Respiratory Exercise Research Articles

Postoperative Respiratory Exercises Reduce the Risk of Developing Pulmonary Complications in Patients Undergoing Lobectomy

ObjectiveTo evaluate the effects of an intensive postoperative physiotherapy program focused on respiratory exercises in patients undergoing lobectomy by open thoracotomy. DesignQuasi-experimental study. SettingTertiary referral academic hospital. Participants208 patients undergoing lobectomy by open thoracotomy. InterventionsControl group patients (n=102) received standard medical/nursing care, and experimental group patients (n=106) added to the standard clinical pathway a daily physiotherapy program focused on respiratory exercises until discharge. OutcomesAnalyzed outcomes were the frequency of postoperative pulmonary complications (PPCs) more amenable to physiotherapy (pneumonia, atelectasis and respiratory insufficiency) and length of hospital stay (LOS). ResultsBoth groups were comparable regarding preoperative and surgical characteristics. Incidence of PPCs was 20.6% in control and 6.6% in experimental group (P=.003). Median (IQR) LOS in control group was 14 (7) days (Huber M estimator 14.21) and 12 (6) days (Huber M estimator 12.81) in experimental. Logistic regression model identified the evaluated physiotherapy program (P=.017; EXP [B] 95% CI 0.081–0.780) and % FEV1 (P=.042; EXP [B] 95% CI 0.941–0.999) as protective factors for the development of PPCs in patients undergoing lobectomy. ConclusionsImplementing a postoperative intensive physiotherapy program focused on respiratory exercises reduces the risk of PPCs and resultant LOS on patients undergoing lobectomy.

Yamamoto New Scalp Acupuncture, Applied Kinesiology, and Breathing Exercises for Facial Paralysis in a Young Boy Caused by Lyme Disease—A Case Report

The case study reports on the effect of pharmacological, complementary, and alternative medicine including YNSA, Applied Kinesiology, and respiratory exercises in a 9-year-old boy with facial paralysis. The boy suffered from borreliosis and one-sided facial paralysis that occurred 3.5 weeks after being bitten by a tick and persisted despite 4 weeks of medication with antibiotics. In the first treatment, muscle function as assessed by the coachman׳s test was normalized, and improvement in the facial paralysis was observed. Within 8 additional treatments over a period of 2 months, the boy showed complete recovery. The case shows a multimodal approach to facial paralysis integrating pharmacological treatment and CAM including YNSA, Applied Kinesiology, and breathing exercises.

The Effect of Types of Respiratory Exercise on Respiratory Muscle Activity and Health-Related Quality of Life of Patients with Severe Chronic Obstructive Pulmonary Disease

Purpose: This study intended to classify voluntary respiratory exercise and exercise using breathing training equipment to suggest proper respiratory exercise to relieve symptoms of patients with severe chronic obstructive pulmonary disease. Methods: Sixteen subjects were randomly selected for experimental group I, which performed feedback breathing exercise and 15 sub jects were randomly selected for experimental group II, which performed a complex breathing exercise. The mediation program was per formed 30 minutes a session, once a day, three times a week, for five weeks. This study analyzed before and after results within groups and between groups through measurement of respiratory muscle activity and health-related quality of life. Results: Activity of sternocleidomastoid muscle and scalene muscle increased meaningfully within experimental group I and activity of diaphragm increased significantly within experimental group II (p<0.05) and there was a meaningful difference in health-related quality of life within experimental group II (p<0.05). Significant differences in change of activity of respiratory muscle and health-related quali ty of life were observed between groups (p<0.05). Conclusion: This study showed conflicting results between activity of agonist and synergist in patients with severe chronic obstructive pulmonary disease according to types of respiratory exercise and that complex respiratory exercise is more effective in health-related quality of life. Therefore, it found that the more severity increase, the more self-respiratory technique is an effective program. Diversified approach methods will be needed to improve respiratory function and quality of life for patients, and continuous clinical studies will be needed in the future.

Los ejercicios respiratorios postoperatorios reducen el riesgo de complicaciones pulmonares en pacientes sometidos a lobectomía

ObjectiveTo evaluate the effects of an intensive postoperative physiotherapy program focused on respiratory exercises in patients undergoing lobectomy by open thoracotomy. DesignQuasi-experimental study. SettingTertiary referral academic hospital. Participants208 patients undergoing lobectomy by open thoracotomy. InterventionsControl group patients (n=102) received standard medical/nursing care, and experimental group patients (n=106) added to the standard clinical pathway a daily physiotherapy program focused on respiratory exercises until discharge. OutcomesAnalyzed outcomes were the frequency of postoperative pulmonary complications (PPCs) more amenable to physiotherapy (pneumonia, atelectasis and respiratory insufficiency) and length of hospital stay (LOS). ResultsBoth groups were comparable regarding preoperative and surgical characteristics. Incidence of PPCs was 20.6% in control and 6.6% in experimental group (P=.003). Median (IQR) LOS in control group was 14 (7) days (Huber M estimator 14.21) and 12 (6) days (Huber M estimator 12.81) in experimental. Logistic regression model identified the evaluated physiotherapy program (P=.017; EXP [B] 95% CI 0.081-0.780) and % FEV1 (P=.042; EXP [B] 95% CI 0.941-0.999) as protective factors for the development of PPCs in patients undergoing lobectomy. ConclusionsImplementing a postoperative intensive physiotherapy program focused on respiratory exercises reduces the risk of PPCs and resultant LOS on patients undergoing lobectomy.

Effects of Respiratory and Motor Rehabilitative Exercises for Patients of Open Heart Surgeries

The current research aims to design some respiratory and rehabilitative exercises for hospitalized post-operative recovery of open-heart surgery male patients in addition to identifying its effects on cardio-vascular functioning (pulse – blood pressure – vital capacity – 1-min breathing rate – blood oxygen levels). The researcher applied the experimental approach (two-group design) with pre- and post-measurements. Research community included all open-heart surgery male patients (40-50 years) from Magdi Yacoub' Institute for heart diseases and research. Sample (n=16) was purposefully chosen after approval of the responsible physician and written consents of patients. Participants were divided into two groups (experimental = control = 8). The respiratory exercises were applied (3) time a day. Total number of sessions was (12) with session duration of (15-35) minutes. The researcher concluded that:

Effect of respiratory exercises on neck pain patients: A pilot study

Abstract Introduction Neck exercises are reported to improve the patient's conditions in chronic neck pain (CNP). However, the existence of pain and loss of range of motion often results in CNP. As a result, respiratory functions are compromised and extended rehabilitation may be required for respiratory parameters among these populations. Aim The purpose of this study was to analyze the effects of respiratory exercises on respiratory muscle endurance, cervical range of motion and chest expansion after a set of prescribed respiratory exercise procedure among CNP. Material and methods Ten patients with CNP participated in this study. Subjects were divided randomly into either an experimental group, which received respiratory exercises or a control group, which received a routine physiotherapy exercises. The outcome measures such as pain, respiratory muscle endurance, cervical range of motion and chest expansion were assessed before and eight weeks following treatment by an assessor blinded to the treatment allocation of the patient. Results and discussion There was a highly significant increase in maximum voluntary ventilation (MVV) scores from before (mean 34.88, SD 21.81) to after treatment (mean 55.10, SD 16.76 and t-value 6.48) with P = 0.003 in the experimental group as compared to control group from before (mean 38.32, SD 19.50) to after treatment (mean 39.74, SD 17.56 and t-value 0.845) with P = 0.446. The two sets of scores in the active flexion and for the visual analogue scale also showed significant difference in the experimental group P Conclusions Respiratory exercise contributes to improvement in respiratory muscle endurance and reduces pain who is enduring from CNP.

Fat-Free Mass Index for Evaluating the Nutritional Status and Disease Severity in COPD.

Despite the high prevalence of weight loss in subjects with COPD, the 2011 COPD management guidelines do not include an index measuring nutritional status. Fat-free mass index (FFMI) can accurately determine the nutritional status of subjects and may be closely correlated with COPD severity. We aimed to determine the nutritional status evaluated by FFMI according to the 2011 Global Initiative for Chronic Obstructive Lung Disease (GOLD) levels in stable subjects with COPD and the association between nutritional status and respiratory symptoms, exercise capacity, and respiratory muscle function. We included 235 stable subjects with COPD in this cross-sectional study. All of the subjects were divided into the 2011 GOLD Groups A, B, C, and D. FFMI (measured by bioelectrical impedance), spirometry (FEV1, percent-of-predicted FEV1, and FEV1/FVC), respiratory muscle function (peak inspiratory and peak expiratory pressures), exercise capacity (6-min walk distance), and dyspnea severity (Modified Medical Research Council dyspnea scale) were measured and compared between the GOLD groups. Malnutrition was identified in 48.5% of subjects and most prevalent in Group D (Group A: 41%, Group B: 41%, Group C: 31%, and Group D: 62%). FFMI was significantly lower in Group D (P < .001), with both sexes considered malnourished. Low FFMI significantly correlated with frequent exacerbation, older age, decreased pulmonary function, 6-min walk distance, peak inspiratory pressure, and worsened dyspnea. FFMI was significantly lower in the emphysema-dominant phenotype and mixed phenotype compared with the normal phenotype and airway-dominant phenotype. A stepwise multiple linear regression analysis identified peak inspiratory pressures and older age as independent predictors of FFMI. Malnutrition is highly prevalent in all COPD groups, particularly in Group D subjects, who warrant special attention for nutritional intervention and pulmonary rehabilitation. FFMI significantly correlated with exercise capacity, dyspnea, respiratory muscle function, and pulmonary function and may be a useful predictor of COPD severity.

The effects of breathing exercise types on respiratory muscle activity and body function in patients with mild chronic obstructive pulmonary disease.

[Purpose] Fragmentary studies on characteristics of respiratory muscles are being done to increase respiratory capacity by classifying exercises into voluntary respiratory exercise which relieves symptoms and prevents COPD and exercise using breathing exercise equipment. But this study found changes on respiratory pattern through changes on the activity pattern of agonist and synergist respiratory muscles and studied what effect they can have on body function improvement. [Subjects and Methods] Fifteen subjects in experimental group I that respiratory exercise of diaphragm and 15 subjects in experimental group II that feedback respiratory exercise were randomly selected among COPD patients to find the effective intervention method for COPD patients. And intervention program was conducted for 5 weeks, three times a week, once a day and 30 minutes a session. They were measured with BODE index using respiratory muscle activity, pulmonary function, the six-minute walking test, dyspnea criteria and BMI Then the results obtained were compared and analyzed. [Results] There was a significant difference in sternocleidomastoid muscle and scalene muscle and in 6-minute walk and BODE index for body function. Thus the group performing feedback respiratory had more effective results for mild COPD patients. [Conclusion] Therefore, the improvement was significant regarding the activity of respiratory muscles synergists when breathing before doing breathing exercise. Although, it is valuable to reduce too much mobilization of respiratory muscles synergists through the proper intervention it is necessary to study body function regarding improvement of respiratory function for patients with COPD.

A Focus on Respiratory TractInfection as an Important Risk Factor in COPD

Tel: +91-11-27662605 Chronic Obstructive Pulmonary Disease (COPD) is a gradually progressive chronic disease that can be characterized by an unavoidable decline in respiratory function, exercise capacity, and health status. Globally more than 3 million people are killed every year due to COPD related complications and it is the fourth largest cause of death worldwide [1]. Exacerbations are events in the natural history of COPD when there is a marked increase in symptoms like dyspnoea, sputum volume, and purulence [2]. The exacerbations are of immense clinical significance as they have a long term effect on health status. There has always been difference in opinion while comparing asthma and COPD. While some clinicians believe that the two of them are similar disease, the others prefer to treat both as different. However, there are several clinical evidences in support the latter view [3-5].

An analysis of pulmonary function in different lying positions in the 20's normal adults.

[Purpose] The purpose of this study was to study the changes in pulmonary functions in relation to lying positions of experimental participants. [Subjects and Methods] Twenty participants participated in this experiment. Measurements were taken in the supine position, the left side-lying position, the right side-lying position, and the prone position. Vital capacity (VC) was evaluated using a Fit mate. [Results] A comparison of four lying position showed significant differences in participants’ VC. In comparison of four position, supine and left sidelying, and between supine and right sidelying, and between supine and prone, between left sidelying and prone. [Conclusion] In conclusion, changing the participants lying position produce changes in pulmonary functions. The greatest change occurred with a supine lying position. We presume that ventilation is affected by body structures. The results provide objective data for establishing the most suitable positions for stroke patients performing respiratory exercises.

Evaluation of two different respiratory physiotherapy methods after thoracoscopy with regard to arterial blood gas, respiratory function test, number of days until discharge, cost analysis, comfort and pain control.

Although the methods used in thoracic surgery have been developing rapidly over the last five decades, postoperative pulmonary complications are seen in this field more than in other surgical branches. We aimed at comparing the acute effects of incentive spirometry (IS) and breathing retraining exercises by a respiratory physiotherapist or experienced physiotherapist. Patients were randomized into two groups as spirometry and physiotherapist. Combined respiratory exercises were implemented through IS inspirometry group and by a physiotherapist in physiotherapist group. Blood gas, respiratory function tests, survey results of the Burford pain thermometer, discharge days, and cost analyses of both groups were examined just before the beginning of physiotherapy and on the 3rd day of therapy. There were no statistical difference in first and last values of pH and PCO2and also there were no difference between groups (P > 0.05). Forced expiratory volume one second (FEV1) values are statistically increased compared to basal levels in both groups and mean difference in FEV1values was statistically increased in physiotherapist group compared to spirometry group (P < 0.001). Forced vital capacity (FVC), PO2and SaO2 values are statistically increased compared to basal levels in both groups but mean difference in FVC values was not statistically different between groups (P > 0.05). Cost analysis was not statistically different, mean hospitalization day and mean pain score were statistically decreased in physiotherapist group. Based on the outcome of this study, respiratory physiotherapy methods carried out by a respiratory physiotherapist are more effective in acute cardiothoracic conditions after thoracotomy compared to IS by patients.

The effect of feedback respiratory exercise on muscle activity, craniovertebral angle, and neck disability index of the neck flexors of patients with forward head posture.

[Purpose] This study aimed to simultaneously investigate the activities of the sternocleidomastoid muscle and scalenus anterior muscle, which are agonists of neck and breathing accessory muscles, by implementing breathing exercises. [Subjects and Methods] Thirteen subjects were selected for the experimental group, which performed feedback respiratory exercises with McKenzie exercises, and 12 subjects were selected for the control group, which performed McKenzie exercises alone. The intervention program was performed for 30 minutes a session, once a day, four times a week, and for 2 weeks before conducting the experiment. Before intervention, muscle activity was measured using surface electromyogram, and the neck disability index was evaluated. [Results] There were meaningful differences in activities of the sternocleidomastoid muscle and the scalenus anterior muscle, craniovertebral angle, and neck disability index within both the experimental group and control group after intervention. There also were meaningful differences in sternocleidomastoid muscle and neck disability index changes between groups. [Conclusion] Neck flexors as accessory respiratory muscle can affect inefficient respiratory imbalance of forward head posture patients. Multimodal intervention method should be studied continually and not be exposed to upper chest breathing patterns by preventing such phenomenon.

EVALUATION OF THE THORACOABDOMINAL MOBILITY OF OBESE SUBJECTS IN PRE-BARIATRIC SURGERY.

ABSTRACTBackground: Obesity can affect the thorax, diaphragm, and alterations in respiratory function even if the lungs are within normality. The respiratory compliance is very reduced by the increase in fat mass. Aim: To evaluate the effect of the physical therapeutic respiratory exercises on the thoracoabdominal mobility of obese individuals in pre-bariatric surgery Methods: Cross-sectional and descriptive study, which used the cirtometry (axillary, xiphoid and abdominal) to evaluate the mobility of 74 individuals, 27 men and 47 women, in pre-bariatric surgery, assisted by the team EMAD, after eight weeks of physiotherapy, following a protocol of exercises, reevaluating and compared the measures pre and post intervention. Results: Had positive correlation abdominal mobility in the total volume of all participants (p=0.010) and also for all the measures in the measurement of residual volume in three levels (p=0.000). Comparing genders, in total volume, cirtometry abdominal greater for women (p=0.015) when compared to men and residual volume, significance for either men or women in all measurements (p=0.000). Conclusion: Obese patients that underwent the physiotherapeutic treatment during the preoperative period, had pré respiratory dynamics improved by the increase in the mobility of the chest cavity and by the improvement of respiratory conscience.

Effect of Nasal Continuous Positive Airway Pressure Therapy on the Functional Respiratory Parameters and Cardiopulmonary Exercise Test in Obstructive Sleep Apnea Syndrome

Effect of Nasal Continuous Positive Airway Pressure Therapy on the Functional Respiratory Parameters and Cardiopulmonary Exercise Test in Obstructive Sleep Apnea Syndrome

Efeitos do exercício muscular respiratório na biomecânica da deglutição de indivíduos normais

RESUMO: Objetivo: analisar os efeitos do exercício respiratórios na biomecânica da deglutição de sujeitos normais. Métodos: o exercício muscular respiratório em sujeitos normais foi aplicado por sete dias consecutivos por meio de incentivador respiratório a fluxo (três séries de dez repetições para inspiração e expiração). A biomecânica da deglutição foi avaliada por videofluoroscopia, utilizando variáveis temporais (tempo de transição faríngea) e visuoperceptuais (número de deglutições, resíduos em seios piriformes e valéculas, penetração/aspiração). Para análise estatística foi aplicado o Teste de Wilcoxon, Igualdade de Duas Proporções e Kappa. Resultados: foram avaliadas 16 jovens do sexo feminino com média de idade de 21,2±3,4 anos. Nas variáveis visuoperceptuais observou-se concordância quase perfeita entre os avaliadores (p&lt;0,001), bem como na temporal (p = 1,00). Após o período de treinamento houve redução no tempo de transição faríngea (p=0,02). Conclusão: o uso de incentivador respiratório a fluxo influenciou significantemente na biomecânica da deglutição, principalmente na redução do tempo de transição faríngea.

The opinion of Romanian male tennis players about the importance of mental trainining

Abstract The aim of this paper is to analyze the importance of mental preparation for competition in Romanian tennis players. We collected data from 67 Romanian male tennis players (mean age: 24 years) by means of questionnaires. Thus, we applied two questionnaires: a demographic test and SCAT - Sport Competition Anxiety Test. Data were analyzed using SPSS Statistics version 20.0. The results indicate fourth aspects of the analyze: who is in charge with the mental preparation, if the athletes know the modern technics used by the specialists for the mental training for competition, the opinion about necessity of mental training and some aspects of anxiety and the strategies to combat it. The conclusions indicate that the mental preparation under the supervision of a specialist is not high practiced by the Romanian tennis players. The need for a specialist is demanded especially to control the emotions before the competition. The current practice to combat the anxiety is music listening, separation from the group, praying or respiration exercise. There is a largely need to improve this technics.

Impact of Respiratory Muscle Exercises on Pulmonary Function and Quality of Sleep among Stroke Patients

PURPOSE: This study attempts to examine the impact of respiratory muscle exercises on the respiratory function and quality of sleep among stroke patients. METHODS: A total of 20 stroke patients were randomly divided into a breathing-exercise training group(n=10) and a breathing-device-training group(n=10). Changes in pulmonary function, as well as the quality, were measured before and after the intervention. The breathing exercise was performed three times a week for a total of eight weeks. Breathing-device exercises made use of a lung-capacity-strengthening device and were performed for three times a week for eight weeks. One Flow FVC was used as a measurement tool for the pulmonary function test. The Pittsburgh Sleep Quality Index(PSQI) and a sleep measurement tool were used for sleep evaluation. RESULTS: In a comparison of changes in pulmonary function before and after the training, the breathing-exercise group and the breathing-device-training group showed a significant difference. In changes of sleeping measure and PSQI, the breathing-exercise group and the breathing-device-training group also showed significant differences. CONCLUSION: Diverse index analyses confirmed that breathing exercises and exercises using a lung-capacity-strengthening device, were effective in improving respiratory function and quality of sleep among stroke patients experiencing respiratory function disorders and sleep disorders.

Association between inflammatory airway disease of horses and exposure to respiratory viruses: a case control study.

BackgroundInflammatory airway disease (IAD) in horses, similar to asthma in humans, is a common cause of chronic poor respiratory health and exercise intolerance due to airway inflammation and exaggerated airway constrictive responses. Human rhinovirus is an important trigger for the development of asthma; a similar role for viral respiratory disease in equine IAD has not been established yet.MethodsIn a case–control study, horses with IAD (n = 24) were compared to control animals from comparable stabling environments (n = 14). Horses were classified using pulmonary function testing and bronchoalveolar lavage. PCR for equine rhinitis virus A and B (ERAV, ERBV), influenza virus (EIV), and herpesviruses 2, 4, and 5 (EHV-2, EHV-4, EHV-5) was performed on nasal swab, buffy coat from whole blood, and cells from BAL fluid (BALF), and serology were performed. Categorical variables were compared between IAD and control using Fisher’s exact test; continuous variables were compared with an independent t-test. For all analyses, a value of P <0.05 was considered significant.ResultsThere was a significant association between diagnosis of IAD and history of cough (P = 0.001) and exercise intolerance (P = 0.003) but not between nasal discharge and IAD. Horses with IAD were significantly more likely to have a positive titer to ERAV (68 %) vs. control horses (32 %). Horses with IAD had higher log-transformed titers to ERAV than did controls (2.28 ± 0.18 v.1.50 ± 0.25, P = 0.038). There was a significant association between nasal shedding (positive PCR) of EHV-2 and diagnosis of IAD (P = 0.002).ConclusionsIAD remains a persistent problem in the equine population and has strong similarities to the human disease, asthma, for which viral infection is an important trigger. The association between viral respiratory infection and development or exacerbation of IAD in this study suggests that viral infection may contribute to IAD susceptibility; there is, therefore, merit in further investigation into the relationship between respiratory virus exposure and development of IAD.

Effects of Inspiratory Muscle Exercise Using Biofeedback on Inspiratory Muscle Activity and Pulmonary Function in Patients with Stroke

Purpose: This study was conducted to determine the influence of inspiratory muscle exercise using visual biofeedback and inspiratory muscle exercise with diaphragm breathing retraining in stroke patients in regard to inspiratory muscle activity and respiratory function and to provide fundamental information on intervention for improvement of pulmonary function in stroke patients. Methods: The current study measured and analyzed inspiratory muscle activity and pulmonary function of 15 randomly selected subjects in a Biofeedback inspiratory muscle exercise (BIE) group that uses visual feedback and 15 subjects in the Diaphragm breathing exercise (DBE) group that uses breathing retraining before and after intervention. Intervention was performed for 30 minutes, 5 times a week, for 8 weeks. Subjects were measured for muscle activity of upper trapezius muscle and lattisimus dorsi muscle using a surface electromyography system and maximum inspiratory pressure was measured using a respiratory measurement device. For homogeneity test of subjects, independent t-test was performed and ANCOVA was performed for comparison of inspiratory muscle activity and pulmonary function between groups. Results: In the study results, the BIE group showed more significant muscle activity than the DBE group in upper trapezius muscle and lattisimus dorsi muscle (p<0.001). In addition, the BIE group showed more pressure than the DBE group in maximum inspiratory pressure (p<0.001). Conclusion: Based on the current study, performing biofeedback respiration exercise simultaneously with breathing retraining in stroke patients can provide more efficient respiratory physical therapy. In addition, it is considered that consistent study on the effectiveness is necessary to further improve clinical availability.

The relationship between biventricular myocardial performance and metabolic parameters during incremental exercise and recovery in healthy adolescents.

Background left ventricular (LV) and right ventricular (RV) myocardial reserve during exercise in adolescents has not been directly characterized. The aim of this study was to quantify myocardial performance response to exercise by using two-dimensional (2-D) speckle tracking echocardiography and describe the relationship between myocardial reserve, respiratory, and metabolic exercise parameters. A total of 23 healthy boys and girls (mean age 13.2 ± 2.7 yr; stature 159.1 ± 16.4 cm; body mass 49.5 ± 16.6 kg; BSA 1.47 ± 0.33 m(2)) completed an incremental cardiopulmonary exercise test (25 W · 3 min increments) with simultaneous acquisition of 2-D transthoracic echocardiography at rest, each exercise stage up to 100 W, and in recovery at 2 min and 10 min. Two-dimensional LV (LV Sl) and RV (RV Sl) longitudinal strain and LV circumferential strain (LV Sc) were analyzed to define the relationship between myocardial performance reserve and metabolic exercise parameters. Participants achieved a peak oxygen uptake (V̇o 2peak) of 40.6 ± 8.9 ml · kg(-1) · min(-1) and a work rate of 154 ± 42 W. LV Sl and LV Sc and RV Sl increased significantly across work rates (P < 0.05). LV Sl during exercise was significantly correlated to resting strain, V̇o 2peak, oxygen pulse, and work rate (0.530 ≤ r ≤ 0.784, P < 0.05). This study identifies a positive and moderate relationship between LV and RV myocardial performance and metabolic parameters during exercise by using a novel methodology. Relationships detected present novel data directly describing myocardial adaptation at different stages of exercise and recovery that in the future can help directly assess cardiac reserve in patients with cardiac pathology.