Consistency of the counting talk test for exercise prescription

The purpose of this study was to assess the consistency of the counting talk test (CTT) method for estimating exercise intensity across various modes of exercise in healthy young adults. Thirty-six individuals completed the study, which required participation in 3 separate sessions within a 2-week time period. During the first session, the individuals completed a maximal effort treadmill test from which each individual's heart rate reserve (HRR) was calculated. During the second and third sessions, the subjects participated in 2 modes of exercise in each session for a total of 4 different modes of exercise. The individuals exercised at 40% HRR, 50% HRR, 60% HRR, 75% HRR, and 85% HRR. The heart rate (HR), CTT, and rating of perceived exertion (RPE) were recorded at each workload. Based on the individual's resting CTT (CTT(rest)), the %CTT for each exercise stage was then calculated. Pearson correlations demonstrated moderate to good correlations between the CTT and HRR methods and the CTT and RPE methods for estimating exercise intensity. This study found that for the individuals with CTT(rest) <25, moderate to vigorous intensity exercise as recommended by the American College of Sports Medicine HRR guidelines could be achieved by exercising at a level of 40-50% CTT(rest). Individuals with a CTT(rest) ≥25, exercising at a level of 30-40% CTT(rest) would place them in the moderate to vigorous exercise intensity range. A high degree of reliability was demonstrated using the CTT method across the various modes of aerobic exercise. As such, independent of the exercise mode, the CTT was found to be an easy and consistent method for prescribing moderate to vigorous aerobic exercise intensity.     

Max试验验证症状限制心肺运动试验为最大极限运动进一步临床研究*

目的: 验证临床受试者所完成的心肺运动试验（CPET）为最大极限运动,进一步设计完善Max试验验证CPET结果客观定量功能评估的准确性及以某特定指标的特定数值作为停止运动的标准是否可行。方法: 选择2017年9月至2019年1月在阜外医院签署知情同意书后进行CPET和Max试验受试者216例。其中正常受试者41例,因CPET峰值呼吸交换率（RER）≤1.10,或运动中心率和血压不上升,对CPET极限运动结果存在质疑的临床患者175例进行研究。其中60例已初步报告,本研究进一步扩大研究。Max试验方法：完成CPET测试后,先蹬车≥60 r/min,再施加130%峰值功率的恒定功率,鼓励受试者运动至不能坚持的极限状态。计算分析Max试验30 s的最大心率和最大摄氧量、及其与峰值心率和峰值摄氧量之间的差值和百分差值。百分差值=（Max值-峰值值）/Max值× 100%。评测标准：①若心率和摄氧量任一指标的差值百分比≤-10%（Max测试的数值低于CPET峰值数据）则定义Max试验操作失败,否则为成功;2若心率和摄氧量的差值百分比均在-10%~10%,则Max试验操作成功,证明CPET数据为极限运动,CPET 峰值相关数据较为准确;③若心率和摄氧量差值任一指标差值百分比≥10%时,则Max试验操作成功,证明CPET结果为非极限运动。结果: 病例组峰值摄氧量（L/min、ml/（min·kg）、%pred）、无氧阈（L/min、ml/（min·kg）、%pred）、峰值氧脉搏（ml/beat、%pred）、峰值RER、峰值收缩压（mmHg）、峰值运动负荷（W/min）、峰值心率（bpm）、摄氧有效性峰值平台（OUEP）（比值、%pred）低于正常组,二氧化碳通气有效性平均90 s最低值（Lowest Ve/VCO₂）（比值、%pred）、二氧化碳通气效率斜率（Ve/VCO₂ Slope）（比值、%pred）高于正常组（P<0.05）。所有正常组与病例组均安全无任何事件完成CPET和Max试验。216例受试者中,Max试验成功198例（91.7%）,其中证明CPET为极限运动182例,为非极限运动16例;失败18例（8.3%）。结论: 在临床检查中,若对CPET结果是否为最大极限存在质疑,利用Max试验可验证CPET是否为极限运动。Max试验方法安全可行,值得进一步深入研究和临床推广应用。     

Cardiopulmonary exercise testing in congenital heart disease: equipment and test protocols

Cardiopulmonary exercise testing (CPET) in paediatric cardiology differs in many aspects from the tests as performed in adult cardiology. Children's cardiovascular responses during exercise testing present different characteristics, particularly oxygen uptake, heart rate and blood pressure response, which are essential in interpreting haemodynamic data. Diseases that are associated with myocardial ischaemia are very rare in children. The main indications for CPET in children are evaluation of exercise capacity and the identification of exercise-induced arrhythmias. In this article we will review exercise equipment and test protocols for CPET in children with congenital heart disease. (Neth Heart J 2009;17:339–44.)     

心肺运动指导个体化心衰患者康复的初步总结报告*

目的: 慢性心力衰竭患者（CHF）康复治疗和二级预防已经是临床共识,但用心肺运动试验（CPET）指导制定个体化运动处方国内尚少。方法: 选择10例CHF完成CPET评估,随机分为两组（n=5）：对照组进行没有运动;运动组增加△50%W功率运动30 min/d,每周5 d,共12周。在治疗前和3个月后分别进行评估。结果: 两组患者没有显著差异（P>0.05）。运动组12周后,运动持续时间从8 min显著提高到23 min（P<0.001）; 6分钟步行距离从394 m显著提高到470 m（P<0.05）;生活质量评分从25分显著降低至3分（P<0.01）。而对照组治疗前后均没有显著改变（P>0.05）;治疗前后的改变均显著小于运动组（P<0.01）。结论: 在CPET客观定量功能评估指导制定个体化高强度运动康复安全有效,值得大力推广应用。     

Comparative testing of disinfectants using proposed European surface test methods

A surface test method for disinfectants currently under development as a standard European test method is described. The test involves determining the number of viable organisms recoverable from a contaminated stainless steel surface before and after application of disinfectant. Evaluation of a range of disinfectant agents and products currently used in the UK indicated that products at recommended use concentrations produced log reductions in viable count ranging from < 1.0 to > 6.4 (i.e. no detectable survivors) after a 5 min contact period against Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecium and Candida albicans. Increased activity was observed by increasing the disinfectant contact time to 30 min. Addition of 3% w/v albumin to the test suspension used to inoculate surfaces caused a substantial reduction in activity.     

Analysis of heart rate variability during exercise stress testing using respiratory information

This paper presents a novel method for the analysis of heart rate variability (HRV) during exercise stress testing enhanced with respiratory information. The instantaneous frequency and power of the low frequency (LF) and high frequency (HF) bands of the HRV are estimated by parametric decomposition of the instantaneous autocorrelation function (ACF) as a sum of damped sinusoids. The instantaneous ACF is first windowed and filtered to reduce the cross terms. The inclusion of respiratory information is proposed at different stages of the analysis, namely, the design of the filter applied to the instantaneous ACF, the parametric decomposition, and the definition of a dynamic HF band. The performance of the method is evaluated on simulated data as well as on a stress testing database. The simulation results show that the inclusion of respiratory information reduces the estimation error of the amplitude of the HF component from 3.5% to 2.4% in mean and related SD from 3.0% to 1.7% when a tuned time smoothing window is used at an SNR of 15 dB. Results from the stress testing database show that information on respiratory frequency produces HF power estimates which closely resemble those from the simulations which exhibited lower SD. The mean SD of these estimates with respect to their mean trends is reduced by 84% (from 0.74×10⁻³ s⁻² to 0.12×10⁻³ s⁻²). The analysis of HRV in the stress testing database reveals a significant decrease in the power of both the LF and HF components around peak stress.     

Translation of exhaled breath volatile analyses to sport and exercise applications

Background

Exhaled breath gases are becomingly increasingly investigated for use as non-invasive measurements for clinical diagnosis, prognosis and therapeutic monitoring. Exhaled volatile organic compounds (VOCs) in the breath, which make up the exhaled volatilome, offer a rich sample medium that provides both information to external exposures as well as endogenous metabolism. For these reasons, exhaled breath analyses can be extended further beyond disease-based investigations, and used for wider biomarker measurement purposes. The use of a rapid, non-invasive (and potentially non-physically demanding) test in an exercise and/or sporting situation may provide additional information for translation to performance sport, recreational exercise/fitness and clinical exercise health.

Aim of review

This review intends to provide an overview into the initial exploration of exhaled VOC measurements in sport and exercise science, and understand current limitations in knowledge and instrumentation that have restricted these methodologies in becoming common practice.

Key scientific concepts of review

Exhaled VOCs have been applied to sport/exercise investigations with a current emphasis on measurement of chemical exposure during and/or following exercise. This includes the measurement of disinfection by-products from chlorine-disinfected swimming pools, as well as exposure to petrochemicals from combustion engines (e.g. vehicle fumes). However, exhaled VOC measurements have been less employed in the context of performance sport. For example, the application of exhaled VOCs to map biochemical/physiological processes of intense exercise is currently under explored and warrants further study. Nevertheless, there is promise for exhaled VOC testing in the development of rapid/on-line anti-doping screens, with initial steps taken in this field.

     

Mutagenicity testing of protein-containing and biological samples using the Ames/Salmonella plate incorporation test and the fluctuation test.

Mutagenicity testing of biological samples and proteins is complicated by the presence of histidine and histidine-related growth factors which may produce a false positive result in the Ames/Salmonella plate incorporation test. A bioassay method, utilizing an automated dispenser-photometer and Salmonella typhimurium strain TA1535 as the indicator bacteria, was used to estimate the presence of histidine-related growth factors in three enzyme solutions submitted for mutagenicity testing. One of the solutions was clearly positive in the Ames/Salmonella test and also contained the highest amount of L-histidine-HCl-equivalents. The two other solutions, with low or undetectable amounts of L-histidine-HCl-equivalents, gave equivocal and negative results, respectively, in the Ames/Salmonella test. Studies were also performed with strains TA98, TA100 and TA1535 to determine the amount of added L-histidine-HCl that would result in a 'positive' result in the Ames/Salmonella test. Because the minimum amount of L-histidine-HCl required to double the number of revertant colonies was 150 nmol/plate, and the maximum amount of L-histidine-HCl-equivalents supplied by the enzyme preparations was 40 nmol/plate at the highest tested dose, the mutagenicity test results of the enzyme solutions cannot be explained solely by histidine or related compounds. Smokers' and non-smokers' urines, concentrated with liquid extraction (CHCl3) and adsorbent (XAD-2 and XAD-2/Sep-Pak C18) techniques, were studied to reveal differences in efficiencies to extract histidine and histidine-related compounds in the urines. Amounts of 'histidine' in concentrates of urine were measured using the bioassay method and a chemical method employing derivatization with fluorescamine. The fluorescamine method also efficiently detected 3-methyl-L-histidine, a product of muscle metabolism excreted in urine, which was found to be unable to support auxotrophic growth in TA1535, leading to exaggerated estimations of the auxotrophic growth enhancing properties of urine extracts. The urine extracts, and pure L-histidine-HCl, were tested using a two-step fluctuation test to estimate auxotrophic growth factor effects in this type of test. Because of a strong dilution effect when adding the histidine-free selection medium, the fluctuation test employed in this study was not found to be particularly sensitive to growth factors. The results of this study indicate that use of a bioassay, employing the same indicator bacteria as the mutagenicity test themselves, is a reliable way to measure histidine-related growth factors in biological samples.(ABSTRACT TRUNCATED AT 400 WORDS)     

Cardiovascular responses of heart transplant recipients to graded exercise testing.

A group of orthotopic heart transplant (OHT, n = 28) and heart surgery (n = 19) patients, with similar ejection fractions and left ventricular end-diastolic pressures, were exercised to symptom-limited maximum to describe differences in cardiovascular and gas exchange responses. Testing was performed at a mean of 3 and 6 mo after surgery, respectively (P less than 0.05). OHT patients have a greater resting systolic and diastolic blood pressure (P less than 0.01) and a significantly greater (P less than 0.01) heart rate (HR) at rest in the supine and standing positions and during minutes 2 through 7 of supine recovery. Peak treadmill time was significantly less (P less than 0.01) in OHT patients. No significant differences were found for systolic blood pressure (SBP) during recovery, peak HR, ventilation, relative O2 uptake (VO2), body weight, ventilatory equivalents for O2 and CO2, O2 pulse, and HR-SBP product (peak HR x peak SBP). Peak pulse pressure, heart rate reserve, total VO2, and absolute VO2 at ventilatory threshold were significantly lower (P less than 0.01) in the OHT patients. We concluded that 1) complete cardiac decentralization is evident, 2) the significantly reduced VO2 at ventilatory threshold should be considered when activities of daily living are prescribed, and 3) SBP response is more appropriate than HR for assessing recovery of the decentralized heart after maximal exercise.     

Standard exercise test to assess peripheral arterial disease.

The fall in ankle systolic pressure after exercise serves as an objective indicator of the severity of haemodynamically important peripheral arterial disease. Twenty-six patients were studied to establish the effects of different work loads on the pressure response and to develop a test to standardise these effects. The patients walked for one or two minutes at 4 km/h and one or two minutes at 6 km/h, and the fall in pressure was the same when measured immediately after exercise. The time taken for the pressure to return to the pre-exercise value varied. As the fall in pressure occurs after only one minute of exercise at 4 km/h on a 10% slope, this might be adopted as a standard test. It is acceptable to the patient, since claudication, angina, and shortness of breath rarely occur. It is sensitive enough to detect mild or asymptomatic disease and is useful in following up patients.     

Evaluation of a microprocessor-controlled exercise testing system

We evaluated a new exercise-testing system (Beckman Horizon MMC), incorporating a microprocessor that controls the acquisition of data, corrects for time delays, applies calibration factors, ensures quality control, and presents results in a variety of formats. Precision of measurements of ventilation (VE) and mixed expired gas concentrations was high. In steady-state exercise (n = 100) VO2 was measured with a precision (+/- SD) of 66 ml/min (4.3%), (r = 0.991); there was a small (4.62%) systematic underestimation of VCO2, but precision was comparable with VO2, with SD being 67 ml/min (4.55%) (r = 0.993). Good agreement was obtained between measurements made in progressive incremental exercise in healthy subjects with correlation coefficients of 0.997 for VE, 0.995 for VO2, and 0.994 for VCO2. Agreement in patients with cardiorespiratory disorders (n = 10) was similar, except in three patients in whom a variable pattern of breathing limited strict comparisons. Comparison with a breath-by-breath analysis system (n = 5) showed that rapid changes in VE, VCO2, and VO2 were followed accurately; the half time for a change in VO2 was not systematically different between the two systems (SD, 3.34 s, r = 0.951). The incorporation of microprocessor-controlled calibration procedures, which are simple to carry out frequently, was judged to be an important feature of this system.