The normal criteria of the ankle joint laxity of the Korean may be different from that of the western. For the objective study, we designed two devices for the anterior drawer test and inversion stress test. Using the devices we radiologically examined the 120 ankle at neutral and 30 plantar flexed position. The following results were obtained; l. In the talar tilt angle, the minimun angle, the maximun angle and the mean were 1.0°, 12.0°, 3.7° respectively at the neutral position and 1.0°, 19.0°, 4.8° respectively at the 30° plantar flexed position. 2. With the Grace method, the minimum distance, the maximum distance and the mean were 3.Omm, 12.0mm, 5.2mm respectively at the neutral position and 3.0mm, 12.6mm, 6.1mm respectively at the 30 plantar flexed position. 3. With the Kelikian method, the minmum value, the maximum value and the mean were Omm, 7.5mm, 2.2mm respectively at the neutral position and Omm, 8.0mm, 2.5mm respectively at the 30 plantar flexed posion. 4. There was no difference in laxity for the age and sex.
Adult ; Ankle Joint ; Ankle ; Exercise Test ; Humans ; Methods

Phonocardiogram exercise testing(PCGET) is a recently developed method for evaluating cardiac contractility and the cardiac reserve of patients with heart disease and of healthy subjects. In order to test the reliability of PCGET method in physical sport, the present author conducted a clinical study. The ratio of the amplitude of the first heart sound after PCGET to that recorded at rest was defined as an indicator, i.e. cardiac contractility reserve index (CCRI). PCGET was performed on 30 athletes and 30 non-athletes. The results showed that the average of CCRI was 10.139 +/- 2.631 in 30 athletes and 6.612 +/- 3.104 in 30 non-athletes. There was a significant difference between CCRI of the two groups (P < 0.01). Thus, PCGET might be a noninvasive, convenient and inexpensive technique to evaluate the cardiac reserve quantitatively for athletes.
Adolescent ; Adult ; Exercise Test ; methods ; Feasibility Studies ; Humans ; Myocardial Contraction ; physiology ; Phonocardiography ; methods ; Sports ; physiology

In this paper a filtering method for EECG (Exercise ECG) signal is proposed which is based on wavelet transform (WT) and Stein's unbiased risk estimate (SURE). This algorithm was used to decompose original EECG signals into detail signals on different frequency bands by using WT and get different thresholds with SURE. According to EECG signal features and by using the above thresholds, the method amended several detail signals so that the main interferences in EECG signal can be removed efficiently. The authors also put forward two indexes to estimate the validity of such algorithms. Our experimental results demonstrate that this is an efficient de-noising method for EECG.
Algorithms ; Echocardiography, Stress ; Electrocardiography ; methods ; Exercise Test ; methods ; Humans ; Signal Processing, Computer-Assisted

BACKGROUNDThere is no research, either at home or abroad, focusing on assessing the cardiopulmonary functional reserve and exercise tolerance in patients with pulmonary embolism (PE), but the benefits of early exercise are well recognized. The goals of this study were to assess cardiopulmonary functional reserve in treated PE patients using the inert gas rebreathing method of the cardiopulmonary exercise test (CPET), and to compare it with traditional methods.

METHODSCPET on the bicycle ergometer were performed in 40 patients with age, gender, body mass index, systolic blood pressure, and pulmonary function matched. The first group was the PE group composed of 16 PE patients (5 male, 11 female) who were given the standard antithrombotic therapy for two weeks. The second group was composed of 24 normal individuals (10 male, 14 female). Both groups were evaluated by cardiac ultrasound examination, 6-minute walking test (6MWT), and CPET.

RESULTS(1) Right ventricular systolic pressure (RVSP) in the PE group increased significantly compared to the control group, (34.81 ± 8.15) mmHg to (19.75 ± 3.47) mmHg (P < 0.01). But neither right atrial end-systolic diameter (RASD) nor right ventricular end-diastolic diameter (RVDD) in the PE patients had changed when compared with the controls. The 6-minute walk distance was significantly reduced in the PE patients compared with normal subjects, (447.81 ± 79.20) m vs. (513.75 ± 31.45) m (P < 0.01). Both anaerobic threshold oxygen consumption (VO(2)AT) and peak oxygen consumption (VO(2)peak) were significantly lower in patients with PE, while CO(2) equivalent ventilation (VE/VCO(2) slope) was higher; VO(2)AT (9.44 ± 3.82) ml×kg(-1)×min(-1) vs. (14.62 ± 2.93) ml×kg(-1)×min(-1) (P < 0.01) and VO2peak (12.26 ± 4.06) ml×kg(-1)×min(-1) vs. (23.46 ± 6.15) ml×kg(-1)×min(-1) (P < 0.01) and VE/VCO(2) slope 35.47 ± 6.66 vs. 26.94 ± 3.16 (P < 0.01). There was no significant difference in resting cardiac output (CO) between the PE and normal groups, whereas peak cardiac output (peak CO) and the difference between exercise and resting cardiac output (ΔCO) were both significantly reduced in the PE group; peak CO (5.97 ± 2.25) L/min to (8.50 ± 3.13) L/min (P < 0.01), ΔCO (1.29 ± 1.59) L/min to (3.97 ± 2.02) L/min (P < 0.01). (2) The 6-minute walk distance did not correlated with CPET except for the VO2 peak in patients with PE, r = 0.675 (P < 0.01).

CONCLUSIONSThe cardiopulmonary functional reserve was reduced in patients with PE. CPET is an accurate, quantitative evaluation of cardiopulmonary functional reserve for PE patients.

Aged ; Exercise Test ; methods ; Exercise Tolerance ; physiology ; Female ; Humans ; Male ; Middle Aged ; Oxygen Consumption ; physiology ; Pulmonary Embolism ; physiopathology ; therapy

BACKGROUNDDual sensor (DS) for rate adaption was supposed to be more physiological. To evaluate its superiority, the DS (accelerometer [ACC] and minute ventilation [MV]) and normal sinus rate response were compared in a self-controlled way during exercise treadmill testing.

METHODSThis self-controlled study was performed in atrioventricular block patients with normal sinus function who met the indications of pacemaker implant. Twenty-one patients came to the 1-month follow-up visit. Patients performed a treadmill test 1-month post implant while programmed in DDDR and sensor passive mode. For these patients, sensor response factors were left at default settings (ACC = 8, MV = 3) and sensor indicated rates (SIRs) for DS, ACC and MV sensor were retrieved from the pacemaker memories, along with measured sinus node (SN) rates from the beginning to 1-minute after the end of the treadmill test, and compared among study groups. Repeated measures analysis of variance and profile analysis, as well as variance analysis of randomized block designs, were used for statistical analysis.

RESULTSFifteen patients (15/21) were determined to be chronotropically competent. The mean differences between DS SIRs and intrinsic sinus rates during treadmill testing were smaller than those for ACC and MV sensor (mean difference between SIR and SN rate: ACC vs. SN, MV vs. SN, DS vs. SN, respectively, 34.84, 17.60, 16.15 beats/min), though no sensors could mimic sinus rates under the default settings for sensor response factor (ACC vs. SN P-adjusted < 0.001; MV vs. SN P-adjusted = 0.002; DS vs. SN P-adjusted = 0.005). However, both in the range of 1 st minute and first 3 minutes of exercise, only the DS SIR profile did not differ from sinus rates (P-adjusted = 0.09, 0.90, respectively).

CONCLUSIONSThe DS under default settings provides more physiological rate response during physical activity than the corresponding single sensors (ACC or MV sensor). Further study is needed to determine if individual optimization would further improve adaptive performance of the DS.

Adult ; Aged ; Cardiac Pacing, Artificial ; methods ; Exercise ; physiology ; Exercise Test ; Female ; Humans ; Male ; Middle Aged ; Pacemaker, Artificial

BACKGROUND: Recently, cardiopulmonary exercise testing (CPX) has become a popular diagnostic method for differentiating the main cause of exertional dyspnea or exercise limitation. We evaluated the difference in the CPX results according to interpretative algorithms and the methods of exercise in Korea. METHOD: Sixty-six patients with chronic lung disease and 48 adults with dyspneic symptoms, but with no abnormalities in a spirometry performed symptom limited CPX, were included in this study. The results were interpreted using both Wasserman's(WA) and Eschenbacher's algorithm (EA), and a comparison between both algorithms was made. Thirty-three healthy medical students performed the CPX with a cycle ergometer and treadmill. The results were interpreted with EA and the concurrenec in interpretations was evaluated according to the methods of exercise. RESULTS: 1. In patients with chronic lung disease, the overall concordance rate between the two algorithms was 63.6%. The concordance rates were 69.8% in patients with obstructive, 25.0% in those with restrictive, and 66.7% in those with mixed pulmonary insufficiency. In patients with dyspneic symptoms but normal findings in resting spirometry, the concordance rate was 60.4%. 2. In healthy medical students, in results interpreted with EA, the concordance rate between the cycle ergometer and treadmill exercise was 25.0%. CONCLUSION: Both interpretative algorithms and methods of exercise may affect the CPX results. In using CPX as a diagnostic test for the causes of dyspnea in the Korean population, the interpretative algorithms and method of exercise need to be standardized, and a predictive VO2max equation needs to be established.
Adult ; Diagnostic Tests, Routine ; Dyspnea ; Exercise Test* ; Humans ; Korea ; Lung Diseases ; Methods* ; Spirometry ; Students, Medical

Exercise Test ; Female ; Heart Sounds ; physiology ; Humans ; Male ; Phonocardiography ; methods ; Pregnancy ; Stress, Physiological ; physiology ; Young Adult

The rupture of anterior cruciate ligament has been diagnosed by stress test, radiogram and diagnostic arthroscopy, but these methods have several disadvantages of lack of objectivity, exposure to radiation and risk of anesthesia. To eliminate these difficulties, the K-T 1,000 knee ligament arthrometer was used for the objective diagnosis in the injury of anterior cruciate ligament. We performed instrumented measurement of anterior-posterior laxity of the knee in 100 normal subjects by using the K-T 1,000 knee ligament arthrometer under the 15 lb., 20 lb. and maximum anterior pulls, and 20 lb. posterior push. The following results were obtained: 1. The mean anterior displacement at 20 lb.: 4.43mm The mean posterior displacement at 20 lb.: 2.30mm 2. The mean right knee-left knee difference in anterior displacement: 0.89mm 3. The mean anterior compliance index: 1.16mm So, we believed that a right knee-left knee difference and a anterior compliance index are sensitive measures of the integrity of the anterior cruclate ligament. And this test method was helpful for the diagnosis and objective recording in the injury of anterior cruciate ligament. This test method has following advantages: 1. There is no anesthesia risk. 2. The patient and examiner undergo no radiation exposure. 3. Diagnostic arthroscopy may be avoided. 4. Due to patient comfort, there is minimal muscle guarding.
Anesthesia ; Anterior Cruciate Ligament ; Arthroscopy ; Compliance ; Diagnosis ; Exercise Test ; Humans ; Knee ; Ligaments ; Methods ; Radiation Exposure ; Rupture

BACKGROUNDIt is still unclear whether pulmonary function tests (PFTs) are sufficient for predicting perioperative risk, and whether all patients or only a subset of them need a cardiopulmonary exercise test (CPET) for further assessment. Thus, this study was designed to evaluate the CPET and compare the results of CPET and conventional PFTs to identify which parameters are more reliable and valuable in predicting perioperative risks for high risk patients with lung cancer.

METHODSFrom January 2005 to August 2008, 297 consecutive lung cancer patients underwent conventional PFTs (spirometry + single-breath carbon monoxide diffusing capacity of the lungs (DLCOsb) for diffusion capacity) and CPET preoperatively. The correlation of postoperative cardiopulmonary complications with the parameters of PFT and CPET was retrospectively analyzed using the chi-square test, independent sample t test and binary Logistic regression analysis.

RESULTSOf the 297 patients, 78 did not receive operation due to advanced disease stage or poor cardiopulmonary function. The remaining 219 underwent different modes of operations. Twenty-one cases were excluded from this study due to exploration alone (15 cases) and operation-related complications (6 cases). Thus, 198 cases were eligible for evaluation. Fifty of the 198 patients (25.2%) had postoperative cardiopulmonary complications. Three patients (1.5%) died of complications within 30 postoperative days. The patients were stratified into groups based on VO(2)max/pred (≥ 70.0%, < 70.0%); VO(2)max×kg(-1)×min(-1) (≥ 20.0 ml, 15.0 - 19.9 ml, < 15.0 ml) and FEV1 (≥ 2.0 L, 1.2 - 1.99 L, < 1.2 L), respectively. The rate of postoperative cardiopulmonary complications was significantly higher in the group with VO(2)max/pred< 70.0% or VO(2)max×kg(-1)×min(-1) < 15.0 ml or FEV1 < 1.2 L than that in the group with VO(2)max/pred ≥ 70.0% or VO(2)max×kg(-1)×min(-1) ≥ 15.0 ml or FEV1 ≥ 1.2 L, respectively. Logistic regression analysis revealed that postoperative cardiopulmonary complications were significantly correlated with age, comorbidities, and poor PFT and CPET results.

CONCLUSIONSFEV1 in spirometry, VO(2)max×kg(-1)×min(-1) and VO(2)max/pred in cardiopulmonary exercise tests can all be used to stratify the patients' cardiopulmonary function status and to predict the risk of postoperative cardiopulmonary complications for the high risk patients with lung cancer. FEV1 and VO(2)max×kg(-1)×min(-1) are better than VO(2)max/pred in predicting perioperative risk. If available, cardiopulmonary exercise testing is strongly suggested for high-risk lung cancer patients in addition to conventional pulmonary function tests, and both should be combined to assess cardiopulmonary function status.

Adult ; Aged ; Aged, 80 and over ; Exercise Test ; methods ; Female ; Humans ; Lung Neoplasms ; physiopathology ; Male ; Middle Aged ; Respiratory Function Tests ; methods

OBJECTIVE: To determine whether there was agreement between the short daytime ApneaGraph (dAG) and nocturnal ApneaGraph (nAG) in diagnosing sleep respiratory events initially and identifying the site of obstruction in airway. METHOD: Twenty four patients diagnosed OSAHS by PSG were enrolled. The apnea-hypopnea index (AHI), apnea index (AI), obstructive apnea-hypopnea index (OAHI), central apnea hypopnea index (CAHI), mixed apnea index (MAHI), lowest oxygen saturation (LSaO2) and the proportion of upper/lower obstruction (UPPER, LOWER) of patients were measured using both dAG and nAG. RESULT: There were no significant differences between nAG and dAG for the following parameters: AHI, AI, CAHI, MAHI, OAHI, the proportion of upper/lower obstruction, or LSaO2 (P>0.05). There were significant positive correlations between nAG and dAG with regard to AHI, AI, MAHI, OAHI, the proportion of upper/lower obstruction , LSaO2 except CAHI. CONCLUSION The dAG has similar results with nAG in early diagnosis of sleep respiratory events and identifying the level of airway obstruction. The time-saving dAG is of considerable referential importance in diagnosis of sleep respiratory events and analysing the level of airway obstruction.
Adult ; Airway Obstruction ; Exercise Test ; methods ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; methods ; Sleep ; Sleep Apnea, Obstructive ; diagnosis ; physiopathology