Acute effect of consumption/omission of breakfast on exercise tolerance in adolescents.

The purpose of this study was to determine the acute effects of the consumption or omission of breakfast on exercise tolerance in adolescents. Physically active adolescents (14 males and 21 females) were randomly assigned to receive a breakfast (B) or placebo (P) after an overnight fast. Exercise tolerance tests were done 1.5 hours (test 1) and again 4 hours (test 2) after consuming B or P and consisted of cycling on a stationary bike for 4 minutes at each of four consecutive power settings: 25, 50, 75, and 100 watts. Blood glucose and beta-hydroxybutyrate concentrations were measured before both tests. VO2 and VCO2 were measured during minute 3 of cycling at loads 50 and 75 watts and were used to compute the respiratory exchange ratio (RER). Heart rates (HR) were monitored throughout the test and ratings of perceived exertion (RPE) were made at the end of each 4 min interval. Repeated measures ANOVA revealed that there were no differences in RPE; however, differences for HR and RER did exist. Mean RER values were higher for the males receiving B vs males receiving P during test 1. For females, HR were higher for P compared B, and beta-hydroxybutyrate was significantly elevated for P before test 2. The data suggest that exercise tolerance as indicated by the ratings of perceived exertion are unaffected by prior ingestion of a breakfast but breakfast does affect the physiologic responses to exercise.     

Noninvasive estimation of the maximal lactate steady state in trained cyclists.

PURPOSE: The purposes of this study were to estimate noninvasively the maximal lactate steady state (MLSS) in trained cyclists on a windload simulator with a velocity based technique and to determine whether the HR at MLSS (HR(MLSS)) elicited a similar blood lactate concentration (BLC) during field testing. METHODS: To determine and verify MLSS, 10 male cyclists performed five to seven laboratory trials on separate days, including a VO2max test; a 5-km time trial (TT); and two or more 30-min trials at specific percentages of each subject's average 5-km TT speed (AVS5km). Mean+/-SD for the following variables were obtained at MLSS: velocity was 90.3+/-2.7% of the AVS5km, BLC was 5.4+/-1.6 mM, RPE was 15+/-2.1, VO2 was 80+/-6.3% of VO2max, and HR was 167+/-9.5 beats x min(-1), which was 88+/-3.8% of the mean maximum HR. Field tests included three laps of an 8-km road circuit at HR(MLSS) +/-3 beats x min(-1) and one lap at maximum sustainable velocity (a road TT). RESULTS: There were no significant differences in BLC, HR, and RPE between the three steady-state road laps and the lab MLSS trial. There was also good agreement between the road and lab MLSS velocity/TT velocity ratios. Conclusions: Our data suggest that 5-km TT cycling velocity, as measured on a windload simulator, may be used to estimate MLSS and the HR at MLSS for training purposes.     

Determinants of endurance exercise capacity in the heat in prepubertal boys

The goal of this study was to identify factors which limit exercise endurance in hot ambient conditions in prepubertal boys. Eight healthy non-acclimatized, highly physically active prepubertal boys performed steady load cycling at approximately 65 % peak VO (2) to exhaustion in both cool (19.6 +/- 0.6 degrees C, 66.4 +/- 11.0 % relative humidity) and hot (31.0 +/- 0.3 degrees C, 56.9 +/- 2.0 % relative humidity) environmental conditions. Cardiac output, oxygen uptake, rectal temperature (T (re)), rating of perceived exertion (RPE), blood pressure, and calculated arterial venous oxygen difference were obtained serially in each testing session, and percent dehydration was calculated from body weight loss. Endurance time was significantly shorter in the hot condition (29.30 +/- 6.19 minutes versus 41.38 +/- 6.30 minutes in the cool room). No significant differences in circulatory markers or hydration status were observed either during testing or between cycling thermal conditions. Rate of rise of T (re) was greater during exercise in the heat, but no significant difference in T (re) between conditions was observed at exhaustion. Mean values of RPE were consistently greater during exercise in the heat, but these differences did not reach statistical significance. These findings support the concept that rises in core temperature and/or brain perception (RPE) rather than circulatory insufficiency may be the critical factors defining limits to exercise in the heat.     

Rating of perceived exertion during high-intensity treadmill running.

PURPOSE: The purpose of this investigation was 1) to evaluate the time course of the rating of perceived exertion (RPE; 6-20 Borg scale) during short-term, high-intensity, constant-load running (ST); and 2) to determine the reproducibility of RPE during ST. METHODS: Fifteen well-trained males (VO2max = 58.0 +/- 4.6 mL x kg(-1) x min(-1), mean +/- SD) performed treadmill running (i.e., between 3 and 4 m.s-1 at 10.5% incline) to volitional exhaustion (Tlim) at an exercise intensity equivalent to 125% VO2max. A total of four RPE measurements were taken during each test, one every 30 s during the first 120 s of the exercise. The tests were repeated at the same time of day on three occasions within a 3-wk period. RESULTS: Tlim for the three tests was 197.6 +/- 34.8 s. RPE was linearly related with exercise time (mean +/- SD for the three tests: RPE at 30 s = 10.8 +/- 2.2; RPE at 60 s = 12.6 +/- 1.8; RPE at 90 s = 14.5 +/- 1.7; RPE at 120 s = 16.0 +/- 1.9; RPE = 9.06 + (0.06 x time (s)); r = 0.71, SEE = 2.0, P < 0.01). Repeated ANOVA revealed no systematic bias between the three tests for RPE, and other measures of reliability were also favorable. These included intraclass correlation coefficients ranging from 0.78 to 0.87 and sample coefficients of variation of between 4.4% and 6.0%. The 95% limits of agreement ranged between 0.0 +/- 2.3 and 0.0 +/- 2.5. CONCLUSION: ST RPE displays a positive linear response during the first 2 min. The measurement of ST RPE appears to be reliable and could thus add a new dimension to ST investigations.     

Effects of precooling on thermoregulation during subsequent exercise

PURPOSE: The purpose of this study was to examine the effect of a decreased body core temperature before a simulated portion of a triathlon (swim,15 min; bike, 45 min) and examine whether precooling could attenuate thermal strain and increase subjective exercise tolerance in a warm environment (26.6 degrees C/60% relative humidity (rh)). METHODS: Six endurance trained triathletes (28+/-2 yr, 8.2+/-1.7% body fat) completed two randomly assigned trials 1 wk apart. The precooling trial (PC) involved lowering body core temperature (-0.5 degrees C rectal temperature, Tre) in water before swimming. The control trial (CON) was identical except no precooling was performed. Water temperature and environmental conditions were maintained at 25.6 degrees C and 26.6 degrees C/60% rh, respectively, throughout all testing. RESULTS: Mean time to precool was 31+/-8 min and average time to reach baseline Tre during cycling was 9+/-7 min. Oxygen uptake (VO2), HR, skin temperature (Tsk), Tre, RPE, and thermal sensation (TS) were recorded following the swim segment and throughout cycling. No significant differences in mean body (Tb) or Tsk were noted between PC and CON, but a significant difference (P < 0.05) in Tre between treatments was noted through the early phases of cycling. No significant differences were reported in HR, VO2, RPE, TS, or sweat rate (SR) between treatments. Body heat storage (S) was negative following swimming in both PC (-92+/-6 W x m2) and CON (-66+/-9 W x m2). A greater S occurred in PC (109+/-6 W x m2) vs CON (79+/-4 W x m2) during cycling (P < 0.05). CONCLUSIONS: Precooling attenuated the rise in Tre, but this effect was transient. Therefore, precooling is not recommended before a triathlon under similar environmental conditions.     

Effects of pseudoephedrine on maximal cycling power and submaximal cycling efficiency

PURPOSE: To study the effects of a therapeutic dose of pseudoephedrine on anaerobic cycling power and aerobic cycling efficiency. METHODS: Eleven healthy moderately trained males (VO (2peak) 4.4 +/- 0.8 L x min(-1) participated in a double-blinded crossover design. Subjects underwent baseline (B) tests for anaerobic (Wingate test) and aerobic (VO (2peak) test) cycling power. Subjects ingested either 60 mg of pseudoephedrine hydrochloride (D) or a placebo (P) and, after 90 min of rest, a Wingate and a cycling efficiency test were performed. During the cycling efficiency test, heart rate (HR) and VO(2) were averaged for the last 5 min of a 10-min cycle at 40% and 60% of the peak power achieved during the VO (2peak) test. RESULTS: There were no significant differences in peak power (B = 860 +/- 154, D = 926 +/- 124, P = 908 +/- 118 W), total work (B = 20 +/- 3, D = 21 +/- 3, P = 21 +/- 3 kJ), or fatigue index (B = 39 +/- 8, D = 45 +/- 5, P = 43 +/- 5%). There were no significant differences in HR at 40% power (D = 138 +/- 10, P = 137 +/- 10 beats.min-1) or 60% power (D = 161 +/- 11, P = 160 +/- 11 beats x min(-1). There were no significant differences in cycling efficiency at 40% power (D = 18.8 +/- 1.8, P = 18.5 +/- 1.8%) or 60% power (D = 20.3 +/- 2.0, P = 20.1 +/- 2.1%). CONCLUSION: A therapeutic dose of pseudoephedrine hydrochloride does not affect anaerobic cycling performance or aerobic cycling efficiency.     

Regulating oxygen uptake during high-intensity exercise using heart rate and rating of perceived exertion

PURPOSE: The purpose of this study was to comparatively evaluate the use of heart rate (HR) or rating of perceived exertion (RPE) in eliminating the slow component of oxygen uptake (.VO2) during high-intensity aerobic exercise. METHODS: Nine sedentary males (age = 23.9 +/- 4.6 yr, height = 177.4 +/- 10.1 cm, weight = 75.28 +/- 12.95 kg) completed three 15-min submaximal exercise cycle ergometer tests based on: 1) constant power output (PO) corresponding to 75% .VO2max (PO75), 2) HR corresponding with 75% .VO2max (HR75), and 3) RPE response corresponding with 75% .VO2max (RPE75). .VO2, HR, RPE, and blood lactate concentration [La-] were measured during all tests. Data were analyzed using repeated measures analysis of variance, and post hoc means comparisons were performed using a Fisher's LSD test. RESULTS: End-exercise .VO2 was significantly higher than the respective 3-min .VO2 for the PO75 and RPE75 tests, but not the HR75 test. End-exercise .VO2 was significantly greater for the PO75 test than both the RPE75 and HR75 tests, but there was no significant difference between end-exercise .VO2 for the RPE75 and HR75 tests. End-exercise HR and RPE were significantly higher for the PO75 test than both the RPE75 and HR75 tests. There were no significant differences between the RPE75 and HR75 tests for end-exercise HR or end-exercise RPE. CONCLUSION: Results suggest using both HR and RPE are effective at reducing the slow component of .VO2 that occurs during high-intensity exercise.     

Oxygen uptake and ventilatory effects of an external nasal dilator during ergometry

INTRODUCTION: Athletes and coaches have begun to use external nasal dilators with the perception that they enhance performance and make it "easier to breathe." This study was conducted to ascertain whether application of an external nasal dilator would enhance performance, as measured by maximal oxygen uptake (VO2max), maximal ventilation (V(Emax)), maximal work rate (Wr(max)) or ratings of perceived exertion and dyspnea (RPE, RPD). METHODS: Fifteen subjects (F = 10; M = 5: age, 20+/-1.4, mean +/- SD) performed three incremental exercise tests to fatigue on an ergometer at 1-wk intervals in randomized order. One test was conducted without a nasal dilator, using a nose clip and mouthpiece for oxygen uptake and ventilatory measurements (control, C). The other two tests used a Rudolph 8900 breathing mask that included the nose in the breathing circuit and subjects wore either a placebo (P) or the active dilator (A). RPE for total body (20-point scale) and for dyspnea (10-point scale) were also measured on all tests. RESULTS: There were no significant differences in VO2max (mean +/- SD; C = 3.12+/-1.1; P = 3.12 + 1.06; A = 3.04+/-0.94). V(Emax) (C = 117+/-26; P = 125+/-31; A = 122+/-26), Wr(max) (C = 256+/-73; P = 255+/-70; A = 257+/-74), RPE (C = 18.8+/-1.78; P = 18.9+/-1.33; A = 18.9+/-1.22), or RPD (C = 9.1+/-1.58; P = 9.3+/-1.2; A = 9.13+/-1.2) during exercise between any group. CONCLUSION: Thus, it is concluded that an external nose dilator does not enhance performance as measured by VO2max, V(Emax), Wr(max), or perceived performance as measured by RPE and RPD.     

Whole-brain apparent diffusion coefficient in traumatic brain injury: correlation with Glasgow Coma Scale score

BACKGROUND AND PURPOSE: Patients with traumatic brain injury (TBI) and low Glasgow coma scale (GCS) scores may have severe injury associated with cellular disruption that can be studied with whole-brain apparent diffusion coefficient (ADC) histograms. We retrospectively studied this hypothesis and correlated ADC with GCS. METHODS: Twenty-one patients (37.81 +/- 41.3 years) with TBI were enrolled: Group A had normal MR imaging findings but low GCS scores (n = 6). Group B had brain stem injury with low GCS scores (n = 6). Group C had cortical lesions with normal GCS scores (n = 5), and group D had cortical lesions with low GCS scores (n = 4). Eleven control subjects were enrolled (32.7 +/- 19.2 years). Whole-brain ADC maps and histograms were generated and normalized for each subject. Mean and peak ADCs were determined. A one-sided t test was performed for each parameter. Average GCS scores and corresponding peak and mean ADCs were correlated. RESULTS: Peak histogram values significantly differed between controls and groups A, B, and D (P <.0019, P <.00129, and P <.0148, respectively). In groups A and D, values were significantly skewed compared with control values. Mean ADC was significantly different between the control ADC and group A (P <.013) but not group C. In each group, peak ADC and GCS score were strongly correlated (R(2) = 0.67). CONCLUSION: Whole-brain peak ADCs and GCS scores are significantly correlated in patients with TBI. Although conventional MR images were normal, ADC independently indicated TBI and better represents the degree of neurologic dysfunction.     

Ratings of perceived exertion among standard treadmill protocols and steady state running

The purpose of this study was to determine if differences exist in ratings of perceived exertion (RPE) at a predetermined relative heart rate between two standard treadmill protocols and steady state exercise in a field setting. Thirty healthy male (N = 15) and female (N = 15) volunteers were maximally tested using the standard Bruce and a modified Balke (3.0 mph with 2.5% grade each two minutes) protocols. Each subject was randomly assigned to one treadmill protocol first, and then completed the second test forty-eight hours later. Within forty-eight hours following the second treadmill test, all subjects completed a field exercise trial consisting of an 800-m run. During the field trial an investigator paced each subject to an individualized target heart rate (75% maximal heart rate reserve) calculated from the treadmill tests. The total exercise time for the field trial was 4:31 +/- 0:22 and 5:36 +/- 0:47 min for the males and females, respectively. During the last 50 m of the field trial, RPE values were recorded. Comparisons of the rating of perceived exertion at the target heart rate (RPE at THR) were made using a 2-way (Gender x Trials) ANOVA with repeated measures across trials. There was a significant gender x trials interaction for RPE at THR, with males reporting significantly higher values during the treadmill tests as compared to the females (BRUCE = 13.5 +/- 1.6 vs 12.2 +/- 1.8; BLAKE = 15.9 +/- 2.3 vs 13.7 +/- 2.4). There was no difference noted between genders for RPE at THR during the field trial.(ABSTRACT TRUNCATED AT 250 WORDS)     

Functional performance deficits in patients with CAI: validity of the multiple hop test.

OBJECTIVES: To investigate the reliability and validity of a functional performance test in patients with chronic ankle instability (CAI). DESIGN: Cross-sectional study. SETTING: All tests were conducted in the practice room of the physical therapy department of the Vrije Universiteit Brussel. PARTICIPANTS: Twenty-nine healthy subjects and 29 patients with CAI were selected. For the main outcome measurements, participants performed a multiple hop test two times, within a 1-week time interval. Subjects hopped on 10 different tape markers and had to try to avoid making any postural correction. Only when subjects stood still were they allowed to continue hopping. The time needed to complete the test and VAS scores for the perceived difficulty were assessed. RESULTS: In unstable ankles, ICCs of time values were >0.90 (SEM = 2.3 seconds); Spearman rho values of VAS scores were >0.80. When hopping on their unstable ankles, patients (41.1 +/- 12.6 seconds) needed significantly more time to complete the test than healthy subjects (31.4 +/- 5.0 seconds; test: P = 0.000; retest: P = 0.002) or when compared with their unaffected contralateral ankles (38.0 +/- 7.1 seconds; test: P = 0.047; retest: P = 0.009). Only with respect to the dominant ankles, patients (median = 64 mm) perceived the test as significantly more difficult than did healthy subjects (median = 37 mm; test: P = 0.018; retest: P = 0.002). VAS scores of unstable ankles in patients (median = 50 mm) were significantly higher than their contralateral, unaffected ankles (median = 30 mm; test: P = 0.001; retest: P = 0.002). CONCLUSIONS: The multiple hop test is a reliable test demonstrating functional performance deficits in patients with CAI.     

Influence of aerobic fitness on ratings of perceived exertion during graded and extended duration cycling

AIM: Ratings of perceived exertion (RPE) have been shown similar across subjects of varying fitness when estimations are made at relative physiological criteria. Because few studies have investigated the influence of fitness during longer duration bouts, the current investigation compared overall exertion (RPE-O), leg exertion (RPE-L) and breathing/chest exertion (RPE-C) between aerobically fit and unfit subjects. METHODS: Aerobically fit (61.6+/-2.5 mL . kg . min(-1)) (n=7) and unfit (41.8+/-6.3 mL . kg . min(-1)) (n=6) males completed a maximal bike test and then cycled for 60 min at approximately 90% of individualized ventilatory threshold (VT) (V(E)/VO(2) vs V(E)/VCO(2)). Heart rate (HR, b . min(-1)), rectal temperature (Tre, degrees C) and RPE estimations were collected during graded testing every 2 min and every 10 min during 60 min bouts. RESULTS: During graded testing, RPE estimations at VT were not significantly different between groups. During 60 min cycling, HR and Tre were not significantly different between groups. Also, there were no significant differences for HR increase (HR 60 min HR 5 min) or Tre increase (Tre 60 min Tre 5 min). Interactions between groups were; RPE-O (P=0.09), RPE-L (P=0.06) and RPE-C (P=0.19). Analyses suggest groups experienced similar relative cardiovascular (HR) and thermal (Tre) strain. CONCLUSIONS: Although RPE responses between groups were similar at 10, 20 and 30 min, RPE drift was magnified in aerobically unfit subjects (vs aerobically fit subjects) beyond the 30 min point. Contrary to previous studies suggesting aerobic fitness does not influence RPE, current results show lower aerobic fitness magnifies RPE at individualized relative intensities when cycling extends beyond 30 min.     

Effects of respiratory muscle endurance training on ventilatory and endurance performance of moderately trained cyclists

This study examined the effects of respiratory muscle endurance training (RMET) on ventilatory and endurance performance among moderately trained, male cyclists. Nine subjects initially completed two cycling VO2 max tests, two endurance cycling tests for time at 95% VO2 max, a 15-s MVV test, and an endurance breathing test for time at 100% MVV. Four subjects then underwent 3 weeks of strenuous RMET while five served as controls. Mean posttest 15-s MVV and endurance breathing time were significantly higher in the RMET group (243 +/- 14 l X min-1 and 804 +/- 94 s) than in the control group (205 +/- 6 l X min-1 and 48 +/- 8 s). No significant group differences in VO2 max or endurance cycling time at 95% VO2 max were observed following RMET. Results of this exploratory study indicated that RMET improved ventilatory power and endurance, but did not alter VO2 max or endurance cycling performance among moderately trained, male cyclists.     

Load carriage energy expenditure with and without hiking poles during inclined walking

The purpose of this study was to compare load carriage energy expenditure with and without using hiking poles. Twenty male volunteers aged 20-48yr (Mean=29.8yr) completed two randomly ordered submaximal treadmill trials with poles (E) and without poles (C). Poles and load (15 kg backpack) were fitted for each subject according to the manufacturers' suggestions. Heart rates (HR), minute ventilation (V(E)), oxygen consumption (O2), caloric expenditure (Kcal), and rating of perceived exertion (RPE) were recorded at the end of each minute. Two trials separated by one week consisted of a constant treadmill speed of 1.5 mph and 1 min at 10% grade, 2 min at 15% grade, 2 min at 20% grade, and 10 min. at 25% grade. Mean HR (E = 144.8 +/- 24.4 b x min(-1); C = 144.0 +/- 25.7 b x min(-1)) and mean V(E) (E=51.4 +/- 15.8L x min(-1); C=50.8 +/- 17.0L x min(-1)), VO2 (E = 26.9 +/- 6.1 ml x kg(-1) x min(-1); C = 27.4 +/- 6.6 ml x kg(-1) x min(-1)), and Kcal (E = 10.6 +/- 2.9 Kcal x min(-1); C = 10.8 +/- 3.1 Kcal x min(-1)) were not significantly different between the two conditions. RPE (E = 13.28 +/- 1.2; C = 14.56 +/- 1.2) was significantly lower (P < 0.05) with hiking poles. Analysis of paired time points yielded no significant differences in HR, VO2, V(E), and Kcal, however, RPE means were significantly lower for 5 of the last 7 trial minutes with the use of poles. These results suggest that during load carriage on moderate grade, the weight and use of hiking poles does not increase energy expenditure but may provide reduced perceptions of physical exertion.     

Isolated core vs. superficial cooling effects on virtual maze navigation

INTRODUCTION: Cold impairs cognitive performance and is a common occurrence in many survival situations. Altered behavior patterns due to impaired navigation abilities in cold environments are potential problems in lost-person situations. We investigated the separate effects of low core temperature and superficial cooling on a spatially demanding virtual navigation task. METHODS: There were 12 healthy men who were passively cooled via 15 degrees C water immersion to a core temperature of 36.0 degrees C, then transferred to a warm (40 degrees C) water bath to eliminate superficial shivering while completing a series of 20 virtual computer mazes. In a control condition, subjects rested in a thermoneutral (approximately 35 degrees C) bath for a time-matched period before being transferred to a warm bath for testing. Superficial cooling and distraction were achieved by whole-body immersion in 35 degree water for a time-matched period, followed by lower leg immersion in 10 degree C water for the duration of the navigational tests. RESULTS: Mean completion time and mean error scores for the mazes were not significantly different (p > 0.05) across the core cooling (16.59 +/- 11.54 s, 0.91 +/- 1.86 errors), control (15.40 +/- 8.85 s, 0.82 +/- 1.76 errors), and superficial cooling (15.19 +/- 7.80 s, 0.77 +/- 1.40 errors) conditions. DISCUSSION: Separately reducing core temperature or increasing cold sensation in the lower extremities did not influence performance on virtual computer mazes, suggesting that navigation is more resistive to cooling than other, simpler cognitive tasks. Further research is warranted to explore navigational ability at progressively lower core and skin temperatures, and in different populations.     

银质针疗法联合骶管阻滞治疗腰椎间盘突出症临床观察

目的 观察银质针疗法结合骶管阻滞治疗腰椎间盘突出症的临床疗效。方法 将60例腰椎间盘突出症患者随机分为3组,A组（n=20）采用银质针疗法,B组（n=20）采用骶管阻滞疗法,C组（n=20）采用银质针联合骶管阻滞治疗,在治疗前及治疗后1天、1周、1个月,分别采用视觉模拟评分法（VAS）进行疗效分析。结果 A、B、C 3组患者在治疗后不同时期VAS评分均低于治疗前,且C组在治疗后不同时期VAS评分均明显低于A、B组。结论 银质针疗法联合骶管阻滞能够迅速缓解疼痛,是治疗腰椎间盘突出症的有效方法。     

Pain after percutaneous liver biopsy for diffuse hepatic disease: a randomized trial comparing subcostal and intercostal approaches

PURPOSE: To compare pain levels as measured by visual analog scale (VAS) and analgesic requirement between intercostal and anterior subcostal ultrasound (US)-guided biopsy. MATERIALS AND METHODS: Seventy consecutive patients were randomized to undergo biopsy via an intercostal (n = 33) or subcostal (n = 37) approach. The groups were matched with regard to baseline characteristics: mean age, 44 years; age range, 20-70 years; sex, 43 male and 27 female; and indications of hepatitis C in 69%, hepatitis B in 16%, and others in 15%. The VAS score was obtained immediately after biopsy and hourly for 4 hours until the patients were discharged. Analgesic requirements and postprocedural complications were documented. RESULTS: No significant difference in VAS scores was seen between the groups. At hours 0, 1, 2, 3, and 4, the VAS scores (on a scale of 100) in the intercostal and subcostal groups were 10.3 +/- 16.7 versus 11.8 +/- 16.0 (P = .70), 19.1 +/- 24.0 versus 13.9 +/- 16.2 (P = .30), 11.5 +/- 14.8 versus 11.8 +/- 15.1 (P = .93), 6.2 +/- 8.9 versus 7.5 +/- 11.5 (P = .63), and 5.4 +/- 8.2 versus 4.7 +/- 8.5 (P = .72), respectively. The average VAS was less than 10. In the intercostal biopsy group, 36.4% of patients required additional analgesia after biopsy, compared with 27.0% in the subcostal biopsy group (P = .64). One patient in the intercostal group refused to have future follow-up biopsy even if it was clinically indicated, compared with no such patients in the subcostal biopsy group. No differences in diagnostic samples or major complications were seen in either group. CONCLUSION: US-guided percutaneous liver biopsy performed with fentanyl and midazolam premedication is a well-tolerated procedure with minimal patient discomfort. The location of the biopsy does not influence the outcome of the procedure.     

Acupuncture and responses of immunologic and endocrine markers during competition

INTRODUCTION: Acupuncture is used to modulate the physical well-being of athletes in Asian countries. However, there is little information on the immediate effects of acupuncture treatment on physiological or psychological responses to exercise. PURPOSE: The purpose of this study was to examine the effect of acupuncture treatment on the physical well-being of elite female soccer players during a competition period. METHODS: Subjects were divided into two groups: those who received acupuncture treatment (18.1 +/- 2.3 yr [+/-SD], N = 9) and a control group (17.7 +/- 2.8 yr, N = 12). In the treatment group, acupuncture stimulus was applied at LI 4 (Goukoku), ST 36 (Ashi-sanri) for 20 min, and ST 6 (Kyosya), LU 6 (Ko-sai) points for 15 min 4 h after the game every night during the competition period. The measured parameters included salivary secretory immunoglobulin A (SIgA) level, cortisol level in saliva, subjective rating of physical well-being, and profile of mood states (POMS). RESULTS: The following were the main results: 1). Exercise-induced decrease of salivary SIgA and increase of salivary cortisol were inhibited by acupuncture. 2). Acupuncture improved subjective rating of muscle tension and fatigue. 3). The POMS score was modulated by acupuncture. CONCLUSION: These results support the effectiveness of acupuncture for physical and mental well-being of athletes.     

Validity of the CALER and OMNI-bike ratings of perceived exertion

PURPOSE: To test the validity of the Cart and Load Effort Rating (CALER) and OMNI bike RPE scales. METHODS: Children (16 boys aged 9.5 +/- 0.7 and 16 girls aged 9.4 +/- 0.8) performed a progressive exercise test on a cycle ergometer to exhaustion. Random effects models and correlation analysis were used to determine the association of the undifferentiated perceived exertion from the CALER and OMNI bike scales with heart rate and V O2 for concurrent validity and the association of the CALER scale with the validated OMNI bike scale for construct validity. Tests of proportions were performed to compare the proportion of maximal RPE scale (CALER, OMNI bike) with the proportion of maximal heart rate achieved during the final stage of the exercise test. RESULTS: Concurrent validity of the CALER and OMNI bike scales was established, as increases in scores of both scales were associated with (P < or = 0.001 regression) increases in heart rate (r = 0.88 and 0.89) and V O2 (r = 0.92 and 0.93). Construct validity of the CALER scale was established through a significant (P < or = 0.001 regression) relationship with the OMNI bike scale (r = 0.93). The proportion of maximal CALER (75 +/- 20%) and OMNI bike (74 +/- 19%) scales were less (P < or = 0.001) than the peak percentage of the predicted maximal heart rate (94.5 +/- 3%). CONCLUSIONS: Validity for both the CALER and OMNI bike RPE scales was established for a progressively increasing exercise paradigm. However, the proportion of maximal perceived exertion scores from both scales was lower than the proportion of predicted maximal heart rate achieved during the final stage of the exercise test.