BACKGROUND: Resting pulmonary function tests(PFTs) are routinely used in the evaluation of pulmonary impairment/disability. But the significance of the cardiopulmonary exercise test(CPX) in the evaluation of pulmonary impairment is controvertible. Many experts believe that dyspnea, though a necessary part of the assessment, is not a reliable predictor of impairment. Nevertheless, oxygen requirements of an organis m at rest are different from at activity or exercising, and a clear relationship between resting PFTs and exercise tolerance has not been established in patients with chronic pulmonary disease. As well, the relationship between resting PFTs and dyspnea is complex. To investigate the relationship of dyspnea, Resting PFTs, and CPX, we evaluated the patients of stabilized chronic pulmonary disease with clinical dyspnea rating(baseline dyspnea index, BDI), resting PFTs, and CPX. METHOD: The 50 patients were divided into two groups: non-severe and severe group on basis of results of resting PFTs(by criteria of ATS), CPX(by criteria of ATS or Ortega), and dyspnea rating(by focal score of BDI). Groups were compared with respect to pulmonary function, indices of CPX, and dyspnea rating. RESULTS: 1) According to the criteria of pulmonary impairment with resting PFTs, VO2 max, and focal score of BDI were significantly low in the severe group(p<0.01). According to the criteria of VO2max(ml/kg/min) and VO2max(%), the parameters of resting PFTs, except FEV1, were not significantly different between non-severe and severe(p>0.05). According to focal score(exercise performance. The focal score had the correlation with max WR(%) (r=0.55;p<0.01). 3) Sensitivity and specificity analysis were utilized to compare the different criteria used to evaluate the severity of pulmonary impairment, revealed that the classification would be different according to the criteria used. And focal score for dyspnea showed similar sensitivity and specificity. CONCLUSION: According to these result, resting PFTs were not superior to rating of dyspnea in prediction of exercise performance in patients with chronic pulmonary diseases and less correlative with focal score for dyspnea than VO2 max and max WR. Therefore, if not contraindicated, CPX would be considered to evaluate the severity of pulmonary impairment in patients with chronic pulmonary diseases, including with severe resting PFTs. Current criteria used to evaluate the severity of impairment were insufficient in considering the degree of dyspnea, so new criteria, including the severity of dyspnea, may be necessary.
Classification ; Dyspnea* ; Exercise Test ; Exercise Tolerance ; Humans ; Lung Diseases* ; Oxygen

OBJECTIVES: To systematically evaluate the effect of exercise rehabilitation on exercise capacity and quality of life in children with bronchial asthma. METHODS: PubMed, Cochrane Library, Web of Science, EBSCO, China National Knowledge Infrastructure, Weipu Data, and Wanfang Data were searched for randomized controlled trials (RCTs) on the effect of exercise rehabilitation on children with bronchial asthma published up to February 2021. RevMan 5.3 was used to perform a Meta analysis. RESULTS: A total of 14 studies were included, with 990 subjects in total. The Meta analysis showed that compared with the conventional treatment group, the exercise rehabilitation group had significantly better exercise capacity (distance covered in the 6-minute walk test: CONCLUSIONS Current evidence shows that exercise rehabilitation has a positive effect in improving exercise capacity and quality of life in children with bronchial asthma. Due to limited number and quality of studies included in the analysis, further research is needed.
Asthma ; Child ; China ; Exercise Therapy ; Exercise Tolerance ; Humans ; Quality of Life

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Echocardiography* ; Exercise Tolerance* ; Humans ; Tetralogy of Fallot*

A double-blind trial of the efficacy of propranolol hydrochloride a new beta adrenergic blocking agent, in the prophylactic treatment of angina pectoris was conducted in 9 patients. Through the trial period of 8 weeks to more than 26 weeks, the patients received propranolol and placebo for equal period. Following are the results. 1. The effective dose of propranolol hydrochloride in the prophylactic treatment of angina pectoris was 80 mg to 120 mg per day. 2. The effectiveness of propranolol hydrochloride was manifested by a reduction in frequency of pain to 40.7%, in nitroglycerin comsumption to 38.8% and by an increase in exercise tolerance. 3. Obseved side effects were transient nausea, vomiting and bradycardia, which were improved with reduction in drug dosage. 4. Further clinical and experimental information may be necessary in order to assess the long-term effects of propranolol hydrochloride.
Angina Pectoris* ; Bradycardia ; Exercise Tolerance ; Humans ; Nausea ; Nitroglycerin ; Propranolol* ; Vomiting

It is known that a pulmonary rehabilitation program improves dyspnea and exercise tolerence in patients with chronic obstructive pulmonary disease. However, it is also known that although it does not improve pulmonary function. This study was performed to evaluate the effect of a 4 week pulmonary rehabilitation on pulmonary function, gas exchange, and exercise tolerance in patients with chronic obstructive pulmonary disease. The pulmonary rehabilitation programs included breathing exercises, such as pursed-lip breathing and diaphragmatic breathing, upper-limb exercises, and inspiratory muscle training. These activities were performed for 4 weeks in twenty one patients with chronic obstructive pulmonary disease. Pre and post-rehabilitation pulmonary function and exercise capacities were compared after the 4 week period. Results are as follows: 1) Before the rehabilitation, the predicted value of FVC and FEV1 of the patients were 70.3+/-16.7% and 41.1+/-11.9% respectively. These pulmonary functions did not change after pulmonary rehabilitation. 2) Aloility of walking a 6 minute distance (325.29+/-122.24 vs 363.03+/-120.01 p=.01) and dyspnea (p=.00) were significantly improved after rehabilitation. Thus showing that pulmonary rehabilitation for 4 weeks can improve exercise performance and dyspnea in patients with chronic obstructive pulmonary disease.
Breathing Exercises ; Dyspnea ; Exercise ; Exercise Tolerance ; Humans ; Pulmonary Disease, Chronic Obstructive* ; Rehabilitation* ; Respiration ; Walking

Maximal oxygen uptake (exercise capacity) is a vital parameter in the evaluation of adaptation to high altitude, providing an index of the integrated function of the oxygen transport system. Previous studies of maximal oxygen uptake in population at high altitude have mainly focused on adults and adolescents, though data on children are uncommon. Maximal oxygen uptake can be measured directly, using an oxygen analyser, or indirectly through the development of equations for estimation from the maximal power output (W(max)). Such estimations and studies of the physiological aspects of children's capacity to work and live at different altitudes in Tibet ancestry were not reported previously, although differences similar to those seen in adults may be expected to occur. The present paper summarized the findings of studies on exercise capacity among children living at high altitude in Tibet.
Adaptation, Physiological ; Altitude ; Child ; Exercise Test ; Exercise Tolerance ; Humans ; Oxygen Consumption ; Tibet

OBJECTIVEDynamic exercise is often used to evaluate the backlog function of cardiovascular system, and the treadmill test is a commonly used dynamic exercise protocol. The study aimed to assess the exercise capacity and cardiovascular response to treadmill exercise in healthy children, and create normal reference values of exercise testing in native children.

METHODSTwo huadveds and ninety-four healthy children aged 5 to 14 years were tested using the Bruce protocol on treadmill.

RESULTSMean exercise capacity in boys increased from 12.2 METs at the age of 5 to 6 years, to 15.2 METs at the age of 13 to 14 years. Mean exercise capacity in girls increased from 11.7 METs at the age of 5 to 6 years, to 12.6 METs at the age of 13 to 14 years. Sex difference was obvious in exercise capacity of children except those at the age of 5 to 6 years. There was no obvious correlation between exercise capacity and the ratio of weight to height. Maximal heart rate ranged from 187 to 235 beats/min. Systolic blood pressure increased gradually until peak exercise was achieved. The mean systolic blood pressure of boys at maximal exercise increased by 38.6 percent compared to resting level, and the girls increased by 34.4 percent. After maximal exercise, mean systolic blood pressure reached resting level in 6 minutes but diastolic blood pressure varied. All children had sinus rhythm at rest. No arrhythmia was recorded during treadmill exercise. However, arrhythmia was found in five children in early recovery period. The incidence of exercise-induced arrhythmia was 1.7 percent.

CONCLUSIONSex difference and age difference was obvious in exercise capacity. In the 21st century, the exercise capacity of children in Shanghai area has approached to the developed country. Using MET as the standardized criterion of exercise capacity is advantageous to standardize maximal or submaximal exercise workloads of all kinds of protocols. Exercise-induced arrhythmia in the early recovery period in children without structural heart disease may not be pathological, but it is necessary for those children to be followed-up.

Adolescent ; Blood Pressure ; physiology ; Child ; China ; Electrocardiography ; Exercise Test ; Exercise Tolerance ; physiology ; Female ; Heart Rate ; physiology ; Humans ; Male ; Sex Factors

The Diltiazem hydrochloride is a new calcium antagonist of which effect on angina pectoris has been reported. Authors studied the clinical effect of Diltiazem in 18 cases of angina pectoris including stable and unstable angina. The 14 cases were male and 4 cases were female with ages ranging 46 to 72 years. All cases had typical anginal attack on 1-6 times in everyday with transient improvement by sublingual nitroglycerin. After coutine physical and laboratory work-up, Diltiazem 30mg tablet was given 3 times a day for 3 consecutive weeks and checked the response of angical pain for first 3 times visit with 3 days interval and thereafter with one week interval. In 13 cases of 15 cases, the Diltiazem alone was medicated. There was considerable improvement of anginal attack in 13 cases of 15 cases with Diltiazem alone, namely complete subsidence of anginal attack throughout 3 weeks in 2 cases, only minimal substernal discomfort on effort once a week in 4 cases and in 7 cases the frequency and severity of anginal pain reduced to about 50% of control state. In 2 of 15 cases there were no effect on anginal pain until one week, subsequently a beta-blocker was added and the anginal attack improved considerably in both cases. In 3 cases of 18 cases, the anginal attacks were so severe and frequent that the Diltiazem with beta-blocker were given from the beginning. In one case the anginal pain disappeared completely and in two cases there were good effect. The effect of Diltiazem usually started to occurs in 3 days to one week after medication. The overall effectiveness of Diltiazem in angina pectoris was 87% with excellent effect in 40%, good effect in 27% and fair effect in 20%. In 5 cases of good response to Diltiazem, the stress exercise test by bicycle ergometer was carried out before and after one week medication with programs of 30 wt, 50 wt, 75 wt, and 100 wt loading for 4 minutes in each stage. The exercise tolerance improved about 25-50 wt, the ST depression by exercise became less by 1-2mm and the maximal heart rate increased by 4-9/min. These data showed marked improvement of exercise tolerance in angina pectoris by Dltiazem objectively. There were macular skin rash, diarrhea and mild dizziness in one case respectively which were improved without treatment. These data showed that Diltiazem was highly effective in angina pectoris except few very severe cases. In severe cases, the combined therapy of Diltiazem and beta-blocker was more effective.
Angina Pectoris* ; Angina, Unstable ; Calcium ; Depression ; Diarrhea ; Diltiazem* ; Dizziness ; Exanthema ; Exercise Test ; Exercise Tolerance ; Female ; Heart Rate ; Humans ; Male ; Nitroglycerin

OBJECTIVE: To compare and analyze the effects of cardiac rehabilitation (CR) in two groups based on the peak respiratory exchange ratio (RER(peak)) 1.1 values using the exercise tolerance test (ETT) results, and to investigate the reasons for early termination of ETT. METHODS: Patients with acute coronary syndrome who participated in CR exercise training were selected and all subjects underwent 6 weeks of CR exercise training. ETT was performed on a treadmill using a Modified Bruce Protocol before and after CR exercise training. According to the result of the first ETT, the subjects were divided into two groups: those with an RER(peak)≥1.1 (n=33) and those with an RER(peak)<1.1 (n=22). We investigated the reasons for ETT termination and compared the effect of CR between the groups. RESULTS: The reasons for the early termination of the first ETT in the RER(peak)<1.1 group were subjective dyspnea, abnormal cardiovascular responses, leg fatigue and other problems. After a 6-week CR, the peak oxygen consumption (VO2(peak)) and ETT time increased, and the rate of perceived exertion (RPE) and RPP (rate pressure product) at stage 3 decreased in both the RER(peak)<1.1 and RER(peak)≥1.1 groups. CONCLUSION: CR exercise training improved exercise capacity, not only in the RER(peak)≥1.1 group, but also in the RER(peak)<1.1 group. This means that patients with a lower exercise tolerance could also benefit from the effects of CR. Thoughtful consideration to identify the direct and indirect causes for the early termination of ETT would be necessary to improve the efficiency of CR.
Acute Coronary Syndrome ; Coronary Artery Disease* ; Coronary Vessels* ; Dyspnea ; Exercise Test ; Exercise Tolerance ; Fatigue ; Humans ; Leg ; Oxygen Consumption ; Rehabilitation*

PURPOSE: We investigated the relationship between severity of pulmonary regurgitation (PR), exercise capacity, right ventricular (RV) volume overload and RV function in the patients with long-term follow-up after repair of tetralogy of Fallot (TOF). METHODS: To evaluate exercise capacity, cardiopulmonary exercise test (CPX) was performed in 26 patients and 18 normal controls on a treadmill, and maximal oxygen consumption (VO(2max)) and anaerobic threshold (AT) were compared among the two groups. To assess severity of PR, RV volume and function, magnetic resonance imaging (MRI) study was performed in the patient group and the PR fraction (%), RV end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction(EF) were measured. Patient group was divided into two subgroups by age and influences of PR on RV volume and function were compared among these subgroups. RESULTS: VO(2max) and AT were significantly decreased in the patients in comparison to the control subjects (28.9+/-10.4 vs 38.1+/-9.9 ml/kg/min, P=0.01; 0.98+/-0.53 vs 1.44+/-0.59 l/min, P=0.03). PR fraction inversely correlated with the VO(2max) (r=-0.58, P<0.01) and had a tendency toward inverse correlation with AT (r=-0.35, P=0.15). In young age group less than 15 years, no significant correlation between RVEDV, RVESV, corrected QRS duration (cQRS) and PR fraction (r=0.48, P=0.19; r=0.45, P=0.22; r=0.12, P=0.76) was observed, but in old age group, RV volume (RVEDV: r=0.73, P=0.01; RVESV: r=0.61, P=0.04) and the cQRS (r=0.66, P=0.03) were increased according to the severity of PR. RVEDV and RVESV showed inverse correlations with RVEF (r-0.59, P=0.003; r= -0.78, P<0.001), and RVEF showed positive correlation with VO(2max) (r=0.62, P=0.04). CONCLUSION: Patients in long-term follow-up after repair of TOF showed impaired exercise capacity than normal subjects. PR has a negative influence on the exercise tolerance in this group of patients, and the deleterious effects of PR on RV volume and QRS prolongation may related with the age and/or duration of PR. RV volume overload may deteriorate RV function and cause resultant exercise impairment.
Anaerobic Threshold ; Exercise Test ; Exercise Tolerance ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Oxygen Consumption ; Pulmonary Valve Insufficiency* ; Tetralogy of Fallot*