Basic Exercise Physiology: Clinical and Laboratory Perspectives

Preface
Contents
About the Authors
Introduction
Chapter 1: Introduction to Exercise Physiology
	Introduction
	Modes of Exercise
	Energy for Exercise
	Myocardial Contractility
	Exercise Benefits
	Physical Work Capacity
	Exercise and Cardiovascular Disease
	Pressure Overload and Volume Overload
	Muscular Function
	Oxygen Uptake and Muscle Fibers
	Muscle Fibers
	Aerobic and Anaerobic Capacities
	Strenuous Exercise
	Energy Interplay
	The Pulmonary Function
	Maximal VO2 Values
	The Cardiovascular System
	Gender Effects on Physiological Differences
	Thermoregulation
	Physiological Responses During Diving
	Physiological Response Altitude
	Physiological and Medical Responses in Space
	Epigenetic Responses
	Aging Effects on Physiological Responses
	Functional Capacity in Health and Disease
	References
Chapter 2: Metabolism
	Anabolism vs. Catabolism
	Energy Production
	Metabolic Pathways
	The Phosphocreatine System
	The Anaerobic Pathway
	The Aerobic Pathway
	Electron Transport-Linked Phosphorylation
	Lactate Production and Utilization
	Fat Metabolism
	The Cori Cycles
	Metabolic Rates
	Factors Affecting BMR and RMR
	Direct vs Indirect Calorimetry
	Respiratory Quotient and RER
	RER for Carbohydrate, Fat, and Protein
	Rate of Energy Expenditure
	Hormonal Regulation of Metabolism
	The Endocrine System
	Anabolic and Catabolic Hormones
	G Protein-Coupled Receptors
	Substrate Oxidation
	Hormonal Regulation During Anaerobic Exercise
	Hormonal Regulation During Aerobic Exercise
	Hormonal Regulation During Resistance Exercise
	Hypothalamic Effect on Metabolic Rate Regulation
	Myocardial Metabolism
	The Metabolic Syndrome
	Diabetes
	Insulin Resistance
	Glycated Hemoglobin
	Effects of Diabetes on Body’s Systems
	Diabetic Ketoacidosis
	Kidney Dysfunction in Diabetes
	The Cardiovascular System in Diabetes
	Nervous System and Epigenetic Role in Diabetes
	Exercise’s Effects on Diabetic Patients
	Endothelial Dysfunction and Exercise
	Effect of Exercise on Calmodulin Signaling Pathway
	Lipids Metabolism
	Resistance Training in Diabetics
	Effect of Aerobic Exercise on GLUT4 Translocation
	Combined Aerobic and Resistance Exercises in Diabetics
	Recommended Exercise Training Intensities
	Obesity
	Body Composition Measurements
	Obesity as a Risk Factor
	Obesity and Cardiovascular Disease
	Mitochondrial Dysfunction in Obesity
	Effects of Exercise on Obesity
	Suppressant
	Resistive Exercise Training Effect on Obesity
	The Endocrine System in Fat Metabolism
	Exercise Epigenetics in Obesity
	Effects of Exercise on Lipids
	Laboratory Assignment on Obesity
	Measurement Techniques
		Underwater Weighing
		Skinfold Method
		Measurement Sites (Figs. 2.55, 2.56, 2.57, 2.58, and 2.59)
		Estimation of Body Density
		Estimation of Percent Fat
	Laboratory on Metabolism
	Laboratory Report Instructions
	References
Chapter 3: Oxygen Uptake and Anaerobic Performances
	Introduction
	Oxygen Diffusing Capacity in the Lung
	Oxygen Deficit and Excess Postexercise Oxygen Consumption (EPOC)
	Maximal Oxygen Uptake
	Postexercise Recovery
	VO2max Determination
	Peak Oxygen Uptake
	Energy Sources at Peak Anaerobic Exercise
	Gender Differences During Anaerobic Bout
	Rating of Perceived Exertion
	Factors Affecting VO2max
	Accurately Measuring VO2max
	Muscle Mass, VO2, and Cardiopulmonary Function
	Aging Effect
	Delivery–Demand Ratio
	VO2max Following Training
	VO2max Response to Insufficient Training Stimulus
	VO2max Prediction
	Field-Tests for VO2max Prediction
	The Harvard Step Test
	The Cooper 12 min Walk/Run Test
	Performing the Test
	The PWC170 Test
	Estimation of VO2max from Submaximal Exercise HR
	Anaerobic Threshold
	Differences Between Lactic Acid and Lactate
	Competitive Sports
	The Lactate Anaerobic Threshold
	Methods Defining Anaerobic Threshold
	Pulmonary Gas Exchange Test
	The Conconi Test
	Training Means to Improve Aerobic Capacity
	Anaerobic Power Measurements
	The Vertical Jump Test
	The Line Drill Test
	The Wingate Anaerobic Test
	Field Test: Vertical Jump Test
	Physical Inactivity
	Gender Variances in (a-v)O2
	Overtraining Syndrome
	Exertional Rhabdomyolysis
	Lactic Acidosis
	Running Injuries
	Laboratory Assignments
	References
Chapter 4: Pulmonary Function
	Introduction
	Pulmonary Gas Exchange
	Minute Ventilation Regulation During Exercise
	Minute Ventilation at Rest and During Exercise
	Alveolar Ventilation/Cardiac Output Ratio
	Maximal Voluntary Ventilation
	Respiratory Muscle Work
	Lung’s Mechanical Work Efficiency
	Physiological Dead Space
	The Oxygen Dissociation Curve
	Carbon dioxide Transportation
	Acid–Base Balance
	Training Effects on the Pulmonary System
	About the Gases
	Lung’s Volumes
	Important Gas Measurements
	Pulmonary Diseases
	Obstructive Lung Diseases
	Asthma
	Restrictive Lung Diseases
	Exercise Training in Asthmatic Patients
	Exercise for Restrictive Lung Disease Patients
	Resistance Exercise for Lung Disease Patients
	Laboratory on Pulmonary Exercise Test
	Before the Testing Session
	Testing Session
	References
Chapter 5: Blood Pressure
	Introduction
	Venous Blood Pressure
	Mean Arterial Pressure
	Pulse Pressure
	Total Peripheral Resistance
	Blood Pressure Regulation
	Measuring BP
	Blood Pressure Responses to Aerobic Exercise
	Gender Effects on Blood Pressure
	Blood Pressure Response During Resistance Exercise
	BP Response During Anaerobic Exercise
	Hypertension
	Aging
	Role of Kidneys in Hypertension
	The Renin-Angiotensin System
	Obesity Effect on Hypertension
	Atherosclerosis
	Inflammation Effect on Hypertension
	Physical Inactivity Effect on Hypertension
	Arterial Stiffening
	Aortic Stiffening
	Aerobic Exercise Effect on Hypertension
	Aerobic Effect on Arterial and Aortic Stiffness
	Resistance Exercise Effect on Hypertension
	Combined Resistance and Aerobic Exercise
	Hypotension During Exercise
	Hypotension Following Resistive Exercise
	Laboratory on Blood Pressure
	References
Chapter 6: Cardiovascular Function
	Introduction
	System’s Uniqueness
	The Myocardium
	The Aorta
		Electrical Stimulation
	Electrocardiograph (ECG) Leads
	The Cardiac Cycle
	Cardiovascular Function
	Autonomic Nervous System
		The Blood
	The Microcirculation Webs
	Red Blood Cell Mechanical Properties
	Effect of Aerobic Exercise Training
	Blood Flow
	Blood Flow During Aerobic Exercise
		Coronary Arteries
	Arterial Autoregulation Mechanism
	Heart Rate Control
	Factors Affecting Stroke Volume
	Stroke Volume During Aerobic Exercise
	The Interplay Between HR and SV
		Cardiac Output in Normal Individuals
	Factors Affecting Cardiac Output
	Cardiac Output in Adolescents
	Cardiac Output During Aerobic Exercise
	Arterial-Venous Oxygen Difference
	Cardiac Output Response to Supine Exercise
	Left Ventricle Function and Volumes
	LV Volumes and EF
	LVEF and Volumes Responses During Aerobic Exercise
	LV Volumes and EF During Resistance Exercise
	LV EF and Volumes Responses During Anaerobic Exercise
	Gender Effect on the Cardiovascular During Anaerobic Bout
	Training Effects on the Cardiovascular System
	Cardiovascular Responses During Isometric and Anaerobic Exercises
	Cardiac Output Redistribution
	Cardiac Output During Isometric Exercise
	Cardiac Output During Anaerobic Exercise
	Cardiac Output During Isodynamic Exercise
	Isodynamic and Cardiac Function in CAD Patients
	All Causes Cardiovascular Mortality
	Myocardial Blood Flow
	Coronary Artery Disease
	Myocardial Oxygen Uptake
	Cardiac Output in Coronary Artery Disease Patients
	Sudden Cardiac Death
		Pathophysiology of Sudden Cardiac Death
	Hypertrophic Cardiomyopathy
	Sudden Cardiac Death in Athletes
	Anemia
	Cardiac Rehabilitation
	Resistance Training in CAD Patients
	Exercise Stress Testing
	Borg’s Rating of Perceived Exertion Scale
	BP Response
	Laboratory on ECG Testing
	References
Chapter 7: Aging
	Aging Considerations
	Aging of the Arteries
	The Renin-Angiotensin System
	Aging Work Capacity
	Cardiopulmonary Function in the Elderly
	Aging Effect on Pulmonary Function
	Mitochondrial Function with Aging
	Age-Related Changes in ATP-Production
	Age Effect on Oxygen Uptake
	Aging Effect on the Balance Between Oxygen Delivery and Extraction
	Exercise in Arterial Stiffness-Hypertension
	Exercise Epigenetic in Aging
	Sarcopenia and Exercise
	Exercise During Aging
	Anaerobic Exercise in the Elderly
	Safety of Resistance Training in the Aged
	S-Klotho Effects on Aging
	Safety Exercising in Aging
	Laboratory on Resistance
	References
Chapter 8: Skeletal Muscles
	Skeletal Muscle Anatomy
	Neural Control of Muscles
	Muscle Function
	Sliding Filament Theory
	Kinds of Muscle Contraction
	Force-Velocity Relationship
	Muscle Fibers
	Muscle Strength and Force
	Cardiovascular Adaptations
	Muscle Elasticity
	Clinical Significance in Muscles
		Muscle Hypertrophy and Atrophy
	Left Ventricular Physiological Hypertrophy
	Pathological Ventricle Hypertrophy
	Athlete’s Heart
	The Renin-Angiotensin System
	Duchenne’s Muscle Dystrophy
	Delayed Onset Muscle Soreness
	Measuring Isometric and Dynamic Strength
	Laboratory on Resistance
	References
Chapter 9: Thermoregulation
	Body Water
	Thermoregulation
	Factors Affecting Heat Gain–Loss
	Control of Skin Circulation
	Sweat and Evaporation
	Blood Flow During Exercise
	Heat Regulation
	Cardiac Output During Exercise in Warm Environments
	Cardiovascular Response in Cold Environment
	Renal Role During Exercise in the Heat
	Heat Acclimatization and Training
	Fluid Regulation During Exercise
	Temperature Regulation in the Cold
	Heat Disorders When Exercising in Hot Environment
	Laboratory on Thermoregulation
	References
Chapter 10: The Immune System
	Introduction
	Immune Deficiency and Autoimmunity
	Antigens
	Lines of Defense
	Inflammation
	Pattern Recognition
	Toll-Like Receptors
	Cytosolic Receptors
	Cellular Components
	Phagocytes
	Granulocytes
	Innate Lymphoid Cells
	The Adaptive Immune System
	Immunoglobulins
	The Immunoglobulin Heavy Chain
	The Immunoglobulin Light Chain
	Effects of Exercise on the Immune System
	Immune Response to All-Out Anaerobic Exercise
	Strenuous Exercise Effects on Immunity in Elderly
	Oxidative Burst
	References
Chapter 11: Exercise in Hostile Environment
	Introduction
	Altitude/Hypoxic Training Effects
	Exercise at Altitude
	The Cardiovascular System
	Renal Regulation of Fluid at Altitude
	Health Risks of Acute Exposure to Altitude
	Altitude Mountain Sickness
	High-Altitude Cerebral Edema
	High-Altitude Pulmonary Edema
	Scuba Diving
	Underwater Physical Activity
	Introduction to Space Physiology
	Arterial Gradient
	Blood Depletion in Spaceflight
	The Impact of μg on the Skeletal
	The Impact of μg on the Cardiovascular System
	The Immune System in Space
	Pulmonary Function in Space
	Exercising in Space
	References
Chapter 12: Epigenetics in Exercise
	Genes
	Regulation of Gene Expression
	Epigenetics
	Epigenetics in Metabolism
	Angiotensin-Converting Enzyme
	Epigenetics in Aging
	Epigenetics and Longevity
	Telomere Shortening
	Exercise Epigenetic
	Aging and Exercise Epigenetics
	References
Chapter 13: Exercise Equipment
	Introduction
	Muscle Mass Influence on VO2
	Stair Climbing
	Stepwise Test
	Stair-Treadmill Ergometer
	Calculating Stepwise Oxygen Uptake
	Stationary Bicycle
	Calculating Bicycle’s Work and Power
	Treadmill Ergometer
	Laboratory Assignments
	References
Appendix A: Measurements in Exercise Physiology
	Definitions of Relevant Terms
Appendix B: Report Formats
	General Guidelines for All Laboratories
		Laboratory Report
	General Notes
Index