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1.
Physical Fitness Predictors of a Warrior Task Simulation Test.
Huang, HC, Nagai, T, Lovalekar, M, Connaboy, C, Nindl, BC
Journal of strength and conditioning research. 2018;(9):2562-2568
Abstract
Huang, H-C, Nagai, T, Lovalekar, M, Connaboy, C, and Nindl, BC. Physical fitness predictors of a warrior task simulation test. J Strength Cond Res 32(9): 2562-2568, 2018-The warrior task simulation test (WTST) has been developed in an attempt to better assess physical fitness required for soldiers to perform battlefield tasks and drills to determine whether laboratory-based measurements of physical fitness components could be used to predict the WTST. Forty-three healthy and physically active men participated in 2 sessions: the WTST and laboratory testing. The WTST comprised 282-m run, low hurdles, high crawl, casualty drag, balance beam, point-aim-move, 100-yard sprint, and agility sprint with participants wearing combat boots, uniform, helmet, and dummy rifle. The laboratory testing included assessments of participants' muscular strength and endurance, postural stability, aerobic capacity, anaerobic capacity, flexibility, body fat, fat-free mass, and agility. Correlation and simple and multiple linear regression analyses were used to analyze the relationship between the WTST and laboratory testing and predict the WTST, respectively (p < 0.05). The correlation and the simple linear regression analyses revealed that anaerobic capability, aerobic capacity, body fat, agility, and muscular endurance correlated with (r = 0.35-0.59) and accounted for 12-34% of the variance in (R = 0.12-0.34) the WTST performance (p < 0.05). The final model included aerobic capacity, agility, fat-free mass, muscular endurance, and body fat (R = 0.52, p < 0.001). The current results highlighted the importance of several components of physical fitness in simulated battlefield tasks and drills (assessed by the WTST). In particular, anaerobic capacity, aerobic capacity, and body fat had the highest correlational and predictive values of the WTST. Additionally, skill-related components of physical fitness, such as agility and muscular endurance, should not be ignored, and they should be assessed and tracked with the above-mentioned components.
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2.
Energy expenditure and physiological responses during walking on a treadmill and moving on the Torqway vehicle.
Maciejczyk, M, Wiecek, M, Szymura, J, Szygula, Z
Acta of bioengineering and biomechanics. 2016;(2):137-43
Abstract
PURPOSE One of the new products which can be used to increase physical activity and energy expenditure is the Torqway vehicle, powered by the upper limbs. The aim of this study was to (1) assess the usefulness and repeatability of the Torqway vehicle for physical exercise, (2) compare energy expenditure and physiological responses during walking on a treadmill and during physical effort while moving on the Torqway at a constant speed. METHODS The participants (11 men, aged 20.2 ± 1.3) performed the incremental test and submaximal exercises (walking on the treadmill and moving on the Torqway vehicle at the same speed). RESULTS Energy expenditure during the exercise on the Torqway was significantly higher (p = 0.001) than during the walking performed at the same speed. The intensity of the exercise performed on the Torqway expressed as %VO2max and %HRmax was significantly ( p < 0.001) higher than during walking (respectively: 35.0 ± 6.0 vs. 29.4 ± 7.4 %VO2max and 65.1 ± 7.3 vs. 47.2 ± 7.4 %HRmax). CONCLUSIONS Exercise on the Torqway vehicle allows for the intensification of the exercise at a low movement speed, comparable to walking. Moving on the Torqway vehicle could be an effective alternative activity for physical fitness and exercise rehabilitation programs.
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3.
A reliable preloaded cycling time trial for use in conditions of significant thermal stress.
Che Jusoh, MR, Morton, RH, Stannard, SR, Mündel, T
Scandinavian journal of medicine & science in sports. 2015;:296-301
Abstract
The purpose of this study was to assess the reliability of a 15-min time trial preloaded with 45 min of fixed-intensity cycling under laboratory conditions of thermal stress. Eight trained cyclists/triathletes (41 ± 10 years, VO2 peak: 69 ± 8 mL/kg/min, peak aerobic power: 391 ± 72 W) completed three trials (the first a familiarization) where they cycled at ∼ 55% VO2 peak for 45 min followed by a 15-min time trial (∼75% VO2 peak) under conditions of significant thermal stress (WBGT: 26.7 ± 0.8 °C, frontal convective airflow: 20 km/h). Seven days separated the trials, which were conducted at the same time of day following 24 h of exercise and dietary control. Reliability increased when a familiarization trial was performed, with the resulting coefficient of variation and intraclass correlation coefficient of the work completed during the 15-min time trial, 3.6% and 0.96, respectively. Therefore, these results demonstrate a high level of reliability for a 15-min cycling time trial following a 45-min preload when performed under laboratory conditions of significant thermal stress using trained cyclists/triathletes.
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4.
Alterations in the rate of limb movement using a lower body positive pressure treadmill do not influence respiratory rate or phase III ventilation.
Buono, MJ, Burnsed-Torres, M, Hess, B, Lopez, K, Ortiz, C, Girodo, A, Lolli, K, Bloom, B, Bailey, D, Kolkhorst, FW
BioMed research international. 2015;:618291
Abstract
The purpose of this study was to determine the effect of alterations in rate of limb movement on Phase III ventilation during exercise, independent of metabolic rate, gait style, and treadmill incline. Subjects completed five submaximal exercise bouts on a lower body positive pressure treadmill (AlterG P 200). The percent body weight for the five exercise bouts was 100, 87, 75, 63, and 50% and each was matched for carbon dioxide production (V CO2 ). Naturally, to match the V CO2 while reducing the body weight up to 50% of normal required a significant increase in the treadmill speed from 3.0 ± 0.1 to 4.1 ± 0.2 mph, which resulted in a significant (P < 0.05) increase in the mean step frequency (steps per minute) from 118 ± 10 at 3 mph (i.e., 100% of body weight) to 133 ± 6 at 4.1 mph (i.e., 50% of body weight). The most important finding was that significant increases in step frequency did not significantly alter minute ventilation or respiratory rate. Such results do not support an important role for the rate of limb movement in Phase III ventilation during submaximal exercise, when metabolic rate, gait style, and treadmill incline are controlled.
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5.
Flecainide therapy suppresses exercise-induced ventricular arrhythmias in patients with CASQ2-associated catecholaminergic polymorphic ventricular tachycardia.
Khoury, A, Marai, I, Suleiman, M, Blich, M, Lorber, A, Gepstein, L, Boulos, M
Heart rhythm. 2013;(11):1671-5
Abstract
BACKGROUND Calsequestrin-associated catecholaminergic polymorphic ventricular tachycardia (CPVT2) can cause sudden death in young individuals in response to stress. Beta-blockers are the mainstay medical treatment for patients with CPVT2. However, they do not prevent syncope and sudden death in all patients. Flecainide was reported to reduce exercise-induced ventricular arrhythmias (EIVA) in patients with ryanodine receptor-associated CPVT. The role of flecainide in CPVT2 is not known. OBJECTIVE To summarize our experience in combining flecainide and beta-blockers in high-risk patients with CPVT2. METHODS All patients with CPVT2 (10 patients) who have high-risk features (syncope, EIVA, or appropriate implantable cardioverter-defibrillator [ICD] shocks) despite beta-blockers with or without calcium channel blockers were treated with a combination of flecainide and beta-blockers. Exercise test was done before and after beginning treatment with flecainide. RESULTS All patients had EIVA and 4 had appropriate ICD shocks before flecainide treatment. EIVA-included frequent ventricular premature beats and or ventricular tachycardia during the exercise test while on high dose of beta-blockers with or without calcium channel blockers before treatment with flecainide. After combination therapy with flecainide and beta-blockers, EIVA were suppressed completely in all patients. During follow-up of 15.5 ± 10.4 months (range 2-29 months), 8 patients were free of symptoms and free of arrhythmias. Two patients had 1 VT storm episode with recurrent ICD shocks despite repeated normal stress test. CONCLUSIONS Flecainide can completely prevent ventricular arrhythmia during exercise and partially prevent recurrent ICD shocks in high-risk patients with CPVT2.
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6.
Utility of treadmill testing in identification and genotype prediction in long-QT syndrome.
Wong, JA, Gula, LJ, Klein, GJ, Yee, R, Skanes, AC, Krahn, AD
Circulation. Arrhythmia and electrophysiology. 2010;(2):120-5
Abstract
BACKGROUND The clinical diagnosis of long-QT syndrome (LQTS) remains challenging when ECG abnormalities are borderline or intermittent. Despite issues with access, cost, and heterogeneity of LQTS mutations, genetic testing remains the diagnostic gold standard for diagnosis of LQTS. We sought to develop a provocative testing strategy to unmask the LQTS phenotype and relate this to the results of genetic testing. METHODS AND RESULTS From 1995 to 2008, 159 consecutive patients with suspected LQTS underwent provocative testing that consisted of a modified Bruce protocol treadmill exercise test, with ECGs recorded supine at rest, immediately on standing, and at 1-minute intervals during exercise, at peak exercise, and at 1-minute intervals during the recovery phase. Similar testing was carried out on a stationary bike in a gradual and burst exercise fashion. LQTS was confirmed with genotyping in all 95 affected LQTS patients and excluded with negative family screening in 64 control subjects. Patients were studied before and after initiation of beta-blockers. Of 159 patients, 50 had an LQT1 mutation and 45 had an LQT2 mutation. In the LQTS group, 44.3% of patients had a normal-to-borderline resting QTc interval. LQTS patients exhibited a greater prolongation in QTc with postural change than unaffected patients (LQT1: 40 ms [IQR, 42]; LQT2: 35 ms [IQR, 46]; and LQTS-negative: 21 ms [IQR, 37]; P=0.029). During exercise, LQT1 patients had marked QTc prolongation compared with LQT2 and LQTS-negative patients (LQT1: 65 ms [60], LQT2: 3 ms [46], LQTS negative: 5 ms [41]; P<0.0001). QT hysteresis was more pronounced in patients with LQT2 mutations compared with LQT1 and LQT-negative patients (LQT2: 40 ms [10], LQT1: 15 ms [40]; LQTS-negative: 20 ms [20]; P<0.001). beta-Blockade normalized the QTc changes seen with standing and QT hysteresis. CONCLUSIONS The presence and genotype of LQTS can be predicted by a combination of postural and exercise changes in the QT/RR relationship. beta-Blockade normalized these changes. Routine exercise testing is useful in predicting and directing genetic testing in LQTS.
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7.
Real time myocardial contrast echocardiography during supine bicycle stress and continuous infusion of contrast agent. Cutoff values for myocardial contrast replenishment discriminating abnormal myocardial perfusion.
Miszalski-Jamka, T, Kuntz-Hehner, S, Schmidt, H, Hammerstingl, C, Tiemann, K, Ghanem, A, Troatz, C, Lüderitz, B, Omran, H
Echocardiography (Mount Kisco, N.Y.). 2007;(6):638-48
Abstract
BACKGROUND Myocardial contrast echocardiography (MCE) is a new imaging modality for diagnosing coronary artery disease (CAD). OBJECTIVE The aim of our study was to evaluate feasibility of qualitative myocardial contrast replenishment (RP) assessment during supine bicycle stress MCE and find out cutoff values for such analysis, which could allow accurate detection of CAD. METHODS Forty-four consecutive patients, scheduled for coronary angiography (CA) underwent supine bicycle stress two-dimensional echocardiography (2DE). During the same session, MCE was performed at peak stress and post stress. Ultrasound contrast agent (SonoVue) was administered in continuous mode using an infusion pump (BR-INF 100, Bracco Research). Seventeen-segment model of left ventricle was used in analysis. MCE was assessed off-line in terms of myocardial contrast opacification and RP. RP was evaluated on the basis of the number of cardiac cycles required to refill the segment with contrast after its prior destruction with high-power frames. Determination of cutoff values for RP assessment was performed by means of reference intervals and receiver operating characteristic analysis. Quantitative CA was carried out using CAAS system. RESULTS MCE could be assessed in 42 patients. CA revealed CAD in 25 patients. Calculated cutoff values for RP-analysis (peak-stress RP >3 cardiac cycles and difference between peak stress and post stress RP >0 cardiac cycles) provided sensitive (88%) and accurate (88%) detection of CAD. Sensitivity and accuracy of 2DE were 76% and 79%, respectively. CONCLUSIONS Qualitative RP-analysis based on the number of cardiac cycles required to refill myocardium with contrast is feasible during supine bicycle stress MCE and enables accurate detection of CAD.
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8.
The diagnostic accuracy of 64-slice computed tomography coronary angiography compared with stress nuclear imaging in emergency department low-risk chest pain patients.
Gallagher, MJ, Ross, MA, Raff, GL, Goldstein, JA, O'Neill, WW, O'Neil, B
Annals of emergency medicine. 2007;(2):125-36
Abstract
STUDY OBJECTIVE We compared the accuracy of multidetector computed tomography (CT) coronary angiography with stress nuclear imaging for the detection of an acute coronary syndrome or 30-day major adverse cardiac events in low-risk chest pain patients. METHODS This was a prospective study of the diagnostic accuracy of myocardial perfusion imaging and multidetector CT in low-risk chest pain patients. The target condition was an acute coronary syndrome (confirmed >70% coronary stenosis on coronary artery catheterization) or major adverse cardiac events within 30 days. Patients were low risk by Reilly/Goldman criteria and had negative serial ECGs and cardiac markers. All had both rest/stress sestamibi nuclear imaging and multidetector CT. Patients with abnormal stress nuclear imaging results (reversible perfusion defects) or multidetector CT results (stenosis >50% or calcium score >400) were considered for cardiac catheterization, and those with discordant results had a greater than 30-day reevaluation (including ECG) by a cardiologist. All were followed up for evidence of major adverse cardiac events within 30 days by review of hospital records and structured telephone interview. Primary outcomes were the accuracy of multidetector CT and myocardial perfusion imaging for the detection of an acute coronary syndrome and 30-day major adverse cardiac events. RESULTS Of the 92 patients, 7 (8%) were excluded because of uninterpretable multidetector CT scans. Of the remaining 85 study patients (49+/-11 years, 53% men), 7 (8%) were found to have the target condition, with all having significant coronary stenosis (88%+/-9%) and none having myocardial infarction or major adverse cardiac events during 30 days. Stress nuclear imaging results were negative in 72 (85%) patients, and multidetector CT results were negative in 73 (86%) patients. The sensitivity of stress nuclear imaging was 71% (95% confidence interval [CI] 36% to 92%), and multidetector CT was 86% (95% CI 49% to 97%), and the specificity was 90% (95% CI 81% to 95%) and 92% (95% CI 84% to 96%), respectively. The negative predictive value of stress nuclear imaging and multidetector CT was 97% (95% CI 90% to 99%) and 99% (95% CI 93% to 100%), respectively, and the positive predictive value was 38% (95% CI 18% to 64%) and 50% (95% CI 25% to 75%), respectively. CONCLUSION The accuracy of multidetector CT is at least as good as that of stress nuclear imaging for the detection and exclusion of an acute coronary syndrome in low-risk chest pain patients.
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9.
The Yo-Yo IR2 test: physiological response, reliability, and application to elite soccer.
Krustrup, P, Mohr, M, Nybo, L, Jensen, JM, Nielsen, JJ, Bangsbo, J
Medicine and science in sports and exercise. 2006;(9):1666-73
Abstract
PURPOSE To examine the physiological response, reliability, and validity of the Yo-Yo intermittent recovery level 2 test (Yo-Yo IR2). METHODS Thirteen normally trained male subjects carried out four Yo-Yo IR2 tests, an incremental treadmill test (ITT), and various sprint tests. Muscle biopsies and blood samples were obtained, and heart rate was measured before, during, and after the Yo-Yo IR2 test. Additionally, 119 Scandinavian elite soccer players carried out the Yo-Yo IR2 test on two to four occasions. RESULTS Yo-Yo IR2 performance was 591 +/- 43 (320-920) m or 4.3 (2.6-7.9) min. Test-retest coefficient of variation in distance covered was 9.6% (N = 29). Heart rate (HR) at exhaustion was 191 +/- 3 bpm, or 98 +/- 1% HRmax. Muscle lactate was 41.7 +/- 5.4 and 68.5 +/- 7.6 mmol x kg(-1) d.w. at 85 and 100% of exhaustion time, respectively, with corresponding muscle CP values of 40.4 +/- 5.2 and 29.4 +/- 4.7 mmol x kg(-1) d.w. Peak blood lactate was 13.6 +/- 0.5 mM. Yo-Yo IR2 performance was correlated to ITT performance (r = 0.74, P < 0.05) and VO2max (r = 0.56, P < 0.05) but not to 30- and 50-m sprint performance. Yo-Yo IR2 performance was better (P < 0.05) for international elite soccer players than for moderate elite players (1059 +/- 35 vs 771 +/- 26 m) and better (P < 0.05) for central defenders (N = 21), fullbacks (N = 20), and midfielders (N = 48) than for goalkeepers (N = 6) and attackers (N = 24). Fifteen elite soccer players improved (P < 0.05) Yo-Yo IR2 performance by 42 +/- 8% during 8 wk of preseasonal training. CONCLUSION This study demonstrates that the Yo-Yo IR2 test is reproducible and can be used to evaluate an athlete's ability to perform intense intermittent exercise with a high rate of aerobic and anaerobic energy turnover. Specifically, the Yo-Yo IR2 test was shown to be a sensitive tool to differentiate between intermittent exercise performance of soccer players in different seasonal periods and at different competitive levels and playing positions.
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10.
Effects of baseline serum levels of Se on markers of eccentric exercise-induced muscle injury.
Milias, GA, Nomikos, T, Fragopoulou, E, Athanasopoulos, S, Antonopoulou, S
BioFactors (Oxford, England). 2006;(3):161-70
Abstract
Inflammation and oxidative stress have been implicated in the mechanism of eccentric exercise-induced muscle injury. This study examined whether baseline serum levels of selenium (Se), a trace element that participates in both antioxidant and anti-inflammatory systems, affects the overall response to injury. Thirteen males performed 36 maximal eccentric actions with the elbow flexors of the non-dominant arm on a motorized dynamometer. Venous blood samples were collected immediately before and after exercise at 2, 24, 48, 72 and 96 hours. Established indicators of muscle damage such as maximum isometric torque (MIT), range of motion (ROM), relaxed arm angle (RANG), flexed arm angle (FANG), arm circumference (CIRC), muscle soreness and serum levels of creatine kinase (CK) and lactate dehydrogenase (LDH) were determined at the same time points. Baseline serum levels of Se were also measured. Complementary data regarding assessment of Se status were retrieved by the use of a semi-quantitative food frequency questionnaire. All measures changed significantly (p<0.05) after exercise. The main finding of this study was that baseline Se serum levels were associated inversely with CK, LDH and FANG and positively with MIT and ROM (p<0.05). These data suggest that beyond overt Se deficiency, suboptimal Se status possibly worsens muscle functional decrements subsequent to eccentric muscle contractions.