Despite evidence that spouses play an important role in the recovery of MI survivors, there have been few studies of pertinent psychosocial factors from the perspectives of both survivors and spouses. Accordingly, the aim of this study was to describe stress, coping strategies and social support experienced by survivors and spouses. This study was limited to first-time MI to focus on a time of uncertainty and transition. Twenty-eight persons (14 couples) participated. Both survivors and their spouses reported similar post-MI stresses: emotional impact, lifestyle changes, encounters with health professionals, and their partners' reactions. Spouses and survivors used diverse strategies to cope with the stresses of MI. Seeking informational support was prevalent. Both spouses and survivors engaged in 'protective buffering' of their partners. Couples described deficient support, conflict and miscarried helping efforts within their relationships. Spouses and survivors referred to inadequate informational support from health professionals.
Factors contributing to maximal incremental and short-term exercise capacity were measured before and after 12 wk of high-intensity endurance training in 12 old (60-70 yr) and 10 young (20-30 yr) sedentary healthy males. Peak O2 uptake in incremental cycle ergometer exercise increased from 1.60 +/- 0.073 to 2.21 +/- 0.073 (SE) l/min (38% increase) in the old subjects and from 2.54 +/- 0.141 to 3.26 +/- 0.181 l/min (29%) in the young subjects. Peak cardiac output, estimated by extrapolation from a series of submaximal measurements by the CO2 rebreathing method, increased by 30% (from 12.7 to 16.5 l/min) in the old subjects, associated with a 6% increase (from 126 to 135 ml/l) in arteriovenous O2 difference; in the young subjects there were equal 14% increases in both variables (18.0 to 20.5 l/min and 140 to 159 ml/l, respectively). Submaximal mean arterial pressure and cardiac output were lower posttraining in the old subjects; total vascular conductance and cardiac stroke volume increased. Although peak power at the start of a short-term maximal isokinetic test did not change, total work accomplished in 30 s at a pedaling frequency of 110 revolutions/min increased in both groups, from 11.2 to 12.6 kJ and from 15.7 to 16.9 kJ in the old and young, respectively; fatigue during the 30-s test was less, and postexercise plasma lactate concentrations were lower. In older subjects, increases in aerobic power after high-intensity endurance training are at least as large as in younger subjects and are associated with increases in vascular conductance, maximal cardiac output, and stroke volume.
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