OBJECTIVE: To examine the use of a submaximal exercise test in detecting change in fitness level after a physical training program, and to investigate the correlation of outcomes as measured submaximally or maximally.DESIGN: A prospective study in which exercise testing was performed before and after training intervention.SETTING: Academic and general hospital and rehabilitation center.PARTICIPANTS: Cancer survivors (N=147) (all cancer types, medical treatment completed > or =3 mo ago) attended a 12-week supervised exercise program.INTERVENTIONS: A 12-week training program including aerobic training, strength training, and group sport.MAIN OUTCOME MEASURES: Outcome measures were changes in peak oxygen uptake (Vo(2)peak) and peak power output (both determined during exhaustive exercise testing) and submaximal heart rate (determined during submaximal testing at a fixed workload).RESULTS: The Vo(2)peak and peak power output increased and the submaximal heart rate decreased significantly from baseline to postintervention (P<.001). Changes in submaximal heart rate were only weakly correlated with changes in Vo(2)peak and peak power output. Comparing the participants performing submaximal testing with a heart rate less than 140 beats per minute (bpm) versus the participants achieving a heart rate of 140 bpm or higher showed that changes in submaximal heart rate in the group cycling with moderate to high intensity (ie, heart rate > or =140 bpm) were clearly related to changes in VO(2)peak and peak power output.CONCLUSIONS: For the monitoring of training progress in daily clinical practice, changes in heart rate at a fixed submaximal workload that requires a heart rate greater than 140 bpm may serve as an alternative to an exhaustive exercise test.
The purpose of this study was to assess predictive value of a new submaximal rowing test (SmRT) on 2,000-m ergometer rowing time-trial performance in competitive rowers. In addition, the reliability of the SmRT was investigated. Twenty-four competitive male rowers participated in this study. After determining individual HRmax, all rowers performed an SmRT followed by a 2,000-m rowing ergometer time trial. In addition, the SmRT was performed 4 times (2 days in between) to determine the reliability. The SmRT consists of two 6-minute stages of rowing at 70 and 80% HRmax, followed by a 3-minute stage at 90% HRmax. Power was captured during the 3 stages, and 60 seconds of heart rate recovery (HRR60s) was measured directly after the third stage. Results showed that predictive value of power during the SmRT on 2,000-m rowing time also increased with stages. CVTEE% is 2.4, 1.9, and 1.3%. Pearson correlations (95% confidence interval [95% CI]) were −0.73 (−0.88 to −0.45), −0.80 (−0.94 to −0.67), and −0.93 (−0.97 to −0.84). 2,000-m rowing time and HRR60s showed no relationship. Reliability of power during the SmRT improved with the increasing intensity of the stages. The coefficient of variation (CVTEM%) was 9.2, 5.6, and 0.4%. Intraclass correlation coefficients (ICC) and 95% CI were 0.91 (0.78–0.97), 0.92 (0.81–0.97), and 0.99 (0.97–1.00). The CVTEM% and ICC of HRR60s were 8.1% and 0.93 (0.82–0.98). In conclusion, the data of this study shows that the SmRT is a reliable test that it is able to accurately predict 2,000-m rowing time on an ergometer. The SmRT is a practical and valuable submaximal test for rowers, which can potentially assist with monitoring, fine-tuning and optimizing training prescription in rowers.
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The aim of the present study was to find early markers for overreaching that are applicable in sport practice. In a group of elite soccer players aged 15–18, the stress–recovery balance and reaction times before and after exercise were assessed. Overreaching was indicated by an elevated submaximal heart rate during a sport-specific field test. Submaximal changes in heart rate were prospectively monitored by means of monthly Interval Shuttle Run Tests during two competitive seasons. Out of 94 players, seven players with an elevated heart rate of at least one month could be included in the study, together with seven controls, matched for age, body composition, training and performance level. The stress–recovery balance was assessed with the Dutch version of the Recovery Stress Questionnaire (RESTQ-Sport). The soccer players with an elevated heart rate reported a disturbed stress–recovery balance (Mann–Whitney test, P<0.05). An ANOVA for repeated measures of reaction times revealed a significant main effect of time (F 1,12=13.87, P<0.01) indicating an improvement of psychomotor speed. No differences between groups were found. We conclude that soccer players with an elevated submaximal heart rate of at least one month share a disturbed stress–recovery balance, but they could not be distinguished from controls based on reaction time after strenuous exercise.
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Regular physical activity is considered to be an important component of a healthy lifestyle that decreases the risk of coronary heart disease, diabetes mellitus type 2, hypertension, colon and breast cancer, obesity and other debilitating conditions. Physical activity can also improve functional capacity and therefore also the quality of life in older adults. Despite all these favorable aspects, a substantial part of the Dutch older adult population is still underactive or even sedentary. To change this for the better, the Groningen Active Living Model (GALM) was developed.Aim of GALM is to stimulate recreational sports activities in sedentary and underactive older adults in the 55-65 age band. After a door-to-door visit as part of an intensive recruitment phase, a fitness test was conducted followed by the GALM recreational sports program. This program was based on principles from evolutionary-biological play theory and insights fromsocial cognitive theory. The program was versatile in nature (e.g. softball, dance, self-defense, swimming, athletics, etc.) in two main ways: a) to improve compliance with the program different sports were offered, which was reported to be more appealing for older adults; b) by aiming at more components of motor fitness (e.g. strength, flexibility, speed, endurance and coordination). Between 1997 and 2005 more than 552,000 persons were visited door-to-door, over 55,700 were tested, and 41,310 participated in the GALM recreational sports program. The aim of the present thesis is to determine the effects of participation in the GALM recreational sports program on physical activity, health and fitness outcomes.Chapter 2 describes the effectiveness of the GALM recruitment in selecting and recruiting sedentary and underactive older adults. Three municipalities in the Netherlands were selected, and in every municipality four neighborhoods were included. Two of each of the four neighborhoods were randomly assigned as intervention and the others as control neighborhoods. In total, 8,504 persons were mailed and received a home visit. During this home visit the GALM recruitment questionnaire was collected on which the selection between sedentary/underactive and physically active older adults was based. Ultimately we succeeded inincluding 12.3% (315 of the 2,551 qualifying) of the older adults, 79.4% of whom could be indeed considered sedentary or underactive. The cost of successfully recruiting an older adult was estimated at $84.To assess the effects of a physical activity intervention on health and fitness and explain the results, it is necessary to know program characteristics regarding frequency, intensity, time and content of the activities. With respect to the GALM recreational sports activity program, the only unknown characteristic was intensity. Chapter 3 describes the intensity of this program systematically. Using heart rate monitors, data of 97 persons (mean age 60.1 yr) were collected in three municipalities. The mean intensity of all 15 GALM sessions was 73.7% of the predicted maximal heart rate. Six percent of the monitored heart rate time could be classified as light, 33% as moderate and 61% as hard. In summary, the GALM recreational sports program meets the 1998 ACSM recommendations for intensity necessary to improve cardiorespiratory fitness.Chapters 4 and 5 describe the effects of 6 and 12 months of participation in the GALM recreational sports program, and 181 persons were followed over time. Results after 6 months revealed only few significant between-group differences favoring the intervention group (i.e. sleep, diastolic blood pressure, perceived fitness score and grip strength). Changes in energyexpenditure for leisure-time physical activities (EELTPA) showed an increase in both study groups. From 6 to 12 months a decrease in EELTPA occurred in the intervention group and an increase in the control group. The significant positive time effects for the health outcomes (diastolic blood pressure, BMI, percentage of body fat) that were found after 6 months were diminishedfrom 6 to 12 months. However, the energy expenditure for recreational sports activities (EERECSPORT) demonstrated a continuous increase over 12 months. Parallel to this, significant main effects for time were found in performance-based fitness outcomes (i.e. simple reaction time, leg strength, flexibility of hamstrings and lower back, and aerobic endurance). After 12 months only a significant between-group difference for flexibility of the hamstrings andlower back was found, favoring the control group. In conclusion, a short-term increase in EELTPA was found with accompanying improvements in health outcomes that more or less disappeared in 6 to 12 months. In the long term, results showed a continuous increase in EERECSPORT and performance-based fitness. This latter increase is probably a reflection of the significantimprovement over time in EERECSPORT and the fact that recreational sports activities are of a higher intensity.Aerobic endurance is regarded as the most important component of motor fitness that is relevant for older adults to function independently. In Chapter 6, the development in aerobic endurance after 18 months of participation in the GALM recreational sports program was assessed by means of changes in heart rate during fixed submaximal exercise. Since both groups were comparable regarding changes in energy expenditure for physical activity after 6 months and testing confirmed this, both groups were combined and considered as one group. Multilevel analyses were conducted and models for change were developed. A significant decrease in heart rate over time was found at all walking speeds (4, 5, 6 and 7 km/h). The average decrease in heart rate was 5.5, 6.0, 10.0 and 9.0 beats/min for the 4, 5, 6 and 7 km/h walking speeds, respectively. The relative decrease varied from 5.1 to 7.4% relative to average heart rates at baseline. These results illustrate that participation in the GALM recreational sports program has a positive significant effect on aerobic endurance, and that the participants are able to perform at submaximal intensity more easily.Based on the overall results it can be concluded that this study contributes to the field in how to effectively recruit sedentary and underactive older adults and stimulate them to become and stay active in recreational sports activities. As far as we know, this recruitment in combination with the recreational sport program is not only unique but also effective toward increasing performance-based fitness in the long term. Short-term effects were found in other leisure-time activities and health outcomes. To further stimulate other leisure-time and probably health outcomes besides the favorable effects that were already seen, additional interventions that pay more attention to behavioral change in terms of how to integrate other activities besides sports activities are recommended.
