Exercise physiology: health indicators and cardiovascular risk factors during childhood and adolescence

Low risk strategies use favourable levels of different behavioural and physiological parameters, which may be accepted as health indicators. High risk strategies are oriented to protect people from the potential risk levels of the same behavioural and physiological parameters. Both strategies are first applied to adults; but the established levels of risk in adults cannot be explained only by their living conditions, these factors must have some genetic and educational roots in childhood and adolescence. Based on several cross-sectional and longitudinal studies of 1652 subjects it was shown that trained and untrained adolescents did not differ in family history of CHD but clearly had different behavioural risk factors. The early identification of children and adolescents with a high risk of developing CHD should be intensified using integrated risk indicators. Thus collaboration between exercise physiology and preventive cardiology should be centered more on studies of children and adolescents.     

舞蹈训练的运动生理学和训练学探讨

文章运用运动生理学和运动训练学的理论与方法,对舞蹈训练的生理学变化规律及应遵循的训练学原则进行了初步的探讨。研究结果认为,从事舞蹈训练的教练员和演员应深入了解和学习一些必须的生理学常识和运动训练学知识,并能够根据人体生理变化的规律和运动训练学的原则科学的安排训练,这将有助于舞蹈教练员和舞蹈演员更好的进行舞蹈的创编,促进舞蹈训练向着科学的方向发展。     

Developing an employee cardiovascular fitness program

Employee fitness programs, which have become increasingly popular in industrial settings, particularly over the past decade, are now also gaining favour in the hospital environment. Whereas employers are interested in the positive relationships between physical fitness, absenteeism and work performance, employees, as a result of participation in fitness activities, enjoy a more positive outlook on life. This paper discusses several points which might be considered during the development of a fitness program for employees, such as: persuading administrators of the need; generating employee interest; pre-testing participants; and actual program planning. The organization of the program -- it frequency and duration, and the warm-up, training and cool-down periods -- is also outlined.     

Exercise physiology and its role in clinical sports medicine

Exercise physiology plays an important role in the practice of clinical sports medicine. Exercise physiology research has identified important effects of exercise on the body's systems, tissues, and cells. Ongoing research is investigating the role of exercise in subcellular, molecular, and chemical processes. Increasingly, sports medicine physicians and other practitioners are using the findings of this research to help athletes achieve peak performance, and nonathletes achieve better health through exercise. Many areas of sports medicine practice, including exercise testing, safety, performance evaluation, correction of training problems, and prevention of problems that affect specific populations (eg, older athletes, women, children), benefit from the application of exercise physiology theory and research. The continued demand for athletes at all levels to be better, faster, and stronger, combined with the national focus on getting all Americans involved in some form of physical activity, will require that sports medicine practitioners and exercise physiologists increasingly work together to optimize sports and exercise performance, health, and safety.     

Exercise training and cardiac rehabilitation in cardiovascular disease

Introduction: The aim of this review is to introduce the audience to exercise training (ET) as a therapeutic tool in coronary heart disease (CHD) and to discuss the role of and advances in cardiac rehabilitation (CR) as a means of effectively delivering ET.

Areas covered: The physiological mechanisms behind ET effects on the cardiovascular (CV) system as well as the implementation of ET in CR and the effects of CR on CV morbidity, risk factor modification, and mortality will be reviewed. Additionally, the clinical and financial impact of CR in today’s healthcare systems will be discussed.

Expert opinion: It is well-established that CR continues to be under-utilized despite significant benefits to patients and healthcare systems alike. Innovation in the structure of CR (such as the implementation of high-intensity protocols) and in accessibility (home and tele-health CR programs) is already helping improve efficacy and increase utilization of CR. However, the efficacy of home/remote delivery protocols is not well established and they comprise a minority of available CR services. More data and efforts are needed to improve such protocols and maximize the reach of remote delivery systems in order to effectively deliver CR services to more eligible individuals at lower costs.     

Coupling of metabolism and cardiovascular response represents normal physiology

In this issue of Clinical Science, Fugmann and co-workers demonstrate a highly integrated cardiovascular response to changes in plasma concentrations of glucose, triacylglycerols (triglycerides), fatty acids and insulin. Since the different substrates, alone and combined, evoked these changes, this response is likely to be a physiological one and directed towards minimizing the extent and duration of substrate elevations that could cause vascular dysfunction.     

Work and cardiovascular health: viewpoint of occupational physiology

The work-related aspects of coronary heart disease have been studied from the view-point of work physiology. The purpose of the following three studies has been to clarify how physical load at work and at leisure affects the risk of developing coronary heart disease. The first study included 120 men, mean age 41 years. They were intensively studied in the laboratory and field conditions, and were classified into four activity categories according to their work and leisure time activities. The results indicated that the highest prevalence rates of obesity, hypertension and angina pectoris symptoms were found among men doing heavy physical work and having no sporting leisure activities. The second study included a postal questionnaire to Finnish municipal employees in 1981 and 1985. Altogether 1999 women and 1419 men responded in both years. Their mean ages at the two survey times were 50.5 and 54.7 years, respectively. The 4-year incidence rates of coronary heart diseases diagnosed by the doctor (myocardial infarction, angina pectoris, coronary insufficiency, hypertension) were the highest in occupations with physical demands, both among women and especially among the men. The incidence rate of hypertension was commonest (greater than 7.0%). Among men doing physical work the incidence rate of coronary artery disease was 5.0%. The risk ratios for muscular work among men were 5.8 in the 44--49 year age group and 2.2 in the 50--58 year age group. The third project was a case-control study.(ABSTRACT TRUNCATED AT 250 WORDS)     

A new fitness test for cardiovascular epidemiology and exercise promotion

The present study suggests that the 2-km walking test is relatively simple to administer by trained instructors, it is as accurate in predicting VO2 max as most available indirect methods, and it is socially acceptable for a normal population. Thus, the test seems to provide a feasible alternative for the testing of cardiovascular fitness in epidemiological research and exercise promotion.     

Exercise treadmill test: estimating cardiovascular prognosis

Abnormal hemodynamic responses to exercise treadmill testing may indicate an increased risk of coronary events and death, even if evidence of ischemia is absent. Exercise duration and the blood pressure, heart rate, and heart rhythm responses to exercise have prognostic significance.     

Vasoactive peptides in cardiovascular (patho)physiology

Numerous vasoactive agents play an important physiological role in regulating vascular tone, reactivity and structure. In pathological conditions, alterations in the regulation of vasoactive peptides result in endothelial dysfunction, vascular remodeling and vascular inflammation, which are important processes underlying vascular damage in cardiovascular disease. Among the many vasoactive agents implicated in vascular (patho)biology, angiotensin II (Ang II), endothelin (ET), serotonin and natriuretic peptides appear to be particularly important because of their many pleiotropic actions and because they have been identified as potential therapeutic targets in cardiovascular disease. Ang II, ET-1, serotonin and natriuretic peptides mediate effects via specific receptors, which belong to the group of G-protein-coupled receptors. ET, serotonin and Ang II are primarily vasoconstrictors with growth-promoting actions, whereas natriuretic peptides, specifically atrial, brain and C-type natriuretic peptides, are vasodilators with natriuretic effects. Inhibition of vasoconstrictor actions with drugs that block peptide receptors, compounds that inhibit enzymes that generate vasoactive peptides or agents that increase levels of natriuretic peptides are potentially valuable therapeutic tools in the management of cardiovascular diseases. This review focuses on ET, natriuretic peptides and serotonin. The properties and distribution of these vasoactive agents and their receptors, mechanisms of action and implications in cardiovascular (patho)physiology will be discussed.     

Vasoactive peptides in cardiovascular (patho)physiology

Numerous vasoactive agents play an important physiological role in regulating vascular tone, reactivity and structure. In pathological conditions, alterations in the regulation of vasoactive peptides result in endothelial dysfunction, vascular remodeling and vascular inflammation, which are important processes underlying vascular damage in cardiovascular disease. Among the many vasoactive agents implicated in vascular (patho)biology, angiotensin II (Ang II), endothelin (ET), serotonin and natriuretic peptides appear to be particularly important because of their many pleiotropic actions and because they have been identified as potential therapeutic targets in cardiovascular disease. Ang II, ET-1, serotonin and natriuretic peptides mediate effects via specific receptors, which belong to the group of G-protein-coupled receptors. ET, serotonin and Ang II are primarily vasoconstrictors with growth-promoting actions, whereas natriuretic peptides, specifically atrial, brain and C-type natriuretic peptides, are vasodilators with natriuretic effects. Inhibition of vasoconstrictor actions with drugs that block peptide receptors, compounds that inhibit enzymes that generate vasoactive peptides or agents that increase levels of natriuretic peptides are potentially valuable therapeutic tools in the management of cardiovascular diseases. This review focuses on ET, natriuretic peptides and serotonin. The properties and distribution of these vasoactive agents and their receptors, mechanisms of action and implications in cardiovascular (patho)physiology will be discussed.     

Feasibility and acceptability of stepping exercise for cardiovascular fitness in women

Nurses conducting clinical research often test the feasibility and acceptability of interventions before using them in large-scale experimental studies. This article specifically reviews stepping exercise as an intervention with women. In a literature review, three stepping modes (steptreadmill, bench/step, and stepper) were compared, with the steptreadmill being identified as the most advantageous for use in experimental research. An exemplar was constructed to illustrate feasibility and acceptability of steptreadmill exercise (motorized stair climbing) in 11 women with hypertension. Steptreadmill exercise is feasible and acceptable and shows promise for use in experimental studies where strict control over the exercise performed is required.     

Exercise training for patients with cardiovascular disease.

This review surveys effort training, a validated and recommended therapy, in patients with atheromatous cardiovascular disease. This true therapy reduces mortality by 25-35%, reduces clinical manifestations and complications (rhythm problems, thrombosis) and improves physical capacity, reintegration and quality of life. The effects are essentially linked to improved metabolic performance of muscles and reduced endothelial dysfunction, insulin resistance and neurohormonal abnormalities. Training also has an impact on the evolution of major risk factors, especially diabetes and arterial hypertension. The risks are limited as long as the contraindications are respected and the programmes supervised. The indications (stable angina, chronic heart failure, peripheral arterial disease) should be described more precisely by taking into account functional criteria: physical deconditioning, exclusion, compliance, mood swings, and seriousness of risk factors. The training programme should be tailor made and based on evaluation of the patient's adaptation to effort, in terms of frequency, intensity and duration of the exercises. Various types of exercise include overall or segmental physical training; concentric, eccentric, even isokinetic muscle contraction exercises; and proprioceptive rehabilitation. However, knowledge is lacking about the molecular mechanisms of the effects of training, the most effective intensity of effort, and strategies to develop physical activity in this ever-growing population for both primary and secondary prevention.     

Exercise capacity and cardiovascular changes in patients with beta-thalassaemia major

Despite the introduction of deferoxamine, 50% of thalassaemia major patients die before the age of 35 years predominantly from iron induced heart failure. Indeed, the assessment of myocardial performance may be of particular interest since it can reveal an early myocardial dysfunction. By using impedance cardiography and mass spectrometry, we studied the cardiac function and the oxygen extraction ratio (O(2)ER) of 14 thalassaemic patients and 15 control healthy subjects during an incremental cycle-ergometer test. The achieved mechanical power output and the relative O(2) uptake did not reach any significant difference between groups. At the highest workload, O(2)ER reached significantly higher values in thalassaemic patients versus control subjects while the relationship between cardiac index (CI) and O(2)ER (CI/O(2)ER) decreased showing a lower contribution of cardiovascular system to maintain O(2) uptake. Results of this study imply that CI/O(2)ER allows an early diagnosis of the iron induced myocardial dysfunction, whereas it is not clinically patent yet. To our knowledge, this is the first study revealing an O(2)ER pivotal role as compensatory mechanism to maintain a normal working capacity in subjects suffering from thalassaemia major.