Effects of Handrail Support usage during CPET on Metabolic Responses in Healthy Participants
DOI:
https://doi.org/10.21527/2176-7114.2023.47.14175Palabras clave:
Cardiopulmonary, Cardiorespiratory Fitness, Exercise Test, Oxygen UptakeResumen
Background: Using the support of a handrail during cardiopulmonary exercise testing (CPET) may alter physiologic parameters. The purpose is investigate the effects of handrail usage during the CPET in the metabolic parameters outcomes of young adults. Material and Methods: 39 young adults (age in years, 20.8 ± 2.9) of both sexes, 17 woman and 22 men performed two treadmill CPET on Ellestad protocol, in non-consecutive days. The first (T1) offered access to the support of a handrail; after 7 days, the second (T2) was performed without it. Differences between protocols for metabolic variables were compared using paried the t-test and repeated measures ANOVAS with interaction. Results: Regardless of sex, all participants exhibited superior results of metabolic parameters at T2 in contrast to T1. During T2, there was a major perception of respiratory and muscular effort, as well as a higher respiratory quotient for both sexes. When comparing T1 with T2, the VE/VCO2 slope was also significantly higher for women (29.31 ± 4.7 and 27.27 ± 4.53). For both sexes, when comparing the tests by stages, it was observed in stages 2, 3 and 4 higher values in the metabolic parameters for T2. The percentile difference for both sexes was 17% higher in S3 for women (T1=26.20±4.1 ml.kg-1.min-1;T2 28.79±4.2 ml.kg-1.min-1) and men (T1= 40.07±6.6 ml.kg-1.min-1; T2 45.92±4.8 ml.kg-1.min-1).Conclusion: The holding of the handrail attenuated the participants' cardiorespiratory and metabolic responses by more than 15% during CPET.
Material and Methods: 39 young adults (age in years, 20.8 ± 2.9) of both sexes, 17 woman and 22 men performed two treadmill CPET on Ellestad protocol, in non-consecutive days. The first (T1) offered access to the support of a handrail; after 7 days, the second (T2) was performed without it. Differences between protocols for metabolic variables were compared using paried the t-test and repeated measures ANOVAs with interaction.
Results: Regardless of sex, all participants exhibited superior results of metabolic parameters at T2 in contrast to T1. During T2, there was a major perception of respiratory and muscular effort, as well as a higher respiratory quotient for both sexes. When comparing T1 with T2, the VE/VCO2 slope was also significantly higher for women (29.31 ± 4.7 and 27.27 ± 4.53). For both sexes, when comparing the tests by stages, it was observed in stages 2, 3 and 4 higher values in the metabolic parameters for T2. VO2 was approximately 17% higher at T2, stage 3, for women and men.
Conclusion: The holding of the handrail attenuated the participants' cardiorespiratory and metabolic responses by more than 15% during CPET.
Citas
Mezzani A. Cardiopulmonary exercise testing: Basics of methodology and measurements. Ann Am Thorac S. 2017;14:S3-S11. DOI: https://doi.org/10.1513/AnnalsATS.201612-997FR
Milani RV, Lavie CJ, Mehra MR. and Ventura HO. Understanding the basics of cardiopulmonary exercise testing. Mayo Clin Proc. 2006;81(12):1.603-1.611. DOI: https://doi.org/10.4065/81.12.1603
Zeimetz G, McNeill J, Hall J. and Moss R. Quantifiable changes in oxygen uptake, heart rate, and time to target heart rate when hand support is allowed during treadmill exercise. J Cardiac Rehabil. 1985;5(11):525-529.
Ijmker T, Lamoth CJ, Houdijk H, Tolsma M, Van Der Woude, LHV, Daffertshofer A, et al. Effects of handrail hold and light touch on energetics, step parameters, and neuromuscular activity during walking after stroke. J Neuroeng Rehabil. 2015;12(1):70. DOI: https://doi.org/10.1186/s12984-015-0051-3
Whitman M, Sabapathy S, Jenkins C. and Adams L. Handrail support produces a higher rate pressure product in apparently healthy non-treadmill users during maximal exercise testing. Physiol Meas. 2019;40(2):02NT01. DOI: https://doi.org/10.1088/1361-6579/ab0565
Duvillard SPV, Pivirotto JM. The effect of front handrail and non-handrail support on treadmill exercise in healthy women. J Cardiopulm Rehabil. 1991;11(3):164-168.
Christman SK, Fish AF, Bernhard L, Frid DJ, Smith BA, and Mitchell L. Continuous handrail support, oxygen uptake, and heart rate in women during submaximal step treadmill exercise. Res Nurs Health. 2000;23(1):35. DOI: https://doi.org/10.1002/(SICI)1098-240X(200002)23:1<35::AID-NUR5>3.0.CO;2-I
Howley ET, Colacino DL, and Swensen TC. Factors affecting the oxygen cost of stepping on an electronic stepping ergometer. Med Sci Sports Exer. 1992;24 (9):1.055-1.058.
Ragg KE, Murray TF, Karbonit LM, and Jump DA. Errors in predicting functional capacity from a treadmill exercise stress test. Am Heart J. 1980;100(4):581-583. DOI: https://doi.org/10.1016/0002-8703(80)90676-6
Arena R, Myers J, Aslam SS, Varughese EB, and Peberdy MA. Peak VO2 and VE/VCO2 slope in patients with heart failure: a prognostic comparison. Am Heart J. 2004;147(2):354-360. DOI: https://doi.org/10.1016/j.ahj.2003.07.014
Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, et al. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001;104(14):1.694-1.740. DOI: https://doi.org/10.1161/hc3901.095960
Silva VSD, and Vieira MFS. International Society for the Advancement of Kinanthropometry (ISAK) Global: international accreditation scheme of the competent anthropometrist. Rev Bras Cineantropom Desempenho Hum. 2020;22:70.517. DOI: https://doi.org/10.1590/1980-0037.2020v22e70517
Lohman TG. Advances in body composition assessment. Hum Kinet. 1992;1-23.
Riebe D, Ehrman Jk, Liguori G, and Magal M. ACSM’s guidelines for exercise testing and prescription. American College of Sports. Wolters Kluwer, 10th Edition, 185-215. Philadelphia, 2018. (Print Version)
Borg G. Psychophysical Bases of Perceived Exertion. Med Sports Exer. 1982;14(5):377-381. DOI: https://doi.org/10.1249/00005768-198205000-00012
de Oliveira GL, Marques AH, da Fonseca VF, Pazzolo BA, Panacioni F, Santos TC, et al. Handrail support interference in cardiac autonomic modulation adjustments in young adults during maximal exercise testing. Sci Rep. 2020;10(1):1-9. DOI: https://doi.org/10.1038/s41598-020-68155-3
Hofmann C, Dougherty C, Abkarian H, and Juris P. The reduction of metabolic cost while using handrail support during inclined treadmill walking is dependent on the handrail-use instruction. Int J Exer Sci. 2014;7 (4):10. Disponível em: https://digitalcommons.wku.edu/ijes/vol7/iss4/10
Arai Y, Saul JP, Albrecht P, Hartley LH, Lily LS, Cohen RJ, et al. Modulation of cardiac autonomic activity during and immediately after exercise. Am J of Physiol-Heart C. 1989;256(1):H132-H141. DOI: https://doi.org/10.1152/ajpheart.1989.256.1.H132
Benarroch EE. The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc. 1993;68(10):988-1001. DOI: https://doi.org/10.1016/S0025-6196(12)62272-1
Teixeira AL, Fernandes IA, and Vianna LC. Cardiovascular control during exercise: the connectivity of skeletal muscle afferents to the brain. Exerc Sport Sci Rev. 2020;48(2):83-91. DOI: 10.1249/JES.0000000000000218
McConnell TR, and Clark BA. Prediction of maximal oxygen consumption during handrail-supported treadmill exercise. J Cardiopulm Rehabil. 1987;7(7):324-331.
Wasserman K. The Anaerobic Threshold Measurement to Evaluate Exercise Performance. Am Rev Respir Dis. 1984;129:S35-S40. DOI: https://doi.org/10.1164/arrd.1984.129.2P2.S35
Corrà U, Mezzani A, Giordano A, Bosimini E, and Gianuzzi P. Exercise haemodynamic variables rather than ventilatory efficiency indexes contribute to risk assessment in chronic heart failure patients treated with carvedilol. Eur Heart J. 2009; 30(24):3.000-3.006. DOI: https://doi.org/10.1093/eurheartj/ehp176
Beaver WL, Wasserman K, and Whipp BJ. A New Method for Detecting Anaerobic Threshold by Gas Exchange. J Appl Physiol. 1986;60(6):2.020-20.277. DOI: https://doi.org/10.1152/jappl.1986.60.6.2020
Sue DY, Wasserman K, Moricca RB, and Casaburi R. Metabolic acidosis during exercise in patients with chronic obstructive pulmonary disease: use of the V-slope method for anaerobic threshold determination. Chest. 1988;94(5):931-938. DOI: https://doi.org/10.1378/chest.94.5.931
Mezzani A, Agostoni P, Cohen-Solal A, Corra U, Jegier A, Kouidi E, et al. Standards for the use of cardiopulmonary exercise testing for the functional evaluation of cardiac patients: a report from the Exercise Physiology Section of the European Association for Cardiovascular Prevention and Rehabilitation. Eur J Card Prev Rehabilitation. 2009;16(3):249-267. DOI: https://doi.org/10.1097/HJR.0b013e32832914c8
Klaassen SH, Liu LC, Hummel YM, Damman K, van der Meer P, Voors, et al. Clinical and hemodynamic correlates and prognostic value of VE/VCO2 slope in patients with heart failure with preserved ejection fraction and pulmonary hypertension. J Cardiac Fail. 2017;23(11):777-782. DOI: https://doi.org/10.1016/j.cardfail.2017.07.397
Corrà U, Giordano A, Mezzani A, Gnemmi M, Pistono M, Caruso R, et al. Cardiopulmonary exercise testing and prognosis in heart failure due to systolic left ventricular dysfunction: a validation study of the European Society of Cardiology Guidelines and Recommendations (2008) and further developments. Eur J Prev Cardiol. 2012;19(1):32-40. DOI: https://doi.org/10.1177/1741826710393994
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2023 Revista Contexto & Saúde
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Autores que publicam na Revista Contexto & Saúde concordam com os seguintes termos:
a) A submissão de trabalho(s) científico(s) original(is) pelos autores, na qualidade de titulares do direito de autor do(s) texto(s) enviado(s) ao periódico, nos termos da Lei 9.610/98, implica na cessão de direitos autorais de publicação na Revista Contexto e Saúde do(s) artigo(s) aceitos para publicação à Universidade Regional do Noroeste do Estado do Rio Grande do Sul, autorizando-se, ainda, que o(s) trabalho(s) científico(s) aprovado(s) seja(m) divulgado(s) gratuitamente, sem qualquer tipo de ressarcimento a título de direitos autorais, por meio do site da revista e suas bases de dados de indexação e repositórios, para fins de leitura, impressão e/ou download do arquivo do texto, a partir da data de aceitação para fins de publicação. Isto significa que, ao procederem a submissão do(s) artigo(s) à Revista Contexto e Saúde e, por conseguinte, a cessão gratuita dos direitos autorais relacionados ao trabalho científico enviado, os autores têm plena ciência de que não serão remunerados pela publicação do(s) artigo(s) no periódico.
b). Autores mantém os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
c). Autores têm autorização para assumir contratos adicionais separadamente, para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
d. Autores têm permissão e são estimulados a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal) a qualquer ponto antes ou durante o processo editorial, já que isso pode gerar alterações produtivas, bem como aumentar o impacto e a citação do trabalho publicado (Veja O Efeito do Acesso Livre).
