Aerobic Capacity In Patients Research Articles

Concordance between spirometry and the electronic device PIKO-6® in asthmatic and healthy children

FEV1, FEF25–75, and the dysynapsis ratio. There was no significant correlation between the dysynapsis ratio and peak VO2 for both groups (CHD: r = 0.17; p =0.926; Control: r = 0.054; p =0.759). Conclusion: Several pulmonary parameters, including the dysynapsis ratio, were unrelated to aerobic capacity in patients with CHD or controls. Decreased aerobic capacity in CHD cannot be explained by airflow limitation, but by other factors that affect aerobic fitness in this population.

The impulse oscillometry system in children with Duchenne muscular dystrophy

FEV1, FEF25–75, and the dysynapsis ratio. There was no significant correlation between the dysynapsis ratio and peak VO2 for both groups (CHD: r = 0.17; p =0.926; Control: r = 0.054; p =0.759). Conclusion: Several pulmonary parameters, including the dysynapsis ratio, were unrelated to aerobic capacity in patients with CHD or controls. Decreased aerobic capacity in CHD cannot be explained by airflow limitation, but by other factors that affect aerobic fitness in this population.

OP0080 Aerobic training in patients with ankylosing spondylitis: A randomized controlled trial

BackgroundAnkylosing Spondylitis (AS) is a systemic inflammatory disease that affects mainly the spine and compromises globally the physical capacity of the patients. Despite new advances in pharmacological therapy, physiotherapy and...

SAT0588-HPR Swimming is as Effective as Walking for Treating Fibromyalgia: a Randomized Controlled Trial.

BackgroundBackground: Fibromyalgia (FM) is a chronic widespread pain syndrome that causes deterioration of physical capacity. Exercises are fundamental in the treatment of FM, however, it is not known the effects...

Functional Aerobic Capacity in Patients With Sleep-Disordered Breathing

Few studies have examined exercise capacity or cardiovascular responses to maximal exercise testing and recovery in patients with sleep-disordered breathing (SDB), and results from these studies are conflicting. The objective of this cross-sectional study conducted at a tertiary referral center was to examine the association between SDB and exercise testing outcomes independent of body mass index (BMI) and other cardiopulmonary risk factors. Between January 1, 2005 and January 1, 2010, 1,424 adults underwent exercise testing and within 6 months before first-time diagnostic polysomnography. Subjects were categorized by apnea-hypopnea index (AHI) into 4 groups: <5, 5 to 14, 15 to 29, and ≥30. A logistic regression model incorporated age, gender, BMI, smoking, hypertension, diabetes, beta-blocker use, and cardiac and pulmonary disease as covariates. The primary variable of interest was functional aerobic capacity (FAC). Mean age was 56.4 ± 12.4 years; 75% were men. Mean BMI was 32.4 ± 7.1 kg/m², and mean AHI 19.5 ± 22.1 per hour. On multivariate analysis, AHI as a continuous variable showed a negative correlation with FAC (R²adj= 0.30, p <0.001) and postexercise SBP (R²adj= 0.23, p= 0.03), and positively correlated with resting and peak DBP (R²adj= 0.09, p= 0.01 and R²adj= 0.09, p= 0.04 respectively). When comparing patients with severe SDB (AHI ≥30) with those without SDB (AHI <5), FAC and heart rate recovery were significantly lower, and resting, peak, and postexercise DBP were higher in those with severe apnea (all p <0.05), after accounting for confounders. In conclusion, SDB severity was associated with reduced FAC and increased resting and peak DBP. Even after accounting for confounders, severe SDB was associated with attenuated FAC, impaired heart rate recovery, and higher resting, peak, and postexercise DBP.

Metabolic rate, cardiac response, and aerobic capacity in fibromyalgia: a case–control study

Objectives: Several studies report reduced aerobic capacity in patients with fibromyalgia (FM). The purpose of our study was to investigate whether a reduction in aerobic capacity in these patients is accompanied by alterations in metabolic rate and heart rate (HR) response.Method: Twelve women with FM and 12 healthy controls (HCs) matched on sex and age, and with similar leisure time physical activity, participated in the study. All subjects performed an incremental submaximal cycle ergometer test to anaerobic threshold [AT; i.e. blood lactate concentration (bLa) ≥ 4 mmol/L], followed by a stepwise test to exhaustion to estimate maximal oxygen consumption (VO2max).Results: Oxygen consumption and workload were lower among patients than HCs both at AT and at termination of the VO2max test (p < 0.011 for all comparisons). Two patients (18%) and nine HCs (75%) reached VO2max criteria. The relationship between metabolic rate and workload did not differ between groups at exercise below AT. At exercise above AT, the metabolic rate increased disproportionally to workload in the patients. Although the patients had a higher anaerobic contribution to the total metabolic rate at the end of the submaximal test, the anaerobic contribution at the end of the maximal test did not differ between groups. HR responses were largely similar between groups.Conclusions: The current study indicates that patients with FM have similar metabolic and cardiovascular responses to submaximal exercise as HCs. However, these patients have reduced ability to reach VO2max and a possible deficit in the metabolic system when exercising above the AT.

Response to exercise in patients with liver cirrhosis: Implications for liver transplantation

End-stage liver cirrhosis is a systemic disease carrying a short-term desperate prognosis without liver transplantation. Given the discrepancy between the growing number of candidates and the limited available liver grafts, the pre-transplantation screening process has become a challenging task. Cardiopulmonary exercise testing, by measuring maximal oxygen consumption at peak exercise, provides a global integrative approach of the health status of an individual. In the setting of liver cirrhosis, decreased oxygen consumption at peak exercise may result from a combination of multiple extra-hepatic complications, including deconditioning, malnutrition-associated muscle weakness, anaemia, cirrhotic cardiomyopathy, and hepato-pulmonary syndrome for instance. In addition, oxygen consumption at peak exercise not only correlated with the severity of the liver disease, but it is also independently associated with survival following liver transplantation. The present article aims to review the numerous determinants of impaired aerobic capacity in patients with severe liver disease, and to discuss how useful is cardiopulmonary exercise testing as a critical tool in the pre-transplantation assessment of these patients.

Are persons with rheumatoid arthritis deconditioned? A review of physical activity and aerobic capacity

BackgroundAlthough the general assumption is that patients with rheumatoid arthritis (RA) have decreased levels of physical activity, no review has addressed whether this assumption is correct.MethodsOur objective was to systematically review the literature for physical activity levels and aerobic capacity (VO2max). in patients with (RA), compared to healthy controls and a reference population. Studies investigating physical activity, energy expenditure or aerobic capacity in patients with RA were included. Twelve studies met our inclusion criteria.ResultsIn one study that used doubly labeled water, the gold standard measure, physical activity energy expenditure of patients with RA was significantly decreased. Five studies examined aerobic capacity. Contradictory evidence was found that patients with RA have lower VO2max than controls, but when compared to normative values, patients scored below the 10th percentile. In general, it appears that patients with RA spend more time in light and moderate activities and less in vigorous activities than controls.ConclusionPatients with RA appear to have significantly decreased energy expenditure, very low aerobic capacity compared to normative values and spend less time in vigorous activities than controls.

Exercise Pathophysiology in Patients With Chronic Mountain Sickness

Chronic mountain sickness (CMS) is characterized by a combination of excessive erythrocytosis,severe hypoxemia, and pulmonary hypertension, all of which affect exercise capacity. Thirteen patients with CMS and 15 healthy highlander and 15 newcomer lowlander control subjects were investigated at an altitude of 4,350 m (Cerro de Pasco, Peru). All of them underwent measurements of diffusing capacity of lung for nitric oxide and carbon monoxide at rest, echocardiography for estimation of mean pulmonary arterial pressure and cardiac output at rest and at exercise, and an incremental cycle ergometer cardiopulmonary exercise test. The patients with CMS, the healthy highlanders, and the newcomer lowlanders reached a similar maximal oxygen uptake at 32 1, 32 2, and 33 2 mL/min/kg, respectively, mean SE( P 5 .8), with ventilatory equivalents for C O 2 vs end-tidal P CO 2 , measured at the anaerobic threshold,of 0.9 0.1, 1.2 0.1, and 1.4 0.1 mm Hg, respectively ( P , .001); arterial oxygen content of 26 1, 21 2, and 16 1 mL/dL, respectively ( P , .001); diffusing capacity for carbon monoxide corrected for alveolar volume of 155% 4%, 150% 5%, and 120% 3% predicted, respectively( P , .001), with diffusing capacity for nitric oxide and carbon monoxide ratios of 4.7 0.1 at sea level decreased to 3.6 0.1, 3.7 0.1, and 3.9 0.1, respectively ( P , .05) and a maximal exercise mean pulmonary arterial pressure at 56 4, 42 3, and 31 2 mm Hg, respectively ( P , .001). The aerobic exercise capacity of patients with CMS is preserved in spite of severe pulmonary hypertension and relative hypoventilation, probably by a combination of increased oxygen carrying capacity of the blood and lung diffusion, the latter being predominantly due to an increased capillary blood volume.

Matched dose interval and continuous exercise training induce similar cardiorespiratory and metabolic adaptations in patients with heart failure

BackgroundThe best format of exercise training in patients with chronic heart failure (CHF) is controversial. We tested the hypothesis that aerobic continuous training (ACT) and aerobic interval training (AIT) induce similar effects on functional capacity, central hemodynamics and metabolic profile in patients with postinfarction CHF provided that the training load is equated by an individually-tailored volume/intensity dose of exercise. MethodsTwenty patients with postinfarction CHF under optimal medical treatment were randomized to ACT or AIT for 12weeks. Exercise training consisted in individualized loads prescribed according to the Training Impulses (TRIMPi) method, which was determined using the individual HR and lactate profiling obtained during a treadmill test at baseline. ResultsPeak VO2 increased significantly by 22% with both ACT and AIT, without differences between the two training programs. Changes in anaerobic threshold and VE/VCO2 slope were not significantly different between ACT and AIT. Resting HR significantly decreased with both exercise modes. Resting cardiac output and stroke volume, left ventricular diastolic dimension and ejection fraction did not change from baseline with both exercise modes. Lipid profile and glucose metabolism were not substantially altered by ACT and AIT. ConclusionsACT and AIT both induce significant improvement in aerobic capacity in patients with postinfarction CHF, without significant differences between the two training modes, provided that patients are trained at the same, individually tailored, dose of exercise. The TRIMPi method might represent a step forward in the individualization of an aerobic training tailored to the patient's clinical and functional status within cardiac rehabilitation programs.

VO2max in patients with chronic pain: Comparative analysis with objective and subjective tests of disability

ObjectivesTo establish the level of maximal aerobic capacity in patients with chronic pain of different etiologies and to compare these results with different parameters of disability. Patients and methodsA cycloergometer exercise test with VO2max measurement, fatigue assessment and objective and subjective disability parameter testing was performed on 155 patients (mean age 42.1±9.9 years) classified into three groups: patients with chronic lower back pain, patients with an upper limb musculoskeletal disorder, and patients with multifocal chronic pain. ResultsThe mean VO2max value was 22.18 mL/min/kg. There was no statistically significant difference in VO2max between the three groups. The patients with poorest aerobic condition were older (P<0.007), were on sick leave longer (P<0.03), had weaker Sorensen test (P<0.01) and P.I.L.E. (P<0.004) results, had more perceived fatigue (P<0.04), a higher mean BMI (P<0.0001) and gained more weight during sick leave (P<0.02). DiscussionNumerous studies have examined loss of aerobic capacity due to chronic low back pain with contradictory results. This is probably due to variability of in the methods used to measure or calculate VO2max as well as to the variability in the studied populations. ConclusionIt seems appropriate to offer patients with chronic pain multidisciplinary exercise rehabilitation programs.

Decreased aerobic capacity 4 years after aortic valve replacement in male patients operated upon for chronic aortic regurgitation

Exercise testing is underutilized in patients with valve disease. We have previously found a low physical work capacity in patients with aortic regurgitation 6 months after aortic valve replacement (AVR). The aim of this study was to evaluate aerobic capacity in patients 4 years after AVR, to study how their peak oxygen uptake (peakVO2) had changed postoperatively over a longer period of time. Twenty-one patients (all men, 52 ± 13 years) who had previously undergone cardiopulmonary exercise testing (CPET) pre- and 6 months postoperatively underwent maximal exercise testing 49 ± 15 months postoperatively using an electrically braked bicycle ergometer. Breathing gases were analysed and the patients' physical fitness levels categorized according to Åstrand's and Wasserman's classifications. Mean peakVO2 was 22·8 ± 5·1 ml × kg−1 × min−1 at the 49-month follow-up, which was lower than at the 6-month follow-up (25·6 ± 5·8 ml × kg−1 × min−1, P = 0·001). All but one patient presented with a physical fitness level below average using Åstrand's classification, while 13 patients had a low physical capacity according to Wasserman's classification. A significant decrease in peakVO2 was observed from six to 49 months postoperatively, and the decrease was larger than expected from the increased age of the patients. CPET could be helpful in timing aortic valve surgery and for the evaluation of need of physical activity as part of a rehabilitation programme.

Gender Differences in Peak Aerobic Capacity in Patients Following Traumatic Brain Injury

Gender Differences in Peak Aerobic Capacity in Patients Following Traumatic Brain Injury

Long-Term Outcome of Cardio Respiratory Exercise Performance After Surgery

Cardio respiratory exercise testing provides an objective measurement of aerobic exercise capacity in patients with congenital heart disease. Many patients with congenital heart disease have decreased exercise capacity despite a lack of symptoms. Patients with simple lesions tend to have better exercise capacity than those with complex lesions, but individual variation exists. The reasons for this impairment in exercise capacity cannot be explained by ventricular dysfunction alone. Chronotropic impairment, disturbances of pulmonary function and deconditioning also play a key role. In patients with congenital heart disease, cardio respiratory exercise testing has prognostic value and could be important in deciding the need for re-interventions. Keywords: Exercise, congenital, heart, physical activity, aerobic, capacity-prognosis, low morbidity, ventricular dysfunction, Chronotropic impairment, prognostic value, musculoskeletal systems

Tissue advanced glycation end products are associated with diastolic function and aerobic exercise capacity in diabetic heart failure patients

Advanced glycation end products (AGEs) are increased in patients with diabetes and are associated with diastolic dysfunction through the formation of collagen crosslinks in the heart. The association among AGEs, diastolic function, and aerobic capacity in heart failure (HF) patients with and without diabetes is, however, unknown. We therefore studied the association among tissue AGEs, diastolic function, and aerobic capacity in patients with HF with or without diabetes. In chronic HF patients (with and without left ventricular systolic dysfunction), tissue AGEs [skin autofluorescence (AF)], diastolic function (echocardiographic mean E' and E/E'), and aerobic capacity [peak oxygen uptake (VO(2)) on cardiopulmonary exercise testing] were obtained. A total of 49 diabetics and 156 non-diabetics were included. Diabetics were older and had more cardiovascular risk factors, but left ventricular ejection fractions (LVEF) were similar. Tissue AGEs were higher in diabetics compared with non-diabetics (2.8 ± 0.8 vs. 2.3 ± 0.7 a.u.; P < 0.001). Furthermore, there was a correlation between tissue AGEs and mean E' (r = -0.30; P < 0.001, after adjustment for age, r = -0.21; P = 0.004). Aerobic capacity was significantly lower in diabetic patients with HF (peak VO(2): 17.4 ± 5.1 vs. 21.7 ± 6.1 mL/min/kg; P = 0.001), even after adjustment for age and LVEF. Peak VO(2) was related to skin AF (P = 0.03), independent of age, diabetes, LVEF, and New York Heart Association functional class. Patients with diabetes and HF have similar LVEF but poorer exercise capacity compared with non-diabetic HF patients. Our data suggest that these findings might be explained by the observed association among tissue AGE levels, diastolic function, and exercise capacity.

Cardiorespiratory Fitness Is Independently Associated with 25-Hydroxyvitamin D in Chronic Kidney Disease

Vitamin D is an established important contributor to muscle function and aerobic metabolism. Hypovitaminosis D is highly prevalent in CKD patients and is associated with increased cardiovascular (CV) mortality via unknown mechanisms. Because aerobic-exercise capacity strongly predicts future CV events, we hypothesized that vitamin D status could be linked to CV outcomes via an effect on maximum aerobic-exercise capacity in patients with CKD and that this effect may be mediated in part via its actions on muscle strength and functional ability. Baseline demographic, anthropometric, and biochemical data were collected in a cross-sectional study of patients with moderate CKD. Peak aerobic capacity was determined during treadmill stress testing using metabolic equivalence of tasks. Physical activity was assessed using the Active Australia questionnaire, grip strength by dynamometer, and functional capacity by "Up & Go" testing. The study included 85 participants (age 59.5 ± 9.7 years, 60% male, 44% diabetic, 92% Caucasian; mean serum 25-hydroxyvitamin D [25-OHD] 78.4 ± 29.4 nmol/L). We demonstrated that 25-OHD status was independently associated with aerobic-exercise capacity (β = 0.2; P = 0.008). Aerobic-exercise capacity was also predicted by younger age, white race, smaller waist circumference, absence of a previous angina history, and increasing weekly physical activity. However, neither muscle strength nor functional ability were significantly associated with 25-OHD. Vitamin D is independently associated with aerobic capacity in CKD patients, and this finding is not explained by changes in muscle strength or functional ability.

Maximal aerobic power in patients with chronic low back pain: a comparison with healthy subjects

The objective of the study was to compare the maximal aerobic capacity of patients with chronic low back pain with healthy asymptomatic controls matched for age, gender and level of physical activity at work and during sports activities. Reported data in the literature with respect to aerobic capacity in patients with chronic low back pain are not conclusive. Nevertheless, based on the assumption that chronic low back pain leads to deconditioning, physical training programs are widely used as a treatment. A total of 70 patients with chronic low back pain and 70 healthy asymptomatic subjects completed questionnaires regarding demographics and performed a graded maximal exercise test until exhaustion on a cycle ergometer. The maximal aerobic power was measured by indirect calorimetry. Heart rate, respiratory exchange ratio and blood lactate levels were also measured. The test was considered maximal when VO₂max achievement criteria were obtained. VO₂max values were compared among groups. The absolute and normalized for weight values of VO₂max measured in patients with chronic low back pain were significantly lower than that of the control group. Independent comparison between men and women showed that absolute values of VO₂max are also significantly lower in men and women with chronic low back pain. Women reached absolute and normalized for weight VO₂max values significantly lower than those of men, both in chronic low back pain and control group. In conclusion, chronic low back pain patients, especially women, seem to have a reduced aerobic capacity compared to healthy asymptomatic subjects.

Effect of Weight Loss on Aerobic Capacity in Patients with Severe Obesity Before and After Bariatric Surgery

Severe obesity has been associated with adverse effects on physical capacity. In a prospective study, the aerobic capacity of severely obese patients was measured in order to observe the physiological response to weight loss from bariatric surgery. Sixty-five consecutive patients (40.4 +/- 8.4 years old; 93.8% female; body mass index = 49.4 +/- 5.4 kg/m(2)) were evaluated before bariatric surgery and then 6 and 12 months after surgery. Aerobic capacity was assessed with a scientific treadmill to measure maximal oxygen consumption (VO(2max)), heart rate, blood pressure, time on the treadmill, and distance walked (modified Bruce test). For the three observational periods, VO(2max) was 25.4 +/- 9.3, 29.8 +/- 8.1, and 36.7 +/- 8.3 ml/kg/min; time on the treadmill was 5.4 +/- 1.4, 6.4 +/- 1.6, and 8.8 +/- 1.0 min; and distance walked was 401.8 +/- 139.1, 513.4 +/- 159.9, and 690.5 +/- 76.2 m. For these variables, significant results (p = 0.0000) were observed for the two postoperative periods in relation to the preoperative period. Severely obese individuals increased their aerobic capacity after successful bariatric surgery. The data also suggests that a positive and progressive relationship between weight loss and improvement in fitness as a moderate loss of weight 6 months after surgery already showed some benefit and an additional reduction in weight was associated with a better performance in the aerobic capacity tests at the 12-month follow-up.

Aerobic capacity in patients with chronic liver disease: Very modest effect of liver transplantation

Aerobic capacity is commonly impaired in patients with liver cirrhosis, as demonstrated by their low oxygen consumption at peak exercise (peak VO(2)). This impairment is correlated with the severity of the liver disease. We investigated the effect of orthotopic liver transplantation (OLT) alone on exercise capacity in this prospective study of patients with liver cirrhosis. Twenty liver transplant candidates, aged 27 to 61years, underwent resting pulmonary function tests, echocardiography, and incremental cardiopulmonary exercise testing (CPET) before OLT and 16.3 + or - 1.6months after OLT. Following OLT, peak VO(2) increased by a mean of only 7.7% (from 63.4 to 71.1% of predicted value), and decreased in one-quarter of the patients. Cardiac function was normal before OLT and no changes in respiratory indicators followed OLT. Change in peak VO(2) after OLT (Delta peak VO(2)) was related to changes in hemoglobin level (r(2)=0.45, p=0.04), the stopping of beta-blocker therapy, and muscle impairment, as suggested by the correlation between Delta peak VO(2) and peak lactate concentration before OLT (r(2)=0.64, p<0.01). Our study provides evidence of a very modest and inconsistent increase in aerobic capacity in liver transplant candidates after liver transplantation alone. This persistent impairment of exercise tolerance was principally of peripheral origin but anemia and beta-blocker treatment should be considered as major aggravating factors. Rehabilitation programs before and after transplantation may increase its benefits to these deconditioned liver transplant recipients in their daily lives.

Impact of Age at Fontan Completion on Postoperative Hemodynamics and Long-Term Aerobic Exercise Capacity in Patients With Dominant Left Ventricle

Impact of Age at Fontan Completion on Postoperative Hemodynamics and Long-Term Aerobic Exercise Capacity in Patients With Dominant Left Ventricle