title: The effect of a submaximal exercise orientation on cardiopulmonary cycle ergometer stress test results in older adults.
abstract: BACKGROUND
  Orientation sessions are sometimes used to habituate subjects before exercise stress testing. The extent of habituation in older subjects has not been clearly defined. Additionally, the use of repetitive maximal stress testing as an orientation method may not be necessarily applicable in the aged.
  
  
  METHODS
  To determine if the employment of a submaximal orientation session would effect cardiopulmonary cycle ergometer exercise results, 266 older adults (68.6 +/- 5.0 years) male (n = 100) and female (n = 166) subjects participated in this study. One hundred thirty-one subjects received an orientation before stress testing. One hundred thirty-five did not.
  
  
  RESULTS
  Analysis of resting values revealed no significant differences. Separate gender analysis was performed at submaximal workloads. Men were examined at 0, 60, and 105 Watts; women at 0, 45, and 75 Watts. Oriented subjects displayed significantly lower heart rates for both males and females at all submaximal workloads. Oxygen uptake was significantly lower for oriented women at 45 Watts (P < or = .05) and men at 60 Watts (P < or = .05). Oriented males displayed significantly lower systolic blood pressure at 0 Watts (P < or = .05), 60 Watts (P < or = .01), and 105 Watts (P < or = .05). The oriented group reached ventilatory threshold (VeT) at a higher workload (P < or = .001), lower heart rate (P < or = .001), and higher VO2 uptake (P < or = .05). Nonoriented subjects obtained a significantly higher maximal heart rate than oriented subjects (147 +/- 15.7 beats per minute (bpm) vs. 140 +/- 17.1 bpm, P < or = .01). Separate gender analysis revealed a significant difference (P < or = .01) in maximal heart rate in males (oriented = 137.4 +/- 18.8 bpm vs. nonoriented = 147.7 +/- 15.7 bpm). Although nonoriented women achieved a higher maximal heart rate, the difference was not significant (146.9 +/- 15.8 bpm vs. 142.6 +/- 16.0 bpm).
  
  
  CONCLUSIONS
  These results indicate that both male and female older subjects display significant modification in physiologic performance from habituation after a single submaximal exercise orientation session. This effect was greater at submaximal than maximal workloads, and appears to be greater than that previously reported in younger subjects.
authors.affiliation: Medical College Hospital, Division of Geriatric Medicine, Philadelphia, PA 19129, USA.
authors.forename: C E
authors.initials: CE
authors.lastname: Shaw
authors.forename: K K
authors.initials: KK
authors.lastname: McCully
authors.forename: L
authors.initials: L
authors.lastname: Landsberg
authors.forename: J
authors.initials: J
authors.lastname: Posner
mesh_terms: D000368:Aged; D001794:Blood Pressure; D005080:Exercise Test / Q000379:methods / Q000523:psychology; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012129:Respiratory Function Tests