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During a continuously increasing exercise workload (WL) a point will be reached at which arterial lactate accumulates rapidly. This so-called lactate threshold (LT) is associated with the maximal lactate steady state workload (MLSSW), the highest WL, at which arterial lactate concentration [LA] does not change. However, the physiological range in which the LT and the MLSSW occur has not been demonstrated directly. We used minor WL variations in the MLSSW range to assess arterial lactate kinetics in 278 treadmill and 148 bicycle ergometer exercise tests. At a certain workload, minimal further increment of running speed (0.1–0.15 m/s) or cycling power (7–10 W) caused a steep elevation of [LA] (0.9 ± 0.43 mM, maximum increase 2.4 mM), indicating LT achievement. This sharp [LA] increase was more pronounced when higher WL increments were used (0.1 vs. 0.30 m/s, P = 0.02; 0.15 vs. 0.30 m/s, P < 0.001; 7 vs. 15 W, P = 0.002; 10 vs. 15 W, P = 0.001). A subsequent workload reduction (0.1 m/s/7 W) stopped the [LA] increase indicating MLSSW realization. LT based determination of running speed (MLSSW) was highly reproducible on a day-to-day basis (r = 0.996, P < 0.001), valid in a 10 km constant velocity setting (r = 0.981, P < 0.001) and a half marathon race (r = 0.969, P < 0.001). These results demonstrate a fine-tuned regulation of exercise-related lactate metabolism, which can be reliably captured by assessing lactate kinetics at the MLSSW.
OBJECTIVE: The aim of this randomized controlled trial was to test the hypothesis that a three-week whole body vibration (WBV) training in addition to a standard rehabilitation program improves walking ability in patients with Multiple Sclerosis (MS). PATIENTS AND METHOD: Sixty patients with definite MS were randomly allocated to the intervention or control group. Training sessions were performed three times per week for three weeks. Patients adopted a moderate squat position on a vibration platform. The training sessions comprised series of 3 × 60-sec exercise sets with increasing amplitude between sessions from 1 to 2 mm. During the exercise series, the vibration platform was turned on for the intervention group and switched off for the control group. A mixed factor ANOVA was used to compare sit to stand test, timed up and go test, 10-meter walk test, and 6-min walk test data between patient groups and between baseline and follow-up. RESULTS: All outcome measures improved from baseline to follow-up (P < 0.001). The 6-minute walk test showed significantly greater improvements from baseline to follow-up for the intervention than for the control group (P < 0.001). CONCLUSION: Determinants of walking ability in patients with MS that are specific to walking endurance tasks are most affected by vibration training designed to improve strength endurance.
The purpose of this study was to quantify changes in volumetric bone mineral density (vBMD) in the tibial plateau of the operated and contralateral leg measured using peripheral quantitative computed tomography (pQCT) before and 3, 6, and 12 months after anterior cruciate ligament (ACL) reconstruction. The ACL was reconstructed with a hamstring tendon autograft using press-fit fixation. pQCT measurements of the proximal tibia were obtained in 61 patients after ACL reconstruction, and total, cortical, and trabecular vBMD were calculated. vBMD in the operated leg decreased from baseline to 3 months (À12% [total], À11% [cortical], and À12.6% [trabecular]; p < 0.001) and remained below baseline for 12 months after surgery (6 months: À9.5%, À9.4%, and À9.6%, p < 0.001; 12 months: À8%, À5%, and À11%, p < 0.001). vBMD in the contralateral leg was slightly reduced only 6 months after surgery. Including age and sex as covariates into the analysis did not affect the results. ACL reconstruction contributed to loss in bone mineral density within the first year after surgery. The role of factors such as time of weight-bearing, joint mechanics, post-traumatic inflammatory reactions, or genetic predisposition in modulating the development of posttraumatic knee osteoarthritis after ACL injury should be further elucidated. ß
The structure of nocturnal sleep of 16 volunteers, participating in the anaerobic sports of trampolining, dancing, and soccer, was monitored by means of polygraphic recordings. Since trampolining requires the acquisition of unfamiliar patterns of motor coordination, it can be considered as a special form of motor learning, whereas the acquisition of motor skills specific for dancing and soccer can be linked with motor patterns of normal biped locomotion. According to this view, an experimental group of 8 volunteers was formed; they participated in a training course of trampolining. In addition, a control group of 8 subjects was recruited, who engaged in one of the other two anaerobic sports. Subjects who had acquired new motor skills during a 13-wk. program in trampolining showed a statistically significant increase in REM-sleep. By contrast, the 8 subjects of the control group showed no considerable changes in REM-sleep. This suggests that efforts in acquiring new and complex motor patterns activate processes specifically involved in the generation of REM stage during nocturnal sleep.
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