recuperation, often using cardiopulmonary exercise testing ( 39 ). Using this noninvasive and dynamic integrative approach, it is possible to uncover potential physiological causes of unexplained exercise-related complaints and symptoms and to observe specific pathophysiological patterns based on physiological
Marco Van Brussel, Bart C. Bongers, Erik H.J. Hulzebos, Marcella Burghard and Tim Takken
Dan M. Cooper, Szu-Yun Leu, Candice Taylor-Lucas, Kim Lu, Pietro Galassetti and Shlomit Radom-Aizik
Consensus has yet to be achieved on whether obesity is inexorably tied to poor fitness. We tested the hypothesis that appropriate reference of cardiopulmonary exercise testing (CPET) variables to lean body mass (LBM) would eliminate differences in fitness between high-BMI (≥ 95th percentile, n = 72, 50% female) and normal-BMI (< 85th percentile, n = 142, 49% female), otherwise-healthy children and adolescents typically seen when referencing body weight. We measured body composition with dual x-ray absorptiometry (DXA) and CPET variables from cycle ergometry using both peak values and submaximal exercise slopes (peak VO2, ΔVO2/ΔHR, ΔWR/ΔHR, ΔVO2/ΔWR, and ΔVE/ΔVCO2). In contrast to our hypothesis, referencing to LBM tended to lessen, but did not eliminate, the differences (peak VO2 [p < .004] and ΔVO2/ΔHR [p < .02]) in males and females; ΔWR/ΔHR differed between the two groups in females (p = .041) but not males (p = .1). The mean percent predicted values for all CPET variables were below 100% in the high-BMI group. The pattern of CPET abnormalities suggested a pervasive impairment of O2 delivery in the high-BMI group (ΔVO2/ΔWR was in fact highest in normal-BMI males). Tailoring lifestyle interventions to the specific fitness capabilities of each child (personalized exercise medicine) may be one of the ways to stem what has been an intractable epidemic.
Matheus Hausen, Pedro Paulo Soares, Marcus Paulo Araujo, Débora Esteves, Hilbert Julio, Roberto Tauil, Marcus Junca, Flávia Porto, Emerson Franchini, Craig Alan Bridge and Jonas Gurgel
cardiopulmonary exercise tests (CPETs). 5 , 6 These pioneering investigations observed no differences in V ˙ O 2 max , 5 , 6 VTs, 5 and the heart rate (HR) deflection point 6 between the 2 exercise modes. Such findings offer initial support for the validity of taekwondo-specific tests. Despite the initial
Aleksandar Sovtic, Predrag Minic, Jovan Kosutic, Gordana Markovic-Sovtic and Milan Gajic
The modified Chrispin-Norman radiography score (CNS) is used in evaluation of radiographic changes in children with cystic fibrosis (CF). We evaluated the correlation of modified CNS with peak exercise capacity (Wpeak) and ventilatory efficiency (reflected by breathing reserve index—BRI) during progressive cardiopulmonary exercise testing (CPET). Thirty-six children aged 8–17 years were stratified according to their CNS into 3 groups: mild (<10), moderate (10–15), and severe (>15). CPET was performed on a cycle ergometer. Lung function tests included spirometry and whole-body plethysmography. Patients with higher CNS had lower FEV1 (p < .001), Wpeak predicted (%; p = .01) and lower mean peak oxygen consumption (VO2peak/kg; p = .014). The BRI at the anaerobic threshold and at Wpeak was elevated in patients with the highest CNS values (p < .001). The modified CNS correlates moderately with Wpeak (R = −0.443; p = .007) and BRI (R = −0.419; p = .011). Stepwise multiple linear regression showed that RV/TLC was the best predictor of Wpeak/pred (%; B = −0.165; b = −0.494; R2 = .244; p = .002). Children with CF who have high modified CNS exhibit decreased exercise tolerance and ventilatory inefficacy during progressive effort.
Aurora de Fátima G.C. Mafra Cabral, Marcelo Medeiros Pinheiro, Charlles H.M. Castro, Marco Túlio De Mello, Sérgio Tufik and Vera Lúcia Szejnfeld
cardiopulmonary exercise test on a treadmill (Life Fitness 9700HR; Life Fitness, Schiller Park, IL, USA). All subjects performed the test in the morning. Weight in kg was measured using a digital scale and height (in meters) were used to calculate body mass index (BMI) in kg/m 2 . Medical evaluation was performed
Marisa Maia Leonardi-Figueiredo, Mariana Angélica de Souza, Elisangela Aparecida da Silva Lizzi, Luciano Fonseca Lemos de Oliveira, Julio Cesar Crescencio, Pedro Vellosa Schwartzmann, Lourenço Gallo Jr and Ana Claudia Mattiello-Sverzut
uptake or peak oxygen uptake (VO 2peak ), during the progressive cardiopulmonary exercise test ( 2 ). However, this test requires many resources in terms of qualified personnel and sophisticated instrumentation, which are not always available and limit the usefulness of this method in routine clinical
Dan M. Cooper
, frequency, duration, and intensity of exercise that can benefit health during critical periods of growth. CPET indicates cardiopulmonary exercise testing. The Physiological Journey of the Exercise Response: Rethinking the Guideposts As previously noted, a major driving concept in exercise science research
Elizabeth F. Teel, Stephen W. Marshall, L. Gregory Appelbaum, Claudio L. Battaglini, Kevin A. Carneiro, Kevin M. Guskiewicz, Johna K. Register-Mihalik and Jason P. Mihalik
outcomes in healthy participants. All subjects completed a preintervention and postintervention maximal cardiopulmonary exercise test (CPET) approximately 14 days apart. Participants randomized to ACTIVE training completed six 30-minute training sessions between CPETs, while nontraining participants
Gerald Barber and Charles T. Heise
Although not well validated, physicians frequently use subjective estimates of exercise ability to assess clinical status and therapeutic results. This study employed a standardized questionnaire and cardiopulmonary exercise test to compare the results of subjective estimates by 211 patients (mean age 13.9 yrs) with objective measurements of exercise ability. Questionnaire data correlated with measured maximal oxygen consumption. Individuals thought to be below average had a maximal oxygen consumption of 21±6 ml/kg/min. Those thought to have average fitness had a maximal oxygen consumption of 26±8 ml/kg/min, and those thought to be above average had a maximal oxygen consumption of 30±7 ml/kg/min. There was a great degree of overlap and scatter of these data, however, such that questionnaire data significantly overestimated exercise ability in 67% and underestimated it in 3% of the subjects. In only 30% of the subjects did the subjective estimate of exercise ability correspond with objectively measured exercise ability. It was concluded that subjective estimates are unreliable and should not be used in assessing the functional status of an individual patient, but subjective estimates may give some idea of objective capabilities in large population studies.
Michelle S.M. Silva, Wladimir Bolani, Cleber R. Alves, Diogo G. Biagi, José R. Lemos Jr, Jeferson L. da Silva, Patrícia A. de Oliveira, Guilherme B. Alves, Edilamar M. de Oliveira, Carlos E. Negrão, José E. Krieger, Rodrigo G. Dias and Alexandre C. Pereira
To study the relationship between the ACTN3 R577X polymorphism and oxygen uptake (VO2) before and after exercise training.
Police recruits (N = 206, 25 ± 4 y) with RR (n = 75), RX (n = 97), and XX (n = 33) genotypes were selected. After baseline measures, they underwent 18 wk of running endurance training. Peak VO2 was obtained by cardiopulmonary exercise testing.
Baseline body weight was not different among genotypes. At baseline, XX individuals displayed higher VO2 at anaerobic threshold, respiratory compensation point, and exercise peak than did RR individuals (P < .003). Endurance training significantly increased VO2 at anaerobic threshold, respiratory compensation point, and exercise peak (P < 2 × 10−6), but the differences between XX and RR were no longer observed. Only relative peak VO2 exercise remained higher in XX than in RR genotype (P = .04). In contrast, the increase in relative peak VO2 was greater in RR than in XX individuals (12% vs 6%; P = .02).
ACTN3 R577X polymorphism is associated with VO2. XX individuals have greater aerobic capacity. Endurance training eliminates differences in peak VO2 between XX and RR individuals. These findings suggest a ceiling-effect phenomenon, and, perhaps, trained individuals may not constitute an adequate population to explain associations between phenotypic variability and gene variations.