Publications (4)15.69 Total impact
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Article: Factor analysis of quality of life, dyspnea, and physiologic variables in patients with chronic obstructive pulmonary disease before and after rehabilitation.
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ABSTRACT: To identify the relationships between quality of life (QOL) and the clinical state using factor analysis pre- and postrehabilitation. Patients with chronic obstructive pulmonary disease (COPD) suffer from a significant physiologic impairment associated with an altered QOL. Comprehensive rehabilitative programs, including exercise training, have beneficial effects on exercise tolerance and QOL for these patients. Factor analysis (n = 6) was conducted using the data of 32 patients with COPD. Patients had been evaluated for QOL using the Nottingham Health Profile (NHP), spirometric values, dyspnea, and the variables assessed by an incremental exercise test at three levels of activity. All measurements were obtained pre- and postrehabilitation. Factor analysis showed that the following two factors characterize the pathophysiologic condition of patients with COPD: (1) the specific cardiorespiratory responses to incremental exercise test and the spirometric values; and (2) the QOL results. The factor analysis results differed with the testing time (pre, post) and the level of activity. QOL, as evaluated by a generic questionnaire and the clinical state of patients with COPD, was independent; this independence characterized the pathophysiologic condition of our patients. Our results reinforce the usefulness of different types of evaluation, especially pre- and postrehabilitation, because they reflect independent benefits used to understand the success and follow-up of rehabilitative programs.American Journal of Physical Medicine & Rehabilitation 03/2001; 80(2):113-20. · 1.58 Impact Factor -
Article: Effect of NaHCO3 on lactate kinetics in forearm muscles during leg exercise in man.
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ABSTRACT: We investigated NaHCO3 infusion effects on plasma lactate removal by forearm muscles and performance during intensive leg exercise. Seven subjects performed the force-velocity (FV) test with placebo and NaHCO3 (2 mEq.min-1) with a double-blind crossover protocol. Blood samples for arterial ([LA]A) and venous ([LA]V) lactate determinations were taken 1) at rest before infusion, and 2, 6, 10, 14, 18, and 22 min following its start; and 2) at the end of each exercise bout. The arteriovenous difference ([LA]A-V) was determined for each sampling. NaHCO3 significantly increased arterial bicarbonate concentration and pH during rest (P < 0.001; P < 0.001) and the FV test (P < 0.001; P < 0.05). During the test, [LA]A and [LA]V were significantly higher with NaHCO3 (P < 0.05, P < 0.001). At test onset, [LA]A-V became positive and increased until the braking force of 6 kg, with NaHCO3 and placebo, with values significantly lower for NaHCO3 (P < 0.001). Peak anaerobic power (Wanae, peak) and the corresponding braking force (Fmax) were also determined. Fmax was significantly increased with NaHCO3 (P < 0.001). In conclusion, the increasing rise in [LA]A and [LA]V induced by NaHCO3 may be partly explained by a decreased rate of lactate uptake by forearm skeletal muscles. NaHCO3 did not improve Wanae, peak, but improved Fmax, thus increasing FV duration.Medicine & Science in Sports & Exercise 06/1996; 28(6):692-7. · 4.43 Impact Factor -
Article: Cardiopulmonary exercise testing. Determinants of dyspnea due to cardiac or pulmonary limitation.
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ABSTRACT: The aim of this study was to bring to light new and simple criteria, obtained during cardiopulmonary exercise testing, in order to demonstrate in patients the cardiac or the pulmonary origin of a comparable exertional dyspnea. Forty male subjects were compared, who exercised with a 30-W/3-min protocol and were divided into three groups: the cardiac heart failure (CHF) group (n = 15), the chronic obstructive lung disease (COLD) group (n = 15), and the control group (n = 10). The two groups of patients differed totally from the control group concerning their spirometric values at rest and a clear inability during effort which was confirmed by all the studied cardiopulmonary parameters at maximal exercise. The CHF and COLD groups differed slightly concerning their maximum symptom-limited oxygen uptake, only when related to body mass (13.26 +/- 0.69 ml/kg/min in CHF group, 17.05 +/- 1.59 ml/kg/min in COLD group; p < 0.05), and concerning their maximum ventilatory equivalent for oxygen which tended to be higher in the CHF group in comparison with the COLD group (p = 0.082). Furthermore, and as foreseen, the two groups of patients clearly differed at maximum exercise concerning the ventilatory reserve respiratory parameter (49.73 +/- 3.18 percent in CHF group, 8.38 +/- 5.85 percent in COLD group; p < 0.01). On the other hand, they did not differ concerning cardiac parameters or those considered as such (maximum heart rate [HR], HR reserve, HR response, maximum O2 pulse measurement). While their maximum ventilation was similar in the CHF and COLD groups, a difference in adaptation during exercise was found by observing their breathing pattern. In the CHF group, this was demonstrated by a significantly lower breathing frequency at maximum exercise (31.24 +/- 1.53 beats/min vs 37.75 +/- 2.24 beats/min; p < 0.05) and a tidal volume that tended to be higher at maximum exercise (p = 0.077) and significantly higher at 60-W work load (p < 0.05). This work shows that the study of ventilatory reserve and breathing pattern during exercise testing allows one to discriminate if dyspnea on exertion in patients is due to cardiac or respiratory disease.Chest 08/1994; 106(2):354-60. · 5.25 Impact Factor -
Article: Effects of benzodiazepine during a Wingate test: interaction with caffeine.
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ABSTRACT: To assess the effects of benzodiazepine alone and associated with caffeine on performance and substrate responses during supramaximal exercise, seven healthy volunteers performed the Wingate test after ingestion of placebo (Pla), benzodiazepine alone, i.e., 1 mg of lorazepam (Bz), and benzodiazepine followed by 250 mg of caffeine (Bz-Caf). Peak power (PP), mean power (MP), and percentage of power decrease (%PD) were determined, and substrate responses were estimated by blood lactate and catecholamine concentrations. Four hours after Bz ingestion, there was a significant decrease in PP (PPBz: 626 +/- 72 vs PPPla: 669 +/- 78 W), maximal blood lactate (La max) (La maxBz: 9.5 +/- 1.5 vs La maxPla: 12.4 +/- 1.8 mmol.l-1), and end-exercise epinephrine (E) (EBz: 339 +/- 113 vs EPla: 672 +/- 247 ng.l-1). No other changes were noted. Caffeine ingestion 1 h before the test (Bz-Caf) corrected the decrease in La max (La maxBz-Caf: 11.5 +/- 1.4 mmol.l-1) and E (EBz-Caf: 573 +/- 190 ng.l-1) but was unable to prevent the impairment of performance (PPBz-Caf: 625 +/- 68 W vs PPPla). Moderate benzodiazepine intake significantly altered performance and substrate responses during supramaximal exercise. Moderate caffeine intake antagonized the metabolic but not the performance effects of 1 mg of lorazepam.Medicine & Science in Sports & Exercise 01/1994; 25(12):1375-80. · 4.43 Impact Factor
