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clinical exercise physiology

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https://www.readbyqxmd.com/read/28940689/clinical-experience-of-a-new-reference-material-for-exercise-capacity-in-exercise-stress-testing-in-sweden
#1
Thomas Lindow, Henrik Mosén, Henrik Engblom
BACKGROUND: In 2014, the Swedish Association of Clinical Physiology recommended the use of a new reference material for exercise capacity in bicycle exercise stress testing, 'the Kalmar material'. Compared to the formerly used reference material, 'the Kristianstad material', an increase in the amount of patients being classified as having decreased exercise capacity was expected, but the extent of this in clinical practice is not known. METHODS: Results of exercise capacity from 1449 bicycle exercise tests, in patients aged ≥20 years (656 women, 793 men) performed at two departments of Clinical Physiology before and after change of reference materials, were collected...
September 21, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28938308/sensor-based-physiologic-control-strategy-for-biventricular-support-with-rotary-blood-pumps
#2
Yu Wang, Steven C Koenig, Zhongjun Wu, Mark S Slaughter, Guruprasad A Giridharan
Rotary biventricular assist devices (BiVAD) are becoming a clinically accepted treatment option for end-stage biventricular failure. To improve BiVAD efficacy and safety, we propose a control algorithm to achieve the clinical objectives of maintaining left-right-sided balance, restoring physiologic flows, and preventing ventricular suction. The control algorithm consists of two proportional-integral (PI) controllers for left and right ventricular assist devices (LVAD and RVAD) to maintain differential pump pressure across LVAD (ΔPL) and RVAD (ΔPR) to provide left-right balance and physiologic flow...
September 21, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28935040/cardiopulmonary-exercise-testing-what-is-its-value
#3
REVIEW
Marco Guazzi, Francesco Bandera, Cemal Ozemek, David Systrom, Ross Arena
Compared with traditional exercise tests, cardiopulmonary exercise testing (CPET) provides a thorough assessment of exercise integrative physiology involving the pulmonary, cardiovascular, muscular, and cellular oxidative systems. Due to the prognostic ability of key variables, CPET applications in cardiology have grown impressively to include all forms of exercise intolerance, with a predominant focus on heart failure with reduced or with preserved ejection fraction. As impaired cardiac output and peripheral oxygen diffusion are the main determinants of the abnormal functional response in cardiac patients, invasive CPET has gained new popularity, especially for diagnosing early heart failure with preserved ejection fraction and exercise-induced pulmonary hypertension...
September 26, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28925073/role-of-cardiopulmonary-exercise-testing-in-clinical-stratification-in-heart-failure-a-position-paper-from-the-committee-on-exercise-physiology-and-training-of-the-heart-failure-association-of-the-european-society-of-cardiology
#4
REVIEW
Ugo Corrà, Pier Giuseppe Agostoni, Stefan D Anker, Andrew J S Coats, Maria G Crespo Leiro, Rudolph A de Boer, Veli-Pekka Hairola, Loreena Hill, Mitja Lainscak, Lars H Lund, Marco Metra, Piotr Ponikowski, Jillian Riley, Petar M Seferović, Massimo F Piepoli
Traditionally, the main indication for cardiopulmonary exercise testing (CPET) in heart failure (HF) was for the selection of candidates to heart transplantation: CPET was mainly performed in middle-aged male patients with HF and reduced left ventricular ejection fraction. Today, CPET is used in broader patients' populations, including women, elderly, patients with co-morbidities, those with preserved ejection fraction, or left ventricular assistance device recipients, i.e. individuals with different responses to incremental exercise and markedly different prognosis...
September 18, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28919728/chronic-obstructive-pulmonary-disease-with-mild-airflow-limitation-current-knowledge-and-proposal-for-future-research-a-consensus-document-from-six-scientific-societies
#5
REVIEW
Andrea Rossi, Bojana Butorac-Petanjek, Marco Chilosi, Borja G Cosío, Matjaz Flezar, Nikolaos Koulouris, José Marin, Neven Miculinic, Guido Polese, Miroslav Samaržija, Sabina Skrgat, Theodoros Vassilakopoulos, Andrea Vukić-Dugac, Spyridon Zakynthinos, Marc Miravitlles
Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity worldwide, with high and growing prevalence. Its underdiagnosis and hence under-treatment is a general feature across all countries. This is particularly true for the mild or early stages of the disease, when symptoms do not yet interfere with daily living activities and both patients and doctors are likely to underestimate the presence of the disease. A diagnosis of COPD requires spirometry in subjects with a history of exposure to known risk factors and symptoms...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28919335/the-effect-of-resistance-exercise-on-sleep-a-systematic-review-of-randomized-controlled-trials
#6
REVIEW
Ana Kovacevic, Yorgi Mavros, Jennifer J Heisz, Maria A Fiatarone Singh
Impaired sleep quality and quantity are associated with future morbidity and mortality. Exercise may be an effective non-pharmacological intervention to improve sleep, however, little is known on the effect of resistance exercise. Thus, we performed a systematic review of the literature to determine the acute and chronic effects of resistance exercise on sleep quantity and quality. Thirteen studies were included. Chronic resistance exercise improves all aspects of sleep, with the greatest benefit for sleep quality...
July 19, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28918861/exercise-self-efficacy-correlates-in-people-with-psychosis
#7
Davy Vancampfort, Paul Gorczynski, Marc De Hert, Michel Probst, Annetie Naisiga, David Basangwa, James Mugisha
Despite the recognition of the importance of exercise self-efficacy in exercise adoption and maintenance, previous investigations on exercise self-efficacy in people with psychosis is scarce. The present study aimed to (1) explore if exercise self-efficacy differed between stages of behavior change in Ugandan outpatients with psychosis, and (2) assess sociodemographic, clinical and motivational correlates of exercise self-efficacy. In total, 48 patients (24 women) completed the Exercise Self-Efficacy Scale (ESES), the Patient-centered Assessment and Counseling for Exercise questionnaire, the Brief Symptoms Inventory-18 (BSI-18), and questions pertaining to intrinsic motivation in the Behavioral Regulation in Exercise Questionnaire-2...
September 8, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28918494/betaine-in-the-brain-characterization-of-betaine-uptake-its-influence-on-other-osmolytes-and-its-potential-role-in-neuroprotection-from-osmotic-stress
#8
Leena S Knight, Quinn Piibe, Ian Lambie, Christopher Perkins, Paul H Yancey
Betaine (N-trimethylglycine), a common osmolyte, has received attention because of the number of clinical reports associating betaine supplementation with improved cognition, neuroprotection and exercise physiology. However, tissue analyses report little accumulation of betaine in brain tissue despite the presence of betaine/GABA transporters (BGT1) at the blood brain barrier and in nervous tissue, calling into question whether betaine influences neuronal function directly or indirectly. Therefore, the focus of this study was to determine what capacity nervous tissue has to accumulate betaine, specifically in the hippocampus, a region of the brain associated with learning and memory and one that is particularly susceptible to damage (e...
September 16, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28918314/empirical-research-evaluating-the-effects-of-non-traditional-approaches-to-enhancing-sleep-in-typical-and-clinical-children-and%C3%A2-young-people
#9
REVIEW
Karyn G France, Laurie K McLay, Jolene E Hunter, Madeline L S France
This paper examines the effects of non-traditional (non-behavioural and non-prescription pharmaceutical) approaches to sleep in children and young people (0-18 y). A systematic search identified 79 studies that met inclusion criteria. Seventeen percent of the studies were rated as having a conclusive level of evidence, forty-two percent with preponderant evidence and forty-one percent with only suggestive evidence. There were promising indications, with certain populations only, for aromatherapy, ketogenic diets, an elimination diet (few foods diet), elimination of cow's milk, avoidance of caffeine, tryptophan with adenosine and uridine, omega-3 and omega-6, valerian, music, osteopathic manipulation and white noise...
July 29, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28906019/response-letter-to-optimising-physiology-for-adolescents-with-dysautonomia
#10
K Armstrong, A M De Souza, P Sneddon, J E Potts, V E Claydon, S Sanatani
We would like to thank Dr Thaxter Nesbeth (1) for her interest and insightful comments on our paper entitled, "Exercise and the multidisciplinary holistic approach to adolescent dysautonomia"(2). We agree that recurrent orthostatic intolerance is often best managed through lifestyle modification rather than pharmacologic intervention (at least as an initial step), and as such in the present study we evaluated the impact of our exercise programme incorporated in addition to our standard clinical multidisciplinary management approach...
September 14, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28903474/nitric-oxide-heat-shock-protein-axis-in-menopausal-hot-flushes-neglected-metabolic-issues-of-chronic-inflammatory-diseases-associated-with-deranged-heat-shock-response
#11
Antônio Azambuja Miragem, Paulo Ivo Homem de Bittencourt
BACKGROUND: Although some unequivocal underlying mechanisms of menopausal hot flushes have been demonstrated in animal models, the paucity of similar approaches in humans impedes further mechanistic outcomes. Human studies might show some as yet unexpected physiological mechanisms of metabolic adaptation that permeate the phase of decreased oestrogen levels in both symptomatic and asymptomatic women. This is particularly relevant because both the severity and time span of hot flushes are associated with increased risk of chronic inflammatory disease...
September 1, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/28893206/efficacy-of-blood-flow-restriction-exercise-during-dialysis-for-end-stage-kidney-disease-patients-protocol-of-a-randomised-controlled-trial
#12
Matthew J Clarkson, Steve F Fraser, Paul N Bennett, Lawrence P McMahon, Catherine Brumby, Stuart A Warmington
BACKGROUND: Exercise during haemodialysis improves strength and physical function. However, both patients and clinicians are time poor, and current exercise recommendations add an excessive time burden making exercise a rare addition to standard care. Hypothetically, blood flow restriction exercise performed during haemodialysis can provide greater value for time spent exercising, reducing this time burden while producing similar or greater outcomes. This study will explore the efficacy of blood flow restriction exercise for enhancing strength and physical function among haemodialysis patients...
September 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28882651/in-cystic-fibrosis-lung-clearance-index-is-sensitive-to-detecting-abnormalities-appearing-at-exercise-in-children-with-normal-spirometry
#13
Riyadh Chelabi, Thibaud Soumagne, Alicia Guillien, Marc Puyraveau, Bruno Degano
Symptom-limited incremental cardiopulmonary exercise test was performed in school-age children with clinically stable cystic fibrosis (CF), all with normal spirometry. Physiological parameters were compared between patients with normal lung clearance index (LCI; n=6) and patients with elevated LCI (n=6). Dyspnoea ratings during exercise were similar in both groups. Although no patient had significant dynamic hyperinflation, end-expiratory lung volumes were higher throughout exercise in patients with elevated LCI...
September 4, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28859664/synergistic-effects-of-aerobic-exercise-and-cognitive-training-on-cognition-physiological-markers-daily-function-and-quality-of-life-in-stroke-survivors-with-cognitive-decline-study-protocol-for-a-randomized-controlled-trial
#14
Ting-Ting Yeh, Ching-Yi Wu, Yu-Wei Hsieh, Ku-Chou Chang, Lin-Chien Lee, Jen-Wen Hung, Keh-Chung Lin, Ching-Hung Teng, Yi-Han Liao
BACKGROUND: Aerobic exercise and cognitive training have been effective in improving cognitive functions; however, whether the combination of these two can further enhance cognition and clinical outcomes in stroke survivors with cognitive decline remains unknown. This study aimed to determine the treatment effects of a sequential combination of aerobic exercise and cognitive training on cognitive function and clinical outcomes. METHODS/DESIGN: Stroke survivors (n = 75) with cognitive decline will be recruited and randomly assigned to cognitive training, aerobic exercise, and sequential combination of aerobic exercise and cognitive training groups...
August 31, 2017: Trials
https://www.readbyqxmd.com/read/28845464/molecular-signatures-of-differential-responses-to-exercise-trainings-during-rehabilitation
#15
Yi-Wen Chen, Chris Gregory, Fan Ye, Naoe Harafuji, Donovan Lott, San-Huei Lai, Sunita Mathur, Mark Scarborough, Parker Gibbs, Celine Baligand, Krista Vandenborne
The loss and recovery of muscle mass and function following injury and during rehabilitation varies among individuals. While recent expression profiling studies have illustrated transcriptomic responses to muscle disuse and remodeling, how these changes contribute to the physiological responses are not clear. In this study, we quantified the effects of immobilization and subsequent rehabilitation training on muscle size and identified molecular pathways associated with muscle responsiveness in an orthopaedic patient cohort study...
2017: Biomedical genetics and genomics
https://www.readbyqxmd.com/read/28842527/mechanisms-contributing-to-cardiac-remodelling
#16
REVIEW
Qing-Qing Wu, Yang Xiao, Yuan Yuan, Zhen-Guo Ma, Hai-Han Liao, Chen Liu, Jin-Xiu Zhu, Zheng Yang, Wei Deng, Qi-Zhu Tang
Cardiac remodelling is classified as physiological (in response to growth, exercise and pregnancy) or pathological (in response to inflammation, ischaemia, ischaemia/reperfusion (I/R) injury, biomechanical stress, excess neurohormonal activation and excess afterload). Physiological remodelling of the heart is characterized by a fine-tuned and orchestrated process of beneficial adaptations. Pathological cardiac remodelling is the process of structural and functional changes in the left ventricle (LV) in response to internal or external cardiovascular damage or influence by pathogenic risk factors, and is a precursor of clinical heart failure (HF)...
September 15, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28831250/an-evaluation-of-activity-tolerance-patient-reported-outcomes-and-satisfaction-with-the-effectiveness-of-pulmonary-daoyin-on-patients-with-chronic-obstructive-pulmonary-disease
#17
Hai-Long Zhang, Jian-Sheng Li, Xue-Qing Yu, Su-Yun Li, Upur Halmurat, Yang Xie, Yan-Fang Wang, Feng-Sen Li, Ming-Hang Wang
BACKGROUND AND OBJECTIVE: Pulmonary Daoyin (PD) (evolved from ancient Chinese daoyin skills), is a rehabilitation technology that combines specially designed movements of the arms and body and controlled breathing exercises, to improve the physiological and psychological status of patients with chronic respiratory disease. Pulmonary rehabilitation is effective for patients with chronic obstructive pulmonary disease (COPD), and the efficacy of PD is unknown. The aim of this study is to investigate the effect of a PD program in enhancing activity tolerance, patient-reported outcomes and satisfaction with the effectiveness on patients with COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28822530/application-of-exercise-ecg-stress-test-in-the-current-high-cost-modern-era-healthcare-system
#18
REVIEW
Gaurang Nandkishor Vaidya
Exercise electrocardiogram (ECG) tests boasts of being more widely available, less resource intensive, lower cost and absence of radiation. In the presence of a normal baseline ECG, an exercise ECG test is able to generate a reliable and reproducible result almost comparable to Technitium-99m sestamibi perfusion imaging. Exercise ECG changes when combined with other clinical parameters obtained during the test has the potential to allow effective redistribution of scarce resources by excluding low risk patients with significant accuracy...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28821271/high-speed-resistance-training-and-balance-training-for-people-with-knee-osteoarthritis-to-reduce-falls-risk-study-protocol-for-a-pilot-randomized-controlled-trial
#19
Pazit Levinger, Jeremy Dunn, Nancy Bifera, Michael Butson, George Elias, Keith D Hill
BACKGROUND: The number of falls experienced by people with knee osteoarthritis (OA) is almost double the number experienced by people with no OA. The neuromuscular elements required to arrest a fall are more impaired in people with knee OA compared to their asymptomatic counterparts. Therefore, these elements may need to be incorporated into an exercise intervention to reduce the risk of falling. The aim of this study will be to examine the feasibility, safety and patient satisfaction of a high-speed resistance-training program, with and without balance exercises, in people with knee OA compared to a control group...
August 18, 2017: Trials
https://www.readbyqxmd.com/read/28820609/cardio-pulmonary-interactions-physiologic-basis-and-clinical-applications
#20
Michael R Pinsky
The hemodynamic effects of ventilation can be grouped into three concepts: 1) spontaneous ventilation is exercise; 2) changes in lung volume alter autonomic tone, pulmonary vascular resistance, and can compress the heart in the cardiac fossa; 3) spontaneous inspiratory efforts decrease intrathoracic pressure (ITP) increasing venous return and impeding left ventricular (LV) ejection; whereas positive pressure ventilation decreases venous return and unloads LV ejection. Spontaneous inspiratory efforts may induce acute LV failure and cardiogenic pulmonary edema...
August 18, 2017: Annals of the American Thoracic Society
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