Exercise Capacity In Men Research Articles

Ventilation asymmetry, diaphragmatic mobility and exercise capacity in men with traumatic brachial plexus injury

ObjectiveTo investigate the repercussions of traumatic brachial plexus injury (TBPI) on diaphragmatic mobility and exercise capacity, compartmental volume changes, as well as volume contribution of each hemithorax and ventilation asymmetry during different respiratory maneuvers, and compare with healthy individuals. The velocity of shortening of the diaphragm, inspiratory, and expiratory muscles were also assessed. ParticipantsThe cross-sectional study was conducted with 40 male individuals (20 with TBPI who have not undergone nerve transfer surgery [mean age 30.1 ± 5.3] and 20 healthy paired by age and body mass index). Only patients with C8-T1 root avulsion were studied. Main outcomeCompartmental and hemithoracic volumes, as well as asymmetry between the affected and unaffected sides were assessed using optoelectronic plethysmography. The 6 minute walking test was performed to evaluate exercise capacity, while diaphragm mobility was assessed during quiet breathing (QB) using an ultrasound device. ResultsTBPI patients with mean lesion time of 174 ± 45.24 days showed a decreased pulmonary function, respiratory muscle strength, exercise capacity, and diaphragm mobility (all p < .001) compared with healthy. The pulmonary ribcage compartment of the affected side was the main contributor to the reduction in volume during inspiratory capacity, vital capacity, and inspiratory load imposition (all p < .05). This compartment also exhibited a higher ventilation asymmetry with reduced shortening velocity of the inspiratory ribcage muscles. ConclusionCompared with healthy, TBPI patients who have not undergone nerve transfer surgery present low exercise capacity and diaphragmatic mobility, as well as reduced volume of the upper ribcage compartment on the affected side that leads to reduced shortening velocity and ventilation asymmetry.

Average Exercise Capacity in Men and Women >75 Years of Age Undergoing a Bruce Protocol Exercise Stress Test

Exercise stress testing is routinely performed to evaluate suspected coronary artery disease in older adults. However, the available data to predict and compare relative exercise capacity in the general population were developed using predominantly younger, healthy cohorts with few or no women. This study aimed to describe the exercise capacity of patients older than 75 years who underwent a clinically indicated Bruce protocol exercise stress test. This was a retrospective, cross-sectional study of 2,041 consecutive patients older than 75 years who performed a Bruce protocol exercise stress echocardiogram that was terminated because of maximal effort without ischemia at Columbia University Medical Center between April 10, 2009, and July 30, 2020. The analytic sample included 2,041 exercise stress tests in 786 women (median [interquartile range] age 79 [77 to 81] years) and 1,255 men (median [interquartile range] age 79 [77 to 82] years). Cardiovascular risk factors and clinical coronary disease were common and more prevalent in men than women. The median exercise time for men aged 76 to 80 years was 7:22 (minutes:seconds) and for women was 6:00 and significantly decreased in both genders as age increased (p <0.001). The mean (SD) METs achieved for women and men were 6.5 (1.6) and 7.7 (1.7), respectively. Most women (85%) and men (95%) completed the first stage, whereas only 32% of women and 64% of men completed the second stage. It was uncommon for women (3%) or men (15%) to complete the third stage. Fewer than 1% of patients completed the fourth stage, and none completed the fifth stage. At all ages, women had a lower exercise capacity than men. These data allow physicians to compare the exercise capacity of older patients who underwent a Bruce protocol exercise stress test more accurately to a representative sample of similarly aged adults.

Skeletal muscle proteins important for work capacity are altered with type 2 diabetes - Effect of 10-20-30 training.

The study examined whether men with type 2 diabetes exhibit lower expression of muscle proteins important for exercise capacity, and whether exercise training promotes adaptations in these proteins. In a cross‐sectional and longitudinal study, conducted at the University of Copenhagen. Twelve men with type 2 diabetes (T2D) were compared to eleven nondiabetes counterparts (ND) matched for age and body composition (body fat percentage). T2D underwent 10 weeks of high‐intensity interval exercise training (10‐20‐30 training). T2D had lower expression of SOD1 (−62%; p < 0.001) and ETC complex V (−34%; p = 0.003), along with higher expression of ETC complex IV (+66%; p = 0.007), MFN2 (+62%; p = 0.001), and DRP1 (+30%; p = 0.028) compared to ND. T2D had higher (p < 0.001) expression of Na+/K+ α1 (+98%), α2 (+114%), and NHE1 (+144%) than ND. In T2D, training increased exercise capacity (+9%; p < 0.001) as well as expression of SOD2 (+44%; p = 0.029), ETC complex II (+25%; p = 0.035), III (+52%; p = 0.041), IV (+23%; p = 0.005), and V (+21%; p = 0.035), CS activity (+32%; p = 0.006) as well as Na+/K+ α1 (+24%; p = 0.034), Kir6.2 (+36%; p = 0.029), and MCT1 (+20%; p = 0.007). Men with type 2 diabetes exhibited altered expression of a multitude of skeletal muscle proteins important for exercise capacity. Ten weeks of 10‐20‐30 training upregulated expression of muscle proteins regulating antioxidant defense, mitochondrial function, and ion handling while enhancing exercise capacity in men with type 2 diabetes.

Effects of cardiac rehabilitation on quality of life and exercise capacity in patients with coronary artery disease: do women benefit equally?

Abstract Background Quality of life is an important factor in the etiology and prognosis of coronary artery disease (CAD) as well as to evaluate effects of different interventions in cardiovascular diseases. Improvement in quality of life (QOL) is an important goal for patients (pts) participating in cardiac rehabilitation (CR). Purpose To examine whether women and men benefit equally from comprehensive CR in terms of QOL and exercise tolerance in pts with CAD. Methods We enrolled 1362 CAD patients (mean age 60.4±9.5 years). All patients participated in a comprehensive three weeks CR program at residential center and in all pts before and after CR exercise test was performed. Psychological dimensions were assessed at baseline and post-CR by validated questionnaire Short-Form 36 Health Status Survey (SF-36). All data were analyzed based on gender. Results Women participate in CR in lower percentage than man: 336 (24.7%) women vs 1026 (75.3%) men. Out of 1362 CAD pts, SF-36 was performed in 119 pts (75.6% men and 23.5% women). Before CR, physical function (PF), fatigue (F) and social functioning (SF) were significantly higher in men than in women (P&amp;lt;0.001; &amp;lt;0.05 and &amp;lt;0.01). After CR, scores of all domains of the SF-36 were significantly improved in all 119 pts (P&amp;lt;0.001). However, compared to the baseline, and based on gender, women had greater improvement than men in PF: 36.6%vs 11.4%, physical limitation (PL): 119.6 vs 52.2%, emotional well-being (EWB): 12.9% vs 7.5%, SF: 23% vs 4.9%, body pain (BP): 16.4%vs 4.9%, F: 14.3%vs 10.9% and health change (HC): 34%vs 17.9%. At the end of stationary CR there was no significant difference in domains of the SF-36 between men and women. At baseline men had significantly higher level and duration of exercise test than women (both P&amp;lt;0.001). After CR, level and duration of exercise test increased significantly in 1026 men ( by 12% and by 16.5%; both P&amp;lt;0,001), and 336 women (by 18% and by 21%; both P&amp;lt;0.001), and it was still higher in men than women after CR (both P&amp;lt;0.001). Conclusions Study demonstrated that women are generally less participate in CR than men. Results indicated that CR improve QOL in CAD pts, especially in women, which was expressed through higher improvement in PF, PL, EWB, SF,BP, F and HC than in men. Those positive changes in QOL were associated with significant improvement in exercise capacity in men as well as in women. CR needs to improve in referral and participation of women. Funding Acknowledgement Type of funding source: None

How to live until 90 – Factors predicting survival in 75-year-olds from the general population

Background: The objective of the study was to explore potential predictors common in a clinical context, for survival to age 90 among 75-year-olds from Sweden’s general population. We performed a prospective community-based cohort study with 15-year follow-up among 75-year-olds from a defined geographical area. Methods: Of 1,100 inhabitants born in 1922 and living in Vasteras in 1997, 618 were invited to participate in a cardiovascular health survey, and 432 individuals accepted participation. Among them, 380 subjects (61% of those originally invited; 191 men and 189 women) had complete records for all examined variables. Variables were categorized into 4 groups: 1) Previous or present disease; 2. Exercise test variables; 3. Conventional risk factors; 4. Other potential risk factors. Through Area Under the Receiver Operating Characteristic (AUROC) curves, strong predictors for survival until age 90 (AUROC≥0.60) in men and women were selected. Results: The strongest individual predictors for reaching the age of 90 were metabolic equivalents and systolic blood pressure (BP) rise during exercise test, QTc interval in resting electrocardiogram (ECG) and peak expiratory flow (PEF) in men, and, for women, white blood cell (WBC) counts and systolic blood pressure BP rise during exercise. The strongest independent predictor in multivariable models were metabolic equivalents in men and WBC counts in women (explained variability 22 and 6%). Conclusions: High exercise capacity in men and low WBC in women were the strongest independent predictors of reaching age 90 among the clinical predictors at 75. The strongest modifiable predictor was exercise capacity in men, which can be improved by physical training.

Association Between Serum Testosterone and Sex Hormone–Binding Globulin and Exercise Capacity in Men: Results of the Study of Health in Pomerania (SHIP)

Testosterone exerts a widespread pattern of effects on metabolism and body composition, and interest is gaining in its correlation with physical fitness. The main focus of our study was to investigate the association of total serum testosterone and sex hormone-binding globulin (SHBG) levels on exercise capacity and maximal power output in men using a cross-sectional, population-based adult cohort. From the Study of Health in Pomerania (SHIP), 624 men age 25 to 85 years who underwent a standardized progressive incremental exercise protocol on a cycle ergometer were included in the analyses. Exercise capacity was characterized by oxygen uptake at anaerobic threshold (V'O(2) at L) and peak exercise (V'O(2 peak)) as well as maximal power output at peak exertion. Multivariable linear regression analyses adjusted for age, sex, body mass index, physical activity, and smoking were performed. Further, linear regression analyses with cubic splines and sensitivity analyses were undertaken. At peak exercise performance, testosterone and SHBG levels showed no associations with V'O(2 peak), V'O(2) at L as well as maximal power output, even after controlling for confounding factors including age, body mass index, physical activity, and smoking. An adverse association between the free testosterone index and V'O(2) at L was found. Linear regression analyses with cubic splines did not change the main results. In conclusion, this is the first study focusing on the association of total serum testosterone and SHBG on exercise capacity and physical performance in healthy volunteers based on a large-scale population-based study. After adjustment for relevant influencing factors, neither total serum testosterone nor SHBG levels had any interference with peak exercise capacity, aerobic exercise capacity, or maximal power output in men.

Effects of erythropoietin administration on cerebral metabolism and exercise capacity in men

Recombinant human erythropoietin (EPO) increases exercise capacity by stimulating erythropoiesis and subsequently enhancing oxygen delivery to the working muscles. In a large dose, EPO crosses the BBB and may reduce central fatigue and improve cognition. In turn, this would augment exercise capacity independent of erythropoiesis. To test this hypothesis, 15 healthy young men (18-34 years old, 74 + or - 7 kg) received either 3 days of high-dose (30,000 IU/day; n = 7) double-blinded placebo controlled or 3 mo of low-dose (5,000 IU/wk; n = 8) counter-balanced open but controlled administration of EPO. We recorded exercise capacity, transcranial ultrasonography-derived middle cerebral artery blood velocity, and arterial-internal jugular venous concentration differences of glucose and lactate. In addition, cognitive function, ratings of perceived exertion, ventilation, and voluntary activation by transcranial magnetic stimulation-induced twitch force were evaluated. Although EPO in a high dose increased cerebrospinal fluid EPO concentration approximately 20-fold and affected ventilation and cerebral glucose and lactate metabolism (P < 0.05), 3 days of high-dose EPO administration had no effect on cognition, voluntary activation, or exercise capacity, but ratings of perceived exertion increased (P < 0.05). We confirmed that 3 mo of administration of EPO increases exercise capacity, but the improvement could not be accounted for by other mechanisms than enhanced oxygen delivery. In conclusion, EPO does not attenuate central fatigue or change cognitive performance strategy, suggesting that EPO enhances exercise capacity exclusively by increased oxygen delivery to the working muscles.

Reduction in Circulating Testosterone Relates to Exercise Capacity in Men With Chronic Heart Failure

Reduction in Circulating Testosterone Relates to Exercise Capacity in Men With Chronic Heart Failure

Reduction in Circulating Testosterone Relates to Exercise Capacity in Men With Chronic Heart Failure

Background We investigated whether anabolic deficiency was linked to exercise intolerance in men with chronic heart failure (CHF). Anabolic hormones (testosterone, dehydroepiandrosterone sulfate, insulin-like growth factor 1 [IGF1]) contribute to exercise capacity in healthy men. This issue remains unclear in CHF. Methods and Results We studied 205 men with CHF (age 60 ± 11 years, New York Heart Association [NYHA] Class I/II/III/IV: 37/95/65/8; LVEF [left ventricular ejection fraction]: 31 ± 8%). Exercise capacity was expressed as peak oxygen consumption (peak VO 2), peak O 2 pulse, and ventilatory response to exercise (VE-VCO 2 slope). In multivariable models, reduced peak VO 2 (and reduced peak O 2 pulse) was associated with diminished serum total testosterone (TT) ( P < .01) and free testosterone (eFT; estimated from TT and sex hormone globulin levels) ( P < .01), which was independent of NYHA Class, plasma N-terminal pro-brain natriuretic peptide, and age. These associations remained significant even after adjustment for an amount of leg lean tissue. In multivariable models, high VE-VCO 2 slope was related to reduced serum IGF1 ( P < .05), advanced NYHA Class ( P < .05), increased plasma NT-proBNP ( P < .0001), and borderline low LVEF ( P = .07). In 44 men, reassessed after 2.3 ± 0.4 years, a reduction in peak VO 2 (and peak O 2 pulse) was accompanied by a decrease in TT ( P < .01) and eFT ( P ≤ .01). Increase in VE-VCO 2 slope was related only to an increase in plasma NT-proBNP ( P < .05). Conclusions In men with CHF, low circulating testosterone independently relates to exercise intolerance. The greater the reduction of serum TT in the course of disease, the more severe the progression of exercise intolerance. Whether testosterone supplementation would improve exercise capacity in hypogonadal men with CHF requires further studies.

679 Reduction in serum testosterone deteriorates exercise capacity in men in the course of chronic heart failure

679 Reduction in serum testosterone deteriorates exercise capacity in men in the course of chronic heart failure

Supine Lower Body Negative Pressure Treadmill Exercise Maintains Upright Exercise Capacity In Women And Men After 30-d Bed Rest

INTRODUCTION We previously reported that supine lower body negative pressure exercise (LBNPex) maintains upright treadmill exercise capacity in men after 5-, 15-, and 30-d of bed rest (BR). PURPOSE This study sought to determine whether the same LBNPex protocol protects exercise capacity during a 30-d BR in women. METHODS Eight sets of male and seven sets of female identical twins completed a 30-d BR. Pre- and post-BR, subjects completed a graded exercise test to volitional fatigue to measure peak exercise capacity (VO2pk). Within each set of twins, one was randomly assigned to a control group (CON) who performed no LBNPex and one was assigned to an exercise group (EX) and performed 40 min of LBNPex, followed by 5 min of LBNP without exercise, six times per week. During LBNPex, −55±4 mmHg was applied to produce footward force equivalent to 1.0–1.2 times static body weight, and subjects performed an interval exercise protocol (40–80% pre-BR VO2pk). Caloric consumption was prescribed to maintain pre-BR body weight. Pre- and post-BR VO2pk were compared between groups and within genders using repeated measures ANOVA. RESULTS VO2pk was significantly decreased in CON after BR in both men and women but was not different from pre-BR in EX. Body weight was similar pre- to post-BR in both CON (64±3.2 vs. 63.8±3.1 kg) and EX (61.3±2.7 vs. 61.7±2.7 kg).TableCONCLUSIONS Our supine interval LBNPex protocol maintains upright exercise capacity during 30-d BR in both women and men. This exercise countermeasure protocol may help prevent microgravity-induced deconditioning during long duration space flight. Supported by NASA NAG9-1425 & UCSD GCRC NIH M01 RR00827

Hypogonadism in Men with Chronic Obstructive Pulmonary Disease

We recently reported that hypogonadism does not affect respiratory muscle performance and exercise capacity in men with chronic obstructive pulmonary disease (COPD). In COPD, however, the relationship between exercise capacity and quality of life is controversial, making it unreliable to extrapolate about quality of life from exercise data. Accordingly, we determined prevalence and impact of hypogonadism on health-related quality of life in men with COPD. We enrolled 101 stable outpatient men (FEV1 1.34 +/- 0.04 L) older than 54 years; 38 patients were hypogonadal-a prevalence similar to that reported in the general population. The degree of airflow limitation did not predict levels of free testosterone. Quality of life, as quantified by a disease-specific instrument (St. George's Respiratory Questionnaire) and a general-health instrument (Veterans Short Form-36) were equivalent in the hypogonadal and eugonadal groups. Both groups demonstrated large decrements in perceived physical health and smaller decrements in perceived emotional and mental health. No relationship was found between free testosterone level and physical activity, respiratory symptoms, or quality of life. In conclusion, hypogonadism, although common among men older than 54 years with COPD, does not worsen the severity of respiratory symptoms or quality of life.

Respiratory and Skeletal Muscles in Hypogonadal Men with Chronic Obstructive Pulmonary Disease

Hypogonadism, found in about one-third of patients with chronic obstructive pulmonary disease (COPD), has potential for decreasing muscle mass and muscle performance. Compared with eugonadal patients, we hypothesized that hypogonadal patients with COPD have decreased respiratory and skeletal muscle performance. Nineteen hypogonadal and 20 eugonadal men with COPD (FEV(1) 1.14 +/- 0.08 and 1.17 +/- 0.11 L [standard error], respectively) were studied. Diaphragmatic contractility, assessed as transdiaphragmatic twitch pressure generated by phrenic nerve stimulation, was similar in hypogonadal and eugonadal patients: 20.6 +/- 2.2 and 19.8 +/- 2.5 cm H(2)O, respectively. During progressive inspiratory threshold loading, hypogonadal and eugonadal patients had similar respiratory muscle endurance times (302 +/- 29 and 313 +/- 48 seconds, respectively) and airway pressure sustained during the last minute of loading (38.2 +/- 3.0 and 40.5 +/- 4.7 cm H(2)O, respectively) (similar to predicted values in healthy subjects). Hypogonadal and eugonadal patients had equivalent limb muscle strength and endurance. During cycle exercise to exhaustion, exercise performance, gas exchange, and respiratory muscle recruitment (estimated by esophageal and gastric pressure swings during tidal breathing) were similar in both groups. In conclusion, hypogonadism does not decrease respiratory or limb muscle performance and exercise capacity in men with moderate-to-severe COPD who, for the most part, are not underweight.

Effect on exercise performance of enalapril therapy initiated early after myocardial infarction

Objectives. The Nordic Enalapril Exercise Trial was a multicenter subtrial of the Cooperative New Scandinavian Enalapril Survival Study (CONSENSUS II) designed to evaluate the effect on maximal exercise performance of a 6-month period of enalapril treatment initiated early after myocardial infarction.Background. When begun early after myocardial infarction, converting enzyme inhibition therapy has been shown to attenuate infarct expansion and reduce left ventricular volume. Therapy has been associated with improved exercise performance.Methods. Three hundred twenty-seven men (mean age 63.3 ± 10.9 years) with documented acute myocardial infarction were randomized to treatment with enalapril or placebo on a double-blind basis. Intravenous enalaprilat or placebo therapy was initiated within 24 h after the onset of symptoms. Oral therapy was continued at a target dose of 20 mg/day. Patients exercised maximally at 1 month and 6 months after infarction to symptom-limited end points on a cycle ergometer with a 20 W/min incremental protocol.Results. The treatment and control groups were comparable in patient age, concurrent therapy and type and site of infarction. At 1 month, for all patients, mean total work performed was 34.9 ± 20.9 kJ in the enalapril group (n = 169) versus 28.5 ± 20.6 kJ in the placebo group (n = 158) (difference = 18.4%, p < 0.01). This between-group difference in favor of enalapril was greatest in patients >70 years old (difference = 41.4%, p < 0.01, n = 105) and those with clinical evidence of heart failure (difference = 33.0%, p < 0.01, n = 122). At 6 months for all patients, mean total work performed was 35.4 ± 23.8 kJ in the enalapril group versus 34.0 ± 23.9 kJ in the placebo group (difference = 4.1%, NS).Conclusions. This trial found that chronic converting enzyme inhibition initiated early after myocardial infarction was associated with significantly greater exercise capacity in men tested at 1 month. This difference was independent of type or site of infarction, patient age or the presence of clinical heart failure. The difference between the treatment and control groups was not significant at 6 months because of improvement in the placebo group. Further research is needed to elucidate the potential mechanisms involved, profile those patients most likely to profit from early therapy and establish the optimal timing and duration for intervention.

Nomogram based on metabolic equivalents and age for assessing aerobic exercise capacity in men

Objectives. The goal of this study was to create a nomogram, based on maximal exercise capacity (in metabolic equivalents [METs]) and age, for assessing a patient's ability to perform dynamic exercise to quantify the level of physical disability or relative capacity for physical activity.Background. Providing an estimation of exercise capacity relative to age is clinically useful. Such an estimate can be derived from measured or estimated maximal oxygen uptake (in METs) from treadmill exercise testing and age. It is an effective means of communicating to patients their cardiopulmonary states, encouraging improvement in exercise capacity and quantifying disability.Methods. Exercise test results of 1,388 male patients (mean age 57 years, range 21 to 89) free of apparent heart disease who were referred for exercise testing for clinical reasons were retrospectively reviewed. This referral group as well as subgroups of active (n = 346) and sedentary (n = 253) patients were analyzed to determine norms for age and for age by decades for exercise test responses, including METs, maximal heart rate and maximal systolic blood pressure. Regression equations were calculated from this information, and a nomogram for calculating degree of exercise capacity from age and MET level achieved by a patient was created. A similar analysis was performed in a separate group of 244 apparently healthy, normal male volunteers (mean age 45 ± 14 years, range 18 to 72) who underwent exercise testing with direct measurement of expired gases.Results. Equations for predicted METs for age were derived for the entire clinical referral group (METs = 18.0 − 0.15[Age]) and for the subgroups of active (METs = 18.7 − 0.15[Age]) and sedentary (METs = 16.6 − 0.16[Age]) patients. All results achieved statistical significance, with p values < 0.001. In the volunteer group of normal men who performed exercise testing with ventilatory gas exchange, the decline in maximal heart rate and METs with age was not as steep as in the referral group.Although the normal group confirmed nomograms published previously among similar subjects, the equations derieved from the patients differed from those previously reported; in contrast to previous studies using healthy volunteers, the equations and nomograms for the referral group are more appropriate for patients typically referred for testing in a hospital or office-based internal medicine practice.Conclusions. Norms for METs based on age are presented as well as population-specific nomograms that enable physicians to assess patients' exercise capacity relative to their age group.

Longitudinal variations in maximal oxygen intake with age and activity.

Longitudinal variations in maximal oxygen intake with age and activity.

Scalene and sternomastoid muscle function.

Scalene and sternomastoid muscle function.