Isolated finger flexor vs. exhaustive whole-body climbing tests? How to assess endurance in sport climbers?

PURPOSE: Sport climbing requires high-intensity finger flexor contractions, along with a substantial whole-body systemic oxygen uptake ([Formula: see text]O2) contribution. Although fatigue is often localised to the finger flexors, the role of systemic ̇[Formula: see text]O2 and local aerobic mechanisms in climbing performance remains unclear. As such, the primary purpose of this study was to determine systemic and local muscle oxygen responses during both isolated finger flexion and incremental exhaustive whole-body climbing tests. The secondary aim was to determine the relationship of isolated and whole-body climbing endurance tests to climbing ability. METHODS: Twenty-two male sport climbers completed a series of isometric sustained and intermittent forearm flexor contractions, and an exhaustive climbing test with progressive steepening of the wall angle on a motorised climbing ergometer. Systemic [Formula: see text]O2 and flexor digitorum profundus oxygen saturation (StO2) were recorded using portable metabolic analyser and near-infra red spectroscopy, respectively. RESULTS: Muscle oxygenation breakpoint (MOB) was identifiable during an incremental exhaustive climbing test with progressive increases in angle (82 ± 8% and 88 ± 8% [Formula: see text]O2 and heart rate climbing peak). The peak angle from whole-body treadwall test and impulse from isolated hangboard endurance tests were interrelated (R2 = 0.58-0.64). Peak climbing angle together with mean [Formula: see text]O2 and StO2 from submaximal climbing explained 83% of variance in self-reported climbing ability. CONCLUSIONS: Both systemic and muscle oxygen kinetics determine climbing-specific endurance. Exhaustive climbing and isolated finger flexion endurance tests are interrelated and suitable to assess climbing-specific endurance. An exhaustive climbing test with progressive wall angle allows determination of the MOB.

[Epidemiologic data of hyperuricaemia prevalence in the conditions of primary care in Slovakia]. / Epidemiologické údaje o výskyte hyperurikémie u muzov a u zien v podmienkach primárnej liecebnej starostlivosti na Slovensku.

UNLABELLED: Hyperuricaemia represents nowaday the new risk factor for cardiovascular diseases. Prevalence data and its treatment in our patient´s population are still missing. Literature data shows, that its prevalence differs in various populations significantly from 4 % up to 40 % with race and geographical means. In the hospital population its prevalence is about 7 % and represents the important predictor of hospital mortality, e.i with heart failure. From the Framingham data relative risk was estimated of 25 % for cardiovascular diseases, coronary heart disease and all-course mortality. From the epidemiologic survey Mirror Slovakia hyperuricaemia was evaluated from the sample of 20 000 patients from the primare care physicians in order to see the picture on this newer risk factor. KEY WORDS: cardiovascular diseases - epidemiology - hyperuricaemia - therapy.

[Epidemiologic data of hyperuricaemia prevalence in the conditions of primary care in Slovakia]. / Epidemiologické údaje o výskyte hyperurikémie u muzov a u zien v podmienkach primárnej liecebnej starostlivosti na Slovensku.

Hyperuricaemia represents nowaday the new risk factor for cardiovascular diseases. Prevalence data and its treatment in our patient's population are still missing. Literature data shows, that its prevalence differs in various populations significantly from 4% up to 40% with race and geographical means. In the hospital population its prevalence is about 7% and represents the important predictor of hospital mortality, e.i with heart failure. From the Framingham data relative risk was estimated of 25% for cardiovascular diseases, coronary heart disease and all-course mortality. From the epidemiologic survey Mirror Slovakia hyperuricaemia was evaluated from the sample of 20 000 patients from the primare care physicians in order to see the picture on this newer risk factor.

[The effect of adding phytosterol to hypolipidemic therapy with statins on the size of lipoprotein particles in patients with very high cardiovascular risk]. / Vplyv pridania fytosterolu ku hypolipidemickej liecbe statínom na velkost lipoproteínových partikúl u pacientov s velmi vysokým kardiovaskulárnym rizikom.

Despite significant improvement in the diagnosis and therapy of cardiovascular diseases their global risk and proportion of their clinical forms remains very high. Still the large part of the patients cannot reach the estimated target lipid levels despite statin therapy. Low adherence to preventive programmes with physical training and diet leads to progression of the pathological process of atherothrombosis. One possible therapeutic approach could be the combined hypolipidemic treatment. In this context we followed-up the size of lipoprotein particles among very high risk patients on statin monotherapy, where phytosterole was added. Lipoprotein profile among very high risk patients during combined therapy lead to improvement and therefore may contribute to lowering of their residual risk.

Metabolic demands of slacklining in less and more advanced slackliners.

Walking or balancing on a slackline has gained increasing popularity as a recreational and school sport, and has been found to be suitable for developing neuromuscular control. The metabolic requirements for neuromuscular control on slackline, however, have not been well described. Therefore, the aim of the study was to determine the metabolic demands of slacklining in less and more advanced slackliners. Nineteen slackliners performed several 4 min balance tasks: parallel and one-leg stance on stable platform (2LS and 1LS), 1 leg stance on a slackline (1LSS), walking at a self-selected speed and at a given speed of 15 m min-1 on a slackline (WSS and WGS). Expired gas samples were collected for all participants and activities using a portable metabolic system. During1 LS and 1LSS, there were 140% and 341% increases in oxygen uptake (V̇O2) with respect to V̇O2 rest, respectively. During slackline walking, V̇O2 increased by 460% and 444% at self-selected and given speed, respectively. More advanced slackliners required mean metabolic demands 0.377 ± 0.065 and 0.289 ± 0.050 kJ·kg-1·min-1 (5.7 ± 0.95 and 3.9 ± 0.6 MET) for WGS and 1LSS, respectively, whilst less advanced slackliners, 0.471 ± 0.081 and 0.367 ± 0.086 kJ·kg-1·min-1 (6.4 ± 1.2 and 5.0 ± 1.1 MET) for WGS and 1LSS, respectively. Our data suggest that balancing tasks on slackline require V̇O2 corresponding to exercise intensities from light to moderate intensity. More advanced slackliners had a ∼25% reduced energy expenditure when compared with lower ability counterparts during simple balance tasks on the slackline.HighlightsBalancing on a slackline is metabolically demanding and slackline training is suitable not only to develop neuromuscular control but also to meet cardiovascular fitness demands.Improved postural control demonstrated by skilled slackliners reduces by ∼25% metabolic cost of balancing tasks on a slackline when compared to less skilled counterparts.Falls during slacklining increase the metabolic demands of the activity. Three falls per minute during walking on a slackline increase the oxygen uptake by ∼50%.

Effect of Climbing Speed on Pulmonary Oxygen Uptake and Muscle Oxygen Saturation Dynamics in the Finger Flexors.

PURPOSE: Although sport climbing is a self-paced whole-body activity, speed varies with climbing style, and the effect of this on systemic and localized oxygen responses is not well understood. Therefore, the aim of the present study was to determine muscle and pulmonary oxygen responses during submaximal climbing at differing speeds of ascent. METHODS: Thirty-two intermediate and advanced sport climbers completed three 4-minute-long ascents of the same route at 4, 6, and 9 m·min-1 on a motorized climbing ergometer (treadwall) on separate laboratory visits. Gas analysis and near-infrared spectroscopy were used to determine systemic oxygen uptake (V˙O2) and muscle oxygen saturation (StO2) of the flexor digitorum profundus. RESULTS: Increases in ascent speed of 1 m·min-1 led to increases of V˙O2 by 2.4 mL·kg-1·min-1 (95% CI, 2.1 to 2.8 mL·kg-1·min-1) and decreases in StO2 by -1.3% (95% CI, 1.9% to -0.7%). There was a significant interaction of climbing ability and speed for StO2 (P < .001, ηp2=.224). The results revealed that the decrease of StO2 was present for intermediate but not advanced climbers. CONCLUSIONS: In this study, the results suggest that V˙O2 demand during climbing was largely determined by climbing speed; however, the ability level of the climber appeared to mitigate StO2 at a cellular level. Coaches and instructors may prescribe climbing ascents with elevated speed to improve generalized cardiorespiratory fitness. To stimulate localized aerobic capacity, however, climbers should perhaps increase the intensity of training ascents through the manipulation of wall angle or reduction of hold size.

The Estimation of Critical Angle in Climbing as a Measure of Maximal Metabolic Steady State.

Purpose: Sport climbing is a technical, self-paced sport, and the workload is highly variable and mainly localized to the forearm flexors. It has not proved effective to control intensity using measures typical of other sports, such as gas exchange thresholds, heart rate, or blood lactate. Therefore, the purposes of the study were to (1) determine the possibility of applying the mathematical model of critical power to the estimation of a critical angle (CA) as a measure of maximal metabolic steady state in climbing and (2) to compare this intensity with the muscle oxygenation breakpoint (MOB) determined during an exhaustive climbing task. Materials and Methods: Twenty-seven sport climbers undertook three to five exhaustive ascents on a motorized treadwall at differing angles to estimate CA, and one exhaustive climbing test with a progressive increase in angle to determine MOB, assessed using near-infrared spectroscopy (NIRS). Results: Model fit for estimated CA was very high (R 2 = 0.99; SEE = 1.1°). The mean peak angle during incremental test was -17 ± 5°, and CA from exhaustive trials was found at -2.5 ± 3.8°. Nine climbers performing the ascent 2° under CA were able to sustain the task for 20 min with perceived exertion at 12.1 ± 1.9 (RPE). However, climbing 2° above CA led to task failure after 15.9 ± 3.0 min with RPE = 16.4 ± 1.9. When MOB was plotted against estimated CA, good agreement was stated (ICC = 0.80, SEM = 1.5°). Conclusion: Climbers, coaches, and researchers may use a predefined route with three to five different wall angles to estimate CA as an analog of critical power to determine a maximal metabolic steady state in climbing. Moreover, a climbing test with progressive increases in wall angle using MOB also appears to provide a valid estimate of CA.

Psychophysiological responses to treadwall and indoor wall climbing in adult female climbers.

The purpose of the study was to compare the psychophysiological response of climbers of a range of abilities (lower grade to advanced) when ascending identical climbing routes on a climbing wall and a rotating treadwall. Twenty-two female climbers (31.2 ± 9.4 years; 60.5 ± 6.5 kg; 168.6 ± 5.7 cm) completed two identical 18 m climbing trials (graded 4 on the French Sport scale) separated by 1 week, one on the treadwall (climbing low to the ground) and the other on the indoor wall (climbing in height). Indirect calorimetry, venous blood samples and video-analysis were used to assess energy cost, hormonal response and time-load characteristics. Energy costs were higher during indoor wall climbing comparing to those on the treadwall by 16% (P < 0.001, [Formula: see text] = 0.48). No interaction of climbing ability and climbing condition were found. However, there was an interaction for climbing ability and post-climbing catecholamine concentration (P < 0.01, [Formula: see text] = 0.28). Advanced climbers' catecholamine response increased by 238% and 166% with respect to pre-climb values on the treadwall and indoor wall, respectively; while lower grade climbers pre-climb concentrations were elevated by 281% and 376% on the treadwall and indoor wall, respectively. The video analysis showed no differences in any time-motion variables between treadwall and indoor wall climbing. The study demonstrated a greater metabolic response for indoor wall climbing, however, the exact mechanisms are not yet fully understood.

Effect of Height on Perceived Exertion and Physiological Responses for Climbers of Differing Ability Levels.

PURPOSE: The purpose of this study was to examine differences in perceived exertion (RPE) and physiological responses for climbers of different abilities completing an identical route low and high above the ground. MATERIALS AND METHODS: Forty-two male (N = 18) and female (N = 24) sport climbers divided into three groups, lower-grade (N = 14), intermediate (N = 14), and advanced climbers (N = 14), completed two visits to a climbing gym, separated by 7 days. In a random order, the climbers completed a close-to-the-ground ascent (treadwall) and climb to height (climbing gym). Immediately after the test, climbers provided their RPE (6-20). Indirect calorimetry was used to assess physiological response during the ascent and recovery. RESULTS: The mean (±standard deviation) RPE was higher for lower-grade climbers when ascending the route on the wall (RPE = 12 ± 1) when compared to the treadwall route (RPE = 11 ± 1, P = 0.040; d = 0.41). For all ability groups, the physiological response was higher on the climbing gym wall as opposed to the treadwall: ventilation (P = 0.003, η p 2 = 0.199), heart rate (HR) (P = 0.005, η p 2 = 0.189), energy cost (EC) (P = 0.000, η p 2 = 0.501). The RPE demonstrated a moderate relationship with physiological variables (R 2 = 0.14 to R 2 = 0.45). CONCLUSION: Climbing to height induced a greater metabolic stress than climbing at a low height (treadwall) and led to higher RPE for lower-grade climbers. In this study, RPE appeared to be a good proxy measure of the physiological demands for advanced climbers but not for intermediate and lower-grade climbers. Therefore, using RPE in climbing with less experienced athletes may perhaps overestimate actual exercise intensity and should be interpreted carefully.

The effects of body weight loss and gain on arterial hypertension control: an observational prospective study.

BACKGROUND: Body weight changes are associated with significant variations in blood pressure (BP). Body mass modifications may, therefore, influence hypertension control in primary care. METHODS: Patients with a history of essential arterial hypertension were observed for 12 months. Anthropometric data and clinical BP were evaluated at the time of the recruitment and after 12 months of follow-up. The association between (body mass index) BMI change and BP control was analyzed by logistic regression. RESULTS: Sixteen thousand five hundred and sixty-four patients were recruited, while 13,631 patients (6336 men; 7295 women) finished the 1-year follow-up. In obese patients, a BMI decrease by at least 1 kg/m2 was negatively associated with uncontrolled hypertension at the end of the follow-up (men p < 0.0001, OR = 0.586, 0.481-0.713, women p < 0.001, OR = 0.732, 0.611-0.876). A similar association was observed in overweight patients (men p < 0.05, OR = 0. 804, 95% CI: 0.636-0.997, women p < 0.05, OR = 0.730, 95% CI: 0.568-0.937). A BMI increase of at least 1 kg/m2 was associated with a significantly higher odd of uncontrolled hypertension in obese (men p < 0.001, OR = 1.471, 1.087-1.991, women p < 0.001, OR = 1.422, 1.104-1.833) and overweight patients (men p < 0.0001, OR = 1.901, 95% CI: 1.463-2.470, women p < 0.0001, OR = 1.647, 95% CI: 1.304-2.080). CONCLUSIONS: Weight loss is inversely associated and weight increase is positively associated with the probability of uncontrolled hypertension in obese and overweight hypertensives.

Polypharmacy in elderly hospitalised patients in Slovakia.

OBJECTIVE: The aims of the present study were to: analyse the prevalence of polypharmacy in a group of older patients; evaluate the influence of hospital stay on the number of drugs taken; assess the most frequently prescribed pharmacological classes; identify risk factors that predisposed the patient to polypharmacy. Setting The study was carried out in the Department of Internal Medicine of a non-university general hospital. METHOD: In the retrospective study, 600 patients aged 65 years or more were enrolled. They were hospitalised in the period from 1st December 2003 to 31st March 2005. Each person taking six or more medications per day was considered to be a patient with polypharmacy. Particular sociodemographic and clinical characteristics, as well as comorbid conditions, were evaluated as factors potentially influencing the prevalence of polypharmacy. MAIN OUTCOME MEASURE: The number and type of medications taken at the time of hospital admission and discharge were recorded and compared for each patient. RESULTS: Polypharmacy on admission and at discharge was observed in 362 (60.3%) and 374 (62.3%) patients, respectively. Hospitalisation led to a significant increase in the number of medications. The spectrum of medications used corresponded to the proportions of diagnoses in the evaluated group, in which cardiovascular diseases were most prevalent. According to the multivariate analysis using a logistic regression model, diabetes mellitus (odds ratio (OR) 2.40; 95% confidence interval (CI): 1.64-3.50), heart failure (OR 2.14; 95% CI: 1.46-3.14), dementia (OR 2.12; 95% CI: 1.26-3.57), living alone (OR 2.00; 95% CI: 1.28-3.10), arterial hypertension (OR 1.63; 95% CI: 1.08-2.44) and cerebrovascular disease (OR 1.58; 95% CI: 1.03-2.44) significantly increased the risk of the presence of polypharmacy. CONCLUSION: Our study confirmed a relatively high prevalence of polypharmacy in Slovak elderly patients. Polypharmacy risk rose especially with the increased prevalence of diseases of advancing age (diabetes mellitus, heart failure, arterial hypertension, dementia and cerebrovascular diseases). The increasing numbers of medications in inpatients indicate the need for the careful re-evaluation of pharmacotherapy during the stay in hospital.