Journal articles on the topic 'Adapted ergometer'
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Devillard, Xavier, Paul Calmels, Bernard Sauvignet, Alain Belli, Christian Denis, Clermont Simard, and Vincent Gautheron. "Validation of a new ergometer adapted to all types of manual wheelchair." European Journal of Applied Physiology 85, no. 5 (September 1, 2001): 479–85. http://dx.doi.org/10.1007/s004210100407.
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Gama, M., F. A. Sousa, I. G. dos Reis, and C. Gobatto. "Reliability of the Three-minute All-out Test for Non-motorized Treadmill Tethered Running." International Journal of Sports Medicine 38, no. 08 (July 13, 2016): 613–19. http://dx.doi.org/10.1055/s-0035-1565238.
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AbstractThe 3-min all-out test was developed and validated on a cycle ergometer using a modification of a linear mathematical equation (1/time vs. power) obtained from the original critical power model. The purpose of this development was to obtain, in a single test, the aerobic and anaerobic capacity parameters and identify the exercise transition moment from heavy to severe intensity. The aim of this study was to propose an adaptation of the all-out 3-min cycle ergometer to a non-motorized treadmill with tethered running. In addition, we tested the reproducibility of this adapted protocol, highlighting the need for mechanical power evaluation using a specific ergometer. Consequently, 10 physically active individuals visited the laboratory 4 times for testing and data collection. The results suggested that the protocol adaptation for the 3-min all-out test for non-motorized treadmill with tethered running was reproducible and feasible. It was also possible to show that the AO3 application in this ergometer ensures the specificity of the sports that involve the running exercise, from assessment of both aerobic and anaerobic parameters, accomplished in a single day of application.
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Rosso, Valeria, Vesa Linnamo, Walter Rapp, Stefan Lindinger, Magdalena Karczewska-Lindinger, Yves Vanlandewijck, and Laura Gastaldi. "Simulated skiing as a measurement tool for performance in cross-country sit-skiing." Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology 233, no. 4 (May 6, 2019): 455–66. http://dx.doi.org/10.1177/1754337119843415.
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The International Paralympic Committee mandates the development of an evidence-based classification system, which requires a measure of performance. Performance in cross-country sit-skiing is mainly dependent on force generated during the poling phase and is enhanced by trunk flexion–extension movements. Since all sit-skiers have neuromuscular impairment, but different ability to control the trunk, this study aimed to verify if simulated action of poling on an adapted ergometer, together with a cluster analysis, could be used for grouping participants with different impairments according to their performance. On the ergometer, eight male and five female participants performed seven poling cycles at maximal speed, while sitting on personal sit-ski. Based on maximal speed, generated force, cycle characteristics, and trunk kinematics, cluster analysis divided participants into three groups showing good accuracy, sensitivity, and precision. Although a validation of this exploratory study is necessary, skiing on the ergometer could be considered as sport-specific measure of performance and may become an interesting tool in the development of an evidence-based classification system for cross-country sit-skiing.
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Fuentes-García, Juan Pedro, Lorena Alonso-Rivas, José Javier Gómez-Barrado, Víctor Manuel Abello-Giraldo, Ruth Jiménez-Castuera, and César Díaz-Casasola. "Modification of the Forms of Self-Determined Regulation and Quality of Life after a Cardiac Rehabilitation Programme: Tennis-Based vs. Bicycle Ergometer-Based." International Journal of Environmental Research and Public Health 18, no. 17 (August 31, 2021): 9207. http://dx.doi.org/10.3390/ijerph18179207.
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Background: The objective is to analyse and compare the effects of an adapted tennis cardiac rehabilitation programme and a classical bicycle ergometer-based programme on the type of motivation towards sports practice and quality of life in patients classified as low risk after suffering acute coronary syndrome. Methods: The Behavioural Regulation in Exercise Questionnaire (BREQ-2) and Velasco’s Qualityof Life Test were applied. The sample comprised 110 individuals (age = 55.05 ± 9.27) divided into two experimental groups (tennis and bicycle ergometer) and a control group. Results: The intra-group analysis showed a significant increase between pre- and post-test results in intrinsic regulation in the tennis group and in the control group. In identified regulation, the bicycle ergometer group presented significant differences from the control group. On the other hand, in the external regulation variable, only the tennis group showed significant differences, which decreased. Significant improvements in all quality-of-life factors when comparing the pre-test period with the post-test period were only found in the experimental groups. As per the inter-group analysis, significant differences were observed in favour of the tennis group with respect to the control group in the variables of health, social relations and leisure, and work time as well as in favour of the bicycle ergometer group compared with the control group in the variables of health, sleep and rest, future projects and mobility. No significant differences were found in any of the variables between the tennis group and the bicycle ergometer group. Conclusion: It is relevant to enhance the practice of physical exercise in infarcted patients classified as low risk as it improves the forms of more self-determined regulation towards sporting practice and their quality of life.
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Silva, Rogério Wagner da, Michel Kendy Souza, Thiago dos Santos Rosa, Carlos Ernesto Santos Ferreira, Hugo de Luca Corrêa, Rodrigo Vanerson Passos Neves, Jéssica Mycaelle Silva Barbosa, et al. "The effects of chronic whole-body vibration training on immune system of sedentary young women." Research, Society and Development 10, no. 5 (April 30, 2021): e11010514377. http://dx.doi.org/10.33448/rsd-v10i5.14377.
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Objective: The aim of this study was to verify the influence of 6 weeks of whole-body vibration training on the pro- and anti-inflammatory cytokines (IL-2, IL-4, IL-6, IL-10, IFN-ɣ e TNF-α) in young, eutrophic and sedentary women. Methods: Twenty-six participants were randomly divided into two groups: Vibratory Platform Group (GV, n = 13) and Ergometry Group (GE, n = 13). The training program of both groups was of 20 minutes / session, 3 times per week, in non-consecutive days for 6 weeks. The load of the training was adjusted with the adapted Borg scale. GE was submitted to aerobic activity sessions in a cycle ergometer. GV was submitted to vibration platform stimulation sessions. After training program both groups were submitted to 6 weeks of detraining. Results: GV increased levels of IL-4, IL-6, IL-10 and TNF-α after training, and it decreased all of them after detraining phase. GE increased IL2, IL-4, IL-6 and IL-10 only after the detraining period. Conclusion: 6 weeks of whole-body vibration training can promote an increase in pro- and anti-inflammatory cytokines in young, eutrophic and sedentary women, however these effects seem to be transitory as the exercise is discontinued.
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Beaudry, Rhys I., T. Jake Samuel, Jing Wang, Wesley J. Tucker, Mark J. Haykowsky, and Michael D. Nelson. "Exercise cardiac magnetic resonance imaging: a feasibility study and meta-analysis." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 315, no. 4 (October 1, 2018): R638—R645. http://dx.doi.org/10.1152/ajpregu.00158.2018.
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Cardiac stress testing improves detection and risk assessment of heart disease. Magnetic resonance imaging (MRI) is the clinical gold-standard for assessing cardiac morphology and function at rest; however, exercise MRI has not been widely adapted for cardiac assessment because of imaging and device limitations. Commercially available magnetic resonance ergometers, together with improved imaging sequences, have overcome many previous limitations, making cardiac stress MRI more feasible. Here, we aimed to demonstrate clinical feasibility and establish the normative, healthy response to supine exercise MRI. Eight young, healthy subjects underwent rest and exercise cinematic imaging to measure left ventricular volumes and ejection fraction. To establish the normative, healthy response to exercise MRI we performed a comprehensive literature review and meta-analysis of existing exercise cardiac MRI studies. Results were pooled using a random effects model to define the left ventricular ejection fraction, end-diastolic, end-systolic, and stroke volume responses. Our proof-of-concept data showed a marked increase in cardiac index with exercise, secondary to an increase in both heart rate and stroke volume. The change in stroke volume was driven by a reduction in end-systolic volume, with no change in end-diastolic volume. These findings were entirely consistent with 17 previous exercise MRI studies (226 individual records), despite differences in imaging approach, ergometer, or exercise type. Taken together, the data herein demonstrate that exercise cardiac MRI is clinically feasible, using commercially available exercise equipment and vendor-provided product sequences and establish the normative, healthy response to exercise MRI.
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Klepin, Heidi D., Janet A. Tooze, Ann M. Geiger, Timothy S. Pardee, Leslie R. Ellis, Dianna Howard, Wendy Demark-Wahnefried, et al. "A symptom-adapted physical activity intervention during induction chemotherapy for older adults with acute myeloid leukemia (AML) to maintain physical function." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): 12009. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.12009.
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12009 Background: Older adults are at risk for physical function decline during therapy for AML. Impaired physical function after induction therapy is associated with shorter survival Interventions designed to maintain function may improve treatment outcomes. We piloted a physical activity (PA) intervention among older adults receiving intensive chemotherapy for AML designed to prevent functional decline. Methods: Single institution randomized pilot study of PA vs. usual care. Eligibility included age ≥60 years, newly-diagnosed AML, ambulatory, planned intensive induction chemotherapy. Intervention participants were offered a PA session five days/week tailored daily to symptoms and conditions during the induction hospitalization. Session options were: 1) Standard (ward-based), walking + balance trahining + resistance exercises; 2) Intermediate (room-based), upper-body ergometer + balance training + resistance exercises; 3) Low-intensity (bed-based), upper-body ergometer + resistance exercises. Behavioral counseling sessions to establish PA goals and overcome barriers were conducted weekly during hospitalization and continued monthly by phone for 6 months. Assessment of physical function occurred at baseline, weekly during hospitalization (approximately 4-6 weeks), 3 months, and 6 months. The primary functional outcome of interest was the Short Physical Performance Battery (SPPB; 5 repeat chair stands, gait speed, balance tests; score 0-12 higher indicates better function). Clinically significant change in physical function was defined as ≥1.0 on the SPPB. Proportions of those that declined, remained stable, or improved on the SPPB were compared by group using an exact test for trend. Results: Among 96 eligible patients 70 enrolled (recruitment rate 73%, average participation 3 sessions/week). The mean age was 72.1±6.3 years, 70% were male. Mean baseline SPPB score was 7.0±3.8. In the surviving intention to treat population (N = 66), more intervention participants, compared to controls, maintained or improved their SPPB score (38% vs. 25%) during induction hospitalization (p = 0.278). Among those who achieved remission (N = 42), function was maintained or improved in a greater proportion of intervention participants (55%) compared to controls (23%), p = 0.047. Maintenance or improvement in SPPB from baseline to last follow-up (3 or 6 months post enrollment) was 62% vs 54% for intervention versus control among the intention to treat cohort (N = 50) and 67% vs. 55% among those who achieved remission (N = 40). Conclusions: A symptom adapted PA intervention with behavioral counseling during induction chemotherapy shows promise in preventing clinically meaningful decline in physical function among older adults with AML who achieve remission. Continued maintenance intervention may sustain benefits. Clinical trial information: NCT01519596.
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di Natale, Josie, Mary Lee, Graham Ward, and Roy J. Shephard. "Loss of Physical Condition in Sightless Adolescents during a Summer Vacation." Adapted Physical Activity Quarterly 2, no. 2 (April 1985): 144–50. http://dx.doi.org/10.1123/apaq.2.2.144.
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The aerobic power and body composition of 18 sightless adolescents (10 males and 8 females) has been tested by standard laboratory techniques. While attending a residential school and participating in specific sessions of vigorous endurance activity at least three times per week, their fitness was comparable to that of normally sighted adolescents (estimated body fat 14.9, 25.3%, directly measured cycle ergometer maximum oxygen intake 51.7, 39.7 ml $$ kg-1 min-1). However, after a 10-week summer vacation spent with their parents, the physical condition of these children had deteriorated to levels previously reported for blind children (estimated body fat 14.7, 27.1%, directly measured maximum oxygen intake 44.9, 33.7 ml $$ kg-1 min-1). It is concluded that sightless students can attain normal levels of fitness for their age if given an adequate and suitably adapted physical activity program. However, if condition is to be maintained, programs should stress patterns of activity suited to the home environment, which typically has no special equipment or trained guides.
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MacDonald, M. J., J. K. Shoemaker, C. Borkhoff, and R. L. Hughson. "Alveolar Oxygen Uptake and Blood Flow Dynamics in Knee Extension Ergometry." Methods of Information in Medicine 36, no. 04/05 (October 1997): 364–67. http://dx.doi.org/10.1055/s-0038-1636847.
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Abstract:The relationship was studied between the increase in oxygen uptake (VO2) measured breath-by-breath at the mouth, and the increase in femoral artery blood flow measured continuously with pulsed and echo Doppler methods. Five men exercised at 50 W on a knee extension ergometer in both the supine and the upright posture. The kinetics of the responses were determined by curve fitting to obtain the mean response time (MRT = 63% of the time required to achieve steady state). In the upright position, the increase in blood flow (MRT = 12.4 ± 9.4 s, mean ± SD) was faster than the increase in VO2 (29.6 ± 9.3 s). Likewise in the supine position, blood flow increased more rapidly (25.1 + 9.7 s vs. 36.7 ± 9.6 s). It should be noted that the increase in blood flow appeared to be faster than VO2, yet when blood flow adapted more slowly in the supine posture, it had an impact on the adaptation of VO2. This suggests that blood flow might have important effects on metabolism at the onset of submaximal exercise.
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Klepin, Heidi D., Janet Tooze, Timothy Pardee, Leslie Renee Ellis, Dmitriy Berenzon, Dianna Howard, Wendy Demark-Wahnefried, et al. "Feasibility of a Symptom-Adapted Physical Activity Intervention during Induction Chemotherapy for Older Adults with Acute Myeloid Leukemia (AML)." Blood 126, no. 23 (December 3, 2015): 2102. http://dx.doi.org/10.1182/blood.v126.23.2102.2102.
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Abstract Background: Poor treatment tolerance contributes to suboptimal outcomes for many older adults with acute myeloid leukemia (AML). Treatment-associated physical deconditioning during induction may limit therapeutic options and impair quality of life. Interventions to enhance physical function during therapy may improve treatment tolerance and benefit. Objective: To test the feasibility of conducting a symptom-adapted inpatient physical activity (PA) intervention among older adults receiving intensive induction chemotherapy for AML. Methods: A single institution randomized controlled pilot study (N=70) was conducted from October 2012-July 2015. Eligibility included age ≥60 years, newly diagnosed AML, and receipt of induction chemotherapy. Exclusion criteria included medical contraindication to PA at the time of enrollment, cognitive impairment, and/or receipt of low intensity therapy. Participants randomized to the intervention were offered a PA session five days per week tailored daily to symptoms and health status during the induction hospitalization. Session options included: 1) Standard (ward-based), walking + balance training + resistance exercises; 2) Intermediate (room-based), upper-body ergometer + balance training + resistance exercises; and 3) Low-intensity (bed-based), upper-body ergometer + resistance exercises. Counseling sessions to establish PA goals and trouble-shoot barriers were conducted weekly during hospitalization. Phone counseling to reinforce PA goals continued monthly post-hospitalization during follow-up (up to 6 months). The control arm received usual care. Assessment of physical function (self-report and objective), mood, symptoms, and quality of life was done at baseline, 3 months and 6 months with weekly physical function testing while hospitalized. The primary outcome was feasibility defined as recruitment (≥60%), adherence (>75%, average 3 sessions/week), and retention (85% follow-up for eligible participants). Results: There were 97 eligible patients of which 70 enrolled (recruitment rate 72%). The study sample was 70% male, mean age was 72.1 years (Standard Deviation [SD] 6.3), mean Hematopoietic Cell Transplantation Comorbidity index score was 2.0 (SD 1.8), mean hemoglobin 9.3 (SD 1.6), mean white cell count 17 (SD 33.7), and 93% had adequate ECOG performance status (0-2). The majority had intermediate (61%) or poor (33%) risk cytogenetics. Most common induction regimens included anthracycline+cytarabine (80%) and clofarabine (15.7%). A total of 732 PA sessions were offered during the course of the study. Patients were deemed medically ineligible to participate in 13% of these sessions. Of eligible sessions, the participation rate was 80%. Of weeks with at least one eligible day, the average number of weekly sessions conducted per participant was 3.0 (SD 1.6). Overall mean number of sessions/participant was 14.5 (SD 9.4). Among the 35 participants randomized to the intervention 74% completed a program evaluation. Most reported that they liked the program (88%), found it helpful (88%) and planned to continue physical activity post discharge (69%). The activities rated to be most helpful were: combination of balance + resistance exercises + walking (31%), resistance exercises alone (23%) and balance exercises alone (15%). Retention was 96% among evaluable participants (survived at least to the 3 month follow-up assessment, N=53). Conclusions: Delivery of a symptom-adapted inpatient PA intervention to older adults receiving intensive induction chemotherapy for AML is feasible and well received by participants. Next steps include estimation of the effect size of the intervention on physical function, symptoms, and quality of life. Disclosures Pardee: Celgene: Speakers Bureau; Novartis: Speakers Bureau.
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Wang, Zun, Lei Wang, Hongjuan Fan, Wenjun Jiang, Sheng Wang, Zhaohua Gu, and Tong Wang. "Adapted Low Intensity Ergometer Aerobic Training for Early and Severely Impaired Stroke Survivors: A Pilot Randomized Controlled Trial to Explore Its Feasibility and Efficacy." Journal of Physical Therapy Science 26, no. 9 (2014): 1449–54. http://dx.doi.org/10.1589/jpts.26.1449.
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Trajković, Nebojša, Dušan Đorđević, Mima Stanković, Tanja Petrušič, Špela Bogataj, and Vanja Peršič. "Exercise-Based Interventions in Middle-Aged and Older Adults after Myocardial Infarction: A Systematic Review." Life 11, no. 9 (September 6, 2021): 928. http://dx.doi.org/10.3390/life11090928.
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This study summarized the relevant literature and aimed to determine the effect of exercise-based interventions after myocardial infarction in middle-aged and older adults. Studies were identified and analyzed according to the PRISMA guidelines. The following electronic databases were used: Google Scholar, PubMed, Mendeley, Science Direct, and Scopus. The identified studies had to be longitudinal, be published in English, have taken place between 2010 and 2020, involve participants who had suffered myocardial infarction, and address different types of exercise-based interventions to be included. Of the 592 relevant studies identified, 20 were included in the qualitative analysis. After analyzing the results obtained, it could be concluded that different types of exercise-based interventions or their combination have a positive effect after myocardial infarction in middle-aged and elderly adults. It can also be suggested that the combination of a cycle ergometer and a treadmill may be the most effective exercise-based intervention. An adequate choice of intensity and volume is crucial, with the optimal duration of the experimental program and the type(s) of exercises adapted to participants after myocardial infarction.
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McKenzie, D. C., L. S. Goodman, C. Nath, B. Davidson, G. O. Matheson, W. S. Parkhouse, P. W. Hochachka, P. S. Allen, C. Stanley, and W. Ammann. "Cardiovascular adaptations in Andean natives after 6 wk of exposure to sea level." Journal of Applied Physiology 70, no. 6 (June 1, 1991): 2650–55. http://dx.doi.org/10.1152/jappl.1991.70.6.2650.
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Six male Quechua Indians (34.0 +/- 1.1 yr, 159.5 +/- 2.1 cm, 60.5 +/- 1.6 kg), life-long residents of La Raya, Peru (4,350-m altitude with an average barometric pressure of 460 Torr), were studied using noninvasive methods to determine the structural and functional changes in the cardiovascular system in response to a 6-wk deacclimation period at sea level. Cardiac output, stroke volume, and left ventricular ejection fractions were determined using radionuclide angiographic techniques at rest and during exercise on a cycle ergometer at 40, 60, and 90% of a previously determined maximal O2 consumption. Subjects at rest were subjected to two-dimensional and M-mode echocardiograms and a standard 12-lead electrocardiogram. Hemoglobin and hematocrit were measured on arrival at sea level by use of a Coulter Stacker S+ analyzer. After a 6-wk deacclimation period, all variables were remeasured using the identical methodology. Hemoglobin values decreased significantly over the deacclimation period (15.7 +/- 1.1 to 13.5 +/- 1.2 g/dl; P less than 0.01). The results indicate that the removal of these high-altitude-adapted natives from 4,300 m to sea level for 6 wk results in only minor changes to the cardiac structure and function as measured by these noninvasive techniques.
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Groves, B. M., T. Droma, J. R. Sutton, R. G. McCullough, R. E. McCullough, J. Zhuang, G. Rapmund, S. Sun, C. Janes, and L. G. Moore. "Minimal hypoxic pulmonary hypertension in normal Tibetans at 3,658 m." Journal of Applied Physiology 74, no. 1 (January 1, 1993): 312–18. http://dx.doi.org/10.1152/jappl.1993.74.1.312.
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Elevated pulmonary arterial pressure in high-altitude residents may be a maladaptive response to chronic hypoxia. If so, well-adapted populations would be expected to have pulmonary arterial pressures that are similar to sea-level values. Five normal male 22-yr-old lifelong residents of > or = 3,600 m who were of Tibetan descent were studied in Lhasa (3,658 m) at rest and during near-maximal upright ergometer exercise. We found that resting mean pulmonary arterial pressure [15 +/- 1 (SE) mmHg] and pulmonary vascular resistance (1.8 +/- 0.2 Wood units) were within sea-level norms and were little changed while subjects breathed a hypoxic gas mixture [arterial O2 pressure (PaO2) = 36 +/- 2 Torr]. Near-maximal exercise [87 +/- 13% maximal O2 uptake (VO2max)] increased cardiac output more than threefold to values of 18.3 +/- 1.2 l/min but did not elevate pulmonary vascular resistance. Breathing 100% O2 during near-maximal exercise did not reduce pulmonary arterial pressure or vascular resistance. We concluded that this small sample of healthy Tibetans with lifelong residence > or = 3,658 m had resting pulmonary arterial pressures that were normal by sea-level standards and exhibited minimal hypoxic pulmonary vasoconstriction, both at rest and during exercise. These findings are consistent with remarkable cardiac performance and high-altitude adaptation.
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Delaney, Kerri Z., Leandra Spatari, Mélanie Henderson, Sylvia Santosa, and Marie-Eve Mathieu. "Substrate Oxidation Is Altered by Obesity During Submaximal Cycling in Prepubertal and Early Pubertal Children: A Quality Study." Pediatric Exercise Science 33, no. 1 (February 1, 2021): 32–39. http://dx.doi.org/10.1123/pes.2020-0059.
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Background: To examine substrate oxidation in prepubertal and early pubertal children as a function of body weight, body composition, and sex during an exhaustive cycling test. Methods: This study included 320 children in prepubertal and early puberty (Tanner stage 1 or 2; n = 188 males) who completed a minimum of 4 stages (2–5 min/stage) of an adapted version of the McMaster exhaustive exercise protocol on an upright cycle ergometer. Substrate utilization, relative to individual VO2peak, was determined using VO2 and VCO2 data, obtained with breath-by-breath gas analysis during exercise. Results: Both peak (mg/kg lean body mass·min) and submaximal lipid oxidation (mg/kg lean body mass·min) were highest (P < .01) in children with healthy weight (HW), then overweight, and lowest in obese (OB). Both females with HW (compared with males with HW) and females with OB (compared with males with OB) had higher (P < .01) peak and submaximal lipid oxidation. In children with OB, fat-free mass correlated positively (P < .01) with submaximal lipid oxidation (r = .50). In contrast, in children with HW and overweight, fat-free mass correlated positively (P < .01) with carbohydrate oxidation (r = .52 and r = .47, respectively). Conclusion: Obesity during childhood may alter substrate oxidation during exercise. These results may have implications in the implementation of exercise programs in prepubertal or early puberty to control adiposity.
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Kesting, Sabine, Peter Weeber, Martin Schönfelder, Anja Pfluger, Henning Wackerhage, and Irene von Luettichau. "A Bout of High-Intensity Interval Training (HIIT) in Children and Adolescents during Acute Cancer Treatment—A Pilot Feasibility Study." Cancers 14, no. 6 (March 12, 2022): 1468. http://dx.doi.org/10.3390/cancers14061468.
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Low- and moderate-intensity exercise is safe and feasible during childhood cancer treatment. The feasibility of a bout of high-intensity interval training (HIIT) in this population has not been analyzed to date. Pediatric cancer patients aged between 6 and 18 years were selected based on clinical conditions to perform ten sets of 15 s HIIT (>90% of estimated maximal heart rate (HRmax)) and 1 min active recovery on a bicycle ergometer within the first three chemotherapy courses. We assessed safety and feasibility criteria and the following parameters: perceived exertion rate, heart rate, and lactate and adrenaline concentrations. Out of 212 eligible patients, 11 patients aged 13.9 ± 3.6 years (n = 7 ♂) with lymphoma, leukemia, rhabdomyosarcoma, nephroblastoma, and synovial sarcoma completed the bout of HIIT without serious adverse events. During exercise, patients reached a BORG value maxima of 16 ± 1.2, and their heart rates rose from 78 ± 17 beats per minute (bpm) at rest to 178 ± 12 bpm after exercise (90 ± 6% estimated HRmax). The power-to-weight ratio was 2 ± 0.5 W/kg (watt per kilogram). Blood lactate concentrations increased from 1.09 ± 0.50 mmol/L (millimole per liter) at rest to 5.05 ± 1.88 mmol/L post-exercise. Our preliminary data suggest that HIIT is applicable only in a small number of childhood cancer patients. Individually adapted exercise protocols for patients with multiple impairments are needed.
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Savelberg, Hans H. C. M., Ingrid G. L. Van de Port, and Paul J. B. Willems. "Body Configuration in Cycling Affects Muscle Recruitment and Movement Pattern." Journal of Applied Biomechanics 19, no. 4 (November 2003): 310–24. http://dx.doi.org/10.1123/jab.19.4.310.
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By manipulating trunk angle in ergometer cycling, we studied the effect of body configuration on muscle recruitment and joint kinematics. Changing trunk angle affects the length of muscles that span the hip joint. It is hypothesized that this affects the recruitment of the muscles directly involved, and as a consequence of affected joint torque distributions, also influences the recruitment of more distal muscles and the kinematics of distal joints. It was found that changing the trunk from an upright position to approximately 20 deg forward or backward affected muscle activation patterns and kinematics in the entire lower limb. The knee joint was the only joint not affected by manipulation of the lengths of hip joint muscles. Changes in trunk angle affected ankle and hip joint kinematics and the orientation of the thigh. A similar pattern has been demonstrated for muscle activity: Both the muscles that span the hip joint and those acting on the ankle joint were affected with respect to timing and amplitude of EMG. Moreover, it was found that the association between muscle activity and muscle length was adapted to manipulation of trunk angle. In all three conditions, most of the muscles that were considered displayed some eccentric activity. The ratio of eccentric to concentric activity changed with trunk angle. The present study showed that trunk angle influences muscle recruitment and (inter)muscular dynamics in the entire limb. As this will have consequences for the efficiency of cycling, body configuration should be a factor in bicycle design.
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Ramsbottom, R., R. F. T. Kinch, M. G. Morris, and A. M. Dennis. "Practical application of fundamental concepts in exercise physiology." Advances in Physiology Education 31, no. 4 (December 2007): 347–51. http://dx.doi.org/10.1152/advan.00015.2007.
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The collection of primary data in laboratory classes enhances undergraduate practical and critical thinking skills. The present article describes the use of a lecture program, running in parallel with a series of linked practical classes, that emphasizes classical or standard concepts in exercise physiology. The academic and practical program ran under the title of a particular year II module named Sports Performance: Physiology and Assessment, and results are presented over a 3-yr period (2004–2006), based on an undergraduate population of 31 men and 34 women. The module compared laboratory-based indexes of endurance (e.g., ventilatory threshold and exercise economy) and high-intensity exercise (e.g., anaerobic power), respectively, with measures of human performance (based on 20-m shuttle run tests). The specific experimental protocols reinforced the lecture content to improve student understanding of the physiological and metabolic responses (and later adaptations) to exercise. In the present study, the strongest relationship with endurance performance was the treadmill velocity at maximal aerobic power ( r = +0.88, P < 0.01, n = 51); in contrast, the strongest relationship with high-intensity exercise performance was the mean power output (in W/kg) measured during a 30-s all-out cycle ergometer sprint ( r = +0.80, P < 0.01, n = 48). In class student data analysis improved undergraduate indepth or critical thinking during seminars and enhanced computer and data presentation skills. The endurance-based laboratories are particularly useful for examining the underlying scientific principles that determine aerobic performance but could equally well be adapted to investigate other topics, e.g., differences in the exercise response between men and women.
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Bizzarini, Emiliana, Luca Chittaro, Mauro Frezza, Marika Polo, Cristina Malisan, Rachele Menosso, and Agostino Zampa. "A mobile app for home-based exercise in spinal cord injured persons: Proposal and pilot study." DIGITAL HEALTH 8 (January 2022): 205520762110707. http://dx.doi.org/10.1177/20552076211070724.
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Background and Objective To preserve cardiovascular health in persons with spinal cord injury (SCI), it is important to promote physical activity programs adapted to them. Home-based exercise programs allow patients to perform clinician-prescribed physical activity without going to a hospital. However, they make it difficult for the clinician to guide and monitor the patient. To face this issue, this paper proposes a novel smartphone-based mobile application (Fisiofriend), and evaluates its feasibility with a pilot study in a real clinical intervention. Methods Fourteen SCI male subjects were involved in a 6-weeks home-based intervention, based on upper limbs exercises: 7 subjects (APP group) used Fisiofriend, and 7 subjects used traditional pictorial instructions on paper (PAPER group). At the beginning (t1) and end (t2) of the study period, we measured: (i) biceps and triceps brachii strength and endurance parameters with an isokinetic dynamometer (Biodex System 4), (ii) O2 maximal consumption with a crank ergometer stress test (VO2000, Medgraphics). Moreover, we collected subjective data about subjects’ perception of the support (app or paper) in the home-based program. Results Physiological results were encouraging for both groups. Questionnaire data suggests a possible advantage of the app in terms of pleasantness, engagement and perception of positive effects. Practical clinical experience with the subjects and their informal reports highlighted which features of the app could be of particular benefit in real interventions, as we discuss in the paper. Conclusions The study showed the feasibility of using a mobile app in home-based exercise programs involving SCI patients. We discuss implications of introducing such kind of apps into clinical practice.
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Schöffl, Isabelle, Benedikt Ehrlich, Simon Stanger, Kathrin Rottermann, Sven Dittrich, and Volker Schöffl. "Exercise Field Testing in Children: A New Approach for Age-Appropriate Evaluation of Cardiopulmonary Function." Pediatric Cardiology 41, no. 6 (May 9, 2020): 1099–106. http://dx.doi.org/10.1007/s00246-020-02359-2.
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Abstract Based on the wide range of problems to effectively perform cardiopulmonary testing in young children, this study strives to develop a new cardiopulmonary exercise test for children using a mobile testing device worn in a backpack in order to test children during their natural movement habits, namely, running outdoors. A standard cardiopulmonary exercise ramp test on a cycle ergometer was performed by a group of twenty 7–10-year-old children. The results were compared with a self-paced incremental running test performed using a mobile cardiopulmonary exercise measuring device in an outdoor park. The children were able to reach significantly higher values for most of the cardiopulmonary exercise variables during the outdoor test and higher. Whereas a plateau in $${\dot{\text{V}}\text{O}}_{{2}}$$ V ˙ O 2 was reached by 25% of the children during the outdoor test, only 75% were able to reach a reasonable VT2, let alone $${\dot{\text{V}}\text{O}}_{{{\text{2peak}}}}$$ V ˙ O 2peak , during the bicycle test. The heart rate at VT1, the O2-pulse, and the OUES were comparable between both tests. OUES was also positively correlated with $${\dot{\text{V}}\text{O}}_{{{\text{2peak}}}}$$ V ˙ O 2peak in both tests. Testing children outdoors using a mobile cardiopulmonary exercise unit represents an alternative to standard exercise testing, but without the added problems of exercise equipment like treadmills or bicycles. It allows for individualized exercise testing with the aim of standardized testing durations instead of standardized testing protocols. The running speeds determined during the outdoor tests may then be used to develop age-adapted testing protocols for treadmill testing.
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Puta, Tiberiu, Claudiu Avram, and Alexandra Mihaela Rusu. "Smart training equals performance." Timisoara Physical Education and Rehabilitation Journal 11, no. 20 (September 1, 2018): 53–58. http://dx.doi.org/10.2478/tperj-2018-0008.
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Abstract Introduction: Training individualization is a key element for optimal sports performance and protection of the athlete’s health. The training program should be adjusted according to each athlete's characteristics and should be based on data obtained using proper evaluation. Cardiopulmonary exercise testing (CPET) is considered the gold standard for aerobic exercise capacity assessment and provides an increased quantity of information in regard to body reaction to effort, offering a complete perspective over the O2 transportation system and its utilization in metabolic processes. The aim of this study was to highlight the importance of a scientific approach regarding the physical training, starting from junior level. Methods: For a 3 years period (2013 - 2016) we followed the evolution of a professional cyclist (14 years old at baseline), in terms of cardiopulmonary parameters. During this period, he was tested 5 times and he followed a special training program adapted according the tests results. The CPET was performed in the laboratory using a stationary electronically braked cycle ergometer (Lode Corival, Netherland) and a breath by breath gas analyzer device (Cortex Metalyzer 3B, Germany). Results: We observed an improvement trend in almost all parameters investigated during the 3 years evaluation period. Comparing post-season records from 2013 and 2016, we noticed an increase of 54% in maximal aerobic power and 50% in peak oxygen uptake at anaerobic threshold and an even greater increase (59%) of these parameters at maximal effort achieved during CPET. After these 3 years of training we observed a significant improvement of ventilatory efficiency and cardiac performance during exercise. Conclusions: The study indicate that proper training adaptation according to data obtained using CPET, can bring an important progress in terms of performance.
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Ewert, Ralf, Till Ittermann, Delia Schmitt, Elena Pfeuffer-Jovic, Johannes Stucke, Kristin Tausche, Michael Halank, et al. "Prognostic Relevance of Cardiopulmonary Exercise Testing for Patients with Chronic Thromboembolic Pulmonary Hypertension." Journal of Cardiovascular Development and Disease 9, no. 10 (October 1, 2022): 333. http://dx.doi.org/10.3390/jcdd9100333.
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Background: Following acute pulmonary embolism (PE), a relevant number of patients experience decreased exercise capacity which can be associated with disturbed pulmonary perfusion. Cardiopulmonary exercise testing (CPET) shows several patterns typical for disturbed pulmonary perfusion. Research question: We aimed to examine whether CPET can also provide prognostic information in chronic thromboembolic pulmonary hypertension (CTEPH). Study Design and Methods: We performed a multicenter retrospective chart review in Germany between 2002 and 2020. Patients with CTEPH were included if they had ≥6 months of follow-up and complete CPET and hemodynamic data. Symptom-limited CPET was performed using a cycle ergometer (ramp or Jones protocol). The association of anthropometric data, comorbidities, symptoms, lung function, and echocardiographic, hemodynamic, and CPET parameters with survival was examined. Mortality prediction models were calculated by Cox regression with backward selection. Results: 345 patients (1532 person-years) were included; 138 underwent surgical treatment (pulmonary endarterectomy or balloon pulmonary angioplasty) and 207 received only non-surgical treatment. During follow-up (median 3.5 years), 78 patients died. The death rate per 1000 person-years was 24.9 and 74.2 in the surgical and non-surgical groups, respectively (p < 0.001). In age- and sex-adjusted Cox regression analyses, CPET parameters including peak oxygen uptake (VO2peak, reflecting cardiopulmonary exercise capacity) were prognostic in the non-surgical group but not in the surgical group. In mortality prediction models, age, sex, VO2peak (% predicted), and carbon monoxide transfer coefficient (% predicted) showed significant prognostic relevance in both the overall cohort and the non-surgical group. In the non-surgical group, Kaplan–Meier analysis showed that patients with VO2peak below 53.4% predicted (threshold identified by receiver operating characteristic analysis) had increased mortality (p = 0.007). Interpretation: The additional measurement of cardiopulmonary exercise capacity by CPET allows a more precise prognostic evaluation in patients with CTEPH. CPET might therefore be helpful for risk-adapted treatment of CTEPH.
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Alibiglou, Laila, and David A. Brown. "Impaired muscle phasing systematically adapts to varied relative angular relationships during locomotion in people poststroke." Journal of Neurophysiology 105, no. 4 (April 2011): 1660–70. http://dx.doi.org/10.1152/jn.00290.2010.
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After stroke, hemiparesis will result in impairments to locomotor control. Specifically, muscle coordination deficits, in the form of inappropriately phased muscle-activity patterns, occur in both the paretic and nonparetic limbs. These dysfunctional paretic muscle-coordination patterns can adapt to somatosensory inputs, and also the sensorimotor state of nonparetic limb can influence paretic limb. However, the relative contribution of interlimb pathways for improving paretic muscle-activation patterns in terms of phasing remains unknown. In this study, we investigated whether the paretic muscle-activity phasing can be influenced by the relative angular-spatial relationship of the nonparetic limb by using a split-crank ergometer, where the cranks could be decoupled. Eighteen participants with chronic stroke were asked to pedal bilaterally during each task while surface electromyogram signals were recorded bilaterally from four lower extremity muscles (vastus medialis, rectus femoris, tibialis anterior, and soleus). During each experiment, the relative angular crank positions were manipulated by increasing or decreasing their difference by randomly ordered increments of 30° over the complete cycle [0° (in phase pedaling), 30°, 60°, 90°, 120°, 150°, 180° (standard pedaling), 210°, 240°, 270°, 300°, 330° (out of phase pedaling)]. We found that the paretic and nonparetic muscle phasing in the cycle systematically adapted to varied relative angular relationships, and this systematic relationship was well modeled by a sinusoidal relationship. Also, the paretic uniarticular muscle (vastus medialis) showed larger phase shifts compared with biarticular muscle (rectus femoris). More importantly, for each stroke subject, we demonstrated an exclusive crank-angular relation that resulted in the generation of more appropriately phased paretic muscle activity. These findings provide new evidence to better understand the capability of impaired nervous system to produce a more normalized muscle-phasing pattern poststroke.
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Pelletier, Chelsea A. "Incorporating physical activity into the rehabilitation process after spinal cord injury." Applied Physiology, Nutrition, and Metabolism 39, no. 4 (April 2014): 513. http://dx.doi.org/10.1139/apnm-2013-0482.
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It is well established that physical activity can improve aspects of physical fitness in individuals with spinal cord injury (SCI). Despite reports of declining health and fitness post-discharge from rehabilitation, there is a limited amount of research exploring exercise status or interventions during this period. The purpose of this dissertation was to investigate the integration of structured exercise into the rehabilitation process following SCI, and to optimize exercise prescription in the community setting. Findings from the first study indicate that exercise is well tolerated among individuals with subacute SCI; performance of a peak exercise test on an arm ergometer was feasible for all injury types. At this stage post-injury, interventions should be mindful of the greater risk of orthostatic intolerance in individuals with complete tetraplegia and focus on building task-specific self-efficacy. The second study involved a direct referral and physical activity counselling intervention post-discharge. Adherence rates were excellent among those participants who received the intervention, suggesting that this model of care can facilitate adherence to community exercise after discharge. The final 2 studies took place in the community. Several modes of adapted exercise were compared and findings indicated that while there were no differences in measures of physiological intensity or enjoyment between the different modes, arm-only exercise was perceived as safer than passive hybrid (arm and leg) exercise. Further, the validity of using ratings of perceived exertion to attain prescribed exercise intensity was established. The efficacy of the physical activity guidelines for improving fitness in adults with SCI were evaluated in a community-based randomized controlled trial and the results revealed that the guidelines were effective in improving both aerobic capacity and muscle strength. Taken together, this series of studies describes a model of care that links rehabilitation with community exercise and suggests options for sustained engagement.
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Tiller, Nicholas B., Thomas R. Aggar, Christopher R. West, and Lee M. Romer. "Exercise-induced diaphragm fatigue in a Paralympic champion rower with spinal cord injury." Journal of Applied Physiology 124, no. 3 (March 1, 2018): 805–11. http://dx.doi.org/10.1152/japplphysiol.00870.2017.
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The aim of this case report was to determine whether maximal upper body exercise was sufficient to induce diaphragm fatigue in a Paralympic champion adaptive rower with low-lesion spinal cord injury (SCI). An elite arms-only oarsman (age: 28 yr; stature: 1.89 m; and mass: 90.4 kg) with motor-complete SCI (T12) performed a 1,000-m time trial on an adapted rowing ergometer. Exercise measurements comprised pulmonary ventilation and gas exchange, diaphragm EMG-derived indexes of neural respiratory drive, and intrathoracic pressure-derived indexes of respiratory mechanics. Diaphragm fatigue was assessed by measuring pre- to postexercise changes in the twitch transdiaphragmatic pressure (Pdi,tw) response to anterolateral magnetic stimulation of the phrenic nerves. The time trial (248 ± 25 W, 3.9 min) elicited a peak O2 uptake of 3.46 l/min and a peak pulmonary ventilation of 150 l/min (57% MVV). Breath-to-stroke ratio was 1:1 during the initial 400 m and 2:1 thereafter. The ratio of inspiratory transdiaphragmatic pressure to diaphragm EMG (neuromuscular efficiency) fell from rest to 600 m (16.0 vs. 3.0). Potentiated Pdi,tw was substantially reduced (−33%) at 15–20 min postexercise, with only partial recovery (−12%) at 30–35 min. This is the first report of exercise-induced diaphragm fatigue in SCI. The decrease in diaphragm neuromuscular efficiency during exercise suggests that the fatigue was partly due to factors independent of ventilation (e.g., posture and locomotion). NEW & NOTEWORTHY This case report provides the first objective evidence of exercise-induced diaphragm fatigue in spinal cord injury (SCI) and, for that matter, in any population undertaking upper body exercise. Our data support the notion that high levels of exercise hyperpnea and factors other than ventilation (e.g., posture and locomotion) are responsible for the fatigue noted after upper body exercise. The findings extend our understanding of the limits of physiological function in SCI.
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Chrétien, Raphaëlle, Sarah Lavoie, Philippe Chalaye, Emmanuelle de Vette, François-Pierre Counil, Frédéric Dallaire, and Sylvie Lafrenaye. "Reduced endogenous pain inhibition in adolescent girls with chronic pain." Scandinavian Journal of Pain 18, no. 4 (October 25, 2018): 711–17. http://dx.doi.org/10.1515/sjpain-2018-0071.
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Abstract Background and aims Chronic pain is affecting a growing number of individuals including adolescents. Different endogenous pain inhibitory systems could confer protection against development of chronic pain. Decreased pain perception can be observed following intense pain (i.e. conditioned pain modulation – CPM) or after physical exercise (i.e. exercise-induced analgesia – EIA). Reduced effectiveness of pain inhibitory mechanisms have been reported in several chronic pain conditions. However, the extent of these dysfunctions has not been thoroughly investigated in adolescents suffering from chronic pain. Our hypothesis was that adolescents suffering from chronic pain have less effective CPM and EIA than pain-free teenagers. Methods Twenty-five healthy adolescent girls and 16 teenage girls with chronic pain participated in this study. Only girls were included in this investigation, since chronic pain is more prevalent in females. The effectiveness of CPM was assessed by comparing heat pain stimulations (individually adapted to induce mild pain intensity) performed with a thermode before and after a cold pressor test (CPT; 2 min, 10 °C). EIA was evaluated by comparing pain intensity produced by an ice cube placed on the forearm before and after a graded exercise test on a cycle ergometer. Results Pain intensity produced by heat pain stimulations decreased following CPT in healthy (p<0.05), but not in chronic pain adolescent girls (p=0.4). Pain intensity induced by the ice cube was reduced after exercise in healthy (p<0.05), but not in chronic pain adolescents (p=0.9). The effectiveness of CPM and EIA was inferior in teenage girls suffering from chronic pain compared to healthy participants (p<0.05). Conclusions Endogenous pain inhibitory mechanisms triggered by intense pain or by physical exercise are effective in healthy adolescent girls. Teenage girls living with chronic pain do not show diminished pain perception after a CPT or a graded exercise test. These results suggest that pain inhibitory mechanisms such as CPM and EIA are ineffective in adolescent girls suffering from chronic pain. Implications In a wider context, the findings of the present research could help understand better the mechanisms involved in the development of chronic pain. Improved comprehension of this subject might help prevent chronic pain conditions and thus, reduce the negative impacts of this burden.
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Błach, Wiesław, Tadeusz Ambroży, Zbigniew Obmiński, Justyna Stradomska, and Łukasz Rydzik. "Proposal for the revision of the Special Fitness Test in judo." Journal of Kinesiology and Exercise Sciences 31, no. 93 (March 28, 2021): 43–49. http://dx.doi.org/10.5604/01.3001.0015.7063.
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Introduction: To assess the level of physical fitness among high-performance athletes, a number of tests are used, including a treadmill, cyclo-ergometer or other mechanical devices integrated with a sensitive power and work measurement system. Such studies, however, involve selected parts of the muscles of the upper or lower limbs, while the specific structure of the task in combat sports requires the work of the muscles with regard to the entire body. For this reason, a field test called Special Judo Fitness Test (SJFT) has long been used in judo. Performing this test requires the participation of 2 sparring partners (uke) with a body mass similar to the tested competitor. In small groups, this requirement may not always be met. In addition, the uke is required to be highly skilled in the safe technique of falling onto a mat (ukemi) in order to minimise the risk of injury. The aim of the work was to develop and validate a throw test with the use of dummies already available on the market. Materials and methods: The study comprised 3 competitors from each weight category. The subjects performed special fitness tests - seoi-nage throwing technique with the participation of 2 uke and the o-goshi technique (Special Fitness Test for Combat Sports - SFTCS) with the use of dummies having masses adapted to ‘conventionally’ lighter (40-81 kg) and heavier athletes (> 81 kg). In the case of seoi-nage, the uke stood up on his own, while in the o-goshi test, the tori personally verticalised the dummy for the next action. For each test, the number of throws was recorded and the Fitness Index was calculated from the measurements of changes in the heart rate/minute after the trials were performed. The trials for both tests were carried out on 2 dates with an interval of 5 days. Using statistical calculation procedures, the results of both tests were compared and the SFTCS was validated. Results: Statistically significant linear correlation coefficients were recorded for the number of throws and the Fitness Index between both tests and the 2 terms. The calculations of the Intraclass Correlation Coefficients for repeated measures and the standard error have demonstrated the great applicative value of the SFTCS. Conclusions. SFTCS provides reliable results of physical fitness, it is easy to perform in field conditions and requires no uke involvement.
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Sibley, Kathryn M., Ada Tang, Dina Brooks, David A. Brown, and William E. McIlroy. "Feasibility of Adapted Aerobic Cycle Ergometry Tasks to Encourage Paretic Limb Use After Stroke: A Case Series." Journal of Neurologic Physical Therapy 32, no. 2 (June 2008): 80–87. http://dx.doi.org/10.1097/npt.0b013e318176b466.
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Chance, B., M. T. Dait, C. Zhang, T. Hamaoka, and F. Hagerman. "Recovery from exercise-induced desaturation in the quadriceps muscles of elite competitive rowers." American Journal of Physiology-Cell Physiology 262, no. 3 (March 1, 1992): C766—C775. http://dx.doi.org/10.1152/ajpcell.1992.262.3.c766.
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A simple muscle tissue spectrophotometer is adapted to measure the recovery time (TR) for hemoglobin/myoglobin (Hb/Mb) desaturation in the capillary bed of exercising muscle, termed a deoxygenation meter. The use of the instrument for measuring the extent of deoxygenation is presented, but the use of TR avoids difficulties of quantifying Hb/Mb saturation changes. The TR reflects the balance of oxygen delivery and oxygen demand in the localized muscles of the quadriceps following work near maximum voluntary contraction (MVC) in elite male and female rowers (a total of 22) on two occasions, 1 yr apart. TR ranged from 10 to 80 s and was interpreted as a measure of the time for repayment of oxygen and energy deficits accumulated during intense exercise by tissue respiration under ADP control. The Hb/Mb resaturation times provide a noninvasive localized indication of the degree of O2 delivery stress as evoked by rowing ergometry and may provide directions for localized muscle power output improvement for particular individuals in rowing competitions.
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Anghel, Razvan, Cristina Andreea Adam, Dragos Traian Marius Marcu, Ovidiu Mitu, and Florin Mitu. "Cardiac Rehabilitation in Patients with Peripheral Artery Disease—A Literature Review in COVID-19 Era." Journal of Clinical Medicine 11, no. 2 (January 14, 2022): 416. http://dx.doi.org/10.3390/jcm11020416.
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Cardiac rehabilitation (CR) is an integral part of the management of various cardiovascular disease such as coronary artery disease (CAD), peripheral artery disease (PAD), or chronic heart failure (CHF), with proven morbidity and mortality benefits. This article aims to review and summarize the scientific literature related to cardiac rehabilitation programs for patients with PAD and how they were adapted during the COVID-19 pandemic. The implementation of CR programs has been problematic since the COVID-19 pandemic due to social distancing and work-related restrictions. One of the main challenges for physicians and health systems alike has been the management of PAD patients. COVID-19 predisposes to coagulation disorders that can lead to severe thrombotic events. Home-based walking exercises are more accessible and easier to accept than supervised exercise programs. Cycling or other forms of exercise are more entertaining or challenging alternatives to exercise therapy. Besides treadmill exercises, upper- and lower-extremity ergometry also has great functional benefits, especially regarding walking endurance. Supervised exercise therapy has a positive impact on both functional capacity and also on the quality of life of such patients. The most effective manner to acquire this seems to be by combining revascularization therapy and supervised exercise. Rehabilitation programs proved to be a mandatory part of the integrative approach in these cases, increasing quality of life, and decreasing stress levels, depression, and anxiety.
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Jost, J., R. Brandt, U. Altuner, M. Müther, W. Stummer, K. Völker, R. Wiewrodt, and D. Wiewrodt. "P08.12.B Conceptual development of an intensive supervised exercise program for brain tumor patients: summary of clinical experience." Neuro-Oncology 24, Supplement_2 (September 1, 2022): ii45—ii46. http://dx.doi.org/10.1093/neuonc/noac174.156.
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Abstract Background Several studies have identified beneficial effects of physical activity on reducing cancer-related symptoms. However, the number of such studies in neuro-oncology is limited, and even today, brain tumor patients are often advised against physically strenuous exercise. Here we summarize our experience with an individualized training program in brain tumor patients over a period of more than 8 years. Material and Methods Patients with primary brain tumors were invited to participate in the individual training program as part of the psycho-oncological consultation. If interested and free of major comorbidity, a professional sport scientist/diploma coach individualized two 60-minute sessions/week adapted to the patients’ respective symptoms and trained them on a 1:1-basis. One session consisted of bicycle ergometry at an average workload of 75% of the max. age-adjusted heart rate (up to 95% at peak; continuous monitoring throughout entire session), the other session was progressive whole-body resistance training based on 10 separate, but standardized exercise tasks using the university’s training facilities. Both training sessions were complimented by challenging elements to improve coordination. Exercise tasks were adapted as needed, and exercise levels were enhanced over time, if possible. Results From 2011 to 2019, 45 patients (19 women, 26 men) aged 20-76 years (mean 49) with different tumor types (65% high-grade gliomas, 22% low-grade gliomas, 13% other) participated in the program. The majority of patients started the program following concurrent radio-chemotherapy and in parallel with adjuvant systemic therapy. On average, 41 training sessions were performed. No training-related adverse events (e.g., falls, head pain, etc.) occurred during the entire period. In a total of 1828 training sessions, two minor epileptic seizures occurred (1 speech arrest; 1 simple focal seizure, left hand affected). Both patients were familiar with the respective type of seizure before entering the program and training could be continued immediately, with reduced intensity. Seizures did not reoccur during subsequent training sessions. Conclusion This supervised intensive physical training program with submaximal exertion zones was feasible, safe, and highly rated by all participants. Based on these experiences and the reported well-being of the patients, we launched a prospective oligocentric study to objectify the improvements in physical performance and quality of life in patients with glioblastoma (ClinicalTrials.gov Identifier: NCT05015543).
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Fox, Benjamin Daniel, Nadav Sheffy, Baruch Vainshelboim, Leonardo Fuks, and Mordechai R. Kramer. "Step oximetry test: a validation study." BMJ Open Respiratory Research 5, no. 1 (August 2018): e000320. http://dx.doi.org/10.1136/bmjresp-2018-000320.
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IntroductionStep climbing is a potentially useful modality for testing exercise capacity. However, there are significant variations between test protocols and lack of consistent validation against gold standard cycle ergometry cardiopulmonary exercise testing (CPET). The purpose of the study was to validate a novel technique of exercise testing using a dedicated device.MethodsWe built a step oximetry device from an adapted aerobics step and pulse oximeter connected to a computer. Subjects performed lung function tests, a standard incremental cycle CPET and also a CPET while stepping on and off the step oximetry device to maximal exertion. Data from the step oximetry device were processed and correlated with standard measurements of pulmonary function and cycle CPET.ResultsWe recruited 89 subjects (57 years, 50 men). Oxygen uptake (VO2) was 0.9 mL/kg/min (95% CI −3.6 to 5.4) higher in the step test compared with the gold standard cycle CPET, p<0.001. VO2 in the two techniques was highly correlated (R=0.87, p<0.001). Work rate during stair climbing showed the best correlation with VO2 (R=0.69, p<0.0001). Desaturation during step climbing correlated negatively with diffusion capacity for carbon monoxide (r=−0.43, p<0.005). No adverse events occurred.ConclusionsThe step oximetry test was a maximal test of exertion in the subjects studied, achieving slightly higher VO2 than during the standard test. The test was safe to perform and well tolerated by the patients. Parameters derived from the step oximetry device correlated well with gold standard measurements. The step oximetry test could become a useful and standardisable exercise test for clinical settings where advanced testing is not available or appropriate.
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Bosenko, A. I., N. A. Orlyk, M. S. Topchii, and I. O. Donec. "Peculiarities of Formation of Girls’ Adaptive Reactions during Physical Activity at Certain Ontogenesis Stages." Ukraïnsʹkij žurnal medicini, bìologìï ta sportu 7, no. 6 (December 28, 2022): 172–81. http://dx.doi.org/10.26693/jmbs07.06.172.
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The purpose of the study was to analyze the adaptive response of girls’ organisms to sawtooth physical exercise at the specific ontogenesis stages according to the heart rate dynamics. Materials and methods. The girls of four age groups from 7 to 22 years old took part in the study under condition of the original model of dosed sawtooth physical exercise. The following methods were used: method of theoretical analysis and general conclusion of scientific and methodical literature, surveys, anthropo-physiometry, oral survey of overall health of the girls under research, cycle ergometry, arterial tonometry, electrocardiography, variation pulsometry, statistical methods of research results processing. Results and discussion. We have received new original results, since we used methods adapted exclusively by K. D. Ushynsky South Ukrainian National Pedagogical University (Odesa) which have no equals in the world science. According to the anthropo-physiometric indices the girls under research do not reliably differ from their peers according to the standards of the Odesa region. The peculiarities of heart rate dynamics to sawtooth physical exercises (closed cycle) is characterized by the increase in economization and improvement of circulatory system regulation and is expressed by the decrease of sphygmic reaction during different stages of work, relative stabilization of inertial system in response to changed exercise direction, strengthening of vagal and cholinergic influences in the regulation of noncardiac function with age which provides higher level of working capacity for older girls (p<0.001). Under these conditions sphygmic cost of the work performed increased by 2.65 times (p<0.001) from 476.36 ± 26.46 heart beats at the age of 7–8 to 1262.21 ± 50.79 heart beats at the age of 21–22 with the average heart rate consistently the same for all age groups (p>0.05) for the entire testing period. To spread and implement the methodology we have come with estimated standardized tables on functioning capabilities of 14–15-year-old girls under research. Conclusion. We have found that with the completion of biological, namely pubertal development of girls, the reactions of the supporting and regulatory systems to sawtooth physical exercise become more adequate. With age, the dynamics of the heart rate of girls under research is characterized by a decrease in its initial values, reactivity, the degree of increase in response to an increase in physical exercises, the establishment of inertness range and better current recovery during testing. Received data on physical capability as an integral criterion of functioning capabilities shows its increase with age (p<0.001) and improvement of mobilization mechanisms of adaptations reserves. The information value and compliance with the requirements of test standardization of the sawtooth change in physical exercises and heart rate indices during its performance under the conditions of their individual evaluation were confirmed
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Geißler, Daniel, Andreas Lison, and Christoph Schulze. "The Relationship between Ergometric Treadmill or Bicycle Performance and Isokinetic Trunk Strength – a Retrospective Analysis." International Journal of Sports Medicine, December 23, 2022. http://dx.doi.org/10.1055/a-1953-6809.
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AbstractThe relationship between trunk strength and athletic performance is well known. In the past, trunk strength and athletic performance were measured in field tests. Previous studies encouraged sport-specific analyses. The goal of this study was to investigate whether there is a relation between ergometrically measured treadmill or bicycle endurance and isokinetic trunk strength. This retrospective analysis included 1334 bicycle and 1838 treadmill ergometry examinations in 1149 subjects. Bicycle and treadmill ergometer performance were analysed in relation to isokinetic trunk strength. Statistics were performed by Pearson correlation and mixed or generalised linear models. Higher treadmill and bicycle power correlated with higher isokinetic trunk strength, with highest absolute trunk strength in the treadmill group. For both running and cycling endurance, a positive correlation with trunk strength could be quantified in regression models. Increased ergometry endurance and lower flexion/extension ratios are connected weakly. Ergometry performance had the strongest correlation with extension trunk strength (r=0.312–0.398 for bicycle ergometry and r=0.168–0.229 for treadmill ergometry, p<0.001). We encourage prospective studies using both kinds of ergometry to evaluate the effect of trunk strengthening to enhance sport-specific endurance performance. Weight-adapted trunk strength values showed overall greater correlation to trunk strength and we recommend the use of weight-adapted values.
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Dirks, Stefan, Peter Kramer, Anastasia Schleiger, Hans-Martin Speck, Bernd Wolfarth, Thomas Thouet, Felix Berger, Hannes Sallmon, and Stanislav Ovroutski. "Home-Based Long-Term Physical Endurance and Inspiratory Muscle Training for Children and Adults With Fontan Circulation—Initial Results From a Prospective Study." Frontiers in Cardiovascular Medicine 8 (February 7, 2022). http://dx.doi.org/10.3389/fcvm.2021.784648.
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BackgroundPatients with congenital heart disease (CHD)—including those after Fontan operation—are encouraged to be physically active.AimTo prospectively determine the effects of an individually adapted, home-based cycle ergometer endurance training in combination with inspiratory muscle training (IMT) in pediatric and adult Fontan patients. We, herein, report the results of the initial 10-months follow-up (phase 1).Methods18 patients (median age 16.5 years; range 10-43 years) completed baseline check-ups, and 4 and 10 months follow-up visits, which each included cardiopulmonary exercise testing (CPET), bodyplethysmography (including measurement of respiratory muscle strength), and a quality of life questionnaire (PedsQL™). The training program consisted of a home-based cycle ergometer endurance training on a “Magbike® AM-5i/3i” (DKN Technology®, Clermont-Ferrand, France) and IMT with a handheld “POWERbreathe® Medic plus” device. Patients performed 90 min of endurance training per week in addition to IMT (30 breaths per day, 6-7 times per week). After the first 4 months, patients underwent additional interval training.ResultsAfter 10 months of training, we observed significant increases in maximum relative workload (W/kg, p = 0.003) and in maximum inspiratory (MIP, p = 0.002) and expiratory (MEP, p = 0.008) pressures. Peak VO2 values did not increase significantly as compared to baseline (p = 0.12) in the entire cohort (n = 18), but reached statistical significance in a subgroup analysis of teenage/adult patients (n = 14; p = 0.03). Patients' subjective quality of life did not show any significant changes after 10 months of training.DiscussionIn Fontan patients, an individually adapted home-based training is safe and associated with improvements in some CPET variables. However, these improvements did not translate into an improved QoL after 10 months. With an unclear, but most likely negative, impact of the COVID-19 pandemic, improvements in QoL may become evident during further follow-up (phase 2 of the study).
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Mafra, Denise, Jessyca S. de Brito, Natalia A. Borges, Drielly C. M. V. Vargas Reis, Greicielle Santos Da Silva, Larissa S. Fonseca, Marcia M. Ribeiro, et al. "MO603: Effects of Intradialytic Bicycle Ergometer Exercise on Inflammation Transcription Factors in Patients with Chronic Kidney Disease." Nephrology Dialysis Transplantation 37, Supplement_3 (May 2022). http://dx.doi.org/10.1093/ndt/gfac075.016.
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Abstract BACKGROUND AND AIMS Oxidative stress and inflammation are involved in the pathophysiological mechanisms in patients with chronic kidney disease (CKD) on hemodialysis (HD). In this context, the therapeutic potential of targeting the gene transcription factors associated with these mechanisms has been studied; for instance, nuclear factor erythroid 2-related factor 2 (Nrf2), the master regulator of antioxidant responses and, nuclear factor κappa B (NF-κB) that promotes the inflammatory response. However, the effects of physical exercise on the modulation of these factors are under investigation in CKD patients. Therefore, the aim of the present study was to evaluate the effects of an intradialytic aerobic exercise training program on the expression of transcription factors (Nrf2 and NF-κB) in patients with CKD on HD. METHODS This is a longitudinal, randomized clinical trial with a washout period and crossover performed with 18 patients randomized into two groups: Exercise (individualized intradialytic aerobic exercise on an adapted stationary exercise bike) three times per week for 3 months and control (without exercise). After the washout period (1 month), the exercise group became the control, and the other group performed the exercises for another 3 months. Peripheral blood mononuclear cells (PBMCs) were isolated, and quantitative real-time PCR analysis was performed to evaluate Nrf2, NF-kB and NAD(P)H: quinone oxidoreductase-1 (NQO1) mRNA expression. The plasma levels of inflammatory cytokines, tumour necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6) were evaluated by ELISA. RESULTS Eighteen patients [11 men, 44.1 ± 8.4 years, 17.3 (6.6–124) months on HD] completed all the study. The obtained data revealed that the intervention did not affect the mRNA expression of Nrf2, NQO1 and NF-κB (Table 1). Also, TNF-α levels were not changed. However, IL-6 showed a tendency to decrease after the exercise intervention (P = 0.054). CONCLUSION Three months of intradialytic aerobic exercise were insufficient for modulating the transcription factors associated with antioxidant activity (Nrf2 and NQO1) and inflammation (NF-κB) in patients with CKD.
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Baker, Barbara, Eric Koch, Kevin Vicari, and Kyle Walenta. "Mode and Intensity of Physical Activity During the Postacute Phase of Sport-Related Concussion: A Systematic Review." Journal of Sport Rehabilitation, 2020, 1–9. http://dx.doi.org/10.1123/jsr.2019-0323.
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Introduction: Sports-related concussions (SRCs) have received attention due to their prevalence in youth. An SRC results from a strong force causing neurological impairment. Recent research has recommended rehabilitation within the first week post-SRC after 24 to 48 hours of rest. The postacute phase is defined as 48 hours to 7 days post-SRC. It is imperative to evaluate the most effective mode and intensity of physical activity to reduce symptoms and improve outcomes. Methods: CINAHL, PubMed, SPORTDiscus, and Web of Science databases were used to search the terms “brain concussion” AND “exercise” and variations of these terms. The evidence level for each study was evaluated using the 2011 Oxford Center for Evidence-Based Medicine Guide. The methodological rigor of each study was evaluated using a scale adapted from Medlicott and Harris. Results: Two thousand sixty-eight records were identified. Six studies were included in this systematic review. Three studies were classified as moderately strong. The remaining 3 studies were considered weak. Five of the studies used either a cycle ergometer or a treadmill. The sixth study used walking, cycling, and swimming, as well as sports drills. All of these modes of exercise were determined to be safe. All studies utilized low- and moderate-intensity interventions, which were found to be nondetrimental and showed improved recovery time and symptom resolution. Five of the studies also incorporated components of high-intensity exercise that was also found to be nondetrimental, and they showed a positive influence on recovery time and symptom resolution. However, all activity in each of the reviewed studies started at a low level and progressed up to a higher level only as each individual client’s symptoms permitted. Discussion: Overall, this review found that various modes of activity at light-, moderate-, and high-intensity levels are efficacious and can be safely used during the postacute phase of SRC. Conclusion: Though the volume of literature at this time is limited, therapists should consider prescribing closely monitored individualized exercise programs utilizing progressive intensities when treating patients during the postacute phase of SRC.
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Kirkham, Amy A., Karen King, Anil A. Joy, André B. Pelletier, John R. Mackey, Kelvin Young, Xiaofu Zhu, et al. "Rationale and design of the Diet Restriction and Exercise-induced Adaptations in Metastatic breast cancer (DREAM) study: a 2-arm, parallel-group, phase II, randomized control trial of a short-term, calorie-restricted, and ketogenic diet plus exercise during intravenous chemotherapy versus usual care." BMC Cancer 21, no. 1 (October 10, 2021). http://dx.doi.org/10.1186/s12885-021-08808-2.
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Abstract Background An underlying cause of solid tumor resistance to chemotherapy treatment is diminished tumor blood supply, which leads to a hypoxic microenvironment, dependence on anaerobic energy metabolism, and impaired delivery of intravenous treatments. Preclinical data suggest that dietary strategies of caloric restriction and low-carbohydrate intake can inhibit glycolysis, while acute exercise can transiently enhance blood flow to the tumor and reduce hypoxia. The Diet Restriction and Exercise-induced Adaptations in Metastatic Breast Cancer (DREAM) study will compare the effects of a short-term, 50% calorie-restricted and ketogenic diet combined with aerobic exercise performed during intravenous chemotherapy treatment to usual care on changes in tumor burden, treatment side effects, and quality of life. Methods Fifty patients with measurable metastases and primary breast cancer starting a new line of intravenous chemotherapy will be randomly assigned to usual care or the combined diet and exercise intervention. Participants assigned to the intervention group will be provided with food consisting of 50% of measured calorie needs with 80% of calories from fat and ≤ 10% from carbohydrates for 48–72 h prior to each chemotherapy treatment and will perform 30–60 min of moderate-intensity cycle ergometer exercise during each chemotherapy infusion, for up to six treatment cycles. The diet and exercise durations will be adapted for each chemotherapy protocol. Tumor burden will be assessed by change in target lesion size using axial computed tomography (primary outcome) and magnetic resonance imaging (MRI)-derived apparent diffusion coefficient (secondary outcome) after up to six treatments. Tertiary outcomes will include quantitative MRI markers of treatment toxicity to the heart, thigh skeletal muscle, and liver, and patient-reported symptoms and quality of life. Exploratory outcome measures include progression-free and overall survival. Discussion The DREAM study will test a novel, short-term diet and exercise intervention that is targeted to mechanisms of tumor resistance to chemotherapy. A reduction in lesion size is likely to translate to improved cancer outcomes including disease progression and overall survival. Furthermore, a lifestyle intervention may empower patients with metastatic breast cancer by actively engaging them to play a key role in their treatment. Trial registration ClinicalTrials.gov, NCT03795493, registered 7 January, 2019.
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Han, E., B. Oeztuerk, R. Rettl, J. Bergler-Klein, D. Bonderman, and R. Badr Eslam. "P869 Effect of transcatheter MitraClip implantation on exercise performance evaluated by CPET." European Heart Journal - Cardiovascular Imaging 21, Supplement_1 (January 1, 2020). http://dx.doi.org/10.1093/ehjci/jez319.513.
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Abstract Background & Purpose Transcatheter MitraClip (MC) implantation has become the most frequently used percutaneous technique to treat severe mitral regurgitation (MR) in patients with high surgical risk. The assessment whether transcatheter MC implantation is the most suitable procedure on each individual patient is done primarily by 2D transthoracic echocardiography (TTE) as well as transesophageal echocardiography (TEE). In this case of a 79-year-old male multimorbid patient with cardiac amyloidosis and severe MR, different imaging modalities were used to assess the heart before and after MC implantation. The dynamic response of the heart after transcatheter MC approach was evaluated by comparing the patient’s exercise capacity before and after treatment with cardiopulmonary exercise testing (CPET). Methods Total body bone scintigraphy, 714 MBq 99m-Tc DPD, was performed to confirm the diagnosis of cardiac transthyretin (ATTR) amyloidosis. The extent of mitral regurgitation was assessed using TTE and TEE before and after MC implantation. Coronary angiography and right heart catheterization were performed prior to MC implantation. CPET by a cycle ergometer was used to measure the dynamic response of the heart before and after the procedure. A ramp protocol, adapted to reach maximal capacity after 8-10 min was chosen for the test. The parameter of main interest was maximal oxygen uptake (VO2 max, ml/min), the major factor known to limit exercise capacity. Results Bone scan showed tracer accumulation in myocardial tissue, genetic testing was negative which confirmed wild type cardiac transthyretin (ATTR) amyloidosis. Significant coronary artery disease was excluded by coronary angiography. Right heart catheterization disclosed post capillary pulmonary hypertension: mean pulmonary artery pressure of 42 mmHg and mean pulmonary capillary wedge pressure of 25 mmHg and end-diastolic pressure of left ventricle of 118 mmHg. A high grade left ventricular concentric hypertrophy (IVS = 26mm) with slightly reduced left systolic function, a severe MR (EROA = 35 mm2) and enlargement of left and right atria (LA = 68mm, RA = 68mm) were demonstrated by TTE. In TEE left atrium including left atrial appendage were free from thrombi; high grade left ventricular hypertrophy, restriction of posterior leaflet and severe MR with eccentric jet with dilated annulus were demonstrated. CPET before MC implantation: VO2 max 1299 ml/min (83% of predicted peak oxygen uptake value). MC implantation was performed with no post-procedural complications. Follow-up CPET showed higher VO2 max 1373 ml/min compared to the data before MC implantation (88% predicted peak oxygen uptake value). Conclusions TTE and TEE are the most common and accurate imaging modalities to evaluate MR regarding MitraClip evaluation. After the MC procedure the dynamic response of the heart can be observed by CPET with VO2 as a surrogate marker for heart function. Abstract P869 Figure. a.b. TEE prior to MC, c.d. TEE after MC
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Martins, Pedro, Diogo Vaz Leal, Manuel Anibal A Ferreira, Kenneth Wilund, and João Viana. "MO607: Intradialytic Exercise: A Large-Scale Nationwide Implementation Study." Nephrology Dialysis Transplantation 37, Supplement_3 (May 2022). http://dx.doi.org/10.1093/ndt/gfac075.020.
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Abstract BACKGROUND AND AIMS Intradialytic exercise (IDE) is recommended for HD patients. However, this recommendation is mostly based on research conducted under optimal instead of real-world conditions, limiting generalizability and its implementation into routine clinical care. This study aims to analyze implementation outcomes of IDE in real-world conditions at a large-scale, nationwide level. METHOD After a pilot experience in a single unit, all NephroCare Portugal dialysis clinics were invited to initiate an IDE program. A national coordinator was nominated, and a nurse and a doctor were selected in each unit as local coordinators. A simple exercise protocol was designed to be easily applied by current dialysis staff (though some units benefited from exercise science student internships). The IDE protocol includes a bout of aerobic exercise (cycle ergometer) and lower limb resistance exercises (ankle weights). The RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework was used to study clinical implementation over the first year. For each RE-AIM dimension, specific implementation outcomes were adapted to IDE. Effectiveness measures included safety (incidence of intradialytic adverse events over 1 year) and physical function at baseline and at 1 year (sit to stand 30, 8-foot up & go, handgrip strength, sit to stand 5 and single leg stance). For safety measures, IDE group was compared to a group of patients that refused IDE. Physical function measures were only applied to IDE patients, and so comparisons were made between low- and high-frequency exercise groups. RESULTS Adoption: 21 dialysis units (58.3%). Reach: 1270 eligible patients (55.8%). Main reasons for noneligibility were physical/cognitive incapacity (50.8%) and cardiovascular risk (34.9%). Eligible patients were younger (P < 0.001) and had a better health status (lower comorbidity index: P < 0.001; lower prevalence of diabetes: P < 0.001; lower fat tissue index: P < 0.001; and a higher lean tissue index: P < 0.001). 811 (63.9%) committed to the intervention. Compared with non-IDE patients, IDE patients were younger (<0.001), had a lower dialysis vintage (<0.001), a lower comorbidity index (P < 0.001) and a higher lean tissue index (P = 0.035). Implementation: adherence to exercise sessions was 75.0% ± 19.7%. In 77% of the 50 356 HD treatments, exercise was performed as prescribed. Non-performed exercise sessions (n = 9768) are mostly justified by patient refusal (61.5%) and pain (8.4%). Patients performed 2.2 ± 0.6 exercise sessions/week achieving 86.3 ± 29.0 min/week. Maintenance (setting level): none of the clinics interrupted IDE. Maintenance (patient level): attrition rate was 57.2% mainly due to voluntary withdrawal (52.4%). Comparing to voluntary withdrawals, completers were mainly males (P < 0.001) and had a lower dialysis vintage (P = 0.007), and higher lean tissue index (P = 0.023). Effectiveness: IDE (n = 347) and non-IDE patients (n = 394) were compared. Total incidence of adverse events was lower in IDE, but no significant differences were found (P = 0.808). The individual analysis of each adverse event demonstrated no significant differences for cramps, hypotension, needle dislodgement and other adverse events. Overall physical function improved in IDE (P < 0.001), despite a slight reduction in handgrip strength (P = 0.001). A within-group (low- versus high-frequency exercise) effect was observed, highlighting a deterioration in handgrip strength in the low-frequency group (P = 0.002), whereas no change was observed in the high-frequency group (P = 0.097). CONCLUSION Large-scale implementation of IDE is a realistic and safe way to promote physical activity in HD patients with benefits on physical function. Yet, to optimize its generalizability, strategies to increase patients´ acceptability and long-term adherence are needed.
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Sawatzky, Bonita, Brandon Herrington, Kevin Choi, W. Ben Mortenson, Jaimie Borisoff, Carolyn Sparrey, and James J. Laskin. "Acute physiological comparison of sub-maximal exercise on a novel adapted rowing machine and arm crank ergometry in people with a spinal cord injury." Spinal Cord, February 3, 2022. http://dx.doi.org/10.1038/s41393-022-00757-2.
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Azevedo Coste, Christine, Vance Bergeron, Rik Berkelmans, Emerson Fachin Martins, Ché Fornusek, Arnin Jetsada, Kenneth J. Hunt, Raymond Tong, Ronald Triolo, and Peter Wolf. "Comparison of strategies and performance of functional electrical stimulation cycling in spinal cord injury pilots for competition in the first ever CYBATHLON." European Journal of Translational Myology 27, no. 4 (December 5, 2017). http://dx.doi.org/10.4081/ejtm.2017.7219.
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Functional Electrical Stimulation (FES) can elicit muscular contraction and restore motor function in paralyzed limbs. FES is a rehabilitation technique applied to various sensorimotor deficiencies and in different functional situations, e.g. grasping, walking, standing, transfer, cycling and rowing. FES can be combined with mechanical devices. FES-assisted cycling is mainly used in clinical environments for training sessions on cycle ergometers, but it has also been adapted for mobile devices, usually tricycles. In October 2016, twelve teams participated in the CYBATHLON competition in the FES-cycling discipline for persons with motor-complete spinal cord injury. It was the first event of this kind and a wide variety of strategies, techniques and designs were employed by the different teams in the competition. The approaches of the teams are detailed in this special issue. We hope that the knowledge contained herein, together with recent positive results of FES for denervated degenerating muscles, will provide a solid basis to encourage improvements in FES equipment and open new opportunities for many patients in need of safe and effective FES management. We hope to see further developments and/or the benefit of new training strategies at future FES competitions, e.g. at the Cybathlon 2020 (www.cybathlon.ethz.ch).