Cycle Ergometry Test Research Articles

Blood pressure response during exercise testing in individuals with and without hypertension: The value of the recovery phase.

Hypertension and exercise testing are essential for cardiovascular risk assessment. However, an exact description of blood pressure (BP) in patients with a hypertensive response during exercise (HRE), especially in the recovery phase is lacking. Herein, we aimed to analyse BP and heart rate during exercise testing and recovery in patients with an HRE. 800 patients aged 17-90 with an HRE during a standardized bicycle ergometry test were recruited. The BP behaviour during exercise testing was correlated with clinical data. Furthermore, data were analysed according to the presence of pre-existent hypertension. Of the 800 patients included in this study 497 (62%) were previously diagnosed with hypertension. Analysis of covariance showed a significantly faster systolic (β [95% CI] 8.0 [4.9-11.1]) and diastolic (2.4 [0.4-4.4]) BP recovery 3 min after maximal exercise in patients without hypertension in univariable models. These results remained robust in fully adjusted models taking into account age, sex, body mass index, cardiovascular disease, and antihypertensive treatment for systolic (5.3 [1.2-9.4]) and diastolic BP (4.5 [1.9-7.0]). Furthermore, patients with hypertension displayed higher systolic BP during maximal exercise in univariable (3.8 [0.1-7.5]) and fully adjusted (5.5 [1.1-10.0]) models. There was no difference in maximum diastolic BP between groups. In this large cohort study, patients without hypertension showed a faster systolic and diastolic BP recovery and lower maximal systolic BP compared to patients with hypertension. Overall, this study provides new insights into cardiovascular health during recovery phase.

EPS1.01 Predicting ‘optimal’ work rate increments for cycle ergometry tests in cystic fibrosis

EPS1.01 Predicting ‘optimal’ work rate increments for cycle ergometry tests in cystic fibrosis

Reproducibility of heart rate recovery measures across differing modalities and intensities of submaximal exercise in healthy volunteers: A healthy volunteer study

PurposeSubmaximal exercise tests (SET) are an easier to conduct and less physically demanding alternative to cardiopulmonary exercise testing for assessment of pre-operative fitness. Assessment of heart rate recovery (HRR) following SETs offers an easily obtained marker of vagal reactivation and sympathetic withdrawal and therefore provides an indication of an individual’s fitness. This study sought to assess the reproducibility of HRR across different workloads and modalities of SET.MethodsThirty-four healthy volunteers were recruited to undergo two SETs at 40% and 60% of their predicted maximal workload. A second group of thirty-one healthy volunteers were recruited to undergo three SETs of differing modalities; Cycle ergometry, Step and Shuttle Walk tests. HRR was quantified using the conventional indices HRR1 and HRR2 (calculated as heart rate (HR) on exercise cessation minus HR at 1 and 2 min of rest) and a novel area under the HRR vs. time curve (HRRAUC) method. Reproducibility of results was assessed using intra-class correlation coefficient (ICC) and limits of agreements.ResultsThe results showed that HRR1 and HRR2 were poorly reproducible across differing workloads and exercise modalities (ICC < 0.45 for all comparisons) whereas HRRAUC proved to be at least moderately reproducible (ICC > 0.52 for all comparisons).ConclusionsThese results suggest that HRRAUC may be a superior way of quantifying HRR following SETs, adding objectivity to SET results. Quantifying HRRAUC could prove to have useful clinical applications for pre-operative risk assessment, assessing fitness to undergo treatment and monitoring disease progression.

Exercise challenge test: indications, protocol, interpretation of the results

Exercise-induced bronchoconstriction mostly presents in patients with asthma, although it is generally recognized that physical activity provokes, but not causes asthma. The lecture discusses the pathogenesis of the syndrome of exercise-induced bronchoconstriction, its diagnosis which includes bicycle ergometry or treadmill test, as well as registration of the flow-volume curve of forced exhalation before and at different time intervals during recovery after exercise challenge test. Besides, indications, and contraindications to the test are listed as well as methodology and the interpretation of the results are considered in detail. A clinical example of the detection of exercise-induced bronchoconstriction in a young adult patient is also given.

Are changes in muscular strength following head‐down bed rest independently associated with improved cognitive function in older adults? A secondary analysis of a randomized controlled trial

AbstractBackgroundPhysical inactivity is common among older adults and is a risk factor for cognitive decline. Even a brief period of physical inactivity, such as bed rest due to hospitalization, in older adults has significant negative impacts. Exercise is strategy to counter the negative effects of physical inactivity. Exercise‐induced improvements in cardiorespiratory fitness is associated with improved cognitive function. Less is known regarding the contribution of exercise‐induced changes in muscle strength to changes in cognitive function. Thus, we aimed to examine the independent contribution of: 1) change in cardiorespiratory fitness; and 2) change in peak muscle torque of the lower extremity to changes in cognitive function in a randomized controlled trial (RCT) of head‐down bed rest (HDBR) vs. HDBR with exercise in healthy older adults.MethodAn analysis of a non‐blinded, parallel‐group, RCT of 22 healthy older adults (11 males and 11 females) aged 55‐65 years. Participants were randomized to: 1) 14 days of 6° HDBR (CON); or 2) HDBR with daily resistance and aerobic exercise training (EX). Outcome measures were taken at baseline and HDBR completion. The Flanker Inhibitory Control and Attention Task measured executive function. Physical fitness measures included: 1) maximal aerobic capacity (VO2max) using a bicycle ergometry test; and 2) knee extension isokinetic muscular strength (KE) using a Biodex dynamometer. We performed two separate multiple linear regressions to determine whether following 14 days of HDBR: 1) VO2max was associated with Flanker score, after accounting for ΔKE; and 2) KE was associated with Flanker score, after accounting for ΔVO2max. Each model was also adjusted for baseline Flanker score and the baseline physical fitness measure of interest.ResultAt baseline, average Flanker t‐score was 48.33, mean VO2max was 32.527 ml/kg/min, and knee extension strength was 64.472 Nm. VO2max at follow‐up was not significantly associated with Flanker performance (b = 0.232 ± 0.716; p = 0.635; R2 adj. = 0.285). However, greater KE strength was significantly associated with better Flanker performance (b = 2.023 ± 0.389; p = 0.043; R2 adj. = 0.633) at HDBR completion.ConclusionThe maintenance of muscle strength even during brief periods of physical inactivity appears to be critical for cognitive health in older adults.

Abstract 15806: An Age Index Derived From Heart Rate Metrics is Associated With Cardiovascular Risk Biomarkers

Introduction: Conventional cardiovascular (CV) risk scores depend on clinical and laboratory measurements, and therefore have limited accessibility in the general population. Consumer wearables provide heart rate measures which individually correlate with CV risk, but it is not known how well they align collectively with conventional clinical biomarkers. Objective: To demonstrate the alignment of a composite index based on heart rate metrics available from consumer wearables with clinical biomarkers and risk scores. Methods: As chronological age is a strong predictor of cardiovascular health, we trained a linear regression model on the UK Biobank (UKB) dataset to predict chronological age from sex, body mass index, resting heart rate (RHR), and mean HR, maximum HR, HR recovery and estimated VO2max during a cycle ergometry test. Data from 53,670 individuals aged 40-70 years were used: 30,247 for training and 23,423 for testing. A cardiovascular age (CVAge) index was obtained as the difference between chronological and predicted age of the individual: a positive/negative CVAge index indicates the CV health is better/worse than the age would suggest. Heart rate predictors and CVAge index were z-scored using age and sex data on the training set. Results: Individuals in the bottom quintile (“Poor CVAge index”) of the test set had higher systolic blood pressure (+5.0 mmHg), diastolic blood pressure (+3.0 mmHg), Framingham 10-year risk score (+1.8%) and ASCVD risk score (+0.8%), than those in the top quintile (“Very Good CVAge index”) - Figure 1. Conclusions: Continuous monitoring of heart rate metrics may help users track their heart health even in the absence of clinical and laboratory measurements.

Analysis of the results of functional diagnostic studies of the cardiovascular system in children after surgical correction of congenital heart defects

Objective. To evaluate the features of the cardiovascular system in children after surgical correction of congenital heart defects revealed by functional diagnostic studies.Materials and methods. A functional diagnostic examination of the cardiovascular system (CVS) was performed in 43 children aged 5 to 17 years with the main clinical diagnosis: “Congenital heart disease” (CHD), of which 33 children of the main group (MG) had corrected CHD, in 10 children of the comparison group (CG) CHD correction was not performed due to the presence of certain contraindications. Patients were on a routine examination and treatment for CHD in the cardio-rheumatology department of the institution “Gomel Regional Children’s Clinical Hospital” in the period 2020-2022.Results. Based on the statistical processing of the results of the study, which included an assessment of clinical and anamnestic data and indicators of functional diagnostic methods for examining the CVS in children with CHD, the need for a comprehensive cardiological examination in children with this pathology was established, regardless of the method of performed surgical intervention. It was found that the majority of children with corrected CHD on the ECG had rhythm and conduction disturbances, as well as combined arrhythmias, and one third of the patients had cardiac complaints. According to the Holter monitoring (HM) and bicycle ergometry (BEM) tests, the children showed signs of electrical instability of the myocardium and a decrease in the adaptive reserves of the cardiovascular system.Conclusion. Children with corrected CHD require a comprehensive functional and diagnostic examination, which makes it possible to identify an “arrhythmogenic substrate” and establish signs of myocardial electrical instability, thereby optimizing the tactics of treatment and rehabilitation of this group of patients.

Home-based exercise improves subclinical atherosclerosis marker in multiple sclerosis

PurposeUsing a 12-week, randomized controlled trial coupled with social cognitive theory behavioral coaching, we aimed to assess the effect of a home-based aerobic training intervention versus an attention-control on aerobic fitness, subclinical atherosclerosis, and mobility in persons with MS. MethodsPersons with MS with an expanded disability status scale score between 0 and 4 were randomized to a 12-week aerobic exercise (EX) (n = 26; 19 females; 49 yrs; 28.8 kg/m2) or attention-control (CON) condition (stretching; n = 22; 16 females; 44 yrs; 29.2 kg/m2). Aerobic capacity was assessed via a graded cycle ergometry test with indirect calorimetry. The co-primary measures of subclinical atherosclerosis assessed included carotid intima media thickness, a test of vasodilatory reactivity, and arterial stiffness. Mobility was assessed via a timed 25-foot walk test (T25FW) and a 6 min walk test. The EX group engaged in cycle ergometry 3d/wk with gradual increases in the intensity and duration of the exercise sessions. CON participated in standardized stretching designed to provide the same contact time as EX 3d/wk. Behavioral coaching took place via weekly phone/video chats to track adherence. ResultsAerobic capacity, vasodilatory reactivity, and T25FW speed increased only in the EX group, 7%, 16%, and 13% (p<0.05), respectively; whereas the CON group did not change. ConclusionThe EX group had modest, yet significant, increases in aerobic capacity over the 12-week period, coupled with improvements in T25FW speed and vasodilatory reactivity. A home-based exercise intervention can improve outcomes of a subclinical marker of atherosclerosis, which provides a basis for examining these outcomes in persons prescreened for CVD-related comorbidities and/or mobility issues.

Поражение сердца у юных элитных спортсменов, перенесших COVID-19

The impact of coronavirus infection (SARS-CoV-2) on cardiac output in underage athletes is uncertain. The study was aimed to determine heart disease in young elite athletes having a history of COVID-19 (SARS-CoV-2). A retrospective analysis of the results of the developed three-phase medical assessment of 236 elite athletes aged 14–17 (16 ± 1), who had had SARS-CoV-2 infection, was performed. The first phase of assessment involved examination, ECG, ECHO, bicycle ergometry (BEM), creatine kinase and creatine kinase MB tests. During the second phase 22 athletes (9.3%) underwent a more thorough assessment that included Holter monitoring (HM) with heart rate turbulence (HRT), microvolt T–wave alternans (MTWA), heart rate variability (HRV) estimation, high-resolution ECG (HRECG), determination of myocardial damage biochemical markers (troponin, NТproBNP) due to alterations revealed. Seven athletes (32%) having alterations revealed during this phase were referred to gadolinium enhancement cardiac magnetic resonance imaging (MRI) (the third phase). Myopericarditis was diagnosed in four cases (1.7% of 236) based on the results. Thus, low (below 2%) myocardial involvement has been revealed in young elite athletes, who have a history of SARSCoV-2 infection. Cardiovascular assessment algorithm has been developed for such athletes. Detection of cardiac arrhythmias by ECG, BEM, and HM is the most informative. HRECG, HRV, HRT, and MTWA can be used as additional methods to determine indications for MRI as a gold standard of the diagnosis of myocarditis.

Does physical fitness affect cognitive functions differently across adulthood? An advantage of being older.

There is a large interindividual variability in cognitive functioning with increasing age due to biological and lifestyle factors. One of the most important lifestyle factors is the level of physical fitness (PF). The link between PF and brain activity is widely accepted but the specificity of cognitive functions affected by physical fitness across the adult lifespan is less understood. The present study aims to clarify whether PF is basically related to cognition and general intelligence in healthy adults, and whether higher levels of PF are associated with better performance in the same or different cognitive functions at different ages. A sample of 490 participants (20-70 years) was analyzed to examine this relationship. Later, the sample was split half into the young to middle-aged group (YM; 20-45 years; n = 254), and the middleaged to older group (MO; 46-70 years; n = 236). PF was measured by a quotient of maximum power in a bicycle ergometry test PWC-130 divided by body weight (W/kg), which was supported by a self-reported level of PF. Cognitive performance was evaluated by standardized neuropsychological test batteries. Regression models showed a relationship between PF and general intelligence (g-factor) and its subcomponents extracted using structural equation modeling (SEM) in the entire sample. This association was moderated by age, which also moderated some specific cognitive domains such as attention, logical reasoning, and interference processing. After splitting the sample into two age groups, a significant relationship was found between cognitive status, as assessed by the Mini Mental State Examination (MMSE), and PF in both age groups. However, apart from cognitive failures in daily life (CFQ), no other association between PF and specific cognitive functions was found in the YM group. In contrast, several positive associations were observed in the MO group, such as with selective attention, verbal memory, working memory, logical reasoning, and interference processing. These findings show that middle-aged to older adults benefit more from PF than younger to middle-aged adults. The results are discussed in terms of the neurobiological mechanisms underlying the cognitive effects of PF across the lifespan. https://clinicaltrials.gov/ct2/show/NCT05155397, identifier NCT05155397.

Preserved hemodynamics in breast cancer survivors not a function of cancer, but fitness

Introduction: One in eight U.S. women will develop breast cancer (BC), and cardiovascular disease is the second leading cause of death among survivors. Improving cardiorespiratory fitness (CRF) and increasing physical activity (PA) reduces risk of adverse cardiovascular events among the general population without BC. Specifically, improved heart rate recovery (HRR) and hemodynamic modulation established through greater PA are traditional methods of risk assessment for cardiovascular disease that may be beneficial for BC survivors. Purpose: The purpose of this study was to examine HRR and hemodynamic adjustments following a maximal test of CRF among active and inactive BC survivors compared to women without a BC diagnosis. Methods: Twenty-two BC survivors were separated into active (n=11, 48±9 yrs, 24.8±3 kg/m2, 373±172 min/wk) and inactive (n=11, 51±9 yrs, 26.1±3 kg/m2, 52±68 min/wk) groups and compared to 18 active women without BC (48±9 yrs, 25.3±5 kg/m2, 327±178 min/wk) based on the Paffenberger PA Questionnaire. Mean arterial pressure (MAP), cardiac output (CO), total peripheral resistance (TPR), and stroke volume (SV) were measured before and 5 minutes after after a cycle ergometry test of CRF (expressed as VO2peak) using an oscillometric device. Continuous heart rate was assessed using a three-lead ECG throughout and following the test to calculate the slow phase (Peak exercise [VO2peak] to 2-min post) of HRR. Results: Active BC survivors demonstrated similar HRR from peak exercise (-52±15 bpm) compared to active individuals without BC (-46±12 bpm), both of which were greater than the HRR observed in non-active BC survivors (-38±12 bpm; p for interaction=0.05). We found a significant relationship between CRF and HRR for the three groups (VO2peak, active BC survivors: 32.6±4 mL/kg·min-1; inactive BC survivors: 20.9±3 mL/kg·min-1; active controls: 29.5±6 mL/kg·min-1; r=0.38, p=0.01). Likewise, inactive BC survivors experienced a blunted change in SV following a maximal CRF test, compared to active BC survivors and control counterparts (%ΔSV [mL/min], active BC survivors: 32.7%; inactive BC survivors: 23.5%; active controls: 39.3%; p for interaction≤0.001). Active BC survivors (before: 1.32±0.1 mmHg/L·min-1, after: 1.13±0.2 mmHg/L·min-1) experienced a greater reduction in TPR following the maximal CRF test compared to their inactive BC survivors (before: 1.23±0.2 mmHg/L·min-1, after: 1.18±0.14 mmHg/L·min-1) and active individuals without BC (before: 1.20±0.2 mmHg/L·min-1, after: 1.16±0.12 mmHg/L·min-1; p for interaction=0.03). MAP was not different between the 3 groups ( p for interaction≥0.05). Conclusion: Physically active BC survivors exhibit preserved cardiac autonomic and hemodynamic control following maximal exercise, similar to active individuals without BC. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Prediction of Maximal Oxygen Consumption in Cycle Ergometry in Competitive Cyclists.

Models for predicting maximal oxygen consumption (VO2max) in average adults might not be suitable for athletes, especially for competitive cyclists who can have significantly higher VO2max than normally active people. The aim of this study was to develop a clinically applicable equation for predicting VO2max during cycle ergometry in competitive cyclists and to compare its accuracy to the traditional American College of Sports Medicine (ACSM) equation. Maximal cycle ergometry tests were performed in 496 male and 84 female competitive cyclists. Six predictors were initially used to model the prediction equation (power output, body weight, body height, fat mass, fat-free mass and age). Power output and body weight were the most important parameters in the model predicting VO2max. Three new equations were derived: for male (VO2max = 0.10 × PO - 0.60 × BW + 64.21), female cyclists (0.13 × PO - 0.83 × BW + 64.02) and the non-gender-specific formula (0.12 × PO - 0.65 × BW + 59.78). The ACSM underestimated VO2max in men by 7.32 mL/min/kg (11.54%), in women by 8.24 mL/min/kg (15.04%) and in all participants by 7.45 mL/min/kg (11.99%), compared to the new equation that underestimated VO2max in men by 0.12 mL/min/kg (0.19%) and in all participants by 0.65 mL/min/kg (1.04%). In female cyclists, the new equation had no relative bias. We recommend that medicine and sports practitioners adapt our proposed equations when working with competitive cyclists. Our findings demonstrate the need to evaluate prediction models for other athletes with a special focus on disciplines that demand high aerobic capacity.

Effects of Medical Face Masks on Physical Performance in Patients With Coronary Artery Disease or Hypertension

In this randomized, prospective monocentric study, 40 subjects with coronary artery disease or hypertension (cardiovascular disease [CVD] group) were assigned to either surgical mask (SM) or class 2 filtering facepiece mask (FFP2). They performed cycle ergometry exercise tests with progressive intensity until exhaustion with the assigned mask and another test with no mask (NM) in random order. A control group of 10 healthy subjects randomly performed 3 exercise tests with NM, SM, and FFP2, respectively. Blood pressure, heart rate, 12-lead electrocardiogram, exertion, shortness of breath, and capillary blood gases from the earlobe were documented. Across all groups, exercise testing with face masks resulted in a significantly reduced peak power output in watts compared with testing with NM (CVD group: SM vs NM: -5.0 ± 7.0%, p=0.005; FFP2 vs NM: -4.7 ± 14%, p=0.03; control group: SM vs NM: -6.8 ± 4.4%, p=0.008; FFP2 vs NM: -8.9 ± 6.3%; p=0.01) without differences in hemodynamic parameters, such as maximum heart rate and systolic blood pressure. Wearing an FFP2 compared with NM resulted in significant higher carbon dioxide partial pressure (CVD group: FFP2: 36.0 ± 3.2 mm Hg vs NM: 33.3 ± 4.4 mm Hg, p=0.019; control group: FFP2: 32.6 ± 2.8 mm Hg vs NM: 28.1 ± 1.7 mm Hg, p <0.001) with corresponding differences in hydrogen carbonate and base excess, but not to a clinically critical extent. In conclusion, exercise testing with SM and FFP2 resulted in a significant reduction of peak power output without differences in hemodynamic parameters in subjects with preexisting CVD and in healthy subjects.

PARASYMPATHETIC INFLUENCE ON THE MYOCARDIUM TO THE ONSET OF EXERCISE AND IMMEDIATE POST EXERCISE RECOVERY

Background: The purpose of this study was to investigate the influence of parasympathetic nervous system on heart rate after the onset of exercise and immediate post exercise recovery. The heart rate is one of the most important cardiovascular parameter, which is very commonly used in sports to measure athletic performance. The parasympathetic nervous system is one of the major factors controlling the heart rate response due to exercise or any other stressful activity. It is also found that parasympathetic nervous system has a trainable characteristic. Hence the study focused on relating the heart rate response to the parasympathetic nervous system during the onset of exercise and immediate post exercise recovery. Methodology: This study followed an experimental approach to the problem through the analysis of archived data in the form of heart rate response to incremental workloads to volitional fatigue. The subjects in the archived data comprised of past research data measured during cycle ergometry testing to volitional fatigue. The demography of the subjects was determined via the archived data. The data consisted of 33 healthy male subjects between 19 and 47 years of age. The subjects were divided into two groups: very fit and moderately fit group, based on their VO2 max. The 50th percentile of the MaxVO2 was determined by using the median for the group. The median value obtained was 57.2 ml/kg/min. The subjects with the MaxVO2 above 57.2 ml/kg/min were grouped into a very fit category of the individuals, and the subjects with MaxVO2 below 57.2 ml/kg/min were grouped into moderately fit category. There were sixteen (n=16) subjects in the very fit group and seventeen (n=17) subjects in the moderately fit group. The outcome of the test was measured in heart rate. The parasympathetic withdrawal includes the heart rate data collected during the first three minutes of exercise. The parasympathetic reinfusion includes the heart rate data collected during the last three minutes of exercise. The statistical analysis comprised of correlation analysis and the t-test for independent samples. The results were: the correlation coefficient for very fit group parasympathetic withdrawal versus parasympathetic reinfusion is -0.81 at p &lt; 0.05 and was found to be significant. The correlation coefficient for moderately fit group parasympathetic withdrawal versus parasympathetic reinfusion is 0.65 at p &lt; 0.05 and was found to be non significant. A t-test for independent samples was used to determine the difference between the heart rate response due to parasympathetic withdrawal and heart rate response due to parasympathetic reinfusion for the very fit group of subjects, and the difference was found to be statistically significant at p value of 0.002. A t-test for independent samples was used to determine the difference between the heart rate response due to parasympathetic withdrawal and the heart rate response due to parasympathetic reinfusion for the moderately fit group of subjects, and the difference was found to be statistically significant at p value of 0.001. The conclusion is that there is significant association between heart rate response due parasympathetic withdrawal and heart rate response due to parasympathetic reinfusion for very fit group of subjects. But there is no significant association between heart rate response due to parasympathetic withdrawal and heart rate response due to parasympathetic reinfusion for moderately fit group of subjects. There exists a significant difference between the heart rate response due to parasympathetic withdrawal and heart rate response due to parasympathetic reinfusion in both very fit and moderately fit group of subjects.

Differences between Treadmill and Cycle Ergometer Cardiopulmonary Exercise Testing Results in Triathletes and Their Association with Body Composition and Body Mass Index.

Cardiopulmonary exercise testing (CPET) is the method of choice to assess aerobic fitness. Previous research was ambiguous as to whether treadmill (TE) and cycle ergometry (CE) results are transferrable or different between testing modalities in triathletes. The aim of this paper was to investigate the differences in HR and VO2 at maximum exertion between TE and CE, at anaerobic threshold (AT) and respiratory compensation point (RCP) and evaluate their association with body fat (BF), fat-free mass (FFM) and body mass index (BMI). In total, 143 adult (n = 18 female), Caucasian triathletes had both Tr and CE CPET performed. The male group was divided into <40 years (n = 80) and >40 years (n = 45). Females were aged between 18 and 46 years. Body composition was measured with bioelectrical impedance before tests. Differences were evaluated using paired t-tests, and associations were evaluated in males using multiple linear regression (MLR). Significant differences were found in VO2 and HR at maximum exertion, at AT and at RCP between CE and TE testing, in both males and females. VO2AT was 38.8 (±4.6) mL/kg/min in TE vs. 32.8 (±5.4) in CE in males and 36.0 (±3.6) vs. 32.1 (±3.8) in females (p < 0.001). HRAT was 149 (±10) bpm in TE vs. 136 (±11) in CE in males and 156 (±7) vs. 146 (±11) in females (p < 0.001). VO2max was 52 (±6) mL/kg/min vs. 49 (±7) in CE in males and 45.3 (±4.9) in Tr vs. 43.9 (±5.2) in females (p < 0.001). HRmax was 183 (±10) bpm in TE vs. 177 (±10) in CE in males and 183 (±9) vs. 179 (±10) in females (p < 0.001). MLR showed that BMI, BF and FFM are significantly associated with differences in HR and VO2 at maximum, AT and RCP in males aged >40. Both tests should be used independently to achieve optimal fitness assessments and further training planning.

Differential Outcomes Following 4 Weeks of Aclidinium/Formoterol in Patients with COPD: A Reanalysis of the ACTIVATE Study

RationaleIt is difficult to predict the effects of long-acting bronchodilators (LABD) on lung function, exercise capacity and physical activity in patients with chronic obstructive pulmonary disease (COPD). Therefore, the multidimensional response to LABD was profiled in COPD patients participating in the ACTIVATE study and randomized to LABD.MethodsIn the ACTIVATE study, patients were randomized to aclidinium bromide/formoterol fumarate (AB/FF) or placebo for four weeks. The primary outcomes included (1) lung function as measured by functional residual capacity (FRC), residual volume (RV), and spirometric outcomes; (2) exercise performance as measured by a constant work rate cycle ergometry test (CWRT); and (3) physical activity (PA) using an activity monitor. Self-organizing maps (SOMs) were used to create an ordered representation of the patients who were randomly assigned to four weeks of AB/FF and cluster them into different outcome groups.ResultsA total of 250 patients were randomized to AB/FF (n = 126) or placebo (n = 124). Patients in the AB/FF group (39.6% women) had moderate-to-severe COPD, static hyperinflation (FRC: 151.4 (27.7)% predicted) and preserved exercise capacity. Six clusters with differential outcomes were identified. Patients in clusters 1 and 2 had significant improvements in lung function compared to the remaining AB/FF-treated patients. Patients in clusters 1 and 3 had significant improvements in CWRT time, and patients in clusters 2, 3 and 6 had significant improvements in PA compared to the remaining AB/FF-treated patients.ConclusionIndividual responses to 4 weeks of AB/FF-treatment in COPD are differential and the degree of change differs across domains of lung function, exercise capacity and PA. These results indicate that clinical response to LABD therapy is difficult to predict and is non-linear, and show doctors that it is important to look at multiple outcomes simultaneously when evaluating the clinical response to LABD therapy.Clinical Trial RegistrationThe original ACTIVATE study was registered on ClinicalTrials.gov, registration number NCT02424344.

Transferability of Cardiopulmonary Parameters between Treadmill and Cycle Ergometer Testing in Male Triathletes-Prediction Formulae.

Cardiopulmonary exercise testing (CPET) on a treadmill (TE) or cycle ergometry (CE) is a common method in sports diagnostics to assess athletes’ aerobic fitness and prescribe training. In a triathlon, the gold standard is performing both CE and TE CPET. The purpose of this research was to create models using CPET results from one modality to predict results for the other modality. A total of 152 male triathletes (age = 38.20 ± 9.53 year; BMI = 23.97 ± 2.10 kg·m−2) underwent CPET on TE and CE, preceded by body composition (BC) analysis. Speed, power, heart rate (HR), oxygen uptake (VO2), respiratory exchange ratio (RER), ventilation (VE), respiratory frequency (fR), blood lactate concentration (LA) (at the anaerobic threshold (AT)), respiratory compensation point (RCP), and maximum exertion were measured. Random forests (RF) were used to find the variables with the highest importance, which were selected for multiple linear regression (MLR) models. Based on R2 and RF variable selection, MLR equations in full, simplified, and the most simplified forms were created for VO2AT, HRAT, VO2RCP, HRRCP, VO2max, and HRmax for CE (R2 = 0.46–0.78) and TE (R2 = 0.59–0.80). By inputting only HR and power/speed into the RF, MLR models for practical HR calculation on TE and CE (both R2 = 0.41–0.75) were created. BC had a significant impact on the majority of CPET parameters. CPET parameters can be accurately predicted between CE and TE testing. Maximal parameters are more predictable than submaximal. Only HR and speed/power from one testing modality could be used to predict HR for another. Created equations, combined with BC analysis, could be used as a method of choice in comprehensive sports diagnostics.

Safety of surgical masks during physical activity evaluated with graded cycle ergometry test.

At the time of the coronavirus disease 2019 (COVID-19) pandemic wearing surgical mask (SM) is recommended for the prevention of contracting or exposing others to airborne transmission of COVID-19. It is somewhat controversial whether wearing SM during exercise affects performance and health status and/or may influence the results. In order to give an answer we planned a prospective, randomized, crossover study to evaluate the effects of wearing a SM or no-SM in 33 (17 male) physically active healthy subjects during a graded exercise cycle ergometry test. The two tests were performed in random order in the same subjects. The participants were all tested the same day, after a recovery time of at least of one hour, in order to avoid interferences on physical performances. Arterial oxygen saturation, heart rate and arterial blood pressure were assessed throughout the exercise tests every step of two minutes, at the end of exercise, performed at the same time with and without mask. Wearing SM had no effect on performance, since the duration of cycle ergometry test with SM and without SM median, respectively, was 14.2 (lower-upper quartile 13.9-14.8) versus 14.3 (13.9-15.5) minutes (P=0.094), and median peak power was 150 W (150-180) versus 150 W (120-180) (P=0.754). When expressed relative to peak exercise performance, no differences were found between wearing or not wearing SM regarding arterial oxygen saturation, or heart rate at any time during the exercise tests. Wearing SM during vigorous exercise had no detrimental effect on cardiovascular parameters, as well as on exercise metrics in all participants. No ventricular repolarization abnormalities and no arrhythmias were reported on the electrocardiograms.

Endurance cycle ergometry tests performed at a sub-maximal work rate elicit peak physiological and symptom responses in adults with cystic fibrosis.

Time to symptom limitation (Tlim ) achieved during constant work rate tests is considerably more responsive to change than measures commonly recorded during ramp-based tests, such as peak rate of oxygen uptake and maximal work rate (Wmax ). There is limited literature on the use of, and physiological and symptom responses to, constant work rate cycle ergometry tests in people with cystic fibrosis (CF). The results of this study provide evidence that the constant work rate cycle ergometry test, when conducted at 80% of the Wmax , elicits peak physiological and symptom responses and appears to be safe in adults with CF. For clinicians prescribing exercise at an intensity approaching or equivalent to 80% of the Wmax in a non-laboratory-based setting, consideration needs to be given to the level of supervision and patient monitoring required.

A study on the prediction of maximal oxygen consumption (VO2 max) among male and female medical college student population using bicycle ergometer

The maximal rate of oxygen uptake (VO2 max) is an important determinant of cardio-respiratory fitness and aerobic performance. Maximal oxygen uptake (VO2max) is an important, independent predictor of cardiovascular health and mortality. The present study was conducted in the Dept. of Physiology, GSL Medical College, East Godavari Dist., Andhra Pradesh, India. The study was conducted to establish prediction norms for VO2 max from physical parameters among sedentary young healthy student subjects (n = 72) consisting of male (n = 36) and female (n = 36) students of Medical College belonging to age group 18 – 24 years. The study was aimed to compare and correlate the measured parameters with the predicted parameters of V·O2max using a sub maximal cycle ergometry test. The parameters studied were age, gender, height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP). The predicted VO2 max was calculated in male (n = 36) and female (n = 36) subjects during multistage sub maximal exercise test with bicycle Ergometer using the modified Astrand-Rhyming Nomogram. The present study results showed that mean heart beat rate, SBP and DBP variables can be identified as the good indicators on prediction of maximal oxygen consumption (VO2 max) using bicycle ergometer among males and female subjects though male individuals showed higher VO2 max values of mean body weight, height compared to female subjects however, was statistically not significant. Future research should focus on the variables involved in the prediction equations by stratification of subjects to obtain a large range of values for the variable (s) investigated. It was not possible to do this with the subjects such as age, weight and height participating in this project because the variables used were not easily stratified.