Challenge Your Body, Challenge Your Mind: the Combined Effect of Fitness Level and Stress Appraisal on Stress Responses and Subsequent Cognitive Performance.

BACKGROUND: Because of the health issues associated with high stress levels, it is important to find new strategies to regulate stress response. Previous research has examined the separate effects of fitness level and stress reappraisal on the stress response, but the combination of both factors is unknown. The goal of the study was to examine the combined effects of fitness and stress appraisal on stress responses and cognitive performance following a stressful event. METHOD: On 2 separate days, 24 highly and poorly fit young men (Mage = 22.33, SD = 3.33) were exposed to a validated stress test and were induced to view their stress as facilitative or debilitative. Objective and subjective stress responses along with cognitive performance were evaluated before and immediately after the stress test. RESULTS: Participants in the high-fit/negative appraisal condition reported lower anxiety scores than participants in the low-fit/negative appraisal condition (d = 1.04). Participants had higher levels of cortisol after the stress test (d = 0.31), but no difference in heart rate, cortisol, or cognitive performance emerged among the conditions. CONCLUSION: Fitness level might have a larger impact on stress response than stress appraisal, and stress reappraisal manipulations require more than just reading a note and a self-talk statement.

The influence of the CYP1A2-163 C>A polymorphism on the hemostatic response to exercise following caffeine supplementation.

BACKGROUND: Prior work from our group suggests that caffeine increases thrombotic potential after acute exercise. The aim of this study was to determine if hemostatic responses to exercise affected by caffeine are influenced by the CYP1A2-163 C>A polymorphism. METHODS: Forty-two healthy men performed two trials in which a graded maximal exercise test was completed one hour after consuming either 6 mg/kg of caffeine or placebo. Subjects were categorized as possessing the C allele (N.=21) or being homozygous for the A allele (N.=21). RESULTS: Factor VIII increased more (265%) during exercise in the caffeinated condition than the placebo condition (178%) (P<0.05). Tissue plasminogen activator (tPA) activity also increased more following caffeine as compared to placebo (increase of 8.70±4.32 IU/mL vs. 6.77±3.79 IU/mL respectively, P<0.05). There was no treatment × genotype or treatment × time × genotype interactions. CONCLUSIONS: Although caffeine increases factor VIII and tPA responses to maximal exercise, these changes are not influenced by the CYP1A2-163 C>A polymorphism.

The Influence of a Total Body Resistance Training Program on Autonomic Modulation and Strength Variables in Young Adults.

The purpose of this study was to examine autonomic modulation using multiple quantitative measures before and after a resistance training (RT) intervention. Seventeen young adults (age 18-35 years) were tested for body composition, muscular strength, and autonomic activity. The RT protocol targeted total-body large muscle groups, which were performed three days a week for eight-weeks. Autonomic assessments included respiratory sinus arrhythmia (RSA), static handgrip exercise, Valsalva maneuver, heart rate variability (HRV), and tilt-table testing. The main finding was that tilt-table duration increased by 68 seconds (p = 0.05) after RT. Upper body strength increased by 11.2 kg (p = 0.001) and lower body strength increased by 68.3 kg (p < 0.001) following completion of the RT intervention. The average total lean mass increased by 1.5 kg (p < 0.01), while total fat mass was unchanged (Δ = 0.5 kg, p = 0.23). RSA (Δ = 0.4, p = 0.89), Valsalva ratio (Δ = -0.09, p = 0.48), static handgrip (Δ = 8 mm Hg, p = 0.07), and HRV (Δ = -0.4, p = 0.53) were not affected by RT. The results from this study suggest that RT improves tilt-table tolerance in a young healthy population as evidence by improved tilt-table duration. However, RT seemed to have no effect on cardio-vagal or adrenergic function.

Head Trauma not Associated with Long Term Effects on Autonomic Function.

Contact-sports can elicit concussions, which impacts autonomic function, as well as elicit repetitive head trauma, where autonomic function has not yet been assessed. The purpose of this study was to determine if differences in autonomic function exist among three groups (CTRL: healthy non-contact-sport participant, RHT: repetitive head trauma contact-sport participant, CONC: previous concussion). Forty participants (16 men and 24 women), aged 18-37 (22 ± 3), participated in the study. Participants were grouped based on their sport and concussion history (CTRL, RHT, and CONC). Body composition was measured via air displacement plethysmography. Prior to testing, participants were outfitted with equipment to evaluate heart rate, blood pressure, and cerebral-artery blood flow velocity (CBFv). The participant performed against three stimuli: deep breathing, Valsalva maneuver, and a 70° head-up tilt test. Following autonomic function testing, a YMCA submaximal cycle test was performed. All group comparisons were analyzed using a one-way ANOVA and all data are presented as means ± standard deviation. The results of this study indicated that the groups did not differ in respiratory sinus arrhythmia (CTRL: 22 ± 6 bpm, RHT: 21 ± 8 bpm, CONC: 19 ± 7 bpm, p = 0.471), Valsalva ratio (CTRL: 2.19 ± 0.39, RHT: 2.09 ± 0.37, CONC: 2.00 ± 0.47, p = 0.519), CBFv (CTRL: 47.74 ± 25.28 cm/s, RHT: 40.99 ± 10.93 cm/s, CONC: 43.97 ± 17.55 cm/s, p = 0.657), or tilt time (CTRL: 806.09 ± 368.37 sec, RHT: 943.07 ± 339.54 sec, CONC: 978.40 ± 387.98 sec, p = 0.479). However, CONC (113.24 ± 11.64 mmHg) had a significantly higher mean systolic blood pressure during the tilt test than CTRL (102.66 ± 7.79 mmHg, p = 0.026), while RHT (107.9 ± 9.0 mmHg) was not significantly different than CTRL (p = 0.39) or CONC (p = 0.319). The results of this study are the first step in determining if long-lasting deficits to the autonomic nervous system occur following a diagnosis of concussion. However, concussions do not seem to have lasting effects on autonomic function. Overwhelmingly, dysautonomia is not present during chronic recovery from concussions or in individuals with RHT from contact-sports. In the future, sex should be considered as a variable.

Regular Resistance Training Enhances Fibrinolytic Potential but Does Not Affect Coagulation.

PURPOSE: This study aimed to identify effects of an 8-wk, whole-body RT program on coagulation and fibrinolysis. METHODS: Sixteen healthy women and men (23 ± 5 yr) completed an RT program three times per week for 8 wk. Exercises included 2-3 sets of 8-12 repetitions performed at approximately 60%-80% of a one repetition maximum. Strength, body composition, and body circumferences were assessed before and after training. Plasma samples were obtained before and after training, and analyzed for active tissue plasminogen activator (tPA activity), total tissue plasminogen activator (tPA antigen), active plasminogen activator inhibitor-1 (PAI-1 activity), total plasminogen activator inhibitor-1 (PAI-1 antigen), fibrinogen, and coagulation factors VII (FVII) and VIII (FVIII). RESULTS: Significant increases in lean mass, arm and thigh circumferences, maximal chest press (PRE: 57.8 ± 37.5 kg, POST: 73.3 ± 43.2 kg), and leg press (PRE: 189.5 ± 96.0 kg, POST: 256.7 ± 97.9 kg) were observed (P < 0.05 for all). PAI-1 activity (PRE: 20.3 ± 32.5 IU·mL-1, POST 9.5 ± 20.9 IU·mL-1) and PAI-1 antigen decreased (PRE: 10.2 ± 9.0 ng·dL-1, POST: 7.2 ± 5.7 ng·dL-1; both, P < 0.05). No change in tPA activity or tPA antigen occurred. Fibrinogen, FVII, and FVIII did not change after training. CONCLUSIONS: Inhibition of fibrinolysis was decreased after training, and coagulation was unaffected. These results suggest that regular RT may beneficially influence the risk of a thrombotic event. More research is warranted to understand the mechanisms through which RT affects hemostasis.

Hemostatic Adaptations to High Intensity Interval Training in Healthy Adult Men.

Regular exercise is theorized to reduce cardiovascular risk by attenuating coagulation and augmenting fibrinolysis. However, these adaptations have not been consistently observed during traditional exercise programs. The purpose of this study was to examine hemostatic adaptations in healthy men following four (4W) and eight (8W) weeks of high intensity interval training. Twenty-one men (age=25±1 y; body mass index=26.5±6.4 kg/m2) completed eight weeks, three days/week of high intensity interval training on a cycle ergometer. Activated partial thromboplastin time, prothrombin time, and plasma concentrations of thrombin-antithrombin III, fibrinogen, tissue plasminogen activator, and plasminogen activator inhibitor-1 were assessed at baseline (BL), 4W, and 8W. Repeated measures ANOVA were used to determine potential effects of training. There were no significant changes observed for activated partial thromboplastin time (BL=43.3±5.5, 4W=43.2±5.1, 8W=44.2±6.4 s); prothrombin time (BL=13.2±0.9, 4W=13.0±0.6, 8W=13.1±0.8 s); thrombin-antithrombin III (BL=6.0±2.3, 4W=5.8±2.3, 8W=5.6±3.1 ng/mL); tissue plasminogen activator (BL=9.7±3.3, 4W=9.4±3.2, 8W=8.7±2.8 ng/mL); and plasminogen activator inhibitor-1 (BL=19.0±17.5, 4W=19.3±17.0, 8W=18.9±18.9 ng/mL) (all p>0.05). Fibrinogen was significantly lower at 4W (238.6±70.3 mg/dL) compared to BL (285.0±82.1 mg/dL; p<0.05) and 8W (285.3±83.2 mg/dL; p<0.05). These findings indicate that eight weeks of high intensity interval training does not influence coagulation potential and/or stimulate fibrinolysis.

Effect of Sex and Menstrual Cycle on Skin Sensory Nerve Contribution to Local Heating.

The purpose of this study was to determine sex differences in the contribution of sensory nerves to rapid cutaneous thermal hyperemia. Healthy young females (n = 15, tested during both the early follicular (EF) and the mid-luteal (ML) phase of the menstrual cycle) and males (n = 15) had a 4 cm2 area of skin on one forearm and one leg treated with a eutectic mixture of local anesthetic (EMLA). EMLA sites, along with corresponding control sites, were instrumented with laser Doppler flowmetry probes and local skin heaters. Baseline (33 °C), rapid and sustained vasodilation (42 °C), and maximal vasodilation (44 °C) skin blood flow data were obtained and expressed as a percentage of maximal cutaneous vascular conductance (%CVCmax). Contribution of sensory nerve involvement was determined by comparing the EMLA site to its matched control site utilizing the formula [(% CVCmax control - % CVCmax treatment) / % CVCmax control] × 100. The contribution of sensory nerves to rapid cutaneous thermal hyperemia in the forearm was 24 ± 18 %CVCmax in males, 41 ± 17 %CVCmax in ML females (p = 0.02 vs. males), and 35 ± 17 %CVCmax in EF females (p > 0.05 vs. males). In the leg, the contribution of sensory nerves was 16 ± 15 %CVCmax in males, 34 ± 17 %CVCmax for ML females (p = 0.02 vs. males), and 28 ± 21 %CVCmax in EF females (p > 0.05 vs. males). ML females exhibited a greater contribution of sensory nerves to rapid cutaneous thermal hyperemia in the forearm and leg, possibly attributed to elevated reproductive hormones during the ML phase.

Caffeine Augments the Prothrombotic but Not the Fibrinolytic Response to Exercise.

Caffeine, a popular ergogenic supplement, induces neural and vascular changes that may influence coagulation and/or fibrinolysis at rest and during exercise. PURPOSE: The purpose of this study was to assess the effect of a single dose of caffeine on measures of coagulation and fibrinolysis before and after a single bout of high-intensity exercise. METHODS: Forty-eight men (age, 23 ± 3 yr; body mass index, 24 ± 3 kg·m) completed two trials, with 6 mg·kg of caffeine (CAFF) or placebo (PLAC), in random order, followed by a maximal cycle ergometer test. Plasma concentrations of fibrinogen, factor VIII antigen, active tissue plasminogen activator (tPA:c), tissue plasminogen activator antigen (tPA:g), and active plasminogen activator inhibitor-1 (PAI-1:c) were assessed at baseline and immediately after exercise. RESULTS: Exercise led to significant changes in tPA:c (Δ 8.5 ± 4.36 IU·mL for CAFF, 6.6 ± 3.7 for PLAC), tPA:g (Δ 2.4 ± 3.2 ng·mL for CAFF, 1.9 ± 3.1 for PLAC), fibrinogen (Δ 30.6 ± 61.4 mg·dL for CAFF, 28.1 ± 66.4 for PLAC), and PAI-1:c (Δ -3.4 ± 7.9 IU·mL for CAFF, -4.0 ± 12.0 for PLAC) (all P < 0.05), but no effect of condition or time-condition interactions were observed. Main effects of time, condition, and a significant time-condition interaction were observed for factor VIII, which increased from 1.0 ± 0.4 IU·mL to 3.3 ± 1.3 IU·mL with CAFF and 1.0 ± 0.4 IU·mL to 2.4 ± 0.9 IU·mL with PLAC. CONCLUSIONS: Coagulation potential during exercise is augmented after caffeine intake, without a similar increase in fibrinolysis. These results suggest caffeine intake may increase risk of a thrombotic event during exercise.

The Influence of Tissue Plasminogen Activator I/D Polymorphism on the tPA Response to Exercise.

The purpose was to determine if the Alu-insertion (I)/deletion (D) polymorphism of the tissue plasminogen activator (tPA) gene influences the tPA response to maximal exercise. Fifty male subjects (age = 23.6 ± 4.7 yrs) completed a maximal treadmill exercise test. Blood samples were drawn before and immediately after exercise for determination of plasma tPA antigen and activity. Isolated DNA was amplified via polymerase chain reaction, electrophoresed, and visually amplified to determine tPA genotype. Subjects were classified as possessing the D allele (D) (n = 28) or being homozygous for the I allele (I) (n = 22). Differences in tPA antigen and activity were assessed using a two-factor (genotype and time) repeated measures analysis of variance. There were significant main effects for time for tPA antigen and activity (p < 0.05), but no main effect for genotype. Furthermore, there was no genotype x time interaction due to a similar increase in tPA antigen in the D group (pre-exercise = 5.83 + 2.39 ng/ml, post-exercise = 21.88 + 7.38 ng/ml) and the I group (pre-exercise = 5.61 + 2.82 ng/ml, post-exercise = 19.05 + 7.67 ng/ml) and a similar increase in tPA activity in the D group (pre-exercise = 0.39 ± 0.19 IU/ml, post-exercise = 9.73 ± 4.22 IU/ml) and I group (pre-exercise = 0.45 ± 0.29 IU/ml, post-exercise = 9.76 ± 5.50 IU/ml). The I/D polymorphism of the tPA gene does not influence the tPA antigen nor tPA activity responses to maximal exercise in healthy, young, sedentary males.

Age and aerobic training status effects on plasma and skeletal muscle tPA and PAI-1.

INTRODUCTION: Reductions in fibrinolytic potential occur with both aging and physical inactivity and are associated with an increased cardiovascular disease risk. Plasmin, the enzyme responsible for the enzymatic degradation of fibrin clots, is activated by tissue plasminogen activator (tPA), while plasminogen activator inhibitor-1 (PAI-1) inhibits its activation. Currently, fibrinolysis research focuses almost exclusively on changes within the plasma. However, tPA and PAI-1 are expressed by human skeletal muscle (SM). Currently, no studies have focused on changes in SM fibrinolytic activity with regard to aging and aerobic fitness. PURPOSE: The purpose of this study was to cross-sectionally evaluate effects of age and aerobic fitness on tPA and PAI-1 expressions and activity in SM. METHODS: Twenty-six male subjects were categorized into the following groups: (1) young aerobically trained (n = 8); (2) older aerobically trained (n = 6); (3) young aerobically untrained (n = 7); and (4) older aerobically untrained (n = 5). Muscle biopsies were obtained from each subject. SM tPA activity was assessed using gel zymography and SM tPA and PAI-1 expressions were assessed using RT-PCR. RESULTS: Trained subjects had higher SM tPA activity compared to untrained (25.3 ± 2.4 × 10(3) vs. 21.5 ± 5.6 × 10(3) pixels, respectively; p = 0.03) with no effect observed for age. VO2 max and SM tPA activity were also significantly correlated (r = 0.42; p < 0.04). SM tPA expression was higher in older participants, but no effect of fitness level was observed. No differences were observed for PAI-1 expression in SM. CONCLUSIONS: Higher levels of aerobic fitness are associated with increased fibrinolytic activity in SM.

The effects of whole-body vibration on the Wingate test for anaerobic power when applying individualized frequencies.

Recently, individualized frequency (I-Freq) has been introduced with the notion that athletes may elicit a greater reflex response at differing levels (Hz) of vibration. The aim of the study was to evaluate acute whole-body vibration as a feasible intervention to increase power in trained cyclists and evaluate the efficacy of using I-Freq as an alternative to 30Hz, a common frequency seen in the literature. Twelve highly trained, competitive male cyclists (age, 29.9 ± 10.0 years; body height, 175.4 ± 7.8 cm; body mass, 77.3 ± 13.9 kg) participated in the study. A Wingate test for anaerobic power was administered on 3 occasions: following a control of no vibration, 30 Hz, or I-freq. Measures of peak power, average power (AP), and the rate of fatigue were recorded and compared with the vibration conditions using separate repeated measures analysis of variance. Peak power, AP, and the rate of fatigue were not significantly impacted by either the 30 Hz or I-Freq vibration interventions (p > 0.05). Given the trained status of the individuals in this study, the ability to elicit an acute response may have been muted. Future studies should further refine the vibration parameters used and assess changes in untrained or recreationally trained populations.

Ambient temperature affects thrombotic potential at rest and following exercise.

INTRODUCTION: During exercise, ischemic risk increases, possibly due to changes in coagulation and fibrinolytic activity. Previous research suggests ambient temperature affects resting thrombotic potential, but the effect of heat and cold on hemostasis during exercise is unknown. The purpose of this study was to assess changes in coagulation and fibrinolysis during maximal exercise in hot and cold temperatures, and to compare those responses to exercise under temperate conditions. MATERIALS & METHODS: Fifteen healthy men completed maximal exercise tests in hot (30°C), temperate (20°C) and cold (5° - 8°C) temperatures. Blood samples were obtained before and immediately after exercise and analyzed for concentrations of thrombin-antithrombin III (TAT), active tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1). Results were analyzed by ANOVA. RESULTS: A main effect of time was observed for TAT (temperate=1.71 ± 0.82 - 2.61 ± 0.43 ng/ml, hot=1.81 ± 0.73 - 2.62 ± 0.67 ng/ml, cold=2.33 ± 0.65 - 2.89 ± 0.81 ng/ml, PRE to POST, respectively) and tPA activity (temperate=0.72 ± 0.44 - 2.71 ± 0.55 IU/ml, hot=0.72 ± 0.38 - 2.64 ± 0.61 IU/ml, cold=0.86 ± 0.45 - 2.65 ± 0.77 IU/ml, PRE to POST, respectively). A trend was observed for the PAI-1 response to exercise (temperate=14.5 ± 23.7 - 12.3 ± 20.2I U/ml, hot=15.1 ± 26.5 - 10.0 ± 15.1 IU/ml, cold=10.5 ± 10.4 - 7.9 ± 9.7 IU/ml, PRE to POST, respectively, p=0.08). TAT concentrations were significantly higher in cold compared to temperate and hot conditions. CONCLUSION: Coagulation potential is elevated during exposure to cold temperatures. These data suggest that risk of an ischemic event may be elevated in the cold.

Responses to exercise differ for chronic fatigue syndrome patients with fibromyalgia.

UNLABELLED: Chronic fatigue syndrome (CFS) and fibromyalgia (FM) are chronic multisymptom illnesses with substantial clinical and diagnostic overlap. We have previously shown that, when controlling for aerobic fitness and accounting for comorbid FM, CFS patients do not exhibit abnormal cardiorespiratory responses during maximal aerobic exercise compared with healthy controls, despite differences in pain and exertion. PURPOSE: The purpose of the present study was to examine cardiac and perceptual responses to steady-state submaximal exercise in CFS patients and healthy controls. METHODS: Twenty-one CFS patients (13 CFS with comorbid FM (CFS + FM)) and 14 controls completed 20 min of submaximal cycling exercise. Impedance cardiography was used to determine cardiac responses during exercise. Systolic blood pressure (SBP), RPE, and leg muscle pain were also measured. Data were analyzed using a doubly multivariate, repeated-measures MANOVA to model the exercise response. RESULTS: There was a significant multivariate time-by-group interaction (P < 0.05). The CFS + FM group exhibited an exercise response characterized by higher stroke index, ventilatory equivalents for oxygen and carbon dioxide and RPE, lower SBP, and similar HR responses compared to controls. CONCLUSIONS: The present results extend on our previous work with maximal exercise and show that CFS and CFS + FM differ in their responses to steady-state exercise. These results highlight the importance of accounting for comorbid conditions when conducting CFS research, particularly when examining psychophysiological responses to exercise.

The effects of whole body vibration and exercise on fibrinolysis in men.

Whole body vibration (WBV) is a novel modality that has been demonstrated to enhance muscular and cardiovascular functions reported to increase fibrinolytic activity. The purpose of this study was to examine the fibrinolytic response to WBV and exercise in men. Twenty healthy males (23.8 ± 0.9 years, 25.6 ± 0.2 kg m(-2)) participated in the study. Each subject performed three trials in randomized order separated by 1 week: exercise (X), vibration (V) and vibration + exercise (VX). Exercise sessions consisted of 15 min of unloaded squatting at a rate of 20 per minute. Vibration sessions were conducted on a WBV platform vibrating for 15 min. Tissue plasminogen activator (tPA) and plasminogen activator inhibitor (PAI-1) were assessed at baseline and immediately after each condition. The increase in tPA activity was significantly greater in VX (0.87 ± 0.35 to 3.21 ± 1.06 IU ml(-1)) compared to X (0.71 ± 0.36 to 2.4 ± 1.13 IU ml(-1)) or V (0.83 ± 0.25 to 1.00 ± 0.37 IU ml(-1)) conditions, and greater in the X condition compared to the V condition. PAI-1 activity decreased significantly more in the VX (6.54 ± 5.53 to 4.89 ± 4.13 IU ml(-1)) and X (9.76 ± 8.19 to 7.48 ± 7.11 IU ml(-1)) conditions compared to the V (5.68 ± 3.53 to 5.84 ± 3.52 IU ml(-1)) condition. WBV does not augment fibrinolytic activity in healthy men. However, WBV combined with squatting exercise increases fibrinolytic activity more than exercise alone.

Physical activity habits of cardiac patients participating in an early outpatient rehabilitation program.

PURPOSE: The primary purpose of the study was to assess whether physical activity (PA) habits change following 4 to 6 weeks of an early outpatient cardiac rehabilitation (CR) program. A secondary purpose was to determine whether the PA habits differ on days attending CR versus not attending CR. METHODS: Fourteen men and 8 women completed the study (age = 65.6 +/- 13.2 years, body mass index = 29.1 +/- 4.6 kg/m). Subjects wore an accelerometer during the entry and exit weeks of CR participation. Steps per day, activity counts per observation minute, percentage time spent inactive, light-intensity PA minutes per day, and moderate-intensity PA minutes per day were compared both at entry and exit from CR and on days attending CR and not attending CR. RESULTS: From entry to exit of the early outpatient CR, patients increased total PA behavior (194.4 +/- 2 to 217.8 +/- 15.3 activity counts per observation minute) and time spent in moderate-intensity PA (13.9 +/- 2.3 to 18.7 +/- 2.5 min/d). Patients were more active, both in total activity (224.0 +/- 15.6 activity counts per observation minute vs 188.2 +/- 14.5 activity counts per observation minute) and in moderate intensity (19.7 +/- 3.3 min/d vs 12.8 +/- 2.0 min/d), on days they attended CR than on days they did not attend CR. CONCLUSIONS: These data support the value of early outpatient CR programs for increasing patient PA levels, particularly moderate-intensity PA on days during which patients attended CR. Because PA targets for coronary risk reduction are not being achieved when patients exit CR, referral to a maintenance CR program and support for performing PA on days they do not attend CR become essential.

Discordant hemodynamic and fibrinolytic adaptations following a 6-week cardiac rehabilitation program.

The present study evaluated changes in hemodynamics and fibrinolysis during 6 weeks of participation in an exercise-based cardiac rehabilitation program. Fourteen patients trained for 3 days per week for 6 weeks using American College of Sports Medicine guidelines for intensity and duration. Blood samples were taken at baseline and after 3 and 6 weeks of participation and analyzed for tissue plasminogen activator (t-PA) activity and antigen, plasminogen activator inhibitor-1 (PAI-1) activity and antigen, and relative quantification of t-PA and PAI-1 RNA. Data were analyzed using repeated measures analysis of variance. Training elicited significant decreases in submaximal exercise heart rate and systolic blood pressure and resting systolic blood pressure (p<.05). There were no significant changes in plasma concentrations of t-PA or PAI-1, and no change was observed in t-PA or PAI-1 gene expression. The present findings suggest that favorable hemodynamic adaptations may occur after only 6 weeks of exercise-based cardiac rehabilitation, but longer training periods may be needed to elicit positive hemostatic adaptations.

The influence of aerobic fitness and fibromyalgia on cardiorespiratory and perceptual responses to exercise in patients with chronic fatigue syndrome.

OBJECTIVE: To investigate cardiorespiratory and perceptual responses to exercise in patients with chronic fatigue syndrome (CFS), accounting for comorbid fibromyalgia (FM) and controlling for aerobic fitness. METHODS: Twenty-nine patients with CFS only, 23 patients with CFS plus FM, and 32 controls completed an incremental bicycle test to exhaustion. Cardiorespiratory and perceptual responses were measured. Results were determined for the entire sample and for 18 subjects from each group matched for peak oxygen consumption. RESULTS: In the overall sample, there were no significant differences in cardiorespiratory parameters between the CFS only group and the controls. However, the CFS plus FM group exhibited lower ventilation, lower end-tidal CO2, and higher ventilatory equivalent of carbon dioxide compared with controls, and slower increases in heart rate compared with both patients with CFS only and controls. Peak oxygen consumption, ventilation, and workload were lower in the CFS plus FM group. Subjects in both the CFS only group and the CFS plus FM group rated exercise as more effortful than did controls. Patients with CFS plus FM rated exercise as significantly more painful than did patients with CFS only or controls. In the subgroups matched for aerobic fitness, there were no significant differences among the groups for any measured cardiorespiratory response, but perceptual differences in the CFS plus FM group remained. CONCLUSION: With matching for aerobic fitness, cardiorespiratory responses to exercise in patients with CFS only and CFS plus FM are not different from those in sedentary healthy subjects. While CFS patients with comorbid FM perceive exercise as more effortful and painful than do controls, those with CFS alone do not. These results suggest that aerobic fitness and a concurrent diagnosis of FM are likely explanations for currently conflicting data and challenge ideas implicating metabolic disease in the pathogenesis of CFS.

Exercise and cognitive performance in chronic fatigue syndrome.

PURPOSE: To determine the effect of submaximal steady-state exercise on cognitive performance in patients with chronic fatigue syndrome (CFS) alone, CFS with comorbid fibromyalgia FM (CFS + FM), and sedentary healthy controls (CON). METHODS: Twenty CFS-only patients, 19 CFS + FM, and 26 CON completed a battery of cognitive tests designed to assess speed of information processing, variability, and efficiency. Tests were performed at baseline, immediately before, and twice following 25 min of either cycle ergometry set at 40% of peak oxygen capacity or quiet rest. RESULTS: There were no group differences in average percentage of peak oxygen consumption during exercise (CFS = 45%; CFS + FM = 47%; Control = 43%: P = 0.2). There were no significant effects of acute exercise on cognitive performance for any group. At baseline, one-way ANOVA indicated that CFS patients displayed deficits in speed of processing, performance variability, and task efficiency during several cognitive tests compared with healthy controls. However, the CFS + FM patients were not different than controls. Repeated measures ANOVA indicated that across all tests (pre- and postexercise) CFS, but not CFS + FM, were significantly less consistent (F2,59 = 3.7, P = 0.03) and less efficient (F2,59 = 4.6, P = 0.01) than controls. CONCLUSION: CFS patients without comorbid FM exhibit subtle cognitive deficits in terms of speed, consistency, and efficiency that are not improved or exacerbated by light exercise. Importantly, our data suggest that CFS + FM patients do not exhibit cognitive deficits either pre- or postexercise. These results highlight the importance of disease heterogeneity in studies determining acute exercise and cognitive function in CFS.

Temporal changes in tPA and PAI-1 after maximal exercise.

PURPOSE: Although fibrinolysis increases with acute exercise, it decreases rapidly during the postexercise period. Therefore, the time point at which blood samples are collected postexercise could affect reported tissue plasminogen activator (t-PA) and/or plasminogen activator inhibitor-1 (PAI-1) levels. The purpose of this study was to determine the time course of t-PA and PAI-1 changes after acute maximal exercise. METHODS: Eight healthy males performed a graded maximal exercise test on a treadmill. Venous blood samples were collected using an indwelling catheter before exercise and at 1, 2, 4, 6, 8, and 10 min postexercise. Mean differences in t-PA activity, t-PA antigen, and PAI-1 activity at each time point were assessed using a repeated measures ANOVA. Post hoc means comparisons were performed by contrasting the 1-min postexercise value against all other time points. RESULTS: Both t-PA activity and t-PA antigen significantly increased from pre- to postexercise (P < 0.05). t-PA activity did not change from 1 to 2 min postexercise but decreased significantly at 4 min postexercise. Likewise, t-PA antigen remained elevated from 1 to 2 min postexercise but decreased at 4 min postexercise. PAI-1 decreased from pre- to postexercise but did not change during the 10-min postexercise period. CONCLUSION: To accurately evaluate the t-PA response to acute exercise, blood samples should be collected within 2 min after the cessation of exercise.

Aerobic capacity of Gulf War veterans with chronic fatigue syndrome.

A large overlap exists between the diagnosis of chronic fatigue syndrome (CFS) and the unexplained symptoms reported by many Gulf War veterans (GV). Previous investigations have reported reduced aerobic capacity in civilians with CFS. The present investigation examined metabolic responses to maximal exercise in GVs with CFS compared with healthy GVs. Cardiorespiratory and metabolic responses were recorded during a maximal exercise test on a cycle ergometer. The groups were not different in any demographic category (p > 0.05) or self-reported physical activity (p > 0.05). No differences were observed between groups for maximal oxygen uptake (28.9 +/- 6.7 mL/kg/min for CFS vs. 30.8 +/- 7.1 mL/kg/min for controls; p = 0.39), heart rate (155.8 +/- 16.1 bpm for CFS vs. 163.3 +/- 14.9 bpm for controls; p = 0.17), exercise time (9.6 +/- 1.5 minutes for CFS vs. 10.2 +/- 1.4 minutes for controls; p = 0.26), or workload achieved (208 +/- 36.7 W for CFS vs. 224 +/- 42.9 W for controls; p = 0.25). Likewise, no differences were observed at submaximal intensities (p > 0.05). Compared with healthy controls, GVs who report multiple medically unexplained symptoms and meet criteria for CFS do not show a decreased exercise capacity. Thus, it does not appear that the pathology of the GVs with CFS includes a deficiency with mobilizing the cardiopulmonary system for strenuous physical effort.