The effects of movement velocity during squatting on energy expenditure and substrate utilization in whole-body vibration

The purpose of this study was to examine whether and how cycle time duration affects energy expenditure and substrate utilization during whole-body vibration (WBV). Nine men performed 3 squatting exercises in execution frequency cycles of 6, 4, and 2 seconds to 90 degrees knee flexion with vibration (Vb+) (frequency was set at 30 Hz and the amplitude of vibration was 4 mm) and without vibration (Vb-) during 3 minutes, each with an additional load of 30% of the subject's body weight. A 2-way analysis of variance for VO2 revealed a significant vibration condition main effect (p < 0.001) and a cycle time duration effect (p < 0.001). When differences were analyzed by Fisher's LSD test, cycle time duration of 2 seconds was significantly different from 4 and 6 seconds, both in Vb+ and Vb-. Total energy expenditure (EE(tot)), carbohydrate oxidation rate (EE(cho)), and fat oxidation rate (EE(fat)) demonstrated a significant vibration condition main effect (EE(tot): p < 0.01; EE(cho): p < 0.001; EE(fat): p < 0.001) and cycle time duration main effect (EE(tot) and EE(cho): p < 0.001; EE(fat): p < 0.01). EE(tot), EE(cho), and EE(fat) post hoc comparisons indicated that values for the 2-second test significantly differed from 4 and 6 seconds when compared in the same vibration condition. VO2 and EE values were greater in Vb+ than in Vb- conditions with the same cycle time duration. Our study confirms that squatting at a greater frequency helps to maximize energy expenditure during exercise with or without vibration. Therefore, cycle time duration must be controlled when vibration exercise is prescribed.     

Diploid and tetraploid grey treefrogs (Hyla chrysoscelis and Hyla versicolor) have similar metabolic rates

We measured oxygen consumption of the diploid frog Hyla chrysoscelis and its recently evolved tetraploid cryptic species Hyla versicolor at rest and during forced locomotory exercise. We also measured whole-body lactic acid concentrations of individuals of the two species at rest and following 4 min of exercise. Contrary to predictions based on tissue-culture experiments, rates of organismal metabolism are not different in this diploid/tetraploid species pair: the diploid and tetraploid species did not differ in rates of oxygen consumption at rest or during exercise. Furthermore, whole-body lactate concentrations of frogs at rest and following forced locomotion were the same in the diploid and tetraploid species. For these species, polyploidy does not appear to be associated with lower maintenance costs at the level of the organism. However, polyploidy also does not appear to have metabolic consequences that would limit the behavioral or ecological repertoire of an anuran.     

Relationships of Oxygen Consumption, Hemodynamics, and Heart Rate Variability with the Functional Class of Coronary Artery Disease Patients

The functional classes (FCs) established according to the criteria of the New York Heart Association were tested for association with oxygen consumption, the state of central hemodynamics, and heart rate (HR) variability in coronary artery disease (CAD) patients. Oxygen consumption, central hemodynamics, and HR variability at rest and during exercise were assayed in 146 CAD patients and 30 healthy individuals (the control group). It was established that the peak oxygen consumption (VO_2max), anaerobic threshold, pulmonary ventilation, systolic and minute blood volume at the threshold load (TL), and HR variability in a supine position significantly decrease and the total vascular peripheral resistance at rest and during exercise increases with increasing FC in CAD patients. The closest correlation of FC was revealed with physical working capacity, anaerobic threshold, age, and peak oxygen consumption. Moderate correlations were established with the chronotropic function of the heart at the threshold load, HR variability, the high- and low-frequency components of the cardiac rhythm at TL, pulmonary ventilation, stroke volume at rest and at TL, and the carbon dioxide ventilation equivalent at TL. In healthy individuals, the peak oxygen consumption closely correlated with the HR variability, the very low frequency component at TL, and physical capacity. With an increase in FC in CAD patients, peak oxygen consumption became more tightly associated with the chronotropic function and the hemodynamic components at TL than with the HR variability in a supine position or at TL.     

Comparison of kettlebell swings and treadmill running at equivalent rating of perceived exertion values

The purpose of this study was to compare metabolic demand of a kettlebell (KB) swing routine with treadmill (TM) running at equivalent rating of perceived exertion (RPE). Thirteen subjects (11 male, 2 female, age = 21.4 ± 2.1 years, weight = 73.0 ± 9.2 kg) completed a 10-minute KB swing routine consisting of 35-second swing intervals followed by 25-second rest intervals. Men used a 16-kg KB, and women used an 8-kg KB. After 48 hours of rest, the subjects completed a 10-minute TM run at equivalent RPEs as measured during the swing workout. Metabolic data were monitored each minute during each exercise using an automated cart, with the final 7 minutes used for analysis. The RPE and heart rate (HR) recorded at minutes 5, 7, 9, and 10 increased by 2-3 and 7-9%, respectively, for each exercise, producing a significantly increasing pattern but no significant difference between exercises. Average HR and RPE were not significantly different between KB and TM and averaged 90 and 89%, respectively, of age-predicted HRmax. Oxygen consumption, METS, pulmonary ventilation, and calorie expenditure were significantly higher for TM (25-39%) than for KB. Respiratory exchange ratio (TM = 0.94 ± 0.04, KB = 0.95 ± 0.05) and respiratory rate (TM = 38 ± 7, KB = 36 ± 4 b·min) were not significantly different between the exercises at any time point. During TM and KB exercises matched for RPE, the subjects are likely to have higher oxygen consumption, work at a higher MET level, and burn more kilocalories per minute during TM running than during KB swings. However, according to the American College of Sports Medicine standards, this KB drill could provide sufficient exercise stress to produce gains in aerobic capacity.     

Acute effects of whole-body vibration on jump force and jump rate of force development: a comparative study of different devices

The goal of this study was to compare the acute effects of whole-body vibration (WBV) delivered by 3 devices with different mechanical behavior on jump force (JF) and jump rate of force development (JRFD). Twelve healthy persons (4 women and 8 men; age 30.5 ± 8.8 years; height 178.6 ± 7.3 cm; body mass 74.8 ± 9.7 kg) were exposed to WBV for 15 and 40 seconds using 2 professional devices (power plate [PP; vertical vibration] and Galileo 2000 [GA; oscillatory motion around the horizontal axis in addition to vertical vibration]) and a home-use device [Power Maxx, PM; horizontal vibration]). The JF and JRFD were evaluated before, immediately after, and 5 minutes after WBV. The JF measured immediately after 40 seconds of vibration by the GA device was reduced (3%, p = 0.05), and JRFD measured after 5 minutes of rest after 40 seconds of vibration by the PM device was reduced (12%, p < 0.05) compared with the baseline value. The acute effects of WBV (15 or 40 seconds) on JF and JRFD were not significantly different among the 3 devices. In conclusion, our hypothesis that WBV devices with different mechanical behaviors would result in different acute effects on muscle performance was not confirmed.     

Blood rheology and oxygen uptake

Continuously measured oxygen uptake during constant work exercise (15' 50W) reveals increasing oxygen consumption in individuals with elevated blood viscosity parameters, indicating persistent contribution of anaerobic glycolysis during steady state exercise far below expected "anaerobic threshold". Improvement of viscosity parameters by prostaglandin E1--infusion (Prostavasin) 40 micrograms i.v., naftidrofurylhydrogenoxalat (Dusodril pi) 400 mg i.v. or hemodilution with 500 ml 6% hydroxyethylamylum MW 40000 (Onkohaes) in 5 patients results in significant reduction of this oxygen gradient in subsequent exercise test. Integrated VO2 during exercise above the mean value at rest or the quotient of VO2 during 15 min by VO2 during 30 min (including recovery time) are not differing significantly due to high variations inter- and intraindividually. Oxygen gradient during submaximal constant exercise permits direct clinical determination of microcirculatory performance in involved muscle tissue as a function of blood viscosity.     

A comparison of the oxygen consumption/body weight relationship obtained during submaximal exercise on a bicycle ergometer and on a treadmill.

It is widely accepted that the relationship between oxygen consumption and body weight obtained during exercise on a bicycle ergometer differs from that obtained during treadmill walking. Experimental evidence to support this claim is lacking. To examine this difference a group of subjects (body weight 41--81 kg) undertook a predetermined level of submaximal exercise on a bicycle ergometer and a treadmill. Oxygen consumption was measured in a steady state at rest (i.e. sitting on the bicycle ergometer and standing on the treadmill) and during the two modes of exercise. A significant positive correlation between oxygen consumption and body weight was obtained under all four conditions of measurement. At rest the two regression lines did not differ in slope or elevation. During exercise the slope and the elevation of the line obtain from treadmill walking were significantly greater than from bicycle ergometer exercise. The 'metabolic cost' of bicycle ergometer exercise, (Vo2 during exercise--V02 at rest), showed no significant correlation with body weight. In contrast, there was a significant positive correlation during walking. It is suggested that these differences have arisen due to a different proportion of the total body weight supported by the subject in the two forms of exercise.     

Cardiovascular hemodynamics with increasing exercise intensities in postmenopausal women.

We sought to determine the cardiovascular responses to increasing exercise intensities in postmenopausal women with different physical activity levels and hormone replacement therapy (HRT) status. Forty-four women (11 sedentary, 19 physically active, 14 master athletes; 24 not on HRT, 20 on HRT) completed treadmill exercise at 40, 60, 80, and 100% of maximal oxygen consumption. Oxygen consumption, heart rate, blood pressure, and cardiac output, determined via acetylene rebreathing, were measured at each exercise intensity. HRT did not affect cardiovascular hemodynamics. Stroke volume (SV) decreased significantly between 40 and 100% of maximal oxygen consumption in all groups, and the decrease did not differ among groups. The greater oxygen consumption of the athletes at each intensity was due to their significantly greater cardiac output, which was the result of a significantly greater SV, compared with both of the less active groups. The athletes had significantly lower total peripheral resistance at each exercise intensity than did the two less active groups. There were no consistent significant hemodynamic differences between the physically active and sedentary women. These results indicate that SV decreases in postmenopausal women as exercise intensity increases to maximum, regardless of their habitual physical activity levels or HRT status.     

The effects of adding different whole-body vibration frequencies to preconditioning exercise on subsequent sprint performance

R?nnestad, BR and Ellefsen, S. The effects of adding different whole-body vibration frequencies to preconditioning exercise on subsequent sprint performance. J Strength Cond Res 25(12): 3306-3310, 2011-The phenomenon postactivation potentiation can possibly be used to acutely improve sprint performance. The purpose of this study was to investigate the effect of adding whole-body vibration (WBV) to body-loaded half-squats, performed as preconditioning activity to the 40-m sprint test. Nine male amateur soccer players performed 1 familiarization session and 6 separate test sessions. Each session included a standardized warm-up followed by 1 of the after preconditioning exercises: 30-seconds of half-squats with WBV at either 50 or 30 Hz or half-squats without WBV. The 40-m sprint was performed 1 minute after the preconditioning exercise. For each subject, each of the 3 protocols was repeated twice on separate days in a randomized order. Mean values were used in the statistical analysis. Performing the preconditioning exercise with WBV at a frequency of 50 Hz resulted in a superior 40-m sprint performance compared to preconditioning exercise without WBV (5.48 ± 0.19 vs. 5.52 ± 0.21 seconds, respectively, p < 0.05). There was no difference between preconditioning exercise with WBV at a frequency of 30 Hz and the no-WBV condition. In conclusion, preconditioning exercise performed with WBV at 50 Hz seems to enhance 40-m sprint performance in recreationally trained soccer players. The present findings suggest that coaches can incorporate such exercise into the warm-up to improve sprint performance or the quality of the sprint training.     

Effects of low-intensity resistance exercise under acute systemic hypoxia on hormonal responses

Previous studies have shown that low-intensity resistance exercises with vascular occlusion and slow movement effectively increase muscular size and strength. Researchers have speculated that local hypoxia by occlusion and slow movement may contribute to such adaptations via promoting anabolic hormone secretions by the local accumulation of metabolites. In this study, we determined the effects of low-intensity resistance exercise under acute systemic hypoxia on metabolic and hormonal responses. Eight male subjects participated in 2 experimental trials: (a) low-intensity resistance exercise while breathing normoxic air (normoxic resistance exercise [NR]), (b) low-intensity resistance exercise while breathing 13% oxygen (hypoxic resistance exercise [HR]). The resistance exercises (bench press and leg press) consisted of 14 repetitions for 5 sets at 50% of maximum strength with 1 minute of rest between sets. Blood lactate (LA), serum growth hormone (GH), norepinephrine (NE), testosterone, and cortisol concentrations were measured before normoxia and hypoxia exposures; 15 minutes after the exposures; and at 0, 15, and 30 minutes after the exercises. The LA levels significantly increased after exercises in both trials (p ≤ 0.05). The area under the curve for LA after exercises was significantly higher in the HR trial than in the NR trial (p ≤ 0.05). The GH significantly increased only after the HR trial (p ≤ 0.05). The NE and testosterone significantly increased after the exercises in both trials (p ≤ 0.05). Cortisol did not significantly change in both trials. These results suggest that low-intensity resistance exercise in the hypoxic condition caused greater metabolic and hormonal responses than that in the normoxic condition. Coaches may consider low-intensity resistance exercise under systemic hypoxia as a potential training method for athletes who need to maintain muscle mass and strength during the long in-season.     

Supine lower body negative pressure exercise during bed rest maintains upright exercise capacity.

Bed rest and spaceflight reduce exercise fitness. Supine lower body negative pressure (LBNP) treadmill exercise provides integrated cardiovascular and musculoskeletal stimulation similar to that imposed by upright exercise in Earth gravity. We hypothesized that 40 min of supine exercise per day in a LBNP chamber at 1.0-1.2 body wt (58 +/- 2 mmHg LBNP) maintains aerobic fitness and sprint speed during 15 days of 6 degrees head-down bed rest (simulated microgravity). Seven male subjects underwent two such bed-rest studies in random order: one as a control study (no exercise) and one with daily supine LBNP treadmill exercise. After controlled bed-rest, time to exhaustion during an upright treadmill exercise test decreased 10%, peak oxygen consumption during the test decreased 14%, and sprint speed decreased 16% (all P < 0.05). Supine LBNP exercise during bed rest maintained all the above variables at pre-bed-rest levels. Our findings support further evaluation of LBNP exercise as a countermeasure against long-term microgravity-induced deconditioning.     

Physiological responses of simulated karate sparring matches in young men and boys

The purpose of this study was to investigate the duration of each series of offensive and defensive techniques and the cardiovascular, metabolic, and perceptual responses during 2- and 3-minute bouts of simulated karate sparring. Six young men (age, 18-20 years) and 6 boys (age, 16-17 years) participated in this study. We formed 3 pairs of men and 3 pairs of boys to create a demanding competitive environment. After a rest period, each pair performed a 2-minute bout of sparring, sat quietly for 60 minutes, and then performed 3-minute bout of sparring. We measured oxygen uptake (Vo2), heart rate (HR), and blood lactate responses and ascertained the rate of perceived exertion (RPE) and energy expenditure (EE) during these sparring bouts. The ventilatory threshold was estimated from ventilatory equivalent and Vo2 obtained during the treadmill test. The duration of each series of offensive and defensive techniques was videotaped. During the 2- and 3-minute bouts of sparring, the duration of longest series of offensive and/or defensive combination techniques performed were 2.1 +/- 1.0 and 1.8 +/- 0.4 seconds, respectively; the mean total times of performing offensive and defensive techniques were 13.3 +/- 3.3 and 19.4 +/- 5.5 seconds, respectively. The mean oxygen uptake (Vo2), the percentage of maximum oxygen uptake (%Vo2max), HR, percentage of maximum HR, RPE, and EE for a 3-minute bout of sparring were significantly higher than for a 2-minute bout of sparring. The mean %Vo2max values for these bouts of sparring were below the ventilatory threshold. It is recommended that karate practitioners perform more specific weight training, plyometric exercises, and interval training to increase the ability to buffer acid muscle and blood concentrations and to build lean body mass, strength, and power to develop the specific motor skills required in sparring.     

Acute effects of stretching exercise on the heart rate variability in subjects with low flexibility levels

The study investigated the heart rate (HR) and heart rate variability (HRV) before, during, and after stretching exercises performed by subjects with low flexibility levels. Ten men (age: 23 ± 2 years; weight: 82 ± 13 kg; height: 177 ± 5 cm; sit-and-reach: 23 ± 4 cm) had the HR and HRV assessed during 30 minutes at rest, during 3 stretching exercises for the trunk and hamstrings (3 sets of 30 seconds at maximum range of motion), and after 30 minutes postexercise. The HRV was analyzed in the time ('SD of normal NN intervals' [SDNN], 'root mean of the squared sum of successive differences' [RMSSD], 'number of pairs of adjacent RR intervals differing by >50 milliseconds divided by the total of all RR intervals' [PNN50]) and frequency domains ('low-frequency component' [LF], 'high-frequency component' [HF], LF/HF ratio). The HR and SDNN increased during exercise (p < 0.03) and decreased in the postexercise period (p = 0.02). The RMSSD decreased during stretching (p = 0.03) and increased along recovery (p = 0.03). At the end of recovery, HR was lower (p = 0.01), SDNN was higher (p = 0.02), and PNN50 was similar (p = 0.42) to pre-exercise values. The LF increased (p = 0.02) and HF decreased (p = 0.01) while stretching, but after recovery, their values were similar to pre-exercise (p = 0.09 and p = 0.3, respectively). The LF/HF ratio increased during exercise (p = 0.02) and declined during recovery (p = 0.02), albeit remaining higher than at rest (p = 0.03). In conclusion, the parasympathetic activity rapidly increased after stretching, whereas the sympathetic activity increased during exercise and had a slower postexercise reduction. Stretching sessions including multiple exercises and sets acutely changed the sympathovagal balance in subjects with low flexibility, especially enhancing the postexercise vagal modulation.     

Cardiorespiratory response to low-intensity walking in water and on land in elderly women.

The purpose of the present study was to determine whether or not the exercise intensity of water-walking for elderly women could be accurately prescribed by heart rate data obtained during treadmill exercise on land. Six healthy female volunteers, with a mean age of 62.2 +/- 4.2 years, took part in this study. Walking on land was performed on a treadmill. Each subject completed three consecutive 4-minute walks at a progressively increasing velocity (40, 60 and 80 m.min-1), with a 1-minute rest after both the first and second walks. The room temperature and relative humidity were 24.5 +/- 0.2 degrees C and 54.8 +/- 4.0%, respectively. Walking in water was performed in a Flowmill, which is a treadmill positioned at the base of a water flume. Each subject completed three consecutive 4-minute walks at a progressively increasing belt and water-flow velocity (20, 30 and 40 m.min-1), with a 1-minute rest after both the first and second walks. The water depth was at the level of the xiphoid process of each subject. The water temperature was 30.7 +/- 0.1 degrees C. The exercise intensity at the highest workrate was equivalent to 44.2 +/- 10.3% of the heart rate reserve (HRR) during water-walking and 38.4 +/- 4.7% of the HRR during land-walking. There was a highly significant linear relationship between heart rate (HR) and oxygen uptake (VO2) during both water-walking and land-walking. The relationship between HR and VO2 in both exercise modes was similar. Thus, the relationship of HR to VO2 derived from a treadmill-graded walking test on land may be used to prescribe exercise intensity for water-walking in thermoneutral water.     

Effects of delayed onset muscle soreness on selected physiological responses to submaximal running

This study examined the effects of delayed-onset muscle soreness (DOMS) on selected physiological responses to submaximal exercise. Seven male and four female subjects (Ss) aged 21-37 years completed two submaximal running sessions at an individualized pace corresponding to a blood lactate concentration (bLa) of approximately 2.5 mmol x L(-1). Following the first session (T1), Ss performed a series of lower extremity resistance exercises designed to induce DOMS. Subjects were then retested (T2) 24-30 hours later, during which time all Ss experienced DOMS. Oxygen uptake, heart rate (HR), respiratory exchange ratio, rating of perceived exertion (RPE), and bLa were measured every 6 minutes. Significant trial effects (p < 0.05) were observed for HR and RPE. HR was significantly higher during T1 at minutes 6 and 12 (p < 0.05), and RPE values were significantly higher at T2 during all recording periods (p < 0.05). Results from this study suggest that DOMS does not affect submaximal oxygen uptake. However, DOMS does appear to affect one's perception of effort.     

Comparison in men of physiological responses to exercise of increasing intensity at low and moderate ambient temperatures

In six male subjects the sweating thresholds, heart rate (fc), as well as the metabolic responses to exercise of different intensities [40%, 60% and 80% maximal oxygen uptake (VO2max)], were compared at ambient temperatures (Ta) of 5 degrees C (LT) and 24 degrees C (MT). Each period of exercise was preceded by a rest period at the same temperature. In LT experiments, the subjects rested until shivering occurred and in MT experiments the rest period was made to be of exactly equivalent length. Oxygen uptake (VO2) at the end of each rest period was higher in LT than MT (P less than 0.05). During 20-min exercise at 40% VO2max performed in the cold no sweating was recorded, while at higher exercise intensities sweating occurred at similar rectal temperatures (Tre) but at lower mean skin (Tsk) and mean body temperatures (Tb) in LT than MT experiments (P less than 0.001). The exercise induced VO2 increase was greater only at the end of the light (40% VO2max) exercise in the cold in comparison with MT (P less than 0.001). Both fc and blood lactate concentration [1a]b were lower at the end of LT than MT for moderate (60% VO2max) and heavy (80% VO2max) exercises. It was concluded that the sweating threshold during exercise in the cold environment had shifted towards lower Tb and Tsk. It was also found that subjects exposed to cold possessed a potentially greater ability to exercise at moderate and high intensities than those at 24 degrees C since the increases in Tre, fc and [1a]b were lower at the lower Ta.     

Influence of vibration training on energy expenditure in active men

The aim of the present study was to analyze the effect of whole-body vibration on energy expenditure, as well as on exercise intensity, during and immediately after a typical set of exercises for muscle hypertrophy in physically active subjects. Seventeen male university students (mean age 18.3 +/- 0.24 years) volunteered to perform 2 different training exercises: half squat (HS), and half squat with vibration (HSV). Both exercises were performed by all subjects on the vibration platform (with vibration only for HSV), the sequence order being assigned randomly. Energy expenditure (EE), respiratory exchange ratio, perceived exertion (PE), and heart rate were recorded for baseline, exercise, and short-recovery conditions. Training consisted of 5 sets of 10 repetitions of HS and HSV, with a 2-minute recovery interval between sets. Analysis of variance with repeated measurements and Bonferroni correction, as well as effect size were used for statistical calculations. Results indicated that EE and PE were significantly higher in the HSV group, during both exercise and recovery. Heart rate did not differ significantly between groups. Thus, it would appear that HS strength training could be rendered more energy-efficient through the addition of vibration. Moreover, it would be feasible to introduce vibration exercises into regular training programs, particularly those whose key objective is muscle hypertrophy along with fat reduction.     

Active intervals between sets of resistance exercises potentiate the magnitude of postexercise hypotension in elderly hypertensive women

Active and passive intervals (AI, PI) between exercise series promote different hemodynamic responses; however, the impact of these intervals on the blood pressure response has not yet been investigated. The objective of this study was to compare the impact of AIs and PIs during resistance exercises with the magnitude of postexercise hypotension (PEH). Elderly hypertensive women (n = 21, 61.2 ± 2 years of age) completed 4 sessions for upper or lower limbs with AI or PI (3 sets, 15 repetitions, 60% load of 15 repetition maximum (RM), and an interval of 90 seconds between sets). Blood pressure was measured 10 minutes before and at 10, 20, 30, 40, and 50 minutes after the exercise sessions. The heart rate at the end of each AI was always significantly higher than that after the PI, but the perceived exertion as measured by the Perceived Exertion Scale (OMNI-RPE) was similar to that of PI exercise protocols. In the lower limb exercises, AI resulted in significantly and consistently higher PEH than in exercises with PI for both systolic (from 20 minutes postexercise) and diastolic (from 10 minutes postexercise) pressures. The upper limb exercises promoted much more discrete PEH in relation to the lower limb exercises, given that the AI promoted significantly higher PEH relative to the PI protocols, but only for systolic PEH and only from 30 minutes postexercise. This is the first time that AIs between sets in a session of resistance exercises have been shown to be a highly effective methodological strategy to increase PEH in elderly hypertensive women.     

Reduced stroke volume during exercise in postural tachycardia syndrome.

Postural tachycardia syndrome (POTS) is characterized by excessive tachycardia without hypotension during orthostasis. Most POTS patients also report exercise intolerance. To assess cardiovascular regulation during exercise in POTS, patients (n = 13) and healthy controls (n = 10) performed graded cycle exercise at 25, 50, and 75 W in both supine and upright positions while arterial pressure (arterial catheter), heart rate (HR; measured by ECG), and cardiac output (open-circuit acetylene breathing) were measured. In both positions, mean arterial pressure, cardiac output, and total peripheral resistance at rest and during exercise were similar in patients and controls (P > 0.05). However, supine stroke volume (SV) tended to be lower in the patients than controls at rest (99 +/- 5 vs. 110 +/- 9 ml) and during 75-W exercise (97 +/- 5 vs. 111 +/- 7 ml) (P = 0.07), and HR was higher in the patients than controls at rest (76 +/- 3 vs. 62 +/- 4 beats/min) and during 75-W exercise (127 +/- 3 vs. 114 +/- 5 beats/min) (both P < 0.01). Upright SV was significantly lower in the patients than controls at rest (57 +/- 3 vs. 81 +/- 6 ml) and during 75-W exercise (70 +/- 4 vs. 94 +/- 6 ml) (both P < 0.01), and HR was much higher in the patients than controls at rest (103 +/- 3 vs. 81 +/- 4 beats/min) and during 75-W exercise (164 +/- 3 vs. 131 +/- 7 beats/min) (both P < 0.001). The change (upright - supine) in SV was inversely correlated with the change in HR for all participants at rest (R(2) = 0.32), at 25 W (R(2) = 0.49), 50 W (R(2) = 0.60), and 75 W (R(2) = 0.32) (P < 0.01). These results suggest that greater elevation in HR in POTS patients during exercise, especially while upright, was secondary to reduced SV and associated with exercise intolerance.