Exercise acute

FIG. 89-1 Pendulum exercise, acute phase—passive motion. 

Hasten DL, Pak-Loduca J, Obert KA et al. (2000) Resistance exercise acutely increases MHC and mixed muscle protein synthesis rates in 78-84 and 23-32 yr olds. Am J Physiol Endocrinol Metab 278, E620-E626. 

In contrast to endurance exercise, acute whole-body resistance exercise does not alter leucine oxidation. In this same study we also did not find an effect of acute resistance exercise on whole-body protein synthesis, either during exerdse or for up to 2 h post-exerdse. We hypothesized that since muscle protein synthesis (MPS) accounted for only 25% of whole-body synthesis, changes in MPS either may be not measurable or would be negated by a redprocal change in the synthesis of another protein, such as one in the gastrointestinal tract. 

Intrinsic asthma, also called idiopathic asthma, usually develops in adulthood. In intrinsic asthma allergic factors are not demonstrable. Episodes of intrinsic asthma may be triggered by a variety of stimuli, eg, emotional state, exposure to cold air, or inert dusts. Both intrinsic and extrinsic asthmatics can be prone to exercise-induced attacks. Individuals who experience a combination of extrinsic and intrinsic asthmatic reactions have mixed asthma. Status asthmaticus refers to an especially acute life-threatening asthma attack which is resistant to normal treatments and which may require hospitalization in order to stabilize the patient. 

Sympathomimetics (drugs that mimic the sympathetic nervous system) are used primarily to treat reversible airway obstruction caused by bronchospasm associated with acute and chronic bronchial asthma, exercise-induced bronchospasm, bronchitis, emphysema, bronchiectasis (abnormal condition of the bronchial tree), or other obstructive pulmonary diseases. 

Lukaszewicz-Hussain A, Moniuszko-Jakoniuk J, Pawlowska D. 1985. Blood glucose and insulin concentration in rats subjected to physical exercise in acute poisoning with parathion-methyl. Pol J Pharmacol Pharm 37 647-651. 

The musculoskeletal system consists of the muscles, bones, joints, tendons, and ligaments. Disorders related to the musculoskeletal system often are classified by etiology. Acute soft-tissue injuries include strains and sprains of muscles and ligaments. Repeated movements in sports, exercise, work, or activities of daily living may lead to repetitive strain injury, where cumulative damage occurs to the muscles, ligaments, or tendons.1-3 While tendonitis and bursitis can arise from acute injury, more commonly these conditions occur as a result of chronic stress.3,4 Other forms of chronic musculoskeletal pain, such as pain from rheumatoid arthritis (see Chap. 54) or osteoarthritis (see Chap. 55), are discussed elsewhere in this text. 

Describe effects of acute exercise on the circulatory system... 

Corticosteroids (e.g., beclomethazone, flunisolide, triamcinolone) have anti-inflammatory and immunosuppressant actions. These drugs are used prophylactically to prevent the occurrence of asthma in patients with frequent attacks. Because they are not useful during an acute attack, corticosteroids are prescribed along with maintenance bronchodilators. These drugs are also administered by inhalation. Cromolyn is another anti-inflammatory agent used prophylactically to prevent an asthmatic attack. The exact mechanism of action of cromolyn is not fully understood however, it is likely to involve the stabilization of mast cells. This prevents the release of the inflammatory mast cell mediators involved in inducing an asthmatic attack. Cromolyn has proven effective in patients with exercise-induced asthma. 

N. Kasuya, Y. Kishi, S. Sakita, F. Numano, and M. Isobe, Acute vigorous exercised primes enhanced NO release in human platelets. Atherosclerosis 161, 225-232 (2002). 

Exercise tolerance (stress) testing (ETT) is recommended for patients with an intermediate probability of CAD. Results correlate well with the likelihood of progressing to angina, occurrence of acute MI, and cardiovascular death. Ischemic ST-segment depression during ETT is an independent risk factor for cardiovascular events and mortality. Thallium myocardial perfusion scintigraphy may be used in conjunction with ETT to detect reversible and irreversible defects in blood flow to the myocardium. 

Spirometry demonstrates obstruction (forced expiratory volume in 1 second [FEVJ/forced vital capacity less than 80%) with reversibility after inhaled P2-agonist administration (at least a 12% improvement in FEVj). Failure of pulmonary function to improve acutely does not necessarily rule out asthma. If baseline spirometry is normal, challenge testing with exercise, histamine, or methacholine can be used to elicit BHR. 

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