A new modeling of the overlapping T wave for the efficient estimation of the P-R intervals during exercise and recovery.

The analysis of the heart period series is a difficult task especially under graded exercise conditions. Having a good tool to characterize the P-R and R-R intervals, i.e. a good method of time delay estimation, would carry out a better knowledge of the neural activity during exercise and recovery in the field of pacemaker's design. Unfortunately, for the P-R intervals, the problem of estimation has been rarely addressed. In this paper, we propose a new method for estimating the P-R intervals based on an iterative Maximum-Likelihood approach. The main contribution is to take into account the overlapping T wave on ECG recorded during exercise. The goal of this study is to compute a model of the T wave which overlaps the P wave and then to cancel this influence before the determination of the P-R intervals.

Assessment of ventilatory thresholds during graded and maximal exercise test using time varying analysis of respiratory sinus arrhythmia.

OBJECTIVE: To test whether ventilatory thresholds, measured during an exercise test, could be assessed using time varying analysis of respiratory sinus arrhythmia frequency (f(RSA)). METHODS: Fourteen sedentary subjects and 12 endurance athletes performed a graded and maximal exercise test on a cycle ergometer: initial load 75 W (sedentary subjects) and 150 W (athletes), increments 37.5 W/2 min. f(RSA) was extracted from heart period series using an evolutive model. First (T(V1)) and second (T(V2)) ventilatory thresholds were determined from the time course curves of ventilation and ventilatory equivalents for O(2) and CO(2). RESULTS: f(RSA) was accurately extracted from all recordings and positively correlated to respiratory frequency (r = 0.96 (0.03), p<0.01). In 21 of the 26 subjects, two successive non-linear increases were determined in f(RSA), defining the first (T(RSA1)) and second (T(RSA2)) f(RSA) thresholds. When expressed as a function of power, T(RSA1) and T(RSA2) were not significantly different from and closely linked to T(V1) (r = 0.99, p<0.001) and T(V2) (r = 0.99, p<0.001), respectively. In the five remaining subjects, only one non-linear increase was observed close to T(V2). Significant differences (p<0.04) were found between athlete and sedentary groups when T(RSA1) and T(RSA2) were expressed in terms of absolute and relative power and percentage of maximal aerobic power. In the sedentary group, T(RSA1) and T(RSA2) were 150.3 (18.7) W and 198.3 (28.8) W, respectively, whereas in the athlete group T(RSA1) and T(RSA2) were 247.3 (32.8) W and 316.0 (28.8) W, respectively. CONCLUSIONS: Dynamic analysis of f(RSA) provides a useful tool for identifying ventilatory thresholds during graded and maximal exercise test in sedentary subjects and athletes.

Effects of oral creatine supplementation on maximal pedalling performance in older adults.

This study was conducted to investigate the effects of giving short-term doses of creatine by mouth to healthy older male subjects, taking into account their training status. A group of 42 volunteers was divided into three: a sedentary group composed of elderly sedentary men [n = 14, mean age 70.1 (SEM 1.2) years], a trained group composed of elderly trained cyclists [n = 14, mean age 66.4 (SEM 1.4) years] and a young group composed of young sedentary men [n = 14, mean age 26.0 (SEM 1.2) years]. In each group, double-blind randomization was carried out: one half was given creatine (3x5 g x day(-1)), and the other was given an iso-nitrogenated placebo (3x10 g x day(-1)). Before and after the 5 days during which the supplements were given, all subjects performed five all-out 10-s sprints separated by 60-s intervals of passive recovery, seated on a cycle ergometer. Power output, work done and heart rate data were recorded during each sprint. The elderly and the young sedentary subgroups given creatine showed significant (P < 0.05) improvements in maximal power (+3.7% and +2.0%, respectively) and work done (+4.1% and +5.1%, respectively) in the subsequent tests. In contrast, no significant change in pedalling performances was observed in the trained elderly subjects. The creatine did not change the exercise and recovery heart rate profiles, in any group. Our study suggested that creatine given by mouth increases the anaerobic power and work capacity of sedentary people of different ages during maximal pedalling tasks. However, the level of physical activity seems to be a determinant of the ergogenic effect of creatine in older subjects.

Effects of strength exercise and training on the natural killer cell counts in elderly humans.

BACKGROUND: To investigate the effects of strength exercise and training on the natural killer cell counts in elderly humans. METHODS: The study examined strength exercise-induced changes in the number of NK cells and changes in stress hormones in 16 sedentary elderly subjects before and after a 8-week strength training intervention. Blood samples were obtained before, immediately and 6 hours after a standardized strength test. Blood samples were also obtained from ten sedentary young subjects, under the same conditions and from ten resting elderly subjects serving as time controls. RESULTS: Prior to training, older adults immediately decreased (from 165.4+/-19.5 microL to 110.6+/-14.3 microL; mean+/-SEM) their NK cell count in response to the standardized strength test, whereas young controls increased their count (from 157.6+/-28.8 microL(-1) to 241.4+/-39.8 microL(-1)). After strength training, the same old subjects slightly increased (from 159+/-19.8 microL(-1) to 166.6+/-19.7 microL(-1)) their NK cell counts in response to the standardized strength test. In elderly subjects, no increase in stress hormone was observed following the strength test either before or after the strength training programme. CONCLUSIONS: The results suggest that in sedentary older adults, unlike young subjects, strength exercises can induce a transient decrease in NK cell count which can be cancelled by a short-term strength conditioning. Therefore, caution should be taken regarding immunocompetence of older adults when initiating a rehabilitation programme based on strength.

Ageing and muscle: the effects of malnutrition, re-nutrition, and physical exercise.

Because of the metabolic changes caused by ageing, malnutrition is accompanied by a preferential loss of fat-free mass in the elderly, and it exaggerates the physiological loss of body cell mass, muscle mass and muscle function observed in the aged. Exercise training has positive anabolic effects even in the frail elderly, and may improve the effect of re-nutrition in malnourished elderly patients.

Cardiovascular tolerance of healthy elderly subjects to weight-lifting exercises.

OBJECTIVE: To evaluate the hemodynamic strain and the myocardial tolerance of weight-lifting exercises in healthy elderly subjects. METHODS: Sixty-five healthy elderly subjects (32 men/33 women) aged 65-80, were studied. Weight-lifting exercises consisted of two sets of 12 repetitions at 12-repetition maximum (RM) and four sets of five repetitions at 5-RM for, horizontal leg press, seated chest press, and bilateral leg extension movements. Cardiovascular tolerance to weight-lifting exercises was evaluated both physiologically and biologically by measuring heart rate (HR) and blood pressures continuously during exercise, and cardiac troponin I (cTnI) blood concentration before and 6 h postexercise. Comparisons between resting and exercise or postexercise values were performed by a bilateral-paired t-test. A value of P < 0.05 was considered statistically significant. RESULTS: No significant increase in cTnI circulating concentration was observed secondary to exercise (16.56+/-2.23 vs 14.40+/-1.96 ng x L(-1); mean +/- SEM). This was observed despite a significant (P < 0.001) exercise-induced increase in systolic (SAP) and diastolic arterial pressures (DAP) and HR. Highest values of SAP, DAP, and HR (223.6+/-3.1 mm Hg, 139.6+/-1.9 mm Hg, and 108+/-2 min(-1), respectively) were measured during the horizontal leg press exercise. CONCLUSION: These data suggest that weight-lifting exercises can be conducted in healthy elderly subjects without clinical, electrical, and biological sign of myocardial ischemia, if appropriate selection criteria, and proper respiratory techniques during exercise are applied.

P300, N400, aerobic fitness, and maximal aerobic exercise.

Electrophysiological effects of aerobic fitness and maximal aerobic exercise were investigated by comparing P300 and N400 before and after a maximal cycling test. Event-related potentials (ERPs) were obtained from 20 students divided into two matched groups defined by their aerobic fitness level (cyclists vs. sedentary subjects). The session of postexercise ERPs was performed immediately after body temperature and heart rate returned to preexercise values. At rest, no significant differences were observed in ERP parameters between cyclists and sedentary subjects. This finding argued against the hypothesis that ERP modifications may be directly assumed by aerobic fitness level. The postexercise session of ERPs showed a significant P300 amplitude increase and a significant P300 latency decrease in all subjects. Similarly, N400 effect increased significantly after the maximal exercise in all subjects. ERP changes were of the same magnitude in the two groups. The present study argues for a general arousing effect of maximal aerobic exercise, independently of the aerobic fitness level.

Reliability and validity of a new device to measure isometric strength in polyarticular exercises.

BACKGROUND: The purpose of this study was to assess the validity of a new device to evaluate isometric strength during multi-joint exercise such as the squat or bench press. METHODS: The device used an electric motor-driven bar to simultaneously generate and measure forces during weight lifting exercises. This new device and a force platform measured the forces generated by either the motor on a fixed telescopic steel girder (passive condition) or a subject pushing vertically against the bar from three squat positions (active condition). In the passive condition, 252 measurements were made, with 3 trials for 6 bar heights and 14 bar loads. In the active condition, 8 young physically active students (age, height and body mass were 25.1 +/- 2.6 years, 179.3 +/- 7.2 cm and 82.0 +/- 9.9 kg, respectively) performed 3 maximal isometric strength (MIS) trials in each of the 3 squat exercise positions (parallel, half and quarter squat), and 3 additional MIS trials in one position randomly assigned two weeks later to test inter-day reliability. RESULTS: In the passive condition, no differences were observed between the forces measured by the force platform and the new device. The coefficient of linear regression (r) and the coefficient of variation (CV) were 1 and below 0.23%, respectively. In the active condition, the peak MIS measured was 2828 N and the values of r and CV were above 0.982 and below 5.96%, respectively. The assessment of inter-day reliability showed an r value of 0.984 and a CV of 3.98%. CONCLUSIONS: This study demonstrated that the new electric motor-driven exerciser provides valid and reliable data when used to generate forces and measure isometric strength throughout the load and motion ranges commonly used in squat exercise.

Muscle enzyme release does not predict muscle function impairment after triathlon.

BACKGROUND: We sought to determine the effects of a long distance triathlon (4 km swim, 120 km bike-ride, and 30 km run) on the four-day kinetics of the biochemical markers of muscle damage, and whether they were quantitatively linked with muscle function impairment and soreness. EXPERIMENTAL DESIGN: Data were collected from 2 days before until 4 days after the completion of the race. PARTICIPANTS: Twelve triathletes performed the triathlon and five did not. MEASURES: Maximal voluntary contraction (MVC), muscle soreness (DOMS) and total serum CK, CK-MB, LDH, AST and ALT activities were assessed. RESULTS: Significant changes after triathlon completion were found for all muscle damage indirect markers over time (p < 0.0001). MVC of the knee extensor and flexor muscles decreased over time (p < 0.05). There is disparity in the time point at which peak values where reached for DOMS, MVC and enzyme leakage. There is no correlation between serum enzyme leakage, DOMS and MVC impairment which occur after triathlon. CONCLUSIONS: Long distance triathlon race caused muscle damage, but extent, as well as muscle recovery cannot be evaluated by the magnitude of changes in serum enzyme activities. Muscle enzyme release cannot be used to predict the magnitude of the muscle function impairment caused by muscle damage.

Responses of total and free insulin-like growth factor-I and insulin-like growth factor binding protein-3 after resistance exercise and training in elderly subjects.

To investigate the effects of an acute bout of exercise on total and free insulin-like growth factor-I and insulin-like growth factor binding protein-3 plasma concentrations, 32 healthy elderly subjects (67-80 years, 16 men) performed a strength test, which consisted of two sets of 12 repetitions at 12-repetition maximum and four sets of 5 repetitions at 5-repetition maximum for horizontal leg press, seated chest press, and bilateral leg extension movements. Ten out of the 32 subjects served as time controls. Blood samples were drawn prior (08.30 h), immediately (10.30 h), and 6 h (16.30 hours) after the strength test in exercising and resting subjects. The 32 subjects were then randomly assigned to habitual physical activity or to an 8-week strength training program. After 8 weeks, both sedentary and trained groups underwent blood samplings under the above-mentioned conditions. The exercising group showed increased total and free insulin-like growth factor-I concentrations immediately (+17.7 and +93.8%, respectively), and 6 h (+7.5 and +31.2%, respectively) after the test, whereas no significant changes in insulin-like growth factor binding protein-3 concentrations were observed in either exercising or resting control groups. Strength training induced no significant changes in baseline insulin-like growth factor-I and insulin-like growth factor binding protein-3 concentrations. Trained and sedentary groups showed similar hormonal response pattern to the strength test, which consisted of increased total and free insulin-like growth factor-I concentrations. The data indicated that strength exercise can induce an early and sustained insulin-like growth factor-I release, in elderly subjects, regardless of their training status.

Effects of a short-term strength training programme on lymphocyte subsets at rest in elderly humans.

The effects of a short-term strength training programme on resting lymphocyte subsets and stress hormone concentrations were analysed in 32 elderly sedentary subjects. Out of these 32 subjects, 8 women and 8 men [mean age 70.1 (SEM 1.0) years] were randomly assigned to a 8-week strength training programme which consisted of three sets of eight repetitions at 80% of one repetition maximum, for leg press, bilateral leg extension and seated chest press, 3 days a week. The remaining 8 women and 8 men [mean age 70.5 (SEM 0.9) years] served as controls. Absolute counts of lymphocyte subsets (CD20+, CD3+, CD3+CD4+, CD3+CD8+, CD3-CD56+CD16+) were measured with a new technique combining fluorescent microspheres and flow cytometry. In the trained subjects, substantial increases in strength took place in one repetition maximum during the 8-week training period for leg press [from means of 20.7 (SEM 1.0) to 23.6 (SEM 1.0) N x kg(-1) LBM (lean body mass)], chest press [from means of 5.4 (SEM 0.3) to 6.2 (SEM 0.3) N x kg(-1) LBM] and bilateral leg extension [from means of 6.3 (SEM 0.2) to 7.4 (SEM 0.3) N x kg(-1) LBM] movements. Baseline cortisol concentration (P < 0.01), CD20+ cell count (P < 0.05), CD3+ cell count (P < 0.05), and CD4+ cell count (P < 0.01) decreased in both groups secondary to circannual variations between winter and summer. No significant effect of strength training on resting adrenaline, noradrenaline and cortisol concentrations or distributions of lymphocyte subsets at rest was observed. The main finding of this study was to demonstrate that 8-week is too short a duration for a strength training programme to modify counts of lymphocyte subsets at rest in elderly sedentary adults.

Effects of creatine monohydrate ingestion in sedentary and weight-trained older adults.

To investigate the effects of an oral creatine supplementation in older adults, 32 elderly subjects (67-80 years; 16 females, 16 males) were randomly assigned to four equivalent subgroups (control-creatine; control-placebo; trained-creatine; trained-placebo) based on whether or not they took part in an 8-week strength training programme and an 8-week oral creatine monohydrate creatine supplementation programme. The strength training programme consisted of three sets of eight repetitions at 80% of one-repetition maximum, for leg press, leg extension and chest press, 3 days a week. The 52-day supplementation programme consisted of 20 g of creatine monohydrate (or glucose) and 8 g of glucose per day for the initial 5 days followed by 3 g of creatine monohydrate (or glucose), and 2 g of glucose per day. Prior to and after the training and supplementation periods, body mass, body fat, lower limb muscular volume, 1-, 12-repetitions maxima and isometric intermittent endurance tests for leg press, leg extension and chest press were determined. In all groups, no significant changes in anthropometric parameters were observed. For all movements, the increases in 1- and 12-repetitions maxima were greater (P < 0.02) in trained than control subjects. No significant interactions (supplementation/training/time) were observed for the 1-, 12-repetitions maxima, and the isometric intermittent endurance, whatever the movement considered. We conclude that oral creatine supplementation does not provide additional benefits for body composition, maximal dynamical strength, and dynamical and isometric endurances of healthy elderly subjects, whether or not it is associated with an effective strength training.

Visual and brainstem auditory evoked potentials and maximal aerobic exercise: does the influence of exercise persist after body temperature recovery?

Transversal studies have shown a strong correlation between specific evoked potential (EP) values and specific physical activities, as well as between EP values and the amount of training. Prior to longitudinal studies investigating the effect of training in EPs, it is mandatory to determine whether a recent training session could interfere with regular EP recording. Exercise-induced hyperthermia is known to modify EP values. The purpose of the study was to determine whether an acute exercise can induce EP modification persisting after body temperature recovery. We measured two sets of visual evoked potentials (VEPs) and brainstem auditory evoked potentials (BAEPs) in 16 males (8 cyclists and 8 sedentary peers), one before and the other after a maximal cycloergometric graded exercise test. The second test was performed immediately after body temperature recovery. We chose to test cyclists, as their specific training corresponded to the exercise test we performed on a cycloergometer. The repeated measures before and after the exercise test showed no significant differences, neither in VEPs nor in BAEPs, for any subject of the study. Recording VEPs and BAEPs in cyclists, we observed no difference related to this particular sport training. This study showed that VEP and BAEP values were similar to those measured before a maximal exercise when body temperature returned to pre-exercise value. This original work demonstrated that VEP and BAEP recordings can be reliably performed after a recent training session, provided body temperature has returned to basal level.

Decreased pulmonary diffusing capacity of divers over a 6-year period.

Non-smoking, male, professional firemen divers (n = 15) underwent two pulmonary function tests (PFT) separated by 6 years. Measured data were compared to European Coal Steel Community recommended reference values to permit cross-sectional and then longitudinal study. Higher vital capacity (VC; P < 0.01) and forced expiratory volume in 1 s (FEV1; P < 0.05), and lower maximal mid-expiratory flow (MMEF) coefficient with VC (MMEF/VC; P < 0.05) were observed in both PFT. Diver's pulmonary diffusing capacity (DL(CO)) and the coefficient with alveolar volume (DL(CO)/V(A)) showed significantly (P < 0.001) different evolution profiles than those expected from predicted values. In divers, DL(CO) and DL(CO)/V(A) decreased from 104.0% to 91.4% and from 106.4% to 91.5% of predicted values respectively. Changes in DL(CO) and DL(CO)/V(A) correlated positively with the initial measurement of DL(CO) (r = 0.67, P < 0.01) and DL(CO)/V(A) (r = 0.74, P < 0.01) respectively, whereas no correlation between changes in pulmonary gas transfer function and age or diving history parameters was found. Thus, it is suggested from our observations that hyperbaric atmosphere exposure increases the effects of aging on pulmonary diffusing capacity and that pulmonary gas transfer function should be regularly tested in professional and recreational divers.

Relationships between oxygen consumption and heart rate in transitory and steady states of exercise and during recovery: influence of type of exercise.

Relationships between percentage of maximal oxygen consumption (%VO2max) and percentage of maximal heart rate reserve (%f(cr)) were compared during steady states of exercise (S), transitory states of exercise (T) and a 5-min recovery period (R). Male adults [mean age 27 (SD 10) years] were studied exercising on a treadmill (TR, n = 26), cycle ergometer (CE, n = 14) and arm traction bench (ATB, n = 14). The exercise intensity was adjusted according to the subjects in order to reach exhaustion in 4-5 steps of 2 min (ATB) or 3 min (TR, CE). The 1st min of each stage was considered as T and the last minute of each stage as S. The oxygen consumption (VO2) and heart rate (f(c)) were recorded simultaneously. Significant correlations were observed for each type of exercise and for each state between %f(cr) and %VO2max (r range 0.87-1.00). During T and R, the %VO2max versus %f(cr) relationships were laterally shifted, suggesting a resetting of f(c) control mechanisms. In S, the intercept was greater than in T and R; in T, the slope was greater than in S and R. The VO2 could be predicted from individual %VO2max versus %f(cr) relationships during T and R as is usually done in S using specific equations. Taking into consideration the average relationships established on the three ergometers, the standard error of the predicted VO2 during S and T reached 10%-20% and 22%-38% in R. During exercise, the higher the intensity the better was the prediction of VO2 from f(c) (r range 0.46-0.60, P < 0.001). Therefore except at high exercise intensities, it was found that individual relationships had to be used to obtain an accurate estimation of VO2.

Correction of protein-energy malnutrition in older adults: effects of a short-term aerobic training program.

Twenty malnourished subjects (average age 67 years old) treated by cyclic enteral nutrition were assigned to an active or control group according to whether they took part or not in a 3-week aerobic training program. Subjects underwent the following tests on d(0)-d(1) and d(20)-d(21): calculation of a global nutritional deficiency index (GND), bioelectrical impedance analysis, evaluation of daily energy expenditures using a 24 h heart rate (HR) recorder and a pedometer, maximal voluntary isometric strength assessment (MVIS), and symptoms limited maximal oxygen uptake ((.)VO(2 max. SL) estimation. Although energy intakes were similar in both groups, active subjects showed greater improvements (P < 0.05) than control subjects regarding GND (-9.8 vs -4.8%), serum albumin and prealbumin. Active subjects also showed a greater increase (P < 0.05) in pedometer readings compared to control subjects. Reduction of resting HR was observed in active (-5 beat/mn, P < 0.05) whereas no significant changes in average HR were noted in either group, reflecting increased metabolic activity. Compared to control, active subjects showed significant (P < 0.05) improvements in MVIS (0.8 vs 0.1 N/kg) and (.)VO(2 max. SL) (5.5 vs 1.4 mL/min/kg). Short-term aerobic training has positive effects on nutritional recovery and functional capacities in elderly malnourished subjects and should be recommended whenever possible.

Short-term effect of cold provocation on single-breath carbon monoxide diffusing capacity in subjects with and without Raynaud's phenomenon.

The lung diffusing capacity for carbon monoxide was determined by the single breath method (DLCOsb) before, during, and after immersion of the left hand in cold water in four groups of subjects: (i) normal individuals; (ii) subjects with idiopathic Raynaud's disease; (iii) patients with progressive systemic sclerosis without associated Raynaud's phenomenon; and (iv) patients with connective tissue disease associated with Raynaud's phenomenon. Our results showed significant differences in the evolution of DLCOsb after cold stimulation between the groups. Control subjects (group one) showed a transient but significant reduction in DLCOsb at the end of two minutes of cold stimulation, normalizing ten minutes later. Subjects with primary Raynaud's phenomenon (group two) showed on the contrary a transient but significant rise in DLCOsb after 2 minutes, while subjects with an isolated connective tissue disease without Raynaud's phenomenon (group three) showed a significant decrease in DLCOsb at both observation times. Patients with Raynaud's phenomenon associated with a connective tissue disease (group four) showed a delayed decrease in DLCOsb ten minutes after cold stimulation. This latter result appeared as an addition to the effects of cold stimulation observed in groups two and three.

Pulmonary function of a firemen-diver population: a longitudinal study.

Non smoking, male professional firemen-divers (n = 20) underwent two pulmonary function tests (PFT) separated by 8-9 years. Measured data were compared to European Coal Steel Community recommended reference values to permit cross-sectional and then longitudinal studies. Higher vital capacity (VC) and forced expiratory volume in 1 s (FEV1; both P < 0.001), and lower residual volume (P < 0.01) were observed in both PFT. Longitudinal analysis showed a smaller VC reduction than FEV1 reduction, leading to a FEV1/VC percentage decrease with time. Maximal mid expiratory flow (MMEF) and MMEF/VC changes during this 9-year period showed an unusually pronounced decrease, suggesting possible chronic effects of diving on small airways. Thus, it is suggested from our observations that a hyperbaric stimulus compensates in part for the effects of aging on VC and that obstructive disease could occur in subjects with long diving experience.