Abstract
PURPOSE: Exercise-based rehabilitation is a standard therapy for patients with heart disease. Despite examples of patients who have extended normal rehabilitation exercise into competitive participation, there are no clear-cut guidelines for patients whether they should participate in competitive-level exercise. This study investigated the occurrence of complications, physiologic responses, and exercise patterns during simulated competitive exercise in active, older nonathletes (most with a history of cardiovascular disease) and compared these with responses during maximal incremental exercise.
METHODS: Fourteen trained older males, 7 with stable cardiovascular disease, performed an incremental exercise test and time trial of 55 kJ (equivalent to running ~1 mile) on a semirecumbent stepping ergometer. Variables of gas exchange, hemodynamics, perception, and power output were measured in both tests.
RESULTS: Subjects attained a remarkably high physiologic and psychologic strain (respiratory exchange ratio >1.0; average peak rating of perceived exertion >8) in both tests, with no evidence of symptomatic, hemodynamic, or electrocardiographic abnormalities. Peak physiologic responses were not significantly different between simulated competition and incremental exercise. The fixed-work time trial was finished in 8.97 +/- 1.85 minutes, mean power output of 100 +/- 26 W. Results showed a distinct pacing pattern in the relative power output, consisting of a conservative start, an even-paced middle portion, and an end spurt.
CONCLUSIONS: Results suggest that in trained individuals with normal incremental exercise test results, competitive-level efforts may be undertaken with no apparent side effects. This may provide a strategy whereby physicians can advise patients concerning their decision to perform in competitive events.