Exploratory Study on Oxygen Consumption On-kinetics During Treadmill Walking in Women With Systemic Lupus Erythematosus

Keyser, Randall E.; Rus, Violeta; Mikdashi, Jamal; Handwerger, Barry S.

doi:10.1016/j.apmr.2010.06.003

“…increased over time, and in healthy subjects it is known that training induces an acceleration of the VO 2 on-kinetics at the same absolute work load. 68 Furthermore, Keyser et al 69 demonstrated that VO 2 on-kinetics was slower in women with SLE. However, whether or not a physical activity intervention could normalize such an abnormality in patients with SLE has not yet been tested.…”

Section: Discussionmentioning

confidence: 99%

Effects of a one-year physical activity programme for women with systemic lupus erythematosus – a randomized controlled study

Boström

¹

,

Elfving

²

,

Dupre

³

et al. 2016

Lupus

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Physical activity and aerobic capacity increased after supervised exercise and coaching, and the improvement was sustained during the one-year programme. However, no interactions between the group differences were seen, which suggests that repeated measurements could motivate to increased physical activity and thereby to increased aerobic capacity. As sub-max. VO2 increased over time, training-induced changes in VO2 on-kinetics could be another explanation. Little influence on HRQL was seen after the programme. The study indicates that physical activity at high intensity over one year is tolerated by patients with mild to moderate SLE.

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“…In addition, the authors observed that VO 2 at anaerobic threshold was 27.9% lower in women with SLE compared to controls (VO 2AT =12.9 ± 2.9 vs. 17.9 ± 3.1 ml/kg/min, respectively). These findings, suggest impaired microcirculatory dynamics and mitochondrial function during exercise, resulting in decreased a-vO 2 difference [30]. In this regard, previous studies have demonstrated that pathological adaptations in the muscle capillary bed of patients with SLE could impair microvascular reactivity and O 2 diffusive transport from muscle capillaries to mitochondria [31,32].…”

Section: Aerobic Capacity In Sle Patientsmentioning

confidence: 92%

“…Lastly, with regard to peripheral abnormalities, previous studies have demonstrated oxidative metabolism impairment in SLE patients compared with healthy controls [21,30]. Kayser et al [30], for instance, found prolonged VO 2 on-kinetics on the square wave test in SLE patients.…”

Section: Aerobic Capacity In Sle Patientsmentioning

confidence: 99%

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Impaired Aerobic Capacity in Systemic Lupus Erythematosus Patients: What are the Physiological Mechanisms

AG¹

2015

Rheumatology (Sunnyvale)

1

0

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Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown origin affecting virtually all organ systems. In addition, SLE patients can present limitations in exercise capacity and reduced quality of life due to various clinical conditions such as fatigue, cardiorespiratory disease and muscle involvement. For instance, impaired tissue O 2 transport due to altered convective O 2 transport (product of arterial O 2 content and blood flow) to the working locomotor muscles or O 2 diffusive transport from muscle capillaries to mitochondria is the major determinant of reduced aerobic capacity in patients with SLE. In this respect, scientific evidences suggest that during exercise SLE patients show an attenuated increase in heart rate and systolic volume, reduced ventilatory efficiency and oxidative metabolism impairment.Importantly, recent investigations suggest that aerobic exercise training has direct effects on improving both aerobic capacity and exercise tolerance in SLE patients. Within this context, previous studies suggest that either central or peripheral components are involved in improved aerobic capacity after exercise training program.In this light, the present review sought to clarify the physiological mechanisms associated with reduced aerobic capacity in SLE patients. Secondly, special focus was given to the role of physical training in improving aerobic capacity in these patients as well as to the underlying mechanisms.

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“…A possible relationship between excess CO 2 expiration and running performance [ 17 ] has also been suggested and concurrent increases in the time (AT-time) required to achieve the anaerobic threshold (expressed as relative O 2 ; AT- O 2 ), distance attained on a timed walk test, and improvement peak and submaximal O 2 /work rate ratio [ 20 ] following aerobic exercise training, even though no significant improvement in peak oxygen consumption was observed, have been reported. Moreover, AT- O 2 has been indirectly associated with Fatigue Severity Scale scores and the ability to meet energy requirements of instrumental activities of daily living [ 19 ]. However, CO 2 relationships have been less frequently considered and are less well understood.…”

Section: Introductionmentioning

confidence: 99%

Measures of excess $$ \dot{\mathrm{V}} $$CO2 and recovery $$ \dot{\mathrm{V}} $$CO2 as indices of performance fatigability during exercise: a pilot study

Wooten

¹

,

Neville

²

,

Keyser

³

2021

Pilot Feasibility Stud

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0

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Background The severity of performance fatigability and the capacity to recover from activity are profoundly influenced by skeletal muscle energetics, specifically the ability to buffer fatigue-inducing ions produced from anaerobic metabolism. Mechanisms responsible for buffering these ions result in the production of excess carbon dioxide (CO2) that can be measured as expired CO2 ($$ \dot{\mathrm{V}} $$ V ̇ CO2) during cardiopulmonary exercise testing (CPET). The primary objective of this study was to assess the feasibility of select assessment procedures for use in planning and carrying out interventional studies, which are larger interventional studies investigating the relationships between CO2 expiration, measured during and after both CPET and submaximal exercise testing, and performance fatigability. Methods Cross-sectional, pilot study design. Seven healthy subjects (30.7±5.1 years; 5 females) completed a peak CPET and constant work-rate test (CWRT) on separate days, each followed by a 10-min recovery then 10-min walk test. Oxygen consumption ($$ \dot{\mathrm{V}} $$ V ̇ O2) and $$ \dot{\mathrm{V}} $$ V ̇ CO2 on- and off-kinetics (transition constant and oxidative response index), excess-$$ \dot{\mathrm{V}} $$ V ̇ CO2, and performance fatigability severity scores (PFSS) were measured. Data were analyzed using regression analyses. Results All subjects that met the inclusion/exclusion criteria and consented to participate in the study completed all exercise testing sessions with no adverse events. All testing procedures were carried out successfully and outcome measures were obtained, as intended, without adverse events. Excess-$$ \dot{\mathrm{V}} $$ V ̇ CO2 accounted for 61% of the variability in performance fatigability as measured by $$ \dot{\mathrm{V}} $$ V ̇ O2 on-kinetic ORI (ml/s) (R2=0.614; y = 8.474x − 4.379, 95% CI [0.748, 16.200]) and 62% of the variability as measured by PFSS (R2=0.619; y = − 0.096x + 1.267, 95% CI [−0.183, −0.009]). During CPET, $$ \dot{\mathrm{V}} $$ V ̇ CO2 -off ORI accounted for 70% (R2=0.695; y = 1.390x − 11.984, 95% CI [0.331, 2.449]) and $$ \dot{\mathrm{V}} $$ V ̇ CO2 -off Kt for 73% of the variability in performance fatigability measured by $$ \dot{\mathrm{V}} $$ V ̇ O2 on-kinetic ORI (ml/s) (R2=0.730; y = 1.818x − 13.639, 95% CI [0.548, 3.087]). Conclusion The findings of this study suggest that utilizing $$ \dot{\mathrm{V}} $$ V ̇ CO2 measures may be a viable and useful addition or alternative to $$ \dot{\mathrm{V}} $$ V ̇ O2 measures, warranting further study. While the current protocol appeared to be satisfactory, for obtaining select cardiopulmonary and performance fatigability measures as intended, modifications to the current protocol to consider in subsequent, larger studies may include use of an alternate mode or measure to enable control of work rate constancy during performance fatigability testing following initial CPET.

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Exploratory Study on Oxygen Consumption On-kinetics During Treadmill Walking in Women With Systemic Lupus Erythematosus

Cited by 12 publications

References 64 publications

Effects of a one-year physical activity programme for women with systemic lupus erythematosus – a randomized controlled study

Effects of a one-year physical activity programme for women with systemic lupus erythematosus – a randomized controlled study

Impaired Aerobic Capacity in Systemic Lupus Erythematosus Patients: What are the Physiological Mechanisms

Measures of excess $$ \dot{\mathrm{V}} $$CO2 and recovery $$ \dot{\mathrm{V}} $$CO2 as indices of performance fatigability during exercise: a pilot study

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