Walter R. Thompson

Effects of Yoga on Inflammation and Exercise Capacity in Patients With Chronic Heart Failure

BACKGROUND Despite recent advances in pharmacologic and device therapy, morbidity and mortality from heart failure (HF) remain high. Yoga combines physical and breathing exercises that may benefit patients with HF. We hypothesized that an 8-week regimen of yoga in addition to standard medical therapy would improve exercise capacity, inflammatory markers, and quality of life (QoL) in patients with HF. METHODS AND RESULTS New York Heart Association Class I-III HF patients were randomized to yoga treatment (YT) or standard medical therapy (MT). Measurements included a graded exercise test (GXT) to V O(2Peak) and the following serum biomarkers: interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), and extracellular superoxide dismutase (EC-SOD). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was administered to assess changes in QoL. A total of 19 patients were enrolled after the initial screening. Of the 19 patients, 9 were randomized to YT and 10 to MT. Patients had a mean EF of 25%. GXT time and V O(2Peak) were significantly improved in the YT versus MT groups (+18% in the YT and -7.5% in MT; P = .03 vs. control and +17 in YT and -7.1 in MT; P = .02, respectively). There were statistically significant reductions in serum levels of IL-6 and hsCRP and an increase in EC-SOD in the YT group (all P < .005 vs. MT). MLHFQ scores improved by 25.7% in the YT group and by 2.9% in the MT group. CONCLUSIONS Yoga improved exercise tolerance and positively affected levels of inflammatory markers in patients with HF, and there was also a trend toward improvements in QoL.

Cardiovascular and thermal responses of triathlon performance.

Triathletes typically train each triathlon event separately. Therefore, to determine the cardiovascular and thermal differences between training and triathlon performance, nine male triathletes performed a simulated 75-min (40 km) control bike and a 40-min (10 km) control run at 70% of maximal oxygen uptake. Control data were compared to data derived from a simulated triathlon (0.8-km swim, 75-min bike, and 40-min run). Results demonstrated that prior swimming significantly decreased (P less than 0.05) triathlon cycling work output (191 +/- 4.2 to 159 +/- 7.6 W) producing mean differences (P less than 0.05) in oxygen uptake (3.18 +/- 0.1 to 3.01 +/- 0.11.min-1), ventilation (84.7 +/- 4 to 80.4 +/- 4.21.min-1), stroke volume (128 +/- 7.1 to 118 +/- 3.5 ml.min-1), cardiac output (20.7 +/- 1.2 to 18.9 +/- 0.8 l.min-1), mean arterial pressure (105 +/- 3.8 to 96 +/- 7.9 mm Hg) and rectal temperature (38.2 +/- 0.2 to 38.4 +/- 0.3 degrees C). Triathlon running, while performing identical control work output, elicited significant increases (P less than 0.05) in oxygen uptake (3.41 +/- 0.1 to 3.85 +/- 0.1 l.min-1), ventilation (91.3 +/- 3.3 to 104.2 +/- 2.8 l.min-1), heart rate (161 +/- 3.1 to 174 +/- 3.6 beats.min-1), arteriovenous oxygen difference (15.3 +/- 0.2 to 17.2 +/- 0.3 ml.100 ml-1) and rectal temperature (38.3 +/- 0.2 and 39.2 +/- 0.3 degrees C) with significantly lower (P less than 0.05) stroke volume (138 +/- 2.4 to 129 +/- 3.6 ml.min-1) and mean arterial pressure (102 +/- 11.2 to 89 +/- 5.5 mm Hg).(ABSTRACT TRUNCATED AT 250 WORDS)

Benefits of Yoga for African American Heart Failure Patients

BACKGROUND The number of African American (AA) patients living with heart failure (HF) has been increasing, especially among the economically disadvantaged. Yoga therapy has been found to improve physical and psychological parameters among healthy individuals, but its effect in patients with HF remains unknown. The purpose of this study was to examine the effects of yoga therapy on cardiovascular endurance (VO2peak), flexibility, quality of life (QoL), and inflammatory markers on medically stable HF patients. METHODS Forty patients (38 AA, 1 Asian, and 1 Caucasian) with systolic or diastolic HF were randomized to the yoga group (YG, n = 21) or the control group (CG, n = 19). All patients were asked to follow a home walk program. Premeasurement and postmeasurement included a treadmill stress test to peak exertion, flexibility, interleukin-6 (IL-6), C-reactive protein (CRP), and extracellular superoxide dismutase (EC-SOD). QoL was assessed by the Minnesota Living with Heart Failure Questionnaire (MLwHFQ). RESULTS The statistical analyses (assessed by ANOVA and t-tests) were significant for favorable changes in the YG, compared with those in the CG, for flexibility (P = 0.012), treadmill time (P = 0.002), VO2peak (P = 0.003), and the biomarkers (IL-6, P = 0.004; CRP, P = 0.016; and EC-SOD, P = 0.012). Within the YG, pretest to posttest scores for the total (P = 0.02) and physical subscales (P < 0.001) of the MLwHFQ were improved. CONCLUSIONS Yoga therapy offered additional benefits to the standard medical care of predominantly AA HF patients by improving cardiovascular endurance, QoL, inflammatory markers, and flexibility.

Boosting in athletes with high-level spinal cord injury: knowledge, incidence and attitudes of athletes in paralympic sport

Autonomic dysreflexia (AD) is unique to individuals with spinal injuries (SCI) at T6 or above and can be voluntarily induced. Although AD improves wheelchair racing performance in some athletes, it also elicits exaggerated blood pressure, which could be dangerous. The International Paralympic Committee considers AD doping and banned its use. Purpose. The purpose of this study is to evaluate AD knowledge, incidence and attitudes (KIA) of Paralympians with SCI. Methods. An existing questionnaire was modified to include questions of AD KIA, validated by three experts and piloted with a small sample. It was administered on-line, mailed to members of a scientific network and distributed during the Beijing Paralympic Games. Fisher Exact test was used to evaluate differences across gender, injury and education. Results. Of 99 participants, 54.5% had previously heard of AD while 39.4% were unaware; 16.7%, all males, had used AD to enhance performance. Participants reported that AD was (1) useful for middle (78.6%) and long distance (71.4%), marathon (64.3%) and wheelchair rugby (64.3%); (2) somewhat dangerous (48.9%), dangerous (21.3%) or very dangerous (25.5%) to health. Results were not influenced by age, injury level or injury duration. Conclusions. Findings indicate the need for educational programmes directed towards enhancing the AD knowledge of rehabilitation professionals, coaches and trainers working with SCI individuals.

Effects of Qigong on Cardiorespiratory Changes: A Preliminary Study

Qigong, a special form of breathing exercise, was investigated to examine its effect on cardiorespiratory changes. Ten volunteers (five males and five females) participated in a 20-minute group instructional session for 10 consecutive days before testing of its treatment effects. The testing protocol followed a C1-T-C2 design, where C1, T, and C2 represented the first, treatment, and second control period, respectively. Each period consisted of a 5-minute interval, and thus each testing session consisted of 15 minutes. The results indicated there were no statistically significant differences (p > 0.05) in heart rate or tidal volume for the three 5-minute periods. There was a significant decrease (p < 0.05) in respiratory exchange ratio between T and C2. A significant increase in ventilatory efficiency for carbon dioxide production was found between C1 and T. Statistically significant differences (p < 0.05) were found in the volume of oxygen consumed and carbon dioxide produced, frequency of breath, expired ventilation, and ventilatory efficiency for oxygen produced between the T and the two control periods. This preliminary study of Qigong demonstrates that the subjects were able to learn the technique in a short period of time. The data also suggest that, with an improvement of nearly 20% in ventilatory efficiency for oxygen uptake and carbon dioxide production, this technique may have useful therapeutic value.

Dietary intake of female U.S. soccer players.

The purpose of this pilot study was to assess the dietary intake of female soccer players from the Under-21 (U-21) United States women’s national soccer team. Participants completed three-day food records and a medical history questionnaire. The female soccer players reported an energy intake of 34 kcal/kg body weight (total 2015 kcal/day). The contribution of protein, fat and carbohydrate to total energy intake were 15%, 30% and 55%, respectively. Dietary intakes of vitamins D and E were less than two-thirds of the recommendations and intake of all minerals was greater than two-thirds of the recommendations. The self-reported health status suggests that this was a healthy group of female athletes. Responses to the nutrition attitude questions suggest that these athletes may benefit from appropriate education regarding the role of nutrients in health and performance. In summary, results of this pilot study suggest that these young female soccer players should be encouraged to eat small, high carbohydrate nutrient dense meals, frequently throughout the day, and they should be provided with appropriate nutrition counseling.

Cardiovascular Responses during Speech: Does Social Support Mediate the Effects of Talking on Blood Pressure?'

Research by James J. Lynch and his colleagues demonstrates that as people speak, their blood pressure rises. Factors which accelerate or diminish this association include the social status of the listener, rate of speaking and resting blood pressure level. Another group of studies indicates that people high in social support are buffered from the negative health consequences of stressful life events. Is talking a stressor? Does social support mediate the effects of talking on blood pressure? Using procedures similar to those of Lynch, the study compared the cardiovascular responses of people high and low in perceived satisfaction with support provided by social contacts. Analysis of variance and simple correlations indicated that cardiovascular reactivity during both resting and talking states was negatively associated with social support.

Standardization indices of cardiac hypertrophy in weight lifters

In order to investigate further the use of standardization procedures to determine training effects on cardiac dimension and function, two groups of subjects were analysed noninvasively. A control group of sedentary men (n = 7) and an experimental group of weight lifters (n = 12) volunteered for a standard M-mode echocardiographic assessment. Indices of cardiac function as well as absolute left ventricular dimensions and left ventricular mass were similar between the groups. Standardizing for body surface area and body weight separated the groups. The weight lifters were shown to have a more muscular left ventricular posterior wall. The weight lifters also demonstrated a dilated left ventricle when indexing for body surface area. All other dimensional and volumetric indices were non-significant. The present investigation underlines the need for matching control and experimental groups to biometric variables in order to avoid misinterpreting cardiac enlargement. There is evidence for a true relative hypertrophy in weight lifters as indicated by similar absolute cardiac dimensions and similar biometric variables. Therefore, when evaluating athletes engaged in a chronic pressure overload, cardiac hypertrophy indices should consider body surface area (BSA), body weight and lean body weight (LBW). Future work in this field should incorporate rigorous controls on all biometric variables for better interpretation of hypertrophy in relative or absolute terms.

Worldwide Survey Reveals Fitness Trends for 2007

Learning Objectives From this article, the reader should understand the following concepts:

Daily Hassles Cause Burnout

Severe competition for the limited investment capital available and the high acquisition cost of bedside terminal systems require that the full benefit potential they offer be identified and realized. The authors discuss a multiple-phase study process used to: 1) identify the savings potential offered (to cost-justify its acquisition); and 2) assure the savings potential offered was realized.