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clinical exercise physiology

Walter H Reinhart
The hematocrit (Hct) determines the oxygen carrying capacity of blood, but also increases blood viscosity and thus flow resistance. From this dual role the concept of an optimum Hct for tissue oxygenation has been derived. Viscometric studies using the ratio Hct/blood viscosity at high shear rate showed an optimum Hct of 50-60% for red blood cell (RBC) suspensions in plasma. For the perfusion of an artificial microvascular network with 5-70μm channels the optimum Hct was 60-70% for high driving pressures. With lower shear rates or driving pressures the optimum Hct shifted towards lower values...
October 21, 2016: Clinical Hemorheology and Microcirculation
Pavol Sajgalik, Vaclav Kremen, Alex R Carlson, Vratislav Fabian, Chul-Ho Kim, Courtney M Wheatley, Vaclav Gerla, John A Schirger, Thomas P Olson, Bruce D Johnson
Cardiac output (CO) assessment as a basic hemodynamic parameter has been of interest in exercise physiology, cardiology and anesthesiology. Non-invasive techniques available are technically challenging, and thus difficult to use outside of the clinical or laboratory setting. We propose a novel method of non-invasive CO assessment using a single upper arm cuff. The method uses the arterial pressure pulse wave signal acquired from the brachial artery during 20 second intervals of suprasystolic occlusion. This method was evaluated on a cohort of 12 healthy individuals (age of 27...
October 20, 2016: Journal of Applied Physiology
Rafael E Pedro, Débora A Guariglia, Sidney B Peres, Solange M Moraes
BACKGROUND: Human immunodeficiency virus-associated lipodystrophy syndrome (HALS) is a major problem among people living with HIV/aids. The exercise training has been used for its treatment; however, the knowledge about benefits and safety still is emerging. The aim was systematically review the literature for physiological, metabolic, immunologic, and morphologic adaptations to aerobic, resistance, and concurrent training in people living with HALS. METHODS: A search of the Medline, Embase, Cinahl, Lilacs, Scielo, Web of Science, the Cochrane Controlled Trials Register Library and PEDro was performed...
October 20, 2016: Journal of Sports Medicine and Physical Fitness
Sebastian Frese, Jens A Petersen, Maria Ligon-Auer, Sandro Manuel Mueller, Violeta Mihaylova, Saskia M Gehrig, Veronika Kana, Elisabeth J Rushing, Evelyn Unterburger, Georg Kägi, Jean-Marc Burgunder, Marco Toigo, Hans H Jung
Huntington disease (HD) is a relentlessly progressive neurodegenerative disorder with symptoms across a wide range of neurological domains, including cognitive and motor dysfunction. There is still no causative treatment for HD but environmental factors such as passive lifestyle may modulate disease onset and progression. In humans, multidisciplinary rehabilitation has a positive impact on cognitive functions. However, a specific role for exercise as a component of an environmental enrichment effect has been difficult to demonstrate...
October 17, 2016: Journal of Neurology
Marie Maagaard, Johan Heiberg
Patients with pectus excavatum (PE) often describe improvements in exercise stamina following corrective surgery. Studies have investigated the surgical effect on physiological parameters; still, no consensus has yet been reached. Therefore, the aim of this literature review was to describe the cardiac outcome after surgical correction, both at rest and during exercise. In February 2016, a detailed search of the databases PubMed, Medline, and EMBASE was performed. We assessed clinical studies that described cardiac outcomes both before and after surgical correction of PE...
September 2016: Annals of Cardiothoracic Surgery
Barry J Maron, Ethan J Rowin, Martin S Maron, Eugene Braunwald
Hypertrophic cardiomyopathy was first recognized as a disease of obstruction to left ventricular outflow, hence its early names and acronyms such as idiopathic hypertrophic subaortic obstruction. The nonobstructive subset of patients, incapable of developing mechanical impedance to left ventricular outflow at rest or with physiologic exercise, was initially recognized by the Braunwald group at the National Institutes of Health >50 years ago in the pre-imaging era and is now recognized as comprising about one-third of hypertrophic cardiomyopathy patients...
October 13, 2016: American Journal of Medicine
Charles C Reilly, Caroline J Jolley, Caroline Elston, John Moxham, Gerrard F Rafferty
The electromyogram recorded from the diaphragm (EMGdi) and parasternal intercostal muscle using surface electrodes (sEMGpara) provides a measure of neural respiratory drive (NRD), the magnitude of which reflects lung disease severity in stable cystic fibrosis. The aim of this study was to explore perception of NRD and breathlessness in both healthy individuals and patients with cystic fibrosis. Given chronic respiratory loading and increased NRD in cystic fibrosis, often in the absence of breathlessness at rest, we hypothesised that patients with cystic fibrosis would be able to tolerate higher levels of NRD for a given level of breathlessness compared to healthy individuals during exercise...
January 2016: ERJ Open Research
Anne Hseu, Mykayla Sandler, Dawn Ericson, Nohamin Ayele, Kosuke Kawai, Roger Nuss
INTRODUCTION: Although dyspnea with exercise in the pediatric population can be multifactorial, the diagnosis of paradoxical vocal fold motion disorder (PVFMD) in this group is not well characterized. The objective of this study is to review the multiple causes of dyspnea with exercise in children, including the prevalence of PVFMD within this study population. METHODS: A retrospective review was conducted of patients seen at a tertiary pediatric hospital for exercise-induced dyspnea suspected to be related to PVFMD between January 2007 and July 2015...
November 2016: International Journal of Pediatric Otorhinolaryngology
Isabelle Merckaert, Florence Lewis, France Delevallez, Sophie Herman, Marie Caillier, Nicole Delvaux, Yves Libert, Aurore Liénard, Jean-Marie Nogaret, David Ogez, Pierre Scalliet, Jean-Louis Slachmuylder, Paul Van Houtte, Darius Razavi
OBJECTIVE: To compare in a multicenter randomized controlled trial the benefits in terms of anxiety regulation of a 15-session single-component group intervention (SGI) based on support with those of a 15-session multi-component structured manualized group intervention (MGI) combining support with cognitive-behavioral and hypnosis components. METHODS: Patients with non-metastatic breast cancer were randomly assigned at the beginning of the survivorship period to the SGI (n = 83) or MGI (n = 87)...
October 8, 2016: Psycho-oncology
Francesco Carli, Enrico M Minnella
Functional capacity has been shown to be a major determinant of surgical outcome since it is related to postoperative complications, activity and daily function, level of independence and quality of life. Anesthesiologists as "perioperative physicians", can identify those scoring systems that assess functional capacity, whether from the basic physical history and walk test to the most complex such as cardiopulmonary exercise testing (CPET), and formulate intraoperative and postoperative interventions (rehabilitation) to minimize the impact of surgery on the recovery process...
October 6, 2016: Minerva Anestesiologica
JoEllen M Sefton, J S McAdam, David D Pascoe, K R Lohse, Robert L Banda, Corbin B Henault, Andrew R Cherrington, N E Adams
CONTEXT:  Heat injury is a significant threat to military trainees. Different methods of heat mitigation are in use across military units. Mist fans are 1 of several methods used in the hot and humid climate of Fort Benning, Georgia. OBJECTIVES:  To determine if (1) the mist fan or the cooling towel effectively lowered participant core temperature in the humid environment found at Fort Benning and (2) the mist fan or the cooling towel presented additional physiologic or safety benefits or detriments when used in this environment...
October 6, 2016: Journal of Athletic Training
Giovanni Lombardi, Silvia Perego, Veronica Sansoni, Giuseppe Banfi
MicroRNAs are endogenous non-coding RNAs that post-transcriptionally regulate gene expression by specifically binding the target mRNA and by consequently inducing its degradation. miRNAs can be released into the circulation where they remain stable and they can be measured. Their changes reflect individual biologic adaptation to exposures to specific environmental conditions. As such, measurement of circulating microRNAs represents an opportunity to evaluate biologic changes associated with interventions such as exercise and diet...
September 27, 2016: Clinical Biochemistry
Tee Joo Yeo, Sanjay Sharma
This article summarizes the role of the 12-lead electrocardiogram (ECG) for the clinical care of athletes, with particular reference to the influence of age, gender, ethnicity, and type of sport on the appearance of the ECG, and its role in differentiating physiologic exercise-related changes from pathologic conditions implicated in sudden cardiac death (SCD). The article also explores the potential role of the ECG in detecting athletes at risk of SCD. In addition, the article reviews the evolution of ECG interpretation criteria and emphasizes the limitations of the ECG as well as the potential for future research...
November 2016: Cardiology Clinics
Rhys Beaudry, Mark J Haykowsky, Aaron Baggish, André La Gerche
Exercise training can have a profound effect on cardiac structure. Recent evidence suggests that the greatest determinants of exercise-induced cardiac remodeling are the intensity, duration, and frequency of training. This also has overlap with athlete fitness. There are many additional factors that are important in determining cardiac remodeling, but while further refinements evolve, the authors argue that the best means of predicting the degree of expected physiologic remodeling is to either quantify training (intensity times total training time) or its by-product (exercise capacity)...
November 2016: Cardiology Clinics
Vasileios Andrianopoulos, Bartolome R Celli, Frits M E Franssen, Victor M Pinto-Plata, Peter M A Calverley, Lowie E G W Vanfleteren, Ioannis Vogiatzis, Jørgen Vestbo, Alvar Agusti, Per S Bakke, Stephen I Rennard, William MacNee, Ruth Tal-Singer, Julie C Yates, Emiel F M Wouters, Martijn A Spruit
Exercise-induced oxygen desaturation (EID) is related to mortality in patients with chronic obstructive pulmonary disease (COPD). We investigated: (1) the prevalence of EID; (2) the relative-weight of several physiological determinants of EID including pulmonary emphysema, and (3) the relationship of EID with certain patients' clinical characteristics. Data from 2050 COPD patients (age: 63.3 ± 7.1years; FEV1: 48.7 ± 15.7%pred.) were analyzed. The occurrence of EID (SpO2post ≤88%) at the six-minute walking test (6MWT) was investigated in association with emphysema quantified by computed-tomography (QCT), and several clinical characteristics...
October 2016: Respiratory Medicine
Nick W Bray, Rowan R Smart, Jennifer M Jakobi, Gareth R Jones
Frailty is a clinical geriatric syndrome caused by physiological deficits across multiple systems. These deficits make it challenging to sustain homeostasis required for the demands of everyday life. Exercise is likely the best therapy to reverse frailty status. Literature to date suggests that pre-frail older adults, those with 1-2 deficits on the Cardiovascular Health Study-Frailty Phenotype (CHS-frailty phenotype), should exercise 2-3 times a week, for 45-60 min. Aerobic, resistance, flexibility, and balance training components should be incorporated but resistance and balance activities should be emphasized...
October 2016: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
Dean Cordingley, Richard Girardin, Karen Reimer, Lesley Ritchie, Jeff Leiter, Kelly Russell, Michael J Ellis
OBJECTIVE The objectives of this study were 2-fold: 1) to evaluate the safety, tolerability, and clinical use of graded aerobic treadmill testing in pediatric patients with sports-related concussion (SRC), and 2) to evaluate the clinical outcomes of treatment with a submaximal aerobic exercise program in patients with physiological post-concussion disorder (PCD). METHODS The authors conducted a retrospective chart review of pediatric patients (age < 20 years) with SRC who were referred to a multidisciplinary pediatric concussion program and underwent graded aerobic treadmill testing between October 9, 2014, and February 11, 2016...
September 13, 2016: Journal of Neurosurgery. Pediatrics
Imogen N Clark, Felicity A Baker, Nicholas F Taylor
BACKGROUND: Music listening during exercise is thought to increase physiological arousal and enhance subjective experience, and may support physical activity participation among older adults with cardiac disease. However, little is known about how music preferences, or perceptions of music during exercise, inform clinical practice with this population. OBJECTIVE: Identify predominant musical characteristics of preferred music selected by older adults, and explore participants' music listening experiences during walking-based exercise following cardiac rehabilitation...
September 3, 2016: Journal of Music Therapy
Denis E O'Donnell, Amany F Elbehairy, Azmy Faisal, Katherine A Webb, J Alberto Neder, Donald A Mahler
Activity-related dyspnoea is often the most distressing symptom experienced by patients with chronic obstructive pulmonary disease (COPD) and can persist despite comprehensive medical management. It is now clear that dyspnoea during physical activity occurs across the spectrum of disease severity, even in those with mild airway obstruction. Our understanding of the nature and source of dyspnoea is incomplete, but current aetiological concepts emphasise the importance of increased central neural drive to breathe in the setting of a reduced ability of the respiratory system to appropriately respond...
September 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
R J Van Lieshout, J E Krzeczkowski
Optimal early cognitive and emotional development are vital to reaching one's full potential and represent our best chance to improve the mental health of the population. The developmental origins of health and disease (DOHaD) hypothesis posits that adverse perinatal exposures can alter physiology and increase disease risk. As physiological plasticity decreases with age, interventions applied during gestation may hold the most promise for reducing the impact of mental disorders across the lifespan. However, this vast clinical potential remains largely unrealized as the majority of human DOHaD research is observational in nature...
August 30, 2016: Journal of Developmental Origins of Health and Disease
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