Influence of excess weight on lower-extremity vertical stiffness and metabolic cost of walking.

The purpose was to test whether lower-extremity vertical stiffness and gait mechanics explain differences in energy cost of walking (Cw) between individuals with normal weight (NW) and obesity (OB). Ten OB (33.1 ± 2.0 kg m-2) and 10 NW (24.2 ± 1.3 kg m-2) walked for six minutes on an instrumented treadmill at 1.25 m s-1 while Cw, lower-extremity kinematics, and vertical stiffness (K vert) were measured. NW completed another trial with a loaded vest (NWL) to simulate the BMI of the obese group. Cw was 24% greater in OB (277.5 ± 45.3 J m-1) and 23% greater in NWL (272.7 ± 35.7 J m-1) than NW (211.0 ± 27.0 J m-1, P < 0.005). Mass-specific Cw (Cwkg) wasn't different between conditions (P = 0.085). Lower-extremity K vert was 40% higher in OB (32.7 ± 5.2 kN m-1) than NW (23.3 ± 4.7 kN m-1, P < 0.001), but neither was different from NWL (27.5 ± 3.4 kN m-1, P > 0.05). Mass-specific K vert (P = 0.081) was similar across conditions. K vert was related to Cw (r = 0.55, P = 0.001). Cwkg wasn't different between NW or OB, but there was a negative correlation between BMI and Cwkg driven by lower Cwkg in NWL. Cw and K vert covaried in proportion to body mass, but mass-specific K vert was unrelated to Cwkg. Mass-specific K vert was lower in NWL than OB due to NWL's greater angle of attack, center of mass displacement, and joint range of motion.

Aging and factors related to running economy.

The purpose of this study was to investigate the relationship that age has on factors affecting running economy (RE) in competitive distance runners. Fifty-one male and female subelite distance runners (Young [Y]: 18-39 years [n = 18]; Master [M]: 40-59 years [n = 22]; and Older [O]: 60-older [n = 11]) were measured for RE, step rate, lactate threshold (LT), VO2max, muscle strength and endurance, flexibility, power, and body composition. An RE test was conducted at 4 different velocities (161, 188, 215, and 241 m·min(-1)), with subjects running for 5 minutes at each velocity. The steady-state VO2max during the last minute of each stage was recorded and plotted vs. speed, and a regression equation was formulated. A 1 × 3 analysis of variance revealed no differences in the slopes of the RE regression lines among age groups (y = 0.1827x - 0.2974; R2 = 0.9511 [Y]; y = 0.1988x - 1.0416; R2 = 0.9697 [M]; y = 0.1727x + 3.0252; R2 = 0.9618 [O]). The VO2max was significantly lower in the O group compared to in the Y and M groups (Y = 64.1 ± 3.2; M = 56.8 ± 2.7; O = 44.4 ± 1.7 mlO2·kg(-1)·min(-1)). The maximal heart rate and velocity @ LT were significantly different among all age groups (Y = 197 ± 4; M = 183 ± 2; O = 170 ± 6 b·min(-1) and Y = 289.7 ± 27.0; M = 251.5 ± 32.9; O = 212.3 ± 24.6 m·min(-1), respectively). The VO2max @ LT was significantly lower in the O group compared to in the Y and M groups (Y = 50.3 ± 2.0; M = 48.8 ± 2.9; O = 34.9 ± 3.2 mlO2·kg(-1)·min(-1)). The O group was significantly lower than in the Y and M groups in flexibility, power, and upper body strength. Multiple regression analyses showed that strength and power were significantly related to running velocity. The results from this cross-sectional analysis suggest that age-related declines in running performance are associated with declines in maximal and submaximal cardiorespiratory variables and declines in strength and power, not because of declines in running economy.

The Talk Test and its relationship with the ventilatory and lactate thresholds.

In this study, we wished to determine the relationship between the Talk Test physiological and perceptual indicators and variables measured at the ventilatory and lactate thresholds, and if the Talk Test indicators were associated with a typical exercise prescription. Fifteen participants (13 males and 2 females; age 18-35 years) underwent a treadmill lactate threshold test followed by a VO2max (maximal oxygen consumption) test in which the ventilatory threshold was determined. On a separate day, a Talk Test was administered in which participants read a passage during exercise and rated speaking comfort: "comfortable" (+Talk Test), "not sure" (+/-Talk Test), or "not able to speak comfortably" (-Talk Test). Exercise prescriptions based on 65% and 80% of heart rate reserve and VO2 reserve were determined. Lactate threshold values were significantly higher than those at the ventilatory threshold (P < 0.05). The heart rate, VO2, and %VO2max recorded at all levels of the Talk Test were significantly higher than similar measurements recorded at the ventilatory threshold (P < 0.05). Lactate threshold measurements were similar to the +Talk Test and +/-Talk Test. Participants were exercising at 64 ± 5% VO2max, 82 ± 7% maximal heart rate, and 12 ± 2% RPE (rating of perceived exertion) at the +Talk Test, and 71 ± 6% VO2max, 90 ± 6% maximal heart rate, and 15 ± 2% RPE at the +/-Talk Test, with all values being within ACSM exercise intensity guidelines. Therefore, the Talk Test can be used in this population to prescribe exercise, and Talk Test data are more strongly related to physiological and perceptual variables corresponding to the lactate threshold than to the ventilatory threshold.

Defining intensity domains from the end power of a 3-min all-out cycling test.

PURPOSE: The purpose of this study was to develop a modified version of a 3-min all-out cycling test (3MT) using equipment readily available to cyclists and to identify exercise intensity domains using the average power output over the last 30 s of the 3MT (end-test power (EP)). METHODS: Sixteen competitive cyclists (V(O2peak) = 60.3 +/- 8.3 mL.kg.min) completed three laboratory visits using their own bicycles and a power-measuring rear wheel. In visit 1, subjects performed an incremental load test to volitional termination on an electronically braked trainer (100 + 25 W every 4 min). Power output at lactate threshold was determined by absolute 4 mmol.L (OBLA-PO) and 1 mmol.L over exercise baseline (LT-PO). Power output at ventilatory threshold (VT-PO) was computed on the basis of the V-slope method. Power output at V(O2peak) (V(O2peak)-PO) was the mean power observed during the stage at which peak O2 consumption was recorded. In visits 2 and 3, subjects performed the 3MT using a progressive resistance trainer with Visit 2 as a familiarization trial. During Visit 3, EP was recorded. RESULTS: EP (273 +/- 52 W) was significantly greater than VT-PO, OBLA-PO, and LT-PO (232 +/- 64, 235 +/- 54, and 208 +/- 45 W, respectively) but significantly less than V(O2peak)-PO (288 +/- 56 W). EP was correlated with V(O2peak)-PO (r = 0.97), VT-PO (r = 0.87), OBLA-PO (r = 0.85), and LT-PO (r = 0.79) with regression estimates through the origin made using 105%, 86%, 86%, and 76% of EP, respectively. Demarcations for moderate- to heavy-intensity (LT-PO at 76% EP) and heavy- to severe-intensity (100% EP) domains may be estimated. CONCLUSION: The 3MT can be used to define exercise intensity in competitive cyclists using readily available equipment.

The impact of different pacing strategies on five-kilometer running time trial performance.

The purpose of this study was to determine the optimal 1.63-km (1-mile) pacing strategy for 5-km running performance in moderately trained women distance runners. Eleven women distance runners (20.7 +/- 0.8 years, 163.8 +/- 2.0 cm, 57.0 +/- 2.2 kg, 51.7 +/- 1.0 ml.kg(-1).min(-1), 18.9 +/- 0.8% fat, 78.1 +/- 1.4% VO(2)max at lactate threshold) performed 2 preliminary 5-km time trials on a treadmill to establish baseline 5-km times. The average 1.63-km split pace of the fastest preliminary trial was manipulated for the first 1.63 km of the experimental trials and run either equal to (EVEN), 3% faster than (3%), or 6% faster than (6%) the current baseline average 1.63-km pace for each subject. Ventilation (V(E)), oxygen consumption VO(2)max )), respiratory exchange ratio, and heart rate were measured continuously. Overall 5-km times were not different (p > 0.05) for the EVEN, 3% and 6% trials finishing in 21:11 (minutes/seconds) +/- 29 seconds, 20:52 +/- 36 seconds and 20:39 +/- 29 seconds, respectively. The fastest time for 8 subjects resulted from the 6% trial and the other 3 subjects' fastest times resulted from the 3% trial. The overall exercise intensity (%VO(2)max , %VO(2)max above lactate threshold, V(E), and respiratory exchange ratio) of the first 1.63-km split was not different between the 3 and 6% trials, despite the 6% trial being 13 seconds faster than the 3% trial. Based on these findings, initial 1.63-km starting paces of a 5-km race can be 3 to 6% greater than current average race pace without negatively impacting performance. In order to optimize 5-km performance, runners should start the initial 1.63 km of a 5-km race at paces 3-6% greater than their current average race pace.

Two short, daily activity bouts vs. one long bout: are health and fitness improvements similar over twelve and twenty-four weeks?

This study sought to determine whether a 12-week intermittent (INT; 2 x 15 min.d(-1)) exercise program yielded similar improvements in cardiovascular health and fitness, compared with a traditional 12-week, 30-minute continuous (CON; 1 x 30 min.d(-1)) exercise program. A second purpose was to determine the effects of switching exercise programs and continuing training for an additional 12 weeks. Twenty women and 17 men, (age 48.8 +/- 9.0 years) were divided randomly into 2 groups: INT (n = 20) and CON (n = 17). Aerobic exercise was performed 4 d.wk(-1) for 12 weeks. Subjects then crossed over to the opposite training program for an additional 12 weeks of training. Subjects exercised incrementally for weeks 1-4 and training was conducted at 70-80% heart rate reserve for weeks 5-24. Both groups showed comparable exercise adherence, completing 96.6 +/- 12.2% (CON) and 96.3% +/- 17.7% (INT) of the prescribed exercise time. The INT walked at a lower percentage of Vo(2)max, maximum heart rate, systolic blood pressure, and diastolic blood pressure (p < 0.05). Maximal oxygen consumption increased by 4.5% in CON and by 8.7% in INT. Following the second 12 weeks, Vo(2)max increased by 3.6 and 7.7% in CON and INT, respectively. Treadmill test time increased by 41 seconds in CON (p < 0.05) and 71 seconds in INT (p < 0.05) after 12 weeks of training. High-density lipoproteins significantly increased in the INT group following the first 12 weeks of training. This study suggests that an INT exercise program, which is incremental in nature, provides comparable, and in some cases greater, health and fitness benefits than those expected following traditional CON exercise training.

Hypohydration effects on thermoregulation during moderate exercise in the cold.

Hyperosmotic hypovolemia impairs vasoconstriction during sedentary cold exposure. The purpose of this study was to determine whether hypohydration alters thermoregulation and cardiovascular responses to exercise in cold air. On four occasions, eight males [35.1 (2.7) years, 175.5 (3.1) cm, 73.3 (2.6) kg, 57.2 (2.6) ml kg(-1) min(-1) maximal oxygen uptake (VO(2max)), 19.6 (2.4)% fat] walked, in t-shirt, shorts, and shoes, at 50% VO(2max), for 60 min in either a 4 degrees C (Cold) or a 25 degrees C (Temperate) environment in both hypohydrated state (HYPO, -4% body mass) and euhydrated state (EU). During exercise-cold stress, rectal temperature ( T(re)), mean weighted skin temperature, heart rate (HR), cardiac output (CO), and stroke volume (SV) were measured every 20 min. Mean weighted skin temperature values were not different between HYPO and EU but were lower ( P<0.05) in Cold versus Temperate trials. T(re) was not different ( P>0.05) between HYPO-Cold and EU-Cold. CO and SV were not different within hydration states and were not different between Cold and Temperate trials ( P<0.05). HR was not different between HYPO-Cold and EU-Cold. These data demonstrate that moderate intensity exercise in the cold while hypohydrated does not alter metabolic heat production, skin temperatures and heat loss, nor does it increase thermoregulatory and cardiovascular strain.

Placenta accreta postpartum.

BACKGROUND: Placenta accreta is the abnormal attachment of the placenta to the uterus. It occurs when the decidua basalis is either absent or incomplete. It is uncommon and most often presents with a retained placenta and hemorrhage. CASE: A 29-year-old gravida 1 had an uncomplicated antenatal course and delivery. The third stage of labor was complicated by a retained placenta necessitating manual removal. Her postpartum course was complicated by a persistent endometritis. The diagnosis of placenta accreta was made with the help of sonohysterography. CONCLUSION: Sonohysterography is a useful tool in discriminating a solid intracavitary mass from a placenta accreta postpartum.

Infant acceptance of breast milk after maternal exercise.

OBJECTIVE: Previous research reported that breast milk lactic acid (LA) levels increase after lactating women complete a bout of exhaustive exercise, resulting in poor infant acceptance of the postexercise breast milk. This highly publicized finding may not apply to more practical, everyday exercise conditions of lactating women. The purpose of the present study was to reexamine the composition and infant acceptance of postexercise breast milk while controlling maternal diet, exercise intensity, and the method, timing, and assessment of infant feeding. RESEARCH DESIGN AND METHODS: Twenty-four women, 2 to 4 months' postpartum, completed 3 test sessions: a maximal oxygen uptake test, a 30-minute bout of moderate exercise, and a resting control session. One hour before and 1 hour after each session, participants fully expressed their milk, placed it in a bottle familiar to the infant, fed their infant, and rated their infant's acceptance of the milk. Each feeding was videotaped and viewed individually by 3 lactation consultants who rated infant acceptance; consultants were blinded to the test sessions. Milk was analyzed for LA and infant milk consumption was measured. RESULTS: There were no differences in presession versus postsession values for maternal skin temperature, breast milk temperature, and infant milk acceptance as judged by either the mothers or lactation consultants. These results prevailed despite a small but significant increase in breast milk LA premaximal versus postmaximal exercise (0.09 vs 0.21 mM, respectively); there was no difference in milk LA premoderate versus postmoderate exercise, or prerest versus postrest. CONCLUSION: These data support the hypothesis that moderate or even high-intensity exercise during lactation does not impede infant acceptance of breast milk consumed 1 hour postexercise.

Hypohydration adversely affects lactate threshold in endurance athletes.

The purpose of this investigation was to observe the effect of hypohydration (-4% body mass) on lactate threshold (LAT) in 14 collegiate athletes (8 men and 6 women; age, 20.9 +/- 0.5 years; height, 171.1 +/- 2.4 cm; weight, 64.8 +/- 2.3 kg; V(O)2 max, 62.8 +/- 1.9 ml x kg(-1) x min(-1); percentage of fat, 11.4 +/- 1.5%). Subjects performed 2 randomized, discontinuous treadmill bouts at a dry bulb temperature (T(db)) of 22 degrees C to volitional exhaustion in 2 states of hydration, euhydrated and hypohydrated. The hypohydrated condition was achieved in a thermally neutral environment (T(db), 22 degrees C; humidity, 45%), with exercise conducted at a moderate intensity as defined by rating of perceived exertion (RPE, approximately 12) 12-16 hours before testing. On average, subjects decreased 3.9% of their body mass before the hypohydration test. Blood lactate, hematocrit, V(O)2, minute ventilation (VE), R value, heart rate (HR), and RPE were measured during each 4-minute stage of testing. In the hypohydrated condition, LAT occurred significantly earlier during exercise and at a lower absolute V(O)2, VE, respiratory exchange ratio, RPE, and blood lactate concentration. Also, the blood lactate concentration was significantly lower in the hypohydrated condition (6.7 +/- 0.8 mmol) compared with the euhydrated condition (10.2 +/- 0.9 mmol) at peak exercise. There were no differences in HR or percentage of maximum HR at LAT nor did plots of V(CO2):V(O)2 reveal differences in bicarbonate buffering during exercise between the 2 conditions. From these results, we speculate that hypohydration did not significantly alter cardiovascular function or buffering capacity but did cause LAT to occur at a lower absolute exercise intensity.