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Effects of an endurance exercise program on cardiovascular variables of a group of middle-aged men Olafson, Gordon Albert Alexander 1966

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THE EFFECTS OF AN ENDURANCE EXERCISE PROGRAM ON CARDIOVASCULAR VARIABLES OF A GROUP OF MIDDLE-AGED MEN by GORDON ALBERT ALEXANDER OLAFSON B.P.E. University of British Columbia, 1962 A THESIS SUBMITTED IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF PHYSICAL EDUCATION i n the School of PHYSICAL EDUCATION AND RECREATION We accept this thesis as conforming to the required standard: THE UNIVERSITY OF BRITISH COLUMBIA Apr i l , 1966 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of Br i t ish Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that per-mission for extensive copying of this thesis for scholarly purposes may be granted by the Head of my Department or by his representatives., It is understood that copying or publ i -cation of th is , thesis for financial gain shall not be allowed without my written permission. Department of School of Physical Education and Recreation The University of Br i t ish Columbia Vancouver 8, Canada Date / ? , ABSTRACT The purpose of this study was to evaluate the effects of an endurance exercise program on a group of middle-aged men. Ten subjects were tested before and after seventeen weeks of endurance t raining at The University of Br i t i sh Columbia using f ive tests , three of which were tests of cardiovascular condition. The tests used are as follows: 1. Schneider Test Variables are: ly ing pulse rate, standing pulse rate, post-exercise pulse rate, time for pulse rate to return to standing value, difference between pulse rate lying to standing, and standing to post-exercise difference, l y i n g systolic blood pressure, standing systol ic blood pressure, the difference between lying and standing systol ic blood pressure and Schneider index score. 2. Progressive Pulse Ratio Variables are: recovery pulse counts for rates of 12, 18, 24, 30 and 36 steps per minute, average rat io and average angle. 3. Pulse Pressure Wave. (Brachial Sphygmograph) Variables are: A. S i t t ing area under the curve, systol ic amplitude, dicrot ic notch amplitude, fatigue r a t i o , d ias to l ic amplitude, rest-to-work r a t i o , obliquity angle, systolic time, dias tol ic time, pulse rate, systol ic blood pressure, dias tol ic blood pressure and pulse pressure. B. Standing area under the curve, pulse rate, systolic amplitude, difference between si t t i n g and standing systolic amplitude. C. Post-Exercise systolic amplitude 4. Body Fat Measurements Variables are: cheek fold, abdominal fold, hip fold, front thigh fold, gluteal fold, rear thigh fold, sum of a l l and average. 5. Body Weight Significant changes at the .05 level of confidence occurred i n ten variables of forty-four used i n this study. A significant reduction i n body fat at the .05 level of confidence occurred i n the abdominal fold, front thigh fold, gluteal fold, sum of a l l and average of a l l , though a reduction i n body weight was not significant at the .05 level of confidence. Sitting pulse rate, s i t t i n g systolic blood pressure, standing airea under the curve and standing pulse rate of the Pulse Pressure Wave were significant at the .05 level of confidence. One variable of the Schneider Test - time for the pulse to return to standing value - was significant at the .05 level of confidence. No significant changes occurred i n the Progressive Pulse Ratio Test variables. Only three correlation co-efficients were of sufficient size to be considered significantly different from zero. These were the co-efficients of correlation between attendance and average pulse ratio, front thigh fat fold and rear thigh fat f o l d . Although only five of thirty-five cardiovascular variables showed s t a t i s t i c a l l y significant improvements, the members of the group stated that their tolerance to the stress of the endurance exercise program had improved. ACKNOWLEDGEMENT The writer wishes to express his sincere appreciation to his advisor, Dr. S.R. Brown, for his patient guidance, counsel, and invaluable assistance i n the research laboratory. In addition, I would l i k e to express my thanks to Dr. E.M. Banister who also assisted i n the research laboratory. To Dr. P. Mullins, Dr. N. Watt, Dr. A. Cox, and Mr. R.F. Osborne, I would l i k e to extend my appreciation for the suggestions and guidance they gave as my Committee. Finally, I would l i k e to thank Dr. D. McKie for his advice concerning the s t a t i s t i c a l treatment of this study. TABLE OF CONTENTS CHAPTER PAGE I. THE PROBLEM AND ITS BACKGROUND 1 II. REVIEW OF LITERATURE 11 III. METHODS AND PROCEDURES 29 IV. RESULTS 34 V. DISCUSSION OF RESULTS 42 VI. SUMMARY, CONCLUSIONS AND RECOMMENDATIONS 52 BIBLIOGRAPHY 56 APPENDICES A. FITNESS DATA SHEET 67 B. DIRECTIONS FOR BASAL CONDITIONS 68 C. INSTRUCTIONS FOR SCHNEIDER TEST 69 D. SCHNEIDER SCORE SHEET 72 E. CONDENSED INSTRUCTIONS FOR THE CAMERON HEARTOMETER . . . . . . 73 F. PERSONAL COMMUNICATION 75 G. SPECIFICATIONS FOR PROGRESSIVE PULSE RATIO TEST 77 H. INSTRUCTIONS FOR PLOTTING PROGRESSIVE PULSE RATIO 79 I. PULSE PRESSURE WAVE MEASUREMENTS 81 J. STATISTICAL TREATMENT 84 K. SCHNEIDER TEST VARIABLES - PRE-TRAINING RAW SCORES 89 L. SCHNEIDER TEST VARIABLES - POST-TRAINING RAW SCORES 90 M. PROGRESSIVE PULSE RATIO VARIABLES - PRE-TRAINING RAW SCORES . 91 N. PROGRESSIVE PULSE RATIO VARIABLES - POST-TRAINING RAW SCORES . 92 APPENDICES • PAGE 0. BODY FAT MEASUREMENTS AND BODY WEIGHT - PRE-TRAINING RAW SCORES 93 P. BODY FAT MEASUREMENTS AND BODY WEIGHT - POST-TRAINING RAW SCORES 94 Q. PULSE PRESSURE WAVE VARIABLES - PRE-TRAINING RAW SCORES . . . . 95 R. PULSE PRESSURE WAVE VARIABLES - POST-TRAINING RAW SCORES . . . 96 L I S T OF TABLES I . THE SIGNIFICANCE OF THE DIFFERENCE BETWEEN INITIAL AND FINAL MEAN SCORES OF THE PULSE PRESSURE WAVE TEST VARIABLES . . . . 34 I I . THE SIGNIFICANCE OF THE DIFFERENCE BETWEEN INITIAL AND FINAL MEAN SCORES FOR EACH OF THE BODY FAT VARIABLES 36 I I I . THE SIGNIFICANCE OF THE DIFFERENCE BETWEEN INITIAL AND FINAL MEAN SCORES FOR BODY WEIGHT 37 IV. THE SIGNIFICANCE OF THE DIFFERENCE BETWEEN INITIAL AND FINAL MEAN SCORES FOR EACH OF THE PROGRESSIVE PULSE RATIO TEST VARIABLES 37 V. THE SIGNIFICANCE OF THE DIFFERENCE BETWEEN INITIAL AND FINAL MEAN SCORES FOR EACH OF THE SCHNEIDER TEST VARIABLES 38 V I . CO-EFFICIENTS OF CORRELATION BETWEEN NUMBER OF ATTENDANCES AND 'IMPROVEMENT* SCORES 39 L I S T OF FIGURES I . DIAGRAM OF PULSE PRESSURE WAVE 81 CHAPTER I THE PROBLEM AND ITS BACKGROUND Research on the work capacity of middle-aged men has shown that variables such as age, environment and work conditions do affect the level of fitness (1). With the average life-span steadily increasing, the problem confronting physical educators is how to develop the desire for physical activity since as the average person becomes older, his desire to remain physically active lessens resulting in a decreased physical work capacity (2). Though research indicates there is a steady decline in the physical work capacity of the sedentary middle-aged man, there is evidence that the capacity to perform a task without undue fatigue can be elevated as a result of participation in a physical exercise program (3,4)• The question remains as to the kind of exercise programs and the amount of exercise which are best suited to the »average* middle-aged man. Medical authorities indicate that an exercise program should be realistically adjusted to suit the physical condition of the subject. There is also a problem of selecting a suitable test which will best serve the purpose of evaluating the cardiovascular condition of the subject and will thereby permit the investigator to select an appropriate program of exercise which will result in maximum cardio-vascular improvement in a minimum amount of time. Investigators are pursuing the question of whether or not exercise is a prophylaxis against heart disease. The question whether or not physical exercise i s beneficial in reducing the increasing 2 incidence of heart disease and whether or not exercise can be used i n the rehabilitation of cardiac patients s t i l l remains unanswered. Physical education has a responsibility to investigate the effects of exercise upon the fitness of middle-aged men and to provide advice on the selection and use of suitable instruments for measuring cardiovascular fitness (5). The Schneider Test, the Progressive Pulse Ratio Test and the Pulse Pressure Wave Test have served as useful indicators of cardiovascular condition i n athletes and non-athletes. These parameters measure certain aspects of circulatory function during rest, exercise and following exercise and reflect the a b i l i t y of the cardiovascular system to adjust to postural changes and to progressively increasing workloads. This study was undertaken to investigate the effects of an endurance exercise program on the cardiovascular fitness of university staff and faculty. THE PROBLEM Statement of Problem The problem of this study was to determine the effects of participation i n an endurance exercise program upon the cardiovascular fitness of a group of middle-aged men as measured by pulse rate, blood pressure and pulse pressure wave tests. Hypothesis That the subjects taking part i n the endurance exercise program 3 w i l l show s i g n i f i c a n t improvement i n cardiovascular f i t n e s s . Limitations 1. Variables outside the t r a i n i n g and experimental environments could not be controlled although the subjects were asked to deviate as l i t t l e as possible from t h e i r normal d a i l y regime. 2. The effects of psychological apprehension of the subject on t e s t r e s u l t s were non-controlled. 3. The ten subjects used i n t h i s study were Faculty and Staff at The University of B r i t i s h Columbia. , Assumptions 1. Cardiovascular condition i s an important factor i n the measurement of physical f i t n e s s and certain aspects of i t can be measured by such externally monitored phenomena as pulse r a t e , blood pressure, and pulse waves. 2. The pulse pressure wave as recorded by the Cameron Heartometer r e f l e c t s c e rtain hemodynamic phenomena which are capable of being modified by an endurance exercise program. 3. The Progressive Pulse Ratio Test measures cardiovascular response to work of a graded i n t e n s i t y through submaximal to maximal. 4. The Schneider Test i n d i r e c t l y r e f l e c t s the action of the autonomic nervous mechanism i n response of postural changes and to exercise of very b r i e f duration. 5. Diurnal v a r i a t i o n i n c i r c u l a t o r y measurements was controlled by t e s t i n g each subject at the same time of the day f o r a l l three t e s t s . 4 6. Changes i n measurements were due primarily to changes i n cardio-vascular fitness and were not due to learning effects. This assumption appeared to be tenable as the tests were separated by considerable periods of time and were only performed twice. 7. The measurements made were a l l reliable estimates of the subjects' true scores. Definitions 1. Cardiovascular condition: "both the heart and the blood vessels are muscular organs which are capable of contracting and relaxing i n ways which move the blood continuously around the body. The efficiency with which this i s done i s called cardiovascular condition" (6). This i s also known as cardiovascular fitness, cardiorespiratory fitness or circulatory endurance. 2. Sitting Pulse Pressure Wave. A. Area under the curve - reflects somewhat the blood pumped per stroke of the heart and also the a r t e r i a l tonicity (7). B. Systolic Amplitude - indicates the magnitude of the heart contraction or systole (8). C. Dicrotic Notch Amplitude - indicates the diastolic blood pressure which acts as a back pressure to close the semilunar valves. I t reflects the cardiovascular tone of associated arteries (9). D. Fatigue Ratio - reflects the relationship between the amplitude of systole to the amplitude of the dicrotic notch. A low fatigue ratio is associated with the lowering of the diastolic blood pressure, which may in some instances be associated with apprehension or fear. A high fatigue ratio is normally associated with good cardiovascular condition (10). E. Angle of Obliquity - the larger angle is associated with a slow, sluggish heart action. However, a slow rate in older subjects may also result in a larger angle due to a slowing of the heart rate with age. A smaller angle denotes a fast and more efficient systole (11). F. Diastolic Pulse Wave Amplitude - indicates the phase of the cardiac cycle associated with the decline of the diastolic pressure (12). G. ^ Diastolic Surge - is probably caused by reflected pressure wave from the active contraction of the aorta after the lowest point of the Dicrotic Notch. It is developed by active athletic subjects (13). H. Time of Diastole - is a measure of the time of the diastole after the closing of the semilunar valves (14). I. Time of Systole - shorter systole is generally associated with young subjects at rest, as contracted to a slow sluggish systole associated with the unfit (15). J. Rest to Work Ratio - is a comparison of systolic time to diastolic time; the resultant ratio i f i t is 4 to 1 is indicative of a strong efficient cardiovascular system whereas a 1.21 to 1 ratio is indicative of an untrained cardiovascular system (16). 6 3. Standing Pulse Pressure Wave. A. Area under the Curve - reflects the cardiovascular adjustment to postural change. The smaller the difference between the si t t i n g and standing area under the curve, the better the adjustment (17). B. Systolic Amplitude - The smaller the difference between the sit t i n g and standing systolic amplitudes, the better the adjustment (18). 4. Post-Exercise Pressure Pulse Wave. Systolic Amplitude - reflects the circulatory adjustment to a one minute run i n place at a frequency of one hundred and eighty steps per minute (19). 5. Pulse Rate - i s the regular rate of heart beat taken i n beats per minute from the pulse wave tracing or by a stethoscope (20). There i s a tendency for the pulse rate to be lower i n subjects who are i n good physical condition (21). 6. Recovery Pulse Rate - The time for the heart rate to return to normal after exercise depends on the work load of the exercise period and on the physical condition of the subject. In men i n good physical condition recovery occurs more rapidly than i n fatigued or poorly trained subjects. 7. Pulse Ratio - i s the ratio of the quiet s i t t i n g pulse rate before exercise divided into the tot a l pulse count for two minutes taken from ten seconds after the exercise. The smaller the ratio at each level of stepping, the more efficient i s the adjustment to the work task (23). Justification of the Problem With the renewed interest of Canadians in physical fitness, as exemplified by the establishment of the Canada Fitness and Amateur Sport Directorate, Health Spas, and Y.M.C.A. Health Clubs, the middle-aged man is becoming aware of the need for and benefits of remaining physically f i t . In order to be successful, the university professor must develop his mental capabilities to the fullest extent. If he wishes to advance himself within the academic community, he must concern himself with research, writing and publishing papers, but he often does l i t t l e to develop or maintain a sound, body. Because of his inactive l i f e , his body may rapidly deteriorate resulting in poor circulation, nervous tension and. over-weight. The professor thus becomes an office worker who is subject to a loss of physical fitness mainly due to a lack of physical exercise (24). Research indicates that daily training will under normal circum-stances improve the cardiovascular condition of the middle-aged man. The type of program offered will determine the degree of improvement (25). Neuromuscular and psychological factors may, however, also determine and limit the working capacity of the individual (26). When the work is increased to exhaustion one gets a measure of the will power of the subject and of the maximum ability of the muscles to work under anaerobic conditions. It is a well-known fact that the trained athlete displays a slower resting heart rate and has.greater ability to sustain a given work task longer than the non-athlete (27). Studies dealing with the effects of aging have indicated that a decrease in work capacity accompanies the onset and advancement of middler-age. Coronary heart disease and other related cardiac disorders have resulted i n an increasing mortality rate i n recent years. Investigations indicate that there i s a probable relationship between the incidence of coronary heart disease and of physical i n a c t i v i t y (28, 29, 30, 31). I t seems, therefore, that i n addition to improvement i n general well-being and function, regular exercise may also offer important prophylactic benefits. ' Some i n d i r e c t evidence of the possible b e n e f i c i a l effects of exercise on the myocardium and blood vessels may be provided by experimental proof of the changes i n cardiovascular condition which can be produced by exercise programs. I t i s also important to know the most e f f i c i e n t and least time consuming methods of producing desirable effects on the cardiovascular system since the great concern of busy professional men i s to obtain maximum benefits i n the small amount of time they can afford f o r p a r t i c i p a t i o n i n exercise programs. The achievement of these ends would appear to j u s t i f y continued research. REFERENCES 9 1. 2. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. Astrand, P.O., "Human Physical Fitness with Special Reference to Sex and Age", Physiological Reviews, vol. 36, no. 3, (July, 1956), pp. 307-335. Fox, S.M., Skinner J.S., "Physical Activity and Cardiovascular Health", The American Journal of Cardiology, vol. 14, (December, 1964), p. 735. Raab, W., "Degenerative Heart Disease from Lack of Exercise", Exercise and Fitness, New York, The Athletic Institute, I960, pp. 1-9. Steinhaus, A.H., "Summary and Conclusions", Exercise and Fitness, New York, The Athletic Institute, I960, pp. 230-235. Fox, Skinner, op. cit.. p. 743• Cureton, T.K., "The Nature of Cardiovascular Condition in Normal Humans (Part I)", Journal of the Association for Physical and  Mental Rehabilitation, vol. 11, (November-December, 1957)» pp. 186-196. Cureton, T.K., Physical Fitness Appraisal and Guidance, St. Louis, C.V. Mosby Co., 1947, pp. 235-236. Ibid Ibid Ibid Ibid Ibid Ibid  Ibid Loc. cit. , pp. 236-240. , pp. 240-243. , pp. 243-244. , p. 244. , p. 247. , pp. 247-249. , p. 249. Loc. c i t . Ibid., p. 235. Massey, B.H., Husman, B.F., Kehoe, C.L. "The Effect of Posture on the Brachial Sphygmogram as an Indicator of Cardiovascular Condition", Research Quarterly, vol. 24, no. 2, (May, 1953), pp. 194-204. 10 19. Cureton, T.K., Sterling, L.F., "Factor Analyses of Cardiovascular Test Variables", The Journal of Sports Medicine and Physical  Fitness, vol. 4, no. 1, (March, 1964), p.7* 20. Cureton, T.K., Physical Fitness Appraisal and Guidance, St. Louis, C.V. Mosby Co., 1947, p. 244. 21. Morehouse, L.E., Miller, A.T., Physiology of Exercise. St. Louis, C.V. Mosby Co., 1963, p. 101. 22. Ibid., p. 104. 23. Cureton, T.K., "The Nature of Cardiovascular Condition i n Normal Humans (Part 3)", The Journal of the Association for Physical  and Mental Rehabilitation, vol. 12. (March-April. 1958). pp. 41-49. 24. Cureton, T.K., "Preservation of the Middle-Aged Man", Journal of Physical Education, v o l . 52, no. 2, (November-December, 1954), p. 27. 25. Cureton, T.K., "Physical Fitness Improvement of a Middle-Aged Man with Brief Reviews of Related Studies", Research Quarterly, vol. 23, no. 2, (May, 1952), pp. 149-160. 26. Patterson, J.L., Graybiel, A., Lenhardt, H.F., and Madsen, M.J., "Evaluation and Prediction of Physical Fitness, U t i l i z i n g Modified Apparatus of the Harvard Step Test", The American  Journal of Cardiology, v o l . 14, (December, 1964), pp. 811-827. 27. Morehouse, Miller, op. c i t . , p. 243* 28. Montoye, H.J., "The Role of Exercise i n Preventive Medicine", The Journal of Sports Medicine and Physical Fitness, vol. 2, no. 4, (December, 1962), pp. 229-232. 29. Cumming, 0., "The Heart and Physical Exercise", Journal of Canadian Medical Association, vol. 88, (June, 1963), pp. 80-85. 30. Rechnitzer, P.A., luhasz, M.S., Pickard, H.A., Lefcoe, N.M., "The Effects of a Graduated Exercise Program on Patients with Previous Myocardial Infarction", Journal of Canadian Medical  Association, v o l . 92, (April, I965), pp. 858-860. 31. Morris, J., Heady, J., Raffle, P., Roberts, C, Parks, J., "Coronary Heart Disease and Physical Activity of Work", Lancet, vol. 2, (1953), PP. 1053, 1111. CHAPTER I I REVIEW OF LITERATURE Research on the middle-aged man and his response'to physical exercise i s somewhat obscured by the d i f f i c u l t y of giving meaning to the term 'middle-age». Although most of the l i t e r a t u r e a r b i t r a r i l y assumes middle-age to begin at t h i r t y , Guild (1) defines "middle-age as beginning approximately three years a f t e r college". There i s general agreement that man's a b i l i t y to p a r t i c i p a t e i n hard endurance exercise i s l i m i t e d by h i s cardiovascular, respiratory and neuromuscular performance (2). Although the l a t t e r must be considered an i n t e g r a l part of the f i r s t two c r i t e r i a , the physiological factors of cardiovascular and respiratory performance have received greater emphasis. Associated with t h i s research i s the problem of whether or not the decline i n cardiovascular f i t n e s s can be attributed to chronological or physiological age. Knutti (3) considers the decrement to be related to changes i n l i v i n g habits and experiences encountered each day. Brouha and Radford (4) attempt to c l a r i f y the problem by s t a t i n g , " i t should be c l e a r l y r e a l i z e d that chronological age i s not the r e a l factor but that physiological age i s the one that influences the capacity f o r exercise". At a recent symposium on the heart and physical exercise, Dr. I . Starr (5) pointed out that: When one considers the evidence concerning the effect of aging on v e l o c i t y and acceleration of cardiac performance, the conclusion i s i r r e s i s t i b l e that strength of heart declines as age advances. The heart tends to lose the f i n e co-ordination of i t s contraction as age advances. No mention i s made as to whether age i s physiological or 12 chronological although as Barry (6) points out, "Biological aging i s the progressive loss of functional capacity of an organism after i t reaches reproductive maturity". Numerous investigations have studied the response of various age groups to specific work tasks (7, 8, 9, 10, 11, 12, 13). These studies indicate that there i s a progressive decline i n the capacity to adjust to different work tasks as age increases. A reduction i n an individual's capacity for work as measured by the adjustment of the circulatory system has been shown by Felzone and Shock (14) and has been supported by other experiments (15, 16, 17). Larson (18) concluded that there i s a progressive and uniform retro-gression i n physical fitness with an increase i n chronological age. Decrements i n cardiovascular fitness have been shown to relate to the onset of age as measured by progressive work task experiments. The components of cardiovascular fitness have been studied by several noted physical educators (19, 20, 21). More recently Cureton and Sterling (22) concluded that the pressure pulse wave, post-exercise or recovery pulse counts, and blood pressure measurements are important indices of cardiovascular fitness. The authors point out that there must be cautious interpretation of these indices because " f u l l agreement cannot always be reached from either the physiological or psychological point of view" (23). The measurement of blood pressure - systolic and diastolic, has been used as an indicator of improved cardiovascular fitness for some time. Cureton (24) states that the unfit person usually has a resting 13 systolic blood pressure below 90 mm. Hg. and over 160 mm. Hg. whereas a normal healthy man has a relatively high diastolic blood pressure i n . lying, s i t t i n g and standing positions; both are f a i r l y good indicators of condition. Henry (25) studied thir t y male students before and after a season of competitive athletics and concluded that there was a significant decrease i n systolic and diastolic blood pressures. Turner (26) found that a high systolic blood pressure i n association with a relatively low diastolic blood pressure results i n a wide pulse pressure which prevents circulatory stagnation i n the splanchnic region. According to Dawson (27) the systolic blood pressure rose more rapidly and much higher i n the trained than i n the untrained. However, the author noted the absence of any conspicuous or constant effect of training upon systolic and diastolic pressures at least when exercise i s moderate as represented by his experiments. Cogswell et. a l . (28) noted an overall decrease i n both systolic and diastolic blood pressures as a result of training. Using adult industrial workers Brouha (29) indicated that there was a decrease i n the pulse pressure as a result of a diminished systolic blood pressure or by an increase i n the diastolic blood pressure or both. He further stated that when the blood pressure had returned to the pre-exercise l e v e l , recovery was complete. The research study of Michael and Gallon (30) reported decreased systolic and diastolic blood pressures as a result of a four month training program. Fraser and Chapman (31) contend that there i s agreement i n the research data that the systolic blood pressure does increase but there 14 is less agreement concerning the corresponding changes in diastolic pressure. Christensen (32), Simonson and Enzer (33) report that the diastolic blood pressure either remains constant or increases slightly whereas Stevenson (34) found a reduction in the diastolic pressure two, three and five minutes after cessation of exercise. However, "the physiological significance of pressure changes during recovery are poorly understood but undoubtedly complex" (35). Norris et al (36) found that the systolic blood pressure levels were higher in older subjects than in young people while the diastolic blood pressure levels were similar. Further, the older subjects increased their systolic blood pressure levels more after exercise and returned more slowly to pre-exercise levels. Only one conflicting point of view negated the value of blood pressure as an indicator of circulatory adjustment to exercise (37). Post-exercise blood pressures "are much more indicative of real capacity than the quiet blood pressures. • • they reflect the warm-up capacity or adjustability to hard exercise" (3&). A summary of research related to blood pressure changes as a result of exercise is presented by two authors (39, 40). The pulse pressure wave which has been standardized (41), reflects important aspects of circulatory condition (42). The systolic amplitude and diastolic amplitude of waves taken in lying, sitting and standing positions have shown to be good measures of circulatory fitness (43). The changes in the pulse pressure wave attributed to a 15 season of basketball resulted i n s i g n i f i c a n t changes i n s y s t o l i c amplitude, pulse wave area, and d i a s t o l i c surge (44)• Cureton and Massey (45) concluded that the pulse pressure wave measurements of the area under the curve, s y s t o l i c amplitude, d i a s t o l i c amplitude and d i a s t o l i c surge increased with t r a i n i n g whereas a decline i n the pulse wave area and d i a s t o l i c surge p a r a l l e l s fatigue. A more recent study indicates the area under the curve and s y s t o l i c amplitude r e f l e c t improved cardio-vascular f i t n e s s (46). An endurance program u t i l i z i n g middle-aged men resulted i n an increase i n the areas of pulse wave, s y s t o l i c amplitude and d i a s t o l i c amplitude (47). Several other studies reinforce this-conclusion (48, 49, 50, 51, 52). Tarr (53), who u t i l i z e d the pulse pressure wave as a measure r e f l e c t i n g improved cardiovascular f i t n e s s i n track performance, concluded that four measures: d i a s t o l i c surge, restr-to-work r a t i o , s y s t o l i c blood pressure, and pulse pressure, showed improvement. A study on middle-aged men who participated i n a nine week endurance t r a i n i n g program, showed no s i g n i f i c a n t changes i n pulse pressure wave measure-ments (54) whereas the effect of c i r c u i t t r a i n i n g on pulse pressure wave measurements resulted i n s i g n i f i c a n t changes i n the area under the curve, s y s t o l i c amplitude, d i c r o t i c notch amplitude, d i a s t o l i c time, rest-to-work r a t i o , pulse rate s i t t i n g , standing s y s t o l i c amplitude and standing area under the curve (5'5). Scott (56) studied the effectiveness of a twice-weekly t h i r t y minute ^physical conditioning class* on improving cardiovascular condition, and concluded that improvement i n the area under the curve and rest-to-work r a t i o were s t a t i s t i c a l l y 16 significant. Pulse rate i s • . .the easiest and simplest way to check circulo-respiratory fitness . . . i t does not represent, however, a complete test of circulo-respiratory fitness but the pulse i s the easiest to measure and i s the most reliable of the physiological variables which reflect the internal bodily efficiency i n response to exercise (56). Taylor (57) concurs by stating "the heart rate problem should be evoked upon as a sensitive indicator of the trend for adaptation to the exercise". The quiet s i t t i n g pulse rate i s a useful index as an indicator of circulatory adjustment, when interpreted before and after an exercise program. Changes i n pulse rate attributed to alteration of posture, which assumes that any external influences upon heart rate are minimal, has also been used as an indicator of improved cardiovascular fitness. A reduction i n the t o t a l beats per minute reflects improved fitness. As Rodahl (58) points out, When a person i s undergoing physical training his pulse rate declines as his state of training and fitness improves. What this actually means i s that a f i t person can do a given amount of work without having to increase his heart rate as much as an unfit person. Heart rate increases between ten and sixteen beats, attributed to changes i n posture, are indicative of good circulatory adjustment (59). Heart rate i s directly affected by circulatory changes such as dissipation of heat and the supply of oxygen to the muscles, and i s therefore considered as an index of the fatigue resulting from muscular ac t i v i t y (60). As a predictor of circulatory adjustment during submaximal work, pulse rate has been thoroughly investigated. Rowell et a l (61) point 17 out the limitation of the capacity to perform acreobic work i s dependent upon the combined capacity of the respiratory and cardiovascular systems to transfer oxygen to the working muscles. The relationship between heart rate and oxygen consumption has been thoroughly investigated (62, 63, 64, 65, 66). The decline of the resting pulse rate as a result of a training program has been investigated on a number of occasions. A l l results indicate a slower post-exercise pulse rate as being indicative of improved circulatory fitness (67, 68, 69, 70, 71). Pulse rate recovery after a specific work task has been studied by many workers i n an attempt to relate the increase i n pulse rate during exercise and the time taken for i t to return to, resting levels. When the t o t a l pulse recovery i s lower after an exercise program than that recorded prior to the training program, the subject w i l l be able to with-stand the stress of the work task for a longer period of time. Cureton and Sterling (72), Morehouse and Tuttle (73), Michael and Gallon (74), Cureton and Phil l i p s (75), Durnin et a l (76) a l l indicate that the higher the recovery pulse count, usually over a two minute period, the poorer the adjustment to that work task. Rodahl (77) reinforces this point by stating that "the person who has the lowest pulse rate at a given work load i s the f i t t e s t person". Maxfield and Brouha (78) conclude that . . . for the individual the higher the pulse rate, the more slowly i t returns to i t s resting l e v e l . Likewise, for a specific work load, the better the physical condition of the individual the smaller the increase i n heart rate and the more rapid the return to i t s resting value. 18 The authors (79) i n another study'confirmed the val i d i t y of heart rate as an indicator of the physiological strain induced by work. Rechnitzer et a l (80) noted that the recovery pulse counts of four male cardiac patients was lower after a training program than the recovery pulse of normal adults.?iln another study, non-athletes had higher recovery rates than athletes as a result of standardized work (81). In order to determine the various working capacities i n a group of individuals, various working intensities must be employed. As the work loads increase, the discrepancies w i l l be accentuated. Pulse rate i s roughly linear to the work load but as the work rate and work load become exhausting, as usually indicated by a heart rate of 170-200, the work load i s said to be maximal (82, 83, 84, 85). Other studies indicate the following: the athlete i s able to sustain a given work load at a much slower pulse rate (86); the pulse rate of middle-aged men at any given work task can be reduced by training (87); and the exercise pulse rate w i l l gradually increase with the speed of the work. The speed of increase also affects the speed at which the pulse rate returned to normal (88). Several investigators have studied the relationship between chronological age and pulse rate. Sheffield (89) noted a steady decline i n heart rate with an increase i n age, but also stated that the general effect of physical training i s to decrease the heart rate although the maximum rate possible i s not materially affected, rather the effort required to produce i t i s increased. Norris, Shock and Yiengst (90) further emphasize that after exercise the heart rate increased more and 19 reached post-exercise levels later in older subjects than in younger subjects. Further evidence emphasizes that as man becomes older his pulse rate recovery to a specific work task is slower than that of a younger person (91, 92). The test-retest reliability of the pulse pressure wave has been studied by Willet (93), and Cureton (94), who concluded that when the testing was conducted on two consecutive days, the following reliability values were obtained: Measure Willet Cureton Diastolic Pulse Wave Amplitude .818 .768 Systolic Pulse Waye Amplitude .818 .909 Obliquity Angle .757 .788 Area of a Single Cycle .811 .864 Diastolic Surge .783 .878 Work to Rest Ratio .719 .640 Pulse Pressure .818 .794 Pulse Rate .928 .996 Systolic Blood Pressure .808 .765 Dicrotic Notch Amplitude .755 .823 Diastolic Blood Pressure .764 .794 Meeland (95) determined the test-retest reliability to be very satisfactory when the heartometer is used by a trained operator. Cureton (96) outlines a number of reliability studies which have been conducted on the pulse pressure wave at the University of Illinois. A reliability study of the pulse ratio test conducted by Henry and Farmer (97) did not resolve any conclusive results, whereas a study by Cureton (98) indicated the step test to be a reliable test with co-efficients of reliability between .87 and .95. McCurdy and Larson (99) made a careful study of the reliability of the Schneider Index and found acceptable reliabilities for blood pressure 20 measurements. The systolic blood pressure r e l i a b i l i t y ranged from .718 to .952. McFarland and Huddleson (100) reported the r e l i a b i l i t y of the Schneider Index as .89 which was considerably better for the separate items constituting the Index: lying pulse (.79), standing pulse (.71), post-exercise pulse (.58), lying systolic blood pressure (.63), and standing systolic blood pressure (.51). Studies conducted on the r e l i a b i l i t y of the Schneider Index on over 800 university students indicated the following r e l i a b i l i t i e s for the test items (101): Item R e l i a b i l i t y Pulse Rate Lying .79 Pulse Rate Standing .91 Pulse Rate Lying to Standing .70 Pulse Rate, After 15" Exercise .60 Pulse Rate Change, Standing to Post-exercise .58 Time for Pulse to Recuperate to Standing Rate .80 Lying Systolic Blood Pressure .85 Standing Systolic Blood Pressure .82 Morehouse and Tuttle (102) demonstrated that the r e l i a b i l i t y of the pulse rate after exercise was better when the exercise was relatively more strenuous. Steps R e l i a b i l i t y 20 .070 30 .205 40 .720 50 .781 21 REFERENCES 1. Guild, W.R., "Fitness for Adults", The Journal of Sports Medicine" and Physical Fitness, vol. 3 , no. 2-3, (June-September, 1 9 6 3 ) , p. 1 0 1 . 2. Chapman, C.B., Mitchell, J.H., "The Physiology of Exercise", Scientific American, vol. 212, no. 5, (May, 1965), pp. 88-96. 3 . Knutti, R.E., "The Youthful Science of Aging", Today*s Health, vol. 42, no. 2, (June, 1964), pp. 16-19, 50-51. 4 . Brouha, L., Radford, E.P., "The Cardiovascular System in Muscular Activity", Science and.Medicine of Exercise and Sports, Warren R. Johnson ed., New York, Harper and Brothers Publishers, I960, p. 200. . . 5. Starr, I., "An Essay on the Strength of the Heart and on the Effect of Aging Upon It", The American Journal of Cardiology, vol. 14, (December, 1964), p. 781. 6 . Berry, R.G., "Neurological Aspects of Aging", Geriatrics, vol. 1 8 , no. 1, (January, 1963), p. 209. 7. Astrand, I., "The Physical Work Capacity of Workers 50-60 Years", Acta Physiologica Scandinavica. vol. 14, (February, 1963), pp. 420-427. 8. Botwinick, J., Shock, N.W., "Age Differences in Performance Decrement with Continuous Work", Journal of Gerontology, vol. 11, no. 4, (October, 1955), pp. 433-436. 9. Lansing, A.I., "Some Physiological Aspects of Aging", Physiological Reviews, vol. 13, no. 3, (July, 1951), pp. 318-339. 10. Lehman, H.C., "Chronological Age Versus Proficiency in Physical Skills", American Journal of Physiology, vol. 64, (1951), p. 1 6 1 . 11. Simonson,. E.E., "Changes in Physical Fitness and Cardiovascular Functions with Age", Geriatrics, vol. 12, no. 1, (January, 1957), pp. 28-38. 12. Patterson, J.L., Graybiel, A., Lenhardt, H.F., Madsen, M.J., "Evaluation and Prediction of Physical Fitness, Utilizing Modified Apparatus of the Harvard Step Test", The American  Journal of Cardiology, vol. 14, (December, 1964), pp. 811-827. 13. Smith, K.R., "Age and Performance in Repetitive Tasks", Journal of Applied 'Physiology, vol. 1 4 , (July, 1959), pp. 569-575. 22 14. Felzone, J.A., Shock, N.W., "Physiological Limitations and Age", Public Health Report, vol. 71, (December, 1956), pp. 1185-1195. 15. Robinson, S., "Experimental Studies of Physical Fitness i n Relation to Age", Arbeitsphysiologievol. 12, (1938), pp. 250-317. 16. Norris, A.H., Shock, N.W., Tiengst, M.J., "Age Changes i n Heart Rate and Blood Pressure Responses to T i l t i n g and Standardized Exercise", Circulation, v o l . 8, no. 4, (October, 1953), pp. 521-526. 17. Simonson, loc. c i t . 18. Larson, L., "Some Findings Resulting From the Army-Air Force Physical Training Program", Research Quarterly, vol. 17, no. 7, (May, 1946), p. 153. 19. McCloy, C.H., "A'Cardiovascular Rating of Present Conditions", Arbeitsphysiologie. v o l . 4, (March, 1931), pp. 7, 108. 20. Murphy, M.A., "A Study of the Primary Components of Cardiovascular Tests", Research Quarterly, v o l . 11, no. 1, (March, 1940), pp. 57-71. 21. Larson, L.A., "A Study of the Validity of Some Cardiovascular Tests", The Journal of Experimental Medicine, vol. 7, (March, 1939), pp. 214-220. 22. Cureton, T.K., Sterling, L.F., "Factor Analyses of Cardiovascular Test Variables", The Journal of Sports Medicine and Physical  Fitness, v o l . 4, no. 1, (March, 1964), pp. 1-23. 23. Ibid., p. 22. 24. Cureton, T.K., Physical Fitness Appraisal and Guidance, St. Louis, C.V. Mosby Co., 1947, pp. 199-201. 25. Henry, F.M., "Influence of Athletic Training on the Resting Cardio-vascular System", Research Quarterly, v o l . 25, no. 1, (March, 1954)$ pp. 28-41. 26. Turner, A.H., "The Circulatory Reaction i n Standing", Research Quarterly, vol. 1, no. 4, (December, 1930), pp. 5-13. 27. Dawson, P.M., "Effect of Physical Training and Practice on the Pulse Rate and Blood Pressures During Activity and During Rest with a Note on Certain Acute Infections and on the Distress Resulting from Exercise", American Journal of Physiology, vol. 50, (October-January, 1919-1920>, pp. 443-473. 23 28. Cogswell, R.C., Henderson, CP., Berryman, G.H., "Some Observations of the Effects of Training on Pulse Rate, Blood Pressure and Endurance i n Humans using the Step Test (Harvard), Treadmill, and Electrodynamic Brake Bicycle Ergometer", American Journal  of Physiology, vol. 146, (1946), pp. 422-430. 29. Brouha, L., "Effects of Muscular Work and Heat on the Cardiovascular System", Industrial Medicine and Surgery, vol. 29, (March, I960), pp. 114-120. 30. Michael, E.D., Gallon, A.J., "Pulse Wave and Blood Pressure Changes Occurring During a Physical Training Program", Research Quarterly. vol..31, no. 1, (March, I960), pp. 43-57. 31. Fraser, R.S., Chapman, C.R., "Studies on the Effect of Exercise on Cardiovascular Function", Circulation, v o l . 9, no. 193, (1954), pp. 193-197. 32. Christensen, B.C., "Variations i n Blood Pressure and Pulse Rate During Exercise i n Effort Syndrome and Normal", Acta Medica  Scandinavica. vol. 121, (1945), pp. 194-216. 33* Simonson, E., Enzer, N., "Physiology of Muscular Exercise and Fatigue i n Disease", Medicine, v o l . 21, (1942), p. 345. 34. Stevenson, I.P., Duncan, C.H., Wolff, A.G., "Circulatory Dynamics Before and After Exercise i n Subjects With.and Without Structural Heart Disease During Anxiety and Relaxation", Journal of Cl i n i c a l  Investigation, vol. 28, (1949), pp. 1534-1543. 35. Fraser, Chapman, op. c i t . . p. 197. 36. Norris, Shock, Yiengst, op. c i t . . p. 523. 37. S a l i t , E., Tuttle, W.W., "The Validity of Heart Rate and Blood Pressure Determinations as Measures of Physical Fitness", Research Quarterly, vol. 15, (October, 1944), pp. 252-257. 38. Cureton, T.K., "The Nature of Cardiovascular Condition i n Normal Humans", (Part 4), The Journal of the Association for Physical  and Mental Rehabilitation, vol. 12, no. 4. (July-August. 1958), p. 124. 39. Cureton, T.K., Physical Fitness Appraisal and Guidance, St. Louis, C.V. Mosby Co., 1947, pp. 193-231. 40. Cumming, C.R., "The Heart and Physical Exercise", Journal of the Canadian Medical Association, vol. 88, (January, 1963), pp. 81-82. . . 24 41• Cureton, T.K., Physical Fitness Appraisal and Guidance, St. Louis, C.V. Mosby Co., 1947, pp. 250-262. 42. Wiggers, C.J. "The Magnitude of Regurgitation With Aortic Leaks of Different Sizes", Journal of the American Medical Association, v o l . 97, (July-December, 1931), pp. 1359-1364. 43. Massey, B.H., Husman, B.F., Kehoe, C.L., "The Effect of Posture on the Brachial Sphygmogram as an Indicator of Cardiovascular Condition", Research Quarterly, v o l . 24, no. 2, (May, 1953), pp. 194-204. 44» Michael, E.D., Gallon, A.J., loc. c i t . 45. Cureton, T.K., Massey, B.H., "Brachial Peripheral Waves Related to Altitude Tolerance and Endurance", The American Journal of  Physiology, vol. 159, (December, 1949), p. 160. 46. Cureton, T.K., Ph i l l i p s , E.E., "Physical Fitness Changes i n Middle-Aged Men Attributed to Equal Eight-Week Periods of Training, Non-Training and Retraining"\ The Journal of Sports Medicine  and Physical Fitness, v o l . 4, no. 2, (June, 1964), p. 88. 47. Cureton, T.K., "Results of Moderate Physical Training on Middle-Aged Men", F.I.E.P. Bulletin, 1955, pp. 58-59. 48. Cureton, T.K., Sterling, L.F., loc. b i t . 49. Cureton, T.K., "Relationship of Physical Fitness to Athletic Performance and Sports", Journal of the American Medical  Association, v o l . 162, (November, 1956), pp. 1139-1151• 50. Cureton, T.K., "What the Heartometer Measures that i s of Special Interest and Importance to Physical Educators and Physical Fitness Directors", Physical Education Today, vol. 7, (March, i960), pp. 10-14. 51. Cureton, T.K., "Rating Cardiovascular Condition by the Heartometer Pulse Wave Tests", Physical Fitness Appraisal and Guidance, St. Louis, C.V. Mosby Co., 1947, pp. 232-280. 52. Cureton, T.K., "The Nature of Cardiovascular Condition i n Normal. Humans", (Part 4), op. c i t . , pp. 113-114. 53. l a r r , A.D., "The Relationship of Brachial Pulse Wave Measurements to the Performance of Cross Country Runners", Unpublished Master»s Thesis, The University of British Columbia, 1963. 25 54. Olenick, N.F.E., "The Effects of Endurance Training Upon Brachial Pulse Wave and Heart Rate Measurements of a Group of Middle-Aged Men", Unpublished Master»s Thesis, The University of British Columbia, 1965. 55* Simmons, R., "The Effect of Circuit Training Upon Cardiovascular Condition and Motor Performance", Unpublished Master»s Thesis, The University of British Columbia, 1965. 56. Cureton, T.K., Physical Fitness Appraisal and Guidance, St. Louis, C.V. Mosby Co., 1947, p. 162. 57. Taylor, C, "Some Properties of Maximal and Submaximal Exercise with Reference to Physiological Variation and the Measurement of Exercise Tolerance", The American Journal of Physiology, vol. 142, (August-December, 1944), p. 210. 58. Rodahl, K., "International Aspects of Comparative Fitness", Proceedings and Research Papers, Saskatoon, Canadian Association for Health, Physical Education and Recreation, 1963, p. 29. 59* Cureton, T.K., op. c i t . , p. 166. 60. LeBlanc, J.A., "Use of Heart Rate as an Index of Work Output", Journal of Applied Physiology, vol. 10, no. 2, (1957), pp. 275-280. 61. Rowell, L.B., Taylor, H.L., Wang, Y., "limitations of Prediction of Maximal Oxygen Intake", Journal of Applied Physiology, v o l . 19, no. 5, (1964), p. 919. 62. Astrand, P.O., Ryhming, I., "A Nomogram for Calculation of Aerobic Capacity (Physical Fitness) From Pulse Rate During Submaximal Work", Journal of Applied Physiology, vol. 7, (July-May, 1954-1955), pp. 218-221. 63. Rowell et a l , op. c i t . , p. 921. 64. Andersen, K.L., Hermansen, L., "Aerobic Work Capacity i n Middle-Aged Norwegian Men", Journal of Applied Physiology, vol. 20, no. 3, (1965), pp. 432-436. 65. Hermansen, L., Andersen, K., "Aerobic Work Capacity i n Young Norwegian Men and Women", Journal of Applied Physiology, vol. 20, (1965), pp. 425-431. 66. Nagle, F.J., Bedecki, T.G., "Use of the 180 Heart Rate Response as a Measure of C r i t i c a l Respiratory Capacity", Research Quarterly, vol. 34, no. 3, (October, 1963), pp. 361-369. 26 67. Michael, E.D., Gallon, A.J., "Periodic Changes i n the Circulation During Athletic Training.as Reflected by a Step Testy Research Quarterly, vol. 30, no. 3, (October, 1959), p. 3H« 68. Henry, op. c i t . , p. 40. 69. Cogswell, Henderson, Berryman, op. c i t . , p. 428. 70. Dawson, op. c i t . , p. 460. 71. Henderson, Y., Haggard, H.W., Dolley, F.S., "The Efficiency of the Heart and the Significance of Rapid and Slow Pulse Rates", American Journal of Physiology, vol. 82, (September-November, 1927), pp. 512-529. 72. Cureton, T.K., Sterling, L.F., "Factor Analysis of Cardiovascular Test Variables", The Journal of Sports Medicine and Physical Fitness, v o l . 4, no. 1, (March, 1964), p. 7. 73. Morehouse, L.E., Tuttle, W.W., "A Study of the Post-Exercise Heart Rate", Research Quarterly, v o l . 13, no. 1, (March, 1942), pp. 1-9. 74. Michael, Gallon, op. c i t . , pp. 303-311. 75. Cureton, P h i l l i p s , op. c i t . , p. 89. 76. Durnin, J.V.G.A., Brockway, J.M., Whitcher, H.W., "Effects of a Short Period of Training of Varying Severity on Some Measurements of Physical Fitness", Journal of Applied Physiology, vol. 15, no. 1, (I960), pp. 161-lIf. 77. Rodahl, op. c i t . , p. 29. 78. Maxfield, M.E., Brouha, L., "Validity of Heart Rate as an Indicator of Cardiac Strain", Journal of Applied Physiology, vol. 18, (1963), p. 1102. 79. Brouha, L., Maxfield, M.E., Smith, P.E., Stopps, G.T., "Discrepancy Between Heart Rate and Oxygen Consumption ^uring Work i n the Warmth", Journal of Applied Physiology, v o l . 18, (1965), pp. 1095-1098. 80. Rechnitzer, P.A., Yuhasz, M.S., Pickard, H.A., Lefcoe, N.M., "The Effects of a Graduated Exercise Program on Patients With Previous Myocardial Infarction", Journal of Canadian Medical Association, v o l . 92, (April, 1965j, pp. 858-860. 81. Faulkner, J.A., "Effect of Cardiac Conditioning on the Anticipatory, Exercise and Recovery Heart Rates of Young Men", The Journal  of Sports Medicine and Physical Fitness, v o l . 4, no. 2, (June, 1964), pp. 79-86. ' 27 82. Wahlund, H., "Determination of the Physical Working Capacity"^ Acta Medica Scandinavica, Supplementum. v o l . 215, (1948), p. 51. 83. Bierring, E., Larson, K., Nielson, E., "Some Cases of Slow Pulse Associated with Electrocardiographic Changes i n Cardiac Patients after Maximal Work on the Krogh Ergometer", American  Heart Journal, v o l . 11, (1936), p. 416. 84. Schneider, E.C., "A Study of Responses To Work Oij a Bicycle Ergometer", American Journal of Physiology, v o l . 97, (April-July, 1931), pp. 353-364. 85. Van Lingen, B. Seaward, P.D., Odendaal, W.A., "Work Speed as a Measure of an Equivalent Exercise Stress i n Subjects of Different Weights", Circulation, v o l . 32, no. 6, (December, 1965), pp. 940-947. 86. Cumming, op. c i t . , p. 82. 87. Waxman, W.W., "Physical Fitness Developments for Adults i n the I.M.C.A.", Exercise and Fitness, New York, The Athletic Institute, I960, pp. 183-192. 88. Le Blanc, op. c i t . , p. 279. 89. Sheffield, L.T., Holt, J.H., Reeves, T.J., "Exercise Graded by Heart Rate i n Electrocardiographic Testing for Angina Pectoris", Circulation, v o l . 32, no. 4, (October, 1965), pp. 622-629. 90. Norris, Shock, Yiengst, op. c i t . . p. 523. 91. Davies, C.T.M., Harris, E.A., "Heart Rate During Transition from Rest to Exercise i n Relation to Exercise Tolerance", Journal  of Applied Physiology, vol. 19, no. 5, (1964), pp. 857-862. 92. Skinner, J.S., Holloszy, J.O., Cureton, T.K., "Effects of a Program of Endurance Exercises on Physical Work", The American Journal  of Cardiology, v o l . 14, (December, 1964), pp. 747-753. 93* Willet, A.E., "Prediction of Treadmill Running from Heartometer Measurements", Unpublished Master's Thesis, University of I l l i n o i s , 1949. 94. Cureton, T.K., Physical Fitness Appraisal and Guidance, St. Louis, C.V. Mosby Co., 1947, p. 268. 95. Meeland, T., "Technical Accuracy of the Heartometer", Unpublished Master's Thesis, University of I l l i n o i s , 1947. 28 9 6 . Cureton, op. c i t . . pp. 2 5 0 - 2 5 9 . 9 7 . Henry, F.M., Farmer, D., "Functional Tests II:' The Re l i a b i l i t y of the Pulse Ratio Test", Research Quarterly, vol. 9 , no. 2 , (May, 1 9 3 8 ) , pp. 81 -87. 9 8 . Cureton, T.K., Huffman, W.J., Welser, L., K i r e i l i s , R.W., Latham, D.E., Endurance of Young Men. Washington, D.C., Society for-Research i n Child Development, National Research Council, 1945 , p. 193* 9 9 . McCurdy, J.H., Larson, L.A., "The Re l i a b i l i t y and Objectivity of-Blood Pressure Measurements", Research Quarterly Supplement, v o l . 6 , (May, 1 9 3 5 ) , pp. 3-28. 1 0 0 . McFarland, R.A., Huddleson, J.H., "Neurocirculatory Reactions i n the Psychoneuroses Studied by the Schneider Method", American Journal of Psychiatry, vol. 9 3 , (November, 1 9 3 6 ) , PP. 5 6 7 - 5 9 9 . 1 0 1 . Cureton, et a l , op. c i t . , p. 2 1 4 . 1 0 2 . Morehouse, Tuttle, loc. c i t . CHAPTER III METHODS AND PROCEDURES Subjects Ten male subjects who voluntarily participated in the Physical Fitness Program for Middle-Aged Men at The University of British Columbia were chosen on the basis of regular attendance in the previous year fs program. The age range was from twenty-seven to fifty-one years. A l l subjects were employed in a professional capacity either as a Faculty or a Staff member. Training Program In September, 1964, a mimeographed brochure (1) was sent to a l l Faculty and Staff members acquainting them with the fitness program which became operational in November, 1964. The sessions were conducted each day Monday through Friday from 12:30 P.M. to 1:30 P.M., excepting university holidays, in the New Education Gymnasium until April 2, 1965. The i n i t i a l sessions of the fitness program were generally informal and consisted of a warm-up period of approximately fifteen minutes during which time general calisthenics involving the use of ropes, medicine balls, benches, walking and flexibility exercises were combined in a non-stop rhythmical manner. As the general level of fitness improved, the emphasis was placed on endurance running in the gymnasium for a maximum of thirty minutes. Cross country running was emphasized in the spring when weather permitted going outside. One session, usually on Wednesday, was devoted to circuit training in the Memorial Gymnasium. At the conclusion of the thirty minute endurance exercise period, the 30 members of the fitness class participated i n a game of volleyball for up to thi r t y minutes after which the hour was concluded with a shower. Each session was conducted alternately by two members of the School of Physical Education Research Staff assisted by two graduate students. The attendance r o l l was kept as effic i e n t l y as possible, although there can be no guarantee of absolute accuracy, since the class members themselves were sometimes responsible for checking the attendance l i s t . Attendances were totalled for each subject and these totals were correlated with the improvement scores for each variable. The purpose of this procedure was to determine whether or not attendance was related to improvements i n fitness. Testing Procedures 1. Pre-training Tests Each subject was tested individually and the measurements were recorded on the subject's fitness data sheet (see Appendix A). The subject arrived at the Fitness Laboratory according to a pre-arranged time, i n a near basal state (see Appendix B), changed into his gymnasium dress and then rested for th i r t y minutes. After the rest period, the Schneider Test was administered (see Appendix C) and recorded (see Appendix D). The subject was then tested with the Cameron Heartometer - the pulse pressure wave test. The pressure cuff was applied over the l e f t brachial artery and the subject remained quiet s i t t i n g for three minutes, after which the tracings were completed s i t t i n g , standing 31 and after one minute run-in-place according to the directions outlined by the Cameron Heartometer Corporation (2) and by T.K. Cureton (3). One notable exception to the directions was used (see Appendices E and F). At the conclusion of the Pulse Pressure Wave Test, the subject»s body fatimeasurements and weight were recorded as outlined by Cureton (4). The Progressive Pulse Ratio Test was completed at a pre-arranged time one week later as per the enclosed directions (see Appendix G). The Schneider Test and the Pulse Pressure Wave Test were conducted between 7:00 A.M. and 9:30 A.M., whereas the Progressive Pulse Ratio Test was administered at a convenient pre-arranged time. 2. Post-training The test times were identical for each subject on q,n tests. The same test procedures were followed as previously outlined. The fitness program, from pre-training to post-training, lasted seventeen weeks• Measurements The variables of the Pressure Pulse Wave were measured according to the directions as outlined in Cureton (5). Calculations for the Schneider Test are outlined in Appendix C. The plotting of the Progressive Pulse Ratio Test was completed as outlined in Appendix H. Analysis of Data The data collected from the three tests were analyzed on the 32 basis of a non-random, dependent sample as described by Ferguson (6). The statistical method used was the »Difference Method*. Garrett (7) states " . . . when groups are small the difference method is often to be preferred. . . ." This method determines the significance of the mean of the differences between the i n i t i a l and final performances. The statistical treatment as outlined in Ferguson (8) was applied to each of the variables comprising the Schneider Test, Progressive Pulse Ratio Test, Pulse Pressure Wave Test, body fat measurements and body weight. A one-tailed test with an arbitrarily chosen (.05) level of confidence was used. The t value for nine degrees of freedom was 1.833, i f the t observed was greater than or equal to the table value of t, the result was considered significant. A table was prepared showing co-efficients of correlation between improvements and the number of attendances for each s ubject. 33 REFERENCES 1. Brown, S.R., "The Physical Fitness Program for Middle-Aged Men at The University of British Columbia", Unpublished Program Outline, School of Physical Education and Recreation, The University of British Columbia, 1964. 2. Cameron, A.S., and Cameron, W.J., Visual and Graphic Methods of Cardiovascular Diagnosis, Chicago, The Cameron Heartometer Corp., 1954, pp. 5-7. 3. Cureton, T.K., Physical Fitness Appraisal and Guidance, St. Louis, C. V. Mosby Co., 1947, pp. 266-267. 4. Ibid., p. 144. 5. Cureton, op. c i t . , pp. 235-250 6. Ferguson, G.A., S t a t i s t i c a l Analysis i n Psychology and Education, New York, McGraw-Hill Book Co., 1959, p. 138. 7. Garrett, H.E., Statistics i n Psychology and Education. New York, D. MacKay Co., 1962, pp. 227-228. 8. Ferguson, op. c i t . . pp. 138-139. CHAPTER IV RESULTS Ten male subjects, a l l Faculty and Staff members at The University of British Columbia, participated in a seventeen week endurance exercise program. Pre-training and post-training cardio-vascular tests included the Schneider Test, the Progressive Pulse Ratio Test, and the Pulse Pressure Wave Test. Body fat and body weight were also measured. The results of the study are summarized in Tables I, II, III, IV, V, VI under the headings of Pulse Pressure Wave Test, Body Fat, Body Weight, Progressive Pulse Ratio Test, Schneider Test, and Co-efficients of Correlation Between Number of Attendances and Improvement Scores. Using individual pre-training and post-training raw scores for a l l variables, the group means were calculated and tested for the significance of the difference using a one-tailed test with a five per cent level of confidence (t*= 1.833). The correlation co-efficients were tested for significance using a one-tailed test at the .05 level of confidence (v = .558). TABLE I THE SIGNIFICANCE OF THE DIFFERENCE BETWEEN INITIAL AND FINAL MEAN SCORES FOR EACH OF THE PULSE PRESSURE WAVE TEST VARIABLES Variable X X d t I F Sitting Area Under the Curve 0.314 0.361 0.047 1.153 (cont'd) X X d t I F Sitting Rest to Work Ratio 2.786 2.797 0.011 0.030 Sitting Systolic Time 0.275 0.276 -0.001 0.046 Sitting Diastolic Time 0.728 0.721 -0.007 0.165 Sitting Dicrotic Notch Amplitude 0.698 0.773 0.075 1.105 Sitting Fatigue Ratio 0.6?8 0.675 -0.003 0.047 Sitting Diastolic Amplitude 0.733 0.818 O.O85 I.46I Sitting Obliquity Angle 22.290 22.080 -0.210 0.258 Sitting Pulse Rate 59.800 55.600 -4.200 2.436* Sitting Systolic Amplitude 1.048 1.211 O.I63 1.322 Sitting Systolic Blood Pressure 116.400 112.300 -4.100 2.088* Sitting Diastolic Blood Pressure 75.500 69.300 -6.200 1.550 Sitting Pulse Pressure 44.800 43.000 -1.800 O.678 Standing Area Under the Curve 0.295 O.356 0.061 2.397* Standing Pulse Rate 66.800 61.800 -5.000 2.677* Standing Systolic Amplitude 1.044 1.097 0.053 0.669 (cont'd) 36 X X t I F Difference Between Systolic Amplitude Sitting and Standing 0,108 0.152 0.044 1.128 Post-Exercise Systolic Amplitude 1.331 1.391 0.060 0.475 * Significant at the .05 level Table I indicates significant changes occurred in sitting pulse rate (t = 2.436), sitting systolic blood pressure (t = 2.088), standing area under the curve (t = 2.397)» and standing pulse rate (t = 2.677) at the five per cent level of confidence. TABLE II THE SIGNIFICANCE OF THE DIFFERENCE BETWEEN INITIAL AND FINAL MEAN SCORES FOR EACH OF THE BODY FAT VARIABLES Variable X I Xp d' t Cheek Fold 9.600 10.000 0.400 0.768 Abdominal Fold 14.700 12.650 -2.050 1.836* Hip Fold 17.100 14.650 -2.450 1.114 Front Thigh Fold 13.200 9.800 -3.400 3.285* Rear Thigh Fold 10.500 8.050 -2.450 1.307 Gluteal Fold 21.400 16.750 -4.650 4.131* Sum of A l l 86.500 72.050 -14.450 2.883* Average of A l l 14.416 12.031 -2.385 2.836* * Significant at the .05 level Table II indicates significant changes occurred in abdominal fold (t = 1.836), front thigh fold (t = 3-285), gluteal fold (t = 4.131), sum of a l l (t = 2.883) and the average of a l l (t = 2.836) at the five per cent level of confidence. TABLE III THE SIGNIFICANCE OF THE DIFFERENCE BETWEEN INITIAL AND FINAL MEAN SCORES FOR BODY WEIGHT Variable Xj d t Body Weight 168.625 168.375 -0.250 0.172 Table III indicates the mean body weight of the group decreased 0.250 pounds. The mean difference was not significant at the five per cent level of confidence. TABLE IV THE SIGNIFICANCE OF THE DIFFERENCE BETWEEN INITIAL AND FINAL MEAN SCORES FOR EACH OF THE PROGRESSIVE PULSE RATIO TEST VARIABLES Variable I I d t I F Total Recovery Pulse Counts 12 Steps 134.000 135.800 1.800 0.327 Total Recovery JPvO_2€ Counts 18 Steps 144.600 I4I.9OO -2.700 0.567 Total Recovery Pulse Counts 24 Steps 151.700 156.800 5.100 0.896 (cont'd) 38 K K d t -I F Total Recovery Pulse Counts 30 Steps 175.200 176.600 1.400 0.209 Total' Recovery Pulse Counts 36 Steps 211.200 203.600 -7.600 1.011 Average Ratio 2.503 2.511 0.008 0.127 Average Angle 39-350 39.350 0 0 Table I? indicates that no significant changes occurred at the five per cent level of confidence in any of the recovery pulse counts for 12, 18, 24, 30 and 36 steps per minute. No significant change occurred in the average ratio and the average angle at the five per cent level of confidence. TABLE V THE SIGNIFICANCE OF THE DIFFERENCE BETWEEN INITIAL AND FINAL MEAN SCORES FOR EACH OF THE SCHNEIDER TEST VARIABLES Variable X X d t I F Index Score 16.500 16.400 0.100 0.015 Lying Systolic Blood Pressure 115.300 112.300 -3.000 1.686 Standing Systolic Blood Pressure 118.900 117.500 -1.400 0.51? Difference Between Lying and Standing Systolic Blood Pressure 7.600 6.600 -1.000 0.457 Difference in Pulse Rate Standing Immediately Following Exercise 15.400 14.000 -1.400 0.399 (cont'd) 39 X T X , , d t I F Difference i n Pulse Rate Lying to Standing 7.000 11.100 4.100 1.011 Time f o r Pulse to Return to Standing Value 78.000 54.000 -24.000 2.058* Immediate Post-Exercise Pulse Rate 80.000 79.400 -0.600 0.156 Standing Pulse Rate 64.600 66.200 1.600 0.529 Lying Pulse Rate 57.200 55.200 -2.000 0.736 *Si g n i f i c a n t at the .05 l e v e l Table V indicates only one variable, time f o r pulse to return to standing value (t = 2.058), was s i g n i f i c a n t at the f i v e per cent l e v e l of confidence. TABLE VI CO-EFFICIENTS OF CORRELATION BETWEEN NUMBER OF ATTENDANCES AND 'IMPROVEMENT' SCORES Variable Correlation with Variable Correlation with Attendance Attendance Schneider Index Test Progressive Pulse Ratio Test Index Score +0.007 Total Recovery Pulse Counts 18 Steps +0.238 Difference Between Lying and Standing S y s t o l i c Blood Pressure +0.383 Total Recovery Pulse Counts 18 Steps -0.254 Standing S y s t o l i c Total Recovery Pulse Blood Pressure +0.131 Counts 24 Steps -0.234 (cont'd) 40 Correlation with Attendance Correlation with Attendance Lying Systolic Blood Pressure -0.131 Difference i n Pulse Rate Lying to Standing +0.383 Difference i n Pulse Rate Standing -0.203 Immediately Following Exercise Time for Pulse to Return to Standing Value -0.201 Immediate Post-Exercise Pulse Rate -0.197 Standing Pulse Rate +0.028 Lying Pulse Rate +0.129 Total Recovery Pulse Counts 30 Steps -0.270 Total Recovery Pulse Counts 36 Steps +0.186 Average Ratio Average Angle Body Fat Measurements Body Weight Cheek Fold Abdominal Fold Hip Fold Front Thigh Fold Rear Thigh Fold Gluteal Fold Sum of A l l Average of A l l -0.639* -0.351 -0.151 -0.330 -0.305 +0.637* +0.631* -0.047 -0.041 -0.412 -0.421 (cont'd) Variable -- Correlation with Attendance Pulse Pressure Wave Test Sitting Area Under Curve -0.189 Sitting Rest/Work Ratio +0.312 Sitting Systolic Time -0.425 Sitting Diastolic Time +0.216 Sitting Dicrotic Notch Amplitude -0.001 Sitting Fatigue Ratio -0.247 Sitting Diastolic Amplitude -0.059 Sitting Angle of Obliquity -0.435 Sitting Pulse Rate -0.437 Sitting Systolic Blood Pressure +0.158 Sitting Diastolic Blood Pressure -0.221 Sitting Pulse Pressure +0.395 Sitting Systolic Amplitude +0.213 Standing Area Under Curve +0.206 Standing Pulse Rate +0.024 Standing Systolic Amplitude +0.261 Difference Between Systolic Amplitude Sitting and Standing -0.099 Post-Exercise Systolic Amplitude +0.147 * Significant at the .05 level Table VI indicates only three variables, average ratio (0.639)> hip fold (0.637) and front thigh fold (0.631) significant at the five per cent level of confidence. CHAPTER V DISCUSSION OF RESULTS Significant improvements were made i n only ten variables of forty-four used i n this study. Significant changes at the five per cent lev e l of confidence (t = 1 . 8 3 3 ) were observed i n the following body fat measurements: abdominal fold, front thigh fold, gluteal fold, sum of a l l and average of a l l . Four variables of the Pulse Pressure Wave Test were significant, namely, si t t i n g pulse rate, s i t t i n g systolic blood pressure, standing area under the curve and standing pulse rate. One variable, time for the pulse to return to standing value, of the Schneider Test was significant. For each test variable, only the significance of the difference was tested between the pre-training and post-training tests. No analysis of individual improvement i s considered for each test variable. No specific r e l i a b i l i t y tests were carried out i n this study. Previous investigators have found a l l variables to be quite reliable and i t was assumed they were reliable i n this study. Subcutaneous fat was reduced as a result of the exercise program. Rechnitzer ( 1 ) has shown a significant reduction i n body fat i n cardiac patients as a result of physical exercise. Similarly a reduction i n body fat was found to be associated with a hard training program ( 2 ) . Though changes i n five variables of body fat were s t a t i s t i c a l l y significant, body weight did decline but this was not significant at the . 0 5 level of confidence. Brozek ( 3 ) and others have found that physical training does reduce body weight. Since fat free weight and 43 lean body mass were not determined, i t is difficult to construct any logical conclusion as to the reason why the changes in body weight did not parallel the changes i n the body fat measurements. Research has shown that a slower post-exercise rate is indicative of improved circulatory fitness (4, 5). When the heart rate is reduced "a f i t person can do a given amount of work without having to increase his heart rate as much as an unfit person" (6). With training there is a small but consistent reduction in the resting heart rate (7). The postural change of the body as reflected by a small increase in the heart rate sitting to standing may be interpreted as a favorable circulatory adjustment. Several studies indicate that the trained person's heart rate from sitting to standing is lower than the untrained. An increase of ten to sixteen beats per minute reflects a good circulatory adjustment (8). However, Morehouse and Millar point out "its value a3 a component of physical fitness is very doubtful" (9). A resting systolic blood pressure below 9© mm. Hg. and over 160 mm. Hg. may be associated with an unfit person (10). A significant reduction in the systolic blood pressure as a result of training has been noted in a number of experiments (11, 12). However, i t is interesting to note that the lying systolic blood pressure of the Schneider Test was not statistically significant at the .05 level of confidence, whereas the sitting systolic blood pressure of the Pulse Pressure Wave Test was significant. No explanation can be advanced for this difference. A statistically significant increase in the standing area under the curve of .063 square centimetres was obtained. According to Cureton and Sterling (13) the standing area of the pulse wave has a factor loading of .62 associated with the component blood ejection velocity proportional to the pulse wave. The authors have also noted "...that some large waves are associated with a slow pulse rate...." (14)• The fact that the standing pulse rate showed a significant decrease at the .05 level may have some bearing upon the increase of the standing area under the curve being significant at the .05 level of confidence. The adaptation of the body to the performance of a specific work load i s dependent somewhat upon the individual's state of training. The changes observed i n the performance of a cardiovascular test must bear some relationship to the type of training program used and i s indicative of the effect of the specific type of training upon cardio-vascular fitness. If this premise i s correct, the fact that only five of thirty-six cardiovascular variables improved significantly, leads to the conclusion that the program was insufficient to produce a general improvement i n cardiovascular condition. The frequency of participation by the subjects was neither uniform nor consistent and this may have played a decisive role i n producing the small number of s t a t i s t i c a l l y significant cardiovascular variables (15)• Rodahl (16) points out: It does not take more than a couple of half-hour training sessions a week...to materially improve the maximal work capacity within a month....the exercise must be sufficiently intense to increase the heart rate to more than 130 beats per minute. Experience has shown that when training ac t i v i t y i s less vigorous than that, no improvement i n physical work capacity occurs. The possibility that the training program did not produce the stimulus of exercise heart rate of 130 beats per minute or more with sufficient 45 frequency may have been the important factor i n producing a large number of non-significant results i n the cardiovascular variables. A greater degree of improvement might have been possible had the subjects participated on a more regular basis. To substantiate this point of view, the average attendance of the group was 1.74 sessions per week which represents i n t o t a l approximately thirty-nine per cent actual attendance of the possible t o t a l attendance. There may be a variety of reasons why the subjects did not come but there was no single overriding reason why the subjects came infrequently. The recovery pulse rate parallels the intensity of the work task (17). Rowell states (18): . . .the emotional state of the subject . . . the degree of physical conditioning, elapsed time after the previous meal, to t a l circulating hemoglobin, the degree of hydration of the subject, alterations i n the ambient temperature, and hydro-statically induced changes resulting from prolonged erect posture . . . w i l l affect the performance of an individual during a submaximal work task. With the possible exception of t h i r t y - s i x steps per minute, which may be assumed to approach a maximal work task, the tests used were submaximal and according to Rowell subject to the aforementioned factors. However, only the emotional factor and the degree of physical training can be considered as possible factors affecting this study. Astrand and Ryhming (19) suggest that: When testing circulatory-respiratory fitness a type of work must be chosen which engages large groups of muscles and the level of work must be relatively high. The duration of the work must be long enough to permit the adjustment of circulation and ventilation to the level of exercise usually requiring five to six minutes. Hypothetically, then, the tests u t i l i z e d were not d i f f i c u l t enough nor 46 long enough to permit the subject to attain a 'steady state 1 which i s noted as a pulse rate between 125 and 170 beats per minute (20). Wahlund (21) suggests that a number of work tasks of increasing intensity should be incorporated i n the determination of the physical work capacity of the individual. These discrepancies between individual members of a group w i l l be accentuated when work tasks are increased. As pointed out earlier, the actual working time employed i n a test i s often too short for reliable determinations of submaximal work capacity. Andersen (22) substantiates this by stating: The duration of the exercise at submaximal rates should be 8-10 minutes, the respiratory and circulatory measurements being taken during the last minutes, after the subject has reached a "steady state". The emotional state of the subject may, as pointed out by Hickam (23), "have a profound effect on the circulation causing changes i n the heart rate". This point of view i s substantiated by Brouha and Radford (24) and Henderson (25). Faulkner (26) adds support to this premise by stating: Human subjects respond to an unknown minimal work intensity with an increased heart rate i n anticipation and an overshoot i n heart rate during the i n i t i a l stages to adjustment to exercise. On the basis of this opinion, the i n i t i a l pulse ratios could have been affected by the subject's pulse rate ri s i n g rapidly prior to and during the lower work loads thereby causing succeeding pulse ratios at the higher work rates to be distorted. Morehouse and Tuttle (27) state that the pulse ratio test i s subject to certain problems: The r e l i a b i l i t y of the pulse rate for two minutes after exercise i s directly related to the strenuousness of the exercise. Thus, i f the response of the heart i s to be measured, the exercise must be strenuous enough ( 4 0 - 5 0 steps/minute) to overshadow environmental stimuli which affect the pulse rate after light exercise ( 2 0 - 3 0 steps/minute) to such an extent that successive readings are unreliable. There was some considerable variation i n the number of attendanced made by the subjects, i . e . attendances ranged from 1 7 to 4 5 with a median of 3 0 . 5 . It was considered possible, therefore, that the number of attendances might have had a direct relationship to the amount of change made by individual subjects between tests. This assumption was tested by correlating attendance with the differences between test one and test two scores. The hypothesis that the correlation co-efficient was significantly different from zero was tested i n each instance by the conventional s t a t i s t i c a l method using a one-tailed test at the . 0 5 level of confidence. It was apparent that a 'direct' relationship between attendance and improvement would, i n some instances, produce a correlation with a negative sign and i n other instances a correlation with a positive sign. This was taken into account when applying the one-tailed test to each correlation co-efficient. Only three correlation co-efficients were of sufficient size to be considered significantly different from zero. These were the co-efficients of correlation between attendance and average pulse ratio ( 0 . 6 3 9 ) , front thigh fat fold (O.63I) and rear thigh fat fold ( 0 . 6 3 7 ) . With the exception of the average pulse ratio, none of the correlations between the cardiovascular variables and attendance approached significance. The values of these co-efficients ranged from 0.001 to 0.637 with a median of 0.240. 'The remaining six of the eight correlations between fat measurements and attendance ranged from 0.042 to 0.421, with a median value of 0.306. There was no relationship between loss of body weight and number of attendances by the subjects. It i s apparent that individual differences i n improvement of cardiovascular condition were not related to attendance. It i s obvious, therefore, that failure to show significant differences between mean scores of the majority of variables cannot be attributed to a high v a r i a b i l i t y i n the attendance record of the group of ten subjects. It seems reasonable, therefore, that any search for possible explanations why the majority of variables did not show significant mean improvements must be directed elsewhere. There are several other possible reasons: the submaximal tests may have not been sufficiently reliable to yield stable results; the subjects on the whole may not have participated sufficiently frequently nor intensively i n order to make adequate improvements i n cardiovascular condition; the variables may not have been sufficiently sensitive to show the changes which did occur as a result of the subjects' participation i n the exercise program. 49 REFERENCES 1. Rechnitzer, P.A., luhasz, M.S., Pickard, H.A., Lefcoe, N.M., "The Effects of a Graduated Exercise Program on Patients with Previous Myocardial Infarction", Journal of Canadian Medical  Association, vol. 92, (April, 1965), pp. 858-860. 2. Cureton, T.K., "The Value of Hard Endurance Exercises and Tests to Produce Changes i n Weight, Fat, Metabolism and Cardiovascular Condition", Vigor, vol. 11, no. 4, (September, 1958), pp.1-6. 3. Brozek, J., "Changes of Body Composition in Man During Maturity and Their Nutritional Implications", Proceedings of the Federation  of American Societies for Experimental Biology, vol. 11, (1952), p. 704. 4. Michael, E.D., Gallon, A.J., "Periodic Changes in Circulation During Athletic Training As Reflected by a Step Test", Research Quarterly, vol. 30, no. 3, (October, 1959), P« 3H« 5. Henry, F.M., "Influence of Athletic Training oh the Resting Cardio-vascular System", Research Quarterly, vol. 25, no. 1, (March, 1954), pp. 28-41. 6. Rodahl, K., "International Aspects of Comparative Fitness", Proceedings and Research Papers. Canadian Association for Health, Physical Education, and Recreation, 1963, p. 29. 7. Morehouse, L.E., Miller, A.T., Physiology of Exercise, St. Louis, C.V. Mosby Co., 1963, p. 260. 8. Cureton, T.K., Physical Fitness Appraisal and Guidance, St. Louis, C.V. Mosby Co., 1947, p. 166. 9. Morehouse, Miller, op. cit., p. 102. 10. Cureton, T.K., Physical Fitness Appraisal and Guidance, St. Louis, C.V. Mosby Co., 1947, pp. 199-201. 11. Cogswell, R.C, Henderson, CP., Berryman, G.H., "Some Observations of the Effects of Training on Pulse Rate, Blood Pressure and Endurance in Humans Using the Step Test (Harvard), Treadmill and Electrodynamic Brake Bicycle Ergometer", American Journal of Physiology, vol. 146, (1946), pp. 422-430. 12. Yarr, A.D., "The Relationship of Brachial Pulse Wave Measurements to the Performance of Cross Country Runners", Unpublished Master's Thesis, The University of British Columbia, 1963. 50 13. Cureton, T.K., Sterling, L.F., "Factor Analyses of Cardiovascular Test Variables", The Journal of Sports Medicine and Physical Fitness, vol. 4, no. 1, (March, 1964), p. 4. 14. Ibid., p. 18. 15. Morehouse, Miller, op. cit.. pp. 102-104. 16. Rodahl, op. cit., p. 30. 17. Morehouse, L.E., Tuttle, W.W., "A Study of the Post-Exercise Heart Rate", Research Quarterly, vol. 13, no. 1, (March, 1942), pp. 3-9. 18. Rowell, L.B., Taylor, H.L., Wang, Y., "Limitations to Prediction of Maximal Oxygen Intake", Journal of Applied Physiology, vol. 19, no. 5, (1964), p. 920. 19. Astrand, P.O., Ryhming, I., "A Nomogram for Calculation of Aerobic Capacity (Physical Fitness) from Pulse Rate During Submaximal Work", Journal of Applied Physiology, vol. 7, (September, 1954), p. 221. 20. Loc. cit., p. 221. 21. Wahlund, H., "Determination of the Physical Working Capacity", Acta Medica Scandinavica. Supplementurn, vol. 215, (1948), p. 16. 22. Andersen, K.L., "Measurement of Work Capacity", The Journal of Sports Medicine and Physical Fitness, vol. 4, no. 4, (December, 1964), pp. 236-240. 23. Hickam, J.B., Cargill, W.H., Golden, A., "Cardiovascular Reactions to Emotional Stimuli Effect on the Cardiac Output, Arterio-venous Oxygen Difference, Arterial Pressure and Peripheral Resistance", Journal of Clinical Investigation, vol. 27, (1948), p. 296. 24. Brouha, L., Radford, E.P., "The Cardiovascular System in Muscular Activity", Science and Medicine of Exercise and Sports, edited by W.R. Johnson, New York, Harper and Brothers, I960, p. 187. 25. Henderson, Y., Haggard, H.W., Dolley, F.S., "The Efficiency of the Heart and the Significance of Rapid and Slow Pulse Rates", American Journal of Physiology, vol. 82, (September-November, 1927), p. 514. 51 26. Faulkner, J.A., "Effect of Cardiac Conditioning on the Anticipatory Exercise and Recovery Heart Rates of Young Men", The Journal  of Sports Medicine and Physical Fitness, vol. 4, no. 2, (June, 1964), p. 83. 27. Morehouse, Tuttie, op. cit., p. 8. CHAPTER VI SUMMARY, CONCLUSIONS AND RECOMMENDATIONS Summary The purpose of this study was to evaluate the effects of an endurance exercise program upon cardiovascular variables of a group of middle-aged men. Ten subjects, a l l faculty and staff members of the university, participated voluntarily i n the Physical Fitness Program for Middle-Aged Men at The University of British Columbia. Each subject was tested before and after participation i n a seventeen week program. The pre-training and post-training test environments and test procedures were standardized for a l l subjects. A basal condition instruction sheet (see Appendix B) was sent to a l l subjects. The tests were conducted according to the enclosed appendices and based upon previous investigations. Each subject arrived at the Fitness Laboratory i n a near basal state, changed into his gymnasium dress and then rested for t h i r t y minutes. The Schneider Test was administered f i r s t after the thirt y minute rest followed by the Pulse Pressure Wave Test. Tracings were completed i n the si t t i n g , standing and after one minute run-in-place. At the conclusion of the pulse wave test, the subject's body fat measurements and weight xirere recorded. The Progressive Pulse Ratio Test was completed on a second occasion one week later. The pre-training - post-training raw scores for a l l variables were analyzed on the basis of the significance of the difference between group mean scores using a .05 level of confidence. The following variables were tested: (1) Schneider Test Variables are: lying pulse rate, standing pulse rate, post-exercise pulse rate, time for pulse to return to standing value, difference between pulse rate lying to standing, and standing to post-exercise difference, lying and standing systolic blood pressure and the difference between systolic blood pressure lying and standing. (2) Progressive Pulse Ratio Variables: recovery pulse counts for rates of 12, 18, 24, 30 and 36 steps per minute, average ratio and average angle. (3) Pulse Pressure Wave (Brachial Sphygmograph) Variables are: A. Sitting area under curve, systolic amplitude dicrotic notch amplitude, fatigue ratio, diastolic amplitude, rest to work ratio, obliquity angle, systolic time, diastolic time, pulse rate, systolic blood pressure, diastolic blood pressure and pulse pressure. B. Standing area under curve, pulse rate, systolic amplitude, difference between sitting and standing systolic amplitude. C. Post Exercise systolic amplitude (4) Body Fat Measurements Variables are: cheek fold, abdominal fold, hip fold, front thigh fold, gluteal fold, rear thigh fold, sum of a l l , and average. 54 (5) Body Weight The results of this study show the following: the mean body-fat measurements - abdominal fold, front thigh fold, gluteal fold, sum of a l l and average of a l l - decreased at the .05 level of confidence. Significant changes at the .05 level of confidence were observed in four of eighteen variables of the Pulse Pressure Wave Test. The variables were sitting pulse rate, sitting systolic blood pressure, standing area under the curve and standing pulse rate. Only one variable of the Schneider Test - time for pulse to return to standing value - was significant at the .05 level of confidence. Ho significant changes were observed at the .05 level on any of the seven variables of the Progressive Pulse Ratio Test. Improvement scores for a l l variables were correlated with the number of attendances made by the subjects. Only three variables - average pulse ratio, front thigh fat fold, rear thigh fat fold - had co-efficients of correlation with attendance which were sufficiently large to be considered statistically significant from zero. Conclusions The results of the study show the exercise program was capable of producing reduction in fat measurements without concomitant loss of body weight but that there were few significant mean improvements in the cardiovascular measurements used. The significant mean improvements were almost exclusively in those variables measuring resting heart rate. The failure to show significant mean improvements in the majority 55 of cardiovascular measurements was not related, to the v a r i a b i l i t y i n •frequency of attendance of the individual subjects. It seems l i k e l y , therefore, that the failure to show significant mean improvements i n cardiovascular condition was due to one or more of the following reasons: the subimximal tests may not have been sufficiently reliable; the subjects as a group may not have participated sufficiently frequently or intensively; the variables may not have been sufficiently sensitive to reflect the changes which did occur as a result of the exercise program. Recommendations The following recommendations seem jus t i f i e d on the basis of the results obtained i n this study. Future studies involving the use of middle-aged men should incorporate the following points i n the overall design of the study, namely: a control group, the case study approach, the use of non-parametric s t a t i s t i c a l analysis, thorough medical examination for each subject prior to engaging i n the study, test-retest r e l i a b i l i t y check of the measuring instruments and an accurate record of compulsory attendance for a l l subjects. BIBLIOGRAPHY BIBLIOGRAPHY BOOKS Adolph, E.F., "Some Physiological Regulations Illustrated in Exercise", Science and Medicine of Exercise and Sports, edited by W.R. Johnson, New York, Harper and Brothers, I960, pp. 67-79. Balke, B., "Circulo-Respiratory Responses to Physical Work", Performance Capacity - a Symposium. Chicago, Advisory Board on Quartermaster Research and Development, Department of the Army, February, 1961, pp. 13-19-Balke, B., "Physiological Background for the Assessment, Evaluation and Classification of Physical Fitness", Proceedings and Research Papers, Canadian Association for Health, Physical Education and Recreation, June, 1963, pp. 5-14. Bortz, E.L., "Exercise, Fitness and Aging", Exercise and Fitness, Chicago, The Athletic Institute, I960, pp. 1-9. Brouha, L., Radford, E.P., "The Cardiovascular System in Muscular Activity", Science and Medicine of Exercise and Sports, edited by W.R. Johnson, New York, Harper and Brothers, I960, pp. 178-206. Cameron, A.S., Cameron, W.J., Visual and Graphic Methods of Cardio- vascular Diagnosis. Chicago, The Cameron Heartometer Corp., 1954. Campbell, W.G., Form and Style in Thesis Writing, Boston, Houghton-Mifflin Co., 1954. Cureton, T.K., Physical Fitness Appraisal and Guidance. St. Louis, C.V. Mosby Co., 1947. Cureton, T.K., Physical Fitness of Champion Athletes, Urbana, The University of Illinois Press, 1951. Cureton, T.K., Huffman, W.J., Welser, L., Kireilis, R.W., Latham, D.E., Endurance of Young Men, Washington, D.C., Society for Research in Child Development, National Research Council, 1945. Ferguson, G.A., Statistical Analysis in Psychology and Education, Toronto, McGraw-Hill Book Co., 1959. Fletcher, J., "Relationship Between Blood Circulation and Physical Fitness", Proceedings and Research Papers, Canadian Association for Health, Physical Education and Recreation, June, 1963, pp. 23-24. Garrett, H.E., Statistics in Psychology and Education, New York 5th Edition, D. McKay Co., 1961. 57 Henry, F.M., Physiology of Work. Berkeley, University of California, 1963. McCloy, C.H., Young, N.D., Tests and Measurements in Health and Physical  Education, 3rd Edition, New York, Appleton-Century-Crofts, 1954. Morehouse, L.E., Miller, A.T., Physiology of Exercise. 4th Edition, St. Louis, C.V. Mosby Co., 1963. Mouly, C.J., The Science of Educational Research. New York, The American Book Co., 1963. Norris, A.H., Shock, N.W., "Exercise in the Adult Years with Special Reference to the Advanced Years", Science and Medicine of Exercise  and Sports, edited by W.R. Johnson, New York, Harper and Brothers, I960, pp. 466-490. Raab, W., "Degenerative Heart Disease from Lack of Exercise", Exercise and Fitness, Chicago, The Athletic Institute, I960, pp. 10-19. Rodahl, K., "International Aspects of Comparative Fitness", Proceedings  and Research Papers., Canadian Association for Health, Physical Education and Recreation, June, 1963, pp. 28-30. Rushmer, R.F., Cardiovascular Dynamics, 2nd Edition, Philadelphia and London, W.B. Saunders Co., 1961. Spiegel, M.R., Theory and Problems of Statistics. Schaum's Outline Series, New York, Schaum Publishing Company, 1961. Steinhaus, A.H., "Chronic Effects of Exercise", Toward an Understanding  of Health and Physical Education, Dubuque, Iowa, W.C. 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Wolf, G.T., "Effects of Posture and Muscular Exercise on the Electro-cardiogram", Research Quarterly, vol. 24, no. 4, (December, 1953), pp. 475-490. Wolffe, J.B., "Cardiovascular Response to Vigorous Activity", Medicina  Sportiva, Rome, vol. 12, (January, 1958), pp. 34-39. Wyndham, C.H., Strydom, N.B., Martiz, J.S., Morrison, J.E., Peter, J., Potgieter, Z.U., "Maximum Oxygen Intake and Maximum Heart Rate During Strenuous Work", Journal of Applied Physiology, vol. 14, no. 6, (1959), pp. 927-936. UNPUBLISHED MATERIAL Brown, S.R., "The Physical Fitness Program for Middle-Aged Men at The University of British Columbia", Unpublished Program Outline, School of Physical Education and Recreation, The University of British Columbia, 1964. Meeland, T., "Technical Accuracy of the Heartometer", Unpublished Master's Thesis, University of Illinois, 1947. Olenick, N.F.E., "The Effects of Endurance Training Upon Brachial Pulse Wave and Heart Rate Measurements of a Group of Middle-Aged Men", Unpublished Master's Thesis, The University of British Columbia, 1965. Scott, H.A., "The Effect of Physical Conditioning on the Motor Fitness and Cardiovascular Condition of College Freshmen", Unpublished Master's Thesis, The University of British Columbia, 1965. Simmons, R., "The Effect of Circuit Training Upon Cardiovascular Condition and Motor Performance", Unpublished Master's Thesis, The University of British Columbia, 1965. 66 Wallace, B.T., "The Effects of Training for Competitive Rowing on Cardiovascular Condition as Measured by the Brachial Pulse Wave", Unpublished Master's Thesis, The University of British Columbia, 1965. Willet, A.E., "Prediction of Treadmill Running from Heartometer Measurements", Unpublished Master's Thesis, University of Illinois, 1949. APPENDICES 67 APPENDIX A FITNESS DATA SHEET U.B.C. Fitness Laboratory-School of Physical Education NAME: AGE: ' jrrs. TIME: I. Anthropometric Measurements Height Weight:_ inches "lbs. II. Body Fat Measurements Date: Tester: 1. Cheek Fold 2. Abdominal Fold 3. Hip Fold 4. Front Thigh Fold 5. Gluteal Fold 6. Rear Thigh Fold Sum of All Average III. Schneider Index Date: Tester: _mm _mm _mm _mm _mm _mm _mm" mm (15 sec.count) (beats/min) Lying Pulse Rate Standing Pulse Rate_ Immediate Post Exer-cise Pulse Rate x x 4 4 x 4 = Time for Pulse Rate to return to standing value min Difference in Pulse Rate lying to standing x 4 = Difference in Pulse Rate stand-ing to immediately following exercise_ Lying Systolic Bp_ sec Standing Systolic Bp Difference between lying and standing Bp. _x 4 = mm. Hg. Hg. mm. IV. Progressive Pulse Ratio Date: Tester: (30 sec.count) (BPM) Initial Pulse Rate Sitting x 2 = Recovery Pulse Counts (2 minutes) Steps per minute Recovery Counts 12 = 18 = 24 = 30 = 36 = Pulse Ratios 12 = 18 = 24 = 30 = 36 = Average Ratio = Average Angle = V. Heartometer Date: Tester: Sitting Cycle T. Sys. T. Dia. T. . Pulse R. Sys.B.p. Dia.B.p. P.Press. Standing Pulse R. mm. Hg. Area Sys.Amp. Die.N.Amp., F. Ratio " Dia. Amp. R/W Ratio \ Dbl.Angle Area Sys.Amp. Diff.Betw.Amp.Sitt. & Stand.. Post Exercise Ampl. Schneider Index 68 APPENDIX B DIRECTIONS FOR PREPARING FOR TESTS TO BE DONE UNDER BASAL CONDITIONS I. Evening before the test:-1. Eat a light dinner. 2. Spend the evening quietly. 3. Use no stimulants after the evening meal, (i.e. coffee, tea, cokes, tobacco, alcoholic beverages). If you are taking any medication, inquire about its use before the test. 4. Retire early. Get at least eight or nine hours of sleep. II. The morning of the test:-1. Get up in time to complete preparations without hurrying. 2. Do not take a morning bath or shower. You may wash your face and hands. 3. Do not eat any breakfast or use any stimulants or drugs. 4. Do not take any exercise. You may walk short distances i.e. to your car or to the Fitness Laboratory. Walk slowly. 5. Arrive at the Physical Fitness Laboratory promptly at the appointed time. 6. Remove a l l tight articles of clothing such as: shoes, garters, collars, etc., and l i e down on the bed and relax completely. Cover up sufficiently to be comfortable. Rest until the test is started. It is quite a l l right to f a l l asleep but not essential. Complete relaxation is important. III. It is of the utmost importance to follow the preceding instructions i f the results are to be reliable. If you have a severe cold accompanied by marked congestion of the nose, coughing, or a fever, i t is advisable to postpone the tests. Advise any cancellation of the appointment as early as possible. 69 APPENDIX C INSTRUCTIONS FOR THE SCHNEIDER TEST The numbers Correspond with Test Sheet. 1. The subject rests in the lying position on the back for five minutes or more. If the pulse is above 70 after five minutes rest, the rest in the horizontal position should continue for another five minutes at least and then the pulse taken again. The lowest pulse should be inserted on line 1 of the Schneider Score Sheet. Count is 15 sees, multiplied by four for the count per minute. 2. The lying systolic blood pressure is taken with a mercurial sphygmomanometer (see Deaver's Fundamentals of Physical Examination, 1939, pp. 216-224). 3. The lying diastolic blood pressure is taken i n similar manner, reading the sound at the 4th phase when there is noted a change in sound from sharp and clear to muffled sounds. This is somewhat higher on the scale than when the sounds disappear. 4. The subject is then asked to get up from the table easily and stand on his feet. At this time the cuff is disconnected from the instrument but not removed from the arm. The subject is also told to hold his arm bent so that the cuff will not f a l l off. He must remain in the relaxed standing position for at least one f u l l minute or two before the standing pulse rate can be taken. 5. The standing systolic blood pressure is taken with precautions that the subject is standing on both feet and is in a relaxed state. A iiford to the subject is helpful as a reminder to stand easily on both feet and to relax. 6. The standing diastolic blood pressure is also taken, similarly to lying diastolic. 7. The standard step-up is demonstrated as one step up and down in 3 sees., or 5 times in 15 sees. The subject is asked to step up five times at that rate. The pulse is counted immediately after for 15 sees, and put down on the data sheet as (15x4—60). This will ensure that no error has been made by multiplying in the head. 8. Thirty seconds after the exercise the pulse i s again counted for 15 sees. This is quickly recorded on the data sheet and compared with the standing pulse. If i t is higher than the standing pulse, another count is taken at 90 and 120 seconds. On the count which is even with or lower than the standing pulse, the procedure is stopped and that pulse is placed in the corresponding time space of the data sheet. 70 9. Each of the sections are scored: A, B, C, D, E, and F. The procedure is as follows: (a) Section A is scored for reclining pulse rate. The best resting pulse rate is compared with the table in Section A and the points immediately after are rung. (b) Section C is scored in like manner for the standing pulse rate. (c) Section B is scored on the same line as previously rung for the lying pulse rate. , It is important to stay on this same line as the amount of change is traced from left to right over to Table B. The amount of change from lying to standing pulse must be subtracted and matched with the headings of Table B. The points earned are rung in the body of the Table B. A pencil is used to encircle the points earned. (d) Section D is scored in similar manner to Section B. It is important to stay on the same line as was used on scoring the standing pulse ratio. The horizontal line is traced from Table C to Table D horizontally across the page from left to right. The amount of pulse rise from the standing rate to the rate after exercise is noted by subtraction and this amount is matched with the table headings in D. The points earned are encircled in the body of Table D. (e) The return of pulse rate to the standing normal is now scored, using Table E. The time for the pulse to return to the standing normal is noted and matched with Table E. The points earned are encircled. (f) The change in systolic blood pressure is noted comparing the difference between the lying and standing pressures. The difference is scored in Table F. The points earned are encircled. Summation of Total Score (Schneider Index): This is obtained by adding up the points encircled in each of the six sections: A, B, C, D, E, F. This result is placed in the space provided, under TRIAL I. The date is inserted just above. Rechecks: It is recommended that a second or third check be taken by completely repeating the Schneider Test procedure. The index is very helpful i f i t is a reliable result. Some people are mentally excited on their f i r s t t r i a l on this test and the pulse rate may be higher than is truly normal. The best of two or three trials is usually preferred as a most reliable result. Diastolic Blood Pressure: This should also be inserted although i t is not used in the Schneider Test. A standing diastolic lower than 60 usually means poor endurance in long continued exertion, such as running or swimmings Good athletes range from 85 to 105 in standing diastolic blood pressure. 71 Systolic Blood Pressure; It is usually recommended that any case with systolic blood pressure over 160 or lower than 80 should be referred to a physician for a more complete diagnosis. The pulse pressure (difference between the systolic and diastolic pressures) is used in several cardiovascular tests. This is usually noted. A pulse pressure above 40 indicates an untrained state. This may be the basis of referring the subject to a conditioning class. Original Data Sheets: The original data sheets should be saved because the data may be used in several ways in the research. The notations should be carefully made. APPENDIX D 72 SCHNEIDER INDEX TEST - SCORE SHEET (Cureton Modification) Name : Date Schneider Index OBSERVATIONS Lying Position: Pulse Rate Systolic BP Diastolic BP. Standing Position: Pulse Rate Systolic BP Diastolic BP. STEP EXERCISE (5 steps-chair 20" high): Pulse Rate Immediately After Exercise, Pulse Rate After Exercise: 30 sec. 60 sec. 90 sec. 120 sec. A. Reclining Pulse Rate SCORING TABLE B. Pulse Rate Increase on Standing Rate . Points 0-10 11-18 19-26 27-34 35-42 41-50 4 4 4 3 2 1 51-60 3 3 3 2 1 0 61-70 3 3 2 1 0 -1 71-80 2 2 2 0 -1 -2 81-90 1 2 1 -1 -2 -3 91-100 0 l 0 -2 -3 -3 101-110 -1 0 -1 -3 -3 -3 C. Standing Pulse Rate ] D. Pulse Rate Increase Immediately After Exercise Rate Points 0-10 11-20 21-30 31-40 41-50 51-60 4 4 4 3 2 1 61-70 3 3 3 2 1 0 71-80 3 3 2 1 0 0 81-90 2 3 2 1 0 -1 91-100 1 2 1 0 -1 -2 101-110 1 1 0 -1 -2 -3 111-120 0 1 -1 -2 -3 -3 121-130 0 0 -2 -3 -3 -3 131-140 -1 0 -3 -3 -3 -3 E. Return of Pulse Rate F. to Standing Normal After Exercise Standing Systolic B.P. Compared with Reclining Systolic B.P. Seconds Points Change in Millimeters Points 0-30 3 Rise 30 and more -2 31-60 2 Rise 21 to 30 -1 61-90 1 Rise 16 to 20 0 91-120 0 Rise 11 to 15 1 AFTER 120 Rise of 6 to 10 2 2-10 beats No change greater than 5 3 above normal -1 Fall of 6 to 10 2 AFTER 120 Fall of .11 to 15 1 11- 30 beats Fall of 16 to 20 1 0 above normal -2 Fall of 21 to 25 -1 Fall of 26 and more -2 4/2/65 73 APPENDIX E CONDENSED INSTRUCTIONS FOR BLOOD PRESSURE FINDINGS  AND MAKING HEARTOGRAPHS  MODEL - 6100 FOLLOW THESE INSTRUCTIONS EXACTLY — NO OTHER METHOD WILL FURNISH PROPER RESULTS. 1. Turn Heartometer so patient can't watch graph being made. 2. Cuff must be put on tight - snugness is important. (Instruct patient to remain quiet - they must not move or speak.) 3. Have clutoh OUT - close air valve in inflation system. DIASTOLIC 4. Inflate, pause - Inflate, pause - Inflate, pause - etc. (The pause should be for two or three seconds.) Continue inflating and pausing until one light (either) is flashed by the pulse. This is the DIASTOLIC point (5th phase). Push clutch in and mark diastolic pressure. Pull clutch a l l the way OUT stopping the graph. 5. Inflate quickly until you have fixed light (no flashing) = collapsed artery. SYSTOLIC 6. Now, deflate, pause - deflate, pause - deflate, pause - etc. (The pause should be for two or three seconds.) Continue deflating and pausing until pulse flashes one (either) light for a count of 10.t This is the SYSTOLIC point. Push clutch in and mark systolic pressure. Pull clutch a l l the way OUT stopping the graph. GRAPHING 7. Now, deflate until 10 or 15 mm. below diastolic mark. StopI (Don't deflate to zero.) Now, increase the pressure above diastolic; 1/4 of the pulse pressure (usually 10 to 20 mm. above diastolic*). Push clutch i n to start motor; make Heartograph. Pull clutch a l l the way OUT stopping the graph. Release pressure from cuff promptly. ( t) When Skipped Beats, Fibrillation, etc. is present there can never be 10 successive pulses to actuate the lights. The term "COUNT c 74 OF 10" is used to cover such cases. (Counts should be INTERVALS of 1 Second.) (*) Exceptions to this rule are: In very low diastolic pressure or obliterated cases in the legs, one may have to make a short graph at different pressures in order to establish the proper graphing point. CAMERON HEARTOMETER COMPANY Chicago Illinois 75 APPENDIX F CAMERON HEARTOMETER CORPORATION The University of British Columbia Vancouver 8, B.C., Canada. Attention: S.R. Brown, Associate Professor, School of Physical Education & Recreation. Gentlemen: In reply to your letter of November 20, 1964, per enclosed condensed instructions, please note that when one light, (EITHER LIGHT) is flashed by the pulse, that is the correct diastolic and systolic level. ALTERNATING LIGHTS, which sometimes take place in the pulse pressure field (between the diastolic and systolic levels) are of no diagnostic value. In almost every case, difficulty or inability to obtain correct light action at either or both the diastolic and systolic levels is caused by the fact that the inflation system is not on tight and snug. This is very important. The inflation system cannot be put on too tight. Also, on brachial (arm) findings, the Ace bandage should always be used over the inflation system cuff when the patient has a large flabby arm. By dropping to zero after you have obtained and marked the systolic pressure level, you certainly are not following the correct established operating procedure. DROP DOWN ONLY 10 to 15MM below the diastolic level and then stop. DO NOT DROP DOWN TO ZERO. If you let out a l l pressure and then re-apply pressure, you will almost certainly obtain a decrease in graphing pressure which will appear to be a pressure loss from the inflation system. It is however nothing more than the muscle of the arm fighting the re-application of pressure. By following the established procedure, i f pressures are taken quickly and accurately (which only requires a minute) there can be no venous congestion and you need not worry about that factor entering the picture. The procedure to re-engage the clutch, i f necessary, to make the pen write in the correct position on the graph has always been mentioned in the Heartometer Technique Book. Latest book has the information on page 7. It states: "At times, the heart graph pen does not always graph at the same distance from the center of the chart. The position of the pen is dependent upon the engaging of the clutch at the beginning, middle or November 23, 19.64 Air-Mail. 76 end of the cardiac cycle. This has no real diagnostic significance. To change position of pen on chart, pull out clutch and re-engage. The graph on page 10 is an example of two tracings made at different positions on the paper". A "sagging graph" is almost always caused because the correct procedure was not followed (all pressure was let out and then the Inf. system was re-inflated to graphing level). However, neither of the above could be responsible for the failure of the lights to operate properly. Further, i f you are making a l l Heartographs at 80MM graphing pressure, you are ignoring the fact that pressures vary in individuals according to age, bio-type, weight, heredity and certainly environment. We have not nor do we intend to suggest that a l l graphs be taken at one pressure. We are not unmindful that (even in the apparent healthy) there is wide variation in pressures. It has been stated for many years and we repeati, "Tell me where you were born, where your parents were born, and the environment one has or is passing through, and we should be able to closely evaluate the normal pressure. Send us 1/2 dozen graphs that you have made (which will be returned to you) and we will attempt to supply additional information that will assist you. We suggest that you return your unit for immediate repair. You cannot accurately check diastolic and systolic pressures with any mercury column and stethoscope with any real degree of accuracy. The average error in trying to use sounds is from plus 7MM to minus 7MM. Thus, the average error is 14MM. Also, few can properly identify the correct diastolic level (5th phase) that the Heartometer gives you for diastolic pressure. Fifth phase diastolic pressure i s the only correct phase to use. Very truly yours, CAMERON HEARTOMETER CORP. "Alex W. Cameron" Alex W. Cameron, V.P.-Treas. AWC/em. APPENDIX G SPECIFICATIONS FOR PROGRESSIVE PULSE RATIO TEST (STEPS OR SQUATS) 77 1. (a) Seat subject 5 Mins. Count sitting pulse for 30 sees. (b) After 30 sees, count sitting pulse for 30 sees, again. (c) If pulse is stable (± 1 beat), go on with the test. If not, count sitting pulse again and continue until two successive counts are the same. If there is s t i l l fluctuation, use the average. 2. Have the subject stand up. Count aloud the timing of the stepping at 5 seconds for each complete trip (12/min.), 2g sees. UP and 2g sees. DOWN. Demonstrate. Ask the subject to count the number of trips he makes in one minute at 12/min. Start the subject on the even minute at the start of one revolution of the minute hand on a stop watch or suitable photo-timer. Count for the subject so that one complete trip coincides with 5 sees, on the clock. Continue stepping for exactly one minute. Tell the subject to sit down. Then after 10 sees, count pulse for 2 Min. i.e., begin the pulse count exactly 10 sees, after the even minute. 3. Compute the pulse ratio and plot the second point while the subject remains seated. Recheck the sitting pulse rate at least twice. Continue until the pulse is stable (+ 1 beat) and record in terms of beats/min. Do not wait longer than 5 minutes after stepping. If pulse is not stable by the end of this period, count pulse, record, and continue stepping. 4. Count the rate of stepping at 3*33 sees, for one complete trip, 18/min. Three trips in 10 sees. Demonstrate. Ask the subject to count the number of steps or use a pulse counter. Step the subject at this rate for exactly 1 minute. At the end, seat the subject and after 10 sees, count the pulse for 2 mins. Compute the pulse ratio and plot the point. 5. After 2 or 3 mins., check pulse at least twice for 15 sees. Continue until the pulse rate is stable. Record the sitting rate. 6. Explain the rate of stepping at 24 steps/min., 2g sees, per trip. Demonstrate. Ask the subject to count his trips. Step the subject for exactly one min. Sit the subject down and after 10 sees., count the pulse for 2 mins. 7. Repeat step 5. 8. Explain to the subject the rate of stepping at 30/min. Demonstrate, one sec. UP and one sec. DOWN. Ask the subject to count the steps (dips). Step the subject for exactly one min. Sit the subject down and after 10 sees., count the pulse for 2 mins. Compute the pulse ratio and plot the 4th point. Recheck the sitting pulse rate at least twice and continue until the pulse is stable. Record the sitting rate. Explain the rate of stepping at 36/min. Demonstrate or count out three trips UP and DOWN in 5 sees. Ask the subject to count the number of steps and step the subject for exactly one minute. 79 APPENDIX H INSTRUCTIONS FOR PLOTTING THE PROGRESSIVE PULSE RATIO Graph Paper: 20 lines to the inch preferred. 1 inch squares in dark lines. Preparation: Label graph at bottom margin - "Progressive Pulse Ratio". Write subject's name and the date of testing at the top of the graph. Draw ordinate (vertical axis) on one of the dark lines about one-half inch In from the left hand edge. Draw abscissa (horizontal axis) on one of the dark lines about two inches up from the bottom edge. Mark the ordinate scale - 1.8, 2.0, 2.2, 2.4, 2.6, 2.8, 3.0, beginning with 1.8 at the junction of ordinate and abscissa, and working upwards at intervals of one inch. Label these 'Ratios'. Mark the abscissa scale - 12, 18, 24, 30, 36, beginning with 12 at the junction of ordinate and abscissa and working along the abscissa to the right at intervals of one and one-half inches. Label these 'Steps per Minute'. Label and record the pulse rates and ratios obtained as the test progresses. Example: Ratios 1.8 STEPS PER MIN. = 12 18 24 30 36 PULSE RATES: 2 MIN. POST EX. = 149 154 162 178 205 1 MIN.QUIET SIT = 74 74 74 76 76 RATIOS 2.01 2.08 2.19 2.34 2.70 PROGRESSIVE PULSE RATIO Procedure 1. Calculate the ratios as the test progresses. Plot  graph and join the points by straight lines. the ratios on the 80 2. Calculate the average ratio - i.e. Sum the five ratios and divide by five. Plot this ratio on the graph directly above *24 steps per minute* on the abscissa scale. Draw a straight line between this point and the point at 2.0 on the ordinate scale. Project this line to the right side of the graph. Label the point - Average  Ratio. 3. Measure the average angle. Measure, with a protractor, the angle at point 2.0 on the ordinate scale between the horizontal and the average ratio. Record the angle obtained, in degrees and half-degrees, on the graph and label - Average Angle. 4. Measure the following angles. Record the values on the graph in degrees and half-degrees. 1. Angle at ratio for 24 steps per minute. 2. Angle at ratio for 30 steps per minute. One side of the angle is formed by the horizontal. The other side is formed by the plotted line joining the respective ratio and the next one to the right - i.e. 24 and 30 steps per minute; 30 and 36 steps per minute. These angles measure the slope of the plotted lines and reflect the amount of increase in pulse counts as a result of increasing the rate of stepping. 5. Consult the standard score tables for the Progressive Pulse Ratio test. Write along side each of the raw measures the appropriate standard score. Enclose the standard score in parenthesis - i.e. (55), to ensure differentiation between raw scores and standard scores. *Angle of Break*. Is the angle between the horizontal and the plotted line where i t fi r s t breaks sharply upward from its previously fairly uniform slope. *Angle of Inclination*. Is the angle between the horizontal and the plotted line between 24 and 30 steps per minute. *Terminal Angle*. Is the angle between the horizontal and the plotted line between 30 and 36 steps per minute. Caution; With older individuals and with anyone who is very unfit, the Progressive Pulse Ratio test should be administered before any *all-out» tests like the Harvard Step test. If a subject reacts badly in the Progressive Pulse Ratio test, administration of the Harvard Step test is contraindicated. APPENBJJC I PULSE PRESSURE WAVE MEASUREMENTS 81 Figure 1 Diagram of Pulse' Pressure Wave 82 DESCRIPTION OF PULSE PRESSURE WAVE VARIABLES 1. AREA UNDER THE CURVE (ABOFCA) Two adjacent mitral valve closing points are connected for a single cycle. The area enclosed is traced with a polar planimeter. Each cycle is traced ten times, constituting one reading. The average area for three readings for three cycles is then determined. 2. SYSTOLIC PULSE WAVE AMPLITUDE (AB) The measurement is made with vernier calipers in cms. and hundredths, nearly vertically and parallel to the blue time lines. 3. DICROTIC NOTCH AMPLITUDE (ED) The measurement is made with vernier calipers in cms. and hundredths almost vertical and parallel to the blue time lines; from a baseline joining points A and C. 4. FATIGUE RATIO (DE/AB) This measurement is the ratio of the amplitude of the dicrotic notch to the amplitude of the systole. The measurements are made as previously described. 5. ANGLE OF OBLIQUITY (ABO) The angle is measured from the maximum systolic point of the graph. One line is drawn from point B to the centre of the hole in the graph. The other line is drawn almost tangentially to the upward systolic stroke line, through point A. Three sets, each made up of three cycles, is measured and the average angle is calculated. A protractor is used to measure the angles. 6. PULSE RATE The regular rate of the heart is determined in beats per minute from the heartogram by counting the heart beats made on the graph in fifteen seconds then multiplying by four. The fractional part of a beat is estimated to the nearest tenth of a beat by inspection before multiplication. 7. DIASTOLIC PULSE WAVE AMPLITUDE (FG) The part of the total heartograph in a single cycle which occurs after the semilunar valves close is represented by the diastolic pulse wave. It is measured by vernier calipers from the peak of the diastolic wave to the base line of the cycle, parallel to the blue lines. 83 8. DIASTOLIC SURGE (FH) The measurement of the diastolic surge is made with vernier calipers, parallel to the blue lines from a baseline drawn parallel to the cycle baseline (AC) to the maximum point of the diastolic amplitude. 9. DIASTOLIC TIME (EC) A horizontal measurement taken with vernier calipers from the Diastolic Surge to the end of the cycle. The measurement is taken in linear cms. and hundredths for convenience without conversion to seconds. 10. SYSTOLIC TIME (AE) The measurement is taken horizontally from the start of the systole to the close of the semilunar valves. The result is proportional to the time of systole and is taken in linear cms. and hundredths for convenience without conversion to seconds. 11. REST TO WORK RATIO (AE/EC) This measurement is the ratio of the systole contraction (from the start of the systolic stroke to the point of closing of the semi-lunar valves) to the overall time of diastole (from the point of closing of the semilunar valves to the start of the next systole). Measurements are described in nine and ten. 12. DIASTOLIC BLOOD PRESSURE This measurement is taken directly from the heartograph by reading the properly made line against the scale provided on the graph. The reading is in millimeters. 13. SYSTOLIC BLOOD PRESSURE This measurement i s taken from the heartograph, as in twelve. 14. PULSE PRESSURE The difference between twelve and thirteen is determined by subtraction. 84 APPENDIX J STATISTICAL TREATMENT Study Design Single Group, Test - Retest Experiment (N = 10) Pre-training Test Group Mean Post-training Test Mean (Pre-training Test) - Experimental Factor (Endurance Exercise Program) - X = Difference F Procedure 1. Selection of subjects based upon attendance in previous year's fitness program. 2. Administration of cardiovascular tests to obtain pre-training scores. 3. Voluntary participation of subjects in the University of B.C. Physical Fitness Class held each day 12:30 to 1:30, Monday to Friday in the New Education Gymnasium. The program lasted seventeen weeks. 4. Administration of cardiovascular tests to obtain post-training scores. Cardiovascular Fitness Tests 1. Schneider Test - Variables are: lying pulse rate, standing pulse rate, post-exercise pulse rate, time for pulse rate to return to standing value, difference between pulse rate lying to standing, and standing to post-exercise difference, lying and standing systolic blood pressure and the difference between systolic blood pressure lying and standing, index score. 2. Progressive Pulse Ratio - Variables are: recovery pulse counts for rates of 12, 18, 24, 30 and 36 steps per minute, average ratio and average angle. 85 3. Pulse Pressure Wave (Brachial Sphygmograph) - Variables are: A. Sitting area under curve, systolic amplitude, dicrotic notch amplitude, fatigue ratio, diastolic amplitude, rest-to-work ratio, obliquity angle, systolic time, diastolic time, pulse rate, systolic blood pressure, diastolic blood pressure and pulse pressure. B. Standing area under curve, pulse rate, systolic amplitude, difference between sitting and standing systolic amplitude. C. Post Exercise systolic amplitude. In addition, the following measurements were made on a l l subjects: 1. Body Fat Measurements - Variables are: cheek fold, abdominal fold, hip fold, front thigh fold, gluteal fold, rear thigh fold, sum of a l l , and average. 2. Body Weight General Statistical Outline The significance of the mean difference between pre-training and post-training test scores was determined for a l l variables. Test of significance of correlation co-efficient. H: f> =0 one-tailed test _ 0.05 level of confidence H: f> =fi 0 degrees of freedom N-2 = 8 The value of y necessary to reject H = 0.558 Formulae 1. Group Mean A. X = E X X = Raw Scores for 1 1 Pre-Training Tests N B. x " = E X„ X = Raw Scores for F F F N Post-Training Tests N = 10 86 2. The Mean Difference Between Raw Scores X - X = d d = Difference Between Pre-Training * F and Post-Training Raw Scores d = L d N = 10 N 3» The Variance of the Difference 2 — 2 2 5 2 = I d - d d = Squared Difference Between N Pre-Training and Post-Training Raw Scores _ 2 d = Squared Mean Difference N = 10 4. An Estimate of the Variance of the Sampling Distribution of d S- 2 = 3 2 S 2 d d d = The Variance of the Difference N-l N-l = 9 5« t ratio d = The Mean Difference t = d = d S S 2 S o ~ The estimate of the variance cT , d _ cf-N-l = 9 87 KEY TO APPENDICES K to R K - L Schneider Test Variables 1. Schneider Index Score 2. Difference Between Lying and Standing Systolic Blood Pressure 3. Standing Systolic Blood Pressure 4. Lying Systolic Blood Pressure 5. Pulse Rate Difference Standing - Post Exercise 6. Pulse Rate Difference Lying to Standing 7. Time for Pulse to Return to Standing Value 8. Post-Exercise Pulse Rate 9. Standing Pulse Rate 10, Lying Pulse Rate M - N Progressive Pulse Ratio Test. Variables 1. Total Recovery Pulse Counts - 12 Steps 2. Total Recovery Pulse Counts - 18 Steps 3. Total Recovery Pulse Counts - 24 Steps 4. Total Recovery Pulse Counts - 30 Steps 5. Total Recovery Pulse Counts - 36 Steps 6. Average Ratio 7. Average Angle 0 - P Body Fat Variables and Body Weight 1. Cheek Fold 2. Abdominal Fold 3. Hip Fold 4. Front Thigh Fold 5. Rear Thigh Fold 6. Gluteal Fold 7. Sum of A l l 8. Average of A l l 9. Body Weight 88 Q - R Pulse Pressure Wave 1. Sitting Area Under the Curve 2. Sitting Rest to Work Ratio 3. Sitting Systolic Time 4. Sitting Diastolic Time 5. Sitting Dicrotic Notch Amplitude 6. Sitting Fatigue Ratio 7. Sitting Diastolic Amplitude 8. Sitting Obliquity Angle 9. Sitting Pulse Rate 10. Sitting Systolic Blood Pressure 11. Sitting Diastolic Blood Pressure 12. Sitting Pulse Pressure 13. Sitting Systolic Amplitude 14. Standing Area Under the Curve 15. Standing Pulse Rate 16. Standing Systolic Amplitude 17* Difference Between Sitting and Standing Systolic Amplitude 18. Post-Exercise Systolic Amplitude APPENDIX K PRE-TRAINING SCHNEIDER TEST VARIABLES RAW SCORES Variable Variable Variable Variable Variable Variable Variable Variable Variable Variable 1 2 mm 3 mm 4 mm 5 6 7 seconds 8 1 min 9. 1 min 10 1 min A 15 14 114 128 18 14 60 86 68 54 B 13 5 112 107 16 14 60 100 84 70 C 16 3 120 117 24 0 120 88 64 64 D 15 6 110 116 16 8 60 . 88 72 60 E 20 8 120 112 16 4 60 64 48 44 F 16 8 136 128 16 2 120 80 64 62 G 15 5 112 107 12 12 60 92 80 68 H 18 18 124 106 18 0 120 60 42 42 I 18 2 136 134 14 6 30 78 64 58 J 19 7 105 98 4 10 90 64 60 50 Mean 16.5 7.6 118.9 115.3 15.4 7.0 78.0 80.0 64.6 57.2 APPENDIX L POST-TRAINtNG SCHNEIDER TEST VARIABLES RAW SCORES Variable Variable Variable Variable Variable Variable Variable Variable Variable Variable 1 2 mm 3 mm 4 mm 5 6 7 seconds 8 1 min 9 1 min 10 1 min A 14 4 118 122 12 24 60 96 84 60 B 13 15 120 105 24 8 60 96 72 64 C 17 4 116 112 4 36 30 76 80 44 D 17 3 114 117 14 2 60 76 62 60 E 17 12 129 117 34 0 60 82 48 48 F 19 2 117 , 115 4 14 60 68 64 50 G 16 2 112 110 8 13 30 84 76 64 H 19 6 114 108 12 2 90 60 48 46 I 14 6 131 125 14 6 30 84 70 64 J 18 12 104 92 14 6 60 72 58 52 Mean 16.4 6.6 117-5 112.3 14.0 11.1 54.0 79.4 66.2 55.2 NO o APPENDIX M PRE-TRAINING PROGRESSIVE PULSE RATIO TEST VARIABLES RAW SCORES Subject Variable 1 12 steps Variable 2 18 steps Variable 3 24 steps Variable 4 30 steps Variable 5 36 steps Variable 6 Variable 7 degrees A 139 151 144 200 247 2.59 42.0 B 140 149 162 170 243 2.54 44.5 C 119 145 149 169 207 2.29 26.0 D 156 169 178 213 234 2.54 42.0 E 101 106 112 119 129 2.70 49.5 F 138 153 160 190 218 2.40 33.5 G 154 170 186 226 281 2.59 44.5 H 124 128 135 147 182 2.50 40.0 I 140 142 149 158 170 2.37 31.5 J 129 133 142 160 201 2.51 40.0 Mean 134.0 144.6 151.7 175.2 211.2 2.503 39.35 APPENDIX N POST-TRAINING PROGRESSIVE PULSE RATIO TEST VARIABLES RAW SCORES i.iect Variable 1 12 steps Variable 2 18 steps Variable 3 24 steps Variable 4 30 steps Variable 5 36 steps Variable 6 Variable 7 degrees A 151 161 172 207 234 2.45 47.0 B 153 153 169 207 224 2.64 40.0 C 146 160 181 198 2.27 24.0 D 136 143 166 190 222 2.62 46.0 E 131 131 148 148 178 2.42 35.0 F 123 130 139 163 188 2.55 42.5 G 156 169 107 205 253 2.45 37.0 H 111 121 129 144 177 2.94 56.5 I 138 143 157 161 185 2.31 27.O J 116 122 131 160 177 2.46 37.5 Mean 135.8 141.9 156.8 176.6 203.6 2.511 39.35 APPENDIX 0 PRE-TRAINING BODY FAT VARIABLES RAW SCORES AND BODY WEIGHT Variable Variable Variable Variable Variable Variable Variable Variable Variable 1 2 3 4 5 6 7 8 9 ).ject mm mm mm mm mm mm mm mm pounds A 13.0 10.0 16.0 18.0 17.0 28.0 102.0 17.00 161.25 B 12.0 14.0 28.0 22.0 15.0 18.0 109.0 18.17 171.00 C 9.5 21.0 5.0 14.0 7.0 24.0 80.5 13.42 174.00 D 9.0 18.0 25.0 9.0 9.0 28.0 98.0 16.33 186.00 E 10.0 14.0 18.0 9.0 18.0 8.0 77.0 12.83 156.00 F 10.0 21.0 30.0 19.0 11.0 25.0 116.0 19.33 214.75 G 5.5 13.0 8.0 7.0 5.0 20.0 58.5 9.75 150.50 H 8.0 9.0 15.0 10.0 5.0 18.0 65.O 10.83 160.25 I 8.0 16.0 12.0 8.0 6.0 22.0 72.0 12.00 175.50 J 11.0 11.0 14.0 16.0 12.0 23.0 87.0 14.50 137.00 Mean 9.60 14.70 17.10 13.20 10.50 21.40 86.50 14.416 168.625 APPENDIX P POST-TRAINING BODY FAT VARIABLES RAW SCORES AND BODY WEIGHT Variable Variable Variable Variable Variable Variable Variable Variable Variable 1 2 3 4 5 6 . 7 8 9 Subject mm mm mm mm mm mm mm mm pounds A 13.0 8.0 16.0 11.0 10.0 15.5 73.5 12.25 159.00 B 10.0 8.5 24.5 14.5 13.5 18.0 89.0 14.83 168.00 C 9.0 14.0 6.0 10.0 7.0 18.0 64.0 10.67 172.00 D 10.5 15.0 25.0 8.5 9.0 24.0 93.5 15.83 183.50 E 13.0 12.0 7.0 4.0 0 3.0 39.0 6.50 156.00 F 9.0 18.0 L4.0 12.0 13.0 17.0 83.0 13.83 227.00 G 8.0 16.0 17.0 7.5 6.0 18.0 72.5 12.08 152.00 H 8.0 8.0 17.0 6.0 6.0 14.0 59.0 9.83 158.50 I 7.0 13.0 10.0 8.0 6.0 20.0 64.0 10.66 173.00 J 12.5 14.0 10.0 16.5 10.0 20.0 83.0 13.83 134.75 Mean 10.00 12.65 14.65 9.80 8.05 16.75 72.05 12.031 168.375 APPENDIX Q POST-TRAINING PULSE PRESSURE WAVE VARIABLES RAW SCORES Var. Var. Var. Var. Var. Var. Var. Var. Var. Var. Var. Var. Var. Var. Var. Var. Var. Var. Subj. 1 sq cms 2 3 cms 4 cms 5 cms 6 7 cms 8 deg 9 1 min 10 mm 11 mm 12 mm 13 cms 14 sq cms 15 1 min 16 cms 17 cms 18 cms A 0.14 1.63 0.30 0.49 0.55 0.696 0.62 22.6 64 115 80 35 0.79 0 .18 64 0.77 0.02 0 .80 B 0.30 1.63 0.40 0.65 0.84 0.739 0.87 21.5 62 115 75 40 1.14 0.20 80 0.90 0.24 1.25 C 0.47 2.60 0.25 0.65 0.86 0.494 0.87 21.6 60 105 65 40 1.74 0.49 64 1.40 0.34 1.76 D O.46 3.12 0.26 0.81 0.84 0.950 0.89 25.1 56 105 64 41 1.11 0.30 64 0.99 0.12 1.40 E 0.49 4.65 0.23 1.07 0.77 O.505 0.94 20.8 40 124 66 58 1 .53 0.59 42 1.54 0.01 1.72 F 0.34 4.83 0.18 0.87 0.78 0.598 0.78 21.8 54 114 51 63 1.30 0.26 64 .96 0.34 1.60 G 0.33 2.11 0.27 0.57 0.68 0.698 0.70 22.5 64 102 80 ZZ 0.97 0.49 68 1.02 0.05 1.40 H 0.37 3.50 0.26 0.91 0.90 0.846 0.93 23.1 42 104 67 37 1.07 0.29 48 1.13 0.06 1.32 I 0.33 1.96 0 .27 0.53 0.69 0.560 0.73 19.8 62' 142 75 67 1.23 0.44 72 1.30 0.07 1.64 J 0.38 1.94 0 .34 0.66 0.82 O.669 0.85 22.0 52 97 70 27 1 .23 0 .32 52 0.96 0.27 1.02 Mean O.36I 2.797 0.276 0.721 0.773 O.676 0.818 22.08 55.6 112.3 69.3 43.0 1.211 0.356 61.8 1.097 0.152 1.391 APPENDIX R PRE-TRAINING' PULSE PRESSURE WAVE VARIABLES RAW SCORES Sub.i. Var. 1 sq cms Var. 2 Var. 3 cms Var. 4 cms Var. 5 cms Var. Var. 6 7 cms Var. 8 deg Var. 9 1 min Var. 10 mm Var. 11 mm Var. 12 mm Var. 13 cms Var. 14 sq cms Var. 15 1 min Var. 16 cms Var. 17 cms Var. 18 cms A 0.19 3.27 0.22 0.72 0.62 0.809 0.63 20.4 68 128 88 40 0.76 0.12 72 0.67 0.09 0.76 B 0.28 1.47 0.43 0.63 0.80 0.730 0.81 21.6 64 112 72 40 1.09 0.22 76 0.85 0.24 1.02 C 0.42 1.11 0.36 0.40 0.70 0.824 0.68 23.1 72 111 79 32 .82 0.43 72 1.02 0.20 1.58 D • 0.33 1.91 0.35 0.67 0.70 0.665 0.75 22.3 56 118 82 46 1.06 0.28 72 0.97 0.09 1.08 E 0.55 3.06 0.24 1.07 1.18 0.600 1.27 21.5 44 130 84 46 1.96 0.55 48 2.10 0.14 2.69 F 0.08 4.53 0.19 0.86 0.37 0.454 0.40 26.1 68 117 78 68 .82 0.09 76 0.68 0.14 1.31 G 0.30 2.39 0.28 0.67 0.60 0.694 0.60 27.0 68 105 80 25 .83 0.28 80 0.83 0 0.92 H 0.38 4.52 0.21 0.95 0.71 0.746 0.72 22.0 48 111 55 56 .95 0.31 48 1.05 0.10 1.28 I 0.47 2.21 0.24 0.53 0.49 0.387 0.63 17.6 58 137 72 65 1.26 0.33 68 1.28 0.02 1.53 J 0.14 3.39 0.23 0.78 0.81 0.874 0.84 21.3 52 95 65 30 .93 0.34 56 0.99 0.06 1.14 Mean 0.314 2.786 0.275 0.728 0.698 0.678 0.733 22.29 59.8 116.4 75.5 44.8 1.048 0.295 66.8 1.044 0.108 1.331 

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