运动康复训练对冠心病多支病变患者运动耐量及血脂的影响

目的:探讨运动康复训练对冠心病多支病变患者活动耐量及血脂的影响。方法:选取冠心病多支病变患者,所有患者均进行不完全血运重建术,分为运动康复训练组及对照组,运动康复训练组自术后第三日起治疗组进行运动康复训练,对照组对运动量无要求。3月后,测量两组患者血脂水平及6分钟步行试验,比较两组患者步行距离、心绞痛发作次数、运动至心绞痛出现时间、6分钟内累积运动时间及血脂水平。结果:经运动康复训练治疗3月后,治疗组6分钟步行距离、运动至心绞痛出现时间及运动累积时间较对照组均明显增加,发生心绞痛次数较对照组明显减少。运动康复训练组治疗后甘油三酯、总胆固醇及低密度脂蛋白水平较治疗前明显降低,对照组仅总胆固醇有所降低,甘油三酯及低密度脂蛋白水平较治疗前无统计学差异。结论:运动康复训练可减少冠心病多支病变患者心绞痛发作次数,增加患者运动耐量并调节血脂代谢。     

Specificity of physiological adaptation to endurance training in distance runners and competitive walkers

The present study was designed to evaluate the specificity of physiological adaptation to extra endurance training in five female competitive walkers and six female distance runners. The mean velocity (v) during training, corresponding to 4 mM blood lactate [onset of blood lactate accumulation (OBLA)] during treadmill incremental exercise (training v was 2.86 m.s-1, SD 0.21 in walkers and 4.02 m.s-1, SD 0.11 in runners) was added to their normal training programme and was performed for 20 min, 6 days a week for 8 weeks, and was called extra training. An additional six female distance runners performed only their normal training programme every day for about 120 min at an exercise intensity equivalent to their lactate threshold (LT) (i.e. a running v of about 3.33 m.s-1). After the extra training, there were statistically significant increases in blood lactate variables (i.e. oxygen uptake (VO2) at LT, v at LT, VO2 at OBLA, v at OBLA; P less than 0.05), and running v for 3,000 m (P less than 0.01) in the running training group. In the walking training group, there were significant increases in blood lactate variables (i.e., v at LT, v at OBLA; P less than 0.05), and walking economy. In contrast, there were no significant changes in lactate variables, running v and economy in the group of runners which carried out only the normal training programme. It is suggested that the changes in blood lactate variables such as LT and OBLA played a role in improving v of both the distance runners and the competitive walkers.(ABSTRACT TRUNCATED AT 250 WORDS)     

不同康复训练频率对急性心肌梗死患者PCI术后心肺运动耐量、炎症转录因子及生活质量的影响

摘要 目的：探讨不同康复训练频率对急性心肌梗死（AMI）患者经皮冠状动脉介入（PCI）术后炎症转录因子、心肺运动耐量、生活质量的影响。方法：根据随机数字表法将长沙市第一医院2021年1月-2022年10月期间收治的92例PCI术后行康复训练的AMI患者分为A组（n=31,康复训练12次）、B组（n=31,康复训练24次）、C组（n=30,康复训练36次）。比较三组患者心功能指标[左室收缩末期内径（LVESD）、左心室射血分数（LVEF）、左室舒张末期内径（LVEDD）、运动耐力[6 min步行试验（6MWT）]、肺功能指标[第1秒用力呼气容积（FEV₁）、用力肺活量（FVC）、呼气峰值流速（PEF）]、炎症转录因子[可溶性细胞间黏附分子-1（sICAM-1）、核因子-kB（NF-kB）]及生活质量变化情况。结果：B组、C组干预后LVEF、6MWT高于A组,且C组高于B组（P<0.05）,B组、C组干预后LVESD、LVEDD小于A组,且C组小于B组（P<0.05）。B组、C组干预后FEV₁、FVC、PEF高于A组,且C组高于B组（P<0.05）。B组、C组干预后sICAM-1、NF-kB低于A组,且C组低于B组（P<0.05）。B组、C组干预后健康调查量表（SF-36）各维度评分高于A组,且C组高于B组（P<0.05）。结论：AMI患者PCI术后进行康复训练,可有效改善心肺运动耐量,降低炎症转录因子水平,提高生活质量,且随着康复训练频率的增加,患者的改善效果越好,建议临床康复训练频率应不少于36次。     

Effects of training on lactate production and removal during progressive exercise in humans.

To determine whether the reduced blood lactate concentrations [La] during submaximal exercise in humans after endurance training result from a decreased rate of lactate appearance (Ra) or an increased rate of lactate metabolic clearance (MCR), interrelationships among blood [La], lactate Ra, and lactate MCR were investigated in eight untrained men during progressive exercise before and after a 9-wk endurance training program. Radioisotope dilution measurements of L-[U-14C]lactate revealed that the slower rise in blood [La] with increasing O2 uptake (VO2) after training was due to a reduced lactate Ra at the lower work rates [VO2 less than 2.27 l/min, less than 60% maximum VO2 (VO2max); P less than 0.01]. At power outputs closer to maximum, peak lactate Ra values before (215 +/- 28 mumol.min-1.kg-1) and after training (244 +/- 12 mumol.min-1.kg-1) became similar. In contrast, submaximal (less than 75% VO2max) and peak lactate MCR values were higher after than before training (40 +/- 3 vs. 31 +/- 4 ml.min-1.kg-1, P less than 0.05). Thus the lower blood [La] values during exercise after training in this study were caused by a diminished lactate Ra at low absolute and relative work rates and an elevated MCR at higher absolute and all relative work rates during exercise.     

运动康复锻炼对冠心病经皮冠状动脉介入术后患者心肺功能及生活质量的影响

目的:探讨运动康复锻炼对冠心病经皮冠状动脉介入术(PCI)后患者心肺功能及生活质量的影响。方法:选取2016年10月-2018年4月期间我院收治的冠心病稳定性心绞痛患者80例,根据随机数字表法将患者分为对照组(n=40)和运动康复组(n=40),其中对照组给予常规康复运动,运动康复组在此基础上联合运动康复训练。比较两组患者术后12周的心肺功能指标,比较两组患者术前、术后2周、术后12周的6 min步行距离,比较两组患者术前、术后12周生活质量评分。结果:运动康复组患者术后12周峰值摄氧量、峰值通气量、峰值功率、每搏输出量、代谢当量以及摄氧效率斜率均高于对照组患者(P0.05)。两组患者术后2周、术后12周6 min步行距离均较术前增加,且运动康复组高于对照组(P0.05)。两组患者术后12周生理机能、生理职能、躯体疼痛、精神健康评分均较术前升高,且运动康复组高于对照组(P0.05);而两组患者术后12周社会功能、总体健康、精力、情感职能评分比较差异无统计学意义(P0.05)。结论:PCI术后患者给予运动康复锻炼,可显著提升患者生活质量,对患者心肺功能恢复具有较好的促进作用。     

Short-term training effects on diastolic function in obese persons with the metabolic syndrome

The aim of this study was to determine the effects of a short-term high-intensity exercise program on diastolic function and glucose tolerance in obese individuals with and without metabolic syndrome (MetSyn). Obese men and women (BMI > 30 kg/m(2); 39-60 years) with and without the MetSyn (MetSyn 13; non-MetSyn 18) underwent exercise training consisting of 10 consecutive days of treadmill walking for 1 h/day at 70-75% of peak aerobic capacity. Subjects performed pre- and post-training testing for aerobic capacity, glucose tolerance (2-h meal test), and standard echocardiography. Aerobic capacity improved for both groups (non-MetSyn 24.0 +/- 1.6 ml/kg/min vs. 25.1 +/- 1.5 ml/kg/min; MetSyn 25.2 +/- 1.8 ml/kg/min vs. 26.2 +/- 1.7 ml/kg/min, P < 0.05). Glucose area under the curve (AUC) improved in the MetSyn group (1,017 +/- 58 pmol/l/min vs. 883 +/- 75 pmol/l/min, P < 0.05) with no change for the non-MetSyn group (685 +/- 54 pmol/l/min vs. 695 +/- 70 pmol/l/min). Isovolumic relaxation time (IVRT) improved in the MetSyn group (97 +/- 6 ms vs. 80 +/- 5 ms, P < 0.05), and remained normal in the non-MetSyn group (82 +/- 6 ms vs. 86 +/- 5 ms). No changes in other diastolic parameters were observed. The overall reduction in IVRT was correlated with a decrease in diastolic blood pressure (DBP) (r = 0.45, P < 0.05), but not with changes in glucose tolerance. Body weight did not change with training in either group. A 10-day high-intensity exercise program improved diastolic function and glucose tolerance in the group with MetSyn. The reduction in IVRT in MetSyn was associated with a fall in blood pressure. These data suggest that it may be possible to reverse early parameters of diastolic dysfunction in MetSyn with a high-intensity exercise program.     

Early adaptations in blood substrates, metabolites, and hormones to prolonged exercise training in man.

This study was designed to investigate the effect of short-term, submaximal training on changes in blood substrates, metabolites, and hormonal concentrations during prolonged exercise at the same power output. Cycle training was performed daily by eight male subjects (VO2max = 53.0 +/- 2.0 mL.kg-1.min-1, mean +/- SE) for 10-12 days with each exercise session lasting for 2 h at an average intensity of 59% of VO2max. This training protocol resulted in reductions (p less than 0.05) in blood lactate concentration (mM) at 15 min (2.96 +/- 0.46 vs. 1.73 +/- 0.23), 30 min (2.92 +/- 0.46 vs. 1.70 +/- 0.22), 60 min (2.96 +/- 0.53 vs. 1.72 +/- 0.29), and 90 min (2.58 +/- 1.3 vs. 1.62 +/- 0.23) of exercise. The reduction in blood lactate was also accompanied by lower (p less than 0.05) concentrations of both ammonia and uric acid. Similarly, following training lower concentrations (p less than 0.05) were observed for blood beta-hydroxybutyrate (60 and 90 min) and serum free fatty acids (90 min). Blood glucose (15 and 30 min) and blood glycerol (30 and 60 min) were higher (p less than 0.05) following training, whereas blood alanine and pyruvate were unaffected. For the hormones insulin, glucagon, epinephrine, and norepinephrine, only epinephrine and norepinephrine were altered with training. For both of the catecholamines, the exercise-induced increase was blunted (p less than 0.05) at both 60 and 90 min. As indicated by the changes in blood lactate, ammonia, and uric acid, a depression in glycolysis and IMP formation is suggested as an early adaptive response to prolonged submaximal exercise training.     

The effect of fatigue and training status on firefighter performance

Firefighting is a strenuous occupation that requires optimal levels of physical fitness. The National Fire Protection Association suggests that firefighters should be allowed to exercise on duty to maintain adequate fitness levels. However, no research has addressed the effect of exercise-induced fatigue on subsequent fire ground performance. Therefore, the primary purpose of this study was to determine the effect that a single exercise session had on the performance of a simulated fire ground test (SFGT). Secondarily, this study sought to compare the effect of physical training status (i.e., trained vs. untrained firefighters) on the performance of an SFGT. Twelve trained (age: 31.8 ± 6.9 years; body mass index [BMI]: 27.7 ± 3.3 kg·m(-2); VO2peak: 45.6 ± 3.3 ml·kg(-1)·min(-1)) and 37 untrained (age: 31.0 ± 9.0 years; BMI: 31.3 ± 5.2 kg·m(-2); VO2peak: 40.2 ± 5.2 ml·kg(-1)·min(-1)) male career firefighters performed a baseline SFGT. The trained firefighters performed a second SFGT after an exercise session. Time to complete the SFGT, heart rate, and blood lactate were compared between baseline and exercise SFGT (EX-SFGT) conditions. In the trained firefighters, time to complete the SFGT (9.6% increase; p = 0.002) and heart rate (4.1% increase; p = 0.032) were greater during the EX-SFGT compared with baseline, with no difference in post-SFGT blood lactate (p = 0.841). The EX-SFGT time of the trained firefighters was faster than approximately 70% of the untrained firefighters' baseline SFGT time. In addition, the baseline SFGT time of the trained firefighters was faster than 81% of the untrained firefighters. This study demonstrated that on-duty exercise training reduced the work efficiency in firefighters. However, adaptations obtained through regular on-duty exercise training may limit decrements in work efficiency because of acute exercise fatigue and allow for superior work efficiency compared with not participating in a training program.     

Training increases muscle blood flow in rats with peripheral arterial insufficiency

This study investigated the effect of physical training on muscle blood flow (BF) in rats with peripheral arterial insufficiency during treadmill running. Bilateral stenosis of the femoral artery of adult rats (300-350 g) was performed to reduce exercise hyperemia in the hindlimb but not limit resting muscle BF. Rats were divided into normal sedentary, acute stenosed (stenosed 3 days before the experiment), stenosed sedentary (limited to cage activity), and stenosed trained (run on a treadmill by a progressively intense program, up to 50-60 min/day, 5 days/wk for 6-8 wk). Hindlimb BF was determined with 85Sr- and 141Ce-labeled microspheres at a low (20 m/min) and high treadmill speed (30-40 m/min depending on ability). Maximal hindlimb BF was reduced to approximately 50% normal in the acute stenosed group. Total hindlimb BF (81 +/- 5 ml.min-1.100 g-1) did not change in stenosed sedentary animals with 6-8 wk of cage activity, but a redistribution of BF occurred within the hindlimb. Two factors contributed to a higher BF to the distal limb muscle of the trained animals. A redistribution BF within the hindlimb occurred in stenosed trained animals; distal limb BF increased to approximately 80% (P less than 0.001) of the proximal tissue. In addition, an increase in total hindlimb BF with training indicates that collateral BF has been enhanced (P less than 0.025). The associated increase in oxygen delivery to the relatively ischemic muscle probably contributed to the markedly improved exercise tolerance evident in the trained animals.     

Day-to-day changes in oxygen uptake kinetics at the onset of exercise during strenuous endurance training.

The aim of this study was to assess the effect of strenuous endurance training on day-to-day changes in oxygen uptake (VO2) on-kinetics (time constant) at the onset of exercise. Four healthy men participated in strenuous training for 30 min.day-1, 6 days.week-1 for 3 weeks. The VO2 was measured breath-by-breath every day except Sunday at exercise intensities corresponding to the lactate threshold (LT) and the onset of blood lactate accumulation (OBLA) which were obtained before training. Furthermore, an incremental exercise test was performed to determine LT, OBLA and maximal oxygen uptake (VO2max) before and after the training period and every weekend. The 30-min heavy endurance training was performed on a cycle ergometer 5 days.week-1 for 3 weeks. Another six men served as the control group. After training, significant reductions of the VO2 time constant for exercise at the pretraining LT exercise intensity (P less than 0.05) and at OBLA exercise intensity (P less than 0.01) were observed, whereas the VO2 time constants in the control group did not change significantly. A high correlation between the decrease in the VO2 time constant and training day was observed in exercise at the pretraining LT exercise intensity (r = -0.76; P less than 0.001) as well as in the OBLA exercise intensity (r = -0.91; P less than 0.001). A significant reduction in the blood lactate concentration during submaximal exercise and in the heart rate on-kinetics was observed in the training group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Non-exhaustive test for aerobic capacity determination in running rats

A simple and applicable method for non-exhaustive aerobic evaluation in running rats is described. Wistar rats were submitted to running test at different velocities (10, 15, 20, 25 m/min) with 48 h recovery among them. At each velocity, the rats ran two bouts of 5 min with 2 min of rest between bouts. Blood samples were collected at the end of each bout for lactate determination. For each intensity, delta lactate was calculated and using deltas obtained by four tests, an individual linear interpolation was plotted. The y-intercept of linear interpolation was the "null delta lactate" equivalent to the critical velocity (CV). To verify the lactate stabilization at CV, the animals were submitted to 25 min of continuous exercise (15, 20, 25 m/min), with blood collection every 5 min. The estimated CV was 16.6 +/- 0.7 m/min, with significant linear regressions (R = 0.90 +/- 0.03). The rats presented maximal lactate steady state (MLSS) at 3.9 +/- 0.4 mmol/L, at 20 m/min. The CV was less than MLSS but significantly correlated with this parameter (r = 0.78). This non-exhaustive test seems to be valid for the aerobic evaluation of sedentary rats and this protocol underestimates the MLSS in 20%. This test seems to be the interesting method for the evaluation of rats submitted to acute exercise or physical training.     

Effects of residential exercise training on heart rate recovery in coronary artery patients

The aims of the present study are twofold: 1) to investigate whether heart rate recovery (HRR) after a cycle ergometry test is affected by exercise training and 2) to test the ability of HRR to replicate the baroreflex sensitivity (BRS) changes that occur in response to an exercise training program in coronary artery patients. We randomized 82 coronary artery patients undergoing a residential cardiac rehabilitation program to an exercise training group (TR; n = 43) and an untrained group (UTR; n = 39). All of the patients underwent an exercise test before and after the rehabilitation program. HRR was recorded at the end of the 1st and 2nd min after exercise. BRS was determined at rest before and after treatment. HRR after the 2nd min was significantly improved in TR patients (-21.4 +/- 0.9 beats/min) compared with UTR patients (-17.8 +/- 1.2 beats/min) at the end of the training program. Improvement in HRR paralleled that in BRS in TR patients (from 3.2 +/- 0.3 to 5.3 +/- 0.8 ms/mmHg; P < 0.001), whereas no significant change was evident in UTR patients (from 3.5 +/- 0 to 4.0 +/- 0.4 ms/mmHg; P = 0.230). Our data show that HRR in the 2nd min after the cessation of a cycle ergometer exercise test increased in coronary artery patients after an exercise training period. This result confirms the positive effect induced by exercise training on HRR and extends the conclusions of previous studies to different modalities of exercise (i.e., cycle ergometer). HRR might provide an additional simple marker of the effectiveness of physical training programs in cardiac patients.     

肺康复训练联合规律性有氧运动疗法对稳定期COPD患者心肺运动功能、生活质量和Th17/Treg细胞亚群失衡的影响

摘要 目的：观察肺康复训练联合规律性有氧运动疗法对稳定期慢性阻塞性肺疾病（COPD）患者心肺运动功能、生活质量和Th17/Treg细胞亚群失衡的影响。方法：选取2019年6月-2021年6月期间于我院接受治疗的80例稳定期COPD患者,根据随机数字表法分为观察组（40例,肺康复训练联合规律性有氧运动疗法）、对照组（40例,接受肺康复训练）,比较两组患者心肺运动功能、运动耐量、生活质量和Th17/Treg细胞亚群失衡相关指标。结果：两组干预3个月后最大分钟通气量（VEmax）、峰值摄氧量（PeakVO₂）升高,且观察组高于对照组（P<0.05）。两组干预3个月后无氧阈时二氧化碳通气当量（VE/CO₂ at AT）下降,且观察组低于对照组（P<0.05）。两组干预3个月后圣?乔治呼吸问卷（SGRQ）评分降低,且观察组低于对照组（P<0.05）。两组干预3个月后6 min步行试验（6MWT）距离、运动时间延长,且观察组长于对照组（P<0.05）。两组干预3个月后Treg含量升高,且观察组高于对照组（P<0.05）;两组干预3个月后Th17/Treg比值、Th17含量下降,且观察组低于对照组（P<0.05）。结论：肺康复训练联合规律性有氧运动疗法用于稳定期COPD患者,可改善其心肺运动功能,提高运动耐量,提高生活质量,同时还可调节Th17/Treg细胞亚群失衡。     

The effect of ”living high–training low” on physical performance in rats

In this research, we hypothesized that, in rats, adaptation to high altitude (2500 m) plus training at low altitude (610 m), ”living high–training low”, improves physical performance at low altitude more than living and training at low altitude (610 m). Rats were divided into four groups: (1) living at low altitude (LL, n=12), (2) living and training at low altitude (LLTL, n=13), (3) living at high altitude (LH, n=12), (4) living at high altitude and training at low altitude (LHTL, n=13). The program for living at high altitude involved raising rats under hypobaric hypoxia (equivalent to 2500 m), and the training program consisted of running on a tread-mill at low altitude. All groups were raised at each altitude and trained to run at 35 m/min for 40 min/day, 6 days/week for 6 weeks. During this program, we measured heart rates both at rest and during exercise, and performed running-time trials. The mean heart rate during exercise was lower in groups with training than in groups without training, and the groups receiving training could run longer than the untrained groups. The LHTL group especially showed the lowest mean heart rate during exercise and the longest running time among all groups. After 6 weeks of the training program, all rats had a catheter implanted into the carotid artery, and the mean systemic arterial pressure was continuously measured during treadmill running. The rate of increase of this pressure as the running intensity increased was lower in groups with training than in groups without training, especially in the LHTL group. Finally, we anesthetized all the rats and extracted both the right and left ventricles, and the triceps surae and liver. Training increased the weight of the left ventricle, triceps surae, and liver. The increase in weight of the left ventricle and triceps surae was higher in the LHTL group than in the LLTL group in particular. It appeared that living high– training low may be an effective strategy to improve performance ability at low altitude. Received: 16 July 1999 / Revised: 24 January 2000 / Accepted: 25 January 2000     

Effect of physical training on hemodynamic performance following myocardial infarction: a controlled study.

The effect of physical training on hemodynamic performance was evaluated in a group of patients who had had a myocardial infarction and a group of healthy, age-matched controls. Before training, the patients'' mean ventilatory equivalent was significantly less than that of the controls at the lowest workload (300 kpm/min), the mean stroke volume was significantly increased at the highest workload then achieved (600 kpm/min), and the mean arteriovenous oxygen content difference was significantly smaller at the highest workload. The patients had a relative bradycardia before training and there was no significant reduction in mean resting or submaximal heart rate after training. Their mean oxygen uptake was significantly reduced at the lowest exercise workload after training and this response was significantly different from that of the controls after 8 weeks of training. Mean cardiac output during exercise was significantly reduced in the patients after training, but only at the 600-kpm/min workload, the response being blunted at 900 kpm/min; mean stroke volume was also significantly reduced at this workload after training; both these responses were significantly different from those of the controls Mean arteriovenous oxygen content difference at 6oo kpm/min was significantly increased in the patients after training, though the response was not significantly different from that of the controls. Mean ventilatory equivalent was also significantly increased in patients after training, becoming similar to that of the controls.     

Sexual activity after myocardial infarction.

Questionnaires on sexual activity were completed by 161 patients attending an exercise-centred rehabilitation program an average of some 3 years after a myocardial infarction. In almost half the group, sexual activity was unchanged or increased compared with the period before the infarction. In the remainder it was reduced; this group included 29 men who had adopted a more passive sexual role and 26 who were now having angina or ventricular premature beats during intercourse. Although the patients with diminished activity could not be distinguished by means of formal personality test, questionnaires completed by their wives suggested that they were less willing to assume responsibility, had increased difficulty in adjusting to life at home and at work and were more neurotic and depressed than those with normal or increased activity. Furthermore, those with decreased sexual activity had a poorer response to training in terms of attendance, final average jogging distance and gains in physiologic status. Since the frequency of angina and ventricular premature beats was less during intercourse than during standard laboratory exercise, it was concluded that normal sexual relations carry no special risk for the average postcoronary patient; indeed, by enhancing self-esteem and encouraging effective participation in an exercise programm, acceptance of normal sexual activity may improve the prognosis.     

Fetal and maternal endocrine responses to exercise in the pregnant ewe

Maternal and fetal concentrations of plasma insulin, pancreatic glucagon, growth hormone (GH), corticosteroids and enteroglucagon, and of blood glucose and lactate, were measured in well-fed, late pregnant ewes before, during and after walking on a treadmill at 0.7 m.s-1, 10 degrees slope for 60 min. Exercise caused rapid and substantial increases in maternal concentrations of glucose, lactate, pancreatic glucagon and corticosteroids, smaller but significant decreases in levels of GH and enteroglucagon, and no change in insulin. With the exception of GH, concentrations of these maternal hormones had returned to pre-exercise levels within 20 min of stopping exercise. The exercise-induced maternal hyperglycaemia was associated with a proportionately similar, rapid increase in fetal blood glucose; fetal blood lactate and plasma corticosteroids also increased, but at slower rates and other fetal hormone concentrations were unchanged. During recovery there was a rapid increase in fetal insulin levels. The results are discussed in terms of the regulation of exercise-induced changes in maternal energy metabolism, and fetal metabolic and hormonal sensitivity to these changes.     

Effects of an 8-week aerobic exercise training on saliva steroid hormones, physical capacity, and quality of life in diabetic obese men

The purpose of the study was to assess the effects of aerobic exercise training on saliva steroid hormones [i.?e., cortisol, dehydroepiandrosterone (DHEA), and testosterone], physical capacity, and quality of life in obese diabetic men. 8 abdominally obese type 2 diabetic men (59.5±1.7 years old, BMI=35.5±1.6?kg/m(2), waist circumference=119.4±3.3?cm) and 9 healthy men (57.4±1.5 years old, BMI=24.5±0.8?kg/m(2), waist circumference=92.3±1.9?cm) participated in the study. The obese diabetic men underwent 8 weeks of aerobic exercise training: twice a week 45?min sessions at 75% of peak heart rate and once a week 45?min session of intermittent exercise. Before and after training, steroid hormone concentrations were analyzed from saliva samples, physical capacity was assessed by the 6-minute walking test, and quality of life was estimated by a specific questionnaire for obese subjects. These data were compared with the data from the healthy untrained men. The basal saliva DHEA and testosterone concentrations, physical capacity, and quality of life scores of the obese diabetic men were significantly lower than those of the healthy men. Aerobic training induces a significant increase in the 6-min walking distance and improve the psychosocial impact dimension of quality of life, without modifying significantly any other parameter investigated. These data suggest that an 8-week aerobic exercise program improves physical capacity and quality of life in obese diabetic men, but was insufficient to correct the anthropometric and hormonal alterations observed in this population.     

Comparison of incremental and steady state tests of endurance training

To compare the results obtained by incremental or constant work load exercises in the evaluation of endurance conditioning, a 20-week training programme was performed by 9 healthy human subjects on the bicycle ergometer for 1 h a day, 4 days a week, at 70-80% VO2max. Before and at the end of the training programme, (1) the blood lactate response to a progressive incremental exercise (18 W increments every 2nd min until exhaustion) was used to determine the aerobic and anaerobic thresholds (AeT and AnT respectively). On a different day, (2) blood lactate concentrations were measured during two sessions of constant work load exercises of 20 min duration corresponding to the relative intensities of AeT (1st session) and AnT (2nd session) levels obtained before training. A muscle biopsy was obtained from vastus lateralis at the end of these sessions to determine muscle lactate. AeT and AnT, when expressed as % VO2max, increased with training by 17% (p less than 0.01) and 9% (p less than 0.05) respectively. Constant workload exercise performed at AeT intensity was linked before training (60% VO2max) to a blood lactate steady state (4.8 +/- 1.4 mmol.l-1) whereas, after training, AeT intensity (73% VO2max) led to a blood lactate accumulation of up to 6.6 +/- 1.7 mmol.l-1 without significant modification of muscle lactate (7.6 +/- 3.1 and 8.2 +/- 2.8 mmol.kg-1 wet weight respectively). It is concluded that increase in AeT with training may reflect transient changes linked to lower early blood lactate accumulation during incremental exercise.(ABSTRACT TRUNCATED AT 250 WORDS)     

个体化精准运动为核心的整体康复方案对冠心病介入治疗术后患者整体功能再提高的临床研究*

目的: 探讨个体化精准运动为核心的整体康复方案对冠心病介入治疗术后患者整体功能再提高的作用。方法: 选择2016 年6 月至2019 年12 月间在北京康复医院临床诊断为冠心病稳定性心绞痛患者20 例,随机分为对照组（n=10）和运动组（n=10）。全部患者择期行冠状动脉介入治疗,术后对照组患者仅进行除运动康复之外的常规治疗指导;运动组患者进行12周个体化运动为核心的心脏康复,介入前、介入后2周、康复后12周分别评估患者标准化症状限制性极限运动的心肺运动试验（CPET）指标、心脏超声、6 min步行距离（6MWD）等。结果: 所有患者均安全无并发症完成症状限制性CPET,运动组患者完成12周全程运动康复治疗。组间比较显示,介入前和介入后2周,对照组和运动组患者CPET指标以及左心室射血分数、6MWD等均无明显差异（P>0.05）。康复12周后,运动组患者无氧阈（ml/min、ml/（min·kg））、峰值摄氧量（ml/（min·kg））、氧脉搏（ml/beat）和6MWD较对照组明显升高,差异有统计学意义（P<0.05）。组内比较显示,康复治疗12周后,运动组患者无氧阈（ml/min、ml/（min·kg）、%pred）、峰值摄氧量（ml/min、ml/（min·kg）、%pred）、峰值氧脉搏（ml/beat）和6MWD均较介入前明显改善,差异有统计学意义（P<0.05）;而且与介入后2周比较,无氧阈（ml/（min·kg））和峰值摄氧量（ml/（min·kg））均明显升高,差异有统计学意义（P<0.05）。对照组患者在康复12周后无氧阈（ml/min）和峰值氧脉搏（ml/beat）较介入前改善,差异有统计学意义（P<0.05）,但CPET指标与介入后2周比较无明显差异。结论: 冠状动脉介入术后进行个体化运动康复为核心的整体管理可进一步提高冠心病稳定性心绞痛患者运动心肺功能和运动耐力。运动康复是介入术后患者二级预防的重要内容,需要大量推广。