"I think the Excalibur sport is a fantastic tool to assess athletes performance."
During the year we test our riders on the Excalibur to determine the different training intensities which elect the specific and desired training effects.
With this top level ergometer we are sure we deliver the right power to the athletes. We have the version with the pedal force measurements and length adjustable cranks. With the continuously variable adjustable seat and handlebar position all our riders fit perfect on the ergometer.
During the testing we measure the pedal forces to analyse the left and right balance and their cycling technique with the software that comes with the ergometer.
This gives us the possibility to advise the riders how to position the non circular chainring if they use it.
Just perfect!
"Lode ECST with Angio is indispensable, enabling observation of cardiac wall motion under stress"
With recent advances in ultrasound systems, extremely clear and precise images of cardiac wall motion under normal physiological conditions have become available to us. However, observation of left ventricular wall motion is still impossible in patients walking on a treadmill or pedaling on an ergometer.
With the use of the Lode Echo Cardiac Stress Table with Angio ergometer, left ventricular wall motion can be consistently observed before, during, and after stress testing, with the patient in the supine position and in no danger of falling.
The table can be tilted to the left, and the back support corresponding to the left side of the chest can be removed, which enables the acquisition of clearer images of the left ventricular wall, thus providing data essential for determining “correct diagnosis and treatment” and “prognosis and plan for future treatment”.
Therefore, the Lode Echo Cardiac Stress Table with Angio ergometer has become one of the most important stress testing devices for us.
"We count on the reliability of our Excalibur Sport Ergometer"
In our testing labs we test a range of participants from those with various risk factors for disease as well performing nutrition and performance studies in athletes.
In order to fulfill our busy lab schedule we count on the reliability of our Excalibur Sport Ergometer and customized Valiant Treadmill that was custom built to my specifications.
The staff at Lode of been very helpful in fine tuning our treadmill to the exact specifications I required.
By using an extra wide and extra long treadmill belt that accommodates speeds ranging from 0.0 to 40 kmh in 0.1 kmh increments, uphill grades to 25% and a downhill grade of 10%, coupled with the Excalibur, I am confident that we can accommodate testing across all spectrums of research participants that visit our facilities.
"We rely on Lode Corival"
It is very easy and convenient to use Lode ergometer. We perform plenty of stresstests for patients with suspected cardiovascular pathologies every day.
We rely on Lode Corival ergometer, which is very stable and performs its function at its best.
".... Lode ergometers are very reliable and are a good investment for many years...."
We have a long standing positive experience with the Lode equipment. When I started working as a PhD student at the Wilhelmina Children’s Hospital 15 years age, we used a Lode Examiner ergometer. Because we were satisfied with the quality and sustainability of the Lode equipment, we obtained a pediatric Corrival to replace the old Examiner ergometer.
Currently we have several Lode ergometers in our laboratory, including the Lode Corival, pediatric Corival, Corival pediatric, Angio arm ergometer, and the Angio Echo Cardiac Stress Table including the LEM software. We are using the ergometers for both our clinical care as well as scientific research for patients in the age range of 4 to 80 years.
It is our experience that the Lode ergometers are very reliable and are a good investment for many years.
"With the Corival we could determine the exercise capacity of people with a lower limb amputation"
Measuring people with a lower limb amputation is a challenge. However, an exercise test can provide the clinician with useful information about the exercise capacity and cardiac health of the patient. We determined the feasibility and validity of a one-legged exercise test using the Lode Corival ergometer. By using an adapted protocol and the Lode ergometer a valid and safe determination of the exercise capacity of people with a lower limb amputation can be obtained. Because the ergometer can be controlled using a computer which simultaneously can measuring ECG and blood pressure, the patient can be continuously monitored and alteration in the cardiac condition can be anticipated upon.
"During clinical exercise testing, we rely on the bicycle ergometers of Lode"
Maximal cardio pulmonary exercise testing is a proven clinically useful test when gas exchange parameters and cardio-circulatory parameters are related to (maximal) exercise tolerance. Therefore a reliable ergometer simply connectable to a metabolic chart is of great importance. In our clinic we use a.o. the Corival (ideal for children) in the function lab and the MRI Ergometer Pedal for supine position measurements during Magnetic resonance imaging from Lode BV.
"We would definitely recommend the Excalbur Sport and LEM software"
For the research conducted in the PhD thesis: “pacing strategies during exercise in the heat” we frequently made use of the Lode Excalibur Sport Cycle ergometer. We examined the effect of several thermal signals on pacing patterns in the heat. Pacing pattern was represented by changes in cycling power output. With the Lode Excalibur Sport we were able to determine the (changes in) power output very accurately. Moreover, analyzing the power output data was very easy with the Lode Ergometry Manager software. We never experienced problems with the ergometer or the software and would definitely recommend it to other researchers who are looking for state of the art ergometers. The ergometer is suitable for elite athletes and for patient populations because of its highly reliable recordings in the low and high power output range.
"Children performed a maximal exercise test and a Wingate test on the Lode Corival ergometer"
Within the Learn 2 Move research project the level of physical fitness of children with cerebral palsy in the age of 7-12 years was investigated. In order to investigate the level of physical fitness the children performed a maximal exercise test and a Wingate test on the Lode Corival ergometer. The LEM software was used to perform the Wingate test. The adjustable cranks enabled adjustment of the crank length for each child. The results showed that physical fitness is decreased in children with cerebral palsy. Therefore, we have implemented these tests, with use of the Lode ergometer and LEM software, in clinical care.
"Lode ergometers are very reliable for clinical care and research purposes."
The Godfrey protocol for maximal bicycle exercise testing and the Steep Ramp test protocol for VO2peak verification were performed on an electronically braked cycle ergometer (Lode Corival, Groningen, The Netherlands). It is our experience that the Lode ergometers are very reliable for clinical care and research purposes.
"I think CMAX is one of the best tools for motion and gait analysis measurement"
Upgrading of our gait laboratory provides an extraordinary atmosphere in our lab. The old gait lab condition from complexity turns into simplicity. All measurement and analysis became user friendly.
Gait problem is our concern to help patient reach better quality of life. Gait pathology can be analyzed using CMAX. By using this software we can assess gait deviations through the ground reaction force and kinematic changes.
Analysis of the ground reaction force and kinematic will determine the appropriate prescription for the patient ; and revisions to the orthoses and prostheses will be easier with accurate measurement.
"Easy to use software, nice people who share their knowledge and expertise in gaining data."
Difference in muscle activity in walking overground vs walking on a treadmill
In many private physical therapy practices and rehab centers treadmills are available for treatment and research. Due to the limited space using a treadmill for gait analysis is a big advantage . This allows clinicians to test long distances in relative small spaces without turning. It’s still unclear what the similarities and differences are in muscle activation between walking overground and treadmill walking. This makes it unclear if it’s possible to use a treadmill for gait analysis in order to analyse muscle activation patterns, especially on the level of central neurological control. Is the muscle activity and the intensity and duration of the muscle contraction during overground walking comparable with treadmill walking?
Results
After a habituation period of ten minutes there still are some small, but significant differences in muscle activity.
"The Lode Excalibur Sport Cycle Ergometers were ideal equipment "
Intensified training can result in short-term fatigue and subsequent supercompensation of the physiological systems. However, imbalanced (exercise-induced) stress and recovery results in (functional) overreaching, characterized by temporally decreased performance capacity and other possible symptoms such as mood disturbances. In my PhD thesis entitled ‘On the physiological and psychological differences between functional overreaching and acute fatigue’ I investigated methods and markers to distinguish between acute fatigue and functional overreaching. Since a decrease in performance is one of the main characteristics of overreaching, we used Lode Excalibur Sport Cycle Ergometers to determine longitudinal changes in cycling performance with greatest precision. The Lode Excalibur Sport Cycle Ergometers were ideal equipment to distinguish between subjects that maintained their physical performance capacity after a period of intensified training, and subjects whose performance capacity decreased.
"The Lode Excalibur Sport and LEM software are easy to use and very reliable"
I used the Lode Excalibur Sport ergometer and the LEM software during my PhD research into the ergogenic effects of dietary nitrate. The lode Excalibur allowed me to assess the effects of dietary nitrate supplementation under various conditions, including steady state cycling and during a simulated cycling time trial. I also used the Lode Excalibur Sport cycling ergometer to assess the exercise capacity of elite cyclist from the National Rwandan Cycling Team during their European Tour. The accompanying LEM software was very easy to use and provided me with real-time data, as well as the possibility to export and process the saved data following the experimental trials. Based on these experiences, I can hardly imagine performing a laboratory based cycling experiment without the use of the Lode Excalibur Sport ergometer and the LEM software.
"The Lode Esseda opens up new possibilities"
One of the main conclusions of my PhD thesis entitled ‘Understanding the motor learning process in handrim wheelchair propulsion’ was that there is a need for new technology to be implemented globally in order to be able to closely monitor the motor learning process of wheelchair propulsion in the context of rehabilitation and beyond. Methods used do far were very time consuming which affected the experience of the patients and made clinical implementation of the lengthy protocols difficult. Implementation of wheelchair propulsion laboratories was proposed as a possible solution to this. The available technology, specifically Lode Esseda wheelchair ergometer in combination with portable sensors, opens up new possibilities to build an efficient multi-center network of wheelchair propulsion laboratories to assist clinicians in providing individualized diagnosis, therapy and wheelchair fitting and to provide a rich source of data from standardized protocols to the research community.
"Lode products are easy to work with"
In our research we used a bicycle ergometer and a treadmill to let people perform cycling and walking activities. These activities were measured with an activity monitor. To validate the activity monitor we recorded the activities also on video and later on compared the data of the activity monitor with the video reference data. The results of the study showed that the activity monitor was able to distinguish upright activities from lying/sitting and cycling. Although the difference between lying/sitting and cycling was sometimes hard to detect, because of slow speed of cycling. In this research it was nice that the bicycle ergometer and treadmill were easy to use and no difficult programming or specific knowledge was needed to get the devices started. Students could help to do the measurements without any problems.
Title: ‘The Accuracy of the Detection of Body Postures and Movements Using a Physical Activity Monitor in People after a Stroke.’
"The use of the Corival cpet was very pleasant"
Exercise electrocardiography in athletes; diagnostic accuracy and pathophysiological background
This thesis gives insight in the value of exercise testing used during pre-participation screening in asymptomatic athletes. Exercise testing is commonly used to detect coronary heart disease. This thesis shows that exercise testing combined with analysis of inspiratory and expiratory breath gasses increased the accuracy of exercise testing to detect any form of dysfunction of the heart. The athletes with abnormal test results were referred to the department of Cardiology for further diagnostic evaluation. The majority of these athletes didn’t show any signs of coronary heart disease. In order to explain the abnormal exercise test results, the geometry of the heart of the athletes was evaluated. Athletes with abnormal exercise test results did not shown the typical signs of the so-called athlete’s heart. However, the function of the smallest arteries (microcirculation) of athletes was attenuated. Therefore, it can be hypothesized that at least a part of the athletes with abnormal exercise test results without obstructive coronary heart disease show signs of premature coronary heart disease together with an attenuated microvascular function. These athletes could be at risk for the development of exercise-induced myocardial ischemia and subsequently for the development of a myocardial infarction and/or sudden cardiac death. Therefore, the findings of this thesis may have important clinical implications for athletes with abnormal test results without obstructive coronary heart disease, as a new potential substrate for the occurrence of sudden cardiac death in athletes is identified.
"We can now also use Lode equipment for the vulnerable hospital and intensive care patients"
Evidence shows that early rehabilitation in critically ill patients is effective, but the optimal training load is unknown. Critically ill patients are extremely vulnerable with a very low exercise capacity and a first important step towards identifying the most optimal training load, is to evaluate the acute response to exercise at different intensities. Given the very low exercise capacities of this extremely vulnerable population, the pertinent question is, whether it is possible to make a clear distinction between different relative exercise intensities, based on the physiological response.
The goal of the current study is to describe the physiological response of
critically ill patients to exercise at different, relative intensities (i.e. low and high) as
determined from maximal exercise testing. Given the very low exercise capacities of this extremely vulnerable population, the question is, whether it is possible to make a
clear distinction between different relative exercise intensities, based on the physiological response. This information is crucial for identifying the most optimal training dose.
"Lode Valiant Treadmill and LEM software easy to use in a research setting"
In our research, 356 healthy children between 6 and 18 years of age performed the Fitkids Treadmill Test (FTT) on the Lode Valiant Treadmill to describe age- and sex-related reference values for FTT performance. A small group of children performed to FTT twice in two weeks and another small group performed both the FTT and the Bruce protocol in two weeks in order to gain insight in the validity and the reproducibility of the FTT. It is our experience that the Lode Valiant Treadmill is very reliable and the LEM software is easy to use. The results showed that the FTT is a valid and reliable maximal exercise test in heathy children. The reference values provided can be used by physical therapists to adequately interpret FTT performance.
"We rely on the Lode Corival during clinical rehab, systematic evaluation and scientific research"
Pediatric burns generally affect exercise capacity. This is mainly due to the bodily response to burns (profound and sustained stress response, increase in resting metabolism, muscle wasting), but also due to the relatively long periods of bed rest and inactivity during hospitalization.
In order to better determine the rehabilitation needs of pediatric burn patients beyond discharge from the burn center, we aimed to gain insight in the course of exercise capacity during the initial six months after discharge.
Exercise capacity was assessed on a Lode Corival Bicycle ergometer, using the Steep Ramp Test protocol that was manually entered in the Lode Ergometry Manager software. Results showed that half of the children achieved healthy levels of exercise capacity within six months, while the other half did. The latter children were considered ‘at risk’ for diminished functioning and adverse (long-term) health outcomes, providing a call for additional rehabilitation attention.
Remarkably, burn severity did not predict the recovery of exercise capacity in our study population. Instead, preliminary results showed that early assessment of exercise capacity with the Steep Ramp Test can help to identify those who will need additional rehabilitation support beyond discharge. Therefore, the Steep Ramp Test, performed on the Lode Corival Bicycle ergometer using the LEM software, will soon be part of standard care. The three Dutch burn centers will start to systematically monitor exercise capacity in children and adolescents after discharge. Children who score low on the Steep Ramp Test six weeks after discharge will receive additional rehabilitation support.
2012-07-19
Title journalRelative degree of stimulation-evoked glycogen degradation in muscle fibres of different type in rat gastrocnemius.
SourceThe Journal of physiology
1. The relative degree of glycogen degradation, caused in different fibre types by supramaximal electrical activation of the muscle nerve, was investigated in m. gastrocnemius medialis of young adult rats under general pentobarbitone anaesthesia. Four different protocols of intermittent maximal tetanic activation were used, each lasting 6 s (33% duty cycle; fast and slow isovelocity concentric (shortening) contractions, brief- and long-burst isometric contractions; 6 rats per group). All contractions were evoked under ischaemic conditions. 2. Work output finally dropped to 29% of the initial value for the fast concentric and to 87% for the slow concentric contractions. In isometric protocols evoked by the same stimulation patterns, the force x time area rose to 110% for brief-burst contractions and dropped to 95% for the long-burst contractions. 3. Following the physiological procedures, the experimental muscle and its contralateral control were removed and prepared for histochemical analysis. Serial sections were stained for glycogen (periodic acid-Schiff (PAS) method) and myofibrillar ATPase (mATPase), the latter reactions being used for classifying the fibres as types I, IIA, IIBd and IIBm. 4. For deep 'red' regions of non-stimulated contralateral control muscles the optical density of PAS staining was ranked between fibre types such that I < IIA < IIBd < IIBm. In superficial 'white' regions of the same muscles, no significant difference in PAS staining density was found between IIBd and IIBm fibres (types I and IIA not present). 5. All contractile protocols produced a significant glycogen degradation in IIBm fibres, and the fast concentric activation procedure was associated with a significant decline of PAS staining in all fibre types. For all activation protocols, the relative degree of glycogen degradation within a given region was ranked such that IIBm > IIBd > IIA > I. For IIBm vs. IIBd fibres, the differences in relative degradation were greater and more consistently significant for superficial white regions than in the deeper red muscle portions. 6. The results are discussed in relation to glycogen degradation measurements in studies of motor unit recruitment. Furthermore, the results from red vs. white muscle regions underline that fibres of seemingly the same mATPase type may differ considerably in other properties.
Related products2012-07-19
Title journalThe effects of replacing a portion of endurance training by explosive strength training on performance in trained cyclists.
SourceEuropean Journal of Applied Physiology
To investigate the effects of replacing a portion of endurance training by strength training on exercise performance, 14 competitive cyclists were divided into an experimental (E; n = 6) and a control (C; n = 8) group. Both groups received a training program of 9 weeks. The total training volume for both groups was the same [E: 8.8 (1.1) h/week; C: 8.9 (1.7) h/week], but 37% of training for E consisted of explosive-type strength training, whilst C received endurance training only. Simulated time trial performance (TT), short-term performance (STP), maximal workload (Wmax) and gross (GE) and delta efficiency (DE) were measured before, after 4 weeks and at the end of the training program (9 weeks). No significant group-by-training effects for the markers of endurance performance (TT and Wmax) were found after 9 weeks, although after 4 weeks, these markers had only increased (P < 0.05) in E. STP decreased (P < 0.05) in C, whereas no changes were observed in E. For DE, a significant group-by-training interaction (P < 0.05) was found, and for GE the group-by-training interaction was not significant. It is concluded that replacing a portion of endurance training by explosive strength training prevents a decrease in STP without compromising gains in endurance performance of trained cyclists.
Related products2002-01-01
Title journalHigh Performance Cycling - Chapter 18.
SourceHuman Kinetics
Strength and Flexibility.
Related products2007-08-01
Title journalA new ultrasonographic technique for diagnosing deep venous insufficiency--imaging and functional evaluation of venous valves by ultrasonography with improved resolution
SourceInt J Cardiovasc Imaging. 2007 Aug;23(4):493-500. Epub 2006 Nov 4.
Abstract
This is to demonstrate a new 2D-ultrasonographic technique which enabled clear resolution of deformed valves, visualization of venous reflux and quantitation of valve incompetence. In a 59-year-old Japanese female patient, ultrasonography was done using Aplio, Toshiba Medical Systems Co., Japan, equipped with 8 MHz linear probe capable of differential tissue harmonic imaging to diagnose the cause of her leg edema. Venous ultrasonography using this device at the popliteal venous valve in this patient demonstrated clear view of deformed venous valve and valve separation at one end of valvular agger while the other part of the valve is closed. Color Doppler failed to show venous reflux due to its low velocity. However, the appearance and disappearance of a thrombus-like echo could be imaged using 2D-ultrasonography. In addition, we were able to demonstrate the time-course change of valve opening and closing, and quantitate the valve incompetence using M-mode ultrasonography.
2012-06-14
Title journalTowards an individualized protocol for workload increments in cardiopulmonary exercise testing in children and adolescents with cystic fibrosis.
SourceJ Cyst Fibros. 2012
BACKGROUND:
There is no single optimal exercise testing protocol for children and adolescents with cystic fibrosis (CF) that differs widely in age and disease status. The aim of this study was to develop a CF-specific, individualized approach to determine workload increments for a cycle ergometry testing protocol.
METHODS:
A total of 409 assessments consisting of maximal exercise data, anthropometric parameters, and lung function measures from 160 children and adolescents with CF were examined. 90% of the database was analyzed with backward linear regression with peak workload (W(peak)) as the dependent variable. Afterwards, we [1] used the remaining 10% of the database (model validation group) to validate the model's capacity to predict W(peak) and [2] validated the protocol's ability to provide a maximal effort within a 10±2minute time frame in 14 adolescents with CF who were tested using this new protocol (protocol validation group).
RESULTS:
No significant differences were seen in W(peak) and predicted W(peak) in the model validation group or in the protocol validation group. Eight of 14 adolescents with CF in the protocol validation group performed a maximal effort, and seven of them terminated the test within the 10±2minute time frame. Backward linear regression analysis resulted in the following equation: W(peak) (W)=-142.865+2.998×Age (years)-19.206×Sex (0=male; 1=female)+1.328×Height (cm)+23.362×FEV(1) (L) (R=.89; R(2)=.79; SEE=21). Bland-Altman analysis showed no systematic bias between the actual and predicted W(peak).
CONCLUSION:
We developed a CF-specific linear regression model to predict peak workload based on standard measures of anthropometry and FEV(1), which could be used to calculate individualized workload increments for a cycle ergometry testing protocol.
2012-02-14
Title journalExercise capacity in children with isolated congenital complete atrioventricularblock: does pacing make a difference?
SourcePediatr Cardiol. 2012;33(4):576-85.
Abstract
The management of patients with isolated congenital complete atrioventricular block (CCAVB) has changed during the last decades. The current policy is to pace the majority of patients based on a variety of criteria, among which is limited exercise capacity. Data regarding exercise capacity in this population stems from previous publications reporting small case series of unpaced patients. Therefore, we have investigated the exercise capacity of a group of contemporary children with CCAVB. Sixteen children (mean age 11.5 ± 4; seven boys, nine girls) with CCAVB were tested. In 13 patients, a median number of three pacemakers were implanted, whereas in three patients no pacemaker was given. All patients had an echocardiogram and completed a cardiopulmonary cycle exercise test. Exercise parameters were determined and compared with reference values obtained from healthy Dutch peers. The peak oxygen uptake/body mass was reduced to 34.4 ± 9.5 ml kg(-1) min(-1) (79 ± 24% of predicted) and the ventilatory threshold was reduced to 52 ± 17% of peak oxygen uptake (78 ± 21% of predicted), whereas the peak work load/body mass was 2.8 ± 0.6 W/kg (91 ± 24% of predicted), which was similar to controls. Importantly, 25% of the paced patients showed upper rate restriction by the pacemaker. In conclusion, children with CCAVB show a reduced peak oxygen uptake and ventilatory threshold, whereas they show normal peak work rates. This indicates that they generate more energy during exercise from anaerobic energy sources. Paced children with CCAVB do not perform better than unpaced children.
2012-02-01
Title journalValidity of the oxygen uptake efficiency slope in children with cystic fibrosis and mild-to-moderate airflow obstruction.
SourcePediatr Exerc Sci. 2012;24(1):129-41.
Abstract
PURPOSE:
The oxygen uptake efficiency slope (OUES) has been proposed as an 'effort-independent' measure of cardiopulmonary exercise capacity, which could be used as an alternative measurement for peak oxygen uptake (VO(2peak)) in populations unable or unwilling to perform maximal exercise. The aim of the current study was to investigate the validity of the OUES in children with cystic fibrosis (CF).
METHODS:
Exercise data of 22 children with CF and mild to moderate airflow obstruction were analyzed and compared with exercise data of 22 healthy children. The OUES was calculated using data up to three different relative exercise intensities, namely 50%, 75%, and 100% of the total exercise duration, and normalized for body surface area (BSA).
RESULTS:
Only the OUES/BSA using the first 50% of the total exercise duration was significantly different between the groups. OUES/BSA values determined at different exercise intensities differed significantly within patients with CF and correlated only moderately with VO(2peak) and the ventilatory threshold.
CONCLUSION:
The OUES is not a valid submaximal measure of cardiopulmonary exercise capacity in children with mild to moderate CF, due to its limited distinguishing properties, its nonlinearity throughout progressive exercise, and its moderate correlation with VO(2peak) and the ventilatory threshold.
2012-02-19
Title journalEffects of Exercise Therapy on Cardiorespiratory Fitness in Schizophrenia Patients.
SourceMed Sci Sports Exerc. 2012 Apr 19. [Epub ahead of print]
Abstract
BACKGROUND:
Increased mortality in schizophrenia is caused largely by coronary heart disease. Low cardiorespiratory fitness (CRF) is a key factor for coronary heart disease mortality. We compared CRF in patients with schizophrenia to CRF of matched, healthy controls and reference values. Also, we examined the effects of exercise therapy on CRF in schizophrenia patients and controls.
METHODS:
Sixty-three schizophrenia patients and 55 controls, matched for gender, age, and socioeconomic status, were randomized to exercise (n=31) or occupational therapy (n=32) and controls to exercise (n=27) or life-as-usual (n=28). CRF was assessed with an incremental cardiopulmonary exercise test and defined as the highest relative oxygen uptake (VO2peak) and peak work rate (Wpeak). Minimal compliance was 50% of sessions (n=52).
RESULTS:
Male and female schizophrenia patients had a relative VO2peak of 34.3 (±9.9) ml·kg·min and 24.0 (±4.5) ml·kg·min, respectively. Patients had higher resting heart rate (p<.01) and lower peak heart rate (p<.001), peak systolic blood pressure (p=.02), relative VO2peak (p<.01), Wpeak (p<.001), respiratory exchange rate (p<.001), minute ventilation (p=.02), and heart rate recovery (p<.001) than controls. Relative VO2peak was 90.5 ± 19.7% (p<.01) of predicted relative VO2peak in male and 95.9 ± 14.9% (p=.18) in female patients. In patients, exercise therapy increased relative VO2peak compared to decreased relative VO2peak after occupational therapy. In controls, relative VO2peak increased after exercise therapy and to a lesser extend after life-as-usual (group: p<.01; randomization: p=.03). Exercise therapy increased Wpeak in patients and controls compared to decreased Wpeak in nonexercising patients and controls (p<.001).
CONCLUSION:
Patients had lower CRF-levels compared to controls and reference values. Exercise therapy increased VO2peak and Wpeak in patients and controls. VO2peak and Wpeak decreased in non-exercising patients.
2012-01-01
Title journalNear-infrared spectroscopy during exercise and recovery in children with juvenile Dermatomyositis.
SourceMuscle Nerve. 2012.
Abstract
BACKGROUND
We hypothesized that microvascular disturbances in muscle tissue play a role in the reduced exercise capacity in juvenile dermatomyositis (JDM).
METHODS
Children with JDM, children with juvenile idiopathic arthritis (clinical controls), and healthy children performed a maximal incremental cycloergometric test from which normalized concentration changes in oxygenated hemoglobin (?[O2Hb]) and total hemoglobin (?[tHb]) as well as the half recovery times of both signals were determined from the vastus medialis and vastus lateralis muscles using near-infrared spectroscopy.
RESULTS
Children with JDM had lower ?[tHb] values in the vastus medialis at work rates of 25%, 50%, 75%, and 100% of maximal compared with healthy children; the increase in ?[tHb] with increasing intensity seen in healthy children was absent in children with JDM. Other outcome measures differed not by group.
DISCUSSION
The results suggest that children with JDM may experience difficulties in increasing muscle blood volume with more strenuous exercise.
2011-01-01
Title journalHabitual physical activity in Dutch children and adolescents with haemophilia.
SourceHaemophilia. 2011;17(5):e906-12.
Abstract
For patients with haemophilia, a physically active lifestyle is important to maintain musculoskeletal health and to prevent chronic diseases, such as cardiovascular disease. Therefore, we studied physical activity levels, in Dutch children and adolescents with haemophilia as well as its association with aerobic fitness and joint health. Forty-seven boys with haemophilia (aged 8-18) participated. Physical activity was measured using the Modifiable Activity Questionnaire (MAQ) and was compared with the general population. Aerobic fitness was determined using peak oxygen uptake (VO(?peak)). Joint health was measured using the Haemophilia Joint Health Score (HJHS). Associations between physical activity, joint health and aerobic fitness were evaluated by correlation analysis. Subjects were 12.5 (SD 2.9) years old, had a Body Mass Index (BMI) of 19.5 (SD 3.1; z-score 0.5) and a median HJHS score of 0 (range 0-6). Cycling, physical education and swimming were most frequently reported (86%, 69% and 50% respectively). Children with severe haemophilia participated significantly less in competitive soccer and more in swimming than children with non-severe haemophilia. Physical activity levels were similar across haemophilia severities and comparable to the general population. VO(?peak) kg?¹ was slightly lower than healthy boys (42.9 ± 8.6 vs. 46.9 ± 1.9 mL kg?¹ min?¹; P = 0.03). Joint health, aerobic fitness and physical activity showed no correlation. Dutch children with haemophilia engaged in a wide range of activities of different intensities and showed comparable levels of physical activity to the general population. Aerobic fitness was well preserved and showed no associations with physical activity levels or joint health.
2011-01-01
Title journalSupramaximal Verification of Peak Oxygen Uptake in Adolescents With Cystic Fibrosis
SourcePed Phys Ther. 2011; 23(1): 15-21
Abstract
PURPOSE: To study whether peak oxygen uptake ((Equation is included in full-text article VO??peak), attained in traditional cardiopulmonary exercise testing (CPET) in adolescents with cystic fibrosis (CF), could be verified by a supramaximal exercise test.
METHODS: Sixteen adolescents with CF (forced expiratory volume in 1 second as % of predicted [range, 45%-117%]) volunteered and successively performed CPET and a supramaximal test (Steep Ramp Test [SRT] protocol).
RESULTS: Cardiopulmonary exercise testing and the SRT resulted in comparable cardiorespiratory peak values. We found no significant difference in oxygen uptake ((Equation is included in full-text article VO??peak/kg) between CPET and the SRT (38.9 ± 7.4 and 38.8 ± 8.5 mL min kg, respectively; P = .81). We found no systemic bias for CPET and SRT measurements of (Equation is included in full-text article VO???peak/kg and no differences between CPET and SRT (Equation is included in full-text article VO???peak values within and between the maximal and non-maximal effort groups (P > .4).
CONCLUSION: The (Equation is included in full-text article VO???peak measured in CPET seems to reflect the true (Equation is included in full-text article.)O2?peak in adolescents with CF.
2013-02-24
Title journalThe steep ramp test in healthy children and adolescents: reliability and validity.
SourceMedicine and Science in Sports and Exercise
Abstract
PURPOSE:
This study aimed to examine the reliability and validity of the steep ramp test (SRT), a feasible, maximal exercise test on a cycle ergometer that does not require the use of respiratory gas analysis, in healthy children and adolescents.
METHODS:
Seventy-five children were randomly divided in a reliability group (n = 37, 17 boys and 20 girls; mean ± SD age = 13.86 ± 3.22 yr), which performed two SRTs within 2 wk, and a validity group (n = 38, 17 boys and 21 girls; mean ± SD age = 13.85 ± 3.20 yr), which performed both an SRT and a regular cardiopulmonary exercise test (CPET) with respiratory gas analysis within 2 wk. Peak work rate (WRpeak) was the main outcome of the SRT. Peak oxygen uptake (VO2peak) was the main outcome of the CPET. Reliability was examined with the intraclass correlation coefficient and a Bland and Altman plot, whereas validity was assessed using Pearson correlation coefficients and stepwise linear regression analysis.
RESULTS:
Reliability statistics for the WRpeak values attained at the two SRTs showed an intraclass correlation coefficient of 0.986 (P < 0.001). The average difference between the two SRTs was -6.4 W, with limits of agreement between +24.5 and -37.5 W. A high correlation between WRpeak attained at the SRT and the V?O2peak achieved during the CPET was found (r = 0.958; P < 0.001). Stepwise linear regression analysis provided the following prediction equation: VO2peak (mL·min) = (8.262 WRpeak SRT) + 177.096 (R2 = 0.917, SEE = 237.4).
CONCLUSION:
The results suggest that the SRT is a reliable and valid exercise test in healthy children and adolescents, which can be used to predict VO2peak.
2013-05-30
Title journalThe Steep Ramp Test in Dutch Caucasian Children and Adolescents: Age- and Sex- Related Normative Values
SourcePhysical Therapy
BACKGROUND:
The steep ramp test (SRT) is a feasible, reliable, and valid exercise test on a cycle ergometer that may be more appealing for use in children in daily clinical practice than the traditional cardiopulmonary exercise test, because of its short duration, its resemblance to children's daily activity pattern and the fact that it does not require respiratory gas analysis.
OBJECTIVE:
The aim of the current study was to provide sex- and age-related norm values for SRT performance in healthy Dutch Caucasian children and adolescents between the ages of 8 and 19 years.
DESIGN:
This was a cross-sectional, observational study.
METHODS:
Two hundred and fifty-two Dutch Caucasian children and adolescents, 118 boys (mean age 13.4 (3.0) years) and 134 girls (mean age 13.4 (2.9) years), performed a SRT (work rate increments of 10, 15, or 20 W·10 s-1, depending on body height) to voluntary exhaustion to assess peak work rate (WRpeak). Norm values are presented as reference centiles developed using generalized additive models for location, scale, and shape (GAMLSS).
RESULTS:
WRpeak correlated highly with age (r=0.915 and r=0.811), body mass (r=0.870 and r=0.850), body height (r=0.922 and r=0.896), body surface area (r=0.906 and r=0.885), and fat free mass (r=0.930 and r=0.902), for boys and girls respectively (P<0.001 for all coefficients). The reference curves demonstrated an almost linear increase with age in WRpeak in boys, even when normalized for body mass. In contrast, absolute WRpeak in girls increased constantly until the age of approximately 13 years, where after WRpeak started to level off. WRpeak normalized for body mass showed only a slight increase with age in girls, with a slight decrease in relative WRpeak as of the age of 14 years.
LIMITATIONS:
The sample may not be entirely representative of the Dutch population.
CONCLUSIONS:
The current study provides sex- and age-related norm values for SRT performance for both absolute and relative WRpeak thereby facilitating the interpretation of SRT results for clinicians and researchers.
2013-07-26
Title journalEstimating peak oxygen uptake in adolescents with cystic fibrosis
SourceArchives of disease in childhood
To predict peak oxygen uptake (VO2peak) from the peak work rate (Wpeak) obtained during a cycle ergometry test using the Godfrey protocol in adolescents with cystic fibrosis (CF), and assess the accuracy of the model for prognostication clustering.
METHODS:
Out of our database of anthropometric, spirometric and maximal exercise data from adolescents with CF (N=363; 140 girls and 223 boys; age 14.77±1.73 years; mean expiratory volume in 1 s (FEV1%pred) 86.82±17.77%), a regression equation was developed to predict VO2peak (mL/min). Afterwards, this prediction model was validated with cardiopulmonary exercise data from another 60 adolescents with CF (28 girls, 32 boys; mean age 14.6±1.67 years; mean FEV1%pred 85.43±20.01%).
RESULTS:
We developed a regression model VO2peak (mL/min)=216.3-138.7×sex (0=male; 1=female)+11.5×Wpeak; R2=0.91; SE of the estimate (SEE) 172.57. A statistically significant difference (107 mL/min; p<0.001) was found between predicted VO2peak and measured VO2peak in the validation group. However, this difference was not clinically relevant because the difference was within the SEE of the model. Furthermore, we found high positive predictive and negative predictive values for the model for prognostication clustering (PPV 50-87% vs NPV 82-94%).
CONCLUSIONS:
In the absence of direct VO2peak assessment it is possible to estimate VO2peak in adolescents with CF using only a cycle ergometer. Furthermore, the regression model showed to be able to discriminate patients in different prognosis clusters based on exercise capacity.
KEYWORDS:
Cystic Fibrosis, Exercise, Paediatric Lung Disaese
2010-07-12
Title journalExercise stroke volume and heart rate response differ in right and left heart failure.
SourceEuropean Journal of Heart Failure
In pulmonary arterial hypertension (PAH), the exercise-induced increase in stroke volume (SV) is limited by the increase in pulmonary artery pressure. In left heart failure (LHF), systemic arterial pressure increases little during exercise, and the SV increase is limited by the left ventricle itself. These differences might be reflected by a dissimilar SV and heart rate (HR) response to exercise, which could have important therapeutic implications, for example in beta-blocker therapy. Therefore, we tested the hypothesis that SV and HR responses during exercise are different between PAH and LHF patients.
Related products2007-01-28
Title journalStroke volume response during exercise measured by acetylene uptake and MRI
SourcePhysiological Measurement
The intra-breath technique to measure acetylene absorption offers the possibility to determine augmentation of the pulmonary blood flow per heart beat (Q(C)) as an estimate of the stroke volume response during exercise. However, this method has not been compared with a validated test until now. Therefore, the aim of this study was to compare Q(C) with stroke volume (SV(MRI)) determined by magnetic resonance imaging (MRI) at rest and during exercise in healthy subjects and patients. For this purpose, ten healthy subjects and ten patients with idiopathic pulmonary arterial hypertension (iPAH) with expected impaired stoke volume response during exercise were measured by both methods. Exercise-induced changes in Q(C) and SV(MRI) were correlated in healthy controls (r = 0.75, p < 0.05). Compared to healthy controls, Q(C) increased less during exercise in iPAH patients (11 +/- 17 ml versus 33 +/- 12 ml, p < 0.05). A similar difference in stroke volume response to exercise between the two groups was measured by MRI (-0.6 +/- 8 ml versus 23 +/- 12 ml, p < 0.05, respectively). Hence, intra-breath and MRI measurements showed similar differences in exercise-induced changes in stroke volume between controls and patients. From these results it can be concluded that the intra-breath measurement of acetylene absorption might be of value as a non-invasive tool to estimate stroke volume augmentation during exercise and can detect differences in stroke volume responses between iPAH patients and healthy subjects.
Related products2008-10-01
Title journalExercise testing to estimate survival in pulmonary hypertension
SourceMedicine and Science in Sports and Exercise
The 6-min walk distance (6MWD) predicts survival in pulmonary hypertension (PH). The peak oxygen consumption (V O2peak) measured during a cardiopulmonary exercise test (CPET) also relates to survival in PH, and it is unknown how the prognostic information from measurements of ventilatory responses and gas exchange during CPET compares to the prognostic information obtained by the 6MWD alone. The aims of our study were to compare prognostic values of different exercise parameters in PH and to assess whether CPET adds prognostic value to the information from the 6MWD.
Related products2008-01-15
Title journalThe effect of oral curcumin supplementation and immobilization on skeletal muscle fiber diameter of rattus norvegicus
SourceMedia Folia Medica Indonesiana
Immobilization may result in skeletal muscle atrophy, in which the diameter of muscle fiber is decreased.
The stimulus response at cellular level presents as the activation of Tumor Necrosis Factor (TNF)-ï•¡ and
NF-ï•«B (Nuclear Factor-ï•«B), which results in the degradation of muscular protein. Curcumin is a yellow
pigment substance commonly found in plants belonging to the genus Curcuma longa (kunyit) and Curcuma
xanthorrhiza Robx (temulawak). One of the actions of Curcumin is inhibition of the NF-ï•«B pathway
activation. The objective of this study was to analyze the effect of oral curcumin and immobilization on the
diameter of skeletal muscle fiber of Rattus norvegicus. Subjects of the study were male Rattus norvegicus
aged 3-4 months, with bodyweight of 150-200 grams. Subjects were divided into three groups, a control
group,an immobilization group without curcumin, and an immobilization group with oral curcumin, each
of which comprised 11 subjects. Immobilization using a splint was applied to the soleus muscle for 2 weeks.
Oral curcumin was given to the immobilization group in a dose of 400 mg/rats (2 g/KgBW) single dose
once a week. The diameter of soleus muscle was measured histopathologically with HE staining, under a
light microscope using a magnification of 400x. Results showed that the diameter of skeletal muscle fiber in
the immobilization group was reduced 42.41% and 26,48% in the immobilization group with curcumin
supplementation the reduction was 26.48%, as compared to the control group. There was significant
difference (p < 0.05) in the diameter of skeletal muscle fiber between control, immobilization, and
immobilization with curcumin supplementation groups. In conclusion, the addition of oral curcumin
significantly reduces atrophy of soleus muscle in rats immobilized for 2 weeks.
2019-07-18
Title journalPredictability of exercise capacity following pediatric burns: a preliminary investigation.
SourceDisability and Rehabilitation
Purpose:
Describe the course of exercise capacity in pediatric burn patients during the initial 6 months after hospital discharge, and examine whether its recovery can be predicted from burn characteristics, sociodemographic characteristics, and/or prior assessment.
Materials and methods:
Exercise capacity was assessed at discharge, and 6 weeks, 3 months, and 6 months after discharge using the Steep Ramp Test (SRT).
Results:
Twenty-four pediatric patients with burns affecting 0.1-34% of total body surface area were included. At group level, exercise capacity was low at discharge and did not reach healthy reference values within 6 months, despite significant improvement over time. At individual level, the course of exercise capacity varied widely. Six months after discharge, 48% of participants scored more than one standard deviation below healthy age- and sex-specific reference values. SRT outcomes at 6 weeks and 3 months were the best predictors of exercise capacity 6 months after discharge, explaining, respectively, 76% and 93% of variance.
Conclusions:
Forty-eight percent of participants did not achieve healthy reference values of exercise capacity and were therefore considered "at risk" for diminished functioning. Our preliminary conclusion that early assessment of exercise capacity with the SRT can timely identify those patients, needs to be strengthened by further research.
IMPLICATIONS FOR REHABILITATION
Pediatric burns can be considered as a chronic medical condition because of the lifelong consequences. Exercise capacity is reduced following- even minor -pediatric burns. Recovery patterns vary widely: some pediatric burn patients achieve healthy levels of exercise capacity without specific intervention, while others do not. The Steep Ramp Test can be used to assess exercise capacity, identifying those "at risk" for adverse outcomes at an early stage. Patients "at risk" should be encouraged to play sports and adopt an active lifestyle.