements. Methods: A systematic review of the literature was conducted in PubMed, Web of Science and Cochrane in Mar-20. The original search yielded 2628 results. One hundred and two full texts were read after the first screening, of which, 69 were included for qualitative synthesis. Relevant variables to be included in the review were set and 17 were selected, including comorbidities, body mass index (BMI), cardiac-related symptoms, echocardiographic variables, medications and outcomes. Results: Study sample consisted of 69 research articles, including 11,672 patients (48 ± 14 years old, 65.9%/34.1% men/women). Treadmill was the most common instrument employed (n = 37 studies), followed by upright cycle-ergometer (n = 16 studies). Mean maximal oxygen consumption (VO2max) was 22.3 ± 3.8 mL·kg−1·min−1. The highest average values were observed in supine and upright cycle-ergometer (25.3 ± 6.5 and 24.8 ± 9.1 mL·kg−1·min−1; respectively). Oxygen consumption in the anaerobic threshold (ATVO2) was reported in 18 publications. Left ventricular outflow tract gradient (LVOT) > 30 mmHg was present at baseline in 31.4% of cases. It increased to 49% during exercise. Proportion of abnormal blood pressure response (ABPRE) was higher in severe (>20 mm) vs. mild hypertrophy groups (17.9% vs. 13.6%, p < 0.001). Mean VO2max was not significantly different between severe vs. milder hypertrophy, or for obstructive vs. non-obstructive groups. Occurrence of arrhythmias during functional assessment was higher among younger adults (5.42% vs. 1.69% in older adults, p < 0.001). Twenty-three publications (9145 patients) evaluated the prognostic value of exercise capacity. There were 8.5% total deaths, 6.7% cardiovascular deaths, 3.0% sudden cardiac deaths (SCD), 1.2% heart failure death, 0.6% resuscitated cardiac arrests, 1.1% transplants, 2.6% implantable cardioverter defibrillator (ICD) therapies and 1.2 strokes (mean follow-up: 3.81 ± 2.77 years). VO2max, ATVO2, METs, % of age-gender predicted VO2max, % of age-gender predicted METs, ABPRE and ventricular arrhythmias were significantly associated with major outcomes individually. Mean VO2max was reduced in patients who reached the combined cardiovascular death outcome compared to those who survived (−6.20 mL·kg−1·min−1; CI 95%: −7.95, −4.46; p < 0.01). Conclusions: CPET is a valuable tool and can safely perform for assessment of physical functional capacity in patients with HCM. VO2max is the most common performance measurement evaluated in functional studies, showing higher values in those based on cycle-ergometer compared to treadmill. Subgroup analysis shows that exercise intolerance seems to be more related to age, medication and comorbidities than HCM phenotype itself. Lower VO2max is consistently seen in HCM patients at major cardiovascular risk.


2021 ◽  
Vol 16 (3) ◽  
pp. 16-25
Author(s):  
Isabelle Schöffl ◽  
Bernhard Bliemsrieder ◽  
Thomas Küpper ◽  
Volker Schöffl

Background: Ski mountaineering is a competitive sport that has gained popularity during the last years. As most competitions are held in altitudes between 1500 m and 3500 m, a considerable amount of training occurs at various hypobaric hypoxia degrees. It was establishing a sport-specific cardiopulmonary exercise protocol using standard ski mountaineering equipment on a treadmill. This study investigated altitude’s effects on a self-regulated incremental exercise field test at 3100 m with this protocol. Methods: Six athletes were tested (24.2 ± 4.2 years) from the German Ski Mountaineering National Team with a portable telemetric cardiopulmonary exercise test equipment. First, an incremental indoor step test with skis on a treadmill (altitude 310 m) and four days later outdoor on glacier snow (3085 m) after three days of acclimatization. All athletes were exposed to repetitive intermittent hypoxia during the weeks before the test. Standard cardiopulmonary exercise parameters were recorded while individual training zones were defined according to ventilatory thresholds. Results: In highly trained athletes, mean V̇ O2peak (72/ml kg KG/min) was reduced by 25% or 9% per 1000 m altitude gain and by 18% and 23% at the first and second ventilatory thresholds, respectively. Mean maximum heart rate and the heart rate at the ventilatory thresholds were reduced at altitude compared to sea-level, as was the O2 pulse. Conclusion: Due to distinctive individual reactions to hypoxia, cold, etc., an individual and sport-specific field performance analysis, representing the daily training environment, is highly useful in world-class athletes for precise training control. Our self-regulated cardiopulmonary field protocol could well prove to serve in such a way.


2019 ◽  
Vol 88 (2) ◽  
pp. 117-122
Author(s):  
Jacek Tarchalski ◽  
Tomasz Piorunek ◽  
Przemysław Guzik

The cardiopulmonary exercise test (CPET) is designed to measure some physiological variables related to the function of the cardiovascular and respiratory systems during exercise. Usually, the CPET is performed either on a treadmill or a cycle ergometer. In this mini‑review, we describe a set of parameters which are most commonly used to quantify CPET. We also summarize clinical indications for this test and interpretation of the obtained results in patients with respiratory system diseases. The CPET, if made appropriately, may deliver valuable information helpful in the diagnosis, e.g., of unexplained dyspnea, and prognosis, e.g., in chronic obturatory pulmonary disease, pulmonary hypertension, or interstitial lung diseases.


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