scholarly journals Smart training equals performance

2018 ◽  
Vol 11 (20) ◽  
pp. 53-58
Author(s):  
Tiberiu Puta ◽  
Claudiu Avram ◽  
Alexandra Mihaela Rusu
Keyword(s):  
Training Program ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Cycle Ergometer ◽  
Aerobic Exercise Capacity ◽  
Proper Training ◽  
Special Training Program ◽  
Almost All ◽  
Maximal Effort ◽  
Important Progress

Abstract Introduction: Training individualization is a key element for optimal sports performance and protection of the athlete’s health. The training program should be adjusted according to each athlete's characteristics and should be based on data obtained using proper evaluation. Cardiopulmonary exercise testing (CPET) is considered the gold standard for aerobic exercise capacity assessment and provides an increased quantity of information in regard to body reaction to effort, offering a complete perspective over the O2 transportation system and its utilization in metabolic processes. The aim of this study was to highlight the importance of a scientific approach regarding the physical training, starting from junior level. Methods: For a 3 years period (2013 - 2016) we followed the evolution of a professional cyclist (14 years old at baseline), in terms of cardiopulmonary parameters. During this period, he was tested 5 times and he followed a special training program adapted according the tests results. The CPET was performed in the laboratory using a stationary electronically braked cycle ergometer (Lode Corival, Netherland) and a breath by breath gas analyzer device (Cortex Metalyzer 3B, Germany). Results: We observed an improvement trend in almost all parameters investigated during the 3 years evaluation period. Comparing post-season records from 2013 and 2016, we noticed an increase of 54% in maximal aerobic power and 50% in peak oxygen uptake at anaerobic threshold and an even greater increase (59%) of these parameters at maximal effort achieved during CPET. After these 3 years of training we observed a significant improvement of ventilatory efficiency and cardiac performance during exercise. Conclusions: The study indicate that proper training adaptation according to data obtained using CPET, can bring an important progress in terms of performance.

scholarly journals Chronotropic Incompetence Limits Aerobic Exercise Capacity in Patients Taking Beta-Blockers

2020 ◽  
Author(s):  
Maciej Tysarowski ◽  
Krzysztof Smarz ◽  
Beata Zaborska ◽  
Ewa Pilichowska-Paszkiet ◽  
Malgorzata Sikora-Frac ◽  
...  
Keyword(s):  
Exercise Capacity ◽  
Beta Blocker ◽  
Partial Correlation ◽  
Beta Blockers ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Chronotropic Incompetence ◽  
Peak Vo2 ◽  
Aerobic Exercise Capacity ◽  
Variance Explained

Background: Chronotropic incompetence in patients taking beta-blockers is associated with poor prognosis; however, its impact on exercise capacity (EC) remains unclear. Methods: We retrospectively analyzed data from consecutive patients taking beta-blockers referred for cardiopulmonary exercise testing. EC was expressed as peak oxygen uptake (peak VO2; mL/kg/min). Chronotropic incompetence was defined as chronotropic index (CI) ≤ 62%. CI was calculated as [(HR at peak-HR at rest) / (maximum predicted HR-HR at rest)] x 100%. Results: Among 140 patients all taking beta-blockers (age 61 ± 9.7 years; 73% males), there were 113 (80.7%) patients with chronotropic incompetence. EC was lower in the group with chronotropic incompetence than the group without it, peak VO2 18.3 ± 5.7 vs. 24.0 ± 5.3 mL/kg/min, p < 0.001. In multivariate analysis EC correlated positively with CI (β = 0.14, p < 0.001) and male gender (β = 5.12, p < 0.001), and negatively with age (β = −0.17, p < 0.001) and presence of heart failure (β = −3.35, p < 0.001). Beta-blocker dose was not associated with EC. Partial correlation attributable to CI accounted for more than one-third of the variance in EC explained by the model. Conclusions: In patients taking beta-blockers, presence of chronotropic incompetence was associated with lower EC, regardless of the beta-blocker dose. CI accounted for more than one-third of EC variance explained by our model.

scholarly journals Cardiopulmonary exercise testing with supramaximal verification produces a safe and valid assessment of V̇o2max in people with cystic fibrosis: a retrospective analysis

2018 ◽  
Vol 125 (4) ◽  
pp. 1277-1283 ◽  
Author(s):  
Adam J. Causer ◽  
Janis K. Shute ◽  
Michael H. Cummings ◽  
Anthony I. Shepherd ◽  
Victoria Bright ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Oxygen Uptake ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Valid Measure ◽  
Exercise Tests ◽  
Cardiopulmonary Exercise ◽  
Adolescents And Adults ◽  
Maximal Effort

The validity and safety of using supramaximal verification (Smax) to confirm a maximal effort during cardiopulmonary exercise testing (CPET) in people with cystic fibrosis (CF) and/or those with severe disease has been questioned. Therefore, this study aimed to investigate these concerns in children, adolescents, and adults with mild-to-severe CF lung disease. Retrospective analysis of 17 pediatric and 28 adult participants with CF [age range: 9.2–62.9 y; forced expiratory volume in 1 s: 66.7% (range: 29.9%–102.3%); 30 men] who completed a routine ramp-incremental cycling test to determine peak oxygen uptake (V̇o2peak) was studied. Maximal oxygen uptake (V̇o2max) was subsequently confirmed by Smax at 110% of peak power output. All participants satisfied the criteria to verify a maximal effort during CPET. However, Smax-V̇o2peak exceeded ramp-V̇o2peak in 3/14 (21.4%) of pediatric and 6/28 (21.4%) adult exercise tests. A valid measurement of V̇o2max was attained in 85.7% of pediatric and 96.4% of adult exercise tests, as Smax-V̇o2peak did not exceed ramp-V̇o2peak by >9%. Adults ( n = 9) experienced a ≥5% reduction in arterial O2 saturation during CPET, 4 during both the ramp and Smax, 3 during only the ramp, and 2 during only Smax. Smax did not significantly worsen perceived breathing effort, chest tightness, throat narrowing, or exertion compared with ramp-incremental testing. Given the clinical importance of aerobic fitness in people with CF, incorporating Smax is recommended to provide a safe and valid measure of V̇o2max in children, adolescents, and adults who span the spectrum of CF disease severity. NEW & NOTEWORTHY Incorporating supramaximal verification into cardiopulmonary exercise testing protocols did not increase the frequency of adverse events or perceived discomfort versus a single-phase incremental exercise test in people with mild-to-severe cystic fibrosis. Furthermore, a valid measure of maximal oxygen uptake (V̇o2max) was obtained from 85.7% of pediatric and 96.4% of adult exercise tests, whereas peak oxygen uptake underestimated aerobic fitness in comparison with V̇o2max in 21.4% of cases (by up to 24.4%).

scholarly journals Chronotropic Incompetence Limits Aerobic Exercise Capacity in Patients Taking Beta-Blockers: Real-Life Observation of Consecutive Patients

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 212
Author(s):  
Krzysztof Smarz ◽  
Maciej Tysarowski ◽  
Beata Zaborska ◽  
Ewa Pilichowska-Paszkiet ◽  
Małgorzata Sikora-Frac ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Capacity ◽  
Beta Blocker ◽  
Beta Blockers ◽  
Cardiopulmonary Exercise Testing ◽  
Real Life ◽  
Peak Oxygen Uptake ◽  
Chronotropic Incompetence ◽  
Aerobic Exercise Capacity ◽  
Variance Explained

Background: Chronotropic incompetence in patients taking beta-blockers is associated with poor prognosis; however, its impact on exercise capacity (EC) remains unclear. Methods: We analyzed data from consecutive patients taking beta-blockers referred for cardiopulmonary exercise testing to assess EC. Chronotropic incompetence was defined as chronotropic index (CI) ≤ 62%. Results: Among 140 patients all taking beta-blockers (age 61 ± 9.7 years; 73% males), 64% with heart failure, chronotropic incompetence was present in 80.7%. EC assessed as peak oxygen uptake was lower in the group with chronotropic incompetence, 18.3 ± 5.7 vs. 24.0 ± 5.3 mL/kg/min, p < 0.001. EC correlated positively with CI (β = 0.14, p < 0.001) and male gender (β = 5.12, p < 0.001), and negatively with age (β = −0.17, p < 0.001) and presence of heart failure (β = −3.35, p < 0.001). Beta-blocker dose was not associated with EC. Partial correlation attributable to CI accounted for more than one-third of the variance in EC explained by the model (adjusted R2 = 59.8%). Conclusions: In patients taking beta-blockers, presence of chronotropic incompetence was associated with lower EC, regardless of the beta-blocker dose. CI accounted for more than one-third of EC variance explained by our model.

scholarly journals Ventilatory response during exercise among chronic Chagas cardiopathy patients

2006 ◽  
Vol 124 (5) ◽  
pp. 280-284 ◽  
Author(s):  
Fátima Palha de Oliveira ◽  
Roberto Coury Pedrosa
Keyword(s):  
Ventilatory Response ◽  
Exercise Duration ◽  
Peak Oxygen Uptake ◽  
Cycle Ergometer ◽  
Control Group ◽  
Gas Exchange Parameters ◽  
Peak Vo2 ◽  
Ventilatory Parameters ◽  
Patients With Heart Failure ◽  
Patient Groups

CONTEXT AND OBJECTIVE: The change in slope of the VE/VCO2 curve with time during exercise (VE/VCO2 slope) has been recommended as a parameter for analyzing the ventilatory response during exercise among patients with heart failure of different etiologies. The aim of this work was to evaluate the ventilatory response among patients with chronic Chagas cardiopathy. METHODS: Forty-eight patients, divided into four groups according to the Los Andes clinical/hemodynamic classification, were studied. They were also classified according to peak oxygen uptake (peak VO2) for a second analysis. The results from the patients were compared with results from a control group consisting of 21 healthy male volunteers (no Chagas disease). Exercise was performed on a cycle ergometer with loads increasing at the rate of 12.5 watts/min, and exercise duration was symptom-limited. Gas concentration and flow rate data were fed into a computer, which produced a real-time report on ventilatory and gas exchange parameters (breath-by-breath). The ventilatory parameters of VE/VCO2 slope and VE/VCO2 ratio computed at different times of the test were adopted. RESULTS: Although there were no significant differences in VE/VCO2 ratio and VE/VCO2 slope when patients were grouped using the Los Andes clinical/hemodynamic classification, these parameters varied significantly when peak VO2 was used to define patient groups. CONCLUSION: Our results indicate that progressive deterioration in ventilatory response among chronic Chagas cardiopathy patients during exercise is more evident when the functional capacity (peak VO2) is reduced, than when changes are related to the Los Andes classification.

scholarly journals Testosterone Attenuates Age-Related Fall in Aerobic Function in Mobility Limited Older Men With Low Testosterone

2016 ◽  
Vol 101 (6) ◽  
pp. 2562-2569 ◽  
Author(s):  
Thomas W. Storer ◽  
Shalender Bhasin ◽  
Thomas G. Travison ◽  
Karol Pencina ◽  
Renee Miciek ◽  
...  
Keyword(s):  
Medical Center ◽  
Exercise Physiology ◽  
Academic Medical Center ◽  
Older Men ◽  
Peak Oxygen Uptake ◽  
Cycle Ergometer ◽  
Aerobic Performance ◽  
Mobility Limitations ◽  
Age Related ◽  
Ergometer Exercise

Abstract Context: Testosterone increases skeletal muscle mass and strength, but the effects of testosterone on aerobic performance in mobility-limited older men have not been evaluated. Objective: To determine the effects of testosterone supplementation on aerobic performance, assessed as peak oxygen uptake (V̇O2peak) and gas exchange lactate threshold (V̇O2θ), during symptom-limited incremental cycle ergometer exercise. Design: Subgroup analysis of the Testosterone in Older Men with Mobility Limitations Trial. Setting: Exercise physiology laboratory in an academic medical center. Participants: Sixty-four mobility-limited men 65 years or older with low total (100–350 ng/dL) or free (&lt;50 pg/dL) testosterone. Interventions: Participants were randomized to receive 100-mg testosterone gel or placebo gel daily for 6 months. Main Outcome Measures: V̇O2peak and V̇O2θ from a symptom-limited cycle exercise test. Results: Mean (SD) baseline V̇O2peak was 20.5 (4.3) and 19.9 (4.7) mL/kg/min for testosterone and placebo, respectively. V̇O2peak increased by 0.83 (2.4) mL/kg/min in testosterone but decreased by −0.89 (2.5) mL/kg/min in placebo (P = .035); between group difference in change in V̇O2peak was significant (P = .006). This 6-month reduction in placebo was greater than the expected −0.4-mL/kg/min/y rate of decline in the general population. V̇O2θ did not change significantly in testosterone but decreased by 1.1 (1.8) mL/kg/min in placebo, P = .011 for between-group comparisons. Hemoglobin increased by 1.0 ± 3.5 and 0.1 ± 0.8 g/dL in testosterone and placebo groups, respectively. Conclusion: Testosterone supplementation in mobility-limited older men increased hemoglobin and attenuated the age-related declines in V̇O2peak and V̇O2θ. Long-term intervention studies are needed to determine the durability of this effect.

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.

Abstract 16002: Chronotropic Incompetence Limits Exercise Capacity in Patients Taking Beta-Blockers

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Maciej Tysarowski ◽  
Krzysztof Smarz ◽  
Beata Zaborska ◽  
Ewa Pilichowska-Paszkiet ◽  
Malgorzata Sikora-Frac ◽  
...  
Keyword(s):  
Exercise Capacity ◽  
Beta Blocker ◽  
Partial Correlation ◽  
Beta Blockers ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Male Gender ◽  
Chronotropic Incompetence ◽  
Cardiopulmonary Exercise ◽  
Variance Explained

Introduction: Chronotropic incompetence in patients taking beta-blockers is associated with poor prognosis; however, its impact on exercise capacity (EC) remains unclear. Hypothesis: We assessed the hypothesis that chronotropic incompetence is associated with decreased exercise capacity in patients taking beta-blockers. Methods: We retrospectively analyzed data from consecutive patients taking beta-blockers referred for cardiopulmonary exercise testing. EC was expressed as peak oxygen uptake (VO 2 peak; mL/kg/min). Chronotropic incompetence was defined as chronotropic index (CI) ≤ 62%. CI was calculated as [(HR at peak-resting HR) / (maximum predicted HR-resting HR)] х 100%. Results: Among 140 patients all taking beta-blockers (age 61 ± 9.7 years; 73% males), there were 113 (80.7%) patients with chronotropic incompetence. EC was lower in the group with chronotropic incompetence than the group without it, VO 2 peak 18.3 ± 5.7 vs. 24.0 ± 5.3 mL/kg/min, p < 0.001. In multivariate analysis ( Table ), EC correlated positively with CI (β = 0.14, p < 0.001) and male gender (β = 5.12, p < 0.001), and negatively with age (β = –0.17, p < 0.001) and presence of heart failure (β = –3.35, p < 0.001). Beta-blocker dose was not associated with EC. Partial correlation attributable to CI (partial R 2 = 24.7%) accounted for more than one-third of the variance in EC explained by the model (adjusted R 2 = 59.8%). Conclusions: In patients taking beta-blockers, the presence of chronotropic incompetence was associated with lower EC, regardless of the beta-blocker dose. CI accounted for more than one-third of EC variance explained by our model.

scholarly journals Awareness and perception of budding doctors: A focal scenario on eye donation

1970 ◽  
Vol 13 (4) ◽  
pp. 141-150
Author(s):  
Mausumi Basu ◽  
Palash Das ◽  
Biman Roy ◽  
Jayanta Kumar Baruah
Keyword(s):  
Medical Students ◽  
Corneal Transplantation ◽  
Cross Sectional Study ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Proper Training ◽  
Sight Restoration ◽  
Almost All ◽  
Perceived Reasons ◽  
Eye Donation

Background: Diseases affecting the cornea constitute a major cause of blindness. Corneal transplantation offers the potential for sight restoration. Due to non-availability of healthy cornea, many people continue to live in a dark world.Objectives: To assess the awareness and perception of undergraduate medical students towards eye donation.Methods: A cross-sectional study was conducted among undergraduate medical students of Kolkata on August 2010 using a pre-designed, pre-tested, semi-structured, self-administered questionnaire. The data were analyzed using Epi-info software package version 6.04.Results: Almost all (98.9%) participants knew that eyes can be donated and 70.8% were aware at the time of eye collection. However, only 43.7% respondents knew whom to approach for pledging their eyes for donation; 80.7% were either willing (76.0%) or had already pledged (4.7%) to donate their eyes. Television was the major source (78.1%) of information on eye donation. Nobility was the main motivation (87.7%) and 75.5% felt the need for helping the blind. Of these medical students, 19.3% were unaware and did not pledge eye donation due to objection by family members and dislike of the idea of separating their eyes.Conclusion: The present study revealed that medical students were well aware of eye donation with a favorable attitude towards it and most of them were inclined to pledge for eye donation. The perceived reasons for not donating eyes need to be considered while creating awareness about eye donation in the community. Students can be actively involved as volunteers in eye donation campaigns and after proper training in counselling techniques, they can act as counsellors for eye donation activities.

scholarly journals Correlation Between N-Terminal Pro-Brain Natriuretic Peptide Levels and Cardiopulmonary Exercise Testing in Patients With Pre-Capillary Pulmonary Hypertension: A Pilot Study

2020 ◽  
Vol 14 ◽  
pp. 117954842095404
Author(s):  
Sahachat Aueyingsak ◽  
Wilaiwan Khrisanapant ◽  
Upa Kukongviriyapun ◽  
Orapin Pasurivong ◽  
Pailin Ratanawatkul ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Pulmonary Hypertension ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Peak Oxygen Uptake ◽  
Cardiopulmonary Exercise ◽  
End Tidal

Background: N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiopulmonary exercise testing (CPET) are useful for severity assessment in patients with pulmonary hypertension (PH). Correlations between these tests in pre-capillary PH patients is less well studied. Methods: We studied 23 patients with pre-capillary PH: 8 with idiopathic pulmonary arterial hypertension (IPAH), 6 with systemic sclerosis-associated PAH (SSc-PAH), and 9 with chronic thromboembolic pulmonary hypertension (CTEPH). Clinical evaluation, NT-proBNP levels, six-minute walking test (6MWT), spirometry, and CPET were evaluated on the same day. Correlation between NT-proBNP levels and CPET parameters were investigated. Results: In all patients, NT-proBNP levels were significantly correlated with peak oxygen uptake (VO2) ( r = −0.47), peak oxygen pulse ( r = −0.43), peak cardiac output (CO) ( r = −0.57), peak end-tidal partial pressure of carbon dioxide (PETCO2) ( r = −0.74), ventilatory equivalent to carbon dioxide (VE/VCO2) at anaerobic threshold (AT) ( r = 0.73), and VE/VCO2 slope ( r = 0.64). Significant correlations between NT-proBNP levels and peak PETCO2 and VE/VCO2 were found in IPAH and CTEPH subgroups, and a significant correlation between NT-proBNP levels and VO2 at AT was found in the CTEPH subgroup. No significant correlation was found in the SSc-PAH subgroup. Conclusion: NT-proBNP levels were significantly correlated with CPET parameters in patients with IPAH and CTEPH subgroups, but not in SSc-PAH subgroup. A further study with larger population is required to confirm these preliminary findings.

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