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Abstract: Objective: To evaluate non-invasively the patterns of the Fick equation components during an incremental ergocycle test. Methods: Simultaneous measurements of gas exchanges and cardiac output () — thoracic impedance device Physioflow Manatec — supply the Fick equation''s variables: . Their dynamics are studied at 1st and 2nd ventilatory threshold (SV1, SV2) and at PMT (Max Tolerated Power) in 41 active adolescent boys; 25 of them are highly trained (TP) and 16 occasionally (P). There is no anthropometric difference between the 2 groups. Results: 1) Individual slopes "a" of regression against are negative: the higher the "a" value the lower , PMT, maximal tissular O2 extraction , and… the adolescents'' performance; 2) as early as at SV1, in TP is always higher than in P; whereas , FC and stroke volume (VES) have similar values in both groups at SV1, SV2 and PMT; 3) in all subjects, TP and P, VES max and were reached at the level of SV2. Conclusion: Non invasive and simultaneaous and mesurements during incremental test lead to Fick equation adjustements, "a" slope and difference contributing thus to interesting indications of subjects'' fitness. [Copyright &y& Elsevier]

Abstract: Aims: To demonstrate that the linear coefficient of the relationship is an indice of the tissular oxygen extraction capacity in children. Synthesis of facts: Twelve soccers (11.7±0.7 years) performed a maximal progressive test. Our results show that is strongly correlated with (r =0.96, p <0.01), and the individual values of the linear coefficient of the relationship are conversely correlated with max values (r =–0.91, p <0.05). Conclusion: It thus seems that max is the main predicting factor for max. [Copyright &y& Elsevier]

Abstract: Aim: As the population ages, a major challenge is to consider how to increase the quality and years of healthy life. Physical activity benefits are well established for older subjects. Therefore, maintenance of their physical fitness and avoidance of sedentary lifestyle are an important goal for community health programs. In this context, we have implemented an outpatient rehabilitation unit in the geriatric department of the University Hospital of Strasbourg with following aims: i) a medical evaluation of the senior fitness including two cardio-respiratory tests (maximal and endurance); ii) 9weeks retraining program consisting in 18 sets of a 30-minute intermittent load exercise; iii) and finally, a cardiorespiratory evaluation of the gain on the pretraining values observed during the two tests. Results: Of more than 200 candidates, only 143 were included in the study. Results for 26 males and females (66,4±5 years) are given as an example of that short retraining programme efficiency. At the maximal test: values for maximal power intensity and are increased to 14 and 18% and onset of the anaerobic threshold is delayed (+31 and +35% of the pretraining intensity value). At the endurance test control: values of the initial endurance-training load (base) have been regularly increased; the final gain is a +41±15% increase of the pretraining base values. During a 30-minute test executed with the initial pretraining load, heart rate and lactate values are decreased, respectively, to −7 and −11%, and to −33 and −37%. Conclusion: Efficiency of this short (9weeks) training programme is similar to that of much longer programmes. The “tailor-made” choice of the training intensities based on the maximal test is probably the best explanation for the good results obtained. The maximal exercise test is also an essential control for the subjects’ security. [Copyright &y& Elsevier]

Résumé Objectif Les bienfaits du réentraînement des patients atteints de broncho-pneumopathie obstructive chronique (BPCO) ne sont plus à débattre. Cependant, le défi majeur à surmonter est de proposer à ces patients un programme de réentraînement peu contraignant, en termes de durée et d’intensité, leur permettant d’améliorer leur tolérance à l’effort. Synthèse des faits et résultats Soixante patients atteints d’une BPCO ou modérée ou sévère ont réalisé une épreuve d’effort maximale avant et après un programme de réentraînement court en endurance. Une amélioration de la puissance maximale tolérée et un retard d’apparition du seuil ventilatoire ont été obtenus à l’issue du programme. Conclusion Un réentraînement intermittent court en endurance dont les charges sont individualisées permet l’amélioration de la tolérance à l’effort des patients atteints de BPCO modéré et sévère. Summary Introduction The benefits of exercise training in patients with chronic obstructive pulmonary disease (COPD) are no longer debating. However, the major challenge to overcome in subjects with COPD is to offer them a short-term training program allowing them to improve their exercise tolerance. Synthesis of the facts and results Sixty patients with moderate or severe COPD performed a maximal exercise test before and after a short endurance training program. An improvement of the maximum tolerated power and delay of onset of ventilatory threshold were obtained at the end of the program. Conclusion An intermittent short-term endurance exercise training where loads are individualized allows improving exercise tolerance in patients with moderate and moderately severe COPD. [ABSTRACT FROM AUTHOR]

The purpose of the study was to determine the potential beneficial effect of six weeks oral L-arginine supplementation (LAS) on endurance exercise, an important determinant of daily-life activity in patients with chronic stable heart failure (CHF). After an initial incremental maximal exercise test, CHF patients performed an identical thirty-minute interval endurance exercise test before and after six weeks with (L-arginine group; ARC) or without LAS (control group; CTL). Hemodynamic, respiratory, and metabolic parameters were determined at rest, during exercise, and during recovery. Mean heart rate decreased throughout exercise and recovery after LAS (-8.2±1.4 b·min-1 p=0.003 and - 6.7 ± 1.6 b·min-1 p <0.001, respectively), systemic blood pressure and respiratory parameters remaining unchanged. Resting L-argininaemia increased from 102±11 to 181 ±37 µmol·l-1 (p <0.004) and exercise-induced peak increase in plasma lactate was blunted after LAS (4.13±0.75 vs. 3.13±0.39 mmol·l-1; p=0.02). No significant change was observed in the control group. In heart failure patients, six weeks oral LAS enhances endurance exercise tolerance, reducing both heart rate and circulating lactates. This suggests that chronic LAS might be useful as a therapeutic adjuvant in order to improve the patient's physical fitness. [ABSTRACT FROM AUTHOR]

PURPOSE: Endurance training is an important component of rehabilitation in patients with chronic obstructive pulmonary disease (COPD). In our study, we investigated the pulmonary hemodynamics' adaptation during a high-intensity intermittent exercise in such patients. METHODS: Eight patients underwent a 30-min exercise, alternating a 4-min work set at their first ventilatory threshold with a 1-min exercise set at 90% of their maximal tolerated power output. Pulmonary arterial pressure was measured by means of a right heart catheter. Cardiac output was calculated using the Fick's principle applied to oxygen. RESULTS: VO(2), cardiac output, and ventilation increased during the first minutes of exercise and remained stable thereafter. Heart rate increased significantly and progressively to its maximal value from rest to the end of the test (P < 0.001). After an initial increase, stroke volume decreased significantly (P < 0.05). Pulmonary arterial pressure increased from rest (mean +/- SEM 23.9 +/- 2.1 mm Hg) to the fifth minute of exercise (41.6 +/- 2.8 mm Hg), and decreased significantly thereafter (35.2 +/- 3.3 mm Hg at the 30th minute) (P < 0.001). Total pulmonary vascular resistance decreased from rest to the end of the test (P < 0.001). CONCLUSION: The high-intensity 1-min bouts of work of our intermittent work exercise are well tolerated without pushing the pulmonary arterial pressure dramatically high in COPD patients. [ABSTRACT FROM AUTHOR]

PURPOSE: It has been suggested that an intermittent work exercise test (IWET) is as efficient but better tolerated than continuous exercise for rehabilitation. Although systemic and pulmonary cardiovascular adjustments have been investigated for continuous exercise, it has not been done for IWET with exercise bouts near maximal work rate. METHODS: In seven healthy subjects, the pulmonary hemodynamics have been studied by the aid of heart catheterization during a strenuous 30-min bicycle IWET where a 4-min work set at the first ventilatory threshold (VT1) alternated with a 1-min work set at the second ventilatory threshold (VT2). RESULTS: During the IWET, cardiac output increased then remained stable with decreasing stroke volume and increasing heart rate, which became near maximal at the end of the test. Mean pulmonary arterial pressure increased from rest to the fifth minute of exercise and decreased significantly thereafter (P<0.01). An identical evolution was observed for mean systemic arterial pressure (SAP). CONCLUSION: Pulmonary hemodynamics adapt well in healthy subjects during a strenuous IWET despite the performance of exercise bouts of near maximal intensity. [ABSTRACT FROM AUTHOR]

Aim. – The interest or relevance of exercise for the general population is emphasized widely; therefore, it must be even more important for paraplegics.Actualities. – Various training programs have already been proposed for people with spinal cord injuries (SCI), however, no consensus about a specific training program has been reached for such a population.Projects. – This review attempts to summarize the available literature on the effects of exercise on paraplegics and will hopefully provide some directions not only for further research but will also provide recommendations for practitioners working in the field. [Copyright &y& Elsevier]

STUDY DESIGN:: Before and after investigation of the effects of a wheelchair ergometer Training programme. OBJECTIVE:: To investigate the effects of an original interval-training programme on work capacity and cardiorespiratory variables with spinal cord-injured persons (SCIP's) on a wheelchair-specific ergometer. SETTING:: BESANCON, FRANCE. METHODS:: Seven SCIP's (male) performed 45?min of wheelchair ergometry three times per week, for 6 weeks. Training effects on maximal dynamic performance and endurance capacity were studied by comparison of performance and cardiorespiratory responses observed during both a maximal progressive test (10?W/2?min) and the same training session performed before and after training. RESULTS:: Training induced significant improvements in maximal tolerated power (+19.6%), in peak oxygen consumption (VO2+16%), and in oxygen pulse (O2p,+18.7%).At ventilatory threshold, significant improvements were also observed in power output (+63%), VO2VT(+ 34.1), ventilation VEVT(+ 37.1%), and V2pVT(+ 19.9% ). Heart rate and ventilation were significantly lower (-11 and -14.6%, respectively) after training at the same work rate, while VO2 was unchanged. Between the first and the last training session, the total physical work was improved by 24.7%, whereas heart rate was unchanged. CONCLUSION:: An interval-training programme individualised to each paraplegic subject using a wheelchair ergometer can significantly improve the fitness level and endurance capacity.Spinal Cord (2003) 41, 451-456. doi:10.1038/sj.sc.3101475 [ABSTRACT FROM AUTHOR]

Aims – To stress that elderly patients with hip osteoarthrosis also present cardiovascular deconditioning and to suggest the potentiel benefits of a reconditioning program after total hip arthroplasty.Current knowledge – Patients with advanced osteoarthrosis are physically deconditioned because of the absence of physical stimulation and there is nowadays a greater prevalence of chronic arthrosis syndromes in the elderly. Epidemiological studies have shown that patients suffering from chronic osteoarthrosis are more susceptible to cardiovascular diseases than healthy individuals of the same age class. Physical deconditioning associated with osteoarthrosis takes place with a progressive decline in functional activities. Therefore, cardiovascular fitness improvement should be a priority in the rehabilitation program of those patients. After both cardiac and thoracic surgeries effective reconditioning program are proposed to geriatrics patients. However, cardiovascular stimulating training does not occurred in the traditionnel programs organized for the patients immediately after total hip joint arthroplasty.Points of view and plans – To our knowledge, it has never been proposed reconditioning programs for geriatrics patients immediately after total hip joint arthroplasty. The aims of such training programs concern the improvement of cardiovascular fitness and the improvement of the quality of life after total hip arthroplasty. [Copyright &y& Elsevier]

BACKGROUND:: Various combinations of training intensity, duration and frequency are often proposed to people with spinal cord injuries in order to improve their fitness. However, no consensus about a specific training program has been reached for such a population. OBJECTIVE:: This study investigated the effects of a short interval training program specifically designed for patients with spinal cord injuries. METHODS:: Paraplegic men performed 30-min wheelchair ergometry three times per week, for 4 weeks. Maximal dynamic performance and endurance capacity were studied before and after the training program with an incremental test (10 W/2 min) until volitional fatigue and a constant work rate test, respectively. Cardiorespiratory responses were continuously studied during each of these tests. RESULTS:: Training induced significant improvement in maximal tolerated power (+27.9%), and in peak oxygen consumption (&Vdot;O2, +18.5%). After training the subjects were able to maintain the load applied during the constant test (total mechanical work +210.7%), for a significantly longer time. The heart rate, &Vdot;O2 and ventilation values observed when the volunteers ended their first constant load test were significantly higher (+10%, +10%, +40% respectively) than those obtained after a similar time period during the second constant load test which was performed after the training program. CONCLUSION:: After this short training period, with an appropriate combination of different types of training, duration, intensity and frequency exercises, we observed a significant improvement in the fitness level and endurance capacity of paraplegic subjects.Spinal Cord (2001) 39, 532–537. [ABSTRACT FROM AUTHOR]

The pulmonary diffusing capacity for carbon monoxide (DLCO) is reduced in chronic heart failure and remains decreased after heart transplantation. This decrease in DLCO may depend on a permanent alteration after transplantation of one or the other of its components: diffusion of the alveolar capillary membrane or the pulmonary capillary blood volume (Vc). Therefore, we measured DLCO, the membrane conductance, and Vc before and after heart transplantation. At the time of hemodynamic measurements, the Roughton and Forster method of measuring DLCO at varying alveolar oxygen concentrations was used to determine the membrane conductance, Vc, DLCO/alveolar volume (VA), the membrane conductance/VA and thetaVc/VA (theta = carbon monoxide conductance of blood, VA = alveolar volume) in 21 patients with class III to IV heart failure before and after transplantation, and in 21 healthy controls. Transplantation normalized pulmonary capillary pressure and increased cardiac index. DLCO was decreased before transplantation (7.11 vs 10.0 mmol/min/kPa in controls), but DLCO/VA was normal (1.67+/-0.44 vs 1.71+/-0.26 mmol/min/kPa/L in controls). DLCO/VA remained unchanged after transplantation, because the decrease in Vc (82+/-30 vs 65+/-18 ml before and after transplantation) and thetaVc/VA was not compensated by the changes in membrane conductance (11+/-4 vs 12+/-5 mmol/min/kPa before and after transplantation, respectively) and membrane conductance/VA. We conclude that the decrease in DLCO in patients with chronic heart failure is due to a restrictive ventilatory pattern because their DLCO/VA remains normal; the decrease in the membrane conductance is compensated by the increase in Vc. After transplantation, the decrease in Vc due to normalization of pulmonary hemodynamics is not completely compensated for by an increase in membrane conductance. Because the membrane conductances, measured before and after transplantation, are negatively correlated with duration of heart failure, its abnormal pulmonary hemodynamics may have irreversibly altered the alveolar capillary membrane. [ABSTRACT FROM AUTHOR]

An abstract of the article "The Intrinsic Mitochondrial Oxidative Capacity of Human Failing Hearts Is Depressed and Relates to Disease Severity But Keeps Normal Regulatory Properties," by B. Mettauer and colleagues, is presented.