Charles F. Emery

Comparison of high- and low-intensity exercise training early after acute myocardial infarction

The effects of the intensity of exercise training on cardiorespiratory variables were investigated in a consecutive series of men with recent (median 8 weeks) acute myocardial infarction. Forty-five patients were randomly assigned either to a high- (65 to 75% maximum oxygen consumption rate [VO2max]) or to a low-intensity (less than 45% VO2max) exercise group. Patients engaged in medically supervised aerobic training 3 sessions a week for 12 weeks. With training, mean VO2max significantly increased by 11% (2.09 to 2.31 liters/min) within the high group and by 14% (1.93 to 2.21 liters/min) within the low group. Differences between groups were not statistically significant. Both groups also had comparable changes in heart rate, blood pressure and double-product at submaximal and maximal workloads. Analysis of blood lipids revealed that both groups experienced a significant increase in high density lipoprotein cholesterol. There were no significant changes in total serum cholesterol or triglycerides. These findings suggest that within an unselected population of patients after acute myocardial infarction referred for cardiac rehabilitation, low- and high-intensity exercise training produces relatively similar changes in cardiorespiratory variables during the initial 3 months of exercise training.

Effects of exercise training on cardiorespiratory function in men and women >60 years of age

Abstract This study reports the physiologic effects of up to 14 months of aerobic exercise in 101 older (>60 years) men and women. After an extensive baseline physiologic assessment (Time 1), in which aerobic capacity and blood lipids were measured, subjects were randomized to an aerobic exercise condition (cycle ergometry, 3 times per week for 1 hour), nonaerobic yoga (2 times per week for 1 hour), or a waiting list nonexercise control group for 4 months, and then underwent a second (Time 2) assessment. At the completion of the second assessment, all remaining subjects completed 4 months of aerobic exercise and were reevaluated (Time 3). Subjects were given the option of participating in 6 additional months of supervised aerobic exercise, and all available subjects completed a fourth assessment (Time 4) 14 months after their initial baseline evaluation. Results indicated that subjects generally exhibited a 10 to 15% improvement in peak oxygen consumption after 4 months of aerobic exercise training, and a 1 to 6% improvement in aerobic power with additional aerobic exercise training. On the other hand, subjects, especially men, continued to have improvements in submaximal exercise performance (i.e., anaerobic threshold). In addition, aerobic exercise was associated with an improved lipid profile; subjects participating in aerobic exercise for up to 14 months exhibited increased levels of high-density lipoprotein cholesterol. Maintenance of regular aerobic exercise for an extended time interval is associated with greater cardiovascular benefits among older adults than has been reported previously.

Effects of Exercise Training on Bone Density in Older Men and Women

Objectives: To determine the effects of up to 14 months of aerobic exercise on measures of bone density in older adults.

Exercise adherence or maintenance among older adults : 1-year follow-up study

Follow-up evaluation was conducted of 101 older men and women (mean age = 67 +/- 5 years) who had participated in a randomized study of physiological and psychological effects of aerobic exercise. Eighty-five subjects completed the follow-up evaluation, and almost all of them (94%) reported continuing with physical activity, as assessed by a self-report measure. Total energy expenditure was calculated as an indicator of exercise maintenance, and energy expenditure at follow-up was predicted from measures of physiological functioning, psychological well-being, and cognitive functioning obtained at the conclusion of the structured exercise program. Greater cardiorespiratory endurance, faster psychomotor speed, and lower anxiety predicted exercise behavior at follow-up, accounting for 13% of the variance in exercise behavior. Gender was not a significant predictor of exercise behavior.

Quality of life among hypertensive patients with a diuretic background who are taking atenolol and enalapril

The cardioselective β‐blocker atenolol and the angiotensin‐converting enzyme inhibitor enalapril were compared for efficacy, safety, and quality‐of‐life factors in 30 patients with hypertension whose hypertension was inadequately controlled with diuretic alone. Atenolol (50 to 100 mg once a day) and enalapril (2.5 to 40 mg once a day), combined with hydrochlorothiazide (25 mg once a day), had similar levels of efficacy and safety. A comprehensive battery of psychologic assessments for quality of life was administered, including measures of anxiety, depression, psychiatric symptoms, memory, and psychomotor function. These five conceptually based clusters were first analyzed by multivariate analysis of variance procedures, followed by univariate analyses of the individual variables composing each domain. In general, neither atenolol nor enalapril was associated with major changes in psychologic functioning. The only data cluster with a statistically significant change was memory function, primarily as a result of lower scores of the digit span (backward) test, for atenolol relative to enalapril. These preliminary findings suggest that atenolol and enalapril have comparable degrees of efficacy and safety, with no major disparities in quality‐of‐life effects, for hypertensive patients with a history of taking diuretics and this sort of quality‐of‐life assessment can be performed during trials of antihypertensive drugs.

Effects of exercise training on psychological functioning in healthy type a men

Abstract This study was designed to assess the effects of exercise on psychological functioning in healthy Type A men. Seventy-three middle-aged men (M=42.2 years) were randomly assigned either to an aerobic exercise (AE) training group or to a strength and flexibility (SF) training group. Subjects completed a comprehensive psychological assessment battery prior to beginning the 12-week exercise programs, and after completing the programs. The psychological test battery included measures of depression, anxiety and stress, as well as various psychiatric symptoms. In addition, subjects underwent graded exercise treadmill tests (ETT) at both times of measurement in order to document changes in cardiorespiratory fitness. Aerobic exercise training consisted of walking, jogging or stair-climbing at an intensity of at least 70% of initial measured maximal oxygen consumption (VO2max determined during the treadmill test). Strength and flexibility training consisted of circuit Nautilus training with no aerobic exer...