Group exercise membership is associated with forms of social support, exercise identity, and amount of physical activity.

Exploring whether the mechanisms underlying the positive relationship between group exercise and physical activity are forms of social support - emotional, validation, informational, instrumental, and companionship and exercise identity. Participants (n=506; M age = 34.3) completed a 235-item questionnaire assessing physical activity, exercise identity, social support, and other determinants of physical activity. Exploratory path analysis was used to model group exercise membership, forms of social support, exercise identity, and metabolic equivalent (MET) minutes/wk. Women and men had similar yet varying results. For women, group exercise membership was significantly associated with MET-minutes/wk (ß = 0.11) and exercise identity (ß = 0.17). There was a significant association between exercise identity and MET-minutes/wk (ß = 0.38). Women perceived belonging to an exercise group provides emotional (ß = 0.36), validation (ß = 0.25), informational (ß = 0.35), instrumental (ß = 0.19), and companionship (ß = 0.46) support. Validation (ß = 0.11), informational (ß = 0.21), and companionship (B = 0.17) were significantly associated with exercise identity for women. For men, group exercise membership was not significantly associated with MET-minutes/wk or exercise identity. Exercise identity was significantly associated with MET-minutes/wk (ß = 0.46). Men perceived belonging to their group provides emotional (ß = 0.31), validation (ß = 0.32), informational (ß = 0.33), and companionship (ß = 0.34). Validation (ß = 0.22), informational (ß = 0.30), and emotional (ß = 0.23) were significantly associated with exercise identity for men. Belonging to an exercise group is associated with forms of social support that strengthen exercise identity.

Mexican-origin male perspectives of diet-related behaviors associated with weight management.

BACKGROUND: Prevalence rates of obesity and related diseases are quickly reaching epidemic proportions among Hispanic males in the United States. Hispanic males suffer from the highest prevalence of obesity-related diseases when compared to all other racial/ethnic groups. Despite evidence showing that weight loss can significantly reduce the risk of obesity-related health implications, literature informing best practices to engage Hispanic males in weight management programs is scarce. PURPOSE: The purpose of the current study was to engage Spanish-speaking, Mexican-origin males with overweight or obesity to examine their perspectives of diet-related behaviors related to weight management. METHODS: Demographic and acculturation data were collected using questionnaires. Fourteen semistructured interviews were completed with an all-Spanish-speaking cohort of men (age: 45.0±9.8 years; BMI: 34.2±6.5 kg m-2) who were born outside of the United States. We conducted a thematic analysis using a hybrid deductive-inductive analysis strategy using a previously developed codebook that was updated during iterative analysis of interview transcripts. RESULTS: Participants reported that healthful eating habits were hindered, among other factors, by lack of knowledge, sociocultural norms and conceptualizations of masculinity. Viable diet-related intervention approaches also surfaced, including building consciousness, promotion of traditional knowledge and the integration of the family in interventions. CONCLUSION: Findings suggest that Spanish-speaking, Mexican-origin men have interest in actively engaging in behavior changes that improve their dietary habits and engage in weight management. Our findings yield valuable insights that can be used to formulate tailored intervention strategies to improve obesity prevention and treatment programs for this vulnerable subgroup.

Peak and submaximal physiologic responses following electrical stimulation leg cycle ergometer training.

Eight males with spinal cord injury (SCI) participated in an exercise training program using neuromuscular electrical stimulation (NMES) leg cycle ergometry. Each subject completed a minimum of 24 (mean +/- SD = 38.1 +/- 17.2) 30-minute training sessions over a 19-week period. The initial work rate (WR) of 0 watts (W) of unloaded cycling was increased when appropriate with subjects exercising at 11.4 +/- 3.7 W (range = 6.1 W-18.3 W) at the end of the training program. Randomized block repeated measures ANOVA was used to compare pretraining and posttraining peak physiologic responses during graded NMES leg cycle tests and subpeak physiologic responses during 10 minutes of NMES leg cycle exercise at an absolute WR (0 W). A significant (P < or = 0.05) increase was observed for peak VO2; (+10%, 1.29 +/- 0.30 to 1.42 +/- 0.39 1.min-1). No other statistically significant differences were noted for any other peak variable (VCO2, VO2 ml.kg-1 min-1, VE, WR, HR, RER) pre- to posttraining. During submaximal NMES leg cycle testing, a significant decrease was noted for RER (-9.2%, 1.19 +/- 0.14 to 1.08 +/- 0.09). No other submaximal variable (VO2 1.min-1, ml.kg-1.min-1, VCO2, HR, VE) showed significant changes as a result of the training. Although the improvement in peak VO2 was not as dramatic as those reported in previous studies, it appears that NMES leg cycle training performed two times per week can significantly enhance cardiorespiratory fitness.

Oxygen uptake and heart rate relationship in persons with spinal cord injury.

The percent (%) peak oxygen uptake (VO2) and % peak heart rate (HR) relationships were determined in 13 persons with high (T1-T6) and 14 persons with low lesion (T7-T12) spinal cord injured paraplegia (SCI PARA) and 15 nonimpaired subjects during graded arm crank (AC) tests to exhaustion. Subjects were instructed to maintain a target cadence of 60 rpm on a modified electronically braked leg cycle ergometer. After 3 min of unloaded cranking, power output (PO) was increased by 8-16 W.min-1. VO2 and HR were determined via open-circuit spirometry and 12-lead ECG, respectively. Absolute HR and VO2 values for each PO were converted to % peak HR and % peak VO2 values. Linear regression slopes describing individual % peak HR and % peak VO2 relationships were calculated and compared between groups with one-way ANOVA. No significant differences (P > 0.05) were noted between the mean (+/- SD) regression slopes for persons with high lesion SCI PARA (1.48 +/- 0.21), persons with low lesion SCI PARA (1.48 +/- 0.26), and nonimpaired subjects (1.53 +/- 0.29). Regression equations derived using all data points within each group were as follows: High lesion SCI PARA: y = 1.3x-37.0, R = 0.85 Low lesion SCI PARA: y = 1.23x-30.9, R = 0.88 Nonimpaired subjects: y = 1.41x-46.2, R = 0.95 (y = % peak VO2, x = % peak HR). These equations are similar to those previously reported for nonimpaired men and women and cardiac patients during AC and leg cycle ergometry.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of posture on arm exercise tolerance and physiologic responses in persons with spinal cord injured paraplegia.

This study compared metabolic and cardiopulmonary responses to incremental supine and upright sitting arm crank ergometry (ACE) in nine men with spinal cord injured paraplegia ranging from T1-T5. Both tests consisted of continuous graded ACE from rest to volitional fatigue on a modified electronically braked cycle ergometer with the work rate increased by 8.2 W.min-1. No significant differences (P > 0.05) existed for peak ACE power output (W), oxygen uptake, pulmonary ventilation, respiratory exchange ratio, and O2 pulse between the two tests. Heart rate and O2 pulse responses at six submaximal work rates representing 0-58% peak W were also not significantly different between postures. These data indicate that ACE tolerance in persons with high-lesion paraplegia was not enhanced when ACE was performed in the supine posture.

Aerobic power of competitive paraplegic road racers.

The purpose of this study was to determine peak aerobic power and associated physiological responses in highly competitive spinal cord injured (SCI) paraplegic road racers. Seven (6 male and one female) active paraplegic (lesions T4-T12) road racers and 9 healthy untrained able-bodied males performed continuous graded arm crank ergometer tests to exhaustion for determinations of peak power output (PO), oxygen uptake (VO2), pulmonary ventilation (VE), heart rate (HR), and respiratory exchange ratio (RER). Compared to able-bodied subjects, male paraplegic road racers elicited significantly (p less than or equal to .05) higher mean (+/- SD) peak levels of PO (141.6 +/- 8.8 vs 111.4 +/- 27.7 W), absolute VO2 (2.72 +/- .52 vs 2.22 +/- .381/min), and VO2 per unit of body weight (43.06 +/- 7.4 vs 30.33 +/- 4.3 ml/kg/min). Although peak HR (180.3 +/- 9.5 vs 173.2 +/- 8.5 bpm) and VE (92.8 +/- 17.2 vs 74.6 +/- 20.3 l/min) tended to be higher for male paraplegic road racers than able-bodied subjects, the differences were not statistically significant. The female paraplegic road racer achieved the highest peak levels of PO (119 W) and VO2 (1.99 l/min; 38.0 ml/kg/min) reported to date for wheelchair-dependent women. These data suggest that intense physical training via wheelchair propulsion can markedly enhance upper body cardiovascular fitness in SCI paraplegics. However, the correlational analysis between 10 km time and peak VO2 was nonsignificant (p greater than .05) indicating that factors other than peak upper body aerobic power may influence wheelchair road racing performance.

Physiologic effects of electrical stimulation leg cycle exercise training in spinal cord injured persons.

The purpose of this study was to assess the physiologic training effects of functional electrical stimulation leg cycle ergometer (FES-LCE) exercise in persons with spinal cord injury (SCI) who were previously untrained in this activity. Ten persons with quadriplegia (C5 to C7) and eight with paraplegia (T4 to T11) performed FES-LCE training on an ERGYS I ergometer 10 to 30 minutes per day, 2 or 3 days per week for 12 to 16 weeks (36 total sessions). Training session power output (PO) ranged from 0.0W (no external resistance) to 30.6W. Each subject completed discontinuous graded FES-LCE and arm crank ergometer (ACE) tests before and after training for determinations of peak lower and upper extremity metabolic, pulmonary, and hemodynamic responses. Compared with pretraining, this SCI group exhibited significantly (p less than or equal to .05) higher posttraining peak PO (+45%), oxygen uptake ([O2], + 23%), pulmonary ventilation (+27%), heart rate (+11%), cardiac output ([Qt], + 13%) and significantly lower total peripheral resistance ([TPR], - 14%) during FES-LCE posttests. There were no significant changes in peak stroke volume (+6%), mean arterial pressure ([MAP], - 5%), or arteriovenous oxygen difference ([a-vO2diff], + 10%) during posttraining FES-LCE tests. In addition, no significant differences were noted for the peak level of any monitored variable during ACE posttests after FES-LCE training. The rise in total vascular conductance, implied by the significant decrease in posttraining TPR during FES-LCE tests, denotes that a peripheral circulatory adaptation developed in the persons with SCI during FES-LCE exercise training.(ABSTRACT TRUNCATED AT 250 WORDS)

Metabolic and hemodynamic responses to concurrent voluntary arm crank and electrical stimulation leg cycle exercise in quadriplegics.

This study determined the metabolic and hemodynamic responses in eight spinal cord injured (SCI) quadriplegics (C5-C8/T1) performing subpeak arm crank exercise (ACE) alone, subpeak functional electrical stimulation leg cycle exercise (FES-LCE) alone, and subpeak FES-LCE concurrent with subpeak ACE (hybrid exercise). Subjects completed 10 minutes of each exercise mode during which steady-state oxygen uptake (VO2), pulmonary ventilation (VE), heart rate (HR), cardiac output (CO), stroke volume (SV), mean arterial pressure (MAP), arteriovenous oxygen difference (a-v O2 diff), and total peripheral resistance (TPR) were determined. Although mean VO2 for both ACE alone and FES-LCE alone was matched at 0.66 l/mi, individualized power outputs ranged from 0-30 W (mean = 19.4 +/- 1.3) and 0-12.2 W (mean = 2.3 +/- 0.6), respectively. Hybrid exercise elicited significantly higher VO2 (by 54 percent), VE (by 39-53 percent), HR (by 19-33 percent), and CO (by 33-47 percent), and significantly lower TPR (by 21-34 percent) than ACE or FES-LCE performed alone (P less than or equal to 0.05). Stroke volume was similar between hybrid exercise and FES-LCE alone, and these two exercise modes evoked a significantly higher SV (by 41-56 percent) than during ACE alone. These data clearly demonstrate that hybrid exercise creates a higher aerobic metabolic demand and cardiac-volume load in SCI quadriplegics than either subpeak levels of ACE or FES-LCE performed separately. Therefore, hybrid exercise may provide more advantageous central cardiovascular training effects in quadriplegics than either ACE or FES-LCE alone.

Musculoskeletal responses of spinal cord injured individuals to functional neuromuscular stimulation-induced knee extension exercise training.

This study was conducted to evaluate a newly designed functional neuromuscular stimulation (FNS)-induced knee extension (KE) exercise system that incorporates the most desired features of previously described systems by determining the musculoskeletal responses of spinal cord injured (SCI) individuals to training. A specially designed chair and electrical stimulator were fabricated for FNS-induced KE resistance exercise. Surface electrodes were placed over motor points of the quadriceps muscles, and KE was alternated between legs at an average rate of 6 KE/min/leg. KE testing protocols were developed for pre- and post-training evaluations of performance, and 12 SCI subjects exercise-trained up to three times per week for 36 sessions using a progressive resistance load at ankle level. Pre- and post-training evaluation data were statistically compared using a 0.05 level for significance. Quadriceps muscle performance (strength x repetitions) improved for both legs in all subjects as indicated by significant increases in load resistance and repetitions over the 36-session training period (right leg mean = 1156.0 versus 1624.8 kg.reps, left leg mean = 1127.3 versus 1721.1 kg.reps). In addition, knee range of motion significantly increased (right leg mean = 134 versus 146 degrees, left leg mean = 133 versus 144 degrees). Thigh skinfold, thigh girth, body weight and bone density were not significantly changed. The lack of decrease in bone density in some subjects suggests that the training may retard the rate of bone loss which typically occurs with SCI. No injuries or problems were encountered during testing and training.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute hemodynamic responses of spinal cord injured individuals to functional neuromuscular stimulation-induced knee extension exercise.

The purpose of this study was to determine and compare acute hemodynamic responses of spinal cord injured (SCI) quadriplegics (quads), and paraplegics (paras) during a graded-intensity knee extension (KE) exercise test utilizing functional neuromuscular stimulation (FNS) of paralyzed quadriceps muscles. Seven quads and seven paras (N = 14) performed a series of 4-minute stages of bilateral alternating FNS-KE exercise (approximately zero to 70 degree range of motion at the knee and 6 KE/min/leg) at ankle loads of 0, 5, 10, and 15 kg/leg. Physiologic responses were determined with open-circuit spirometry, impedance cardiography, and auscultation. Comparing rest with peak FNS-KE for both groups combined, FNS-KE exercise elicited significant (p less than 0.05) increases in oxygen uptake (130 percent), pulmonary ventilation (120 percent), respiratory exchange ratio (37 percent), arteriovenous oxygen difference (57 percent), cardiac output (32 percent), stroke volume (41 percent), mean arterial pressure (18 percent), and rate-pressure product (23 percent). Heart rate increased significantly by 11 percent from the 5- to the 15-kg/leg stages. Physiologic responses of quads and paras were very similar, except for lower (p less than 0.05) arterial pressures, rate-pressure product, and peripheral vascular resistance in quads. This graded FNS-KE exercise up to the 15-kg/leg load induced relatively small but appropriate increases in aerobic metabolism and cardiopulmonary responses that appear to be safe and easily tolerated by quads and paras. Arterial pressure needs to be monitored carefully in quads to prevent excessive hypertension or hypotension. Although FNS-KE exercise has been shown to elicit peripheral adaptations to improve muscle strength and endurance, it is probably not an effective central cardiovascular training tool for all but the least fit SCI individuals. This information is important for understanding the effects of FNS use during more complex activities such as cycling and ambulation.

Differences in epinephrine and substrate responses between arm and leg exercise.

The purpose of this study was to determine epinephrine (EPI) and selected substrate responses during arm crank (AC) and leg cycle (LC) exercise at the same absolute and relative exercise intensity. Nine males performed 30 min AC and LC tests at 70% of ergometer-specific peak oxygen uptake (VO2), and a 30 min LC test eliciting a similar VO2 required during the AC test. Blood samples (30 ml) were collected via an indwelling arm catheter at rest, and at minutes 13 and 28 of exercise for determinations of plasma EPI, serum free fatty acid (FFA), serum glycerol (GLY), blood glucose (GLU), and blood lactate (LA) concentrations. At equivalent VO2, higher (P less than 0.05) EPI, LA, and respiratory exchange ratio (RER) responses were obtained during AC than LC exercise. However, these physiologic responses were similar during AC and LC exercise at the same relative intensity. No significant differences over time were observed for FFA, GLY, and GLU between AC and LC exercise at either the same absolute or relative intensity. The results support previous hypotheses that AC exercise is physiologically more stressful than LC exercise at the same VO2. The data further indicate that adrenomedullary activity (EPI response) and substrate utilization (LA and RER responses) are regulated by relative exercise intensity and not the exercising muscle mass.

Physiologic responses to prolonged electrically stimulated leg-cycle exercise in the spinal cord injured.

This study determined the physiologic responses to prolonged functional neuromuscular stimulation (FNS) leg-cycle exercise in seven quadriplegic and seven paraplegic subjects. Each subject completed 30 minutes of continuous FNS leg cycling during which open-circuit spirometry, impedance cardiography, auscultation, and fingertip capillary blood sampling were used to assess metabolic and hemodynamic responses. Compared with resting values, oxygen uptake, carbon dioxide production, respiratory exchange ratio (RER), pulmonary ventilation, heart rate (HR), left ventricular stroke volume (SV), cardiac output (Qt), and blood lactate (La) concentration were significantly (p less than .05) elevated, whereas plasma volume, bicarbonate concentration, and pH were significantly decreased in both groups during prolonged FNS leg-cycle exercise. Mean arterial pressure remained unchanged in quadriplegic and paraplegic subjects during the prolonged FNS leg-cycle exercise bout. Persons with quadriplegia elicited significantly lower MAP and tended to have lower SV and Qt responses than persons with paraplegia, probably due to a higher degree of sympathetic dysfunction and circulatory hypokinesis during FNS leg-cycle exercise. All other physiologic variables responded similarly between groups. We speculate that the relative increases observed for HR (33% to 60%), SV (45% to 69%), and Qt (113% to 142%) during prolonged FNS leg-cycle exercise create a sufficient cardiac-volume load to promote central cardiovascular conditioning in persons with both quadriplegia and paraplegia. The La accumulation (4.7 to 5.2 mmol.L-1) in the spinal cord injured during prolonged FNS leg cycling is unusually high for the power output attained (5.2W and 6.1W for quadriplegia and paraplegia, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Physiologic responses of elite paraplegic road racers to prolonged exercise.

The purpose of this study was to determine cardiopulmonary and selected metabolic responses in spinal cord injured (SCI) paraplegics during prolonged arm crank exercise (ACE). Six male and one female elite SCI paraplegic (T4-12 lesions) road racers performed 40 continuous minutes of ACE at 60% of peak ACE oxygen uptake (VO2). Blood samples (30 ml) were collected via antecubital venipuncture at rest and minutes 20 and 40 of ACE for determinations of hemoglobin, hematocrit, serum free fatty acid (FFA), and blood lactate (LA) concentrations. No significant differences were observed over time for VO2 or pulmonary ventilation. Heart rate recorded at minutes 30 and 40 was significantly elevated above HR at minutes 10 and 20 of ACE indicating the presence of an upward drift in HR in paraplegics performing prolonged ACE. Compared to rest, LA concentration was significantly higher at minute 20 and remained relatively stable thereafter. A significant increase in FFA concentration at minute 40 combined with a significant decline in the respiratory exchange ratio suggested a preference for lipid substrate utilization by exercising muscle as ACE continued. The data indicate that the autonomic sympathetic nervous system impairment associated with paraplegia had no apparent adverse effects on cardiopulmonary or metabolic adjustments to prolonged ACE in these well-trained subjects.

Physiologic responses of paraplegics and quadriplegics to passive and active leg cycle ergometry.

The purposes of this study were three-fold: (a) to determine acute physiologic responses of spinal cord injured (SCI) subjects to peak levels of leg cycle ergometry utilizing functional neuromuscular stimulation (FNS) of paralyzed leg muscles, (b) to determine the relative contributions of passive and active components of FNS cycling to the peak physiologic responses, and (c) to compare these physiologic responses between persons who have quadriplegia and those who have paraplegia. Thirty SCI subjects (17 quadriplegics and 13 paraplegics) performed a discontinuous graded FNS exercise test from rest to fatigue on an ERGYS 1 ergometer. Steady-state physiologic responses were determined by open-circuit spirometry, impedance cardiography with ECG, and auscultation. In the combined statistics of both groups, it was noted that peak FNS cycling significantly increased (from rest levels) mean oxygen uptake by 255%, arteriovenous O2 difference VO2 and VE, Q and a-vO2 and VCO by 69%, and stroke volume by 45%, while total peripheral vascular resistance decreased by 43%. Mean peak power output for paraplegics (15 W) was significantly higher than for quadriplegics (9 W), eliciting higher peak levels of pulmonary ventilation and sympathetically mediated hemodynamic responses such as cardiac output, heart rate, and systolic and diastolic arterial blood pressure. Passive cycling without FNS produced no statistically significant increases in physiologic responses above the resting level in either group.

Effects of low- and moderate-intensity training in spinal cord-injured persons.

This study examined the applicability of exercise prescription guidelines established for the able-bodied to spinal cord-injured (SCI) persons. Two SCI groups performed wheelchair ergometry (WCE) 20 min three times per week for 8 wk. Low-intensity (LI, N = 6) and moderate-intensity (MI, N = 5) groups trained at 50-60% and 70-80% maximal heart rate reserve (HRR), respectively. The subjects completed an incremental discontinuous maximal WCE test to exhaustion pre- and post-training. A submaximal WCE test consisting of 4-min exercise stages at power outputs of 5, 10, and 15 W was also performed pre- and post-training. Blood samples were collected before and after training and analyzed for total cholesterol (TC), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C). The TC/HDL-C ratio was calculated. Both groups exhibited no significant changes (P greater than 0.10) in VO2max, HRmax, POmax, lactate (La)max, and VO2 at 4 mmol [La]. No pre- to post-training differences were recorded in the LI group for submaximal VO2, HR, VE, La, and ratings of perceived exertion (RPE). The MI group had significantly lower (P less than or equal to 0.10) post-training submaximal HR, La, and RPE and no changes in VO2 or VE. Blood lipid levels remained unaltered in the LI group, while the MI group exhibited significant increases in HDL-C and decreases in TG, LDL-C, and the TC/HDL-C ratio. The maximal test data revealed that 8 wk of LI and MI wheelchair ergometry training did not improve VO2max in SCI persons.(ABSTRACT TRUNCATED AT 250 WORDS)

Acinic cell adenocarcinoma of minor salivary glands.

Nine cases identified as acinic cell adenocarcinoma of minor salivary glands from the files of the Armed Forces Institute of Pathology and the Department of Pathology, Temple University School of Dentistry were studied to determine the clinical and histomorphologic parameters of this lesion. One case was examined ultrastructurally. Clinical results show that the tumor is more common in females and the average age of patients was 42.5 years. The most common sites were upper and lower lips and buccal mucosa. The tumor tends to be locally limited, but recurrence is a distinct possibilty. Cytologic features usually associated with malignancies are generally not present. However, perineural space and muscle invasion occur, and it is felt that this tumor should be considered as a low-grade malignancy. Fine structural observations showed the presence of cells with serous secretory granules and cells with mucous globules. However, the serous secretory granules were not as numerous as those reported in the acinic cell adenocarcinoma of the parotid gland. It appears that these tumors arise from intercalated duct cells or pluripotential duct cells rather than from fully differentiated serous cells.

Intraosseous angiolipoma of the mandible.

A case of intraosseous angiolipoma, one of the rarest benign tumors of bone, is reported. This tumor represents an example of an intraosseous neoplasm consisting of both blood vessels and fat. To our knowledge, such a tumor of the mandible has not been reported previously.