Cardiovascular responses during arm exercise and orthostatic challenge in individuals with paraplegia

In this study the cardiorespiratory responses during arm crank ergometry (ACE) performed at two submaximal intensities (30% and 50% of heart rate reserve) and moderate orthostatic challenge were investigated in individuals with paraplegia (PARA). The effect of concurrent electrical stimulation (ES)-induced leg muscle contractions on the responses to ACE during orthostatic challenge was also investigated. Eight PARA (T5–T12) and eight able-bodied (AB) individuals participated in this study, however only seven subjects from each group completed all tests and were used in subsequent data analyses. Oxygen uptake ( ), heart rate (f _c), stroke volume (SV) and cardiac output ( ) were assessed during (1) ACE alone, (2) ACE and lower body negative pressure (ACE+LBNP), and, in PARA only, (3) ACE+LBNP with ES (ACE+LBNP+ES). In both PARA and AB, ACE+LBNP decreased SV (by 13–18% and 20–23%, respectively) and increased f _c (by 13–15% and 16%, respectively) compared to ACE alone. The decrease in SV was greater in AB than in PARA (significant group × trial interaction; both ACE intensities pooled), but there was no difference in the magnitude of increase in f _c between groups. ES-induced leg muscle contractions increased SV (up to 16%) but did not change or . The smaller reduction in SV from ACE to ACE+LBNP in PARA may indicate a mechanism by which adequate central blood volume can be maintained in the face of orthostatic challenge, despite the absence of supraspinal control below the spinal cord lesion. With ES-induced leg muscle contractions, the decrease in SV, which occurred during ACE+LBNP, was reversed via reactivation of the lower limb muscle pump and augmented venous return. Electronic Publication     

Effect of arm position on the prediction of kinematics from EMG in amputees

Myoelectric control has been extensively applied in multi-function hand/wrist prostheses. The performance of this type of control is however, influenced by several practical factors that still limit its clinical applicability. One of these factors is the change in arm posture during the daily use of prostheses. In this study, we investigate the effect of arm position on the performance of a simultaneous and proportional myoelectric control algorithm, both on trans-radial amputees and able-bodied subjects. The results showed that changing arm position adversely influences the performance of the algorithm for both subject groups, but that this influence is less pronounced in amputee subjects with respect to able-bodied subjects. Thus, the impact of arm posture on myoelectric control cannot be inferred from results on able-bodied subjects and should be directly investigated in amputee subjects.     

The effect of lower body positive pressure on the cardiovascular response to exercise in sedentary and endurance-trained persons with paraplegia

Exercise intolerance in persons with paraplegia (PARAS) is thought to be secondary to insufficient venous return and a subnormal cardiac output at a given oxygen uptake. However, these issues have not been resolved fully. This study utilized lower-body positive pressure (LBPP) as an intervention during arm crank exercise in PARAS in order to examine this issue. Endurance-trained (TP, n= 7) and untrained PARAS (UP, n= 10) with complete lesions between T6 and T12, and a control group consisting of sedentary able-bodied subjects (SAB, n= 10) were tested. UP and TP subjects demonstrated a diminished cardiac output (via CO₂ rebreathing) during exercise compared to SAB subjects. Peak oxygen uptake (V˙O_2peak) remained unchanged for all groups following LBPP. LBPP resulted in a significant decrease in heart rate (HR) in UP and TP (P≤0.05), but not SAB subjects. LBPP produced an insignificant increase in cardiac output (Q˙) and stroke volume (SV). The significant decrease in HR in both PARA groups may indicate a modest hemodynamic benefit of LBPP at higher work rates where circulatory sufficiency may be most compromised. We conclude that PARAS possess a diminished cardiac output during exercise compared to the able-bodied, and LBPP fails to ameliorate significantly their exercise response irrespective of the conditioning level. These results support previous observations of a lower cardiac output during exercise in PARAS, but indicate that lower-limb blood pooling may not be a primary limitation to arm exercise in paraplegia.     

Experimental analyses of pulmonary gas exchange in a standing position at rest and during treadmill exercise

Quantitative relations between O2 uptake (Vo2), arterial-venous O2 content difference [a-v)CO2), and contact time (tc) were measured at rest and during exercise in 7 normal subjects, using a rebreathing technique. By injecting a known amount of pure O2 into a rebreathing circuit, the VO2 was measured from the time interval during which the injected O2 volume was consumed. From the O2 and CO2 concentrations in rebreathing air the gas exchange ratio (R), which was linearly related to the PCO2, was determined. By using the slope of the R-PCO2 relation, the (a-v)CO2 was evaluated from the slope of the CO2 dissociation curve between the true- and oxygenated-venous PCO2. These two venous PCO2 were estimated from the R-PCO2 relation by use of the Haldane effect coefficient and by extrapolating it to the abscissa, where R = O. Furthermore, tc was evaluated by inserting the above two venous PCO2 together with the alveolar PCO2 into a contact time equation. The mean (a-v)CO2 and tc had consistent relations to the VO2 and (a-v)CO2, respectively. (a-v)CO2 = 9.5 X VO2 0.35, (vol%), and tc = 4.86 X (a-v)CO2 -1.025, (s).     

Cardiovascular and respiratory responses to passive leg cycle exercise in people with spinal cord injuries

The purpose of this study was to determine the effect of passive leg cycle exercise (PLE) on cardiovascular and respiratory responses in people with spinal cord injuries (PSCI). Eight PSCI with lesions from T8 to L1 and five control subjects (CS) performed PLE at pedalling frequencies of 20 or 40 rpm for 7 min at room temperature of about 25°C. We measured, at rest and during PLE, the pulmonary ventilation (V_E), oxygen uptake (VO₂), cardiac output (Q), stroke volume (SV), heart rate (HR) and arterial blood pressure, as well as the skin blood flow (SBF) in the lower limb after PLE. An increase in pedalling frequency promoted an increase in V_E and VO₂ in both groups. Compared with the CS, the PSCI showed significantly smaller increases in VO₂ (P < 0.05). The Q_c was significantly elevated during PLE at 20 and 40 rpm in CS, and at 40 rpm in PSCI (P < 0.05). In CS, it resulted from increases in both SV and HR, whereas in PSCI, it was contributed to by a greater increase in SV without a rise in HR. In CS, the increase in pedalling frequency promoted the increases in SV and HR and consequently in Q_c In PSCI, however, the values remained constant irrespective of pedalling frequency. The arterial blood pressure and SBF in the lower limbs were unchanged by PLE in both groups. These results would suggest that passive leg exercise promotes venous return from the paralyzed lower limbs in PSCI.     

VE response to VCO2 during exercise is unaffected by exercise training and different exercise limbs

We designed two experiments to investigate the relationship between ventilation (VE) and CO2 output (VCO2) during exercise under the conditions of exercising different limbs, the arms as opposed to the legs (experiment 1), and of different physical training states after undergoing standard exercise training for 90 d (experiment 2). Six healthy young subjects underwent submaximal ramp exercise at an incremental work rate of 15 W/min for the arm and leg, and 11 healthy middle-aged subjects underwent an incremental exercise test at the rate of 30 W/3 min before and after exercise training. We measured pulmonary breath-by-breath VE, VCO2, oxygen uptake (VO2), tidal volume (VT), breathing frequency (bf), and end-tidal O2 and CO2 pressures (PETO2, PETCO2) via a computerized metabolic cart. In experiment 1, arm exercise produced significantly greater VE than did leg exercise at the same work rates, as well as significantly higher VO2, VCO2, and bf. The slopes of the regression lines in the VE-VCO2 relationship were not significantly different: the values were 27.8 +/- 2.1 (SD) during the arm exercise, and 25.3 +/- 3.9 during the leg exercise, with no differences in their intercepts. In experiment 2, the VO2, VCO2, and VE responses at the same work rates were similar in both before and after the 90-d exercise training, whereas the heart rate (HR) and mean blood pressure (MBP) were significantly reduced after training. Exercise training did not alter the VE-VCO2 relationship, the slope of which was 31.9 +/- 4.9 before exercise training and 34.2 +/- 4.4 after exercise training. We concluded that the VE-VCO2 relationship during exercise is unaltered, independent of not only working muscle regions but also exercise training states.     

Differences in autonomic modulation of heart rate during arm and leg exercise.

Heart rate (HR) is higher during dynamic arm exercise than during leg exercise at equal oxygen consumption levels, but the physiological background for this difference is not completely understood. The vagally mediated beat-to-beat R-R interval fluctuation decreases until the level of approximately 50% of maximal oxygen consumption during an incremental bicycle exercise, but the vagal responses to arm exercise are not well known. Changes in autonomic modulation of HR were compared during arm and leg exercise by measuring beat-to-beat R-R interval variability from a Poincaré plot normalized for the average R-R interval (SD1n), a measure of vagal activity, in 14 healthy male subjects (age 20 +/- 4 years) who performed graded bicycle and arm cranking tests until exhaustion. Seven of the subjects also performed the dynamic arm and leg tests after beta-adrenergic blockade (propranolol 0.2 mg kg-1 i.v.). More rapid reduction occurred in SD1n during the low-intensity level of dynamic arm exercise than during dynamic leg exercise without beta-blockade (e.g. 11 +/- 6 vs. 20 +/- 10 at the oxygen consumption level of 1.2 l min-1; P < 0.001) and with beta-blockade (e.g. 13 +/- 4 vs. 25 +/- 10 at the level of 1.0 l min-1; P < 0.05), and the mean HR was significantly higher during submaximal arm work than during leg work in both cases (e.g. during beta-blockade 81 +/- 12 vs. 74 +/- 6 beats min-1 at the level of 1.0 l min-1; P < 0.05). These data show that dynamic arm exercise results in more rapid withdrawal of vagal outflow than dynamic leg exercise.     

Effect of electrical stimulation of leg muscles on physiological responses during arm-cranking exercise in healthy men

The purpose of this study was to investigate the hypothesis that changes in physiological responses during arm-cranking exercise using electrical stimulation of the leg muscles (ACE-ES) compared to arm-cranking exercise alone (ACE) in able-bodied subjects (ABS) are based on an increase in active muscle mass rather than the enhancing effect of the leg muscle pump. In ABS the sympathetic nervous system induced vasoconstriction and activity of the leg muscle pump are intact, therefore, a normal redistribution of blood takes place during exercise. Consequently, ES should have no additional effect on the redistribution of blood in these ABS during exercise and, thus, changes in physiological responses will be based on an increase in active muscle mass. A group of 11 ABS performed three maximal arm-cranking tests. In the first test peak power output (PO _peak) was determined. The other tests were both submaximal and maximal ACE, once with ACE-ES and once with ACE. The PO _peak was not significantly different between ACE-ES and ACE. Oxygen uptake ( O₂) increased significantly during ACE-ES compared to ACE. Cardiac output ( ), stroke volume (SV), heart rate and ventilation were not significantly different during ACE-ES compared to ACE. Respiratory exchange ratios were significantly lower during ACE-ES compared to ACE at 60% PO _peak and at maximal exercise. In conclusion, ACE-ES caused significant increases in O₂ with a lack of elevation in and SV during submaximal and maximal exercise in ABS. The results of this study suggest that changes in physiological responses during ACE-ES are based on an increase in the active muscle mass rather than stimulation of the leg muscle pump.     

Cardiovascular responses to arm static exercise in men with thoracic spinal cord lesions

Isometric muscle contraction (static exercise) induces circulatory response. Static exercise in individuals with thoracic spinal cord injury (TSCI) induces cardiovascular response and blood redistribution to the non-exercising muscles. The aim of our study was to determine the circulatory response during arm static exercise in individuals with TSCI and able-bodied (AB) controls. Mean blood pressure (MBP), heart rate (HR), cardiac output (CO), leg skin blood flow (SBF), and leg muscle blood flow (MBF) were recorded noninvasively, total peripheral resistance (TPR) was estimated by dividing MBP by CO, and hormonal changes were measured before, during and after static 35% maximal voluntary contraction (MVC) of the arm flexor muscles in seven male individuals with TSCI (T7–T11) and seven age-comparable AB control (32.2 ± 7.6 and 31.0 ± 4.7 years, respectively). The 35% MVC was similar in TSCI and AB individuals (107.3 ± 28.2 and 101.0 ± 22.5 N, respectively). HR, CO, MBP, TPR, SBF and MBF increased in both groups during arm static exercise. Plasma epinephrine concentration increased during arm static exercise in AB controls only (P < 0.05). Circulation to leg muscles was similar in TSCI and AB individuals and the lack of sympathetic vasoconstriction in the paralyzed leg area did not alter the cardiovascular responses during 35% MVC of arm static exercise. We conclude that sympathetic vasoconstriction in the resting leg area did not contribute to the pressor reflex during 35% MVC of arm static exercise.     

The forearm and leg perfusion techniques in man do not give the same metabolic information

The present study evaluates whether forearm and leg perfusion techniques give the same metabolic information. Seven patients hospitalized for operation of uncomplicated disease were investigated pre-operatively in the fasted state, while seven other patients who were on intravenous nutrition were studied in the fed state. Blood flow and the extremity exchange of glucose, lactate, glycerol, free fatty acids and amino acids were measured simultaneously across the forearm and the leg in all individuals. In the fasted state the arteriovenous difference (a-v) of glucose uptake was statistically significant across the forearm while it was statistically insignificant across the leg (0.27 +/- 0.06 vs. -0.04 +/- 0.13 mmol l-1). The a-v differences of glycerol (0.025 +/- 0.028 vs. -0.043 +/- 0.013 mmol l-1) and free fatty acids 0.10 +/- 0.03 vs. -0.10 +/- 0.04 mmol l-1) were positive across the forearm while they were negative across the leg (P less than 0.01). In the fasted state the a-v difference of oxygen uptake (3.93 +/- 0.67 vs. 3.21 +/- 0.44 mmol l-1) and blood flow (4.1 +/- 1.0 vs. 4.0 +/- 0.7 ml min-1 100 g-1) did not differ between the arm and the leg, but the a-v difference in carbon dioxide production was significantly higher (P less than 0.05) across the forearm (2.43 +/- 0.37 vs. 1.29 +/- 0.29 mmol l-1) compared to the leg. In the fed state all the above-mentioned differences between forearm and leg became statistically insignificant. In the fed state the a-v difference of the sum of all amino acids was not significantly different from zero balance across the forearm (-146 +/- 103 mmol l-1) while there was a significant release from the leg (-175 +/- 6 mmol l-1, P less than 0.05). In the fed state the flux of the sum of all amino acids became significantly positive across the arm while it was not significantly different from zero balance across the leg. In the fed state, forearm blood flow was significantly higher than leg blood flow (6.2 +/- 0.5 vs. 4.0 +/- 0.2 ml min-1 100 g-1, P less than 0.001). The results in the present study demonstrate that the metabolic balance across regions of peripheral tissues may simultaneously differ considerably, i.e. being positive across the forearm and negative across the leg. This fact may imply that some previous claims may need reconsideration about 'peripheral tissue metabolism' associated with a certain clinical condition.     

Is the high lactate release during arm exercise due to a low training status?

To determine whether arm lactate release during arm exercise is related to the training status of the arms, seven arm-trained athletes were studied during 30 min of continuous arm exercise (AE) or leg exercise (LE) of increasing intensities corresponding to 30%, 50%, and 80% of peak VO2 during AE and LE respectively. Blood vessels were catheterized for determination of regional blood flows and substrate exchanges. The respiratory exchange ratio was higher during AE than LE (P less than 0.01). The arteriovenous oxygen difference, [(A-V)O2], for the leg during LE was 11-19% higher than the (A-V)O2 for the arm during AE (P less than 0.01). At the highest intensity the (A-V)O2 was 170 +/- 6 ml O2l-1 during LE, vs. 143 +/- 9 during AE (P less than 0.01). Arm blood flow in relation to limb volume was 56-95% higher during AE (P less than 0.05). Arterial lactate concentrations were 27-60% higher during AE (P less than 0.01) and lactate release from the exercising limb was 2-4 times higher (P less than 0.05) during AE compared to LE. Adrenaline and noradrenaline rose 6- and 21-fold, respectively, during AE and did not differ from corresponding LE values. During AE the (A-V)O2 difference across the arm, arterial lactate concentration, and arm lactate release were of the same magnitude in arm-trained and relatively less arm-trained subjects. Lactate release in relation to O2 uptake by the exercising limb was 7-37% lower during AE in arm-trained subjects compared to AE in arm-untrained subjects but was 3-6 times higher than the corresponding relation during LE (P less than 0.01). We conclude that AE is associated with a larger lactate release compared to LE. This difference is only to a minor extent influenced by intense training of the arms. The high arm vs. leg lactate release appears to be associated with differences in regional circulatory adaptation by the exercising limb.     

Physiological responses at five estimates of critical velocity

The purpose of this study was to compare critical velocity (CV) estimates from five mathematical models, and to examine the oxygen uptake (VO(2)) and heart rate (HR) responses during treadmill runs at the five estimates of CV. Ten subjects (six males and four females) performed one incremental test to determine maximal oxygen consumption (VO(2max)) and four or five randomly ordered constant-velocity trials on a treadmill for the estimation of CV. Five mathematical models were used to estimate CV for each subject including two linear, two nonlinear, and an exponential model. Up to five randomly ordered runs to exhaustion were performed by each subject at treadmill velocities that corresponded to the five CV estimates, and VO(2) and HR responses were monitored throughout each trial. The 3-parameter, nonlinear (Non-3) model produced CV estimates that were significantly (P < 0.05) less than the other four models. During runs at CV estimates, five subjects did not complete 60 min at the their estimate from the Non-3 model, nine did not complete 60 min at their estimate from the Non-2 model, and no subjects completed 60 min at any estimate from the other three models. The mean HR value (179 +/- 18 beats min(-1), HR(peak)) at the end of runs at CV using the Non-3 model was significantly less than the maximal HR (195 +/- 7 beats min(-1), HR(max)) achieved during the incremental trial to exhaustion. However, mean HR(peak) values from runs at all other CV estimates were not significantly different from HR(max). Furthermore, data indicated that mean HR(peak) values increased during runs at CV estimates from the third minute to the end of exercise for all models, and that these increases in VO(2) (range = 367-458 ml min(-1)) were significantly greater than that typically associated with O(2) drift ( approximately 200 ml min(-1)) for all but the exponential model, indicating a VO(2) slow component associated with CV estimates from four of the five models. However, the mean VO(2) values at the end of exercise during the runs at CV estimates for all five mathematical models were significantly less than the mean VO(2max) value. These results suggest that, in most cases, CV estimated from the five models does not represent a fatigueless task. In addition, the mean CV estimates from the five models varied by 18%, and four of the five mean CV estimates were within the heavy exercise domain. Therefore, CV would not represent the demarcation point between heavy and severe exercise domains.     

Allometric relations of cardiovascular function in birds

The avian cardiovascular system is interesting because birds have larger hearts and lower heart rates than mammals of the same size. This study defines how cardiovascular function is related to body size in nine species of birds encompassing a 1,000-fold size range. Heart mass (HM, g) was related to body mass (M, kg) by the following equation: HM = 8.76 M0.92, and the heart rate (HR, beats X min-1) to body mass by HR = 178.5 M-0.282. Cardiac output (Q, ml X min-1) was related to body mass as Q = 290.7 M0.69. Birds also had a greater cardiac output for a given body mass than mammals. Cardiac output was directly proportional to the rate of O2 consumption (VO2, ml X min-1): Q = 17.5 VO2(1.04), with birds having a greater cardiac output for a given VO2 than mammals. (Variables are considered directly proportional if the exponent does not differ significantly from one). As in mammals, stroke volume (SV, ml) was also directly proportional to body mass: SV = 1.72 M0.97, but for a given body size stroke volume was larger in birds than in mammals. However, as bird hearts are disproportionately large in comparison with body size, when stroke volume is expressed per gram of heart (SV = 0.177 HM1.05) birds have a significantly lower stroke volume-to-heart weight ratio than mammals.(ABSTRACT TRUNCATED AT 250 WORDS)     

Aerobic performance capacity in paraplegic subjects

Summary To determine adaptation to prolonged exercise in paraplegics, maximal O₂ uptake ( ) and lactate threshold (LT) were evaluated during an arm cranking exercise in nine patients (P) and nine able-bodied (AB) subjects.Mean averaged 25.1 and 31.6 ml · min^–1 · kg^–1 in P and AB groups respectively. in P was found to be directly related to the level of spinal injury: the higher the lesion the lower the uptake. Lactate threshold expressed as a percentage of was higher in P (59%) than in AB (43%), and close to that observed in armtrained athletes.Since training has less effect on in paraplegics than in able-bodied subjects, attributable to a deficiency in the circulatory adaptation of paraplegics to exercise, the observed differences between AB and P in lactate threshold and submaximal exercise indicate that the possible effect of training in paraplegics is located at the level of intracellular chemistry, with a diminution in glycogenolysis (higher LT) and a higher rate of lipid utilization (lower RQ).     

Conditioning and sampling issues of EMG signals in motion recognition of multifunctional myoelectric prostheses

Historically, the investigations of electromyography (EMG) pattern recognition-based classification of intentional movements for control of multifunctional prostheses have adopted the filter cut-off frequency and sampling rate that are commonly used in EMG research fields. In practical implementation of a multifunctional prosthesis control, it is desired to have a higher high-pass cut-off frequency to reduce more motion artifacts and to use a lower sampling rate to save the data processing time and memory of the prosthesis controller. However, it remains unclear whether a high high-pass cut-off frequency and a low-sampling rate still preserve sufficient neural control information for accurate classification of movements. In this study, we investigated the effects of high-pass cut-off frequency and sampling rate on accuracy in identifying 11 classes of arm and hand movements in both able-bodied subjects and arm amputees. Compared to a 5-Hz high-pass cut-off frequency, excluding the EMG components below 60 Hz decreased the average accuracy of 0.1% in classifying the 11 movements across able-bodied subjects and increased the average accuracy of 0.1 and 0.4% among the transradial (TR) and shoulder disarticulation (SD) amputees, respectively. Using a 500 Hz instead of a 1-kHz sampling rate, the average classification accuracy only dropped about 2.0% in arm amputees. The combination of sampling rate and high-pass cut-off frequency of 500 and 60 Hz only resulted in about 2.3% decrease in average accuracy for TR amputees and 0.4% decrease for SD amputees in comparison to the generally used values of 1 kHz and 5 Hz. These results suggest that the combination of sampling rate of 500 Hz and high-pass cut-off frequency of 60 Hz should be an optimal selection in EMG recordings for recognition of different arm movements without sacrificing too much of classification accuracy which can also remove most of motion artifacts and power-line interferences for improving the performance of myoelectric prosthesis control.     

Cardiac output and heart rate in man during simulated swimming while breath-holding

We measured stroke volume (SV), heart rate (HR), cardiac output (Q), arterial pressure and intrapulmonic (mouth) pressure in four healthy, male subjects during simulated swimming (i.e., performing crawl movements with the legs continuously at a constant rhythm) with and without apnea (water temperature: 31 degrees C). We wanted to see whether the exercise tachycardia response persisted, or whether the HR decreased during apnea, just as in the "diving response" of diving animals. The SV and the Q fell to half its value in the control phase (i.e., swimming with normal breathing), when the 15-s apnea was performed at a high mouth-pressure; at low mouth-pressure, SV and Q hardly changed. These results are replicates of our previous findings in man during rest in air. Due to the light work, HR increased slightly from rest, but the exercise HR did not change much during apnea with or without high mouth-pressure. The results show that man tends to preserve his exercise HR response, and does not react as an oxygen-conserving animal, whether he is in air or in water under these conditions. However, man, as well as diving animals, may well have a "diving response" as an emergency reaction, which may not be restricted to only the water environment.     

Cardiovascular responses at the onset of passive leg cycle exercise in paraplegics with spinal cord injury

The purpose of this study was to examine the cardiovascular responses at the onset of passive leg cycle exercise (PLCE) in paraplegics with spinal cord injury (PSCI) to investigate the increase in venous return from the paralyzed lower limbs during PLCE. Six male PSCI having lesions at levels ranging from T8 to L1 and five male able-bodied subjects (ABS) participated in this study. The subjects performed PLCE at pedalling frequencies of 40 rpm for 6 min. Cardiac output (Q˙ _c), stroke volume (SV) and heart rate (f _c) were measured before and during PLCE. In the steady state (4th and 5th min) of PLCE, both PSCI and ABS showed a significant increase in Q˙ _c. At the onset of PLCE, however, clear differences in the cardiovascular response were found between PSCI and ABS. The ABS showed a rapid and marked increase in f _c and consequently Q˙ _c within 20 s of the onset of PLCE. On the other hand, in PSCI, the Q˙ _c increased more slowly, compared with that in ABS, because of a smaller increase in f _c and a delayed increase in SV. The observed delay in the increases of Q˙ _c and SV at the onset of PLCE in PSCI was presumably due to the absence of afferent reflexes from the lower limbs, and to the additional time needed for venous return to arrive at the heart from the passively moved muscles. Accepted: 23 September 1999     

Effect of arm-cranking on leg blood flow and noradrenaline spillover during leg exercise in man.

Controversy exists whether recruitment of a large muscle mass in dynamic exercise may outstrip the pumping capacity of the heart and require neurogenic vasoconstriction in exercising muscle to prevent a fall in arterial blood pressure. To elucidate this question, seven healthy young men cycled for 70 minutes at a work load of 55-60% VO2max. At 30 to 50 minutes, arm cranking was added and total work load increased to (mean +/- SE) 82 +/- 4% of VO2max. During leg exercise, leg blood flow average 6.15 +/- .511 minutes-1, mean arterial blood pressure 137 +/- 4 mmHg and leg conductance 42.3 +/- 2.2 ml minutes-1 mmHg-1. When arm cranking was added to leg cycling, leg blood flow did not change significantly, mean arterial blood pressure increased transiently to 147 +/- 5 mmHg and leg vascular conductance decreased transiently to 33.5 +/- 3.1 ml minutes-1 mmHg-1. Furthermore, arm cranking doubled leg noradrenaline spillover. When arm cranking was discontinued and leg cycling continued, leg blood flow was unchanged but mean arterial blood pressure decreased to values significantly below those measured in the first leg exercise period. Furthermore, leg vascular conductance increased transiently, and noradrenaline spillover decreased towards values measured during the first leg exercise period. It is concluded that addition of arm cranking to leg cycling increases leg noradrenaline spillover and decreases leg vascular conductance but leg blood flow remains unchanged because of a simultaneous increase in mean arterial blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)     

Physical fitness in aging men

Of 56 middle-aged male joggers (mean age 43.3 yr), 38 were measured for maximal oxygen uptake (VO2max) and 18 for cardiac output at a heart rate of 170 bpm (Q170). Each Q170 was divided by subject body surface area to yield cardiac index (CI170). A treadmill protocol was used to elicit maximal exercise during measurement of VO2max. The bicycle ergometer was employed when measuring Q170. For maximal exercise, termination was upon subject-declared fatigue. In subjects measured for VO2max, heart rate at 3.5 miles/h and 5% treadmill grade (HRsubmax) as well as heart rate at maximal exercise (HRmax) were noted. Heart rates were monitored electrocardiographically. A modified Douglas bag technique was applied when sampling expired air for determination of VO2max. Carbon dioxide rebreathing was used to estimate Q170. Data were grouped according to age (43 yr and older; 42 yr and younger). There were significant (P less than 0.05) positive relationships between VO2max and HRmax and between HRsubmax and age. Significant negative relationships existed between HRmax and HRsubmax, and between CI170 and 10 km running time. There were no significant differences (P greater than 0.05) between means achieved by the age groups. The overall mean for VO2max was 43.36 ml/kg per min and for Q170 33.53 1/min. Findings suggest that men who remain physically active retain youthful characteristics of cardiorespiratory function.     

Cardiovascular responses to an orthostatic challenge and electrical-stimulation-induced leg muscle contractions in individuals with paraplegia

The purpose of this study was to investigate the cardiovascular and haemodynamic responses that occur during moderate orthostatic challenge in people with paraplegia, and the effect of electrical stimulation (ES)-induced leg muscle contractions on their responses to orthostatic challenge. Eight males with complete spinal lesions between the 5th and 12th thoracic vertebrae (PARA) and eight able-bodied individuals (AB) volunteered for this study. Changes in heart rate (f _c), stroke volume (SV), cardiac output (Q˙ _c), mean arterial pressure (MAP), total peripheral resistance (TPR), limb volumes and indices of neural modulation of f _c, [parasympathetic (PNS) and sympathetic (SNS) nervous system indicators] were assessed during: (1) supine rest (REST), (2) REST with lower-body negative pressure at ?30 torr (LBNP ?30, where 1 torr?=?133.32?N/m²), and (3) for PARA only, LBNP ?30 with ES-induced leg muscle contractions (LBNP?+?ES). LBNP ?30 elicited a decrease in SV (by 23% and 22%), Q˙ _c (by 15% and 18%) and the PNS indicator, but an increase in f _c (by 10% and 9%), TPR (by 23% and 17%) and calf volume (by 1.51% and 4.04%) in both PARA and AB subjects, respectively. The SNS indicator was increased in the AB group only. Compared to LBNP ?30, LBNP?+?ES increased SV (by 20%) and Q˙ _c (by 16%), and decreased TPR (by 12%) in the PARA group. MAP was unchanged from REST during all trials, for both groups. The orthostatic challenge induced by LBNP ?30 elicited similar cardiovascular adaptations in PARA and AB subjects. ES-induced muscle contractions during LBNP ?30 augmented the cardiovascular responses exhibited by the PARA group, probably via reactivation of the skeletal muscle pump and improved venous return.