Our results suggest that energy demands of tennis matches are significantly influenced by DR. The highest average VO2 of a game of 47.8 mL.kg-1.min-1 may be regarded as a guide to assess endurance capacity required to sustain high-intensity periods of tennis matches compared with average VO2 of 29.1 mL.kg-1.min-1 for the 270 games. Our results suggest that proper conditioning is advisable especially for players who prefer to play from the baseline.

In 1992 Conconi et al. (20) presented an indirect and noninvasive method for the determination of anaerobic threshold (AnT) in an incremental field test for runners. This noninvasive method for the determination of anaerobic threshold is dependent on the occurrence of a deflection of the heart rate performance curve (HRPC). The aim of our study was to evaluate the degree and direction of the deflection of the HRPC and the relationship of the heart rate threshold (HRT) to the lactate turn point in a group of 227 healthy young subjects (age: 23 +/- 4 yr). The subjects were divided into three groups by means of second degree polynomial fitting (GI: regular deflection, kHR > 0.1; G II: no deflection, 0 < kHR < 0.1; G II: inverse deflection, k < -0.1). No significant differences between the groups were found in the anthropometric data or in the power output and the blood lactate concentration at both the first (LTP1) and second (LTP2) lactate turn points and at maximum performance (Pmax). Using the method of Conconi et al. (20), 85.9% of the subjects showed a "regular" deflection, 6.2% showed no deflection at all, and 7.9% showed even an inverted deflection of the HRPC. An HRT could be obtained in both G I and G III, and power output at HRT was not significantly different in comparison to that at the LTP2. No HRT could be assessed in G II. The heart rate at HRT and the LTP2 were significantly lower in G III compared with G I. The phenomenon of heart rate break point may be attractive in training regulation, but its application is limited because a heart rate deflection cannot be found even in young subjects in some cases.

We investigated the changes in the cardiovascular system [resting blood pressure (BP) and heart rate (HR), measured by means of a 24-h ambulatory BP and a holter-electrocardiogram (ECG)], glycemic parameters, and lipid metabolism of subjects suffering from metabolic syndrome during a 3-week sojourn at 1,700 m in the Austrian Alps. A total of 22 male subjects with metabolic syndrome were selected. Baseline investigations were performed at Innsbruck (500 m above sea level). During the 3-week altitude stay the participants simulated a holiday with moderate sports activities. Examinations were performed on days 1, 4, 9, and 19. After returning to Innsbruck, post-altitude examinations were conducted after 7-10 days and 6-7 weeks, respectively. The 24-h ambulatory BP and holter ECG revealed a decrease in average HR, BP, and rate pressure product (RPP: systolic blood pressure x HR) after 3 weeks of altitude exposure. In some patients, an increase in premature ventricular beats was observed at the end compared to the beginning of the exposure to moderate altitude. The ECG revealed no ischemic ST-segment changes. Maximal physical capacity as measured by symptom-limited maximal cycle ergometry tests remained unchanged during the study. Six weeks after the altitude exposure the blood pressure increased again and returned to pretest levels. The Homeostasis Model Assessment index, which is a measure of insulin resistance, decreased significantly and glucose concentrations obtained after an oral glucose tolerance test were significantly lower after the stay at altitude compared to the basal values. We conclude that after a 3-week exposure to moderate altitude, patients with metabolic syndrome (1) tolerated their sojourn without any physical problems, (2) exhibited short-term favorable effects on the cardiovascular system, and (3) had significant improvements in glycemic parameters that were paralleled by a significant increase in high-density-lipoprotein-cholesterol.

The aim of this study was to investigate heart rate threshold (HRT) related exercise intensities by means of two endurance cycle ergometer tests using blood lactate concentration [La], pulmonary ventilation (VE), oxygen uptake (VO2), heart rate (HR) and electromyogram (EMG) activity of working muscle. Firstly, 16 healthy female students [age, 21.4 (SD 2.8) years; height, 167.1 (SD 5.1) cm; body mass 62.7 (SD 7.1) kg] performed an incremental exercise test (10 W each minute) on an electrically braked cycle ergometer until they felt exhausted. The HRT and lactate turn point (LTP) were assessed by means of computer-aided linear regression break point analysis from the relationship of HR or [La] to power output. No significant difference was found between HRT and LTP for all the variables measured. Secondly, two endurance tests (ET) of 20 min duration were performed by 7 subjects. The first (ET I) was performed at an exercise intensity which was about 10% lower than the power output at HRT [61.2 (SD 3.1)% maximal oxygen uptake (VO2max)], the second (ET II) at an exercise intensity about 10% higher than the power output at HRT [79.2 (SD 3.4) % VO2max]. The parameters measured showed a clear steady state in ET I. All mean values were lower than values at HRT [power, 138.7 (SD 18.9) W; HR, 172.1 (SD 4.7) beats.min-1; VO2, 2.2 (SD 0.3) l.min-1; VE, 54.0 (SD 9.1) l.min-1; [La], 3.7 (SD 1.1) mmol.l-1; EMG, 81.1 (SD 24.0) microV] except HR which was the same.(ABSTRACT TRUNCATED AT 250 WORDS)

OBJECTIVE-We tested the hypothesis that short-term exercise training improves hereditary insulin resistance by stimulating ATP synthesis and investigated associations with gene polymorphisms. RESEARCH DESIGN AND METHODS-We studied 24 nonobese first-degree relatives of type 2 diabetic patients and 12 control subjects at rest and 48 h after three bouts of exercise. In addition to measurements of oxygen uptake and insulin sensitivity (oral glucose tolerance test), ectopic lipids and mitochondrial ATP synthesis were assessed using 1 H and 31 P magnetic resonance spectroscopy, respectively. They were genotyped for polymorphisms in genes regulating mitochondrial function, PPARGC1A (rs8192678) and NDUFB6 (rs540467).RESULTS-Relatives had slightly lower (P ϭ 0.012) insulin sensitivity than control subjects. In control subjects, ATP synthase flux rose by 18% (P ϭ 0.0001), being 23% higher (P ϭ 0.002) than that in relatives after exercise training. Relatives responding to exercise training with increased ATP synthesis (ϩ19%, P ϭ 0.009) showed improved insulin sensitivity (P ϭ 0.009) compared with those whose insulin sensitivity did not improve. A polymorphism in the NDUFB6 gene from respiratory chain complex I related to ATP synthesis (P ϭ 0.02) and insulin sensitivity response to exercise training (P ϭ 0.05). ATP synthase flux correlated with O 2 uptake and insulin sensitivity.CONCLUSIONS-The ability of short-term exercise to stimulate ATP production distinguished individuals with improved insulin sensitivity from those whose insulin sensitivity did not improve. In addition, the NDUFB6 gene polymorphism appeared to modulate this adaptation. This finding suggests that genes involved in mitochondrial function contribute to the response of ATP synthesis to exercise training. Diabetes 58:1333-1341, 2009

Treadmill testing (TT) commonly used in endurance testing is often not sport-specific. Therefore a field test (FT) for tennis players was developed. The purpose was 1) to compare metabolic and cardiorespiratory response between TT and FT and 2) to assess tennis stroke ratings during FT. In both tests ventilatory variables (VO2, VE, VT, Bf, VE x VO2(-1)), heart rate (HR), and lactate (LA) were measured. For both tests an "individual anaerobic threshold" (IAT) was calculated. The comparison of TT and FT yielded significant differences in cardiorespiratory and metabolic response. LA and VE were significantly higher in TT compared to FT at VO2 of 35, 40, and 45 ml x kg(-1) x min(-1). There were statistical differences between IAT resulting from both tests (TT vs. FT): HR (165+/-16, 175+/-11, p<0.001), VO2 (44.4+/-4.3, 47.8+/-4.8, p<0.05), LA (3.1+/-0.5, 2.5+/-0.4, p < 0.001), VE (97.0+/-15.6, 89.1+/-14.9, p < 0.05), VT (2.66+/-0.34, 2.34+/-0.47, p<0.05), VE/VO2 (27.9+/-3.9, 23.9+/-2.9, p<0.01). High correlation was found between stroke ratings and the national ranking of the players. We concluded that 1) metabolic, ventilatory, and cardiorespiratory demands of TT vs. FT were (semi)sport-specific and significantly different and 2) that the stroke rating in our study was a good predictor for tournament performance (r = 0.94). This type of stroke rating can be implemented in a FT.

Exercise prescription using %HRmax or %HRR methods are of limited accuracy for patients taking beta-blockers. Although %HRmax and %HRR are easy to determine and therefore attractive, we suggest that the most precise exercise prescription would depend on AeT and AnT. Percentages of maximal oxygen consumption or maximal workload or ratings of perceived exertion may be suggested as a substitute. Alternatively, upper limits for %HRmax and %HRR should be lower for patients taking beta-blockers.

Over the past decades undisputable evidence has accumulated identifying the panoply of beneficial effects of exercise training, smoking cessation, blood pressure lowering, glycaemic and lipid control, as well as psycho-social interventions on cardiovascular risk factors, the well-being, morbidity and mortality of patients with cardiac diseases with or without acute events. Nevertheless, despite all the evidence, insurance companies are more than hesitant to provide patients with an adequate infrastructure to allow outpatient cardiac rehabilitation in their community. Whereas some countries still favour in-hospital rehabilitation, others are on the verge of introducing cardiac rehabilitation for the first time. Thanks to the efforts of the Working Group of Outpatient Cardiac Rehabilitation of the Austrian Cardiac Society, detailed guidelines for outpatient cardiac rehabilitation have been introduced, which not only include aims, contents and duration of outpatient cardiac rehabilitation, but also requirements for staff, quality of care and infrastructure. As a result cardiac rehabilitation in Austria is currently undergoing a transition process from exclusive in-hospital cardiac rehabilitation to a more open approach of granting patients a choice between in-hospital and outpatient rehabilitation. Experience gained appears relevant to a great number of colleagues in many countries Europe - as well as worldwide. Since these guidelines were and still are the basis for implementing outpatient cardiac rehabilitation, they are presented in great detail, so that they may either be applied as is or simply stimulate discussion.