The influence of a physical conditioning program on the transient electrocardiographic changes induced by exercise
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THE INFLUENCE OF A PHYSICAL CONDITIONING PROGRAM ON THE TRANSIENT ELECTROCARDIOGRAPHIC CHANGES INDUCED BY EXERCISE
A Dissertation Presented to the Faculty of the Department of Physical Education The University of Southern California
In Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy
Leroy B. Cochran August 1950
UMI Number: DP29688
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T h is d is s e rta tio n , w r itte n by
LEROY B. COCHRAN u n d e r th e g u id a n c e o f h .ls ... F a c u lty C o m m itte e on S tu d ie s, a n d a p p ro v e d by a l l its m em b ers, has been p re se n te d to a n d a cce p te d by th e C o u n c il on G ra d u a te S tu d y a n d R e se a rch , in p a r t ia l f u l f illm e n t o f re q u ire m e n ts f o r th e degree o f DOCTOR
OF
P H IL O S O P H Y
Dean
C om m ittee on Studies
/
C hairm an
TABLE OF CONTENTS
CHAPTER I.
PAGE
INTRODUCTION.............
1
Statement of the pr o b l e m ................... ,
1
Importance of the p r o b l e m ...........
1
Definitions of terms u s e d .............................
2
...................................
2
Electrocardiogram
Electrocardiogram deflections
.......................
Repolarization .......................................
3
Positive w a v e .......................................
3
Negative w a v e .......................................
3
Isoelectric
3
........................................
Positive response II.
2
HISTORICAL DISCUSSION
..... ...................................
3 b
The heart and its autonomic c o n t r o l ................... Diagnostic electrocardiography ......................... Electrocardiography and its place in flight examinations
k
6
Some factors associated with electrocardiographic deviations at rest and under stress Exercise . . .
.................
1 .....................................
7 7
A n o x i a ..............................................
16
Hyperventilation.....................................
18
Acidosis ....................................
20
Posture
.
.....
........................................
20
T e m p e r a t u r e ........................................
21
iii
CHAPTER
PAGE Tests of myocardial function........................... Master's step test
22 22
Two step test
.........................
22
Summary of interpretations of the post-exercise electro
III.
cardiogram ...........................................
2b
METHODS AND PROCEDURES...................................
26
M e t h o d s .............................................. Outline of the problem .
26
...........................
26
P e r s o n n e l ...........................................
26
E x a m i n e r s ...........................................
26
Time s c h e d u l e .................
26
Method of taking an electrocardiographictracing . . . .
27
Determination of cardiac tolerance to stress ..........
28
The administration of the Master's doublestep test
. .
28
Determination of fitness for strenuous w o r k ..........
29
Experimental procedures
...............................
30
.................................
30
Physical conditioning p r o g r a m .......................
31
Second test p e r i o d ...............................
31
Deconditioning p r o g r a m...............................
31
Third test p e r i o d ...................................
32
Records and electrocardiograms .........................
32
S u m m a r y ..............................................
33
First test period
iv CHAPTER
PAGE
IV. R ESULTS.................................................... Statistical analysis of d a t a .............................
3^ 3^
36
Consideration of r e s u l t s ........................... Influence of a six and one-half weeks conditioning program on fitness for strenuous w o r k
•36
The influence of an eight weeks deconditioning program on fitness for strenuous w o r k .........................
37
The influence of a six and one-half weeks conditioning program and an eight weeks deconditioning program on the resting electrocardiogram.........................
38
The influence of a six and one-half weeks conditioning program and an eight weeks deconditioning program on the electrocardiographic response to stress ...........
39
The relationship between fitness for strenuous work
V.
and the post-exercise electrocardiogram ...............
k5
Summary of r e s u l t s ......................................
kj
D I S C U S S I O N ................................................
if9
Interpretations of electrocardiographic changes after conditioning and deconditioning.........................
51
RS-T interval and T d u r a t i o n ...........................
51
P-R i n t e r v a l ..........................................
52
T wave
53
..............................................
Q w a v e ...............................
V CHAPTER VI.
PAGE
SUMMARY AND CONCLUSIONS...................................
56
Summary................................................
56
Conclusions
58
.-..........................................
Recommendations...................................... . . BIBLIOGRAPHY
...........................................
A P P E N D I X ......................................................
59 6l 66
Appendix A
............................................
66
Appendix B
.............................
79
Appendix C
............................................
8l
Appendix D
............................................
98
LIST OF TABLES
TABLE I. IT.
PAGE Changes in Harvard Step Test S c o r e s ..................... Changesin the Army Air Force Physical Fitness Test from Test Period I to Test Period I I .......................
III.
IV. V.
Test Period II to Test Period I I I .....................
68
Changesin Hand Dynamometer Strength Test S c o r e s ........
69
Changes in Post Exercise Heart Rates from Test Period I
...............
* ...........................
71
Changes in Post Exercise Systolic Blood Pressure from Test Period II to Test Period I I I .....................
XI.
71
Changes in Post Exercise Pulse Pressure from Test Period I to Test Period II . . .
X.
71
Changes in Post Exercise Diastolic Blood Pressure from Test Period I to Test Period I I .......................
IX.
70
Changes in Post Exercise Systolic Blood Pressure from Test Period I to Test Period II . . .
VIII.
70
Changes in Post Exercise Heart Rates from Test Period II to Test Period I I I ...................................
VII.
6?
Changes in the Army Air Force Physical Fitness Test from
to Test Period I I ................. ^.................. VI.
66
72
Changes in Post Exercise Diastolic Blood Pressure from Test Period II to Test Period I I I .....................
72
XII. Changes in Post Exercise Pulse Pressure from Test Period II to Test Period I I I .........................
72
vii
TABLES XIII.
PAGE Statistical Summary of Electrocardiographic Deviations after Exercise Stress in Test Period I, Test Period II, and Test Period III
XIV.
............. .
Statistical Significance of Electrocardiographic Changes from Test Period I to Test Period I I .........
XV.
73
7^
Statistical Significance of Electrocardiographic Changes from Test Period II to Test Period I I I ........
XVI.
Relationship of Normal and Abnormal Exercise Electro cardiograms (T wave) and Harvard Step Test Index Scores for Test Period I and Test Period II in Leads I, II, and I I I ...........................................
XVII. XVIII. XIX.
Personal Data on Experimental Subjects
.................
Harvard Step Test Scores for Test Periods I, II, and III
85
89
91
Pulse Pressures on the Harvard Step Test for Test Periods I, II, and I I I ...............................
XXIII.
82
Diastolic Blood Pressures on the Harvard Step Test for Test Periods I, II, and I I I ...........................
XXII.
.
Systolic Blood Pressures on the Harvard Step Test for Test Periods I, II, and I I I ................. '........
XXI.
81
Resting and Recovery Heart Rates on the Harvard Step Test for Test Periods I, II, and I I I .................
XX.
78
93
Army Air Force Fitness Test Scores for Test Periods I, II, and I I I .......................................
95
viii
TABLE XXIV.
PAGE Hand Dynamometer Strength Test Scores for Test Periods I, II, and III
XXV.
.....................
97
Electrocardiographic Measurements in Seconds for the Length of the RS-T Interval, Lead I, Test Periods I, II, and I I I ..................
XXVI.
98
Electrocardiographic Measurements in Seconds for the Length of the T Duration, Lead I, Test Periods I, II, and I I I .........................................
XXVII. Electrocardiographic Measurements in Millivolts
100
for the
Height of the T Wave, Lead I, Test Periods I, II, and I I I ............................................. XXVIII.
102
Electrocardiographic Measurements in Millivolts for the Height of the T Wave, Lead II, Test Periods I, II, and I I I .............................................
XXIX.
lOil-
Electrocardiographic Measurements in Millivolts for the Height of the T Wave, Lead III, Test Periods I, II, and I I I ............................................
XXX.
106
Electrocardiographic Measurements in Millivolts for the Depth of the Q Wave, Lead I, Test Periods I, II, and I I I .............................................
XXXI.
Electrocardiographic Measurements in Millivolts
108
for the
Height of the QRS Complex, Lead I, Test Periods I, II, and I I I ............................ '............
110
ix
TABLE XXXII.
PAGE Electrocardiographic Measurements in Seconds for the Length of the P-R Interval, Lead I, Test Periods I, II,
XXXIII.
and
III. . .
* ............... ;............
112
Electrocardiographic Measurements in Seconds for the Length of the T-P Interval, Lead I, Test Periods I, II,
XXXIV.
and
I I I .......................................
Ilk
Electrocardiographic Measurements in Seconds for the Length of the P-P Interval, Lead I, Test Periods I, II,
and
I I I .......................................
116
LIST OF FIGURES
FIGURE 1. 2.
PAGE
The Normal Electrocardiogram...........................
79
Changes in Post Exercise Electrocardiographic Mean Measurements, Lead I, Test Periods i, II, and III . . .
80
CHAPTER I
INTRODUCTION
^
The heart and its autonomic Gontrol ie often the limiting factor
in man's ability to work under stress.
Man's cardiovascular system is
subjected to various stresses such as hypoxia and accelerative forces during maneuvers^fn high speed aircraft.
Thus it is important that a
flyer's physical condition, particularly his circulatory system, is maintained at a sufficiently high performance level to enable him to withstand these stresses.
Some preliminary electrocardiographic obser
vations (Morehouse, 19^6) have indicated that a program of frequent and regular exercise may increase cardiac tolerance to stress.^
Statement of the problem. The purpose of this study was to inves tigate the influence of a physical conditioning program on the cardiac response to stress by means of electrocardiographic records. mental design of this problem consisted of three phases:
The experi
first, to deter
mine the heart's tolerance to standard work loads; second, to determine the influence of a physical conditioning program on the ability of the heart to withstand added stresses; third, to investigate the cardiac re sponse to stress after a deconditioning program.
Importance of the problem. Exercise amplifies cardiac function, and deficiencies in function that could not be detected at rest may become observable.
One of the more sensitive indications of cardiac function is
the electrocardiogram.
Although the electrocardiogram may be limited in
2 its application, it does, however, detect signs of weakness in the heart muscle.
An understanding of the relation between fitness for stress and
electrocardiographic response to exercise may form the basis of a simple test of stress tolerance. Furthermore, the heart, like any other muscle is subjected to atrophic changes if not frequently and regularly exercised. terioration would reduce tolerance to added stresses.
Such de
An understanding
of the influence of a conditioning program upon cardiac tolerance to stress is an important consideration in establishing the basis for optimum physical training programs for flyers.
y
Definitions of terms used,
(l) Electrocardiogram. A graphic
tracing of the electric current produced by the contraction of the \/ heart muscle./N
(2) Electrocardiogram deflections. The normal electrocardiogram consists of a series of deflections P, Q, R, S, and T, with time elements between.
The P wave represents the spread of activation process through
the auricles.
The QRS complex represents the spread of activation through
the ventricles, in which depolarization occurs.
The RS-T segment repre
sents the interval between depolarization and repolarization of the ven tricles.
The T duration represents the time required for repolarization.
The T-P interval represents the time from the end of repolarization of the ventricles to the beginning of depolarization of the auricles. P-R interval is the time required for the impulse to spread from the
The
sino-auricular node to the ventricles.
S-T depression signifies the
deflection of the S-T segment from the isoelectric line.
The P-P
interval is the time required for the complete cardiac cycle.
r
(3) Repolarization. An alteration of negatively and positively
(
/
,
I charged
! I
ions during restitution period of the ventricles, in which
.
^ there is a flow of electrical potential.
(^) Positive wave. A wave that deflects above the isoelectric line.
(5) Negative wave. A wave that deflects below the isoelectric line. (6) Isoelectric. Indicates the phase of the electrocardiogram in which there is no flow of electrical potential from the heart.
(7) Positive response. Indicates that the subject’s post exercise electrocardiogram is normal.
\ 1
/
CHAPTER II
HISTORICAL DISCUSSION THE HEART AND ITS AUTONOMIC CONTROL
Bozler (19^2) made a study to determine the origin of cardiac impulses.
He used strips of cardiac muscle from rabbits, cats and dogs
and recorded the electrical current produced from various parts of the muscle on and near the sino-auricular node.
The precise origin of the
impulses in a spontaneously beating muscle strip was found by placing the leads close together and by determining the point where the direction of the deflection reversed itself if the leads were successfully shifted in one direction along the muscle preparation.
Pre-potentials which did
not resemble the rhythmic potentials were observed.
DIAGNOSTIC ELECTROCARDIOGRAPHY
Katz, Goldman and Langendorf (19^2) investigated the diagnostic value of the electrocardiogram based on an analysis of 1^9 autopsy cases. The important phase applicable to this study was the diagnosis of normal electrocardiograms.
Electrocardiograms were analyzed without knowledge
of the patient’s pathologic record.
The following criteria were set up
for a normal electrocardiogram: P-R interval between .12 and .21 seconds. QRS interval .10 seconds or less. QRS amplitude of more than 15 mm. (1.5 mv.).
Q wave (defined as an initial inverted phase of a diphasic QRS, measuring l/k or more of the upright phase) was absent. S-T depressions of not more than .5 nun. and S-T elevations of not more than 2 ram. T wave in Leads I and II was upright and not notched. In analyzing the S-T and T deflections, the combined ST-T complex was considered of more significance than the degree of the S-T deviation. When the autopsy records were compared with the standards set up, only one electrocardiogram was wrongly classified. was very high.
The resulting correlation
There was a high degree of consistency in that no electro
cardiogram was abnormal when the heart was normal. Nahum, Hoff and Kisch (19^1) investigated the significance of the displacement of the S-T segment.
In order to study the causes of S-T de
flections, they experimented with exposed hearts of twelve cats, dogs and monkeys.
They observed that elevation of the S-T segment might be caused
by injury to the left ventricle and that injury to the right ventricle caused a depression of the S-T segment.
When the injury was restricted
to a single ventricle, deflection of the S-T segment was in the same direction for all leads.
Elevation of the S-T segment in one lead and
depression in another indicated that the damage involved areas of both ventricles.
They pointed out, however, that factors other than damage
to the heart muscle could have caused the S-T deflections. Blair, Wedd and Young (19^1) investigated the relation of the Q-T interval to the refractory period, diastolic interval, duration of contraction and rate of beat in the heart muscle. Ten subjects were
6 studied in an attempt to determine whether the drifting of Q-T would occur in the human heart.
They noted that the heart rate was deranged
by a short period of exercise.
Following exercise, with the heart rate
higher, the Q-T interval was considerably shortened:
although the heart
rate returned to normal after exercise, the Q-T interval remained short, but gradually lengthened to the pre-exercise value.
It became evident
from this study that the Q-T interval was subject to influences other than those directly related to heart rate and that there was no direct relationship between heart rate and Q-T interval alone. Ashman (19^2) determined the normal duration of the Q-T interval in relation to the cardiac cycle.
He selected a large group of subjects
whose electrocardiograms were normal and computed the relationship be tween the Q-T interval and the length of the cardiac cycle.
He then
developed a formula to show the close relationship between the two. Evidence from this study indicated that the Q-T interval alone was meaning less unless the cardiac cycle length also was considered.
Electrocardiography and its place in flight examinations. Leedham (1939) surveyed the possibilities and limitations of electrocardiography in examinations for flying.
Because the electrocardiogram indicates and
differentiates arrhythmias and blocks, he believed that electrocardio graphy should have an important place in flight examinations.
SOME FACTORS ASSOCIATED WITH ELECTROCARDIOGRAPHIC DEVIATIONS AT REST AND UNDER STRESS
Exercise. Hoogenwerf (1930) studied the electrocardiographic re cords of 260 Olympic athletes before and after competition in Amsterdam. His examinations indicated that severe bradycardia with slow impulse con duction in the atria could be borne without complaint.
Strenuous compe
tition caused an increase in the P-Q, interval, a diminution of the QRS interval and an increase in the duration of the QRST interval. In all athletes the T wave peak was very high during rest.
The author considered
the peak height of the T wave as an indication of ideal cardiac function. From this, it would appear that systematic physical training enabled the heart to withstand the stress of more strenuous physical activity. Knoll (1932) investigated the effects of stress on the electro cardiogram in Lead 1 during the work period.
His subjects were twelve
highly trained athletes who performed forty seconds of knee bending while their arms were immobilized.
Electrocardiograms were taken simultaneously.
The electrocardiographic responses varied in frequency and intensity. most frequently observed deviations were:
The
depression of the T wave and
S-T segment and duration of the QRS interval; however, the direction of the deflection was not consistent.
Knoll (1932) believed that the con
dition of the heart was related to the changes in the electrocardiogram and that different types of work produced different and varying reactions in the heart. Takenaka, Yasaki, Mandai and Saito (1931) studied seventy-two
8 athletes to determine the influence of various athletics, including Judo, rugby, swimming, basketball, hockey, jumping, and riding, on the electrocardiographic waves. after exercise.
Electrocardiograms were taken before and
The following changes were observed:
the height of
the T wave was increased in nearly all cases, and the Q wave also showed an increase in height, although less marked.
The increase in the height
of the T wave was most marked when the subjects participated in strenuous activities to which they were not accustomed. The calculated changes in the impulse conduction time and the ventricular contraction time after bodily exercise were determined by Saito, Mandai, Yasaki and Takenaka (1931)•
From this study these authors
reported that there is a 36 per cent decrease in the heart cycle (P-T), a 6l per cent decrease in the pause (T-P) and a 16 per cent decrease in ventricular contraction
time after bodily exercise.
In these estimations
the impulse production time (P-P) was considered only in the absolute terms of the electrocardiogram, not in terms of pulse rate.
By taking
production time (P-P) into consideration, measurements (in .01 seconds) were made at various intervals on the electrocardiogram before and after exercise.
The 1^4 experimental subjects were divided into two groups,
practiced and non-practiced.
In the non-practiced group the impulse
conduction time was prolonged and the ventricular contraction time was shortened after exercise with no exceptions.
In the practiced group, the
impulse conduction time was prolonged in forty-one cases and shortened in 31 cases.
The ventricular conduction time diminished in fifty-four cases
9 and increased in eighteen cases.
These data showed a reverse in ^3 per
cent for impulse conduction time and 25 per cent for impulse contraction time.
An attempt to explain these changes was not made by the authors. The influence of physical exercise on impulse conduction and con
traction time was also studied by Takahashi, Sato, Mikawa, Nomura, Maek&wa and Miyama (1928-1929)• The post-exercise electrocardiograms of one hundred subjects, consisting of both athletic and pathologic, were studied and compared with records taken at rest.
These investi-
.gators reported findings similar to those of Saito, Mandai, Yasaki and Takenaka (1931-1932). In the pathologic cases, as shown by their electro cardiograms, the impulse conduction time and contraction time tended to increase or deviate from the calculated normals.
It was concluded that
the post-exercise electrocardiograms of the athletic subjects approached the normal, whereas, the electrocardiograms of the pathologic subjects deviated from the normal. In this series of studies on physical exercise, Takahashi, Sato, Mikawa, Nomura, Maekawa and Miyama (1928-1929) determined the relationship between impulse production and impulse conduction of the heart before and after athletic exercise (200 and 1500 meter run), and the influence on the electrocardiogram.
Both athletes and non-athletes were studied.
It was
found that when the impulse production was accelerated after exercise, the conduction of the impulse approached the calculated value or decreased for the practiced athlete, but receded or increased for the non-practiced athlete.
The T wave of the post-exercise electrocardiogram generally
increased in height.
These authors believed that the wave changes were
10 probably the result of an increase in the contractility of the heart by exercise, which consequently produced a stronger action current of the heart.
Cases of arrhythmia after exercise were not observed. Cunoon and Pettit (1932) studied the electrocardiographic response
of a woman thirty years old after a forty-three hour salt-water swim. After cessation of the work, the blood pressure was 118/100 mm. of mercury and the electrocardiogram showed a moderate degree of left ventricular pre dominance.
After nine hours of rest, the blood pressure was 108/72 mm. of
mercury; no electrocardiogram was taken.
After ninety-six hours of rest,
the blood pressure was 110/72 mm. of mercury and the electrocardiogram showed a lesser degree of left ventricular predominance. Cassinis and de Negri (1933) investigated the influence of sports activity on the electrocardiogram.
Ten subjects were employed for this
experiment, eight of whom were normal and two of whom had shown abnormali ties in previous electrocardiograms taken with the subjects resting.
The
two abnormal cases showed a mild disturbance of the functional equilibrium, specifically the T wave, and indications of slight flutter.
It was ob
served that muscular work caused the disturbance to disappear and re establish normal conductibility. Ludwig (1933) investigated the electrocardiographic changes result ing from skiing at the F.I.S. games at Innsbruck, Austria in 1933*
Exami
nations before and after the contest were made on thirty-two contestants, fifteen of whom competed on the 18 kilometer course and seventeen of whom competed on the 50 kilometer course.
The following observations were made
11 after the contest:
The peak of the T wave was always good; changes in
the height of the P, R and T waves; changes in the sense predominance of the right heart; a negative T wave in Lead 2, indicatin g severe fatigue of the heart; and diminution of all peaks.
Ludwig emphasized the import
ance of electrocardiography in detecting and interpreting early functional disturbances of the heart. In 193^ Caccuri observed the electrocardiographic modifications on sixteen healthy athletes after administering a test consisting of knee bending and a 300 yard run.
Bradycardia appeared in three cases, the
T wave was higher and fuller (width T-T) , and intervals P-R, S-T and QRS presented normal and uniform behavior.
This investigator believed
that the modifications of the pulse, the changes in the waves, especially the T wave, could be interpreted as phenomena of a sympatho-vago-diffused nature because these changes appeared in the normal as well as in the fatigued state. Schlomka and Reindell (193^) made electrocardiographic observations on sixteen well trained athletes after subjecting the heart to stress. The subjects exercised by deep knee bending for varying time intervals. From examination of the electrocardiograms taken after exercise, it was determined that the reactive changes in the electrocardiogram depended on the severity of the burden.
Up to twenty knee bends, the height of the
T wave decreased; conversely, with heavier work loads, the height of the T wave increased considerably, approaching the initial value and even exceeding it considerably after maximum performances.
The height of the
12 T wave then diminished moderately but, apparently, only to a limit (total amount of work was not reported). After light work loads, the QRS was not shortened; after heavy work loads, the width of the QRS complex diminished to a certain degree*
Thus, these investigators demonstrated
that the direction and the degree of T wave deviation in response to various intensities of work depended on the ability of the heart to per form optimally under stress. An investigation was made by Katz and Landt (1935) of the effect of standardized exercise on the electrocardiogram and its value in the study of coronary disease.
Twenty-three angina patients were given
exercises of varying intensity, following which electrocardiograms were taken.
On the basis of their results these authors concluded that the
use of the exercise test, together with the interpretation of the elec trocardiogram, was a valuable aid in ascertaining the status of the coronary circulation. An investigation of the effects of vigorous exercise (a game of squash) was made by Cooper, Sullivan and Hughes (1937) on the post exercise electrocardiograms of twenty-five oarsmen.
It was observed that
the T wave increased in Lead I but decreased in other leads.
Inversion
of the T wave in Lead III was common, but after exercise the depth of the S-T deviation below the isoelectric line was usually increased (depressed) and the R wave was usually greater.
These investigators found that a
change in the electrocardiogram began very soon after exercise started and continued after the actual muscular movements ceased, even when the
13 heart rate had returned to its resting level. Master, Friedman and Dack (19^2) found that normal subjects could perform the Master’s Double Step Test and the electrocardiogram would remain negative; if however, the amount of exercise was increased, the response was positive, thereby demonstrating coronary insufficiency. After studying one hundred normal subjects of an athletic type, Tuttle and Korns (19^1) concluded that an improvement in physical condi tion, in general, produced only negligible changes in the electrocardio gram; however, it was their opinion that the level of physical condition was not adequately controlled in their study. Barrow and Ower (19^3) made an extensive investigation on one hundred athletes.
After administering the Schneider Test (Schneider,
1920), they took post-exercise electrocardiograms.
Those subjects having
positive electrocardiograms were given another exercise test of longer duration.
In a few cases the distortion of the T wave and S-T segment
disappeared with vigorous and prolonged exercise, which may be con sidered as occasional variants of the normal electrocardiogram. Stokes (19^6) selected subjects who had abnormal records or T wave deformities to perform a series of exercises until they were fatigued or breathless.
After exercise he observed an elevation of the T wave in
approximately 25 per cent of the cases.
He could not postulate from this
experiment, however, that restoration of the T wave to normal was brought about by relief of myocardial ischemia since the deformed T wave of hyper ventilation responded in the same manner.
Ih Gotshalk and Hartwell (19^-6) studied one hundred normal subjects to investigate the influence of knee-bending on the post-exercise elec trocardiogram.
They found a noteworthy diminution in the height of the
QRS in Lead I and depression of the S-T segment in Lead II; moreover, they observed a lower amplitude of the T wave following exercise in eighty-three cases. Baum, Malmo and Sievers (19^5) made a comparative study of the electrocardiographic response to exercise and anoxia on twenty-three subjects. depressed.
They noted that both the T wave and the S-T segment were The depression of the S-T segment was more pronounced than
the reduction in the height of the T wave.
The correlation between the
two sets of data was .86 . They concluded that exercise tests and anoxic tests could be used interchangeably. Master (19^2) examined the correlation between the effects of exercise and anoxia by observing changes in the electrocardiogram;specifi cally, the T wave and S-T segments as they were known to alter in both anoxia and exercise.
Electrocardiograms were taken after the Master1s
Step Test and also at an altitude of 18,000 feet for comparison.
In both
cases it was noted that the T wave lowered and the S-T segment was depressed, the latter change being more pronounced.
These deviations were
observable for six minutes before returning to normal.
Correlation between
the deviations of the two sets of data was .86 . Master believed that factors common to both anoxia and exercise appeared to be responsible for flattening of the T wave and for depression of the S-T segment.
It was
15 his conclusion also that tests for exercise tolerance and anoxia could be used interchangeably. Twiss and Sokolov (19^2) made a study on one hundred control sub jects to determine the effect of physical work on the post-exercise electrocardiogram.
They noted that exercise produced a relative lengthen
ing of the systole as an after-effect; moreover, that the QRS complex was little shortened as a result of exercise.
A normal electrocardiogram
with an upright T wave in Lead I in no case had a diphasic or inverted T wave after exercise.
The P-R conduction time, as well as the duration of
the QRS complex, remained within normal limits except in one case in which a QRS interval of .10 mm. increased to .12 seconds.
These investigators
concluded that the abnormal electrocardiographic response to exercise con sisted of depression or elevation of 1.0 ram. or more in Lead I of the S-T segment. Hartwell,"Burrett, Graybiel and While (19^2) studied the influence of acute exercise on the post-exercise electrocardiogram, with particular reference to T wave changes.
Five subjects were given vigorous exercise
on an orthopedic exerciser and electrocardiograms were taken after exer cise at the third and twelfth minutes during recovery.
In three subjects
electrocardiograms were taken just prior to a stepping exercise and for two minutes thereafter.
It was noted that exercise caused slight flatten
ing of the T wave in Lead II in all electrocardiograms and flattening of the T wave in Lead I in all but one case; also, that within one-half minute after cessation of exercise, the flattened T waves began to return to (or surpass) their former heights.
16 Butterworth and Poindexter (19^2) investigated the effect on the electrocardiogram of trauma caused by severe chest blows sustained in strenuous bouts of boxing.
Electrocardiograms were taken before and imme
diately after three rounds of two minutes each. tions observed were:
The post-exercise devia
A decrease in the Q-T interval, a slight decrease in
the height of the R wave, inversion of the T wave and a definite decrease in the height of the T wave in four of the thirty-five cases.
All other
phases of the electrocardiogram were not significantly changed.
There is
no evidence from this study that trauma of this nature to the chest wall caused any change in the heart.
Their observation of a definite decrease
in the height of the T wave disagreed with Barber, Malmo and Ronzoni (1929)> who studied four normal subjects before and after exercise and reported that "Exercise is followed by acidosis and by a striking increase in the amplitude of the T wave.”
Anoxia. As a result of exercise it is possible that a temporary state of artificial hypoxia exists which may influence the electrocardio graphic response to exercise.
Katz, Hamburger and Schultz (193*0 investi
gated the effect of anoxemia on the electrocardiogram.
Anoxemia was
induced by requiring subjects to inhale from a recording segment spirometer which removed the carbon dioxide until the subject felt moderately un comfortable.
The most consistent changes in the electrocardiograms were
flattening of the T wave and shifting downward of the S-T segment to the isoelectric line or even below.
These changes were progressive and
developed gradually as the oxygen in the inspired air decreased.
The
17 electrocardiograms were restored to their original form when the subjects again breathed normal air.
It was concluded that anoxemia caused undue
strain on the heart and might be a severe hazard to patients with heart disease. In 1939t May investigated the effect of gradually induced oxygen deficiency on fifty normal subjects in various age groups.
He found that
gradually induced anoxemia accelerated the heart rate, the degree of acceleration varying in different subjects.
The changes were always of
the same nature, that is, flattening, eradication or inversion of the T wave and occasionally depression of the S-T segment.
The effect of oxygen
deficiency, as measured by diminution in the height of the T wave, lessened considerably in young individuals.
There appeared to be a striking rela
tionship between exercise tolerance and the degree of diminution in the height of the T wave.
Complete obliteration of the T-wave occurred
exclusively in persons who were extremely active or athletes.
It was
suggested that the T wave might be regarded as evidence of myocardial impairment.
The fact that the highest degree of reduction in the height
of the T wave occurred in young, athletic subjects strongly indicated that these changes were associated with greater adaptability. The effect on the electrocardiogram of anoxia developed in high altitude flights was studied by White (19*+0) . Forty-five normal subjects were exposed to anoxia by flights to altitudes of 20,000 feet, varying rates of ascent and to an altitude of 15>QQ0 feet for a period of two hours. Significant changes in the electrocardiogram were noted consisting of an
18 early increase in heart rate and a decrease in voltage of the T wave. The deviations were first noted at 5>000 feet and became progressively greater with increasing altitude.
During the two hour flight at 15,000
feet compensatory mechanisms caused a decrease in heart rate and an increase in voltage of the T wave.
It was observed further that all
changes were reversed by the administration of oxygen.
The evidence
from this investigation supported the theory that myocardial anoxia is a contributing factor in the production of the symptoms of coronary disease. Levy,
Bruenn and Russell (1939) studied the changes in the elec
trocardiogram caused by induced anoxia as a test for coronary insuffi ciency.
Changes in the form of the electrocardiogram were analyzed
following the induction of anoxemia for 105 subjects, 66 normal and 39 with heart disease.
In examining the records of the normal subjects, it
was observedthat the S-T junction was any lead and
not displaced more than 1 mm. in
that the Twave tended to decrease in amplitude.
healthy subjects responded positively to anoxia. was considered to be:
All un
An abnormal response
(l) a change in S-T deflection without change in
the T wave; (2) inversion of the T wave, especially in Lead I; and (3) deflection of the S-T segment and inversion of the T wave.
A depression
of the S-T segment of as little as .5 *ma. was considered an abnormality in the electrocardiogram. Hyperventilation. It is possible that an individual may hyper ventilate at the onset of exercise as a result of disturbances of the
19 nervous system or acid base balance.
Christensen (19^6) investigated
the possibility of coronary insufficiency as a result of voluntary hyper ventilation for a period of five minutes.
He reported that the T wave
decreased 2.5 mm. in Lead I and the S-T segment was depressed 1 to 1.5 mm.
He believed that hyperventilation brought about hypoxemia, probably
as a result of increased intra-myocardial tension caused by the acapnia and alkalosis; also, that the changes in the T wave might be the result of a change in position of the heart brought about by local tetany of the diaphram. A similar study to Christensen*s was made by Scherf and Schlachman (19V 7) . Fourteen subjects voluntarily hyperventilated for a period of five minutes, during which time the blood Ph was determined.
The electro
cardiographic responses were found to be the same as those observed by Christensen (19^6), but there was no correlation between the shift of the blood Ph to alkaline and the electrocardiographic change. In a more thorough study by Thompson (19^3) it was observed that in healthy subjects maximum alkaline shifts occurred at the same time that the maximum electrocardiographic abnormalities developed.
The
abnormalities were attributed to alkalosis, but it appeared that this was not the sole factor in altering the electrocardiogram. Barker, Shrader, and Ronzoni (1939) also consistently observed changes similar to those induced by hyperventilation; the T wave being depressed in nearly all of the sixteen normal subjects.
These investi
gators found that the same results could be produced by ingestion of
20 large quantities of sodium bicarbonate and that if the blood Ph shifted to acid, the height of the T wave increased. Brock (19^6) studied the influence on the electrocardiogram of the acid-base balance and dehydration.
Consistent deviations were observed
during extreme alkalosis and acidosis.
As a rule, these changes were con
comitant with a disturbance in the water balance.
Changes in the electro
cardiogram were chiefly depression of the S-T segment in one or more leads and, in some cases, a high but not very broad T wave was observed.
When
the water balance was restored to normal, the marked electrocardiographic abnormalities disappeared without any biochemical normalization neces sarily attained. Potassium injections also altered the electrocardiograms in the samemanner, but
the author did not offer an explanation as to why this
occurred.
Acidosis.
Exercise results in a disturbance of the acid base
balance of the blood.
This physiological change may influence the post
exercise electrocardiogram.
Deviations in the electrocardiogram caused
by the administration of carbon dioxide were studied by Altschule and Sulzback (19^7)* who stated that changes attributed to anoxia or ischemia might develop when the content of carbon dioxide in the arterial blood was high and other factors making for increased tissue carbon dioxide tension existed; however, this was demonstrated in only two cases.
s/ Posture. Exercise, in which heart rate and respiratory rate r increase, causes a change of the position of the heart with relation to
the intrathoracic lining and diaphram. the post-exercise electrocardiogram.
These changes may he related to Scherf and Weissberg (19^-1) found
that deviations of the T "wave occurred regardless of exercise.
If the
subject resumed the supine position after exercise, it appeared, in general, that the electrocardiogram tended to return immediately to its former height and configuration.
These authors suggested that neither
anoxia nor insufficient blood supply was responsible for the depression of the T wave but, rather, a change in posture, and therefore, a change in contact between the heart muscle and the neighboring tissues. The significance of posture in the evaluation of electrocardio grams was studied by Ylvisaker and Kirkland (19^0) on thirty-seven normal subjects.
They observed that, in general, there was S-T and T-P distor
tions when subjects changed from the recumbent position.
The marked
changes in T wave configurations as a result of alteration of body posture increased the possibility of diagnostic errors considerably.
Temperature. Increased physical activity causes an increased body temperature. gram.
This change may be related to the exercise electrocardio
Byer, Ashman and Toth (19^7) exposed a dog's heart and controlled
the temperature of the heart muscle. They observed electrocardiographic changes which occurred as a result of temperature change, f Cooling
^
_
r) f
#/rnT
caused an increase in the QRS interval and warming caused the T wave to invert.1 It was noted further that warming the heart muscle accelerated
n 3
£repolarizationNemd cooling slowed repblarization.
These authors believed
that the large, upright T waves in the human electrocardiogram, together
with prolongation of the Q-T interval, might often be the result of ischemic changes preponderantly involving the muscular layers at the endocardial surface of the left ventricle.
TESTS OF MYOCARDIAL FUNCTION
Master1s Step Test. Master and Oppenheimer (1929) stated that an objective test of cardiac function was of importance in distinguishing functional from organic heart diseases.
It was useful in diagnosis and
was helpful in studying the functional state of the heart or the degree of physical disability.
These investigators devised two steps, nine
inches by twenty-two inches, which the subject ascended and descended at a specified rate.
One hundred fifteen subjects, ranging in age from 10
to Jk years were employed for this study.
Blood pressures and heart rates
were taken following the known amount of work accomplished, which was measured in foot pounds and were used as an index of recovery.
The maxi
mum number of steps was used as a standard for that age, weight and sex. These investigators concluded that within limits this test determined exercise tolerance and the degree of circulatory insufficiency; also, that circulatory efficiency could be observed during a program of organic conditioning of the heart.
Two Step Test. Master (193^) did additional work on the develop ment of the Two Step Test of myocardial function.
He employed over
three hundred subjects of both sexes, ranging in age from ^ to 7^ years.
23 The average exercise tolerances for all ages, weights and sexes were determined and standard tables prepared, which indicated the amount of work to be done.
On the basis of the results of this study, it was con
cluded that the exercise tolerance test might be the only objective test for myocardial function.
This test is a definite aid in the diagnosis
and evaluation of cardiovascular disease and in determining the type and extent of work or sport in which a person may participate.
Clinical
experience, mathmatical deductions and physiologic reasoning'1appear to prove that the test is an index of myocardial function. Master, Friedmand and Dack (19^2) used the standardized Two Step Test to determine negative or positive myocardial function for sixtyfive subjects who included both healthy individuals and cardiac patients (angina pectoris). They found a consistently positive response in cases of angina pectoris as evidenced by electrocardiographic deviations, namely, S-T depression and T wave inversion.
Depression of the S-T seg
ment to more than .5 mm. below the isoelectric line, an alteration from a positive T wave to a flat or inverted T wave, or a change from a pre viously inverted T wave to a flat or upright T wave was considered an abnormal response in the electrocardiogram.
The S-T depression and T wave
inversions were the changes commonly observed;„occasionally, multiple pre mature beats, widening of the QRS interval, deep Q waves, prolongation of the P-R interval or heart block may occur.
These investigators believed
that S-T depressions and T wave inversions were due to the anoxemia of the myocardium resulting from a discrepancy between the coronary blood
2k flow and the increased demand of the myocardium for oxygen.
In other
words, exercise induced a transient coronary insufficiency which was relieved in a few minutes by rest.
SUMMARY OF INTERPRETATIONS OF THE POST-EXERCISE ELECTROCARDIOGRAM
The post-exercise electrocardiographic changes observed by various investigators are summarized below.
Some factors which are probably re
lated to the exercise electrocardiogram are also included. RS-T interval.
It has been found by some investigators that the
length of the QRST interval increased after an exercise stress.
Other
investigators have found that the length of the Q-T interval decreased after vigorous exercise. T. duration.
It has been found that the length of T duration was
directly related to the heart rate.
If the heart rate increases, the
length of T duration tends to increase also; if the heart rate decreases, the length of T duration tends to decrease. T wave.
Conflicting findings have been reported on transient post
exercise electrocardiographic exercise T wave changes.
Some workers found
that the height of the T wave decreased or inverted after exercise, while others found that the height of T wave increased.
A relatively large up
right T wave was observed in health athletes. It was observed that anoxemia and hyperventilation decreased the height of the T wave.
Electrolyte balance, posture, and temperature may
decrease or increase the height of the T wave.
25 T-P interval.
The length of the T-P interval varies directly
with the length of the cardiac cycle.
If the cardiac cycle increases
or decreases, so does the length of the T-P interval. Q wave.
The depth of the Q wave was observed to increase after
an exercise stress.
There were no findings that showed a decrease in
the depth of the Q wave after an exercise stress. QRS interval.
The length of the QRS interval was found to decrease
after an exercise stress by some investigators.
Others, however, found
that the length of the QRS interval incerased after an exercise stress. QRS amplitude.
The height of the QRS complex was found to increase
after an exercise stress if the subject had conditioned.
The height of
the QRS complex was found to decrease after any one specific exercise stress.
No findings were observed to be significant after a decondition
ing program. P-R interval.
Investigators reported that the length of the P-R
interval increased after an exercise stress. P-P interval.
The length of the P-P interval (cardiac cycle) was
found to decrease immediately after an exercise stress and increase during the recovery period following the exercise. P-P interval increased after a conditioning program.
The length of the
CHAPTER III
METHODS AND PROCEDURES
METHODS
Outline of the problem* Resting and post-exercise electrocardio grams were recorded for fifty-four healthy male university students who participated in a physical conditioning program lasting six and a half weeks and a deconditioning program lasting eight weeks.
Physical fitness
index scores were also obtained before conditioning, after conditioning, and after deconditioning to ascertain the changes in their performance levels.
Personnel. In this study the majority of the subjects were physi cal education majors.
Twenty-five were members of athletic teams.
The
subjects ranged from nineteen to thirty-three years of age (average, twentyfour years). The weight range of the subjects was from 125 pounds to 250 pounds (average, 175 pounds).
See Appendix C.
Examiners. All electrocardiogram tracings and measurements of physical fitness were taken by six trained graduate students at the Uni versity of Southern California under the supervision of a physiologist. The reliability of the blood pressure measurements on the physical fit ness indices was within 5 nim. of mercury.
Heart rates were taken by an
experienced operator of the electrocardiograph.
Time schedule. The first test period was from September 30, 19^9 to October 15 , 19^9*
After all subjects had been tested for their post-
exercise electrocardiographic responses to stress and fitness for strenu ous work, a six and one-half weeks* conditioning program was administered from October YJ, 19*1-9 to December 1, 19*1-9• At the end of the conditioning program the subjects were retested, using the same tests administered during the first test period.
The second test period was from December 1,
19^9 to December 16, 19*1-9• The subjects were than instructed to cease participation in the systematic conditioning program for a period of eight weeks.
This deconditioning period lasted from December 16, 19*1-9 to
February 10, 1950, which included Christmas vacation, final examinations, and registration period at the university.
At the end of the decondition
ing period, from February 10, 1950 to March 15 } 1950, the subjects were tested the third time.
Method of taking an electrocardiographic tracing. In this study a ^Cardiotron, a commercial machine, was used to record the electrocardio4 grams.
The electrocardiograms were taken from three planes crossing
through the heart. Lead I. Lead II. Lead III.
Electrodes placed on both arms. Electrodes placed
on right arm and left leg.
Electrodes placed on left arm and left leg.
Before taking an electrocardiogram the electrocardiograph (Cardiotron) was standardized so that 1 millivolt of electrical potential caused a deflection of 10 millimeters, or lines
the distance between two horizontal
on the electrocardiogram was equal to 0.1 millivolt; each small
vertical line interval represented .0*1 seconds.
The electrocardiogram
28
indicated the relative amounts of electrical potential produced by the heart in all phases of the heart cycle. Determination of cardiac tolerance to stress. The Master*s Double Step Test, with standard tables (Master, Oppenheimer, and Dack, 19^2) was used to determine myocardial function as shown by the electrocardiogram. The standard tables used in the Master*s Double Step Test indicated the number of times the subject ascended and descended two nine inch steps for a duration of three minutes.
The appropriate number of ascents and
descents were determined according to age, weight, and sex of the individual. /A The admini strat ion of the Master *s Double Step Test. The subject was seated for a period of ten minutes, during which time the electro cardiograph was standardized and platinum electrodes were placed on the right arm, left arm, and left leg.
At the end of the ten minute rest
period, an electrocardiogram was taken in Leads I, II, and III with the subject in the sitting position. The subject, keeping step with a metronome, ascended and descended two nine inch steps at the rate specified on the prepared tables (Master, Friedman, and Dack, 19^2).
After descending the steps, the subject turned
and ascended in the opposite direction. duration of three minutes.
This exercise continued for a
During the actual performance, the electrodes
were left strapped in place to aid the investigator in taking the. electro cardiogram immediately after cessation of the exercise.
29 The subject was seated and electrocardiograms in all three leads were taken immediately after the exercise, and at the third and eighth minutes during recovery.
Determination of fitness for strenuous work. The tests used for this measurement were the Harvard Step Test, the Army Air Force Fitness Test, and a hand dynamometer strength test. Harvard Step Test (Johnson, Brouha, and Darling, 19^2), represented a test of physical fitness for strenuous exertion.
The test was performed
by having the subject step up and down on a 20 inch bench at the rate of thirty steps per minute for five minutes, or until he was completely exhausted.
Each subject was required to maintain an erect position and
completely extend the knee before stepping down from the bench.
A metro
nome was used to aid the subject in maintaining a proper rate of work throughout the five minute work period.
The short form of the test
described by Morehouse and Miller (19^8)? was used in this study. Heart rates and blood pressures were taken before and after the Harvard Step Test.
Heart rates were recorded by the electrocardiograph'
from one to one and one-half minutes during recovery to obtain the Harvard Step Test Index score and on each successive minute during an eight minute recovery period.
Systolic and diastolic blood pressures were taken, using ^ A A A Q{j the ausculatory method as d^sorj^bgdny McCurdy and Larson, (1939) on the first, fourth, and ninth minutes during the recovery periods. The Army Air Force Fitness Test represented a test of endurance, muscular strength, speed, agility, and power (Stansbury, 19^3)•
The three
30 test items, which correlated .91 with the entire battery of test items, used in this test were:
a two minute sit-up test; a pull-up or chin-up
test; and a 250 yard indoor shuttle r u n ^ The test is described by Larson (I9U6) as follows: Sit-ups: Subject will assume a supine position with the legs comfortably spread and hands clasped behind head. Legs will be Held by individual at the ankle. Said individual will not sit on subject’s feet. Subject will lift his trunk upward, touching right elbow to left knee and then lower trunk, touching head to floor. . He will continue without pause, alternating left elbow to right knee and right elbow to left knee. Subject is not to bounce from floor. Recorder will count the number of sit-ups subject completes in two minutes. Pull-ups: Subject will grasp bar with the palms of the hands, facing away from body. Subject will start each pull-up with arms straight. He will lift until chin is over bar; then lower until arms are straight. Subject is not permitted to kick, kip, swing or rest. Partial pull-ups will not be recorded. 250 yard shuttle run (indoors): Subject may use any starting position. Subject will make ten 25 yard trips in the same lane. Total of 250 yards. Any method of turning is permissible. Time will be recorded to next full second. Subject will be started by a standard track command. Stop watch will be started on command ’go1 and stopped when subject crosses finish line. The Hand Dynamometer Strength Test as described by Cureton (19^7) determines the grip strength, which was considered to be an indication of the general body strength.
The subject clasped his right hand around the
"grip” of the dynamometer and gave a maximum contraction, which was registered on the dial as the force in number of pounds.
EXPERIMENTAL PROCEDURES First test period. The subjects reported to the Physical Perform ance Laboratory at the University of Southern California in gymnasium
31 uniform and shoes for the Master's Double Step Test and the Harvard Step Test on one day and for the Army Air Force Fitness Test and Hand Dynamo meter Strength Test on another day.
Physical conditioning program. Upon completion of the first test period the subjects underwent a supervised physical training program of six and one-half weeks' duration.
All subjects reported three times
weekly to the laboratory for the weight training program (Morehouse and Rausch, 19^8), supplemented by either the Harvard Step Test or treadmill running for either five minutes or until exhaustion.
The weight training
program consisted of weight lifting exercises in which the weights and the duration of the exercises were increased throughout the six and one-half weeks conditioning program. Subjects also participated in activity classes, including badminton, tennis, golf, handball, basketball, and touch football, and a diary of these activities was kept.
It is estimated that each subject participated
in strenuous activity approximately four to six hours per week.
Second test period. On completion of the physical training pro gram, all subjects reported to the laboratory on two different days for the same battery of tests as was given in the first test period.
Testing
procedures were the same as those employed in the first test period.
An
attempt was made to schedule subjects at approximately the same hour of the day as in the first test period, but this was not always possible.
Deconditioning program. After completion of the second test
32 period, all subjects underwent a deconditioning program for a period lasting eight weeks.
During this time they were requested to abstain
from strenuous physical exertion, and the supervised experimental physi cal training program was discontinued.
Third test period. After the eight weeks deconditioning period, the subjects reported to the laboratory on two different days for the same battery of tests that was given in the two previous test periods. Again, all experimental procedures were carried out in the same manner. An attempt was made to schedule subjects at approximately the same hour of the day as for the preceeding tests.
RECORDS AND ELECTROCARDIOGRAMS The electrocardiographic tracings in Leads I, II, and III, which were taken fro the Masterfs Double Step Test immediately after, three and eight minutes following the exercise stress were mounted on separate sheets.
To facilitate reading and to insure accuracy, the electrocardio
grams were magnified fifteen times by placing them in a delineascope and projecting them onto a screen ten feet away.
Engineering dividers were
used to make all measurements in order to increase the reliability of interpolating factions between the vertical and horizontal lines.
Inter
polations were made to .01 millivolts and .01 seconds. Because the wave form of the segment from S wave to T wave was in the nature of a slope, it was impossible to make accurate measurements of
33 the length of the QRS interval and the level of the S-T segment in rela tion to the isoelectric line. Performance scores on the Harvard Step Test index, Army Air Force Fitness Test and the Hand Dynamometer Strength Test were determined from tables and recorded for statistical analysis.
SUMMARY Cardiac tolerance to an exercise stress was determined by the post-exercise electrocardiographic response on all subjects before the conditioning program, after the conditioning program, and after the deconditioning program, using the Master's Double Step Test.
Physical
fitness for strenuous work was determined by the administration of the Harvard Step Test, the Army Air Force Fitness Test, and the Hand Dynamo meter Strength Test.
CHAPTER IV
RESULTS The results were analyzed to determine the influence of a six and one-half weeks conditioning program and an eight weeks deconditioning program on:
(l) fitness for strenuous work; (2) the resting electro
cardiogram; and (3) the electrocardiographic response to exercise. The relationship between fitness test scores and the resting and post-exer cise electrocardiograms was studied.
An outline of the statistical
analysis designed to study the above problems is presented below.
STATISTICAL ANALYSIS OF DATA Electrocardiographic measurements obtained from Lead I were selected for analysis because inspection of Leads I, II, and III indi cated that Lead I reflected interval changes in Leads II and III.
The
height of the T wave was determined in Leads I and II, and T wave inver sion was noted in Leads I, II, and III. 1. The influences of a six and one-half weeks conditioning program and an eight weeks deconditioning program on physical condition were determined from the performance scores obtained on the Harvard Step Test, the Army Air Force Fitness Test and the Hand Dynamometer Strength Test. 2. The resting electrocardiogram and the electrocardiographic response to exercise were determined by analyzing the electrocardiographic tracings taken during the administration of the Master’s Double Step Test
35 in test periods I, II, and III.
3 . Statistical significance of the obtained differences in per formance scores and the electrocardiographic changes in test periods I, II, and III were determined, using Fisher’s ”tM .
(Guilford, 19^2).
*4-. Graphs and statistical summaries were prepared, showing the means, mean differences, "t" ratios, and level of confidence for statis tically significant differences in fitness for strenuous work, changes in the resting electrocardiogram and changes in the electrocardiographic response to stress.
5 . Means and standard error of means of measures obtained from the electrocardiographic responses to stress were computed and plotted graphically for the three testing periods.
These show the changes in
the post-exercise electrocardiographic deviations from the resting electrocardiogram following the conditioning program.
6 . The post-exercise electrocardiograms were analyzed to obtain percentages of normal and abnormal electrocardiographic responses to stress for all electrocardiographic phases in Lead I, and for the T wave in Lead I, II, and III in the three test periods, according to Master, Friedman, and Dack, (19^2).
7 . Simple correlations were computed to investigate the rela tionship between changes in the Harvard Step Test index scores and the post-exercise electrocardiographic changes immediately after the exercise of Master’s Double Step Test.
8 . Chi squares were computed to compare the electrocardiographic changes before conditioning with those following a conditioning program.
36 They were computed for the electrocardiographic changes that were ob served to be statistically significant,
CONSIDERATION OF RESULTS
Influence of a six and one-half weeks conditioning program on fitness for strenuous work. All subjects improved in fitness for strenu ous work as a result of the six and one-half weeks conditioning program. A statistically significant increase in performance scores on all fitness measures was shown between Test Period I and Test Period II (before and after the conditioning program)..
In Test Period I the subjects had a
mean score of 68 on the Harvard Step Test. In Test Period II the mean score increased to 82 (Appendix A, Table I), The heart rate after the Harvard Step Test showed a statistically significant decrease in all heart rate recovery records.
The observed mean decrease in post-exercise
heart beats per minute from Test Period I to Test Period II were as follows:
one minute after exercise, 11; two minutes after exercise, 75
three minutes after exercise, A; four minutes after exercise, 35 five minutes after exercise,
six minutes after exercise,
seven minutes
after exercise, 35 and eight minutes after exercise, ^ (Appendix A, Table V ) . A statistically isgnificant decrease in systolic blood pressure was observed at rest and at the ninth minute of recovery (mean decrease of 5 ram* and 5 mm. of mercury, respectively (Appendix A, Table VII. statistically significant decrease was also observed in the diastolic
A
37 blood pressure at rest and in the first, fourth, and ninth minute of recovery from the above exercise test (mean decrease of 5, 8 , 3, and 3 mm. of mercury, respectively (Appendix A, Table VIII). No statisti cally significant changes were observed in the pulse pressure from Test Period I to Test Period II (Appendix A, Table IX) .■ On the Army Air Force Fitness Test, the mean composite score increased from 179 in Test Period I to 196 in Test Period II (Appendix A, Table II) . The Hand Dynamometer Strength Test showed a mean increase from 120 pounds in Test Period I to 128 pounds in Test Period II (Appen dix A, Table IV).
The influence of an eight weeks deconditioning program on fitness for strenuous work. A statistically significant drop-off in fitness for strenuous work was indicated by the decrease in the performance scores made by the subjects on the Harvard Step Test.
The subjects had a mean
score of 80 in Test Period I I . This mean decreased to 7^ in Test Period III, after the deconditioning period (Appendix A, Table I). No statistically significant changes were observed in the means of the heart rates or of the systolic blood pressure, diastolic blood pressure, and pulse pressures at rest and during recovery following the Harvard Step Test (Appendix A, Tables VI, X, XI, and XII). The composite scores on the Army Air Force Fitness test decreased, but this difference was not statistically significant (Appendix A, Table III). The Hand Dynamo meter Strength Test showed a mean increase but this change was not statistically significant (Appendix A, Table IV). Individual raw scores
38 made on the fitness /tests used in this study in Test Periods I, II, and III may he observed in Appendix C.
The influence of a six and one-half weeks conditioning program and an eight weeks deconditioning program on the resting electrocardiogram. This phase of the statistical analysis was designed to determine the statistical significance of changes in the resting electrocardiogram after a conditioning program (Test Period I to Test Period II) and after a deconditioning program (Test Period II to Test Period III). A statisti cal summary of the ranges of measurements and electrocardiographic changes may be observed in Appendix A, Tables XIII, XIV, and XV. 1. RS-T interval.
The length of the RS-T interval showed no sta
tistically significant change in either conditioning or deconditioning. 2. T wave, Lead I.
The height of the T wave in Lead I and II
showed no statistically significant change in either conditioning or deconditioning. 3. T. Duration.
After a conditioning program the T duration in-
X creased .02^ seconds; this increase was statistically significant.
No
significant change in T duration was found after deconditioning. k. T-P Interval.
No significant changes in the length of the T-P
interval were noted in either conditioning or deconditioning. 5. QRS Amplitude.
The height of the QRS complex showed no statis
tically significant changes in either conditioning or deconditioning.
6 . Q Wave.
After a conditioning program the depth of the Q wave x
showed a consistent decrease in all subjects.
The mean decreased .011
39 millivolts, which was statistically significant. After a deconditioning program the depth of the Q waves continued to show a decrease but the changes were not statistically significant.
7 . P-R Interval.
No statistically significant change was observed
in the length of the P-R interval in either conditioning or deconditioning.
8 . P-P Interval.
No statistically significant change in the length
of the P-P interval was observed in either conditioning or deconditioning. (See Appendix D).
The influence of a six and one-half weeks conditioning program and an eight weeks deconditioning program on the electrocardiographic response to stress. The electrocardiographic response to stress was determined by analyzing the post-exercise electrocardiograms taken after the administration of the Master*s Double Step Test.
The post-exercise
electrocardiograms were taken immediately after, and three and eight minutes following the exercise.
A statistical summary of the post-exer
cise electrocardiographic changes from Test Period I to Test Period II may be found in Appendix A, Tables XIII and XIVj changes between Test Period II and Test Period III may be found in Appendix A, Tables XIII, and XV.
Following is a summary of the changes in the post-exercise elec
trocardiographic phases. 1.
RS-T Interval.
After a conditioning program a statistically
significant increase in the mean was observed for the measures taken immediately, and eight minutes following the exercise stress.
The mean
change was observed to be .010 seconds immediately after and .010 seconds
ho eight minutes following the exercise stress.
Three minutes following
the exercise stress the mean was also increased hut the amount was not statistically significant. The post-exercise electrocardiographic deviations of the RS-T segment were computed and plotted to show the amount of variation of the post-exercise electrocardiogram from the resting electrocardiogram.
It
was observed after the conditioning program that the amount of variation of the post-exercise electrocardiogram from the resting electrocardiogram did not change (Appendix A, Table XIII, and Appendix B, Figure 2) . After a deconditioning program the RS-T interval showed a statis tically significant decrease immediately and three minutes following the exercise test. respectively.
The mean decreases observed were .005 a-ncl .00^ seconds, The mean change observed at eight minutes following the
exercise was not statistically significant. 2.
T Wave,
(a)
(Lead I)
After a conditioning program the height
of the T wave showed a statistically significant increase three and eight minutes following the exercise stress (mean increase of .028 milli volts and .028 millivolts respectively). The mean increased immediately after the exercise but the change was not statistically significant. (b)
(Lead II) The mean height of the T wave in Lead II showed
a consistent decrease during the recovery from the exercise but the changes were not statistically significant. After a deconditioning program the mean height of the T wave in Lead I and II showed a decrease in all Test Periods but these changes were not statistically significant.
kl The post-exercise electrocardiographic deviation shows the change between the post-exercise electrocardiographic mean measurements and the resting electrocardiographic values, showing the changes in the tolerance of the heart to stress.
Before the conditioning program, (Test Period I)
immediately following the exercise stress, the. mean height of the T wave was depressed .017 millivolts below the resting height.
Three minutes
following the exercise test the height of the T wave had returned to its original resting height and remained at that height throughout the eight minutes of recovery from the exercise stress.
After the conditioning
program the height of the T wave, immediately following the exercise, was depressed .021 millivolts below the resting level.
The height had ele
vated above the resting level three minutes following the exercise stress and then decreased to below the resting level at the end of the eight minute recovery period.
After a deconditioning program the mean height
was depressed .010 millivolts below the resting level immediately follow ing the exercise stress and remained depressed throughout the eight minutes following the exercise stress.
(Appendix A, Table XIII, and
Appendix B, Figure 2). The post-exercise electrocardiograms were analyzed to determine the normal and abnormal electrocardiographic responses to a standardized exercise tolerance test.
An abnormal electrocardiographic response to
the stress in this study was determined by the alterations in the T wave immediately following the exercise, that is, an alteration from a posi tive upright T wave to an inverted T wave or a change from a previously
k-2
inverted T -wave to a flat or upright T wave.
These individual findings
are summarized: T Wave, Lead I:
Before the conditioning program (Test Period I)
it was found that four subjects showed an inverted T wave in response to stress.
After a six and one-half weeks conditioning program, the same
four subjects* T waves showed a normal response (Maintenance of T wave position) to the Master's Double Step Test. T Wave, Lead II:
Before the conditioning program, (Test Period I)
it was observed that two subjects showed an abnormal (T wave inversion) electrocardiographic response to the exercise stress.
In each case, the
abnormal T wave showed a normal (maintenance of T wave position) electro cardiographic response to exercise stress after a six and one-half weeks conditioning program, (Test Period II). T Wave, Lead III:
Before the conditioning program, (Test Period I)
it was observed that seven subjects showed an abnormal (T wave inversion) response to the exercise test.
After the conditioning program (Test
Period II) five of these subjects showed a normal (Maintenance of T wave position) response to the exercise tolerance test and two continued to exhibit the same abnormal alteration of T wave inversion.
After the de-
conditioning period (Test Period III) there was only one abnormal electro cardiographic response to the exercise test.
One of the two subjects who
showed an abnormal exercise response in Test Period II continued to show the same deficiency in Test Period III.
(Appendix A, Table XVI).
In no subjects was there an abnormal electrocardiographic response
^3 to the exercise tolerance test found in Test Period II and Test Period III that -was not found in Test Period I.
3.
T Duration.
After a conditioning program statistically sig
nificant increases were observed in the length of the T duration. following mean increases were observed:
The
yC
Immediately after the exercise,
.023 seconds; three minutes following the exercise, .021 seconds; eight minutes following the exercise, .015 seconds. After the deconditioning program the mean length of the T duration showed a slight decrease but the observed changes immediately after, and three and eight minutes following the exercise stress were not statis tically significant. The post-exercise T duration deviated from the resting value in Test Periods I, II, and III; however, neither conditioning nor decondi tioning affected the quantity of this differential.
This consistency is
observed in Appendix A, Table XIII and Appendix B, Figure 2. k . T-P Interval.
No statistically significant changes were
observed in the length of the T-P interval in either conditioning or deconditioning. 5- QRS Amplitude.
After the conditioning program the height of
the QRS complex showed a consistent imcrease immediately after, and three and eight minutes following the exercise test, but the changes were not statistically significant. After a deconditioning program the height of the QRS complex showed a statistically significant decrease for the measure eight minutes
44
following the exercise test (mean decrease .143 millivolts). A decrease in the mean changes were observed immediately after and three minutes following the exercise stress but they were not statistically significant.
6 . Q Wave.
After a conditioning program the depth of the Q wave
showed a consistent decrease following the exercise stress.
The mean
changes observed immediately after and three minutes following the exer cise stress were not statistically significant.
The mean change observed
at eight minutes following the exercise stress was statistically signi ficant (mean decrease .008 seconds). After a deconditioning program the depth of the Q wave showed a mean increase immediately after and eight minutes following the exercise test.
Three minutes following the exercise test the mean change decreased.
None of the changes were found to be statistically significant.
(Appendix
A, Table XIII, and Appendix B, Figure 2). 7. P-R Interval.
After a conditioning program a statistically
significant increase was observed in the length of the P-R interval imme diately following the exercise test (mean change, .003 seconds) . The mean changes found for three and eight minutes following the exercise stress were not statistically significant. After the deconditioning program the length of the P-R interval showed a consistent decrease for the three post-exercise electrocardio grams but the mean changes were not statistically significant. 8.
P-P Interval.
No statistically significant changes were
observed in the length of the P-P interval in either conditioning or deconditioning.
k-5
Raw score measurements of the resting and post-exercise elec trocardiographic phases in Test Periods I, II, and III may he observed in Appendix D.
The relationship between fitness for strenuous work and the post exercise electrocardiogram> This phase of the statistical analysis was carried out to determine the relationship between the Harvard Step Test %
index scores and the post-exercise electrocardiographic changes imme diately after the exercise stress of the Master’s Double Step Test.
Only
the measures which showed statistically significant changes after a con ditioning program (Test Period I to Test Period II) were studied. (a) The correlations with the Harvard Step Test were: interval,
RS-T
r = -. 26+. 13 > Q wave , r — .**6+.11$ T duration, r = .15+’*13 • (b) Chi squares (Guilford, 19^2) were computed to determine the
existing relationship between the post-exercise electrocardiographic records taken before and after a physical conditioning program (Test Period I and Test Period II). This statistical method was employed first to determine if there existed a relationship between the electrocardio graphic changes and second, to observe the trend or direction of the change.
Chi squares were confuted for the electrocardiographic changes
for the RS-T interval, T duration and the T wave. were obtained:
The following results
RS-T interval,(and T duration, the relationships were
statistically significant at the 1 per cent level; T wave relationship was not statistically significant (20 per cent level). As a result of these findings, and from inspection of the
k6
scattergrams it is possible to predict the general direction of the post exercise electrocardiogram shifts from a conditioning program.
The length
of the RS-T interval tended to increase; the T duration tended to increase; and the T wave tended to increase even though the electrocardiographic measures at the upper limit of the range tended to decrease toward the mean. (c)
The relationship between abnormal post-exercise electro
cardiograms (T wave inversion) and the Harvard Step Test index scores and changes in index scores after a conditioning program may be observed in Ap pendix A, Table XVI.
The abnormal post-exercise electrocardiograms were de
termined according to standards set up by Master, Friedmand and Dack, (19^2). It was observed in Test Period I that 13 subjects had inverted T waves in response to the exercise stress of which three cases had "good” fitness index scores; four cases with "average fitness index scores showed an inverted T wave in response to the exercise stress; and six cases with "poor" fitness index scores showed an inverted T wave in response to the exercise stress. After the conditioning program, Test Period II, it was observed that for 11 of 13 cases the T wave showed a normal response (maintenance of position) to the exercise test.
The 13 cases showed improvement in
fitness index scores from 3 to 51 points.
Of the two subjects who did
not show a normal response to the exercise test in Test Period II, one improved 3 points in the fitness index scorei.and the other one improved
9 points.
SUMMARY OF RESULTS
After a six and one-half weeks conditioning program statistically significant changes in the measures studied were noted as follows: 1. The means of the scores for all fitness measures were increased (Harvard Step Test score, l*f points; Army Air Force Fitness Test score, 15 points; and Hand Dynamometer Strength Test, 8 pounds) . The heart rate showed a mean decrease during the entire recovery period following the Harvard Step Test.
The mean blood pressure readings showed the following:
The systolic blood pressure decreased at rest and nine minutes following the above exercise test; the diastolic blood pressure showed a decrease at rest and one minute, four minutes, and nine minutes following the Harvard Step Test exercise. 2.
The mean of the measurement of T duration taken on the resting
electrocardiogram was increased; the mean of the Q wave was decreased.
3 . The means of the electrocardiographic changes in the RS-T interval, the T wave, Lead I, and T duration measured immediately after, and three and eight minutes following the exercise stress of the Master*s Double Step Test, were increased; the mean of the P-R interval increased immediately after the Master’s Double Step Test; and the Q wave showed a mean decrease eight minutes following the same exercise stress. 4. While the means for the post-exercise T wave showed an increase, it was noted that the range decreased; the measures being more closely grouped in the center of the distribution.
5 . Eleven subjects who showed inverted T waves after the exercise
48
stress before conditioning had normal T waves after conditioning; two subjects continued to show inverted T waves.
6 . T wave inversions of the post-exercise electrocardiogram were observed in subjects whose Harvard Step Test index scores were "good,”
11average,” and "poor.” 7. After the deconditioning program the Harvard Step Test index scores showed statistically significant decrease of 6 points.
8 . After the deconditioning program the length of the RS-T interval showed a statistically significant decrease immediately following the exercise stress of the Master*s Double Step Test and the height of the QRS complex decreased eight minutes following the same exercise stress. 9. After the deconditioning program the amount of the T wave de flection below the resting level immediately after the exercise stress of the Master’s Double Step Test increased and the speed of the T waves return to its resting values lessened. 1G. An inverse relationship was found between the Harvard Step Test index scores and the electrocardiographic changes in the RS-T interval following the exercise stress (r= -.26^. 13). 11.
A statistically significant positive relationship was found
between the changes in the Harvard Step Test index scores and the elec trocardiographic changes in the depth of the Q, wave (r= .46+. 11) .
CHAPTER V
DISCUSSION Electrocardiograms of fifty-four healthy male university students were observed during programs of physical doncitioning and decondition ing.
The levels of physical conditioning were ascertained by means of
the Harvard Step Test, Army Air Force Fitness Test and the Hand Dynamo meter Strength Test. Electrocardiographic observations were made at rest and after the Master*s Double Step Test exercise.
These electrocardiograms were
examined to determine the relationship between the electrical activity of the heart and changes in physical conditioning. The physical conditioning program consisted of weight training and running, supplemented by vigorous sports activities performed daily. Marked changes in the subject’s physical condition after the six and onehalf weeks program of frequent and regular exercise were observed.
The
improvement in levels of performance of the subjects was shown on all tests. They were all able to do more chin-ups, sit-ups and run the shuttle run in faster times.
Their improvement in strength was demonstrated by their
ability to exert more force on the hand dynamometer.
All subjects after
conditioning were able to either work for a longer time on the Harvard Step Test or had a quicker recovery to resting heart rate.
Both the
resting and the post-exercise systolic and diastolic blood pressures were decreased.
These blood pressure changes, which are related to the ability
of the body to sustain physical activity, are indicative of a reduced
%
50
strain placed on the circulatory system. Several subjective observations also reflected improved levels of performance.
The subjects performed the. Harvard Step Test much more
easily and there was less distress after the work period.
There was a
decrease in respiratory embarrassment during the strenuous tests.
The 'V.
subject’s muscular size and definition showed an improvement and there was an apparent reduction in body fat about the waist. After deconditioning, endurance as measured by the Harvard Step Test decreased the most and strength showed the least change. Statistically significant resting electrocardiographic changes
after the conditioning program were found to be an increase, in the dura tion of the T wave and a decrease in the depth of the Q wave.
In addi
tion to the changes observed at rest the exercise electrocardiogram also showed a prolonged RS-T interval, increased height of the T wave, and prolonged P-R interval immediately after the exercise stress. After deconditioning all changes in the resting electrocardiogram resulting from conditioning persisted.
The post-exercise electrocardio
gram showed only a decrease in the length of the RS-T interval immediately after the Master’s Double Step Test exercise and a decrease in the height of the QRS complex eight minutes following the exercise after decondition ing; all other changes resulting from conditioning persisted.
51 INTERPRETATIONS OF ELECTROCARDIOGRAPHIC CHANGES AFTER CONDITIONING AND DECONDITIONING .{
The physiological changes accompanying conditioning have been described as:
less shift in-blood acid-base balance toward the acid
during exercise (Morehouse and Miller, 19^8); lower heart rate and less respiratory distress during strenuous activity (Brouha and Heath, 19^+3> and Morehouse and Miller, 19^8); more prolonged spread of conduction resulting from an increase in volume of the heart musculature which increases the distance the impulses pass over (Morehouse and Cooper, 1950)> and a greater cardiac output (Morehouse and Miller, 19^8).
To
some extent these changes are reflected in the exercise electrocardio grams and serve to provide possible explanations for changes occurring in the electrocardiograms as a result of the conditioning program.
RS-T interval and T duration. The length of the RS-T interval and the T duration increased in the post-exercise electrocardiogram. These measurements denote the length of time necessary for complete re polarization of heart muscle.
Hoogenwerf (1930) observed that the time
interval between depolarization and repolarization (QRST) increased in healthy athletes after a work period while the QRS interval slightly decreased.
It was also found by Butterworth and Poindexter (19^2) that
the Q-T interval decreased after vigorous exercise (boxing). Saito, et al, (1931) i has shown the relationship between the interval phases of the electrocardiogram and the cardiac cycle length.
The decrease in the lengths of the RS-T interval and the T duration appear to he directly related to the heart rate.
This relationship is
also observed in Appendix A, Table VI, and Appendix B, Figure 2.
The
above interval changes reflect an increased efficiency of the heart result ing from a slower heart rate (Appendix A, Table V) and a more complete ventricular emptying.
The decrease in heart rate provides for longer rest
periods and more complete filling of the ventricles. These changes also reflect an increased conduction time.
Increased muscle protoplasm and
tonicity of the muscle may also be indicated by the increased conduction time as reflected by the prolonged RS-T interval and T duration.
The
increase of the lengths of RS-T interval and T duration thus indicate increased tolerance to stress. P-R interval.
The length of the P-R interval increased in the
post-exercise electrocardiogram immediately after the exercise stress. Butterworth and Poindexter (19^2) observed an increase in the length of the P-R interval after exercise but the changes observed were not statis tically significant.
This prolongation of the depolarization and repol
arization of the auricles may reflect either greater dilation of the auricles or a change in auricular conduction time.
This change after
conditioning appears to be also directly related to heart rate and re flects improved cardiac efficiency. After the deconditioning program the length of the RS-T interval in the post-exercise electrocardiogram decreased.
This change indicates
a decrease in heart tolerance to stress, especially since this electro
53 cardiographic change is related directly to the decline in physical fit ness scores.
A decrease in the height of the QJRS complex resulting from
deconditioning was also' noted eight minutes after the exercise stress. There appears to be no valid explanation for this post-exercise electro cardiographic change as no other mean measurements of the QjRS comples throughout the study were statistically significant.
T Wave. After a conditioning program the height of the T wave showed an elevation (increased height of the positive wave) after exercise. There have been conflicting findings reported for the post-exercise T wave. High resting T waves have been observed in athletes.
Caccuri (193*4-)*
Takenaka, et al (1931“32) and Ludwig (1933) observed resting T wave ele vations during seasons of training.
After increasing exercise stress
loads, Hartwell, et al (19*4-2), Gotshalk and Hartwell (19*4-6), Schlomka and Reindall (193*0 > Knoll (1932), and Master (19*4-2) have observed depressions of varying degrees for the post-exercise T waves.
These observers sug
gested that the onset of the depression of the T wave may indicate the level of stress at which the heart is beginning to fail to compensate. Thirteen subjects showed a T wave inversion in response to the exercise test before conditioning.
This inversion of the T wave is con
sidered by Master, Friedman and Dack (19*4-2) to be an abnormal finding. After the conditioning program the T waves of eleven subjects were no longer inverted by exercise.
According to Master, Friedman, and Dack
(19*4-2) these eleven subjects no longer had abnormal hearts.
In no instance
did a subject with a normal (T wave persistence of position) electro-
5^ cardiogram before conditioning change to an abnormal (inverted T wave) after conditioning.
From these findings it appears that a conditioning
program may improve cardiac tolerance to stress. T wave changes are also caused by changing body position, (Scherf and Weissberg, 19^1), but it is doubtful that body position strongly influenced the exercise electrocardiogram in this study. were taken with the subjects in a sitting position.
All measures
It has been found
further that temperature (Byer, Ashman, and Toth, 19^7)> anoxia (White, 19^0; Master, 19^2), acid base balance and dehydration (Brock, 19^6), and hyperventilation (Barker, Shrader and Ronzoni, 1939) caused electrocard iographic T wave changes similar to those of the exercise electrocardio gram.
It is possible that these factors played a part; however, since
the test exercise was not strenuous enough to cause marked changes in these conditions it is not believed that they influenced the post-exer cise electrocardiographic changes.
A further feasible explanation for
T wave changes after conditioning may lie in the alterations of the posi tion of the heart.
Postural changes have been shown (Scherf and Welssberg,
19^1) to affect the T wave.
The position of the heart could be altered
by the position of the diaphram, tonicity of muscles of thorax and abdo men, and loss of fatty tissue about the heart.
T wave changes following
conditioning remained during the eight weeks of deconditioning.
This
indicates that even though there may be a decrease in fitness for strenu ous work, it does not necessarily reflect a decrease in tolerance to stress as shown by the post-exercise electrocardiogram.
55 9i Wave. The depth of the Q wave in both the resting and the exer
cise electrocardiogram decreased after the conditioning program.
It was
found by Master, Friedman, and Dack (19^2) that the decreased depth of the Q wave indicated an increase in the ability of the heart to withstand the stress of exercise.
Deep Q waves are considered by the above investi
gators to be an abnormal electrocardiographic response to exercise.
The
relationship between the decrease in the depth of the post-exercise Q, waves and the Harvard Step Test scores after conditioning showed a sig nificant correlation.
These findings would indicate that the heart
increases its tolerance to stress after conditioning.
The subjects
whose post-exercise electrocardiograms showed T wave inversions before conditioning, had physical fitness index scores of "good," "average" and "poor."
Yet, after the conditioning program the post-exercise T wave was
observed to be normal (persistence of T wave position) and also an improvement in physical fitness index scores. suggest the following:
These findings strongly
an individual may be in physical condition to
withstand strenuous work but at the same time have an abnormal heart as shown by the post-exercise electrocardiogram; but whether an individual is in good physical condition or not, further conditioning tends to improve heart function.
CHAPTER VI
SUMMARY AND CONCLUSIONS
SUMMARY
1. An investigation was made of the influence of a six and one-half weeks conditioning program followed by an eight weeks deconditioning pro gram on the cardiac response to stress by analyzing the resting and post exercise electrocardiograms of fifty-four healthy male university students. 2. The experimental design consisted of three phases:
(l) the
determination of the cardiac response to standardized stress; (2) the determination of the influence of a physical conditioning program on the cardiac response to stress; (3) the determination of the cardiac response to stress after a deconditioning program. 3- The standardized Masterrs Double Step Test was employed to determine myocardial function.
Standard electrocardiograms for Leads I,
II, and III were recorded before the exercise, immediately after, and three minutes and eight minutes following the exercise during the recovery period.
The following measures were determined:
P-R interval, QRS ampli
tude, RS-T interval, T wave, T duration, T-P interval, Q wave, and P-P interval. if. Physical performance levels of all subjects were determined by administering the Harvard Step Test, the Army Air Force Fitness Test and the Hand Dynamometer Strength Test.
The performance levels were deter
mined before conditioning, after conditioning and after deconditioning.
57 5* The basic exercises used in the six and one-half weeks condi tioning program were weight lifting and running. These were supplemented by daily participation in such active sports as basketball and handball. Each subject participated at least three times weekly in the conditioning program.
6.
During the eight weeks deconditioning program the subjects did
not perform the basic exercises, participated as little as possible in systematic exercises, and totally discontinued participation in sports. 7* Analysis of the fitness test scores revealed that most subjects were in "average” physical condition before conditioning.
Their levels
were raised to "good” after the conditioning program and dropped to "average” eight weeks after the conditioning program" ended.
8.
After the conditioning program the following statistically sig
nificant electrocardiographic changes were observed in the resting elec trocardiogram:
T duration increased, and the depth of the Q wave de
creased. 9- After the conditioning program the following statistically sig nificant post-exercise electrocardiographic changes were observed:
the
RS-T interval increased; the* height of the T wave increased and the range of the scores decreased, showing closer grouping; the T duration increased; and the P-R interval increased immediately after the exercise.
After the
deconditioning program, it was observed that the duration of the RS-T interval decreased. 10.
Thirteen subjects showed abnormal (T wave inversion) electro
cardiographic response to the Master’s Double Step Test before conditioning.
58 In the same test period three of these subjects had ”good” Harvard Step Test index scores; four had “average” index scores; and six had ”poor” index scores.
Of these subjects, eleven showed improvement after a con
ditioning program as evidenced by persistence of position of post-exer cise T waves. 11. Ho subject who showed a normal exercise electrocardiogram before the conditioning program had an abnormal (T wave inversion) post-exercise electrocardiogram after the conditioning program. 12. The Harvard Step Test index scores were correlated with the post-exercise electrocardiographic measurement immediately after the Master’s Double Step Test;
with the RS-T interval, r-= - .26+. 13; with T
duration, r-=.15+.13; and with the depth of Q wave, r=.*f6+.ll.
CONCLUSIONS
The findings in this study appear to warrant the following con clusions: 1. Changes in physical condition and physical performance ability are reflected in the post-exercise electrocardiogram.
Improved physical
condition tends to increase the RS-T interval, increase the T duration, increase the T wave height, and decrease the depth of the Q wave.
These
changes appear to be transient, being reversed when improved physical condition is not maintained. 2. Improvement in physical condition may change an abnormal (T wave inversion) exercise electrocardiogram to a normal one.
59
3 . It is possible to have a "poor,” "average," or "good” fitness \
test score while also having what is considered to be an abnormal post exercise electrocardiogram. ^ * Although significant correlations exist between measures of performance and resting and post-exercise electrocardiograms, these corre lations are too slight to be of value in interpreting performance ability from individual electrocardiograpahic records.
5.
High performance scores on the physical fitness tests for
strenuous work may not necessarily reflect a normal functional heart as indicated by the post-exercise electrocardiogram.
RECOMMENDATIONS 1. Since a satisfactory explanation of the factors that may influ ence the post-exercise electrocardiographic changes is not known, it is suggested that an investigation be made of the possible effects on the post-exercise electrocardiogram of such factors as body position, posi tion of the diaphram, hyperventilation, blood acid-base balance, dehydra tion, anoxia, loss of body weight, and body temperature. 2. The post-exercise electrocardiogram should not' be considered
♦
meaningful unless the physical condition is also known.
A positive test
may be cleared up in a few weeks by a program of frequent and regular exercise.
3 . Tests of "cardiovascular endurance" such as the Harvard Step Test should not be considered as accurate measures of cardiac function
60 since an abnormal electrocardiogram is compatible with a high fitness score.
B I B L I O G R A P H Y
BIBLIOGRAPHY
A.
BOOKS
Cureton, T. K., Physical Fitness Appraisal and Guidance. London: Kernpton, 19^7 * 558 PP*
Henry
Guilford, J. P., Fundamental Statistics in Psychology and Education. New York: McGraw-Hill Book Company, Inc., 19^27 330 pp. McCurdy, J. H. and L. A. Larson, The Physiology of Exercise. Philadelphia: Lea and Feberger, 1939* 3*5- PP» Morehouse, Laurence E., and Augustus T. Miller, Physiology of Exercise. St. Louis: The C. V. Mosby Company, 19^8. 33§ PP*
B.
PERIODICALS
Altschule, M. D., and W. M. Suzbach, "Tolerance of Human Heart to Acidosis; Reversible changes in RS-T interval during Severe Acidosis caused by Administration of Carbon Dioxide,” A m . Heart J., 33:^58, April, I9V 7. Ashman, Richard, "The Normal Duration of the Q-T interval," Am. Heart J., 232 522, January-June, 19^2. Barker, Paul S., E. Lee Shrader, and Ethel Ronzoni, "The Effects of Alkalosis and of Acidosis upon the Human Electrocardiogram," A m . Heart J., 17:169* January-June, 1939* Barrow, William H., and Roy A. Ouer, "Electrocardiographic Changes with Exercise," Arch. Int. Med., 71:5^7* January-June, 19^3* Baum, W. S., R. B. Malmo, and R. F. Sievers, "A Comparative Study of the Effects of Exercise and Anoxia upon the Human Electrocardiogram," J. Aviation Med., 16:^22, December, 19^5* Blair, H. A., A. M. Wedd, and A. C. Young, "Relations of the QR Interval to Refractory Period, Diastolic Interval, Duration of Contraction, and Rate of Beating in Heart Muscle," Am. J. Physiol., 132:157* February, 19^1Bozler, Emil, "The Imitation of Impulses in Cardiac Muscle," Am. J. Physiol., 138:273* December-April, 19^2-^3»
62 Brock, 0. J., "Electrocardiograms on Dearrangements of the Organism’s Water and Electrolyte MetabolismV" Acta. Med. Scandinav., 126:157, 19U6-V7. Brouha, Lucin, and C. W. Heath, "Resting Pulse and Blood Pressure Values in Relation to Physical Fitness in Young Men," New England J. Med., 228:^73, April, 19U3 . Butterworth, J. S., and C. A. Poindexter, "An Electrocardiographic Study of the Effects of Boxing," Am. Heart J., 23:59* January, 19^2 . Byer, E., R. Ashman, and L. A. Toth, "Electrocardiograms with Large, Upright T Waves and Long QR Intervals," Am. Heart J., 33:796, June, 19^7• Caccuri, S., "Electrocardiogram in Athletics," Clin. Med. Ital., 65:5H> June, 193^• Cassinis, V., and E. de Negri, "Electrocardiographical Researches in Sportsmen," Rassegna de Med. Appl. Lavoro Indust., , JulyAugust, 1933* Christensen, B. C., "Electrocardiographic changes in Normal Man During Voluntary Hyperventilation," Clin. Invest., 25:880, 19^6. Cooper, Eric L., John O ’Sullivan, and E. Hughes, "Athletics and the Heart: An Electrocardiographic and Radiological Study of the Response of the Healthy and Diseased Heart to Exercise," Med. J. of Australia, 1:569> January-June, 1937* Gotshalk, H. C., and A. S. Hartwell, "EKG Response to exercise in 100 Normal Subjects," Hawaii Med. J., 5:323> July-August, 19^6. Gunson, E. B., and T. H. Pettit, "State of Circulation after Endurance Test," Brit. Med. J;, 1:280, February, 1932. Hartwell, A. S., J. B. Burrett, A. Graybiel, and P. D. White, "Effect of Exercise and of U commonly Used Drugs on Normal Human Electrocardio gram, with Particular Reference to T wave Changes," J. Clin* Invest., 21:409* July, 1942. Hoogenwerf, S., "Electrocardiographic Examinations in Olympiade Athletes in Amsterdam," Arbeitsphysiol♦, 2:61, 1930* Johnson, R. E., Luncin Brouha, and R. C. Darling, "A Test of Physical Fitness for Strenuous Exertion," Rev. Canad. de Biol., 1:491, June, 1942.
63
Katz, L. N., A. M. Goldman, R. Langendorf, L. G. Kaplan, and S. T. Killian, "The Diagnostic Value of the Electrocardiogram Based on an Analysis of 1^9 Autopsy Cases,** Am. Heart J., 2^:627, JulyDecember, 19^2. Katz, L. N., W. W. Hamheruger, and W. F. Schultz, "The Effect of General ized Anoxemia on the Electrocardiogram of Normal Subjects, Its Bearing on the Mechanism of Attacks of Angina Pectoris," Am. Heart J ., 9:771, 193^. Katz, L. N., and H. Landt., "Effect of Standardized Exercise on ^-lead Electrocardiogram; Value in Study of Coronary Disease,” Am. J. Med. Sc., 189:3^6, March, 1935* Knoll, W., "Working Electrocardiography in Athletics,” Arbeitsphysiol. 5-.h2h, 1932. Larson, L. A., "Some Findings Resulting from the Army Air Force*s Physical Training Program,” Research Quart♦, 17:1^-, May, 19^6. Leedham, G. L., "EKG Place in Examination for Flying: Posibilities and Limitation," J. Aviation Med., 10:31, March, 1939* Levy, R. L., H. G. Bruenn and N. G. Russell, Jr., "Use of the EKG Changes Caused by Induced Anoxia as Test for Coronary Insufficiency," Am. J . Med. Sc♦, 197:2^1, February, 1939* Ludwig, W., "Results of Electrocardiographic Examinations of Participants in FIS Games at Innsbouck," Weiner Klinishche Worchenschrift, ^6:1^79, December, 1933* Master, Arthur M., "The Two Step Test of Myocardial Function," Am. Heart J., 10:^95, 193^-35, "Electrocardiogram After Exercise," U. S. Navy Med. Bui., 5573b6, April, 191*2 . Master, Arthur M., Rudolph Friedman, and Simon Dack, "ECG After StandardExercise as a Function Test of the Heart," Am. Heart J., 2^:777, December, 19^2. Master, Arthur M., and Emil Tribe Oppenheimer, "A Simple Exercise Toler ance Test for Circulatory Efficiency with Standard Tables for Normal Individuals," Am. J. Med. Sc., 177:223, January-June, 1929* May, S. H., "EKG Response to Gradually Induced Oxygen Deficiency; Response of Normal Hearts in Various Age Groups," Am. Heart J ., 17:655, June, 1939.
64 Morehouse, Laurence E., and P. J. Rausch, "Weight Training,*1 Scholastic Coach, 17:12, December 1947* 17:13* February, 1948. Nahum, L. H., H. E. Hoff, and B. Kisch, "Significance of the Displacement of RST Segment," Am. J. Physiol., 131:693* January, 1941. Saito, C., H* Mandai, S. Yasaki* and S. Takenaka, "Investigations Into the Function of the Circulatory System," Acta Scholae Medincinalis, Universitatis Imperialis, 14-15:353, 1931-32. Scherf, David and Milton Schlachman, "The Electrocardiographic Changes Caused by Hyperventilation," A m . J. Med. Sc., 213:342, January-June,
19^7
*
Scherf, David and Jonas Weissberg, "The Alterations of the T Waves Caused by a Change of Posture," Am. J. Med. Sc., 201:693* January-June, 19 *1-1 .
Schlomka, A., and H. Reindall, "The Electrocardiogram for the Heart under Stress," Arbeitsphysiol., 8:172, 193**-* Schneider, E. C., "Cardiovascular Rating as Measurement of Physical Fitness and Efficiency," J. A. M. A., 74:1507* May .29* 1920. Stansbury, E. B., "The Physical Fitness Program of the Army Air Forces," J . Health and Phys, Educ., 14:463* November, 19^3* Stokes, W., "The Effect of Nitrite and Exercise on the Inverted T Wave," Brit. Heart J., 8:62, 1946. Takahashi, Jun, Masuru Sato, Tadahiko Mikawa, Gonishi Nomura, Takahiko Maekawa, and Akira Miyama, "Investigation of the Influence of Bodily Exercise on the Function of the Circulatory System," Acta Scholae Medlninalis, Universitatis Imperialis, 11:519* 1928-29* Takenaka, S., S. Yasaki, H. Mandai, and C. Saito, "Investigation into the Influence of Bodily Exercise on the Function ofrthe Circulatory System," Acta Scholae Medicinalis, Universitatis Imperialis, 14-15: 345, 1931-32. Thompson, W. P., "Electrocardiogram in Hyperventilation Syndrom," Am. Heart J., 25:372, 1943* Tuttle, W. W., and H. M. Korns, "Electrocardiogram Observations on Athletes Before and After a Season of Physical Training," Am. Heart J., 21:104, 1941.
65 Twiss, Arthur and Maurice Sokolow, "Angina Pectoris: Significant Electrocardiographic Changes Following Exercise," Am. Heart J., 23 s**98, January-June, 19**2. White, M. S., "Effect of Anoxia on High Altitude Flights on Electro cardiogram," J. Aviation Med., 11:166, December, 19*4-0. Ylvisaker, L. S., and H. B. Kirkland, "Significance of Position of Subject in Evaluation of Electrocardiogram," Am. Heart J., 20:592, November, 19**0.
C.
UNPUBLISHED MATERIALS
Morehouse, Laurence E., and John M. Cooper, "Kinesiology." in press, The C. V. Mosby Company, St. Louis, 1950. Morehouse, Laurence E. 19*4-6.
Unpublished,
Unpublished data, Harvard Fatigue Laboratory,
A P P E N D I X
"A"
Statistical Summaries of Fitness Test Scores and Electrocardiographic Measurements for Conditioning and Deconditioning
66
TABLE I CHANGES IN HARVARD STEP TEST SCORES
Number of subjects
Mean-^
Meang
Mean difference
t
Test Period ITest Period II
53
67*75
82 .1^
1^*39
7^
Test Period IITest Period III
27
80.55
7^.18
NOTE:
-6.37
2.6
Mean-^ refers to the first test period listed. Meang refers to the second test period listed.
Level of confidence
5#
67
TABLE II CHANGES IN THE ARM! AIR FORCE PHYSICAL FITNESS TEST FROM TEST PERIOD I TO TEST PERIOD II
Number of subjects
Mean^
Meang
Mean difference
t
Level of confidence
Sit-ups
37
61.78
65 -6k
3.86
3.9
1#
Pull-ups
36
53*97
57.66
3.69
2.5
%
250-yard shuttle run
36-
61.00
71.39
9.39
6.5
1$
Score
35
178.60
195.61
17.01
5.9
1$
Physical fitness rating
35
59.72
65.03
5.31
5.6
1$>
NOTE:
Meani refers to Test Period I. Mean2 refers to Test Period I I .
68
TABLE III CHANGES IN THE ARMY AIR FORCE PHYSICAL FITNESS TEST FROM TEST PERIOD II TO TEST PERIOD III
t
19
64.63
63.00
-1.63
1.1
Pull-ups
19
58.56
57.68
•3
250-yard
19
68.88
63.63
-5.25
2.7
Score
19
192.10
184.30
-7.80
1.9
Physical fitness rating
19
64.13
61.63
-2.50
1.8
•
Mean difference
GO CO
Sit-ups
Mean^
Meang
1
Number of subjects
shuttle run
NOTE:
MeaxijL refers to Test Period II. Meari2 refers to Test Period III*
Level of confidence
1$
69
TABLE IV CHANGES IN HAND DYNAMOMETER STRENGTH TEST SCORES
Number of subjects
Meani
Test Period ITest Period II
1*5
119.70
127.60
Test Period IITest Period III
18
125.30
127.60
NOTE:
t
Level of confidence
6.50
2.6
5$
2.30
.9
Mean Mean2 difference
Mean^ refers to the first Test Period listed. Meang refers to the second Test Period listed.
TO
TABLE V CHANGES IN POST EXERCISE HEART RATES FROM TEST PERIOD I TO TEST PERIOD II
Heart rate Resting 1 min. recovery 2 min. recovery 3 min. recovery k min. recovery 5 min. recovery 6 min. recovery 7 min. recovery 8 min. recovery NOTE:
Number of subjects 53
52 51 53 52 53 53 53 53
Mean-^
Meang
79* ko lkk.51 125.25 115.83
77.15 133.55 118.^3 111.83 107.73 105.32 103.^3
111.07 109.26 106.96 105.33 lOk .50
102.08 100.5^
Mean difference -2.25 -10.96 -6.82 -1*-.00 -3.35 -3.9k -3.53 “3-25 -3.96
t 1.3 5.5 3.9 2.3
2.2 2.6 2.7* 2.3
2.6
Level of confidence l£ 1% % % % % % %
Mean-^ refers to Test Period I. Mean2 refers to Test Period II.
TABLE VI CHANGES IN POST EXERCISE HEART RATES FROM TEST PERIOD II TO TEST PERIOD III
Number of subjects
Heart rate Resting *1 min. recovery 2 min. recovery 3 min. recovery k min. recovery 5 min. recovery 6 min. recovery 7 min. recovery 8 min. recovery NOTE:
26 26 26 26 26 26 26 26 26
Mean^
Meang
76-53 130.23 116.12
101.90
79.76 136.50 II9 .OO 110.10 105.50 10k .50 103.30 103.90
Mean difference 1.23 6.27 2.88 1.23 - .35 -2.k2 .15 2.00
99.8k
101.80
1.96
108.87 105.85 106.93 103.15
Mean^ refers to Test Period II. Meang refers to Test Period III.
t .k 1.7 1.1 .5 •2 1.1 .1 1.1 .8
Level of confidence
71
TABLE VII CHANGES IN POST EXERCISE SYSTOLIC BLOOD PRESSURE FROM TEST PERIOD I TO TEST PERIOD II
Systolic Blood Pressure Resting 1 min. recovery 4 min. recovery 9 min. recovery NOTE:
Number of subjects 5^ 5^ 5^ 54
119.32 166.87
141.70 123-45
Mean difference -5.26 -5.13 -4.72 -4.81
Meang
Mean^
11^.06 161.74 136.98 118.64
Level of confidence 2.6 5% 1.7 1.9 2.6 % t
Mean^ refers to Test Period I. Meang refers to Test Period II. TABLE VIII
CHANGES IN POST EXERCISE DIASTOLIC BLOOD PRESSURE FROM TEST PERIOD I TO TEST PERIOD II
Diastolic Blood Pressure Resting 1 min. recovery 4 min. recovery 9 min. recovery NOTE:
Number Level of t Meang of Mean Mean^ confidence subjects difference '54 81.30 •76.67 -4.63 * 3*3 1i 70.24 54 4.4 78.46 -8.22 1$ 54 -3.20 76.81 2.0 73.61 % 2.4 80.28 % 77.17 -3.11 ...
Mean^ refers to Test Period I. Mean2 refers to Test Period II. TABLE IX CHANGES IN POST EXERCISE PULSE PRESSURE FROM TEST PERIOD I TO TEST PERIOD II
Pulse Pressure Resting 1 min. recovery 4 min. recovery £ min. recovery NOTE:
Number of subjects 54 54 5^ 54
Mean^
Meang
37* $9
37 A 3 90.87 62.63 43.89
87.63 65.04 43.20
Mean^ refers to Test Period I. Meang refers to Test Period II.
Level of Mean t confidence difference - .46 •3 3-24 1.8 -2.41 1.6 .69 •3
72 TABLE X CHANGES IN POST EXERCISE SYSTOLIC BLOOD PRESSURE FROM TEST PERIOD II TO TEST PERIOD III Systolic Blood Pressure Resting 1 min. recovery 4 min. recovery 9 min. recovery NOTE:
Number of subjects
26 26 26 26
Mean-]_
115.06 161.39 138.79 122.63
Level Mean t of difference confidence 112.10 2.962 1.4 161.20 .19 .1 2.26 .6 136.53 118 .bo 4.23 .2 Meang
Mean]_ refers to Test Period II. Meang refers to Test Period III.
TABLE XI CHANGES IN POST EXERCISE DIASTOLIC BLOOD PRESSURE FROM TEST PERIOD II TO TEST PERIOD III Diastolic Blood Pressure Resting 1 min. recovery 4 min. recovery 9 min. recovery NOTE:
Number of subjects 26
26 26 26
Mean^ 77.34
71.22 7^.11
76 .88
Meang
t
73.15 76.65
•9 .4 .6 .1
Mean difference 75.98 1.39 1.04 72.76
.96 .231
Level of confidence
Mean^ refers to Test Period II. Meang refers to Test Period III.
TABLE XII CHANGES IN POST EXERCISE PULSE PRESSURE FROM TEST PERIOD II TO TEST PERIOD III
Pulse Pressure Resting 1 min. recovery 4 min. recovery 9 min. recovery NOTE:
Number of subjects
Mean
26 26 26
89.66
. 26
1
37.31* 63.53 Mt-.96
Mean
2
35.92 86.54 64.07 43.73
Level of Mean t confidence difference 1.42 .5 3.12 .7 .54 .2 1.23 1.1
Mean^ refers to Test Period II. Meang refers to Test Period III.
TABLE XIII STATISTICAL SUMMARY OF ELECTROCARDIOGRAPHIC DEVIATIONS AFTER EXERCISE STRESS IN TEST PERIOD I, TEST PERIOD II, AND TEST PERIOD III EKG Phase Lead I RS-T Inter vals in Seconds T Wave in Milli volts T Duration in Seconds T-P Inter vals in Seconds QRS Ampli tude in Millivolts Q Wave in Milli volts P-R Inter val in Seconds P-P Inter val in Seconds NOTE:
Test No. I II III I II III I II III I II III I II III I II III I II III I II III EKG
No. of Immediately After 3 Min. After At Rest subExercise Exercise jects Range Mean Mean Range Mean Mean Range Mean Mean .07 -.17 .118 .02l»T .06 .14 .097 .0206 .09 .17 .118 .0203 53 .09 -.15 .123 .0172 .07 .Ik .109 .0165 •07 .16 .124 .0171 53 28 .10 -.14 .117 .0111 .07 .Ik .099 .0193 .08 .16 .120 .0204 54 -*.l4 .21*6 .09W - .10 .49 .229 .0956 .11 .45 .247 .0973 54 •15 .44 .258 .0707 .10 .40 .244 .0664 .12 .38 .272 .0747 28 .12 •56. .21*8 .0996 .12 •57 .225 .O893 .12 .228 .0828 -.24 .0270 .12 .26 .152 .172 .167 .0337 .23 .09 53 .0313 .13 -. 2 k .0286 53 .15 .25 .186 .0277 .15 .195 .0281 •13 .32 .173 28 .15 -.25 .186 .0283 •!3 .26 .166 .0268 .15 .24 .183 .0241 .07 .52 .321 •13& •05 .70 .260 .1315 .08 .60 .291 .1245 53 .05 .56 •305 .1175 .06 •57 .258 .1221 .12 •59 .299 .1155 53 28 •15 .54 .280 .1100 .07 .60 .269 .1275 .12 .50 .294 .0858 •30 1.71 .823 .2962 .29 1 A 9.693 .25^5 .36 1.45.805 .2540 53 .24 i.ko .832 .2865 .28 1 .40.700 .2575 .15 1.82.807 .2982 53 28 •09 1.22 .71*9 .3565 .08 1.18.646 •3°35 .08 1.14.739 .3130 .00 .11 .016 .0315 .00 .10 .009 .0242 .00 .10 .013 .0253 5^ .00 .08 .005 .0166 .00 .10 .005 .0179 .00 .08 .003 .0128 54 28 .00 .Ok .003 .0121 .00 .04 .006 .0103 .00 .04 .001 .001 .12 53 .19 .11*3 .0198 .10 .17 .137 .0196 .09 .18 .141 .0236 .12 .19 .11*7 .0200 .09 .21 .145 .0227 .10 .19 .142 .0195 53 28 .12 •17 .11*2 .0190 .10 .18 .137 .0205 .11 .18 .141 .0172 53 •57 1.13 .817 .1308' •45 1 .02.687 .13& .53 1.16.757 .1496 52 •54 1.16 .839 -1*75 .29 1 .17.708 .1722 .50 1 .13.786 .1475 28 •5? 1.10 .832 ..•I3.3.8.:3S 1 .11.710 .1728 •55 1-07^771., .1345
8 Min. After Exercise Range Mean Mean •07 .16 .114 .0229
.08 .16 .16 •Q? .08 .40 .12 .44 .12 .44 .13 .23
.16 .26 •15 .13 .11 .15 .14 .29 .08 .00 .00 .00
.10 .10 .10 .59 .54
•57
.22
.60
.123 .0180 .118 .0183 .246 .0968 .274 .0718 .245 .0927 .178 .0282 .191 •0257 .189 .0205 .292 .1295 .306 .1155 .298 .101*8
•50 .52 1.61.824 2 .01.836 1.40.698 .08 .010 .05 .002 .04 .001 .20 .i44 .18 .146 .18 .136 1.13.775 1 .08.797 1.10.790
.2670 .3lto
.3289 .0223 .0079 .0082 .0212 .0285 .0221 4^5 .11*82 .11*62
a Electrocardiographic OJ
74 TABLE XIV STATISTICAL SIGNIFICANCE OF ELECTROCARDIOGRAPHIC CHANGES FROM TEST PERIOD I TO TEST PERIOD II
Resting RS-T In terval in Seconds T Wave in L-I Milli-
Range .05 to -.04 .29 to -.14
1 minute recovery
Mean
Mean
t
.0045
.0035
1.3
.01*4-0
.0082
1.7
to -.0209 -•3* .12 to .0236
.0181
1.2
LC
*36 L-II volts T Dura tion in Seconds T-P In terval in Seconds QRS Ampli tude in Millivolts Q Wave in Milli volts P-R In terval in Seconds P-P In terval in Seconds
NOTE:
Mean
t
LC
.0033
3.1
.0160
1.0
.0168
.5
.0229
.0039
5.8 .
-.0023
.0209
.1
.0047
.0033
1.4
-.0031
.0045
.7
.0085
.0036
2.3
.0224
.0251
•9
-.35 .03 .0044
5.3
.0210
.6
1#
-.06 .25 to -.0132 -.42 •58 to .0089 -1.4*7 .06 to -.0113 -.10 .03 to .0030 -.04 *3^ to .0252 -•25
Range Mean .o4 to .0100 -.05 .16“ to .0159 -.37 •31 to -.0770 to -.14 .28 to
-.30 .005*4-
1.6
.0045
2.5
.0038
1.0
.0205
1.2
%
LC = Level of Confidence
.7k to - ,37 .04 to -.10 .66 to - .06 .4i to
-.54
%
75 TABLE XIV (continued) STATISTICAL SIGNIFICANCE OF ELECTROCARDIOGRAPHIC CHANGES FROM TEST PERIOD I TO TEST PERIOD II
3 minute recovery
RS-T In terval in Seconds
Range .05 to
Mean
Mean
.0058. .0030
t
8 minute recovery LC
1.9
-.0*4
.20 L-I T Wave in L-II Millivolts T Dura tion in Seconds T-P In terval in Seconds QRS Ampli tude in Millivolts Q Wave in Milli volts P-R In terval in Seconds P-P In terval in Seconds
to .0275 -.12 .27 to -.0138 -.*+5 .10 to .021*4 __-.05_ .17 .010*4 to -.*+3 .7**to .0016 -.85 .10 to -.0069 -.10
NOTE:
.0117
2.*4
.0178
.8
%
Range .05 to - .06 .35 to - .22 .33 to -.*+*+
Mean
t
LC
.0096
.0036
2.7
1$
.0280
.0122
2.3
5#
-.0176
.0200
•9
.01*4-7
.00*45
3.3
.01*42
.0177
.1
.0076
.0039
1.9
-.0083
.0030
2.8
.0022
.0027
.8
.0228
.0192
1.2
.08 .00*47
*+.5 1$
to
.0157
.7
.00*+3
.*+
to “ *33__ .37 to
-.65 .01 to -.08
•5
-.0*4
to -.0*4
.35 to -•3*
1.5
to -.27
.0039
.06
.05 .001*+
.0029
.28 .0289
1$
-.06 .27
1.7
to
Mean
.0186
LC » Level of Confidence.
1*
76 TABLE XV STATISTICAL SIGNIFICANCE OF ELECTROCARDIOGRAPHIC CHANGES FROM TEST PERIOD II TO TEST PERIOD III
Resting Range Mean RS-T In ... :&r terval in to -.005^ -.Oh Seconds .13 L- I to -.0092 T Wave -.16
1 minute recovery
Mean
t
.0033
1.6
.0128
.7
-.0057
.0135
.h
-.0071
.0065
1.1
-.0257
.0239
1.1
-.0196
.056^
-.0036
.0025
.1
-.00^2
.0037
1.1
-.001*2
.0028
1-5
.18 0\ CO o 0o •p . 1
in L- II to .Millivolts -.11 T Dura tion in Seconds T-P In .28 terval in to Seconds -.21 QRS Ampli •52 to tude in Millivolts -.1*8 Q Wave .05 to to Milli volts -.05 P-R In .03 terval in to Seconds -.Oh P-P. In .23 terval in to Seconds -.32 NOTE:
LC
Range Mean .oh to -.0078 -.01* .25 to -.0237 -.07 .19 to -.0273 -.12 .09 to -.0071* -.03 .1*0 to .0126 -.25 •53 to -.0682 -.53 .Oh to .0011 -.01 .Oh to -.0085 -.07 .1*7 to .0021 ... - 1 ?
LC - Level of Confidence.
Mean
t
.0038 2.0 .0135
1.8
.0155
1.8
.053^
1.1*
.0280
•5
.01*29
1.6
.0015
•7
.0051
1.6
.OO36
.6
LC
5$
77 TABLE XV (continued) STATISTICAL SIGNIFICANCE OF ELECTROCARDIOGRAPHIC CHANGES FROM TEST PERIOD II TO TEST PERIOD III
3 minute recovery Range Mean .03 to -.0010 -.07 .11 L-I to -.0*4-20
RS-T In terval in Seconds
T Wave -.18 in .09 Milli- L-II to volts -.18 T Dura .08 to tion in Seconds -.07 .18 T-P In to terval in Seconds -.23 QRS Ampli .75 to tude in Millivolts -.53 Q Wave .00 to in Milli volts -.08 P-R In .02 terval in to -.04 Seconds P-P In .l6 terval in to Seconds -.30 NOTE:
Mean
t
LC
.0044
2.3
%
8 minute recovery Range .03 to
Mean
Mean
t
-.0035
.004l
.8
-.0300
.0173
1.7
-.0176
.0131
1.3
- .0010
.0060
1.7
-.0081
.0258
•3
-.1429
.0476
3.0
-.0022
.0016
1.4
-.0073
.0037
1-9
-.0071
.0031
.2
LC
-.06
.16 .0280
1.5
-.0V31
.0156
2.7
-.0029
.0059
•5
%
to -.23 .10 to -.12 .05 to
-.08 -.0040
.0194
.0
-.06kl
.0521
1.2
-.0029
.0029
1.0
-.0007
.0030
.2
-.0140
.0220
.1
LC s Level of Confidence.
.41 to -.32 .41 to -.48 .00 to -.04 .02 to -.04 .47 to -.42
1$>
78 TABLE XVI RELATIONSHIP OF NORMAL AND ABNORMAL EXERCISE ELECTROCARDIOGRAMS (T-WAVE) AND HARVARD STEP TEST INDEX SCORES FOR TEST PERIOD I AND TEST PERIOD II IN LEADS I, li, AND III
Test Period I Subject 6 10 35 37
T Wave L-I L-I L-I L-I
23 29
L-II L-II
1 1
Good Poor
21
L-III L-III L-III L-III L-III L-III L-III
1 1 1 1 1 1 1
Poor Poor Poor Average Poor Average Good
26 31 38 1*5 1*7 52
Total Mean NOTE:
Abnormal Normal Fitness Abnormal Normal - 1 1 Poor 1 1 Average 1 Good 1 1 1 Average
13
H.S.T. - Harvard Step Test. L-I - Lead I. L-II - Lead II. L-III - Lead III.
Changes in H.S.T. Index Fitness Score Poor 17 Good * 5 Good 53 Good 9
Test Period II
1
Good Average
20 3
1 1 1
Good Good Average Good Average Average Good
1*7 1*7 ll* 9 10 1* 13
1
1 1 1 1
2
11
251 19
A P P E N D I X
”B"
The Normal Electrocardiogram and The Electrocardiographic Deviations after an Exercise Stress
79
THE
NORMAL
E L E C T R O C A R D IO G R A M
S TA N OA R 0 1 Z AT IO N S
IMM 0 0 4 SEC
D
0 15 TO 2 . 0 MV
ifl C -y
0.1 MV. AT
Ittr .
,
I
O R IG IN
0 . 0 5 TO 0 . 2 5 MV
O TO 0 .6 M V L I - O TO 0 . 2 MV L l l - O TO 0 . 2 5 M V L l H - O TO 0 . 3 M V
P -R I NT Q R S " IN T 0 .1 2 TO 0 . 2 SEC.
0.1 SEC. OR L ESS
H
Q - T IN T E R V A L MAX K .s 0 . 4 ^ .1 0 . 4 4 9
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TABLE m i l
(continued)
HARVARD STEP TEST SCORES FOR TEST PERIOD I, II AND III
TEST
Subject i+lf. ^5 k6 i^7
1*8 ^9 50 51 52 53
PERIODS
Number of Heart Beats in 30° Recovery________ Duration of work____________Score_______________ Fitness Rating I II III I II III i II III . I II III 66 Good Good Good k9 115 99 5^ 51 5* 83 y J4.I4. 88 81 Poor Good 67 3*35" 5' 66 Av. Poor Av. 72 70 76 76 83 y 51 y 6 k Av. Av. Av. 76 70 78 85 y y 51 75 Av. Av. 72 76 76 71 51 y 3*1*1" k' Good Good Good 82 103 100 53 35 y 53 Av. Av. k'ko" y Av. 65 78 71 77 75 73 y Av. Poor 2*^0” 78 70 39 y 75 Av. Good 78 101 70 y 5^ 5* 9k Good Good 58 107 5* 5* 51 8k Good Good 81 5' 65 5' 67
85 TABLE XIX RESTING AND RECOVERY HEART RATES ON THE HARVARD STEP TEST FOR TEST PERIODS I, II, AND III
1 * Recovery Resting I II III I II III 120 62 99 57 150 130 100 79 70 159 135 53 68 100 159 15*4180 109 107 173 74 96 iko 153 80 85 83 lk2 160 148 92 79 135 130 162 135 78 98 72 1^5 123 130 70 90 160 90 87 80 72 173 165 163 78 98 68 130 1*4-9 70 70 150 126 135 75 86 150 116 125 83 85 6k 59 123 108 137 62 74 100 156 145 165 84 58 73 lk2 127 128 5^ 70 151 134 l4l 85 69 82 92 l40 147 150 70 82 89 'ik3 137 152 95 88 68 151 148 147 71 9k 76 125 106 105 71 154 123 60 70 8k 78 130 113 133 91 152 147 70 69 76 105 147 144 72 93 100 103 1*4-6 140 124 117 60 67 9k 9k 87 136 134 147 158 163 12 88 80 142 113 143 Ik 75 78 152 72 139 60 80 95 101 75 123 78 99 159 153 86 156 149 82 76 86 159 132 80 94 114 61 77 108 84 93 103 131 127 146
Subject
1 2 3 5 6 7 8 9 10 11 12 13 14 15
16 17
18 19 20 21 22 23 2k 25
26 27 28 29 30 31 32 33 34 35 36 37 38 39
2 * Recovery I 96
126 138 138 174
118 127
116 144
126 152 120 141
126 105 l4l 120 121 129 118 135 111
128 116 128 124 136 108 120 143
118 136 102 140
II 92 105 105 142
160 131 l4l 105 110 120 129 144 127 104 114 113 134 111 113 131 120
128 91 107 103 125 123 131 101 127 142 105 125 82 143
126
118
140 112
124 77 114
116
III
140
122 144
3 * Recovery I II III 96 88 112 XOO 119 95 130 137 159 153 110 123 124 139 130 106 100 l4l 115 108 119 i n 133 118 123 137 135
116 119 121
138
145 114 124 128
131 117 123 118 108 120 105 119
126 121 90 110 121
127
116 81
105 120 128 120 92 108
126 117 118
95 133
112 122 99 137 113 130 80 100
117 100 105 107 119 98 111 120 114 122 86 105 100 125 129
107 112 103 132 103 113 114 112
116 92
106 ll4
126 92
118 124 102 120 79 135 110
117 107 123
118 75 112
91 122
86
TABLE XIX (continued) RESTING AND RECOVERY HEART RATES ON THE HARVARD STEP TEST FOR TEST PERIODS I, II, AND III Resting 1* Subject. I II III I W " 66 78 \152 6*4 68 *1*40 h i 68 *42 57 179 63 110 89 87 1*43 *4*4 9*4 101 89 163 152 70 65 ^5 6*4 56 105 b 6 68 66 82 105 16*4 b l 7k 80 150 *48 61 68 150 b 9 56 5*4 50 117 80 77 51 13^ 12*4 56 52 65 8*4 63 152 92 53
Recovery II fIII 111 \ 115 V101 139 1*1-9 170 177 161 1*1-2 109 73
1*47 119 Ikk 122 102 137 1*40 138
150
2* Recovery III
1 II 12*4 100 110 99
120 1*1-2 132 137 150 131 125 82 90 125 127 13^ 132 122 101 98 93 120 122 107 121 131 132
82 127 139 70 119
3* I 112 102 122 132 129 131 77
108 122 110
125
Recovery II III 110 78 85 11*4 118 120 1*1-0 129
118 93 118
6*4 11*4
118
96
105 93
113 92 123
110 12*4
108 115
87 TABLE XIX (continued) RESTING AND RECOVERY HEART RATES ON THE HARVARD STEP TEST FOR TEST PERIODS I. II. AND III k-; Recovery Subject I II III 1 92 87 2 108 9k 3 108 96 *4 12*4 13*4 5 1k6 1*4-5 6 106 120 7 120 132 120 8 100 9k 9 137 112 10 107 105 106 11 122 112 12 131 125 118 13 112 113 1*4 126 9*4 107 15 11*4 110 112 16 89 10*4 101 17 129 119 130 18 113 9k 99 19 122 10*4 106 20 113 11*4 98 21 106 107 109 22 120 11*4 112 78 87 23 2k 117 103 25 105 98 101 26 116 115 27 118 12*4 108 28 116 12*4 29 93 82 30 115 113 11*4 31 116 120 9k 9*4 10*4 32 33 118 112 3*4 95 87 115 35 120 135 36 110 103 37 122 110 8k 70 8*4 38 39 100 111 118 *40 106 105
5* Recovery I . II III 90 85 10*4 96 102 92 12*4 130 1*4*4 1*45 100 113 120 130 127 100 96 138 107 120 99 107 120 103 130 128 109 112 111 117 92 102 119 113 11*4 101 101 117 128 120 127 113 9*4 99 121 102 109 108 112 87 10*4 10*4 107 123 11*4 108 101 86 82 110 91 105 96 9*4 113 112 120 118 110 11*4 125 80 78 105 115 111 11*4 110 102 95 100, 11*4 112 95 91 113 110 123 10*4 9*4 120 106 75 87 77 92 112 118 106 112
Recovery II ill 82
7* Recovery 8* Recovery I II III I II] II 81 80 83 82 96 100 80 100 9*4 9*4 108 95 90 88 122 136 120 126 130 138 1*4*4 1*43 133 133 10*4 108 10*4 105 108 107 115 127 110 107 123 118 112 83 11*4 100 9*4 96 89 95 9*4 128 110 98 123 129 97 10*4 105 103 105 98 10*4 107 99 10*4 118 10*4 120 107 118 10*4 123 119 105 123 115 107 123 117 10*4 106 10*4 106 103 106 108 11*4 96 100 111 9*4 102 105 92 100 119 107 112 111 109 110 119 10*4 112 95 93 11*4 105 100 111 102 97 11*4 120 113 126 120 11*4 129 119 120 125 116 9*4 99 100 88 98 93 85 91 97 113 100 108 11*4 97 102 117 102 96 101 108 92 102 110 93 99 110 96 102 ill 92 99 108 9*4 97 106 123 11*4 106 119 110 107 120 113 100 10*4 8*4 90 10*4 92 90 102 8*4 87 10*4 89 110 91 110 96 102 97 99 100 98 96 100 101 95 108 99 107 102 110 108 120 116 105 120 117 105 112 117 10*4 11*4 123 118 125 120 123 88 83 88 77 87 86 108 106 108 108 107 109 10*4 100 107 110 109 117 110 105 107 105 93 99 98 92 93 100 90 100 110 108 110 111 110 108 11*4 ' 8 0 95 85 113 93 77 109 95 106 119 103 123 99 123 10*4 92 118 92 112 92 (d * I 80 100 112 122 1*43
118 105 7*4 81 86 99 103 106 106 102
116 108 116 105 80 87 81 76 95 11*4 98 105 98 105 100 109 99 106
92 113
88 TABLE XIX (continued) RESTING AND RECOVERY HEART RATES ON THE HARVARD STEP TEST FOR TEST PERIODS I, II, AND III 4 * Recovery Subject I II ill 4l 198 -78 ,72 k2 r 116 108 ^3 123 116 123 44 126 137 13^ k5 116 105 66 k6 78 86 kl 111 117 ill k8 114 116 k9 108 87 88 85 50 51 105 107 52 87 102 53 116 123 107
5* Recovery I II III 9k 83 77 111 105 122 114 114 126 135 118 111 107 7^ 85 70 115 116 112 112 110 105 79 76 78 113 107 84 106 114 116 100
6 ' Recovery I II 92 77 113 105 117 112 122 131 111 112 75 79 109 108 114 108 98 80 80 85 105 102 81 99 108 115
III 77 113
116 64
105
100
7* I 90 107 117 119 120 76 110
Recovery II h i 81 78
101 114 108 129 117 103
80
74
8 * Recovery 1 II III 90
77
75
96 118 116 116
105 108
112
83 115 108 100 80
139 104 83 111 111 75
112 115 116 111 92 81 80 75 107 98 75 96
105 100 71 97
108 110 107
101 110
114
61 117
70 100
89 TABLE XX SYSTOLIC BLOOD PRESSURES ON THE HARVARD STEP TEST FOR TEST PERIODS I, II, AND III Resting II III
Subject
I
1 2
108 108 120
3 4 5
6 7
8
iko 146 98 124
106 104 124 148 124
118 128
10 11 12
108 104 110 108 102 114 126 114 132 124
13 14 15
136 152 120
16
136
9
17
128
124 114 108 138 110
18
126
128
19 20 21 22 23 24 25
12b
118 122 124 118
26 27
28 29 30 31 32 33 34 35 36 37 38 39 ho
130 124 114 110 110
118 96
108 128
144
100 144 112 110 138
130 228 98 100
108 96
108
108
114 120 110 io4
108 126
102 108
147 170
200 204
166 150
168 164
180 124 110
122 100 122
98 124 110 114 - 118 110
11 Recovery 1 III II 164 178 140 176 212 210 192 176 166 148 158 170 150 168 190 180 170 150 151 148 174 168 192 152 185 175 158
118 108
146 188 173 192 174
176 156 174 142 200 158 170
162
160
210
164 154
156 160 190 186
176 156
130
134
144
150 158
118
106
124 l4o
104 138
114 108
178 168
128
128
195
122 144 158 120 142 148
154 164 146
160 194
120 174 184
152 135 114 136
126 130
150
160 138 128 172
186
128 180 168 124 136 178
136
116 168 110 148
168 128 175
136
126
134
122 138
130 156 118 130 140 120 138 ll4 146
174 124
128 158 154 130
118 142 130 180
126
120 120 154 144 116 108 116 106 106 128 108 122 118 134 118 118 136 132 150 120 126 122 138 130 124 142 136 136 122
98 148 110
128 136
128 128
120 129 128 95
126
112
126
108 112
126
130 100
100
120 130 122 148 148
120
120 102
112
138
128
144 146 155
122 138
176
142 114
128
118 126
128 138
110 108 152
122 138 110 120
150 134 124 148
116 108
142 148 180 134 132
158 11.2 144 120
9* Recovery 1 II III 149 130 l4o 104
128 122
149 172
160
162
128 170 160 146 116 . 158
98 92
110
200
148 179
158
114 107
103
128 160
182 158 204
130 l66
154 n4
198 l4o 150 170
4* Recovery I III II 12$ 124
168
96 122 112 118 114
116
118
94 122 120 118 110 124' 124 96 118 110 108 116 110 104 92 130 110 130 122 132 118 130 132
120 120
108 126 106
152
90 TABLE XX (continued) SYSTOLIC BLOOD PRESSURES ON THE HARVARD STEP TEST FOR TEST PERIODS I, II, AND III Resting ibject I II **1 110 110 98 b2 128 **3 98 126 **** 86 Ikk 2*5 110 102 k6 128 11b 110 110 bl **8 116 115 106 lib **9 50 130 12b iko 12b 51 52 132 110 122 110 53 126 11** 5^
III 110 100
102 100 112 98
1' Recovery I II III 168 1**8 16** 170 1**2 138 158 170 17** 138 138 iko 160 156 1**8 152 16** 1**6 170 158 180 162 158 15** 15** 155 19** 196 170 1**8 170 160 170 190
**' I 136 1**5 138 136
Recovery II III 118 132 116 100 120
9' Recovery I II III 122 110 120 128 112 95
118
108
106
130 100 12** 110 122
10** 120 118 122 11**
118 118
128
108
120 136 110 100 112
105
90 138 1**** 132 138 15** l**6 1**8 138 128 1**8 138 168 180 138 132 13** 120 130 15**
128 132
12b 130
150
126 130
120 122
91 TABLE XXI DIASTOLIC BLOOD PRESSURES ON THE HARVARD STEP TEST FOR TEST PERIODS I, II, AND III Resting Subject I II III 1 72 62 2 90 60 84 82 3 ’ 84 76 4 92 88 5 6 76 82 104 100 92 7 8 70 60 86 82 9 10 70 70 84 84 80 11 98 12 82 76 76 82 13 14 80 98 78 82 70 15 75 86 16 -90 82 82 72 17 18 72 86 78 82 82 70 19 20 82 84 92 21 72 90 70 84 72 80 22 86 70 74 23 24 80 82 76 80 90 25 26 76 68 70 74 68 27 84 76 28 70 80 80 29 70 78 90 30 84 82 31 84 78 78 32 80 74 33 84 74 34 74 74 80 35 84 70 72 36 84 78 37 80 82 38 82 78 39 86 72 40 74
I 76 70 82 76 80 90 102 72 70 68 76 95 70 118 90 68 90 90 90 80 90
60 82 82 72 78 78 86 90 80
62 78
l 1 Recovery II III 64
60 50
74
52 82 80 90 50 85 68 70
80 90 84 72 84
80
76 90
84 90 70 70 48
60 84 80 72
80
80
80 90
90
78
70
80 70
60 70
85 •
60
72 102 90 68 82 82
92
94
82
82 80 70 84 85 76 76 72 68 84 84
74 80
96
^5 76 78 75
65
89 76 79 86 88
100 70 70 70 78
58
60
64 68 68 56
70 60 86
V I 76 70 78
75 78
80 82
84
60 76 70
50
68 72 80 88 90 84 80
Recovery II III 68
62 70 56 80 78 90
62 86
62 78 68 78 76 90 78 78
80
58 78 70 82 90
64
80 82 70 75 70 70 84
68 82 86 53 82 70 76 70
78 70
68
78 80 82 84 56 68 70 68 68
74 80 68 78
80 80 75
78 80 100 68 86 68 78 82 70 98 92
76 82
90 72
9* I 86 88 85
68
82
Recovery II III 70 78 82
60 76 78 90 78 . 84 70
94 68
80 74 86 82
74 80 64 76
86 82 90 80 84 88 80 72 84 75 82 84 84 100 76 68 70 74 90 70 84 86 78 86 84 84 84 84 74 62 74 74 86 78 80 70 90 78 100 82 84 86 96 90
78 80 76
94 66 92 84
45 78 70 80 80 72 72 78 76 72
94
92 TABLE XXI (continued) DIASTOLIC BLOOD PRESSURES ON THE HARVARD STEP TEST FOR TEST PERIODS 1/ II, AND III
Subject kl k2 ^3 ij.ii. ^5 k6 kl k8 k9 50 51 52 53 54
Resting I II III 68 8^ 65 70 82 6k 60 90
86 64 92
82 70 72 92 92
62 84 76
66 70 72 7^
68 80
69 7^ 84 92 70 70 70
76 78
1 * Recovery II III 60 58 60 5^ 60 70 72 60 6k 60 60 98 62 6k 60 88 70 60 70 70 50 80 56 85 86 86 7^ 72 70 60 I 86 70
80
62
k' I 82 72
60
Re< very II III 70 78 5^ 65 6k
70
62
60 96 60 52 76 82
68 6k 78 98 72 70
80
82
66 70 68
60
78 68
58 78
6k 82
9* Recovery I II III 74 82 68 82 60 68 6k 70 80 80 50 7^ 88 72 72 80 72 78 72 68 72 7^ 70 80 80 78 78 90 70 76 76 72 80 72
93 TABLE XXII PULSE PRESSURES ON THE HARVARD STEP TEST FOR TEST PERIODS I, II, AND III
i 2
3 4 5
6 7
8 9 10 11 12
13 14 15 16
17 18
19 20 21 22 23 24 25 26
27 28
29 30 31 32 33
34
35
36
37 38
39
kn
R I 36 18 56
e s t i n g 11 II III______I 44 66 44 70 116 72 60 36
22 54 35 36 42 24 26 24 36 38 44 32 30 42 34 60 42 50 38 54 36 46 46 38 38 40 50 26 38 30 46 48 38 42 36 50 34 24 38 30 46 24 54 38 32 20 32 30 34 40 32 36 39 34 28 42 3^ 26
26
28 28 34 24 23 22 34 28 56 30 42 46 26 35
86 130 80
40
48 108
30
80 116 130
66 32 42 35 52 18
38 40 58 26 26 26
38 48 40 30 31 36 42
90 86 96 78
Recovery II III
114
50 50 110
116
124 90 66
60 74
160
66 78 120
100
106
110
82 108 95 56
86 78
k * Recovery I II III
78 108 108 78 88
56 76 68 90 114 108 78 92 78 93 98 110 87 log 140 119 98 94 100 81 74 108 102 73 122 1-6 64 58 69 80 87 54 72 83 84 66 48 58 98 88 90 76 72 78 38 84 58 72 90 64 54 33 52 50 88 100 135 124 136 88 106 82
96 56 50 66 60 69
94 95 48 92 70
46 56
56 66 112 58 44 110 44 78 66 68 50
60
54 72
60
42 56
40 72 50 54 42 58 64
38 58 60
30 86 66 40 50 62
75 52
66 4o 72 90 48 58
80 62
104
82 52 88 38 68 46 48 86 100 52 54 66
60
127 62
50 50 62
48 80
68
62
50 34 48 58 102 48
II
30 20 68 24
4o 56
62
60
56 67 88 92 50 45 88
9 ' Recovery I
34
100 5^
64 30 44 48 38 44 66 52 52 62
III
82
42 48 70 22 88 30 58 38 46 44 38 58 24 52 44 38 38 46 50
30 42 48 42 46 56 52 45 44 42 30 44 52 42 30 20 32 36 3^ 24 42 36 3^ 26 34 34 36 40 40 44 39 32 30 24 22 4o 110 48 32 34 42 40 42
80 40 40 46 52 52 54 38
40 37 50 48 32 20 58 48 50 30 34 58 46
94
TABLE XXII (continued) PULSE PRESSURES ON THE HARVARD STEP TEST FOR TEST PERIODS I, II, AND III Resting ib.ject kl k2
43 kb 45 k6 kl 48 b9 50 51 52 53 54
I 24 38 58 46 46 28 36 46 34 38 38 48 70 50
II 32 36 20 34 46 36 56 32 40 40 .40 32 40 44
4 1 Recovery
1* Recovery
III
30 20 34 36 20
I 100 98 102 100 100 92 62
74 110 72 100 82
96 90
II 88 100 78 72 98 86 102
III
78 82 68
80
104 98 100 110 76 128
88 70
I 5^ 78 66 73 94 78 48 30 62
66 64 86 72 62
II 42 46 44 62
50 84 68 70 56 68
III *
35 54 70 60 48
9* Recovery
I 30 54 50 46 50 30 36 50 46 38
II 4o 38 24 52 46 50 46 46 56 4o
72 65 50
46 34 50
60
98 54 86
III
27 44 48 38 27
95
TABLE XXIII ARMY AIR FORCE FITNESS TEST SCORES FOR TEST PERIODS I, II, AND III
Sit-up3 Score
Pull-ups Score
Subject I II III
I
II
64 64 70 59 59 53 49 74 52 58 64 65 68 78
75 68
78
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
17 18 19 20 21 22 23 2k 25 26
27 28 29 30 31 32 33 34
66 70
26 49
41 26
64
36 58
81
63
69
70 70
62 65 65 80
67
49 26 85
81 38 4l 78 78 78 78 49 54 93 75 68 68 26 38 26 32 65 62 68 72 45 49 78 45 26 .35 45 58 68 36 32 35 58 62 100 100 54 5k
79 60 64 69 59 63 51 65 54 61 51 61 58 71 61 64 55 74 75 72 57 64 72 74 72 42 52 50 59 70 70 63 48 57 54 58 68 90 91 59 63 66 69 49 68 73 78 45 38 45 17 NOTE:
38 72 49
62
72 26
Shuttle Score
Composite Physical Score Performance Rating Rating III I II III I II III I II i n i ii h i 56 VG 195 65 60 65 64 69 192 209 VG VG 76 60 152 52 56 156 A 50 A A 63 167 55 48 148 A 49 150 71 A 50 147 169 A A 63 67 49 56 210 231 78 78 70 77 VG E 49 56 71 60 157 183 168 52 61 56 A A A l4l 48 A 47 58 60 73 78 179 224 198 60 75 66 A 'VG VG k l 48 56 56 151 163 162 50 54 54 A A A 72 56 65 44 202 210 181 68 70 60 VG VG A VG 75 67 75 73 223 232 228 74 77 76 VG E VG 59 54 71 ‘ 71 165 189 199 55 63 66 A A 75 60 56 60 212 194 186 71 65 62 VG VG A 68 73 78 75 206 200 204 69 67 68 VG VG VG 48 65 111 164 P A 37 55 184 168 61 56 60 65 A A 38 63 85 'jty 189 211 188 63 70 63 A VG A 65 71 78 63 213 225 200 71 75 67 VG VG VG 156 186 52 62 A A 67 78 206 66 VG VG VG 56 78 74 297 229 69 65 73 114 150 46 65 P A 38 51 44 40 132 48 46 A A 38 144 68 73 93 96 194 231 234 65 77 78 VG E E ' 4 4 48 P 131 47 52 A A 52 65 141 154 168 208 52 78 56 69 A VG 60 73 250 264 E E 83 87 40 65 A A 51 61 153 182 188 209 A VG 73 78 63 70 222 217 VG VG 74 72 71 67 P 38 65 50 52 127 124 135 42 4l 35 P P
A - Average; P - Poor; E - Excellent; VG - Very Good
96 TABLE XXIII (continued) ARMY AIR FORCE FITNESS TEST SCORES FOR TEST PERIODS I, II, AND III
Sit-ups Score abject I 61 35 36 73 48 37 38 63 39 55 ko 66 54 kl 66 k2 k3 46 kk 57 45 65 k6 66 kl 65 48 54
II III 67 71 55 57 63
66 56
62 75 49
65 75 6k
70
62
Pull-ups Score
Shuttle Score
I II III I II ill k*=> 54 65 71 kl 45 75 96 35 54 67 65 45 57 kl 52 67 67 66 48 67 45 49 49 73 73 32 38 71 67 81 90 78 56 60 46 26 32 40 35 67 58 67 75 85 67 75 71 85 35 45 58 58 60 71 60
Composite Physical Score Performance Rating Rating I II III I II III I 11 : III A VG 171 192 57 64 A VG 189 212 63 70 150 174 50 58 A A 160 171 171 54 57 57 A A A 170 A A 58 167 55 188 178 A A 63 59 52 56 A A 157 168 203 225 194 68 75 65 VG VG VG 112 P 38 A 159 53 190 A 63 208 225 70 75 VG VG A 171 57 A A 159 193 180 53 64 60 A
97
TABLE XXIV HAND DYNAMOMETER STRENGTH TEST SCORES FOR TEST PERIODS I, II, AND III Right Grip (Pounds) Right Grip (Pounds) II III I II III_______ Subject______I
c.
3 4 5
119 84 Ikl 95 99
26
130
27 136
8
125 127
125
43
161
145
97 111
114
128
44 ^5 46
125
47
170
143
119
139
48 49 50
141 123
125
128
122
117 114 125 121 114 128
11 12
13 14 15 17 18 19 20 21 22
23 2k
119 ll4 iq 6 13^ 110 117 ll4 123 114 130
112
125 114 134
108
130 130 121 125 126
139
125 l4l
128
114
112
16
169 130
135
9 10
129
29 30 31 32 33 3^ 35 36 37 38 39 40 4l 42
6 7
28
119 107 119 123 132 121 121
138 154 121 106 88 110
l4l 106
95 110
121
123 90 139 170 136 117 106 117 136 119 132
121
108
143
128
157
156 101
143 114 130
A P P E N D I X
"D"
Electrocardiographic, Measurements Taken on the Master*s Double Step Test
98 TABLE XXV ELECTROCARDIOGRAPHIC MEASUREMENTS IN SECONDS FOR THE LENGTH OF THE RS-T INTERVAL, LEAD I, TEST PERIODS I, II, AND III
.12
.08
.12
.07 .09
.14 .14
13 14 15
.13 .13 .07
16 17
.11 .06
18
.14
.11 .12 .11 .12
19
.11 .11
.15 .14
.13
.14
.12 .10
.12 .12
.15
.14
20 21 22 23 24 25
26 27
28 29 30 31 32 33 34 35
.12 .12 .11 .13 .09 .09 .13
.18 .17
.11 .13
.11 .15 .09
.13 .13
.11
.12 .11 .10 .11 .12
.16 .14 .13
.10 .12 .15 .13
.10 .06 .11 .12 .08 .08 .08 .10 .12 .10 .09
.10 .11 .10 .09
.12
.08 .12
.12 .12
.09 .14
.10 .11 .12 .11
.12 .12
.14
.13
.12 .06 .08 .08 .10 .16
.10 .10 .10
.10
.09
.11 .11 .10 . .14 .09 .10 .12 .10 .08 .07 .11 .12 .10 .12 .10 .12 .10 .11 .07 .11 .10 .12 .11 .14 .13
.12 .12 .12 .12 .12 .09
.10 .12 .11 .12
.12 .10 .08 .11 .12 .15 .14 .09
.10 .10 .14
.12 .12 .12 .11 .12 .12 .13
.10
.08
.11
.13 .13
.14
.10 .12
.18 .11 .08 .10 .12
.10 .10 .10
.11 .12
.13
.12 .12 .12 .10 .10 .10
.14 •15
.12 .10 .09
.10
.10 .08 .11 .11 .09 .13
.10 .12 .12
.12 .10
.14
.08 .10 .12
.10 .16 .10 .10 .10 .12
.14 .15
.14
.10
.12
.14 .14
.14
.13
.16 .12 .10 .09
.13 .13 .14
.13
.11
.12
.14
.16 .11
.09
.13
.12 .16
.11 .12 .11
.12 .10 .13
.13
.13
.08 .11 .12 .16 .12
.12 .12
.12
.13 .13 .15
.12 .13
.12 .12
.10 .10
.14 .14 .14 .13 •12 .13 .14 .15 .14
.12
.10 .12 .14
.10 .10
.13
.13
.12
.12
.13
.09
.07
.10
.10 .13 .13
.16
.07 .09
.14
.12
.14
.12
0 CD
.13
.09 .10 .12 .11 .10
•
.12 .11
•
.16 .10 .10
O Oo
10 11 12
I .l4 .14 •13 .13 .10
0 00
1 2 3 4 5 6 7 8 9
Immediately 3* After 8 * After Resting____ After Exercise Exercise______ Exercise III I II III I III I II II III II .11 .12 .12 .13 .13 113 .13 .14 .11 .16 .12 .15 .08 .12 .11 .12 .12 .09 .11 .14 .12 .11 .15 .09 .12 .10 .11 .10 .10 .11 .09 .10 .11 .07 .10 .08 .08 .07 .09 .15 .16 .15 .13 .14 .15 .16 .12 .14 .10 .12 .08 .12
•
Subject
99 TABLE XXV (continued)
ELECTROCARDIOGRAPHIC MEASUREMENTS IN SECONDS FOR THE LENGTH OF THE RS-T INTERVAL, LEAD I, TEST PERIODS I, II, AND III
Subject
36 37 38 39 Mo Ml M2 ^3 MM ^5 M6 M7 M8 M9 50 51 52 53 5^
I .10 .11 .10 .10 .lM .13 .10 .lM .1 6
.11 .07 .10 .0 8 .15 .12 .13 .09 .12
Resting I I . Ill .10 .lM .13 .12 .lM .10 .12 .10 .12 .10 .12 .10 .15 .12 .10 .12 .11 .12 .13 .12 .11 .10 .15 .12 .13 .12 .13
Immediately After Exercise I II III ,06 .0 8 .0 8 .10 .10 .12 .lM .08 .10 .09 .12 .10 .0 8 .0 8 .12 .0 8 .07 .12 .09 .13 .lM .10 .0 8 .0 8 .09 .08 .10 .07 .0 9 .12 .0 9 .0 8 .10 .0 7 .12 .12 .11 .10 .11 .10 .10 ♦13 .12 .10
3* After 8 * After Exercise_______Exercise I II I III II .10 .0 9 .09 .10 .08 .13 .12 .12 .11 .12 .10 .12 .12 .lM .10 .12 .12 .lM .1 6 .17 .lM .12 .12 .11 .11 .12 .11 .11 .11 .12 .10, .08 .11 .12 .12 .12 .13 .10 .11 .08 .11 .10 .09 .12 .12 .10 .12 .10 .13 .08 .13 .12 .12 .09 .12 .lM .12 .10 .12 .1 6 .12 .15 .13 .12 .12 .12 .12 .lM *15 .12 .lM .lM .12 .12 .12 .12 .12 .13 .12
III
.11 .13 .10 .10 .10 .12 .09
10G TABLE XXVI ELECTROCARDIOGRAPHIC MEASUREMENTS IN SECONDS FOR THE LENGTH OF THE T DURATION, LEAD I, TEST PERIODS I, II, AND III
Subject
1*
.16 .16 .16 .16
5
,1k
6
.18 .20 .19 .18 .11 .15 .15 .15 .15 .20 .16 .17 .17 .20 .15 .19 .13 .20 .17 .15 .18 .15 .21* .13 ,2k .17 .22 .18 .15 .17 -.17 .15 .19 .15 .16 .20 .16 .17 .26 .21 .16 .18 .21 .21 .17 .20 .18 .18 .21 .20 .16 .18 .16 .16 ,ik .18 .16 .15 .21 .20 .16 .18 .15 .17 .20 .26 .23 .20 .20 .19 .22 .16 .17 .15 .13 .17 .15 .17 .17 .20 .22 .22 .20 .20 .18 .21 .19 .21 .26 .18 •15 .18 .16 .21 .21 .19 .18 .27 .15 .18 .16 .18 .23 .20 .17 .18 .16 .16 .16 .17 .16 ,lk .18 .15 ,1k .17 .17 .11* .22 .16 .17 .11 .15 .15 .18 ,2k .23 .23 .24 •23 .20 .18 .17 .16 .18 .17 ,ik .18 .16 .18 .15 .12 .13 .13 ,1k •17 .17 .19 .17 .16 .18 .17. .16 .16 .18 .18 .10 .16 .18 .13 .18 ,lk .26 .21* .25 •17 .20 .16 .21 .16 .12 .17 .17 .17 .20 .15 .18 .16 .12 .11* .19 .13 .16 .18 .19 .15 .16 .15 .16 ,lk .18 .16 .10 .12 .17 .18 .13 .18 .19 .20 .20 .19 .18
7
8 9
10 11 12 13 Ik 15
16 17
18 19
20 21 22 23
2k 25
26 27
28 29 30 31 32 33
4
35
.16
.15
.16 .11* .09 .15 .17
.19
.22 .18 .22
H
3
.18 .20 .20 .22 .16
CD
1 2
3
Immediately 3' After 8 * After After Exercise Exercise______ Exercise II III I II III I III I II .18 .20 .15 .17 .15 •19 .16 .17 .15 .17 •17 .20
Resting I ■ II III
.18 .16 .11* .18
.18
.16 .16 .11 .17 .10 .12 .16 .12
.19
.16
.18
,1k
.13 .15 .17 .17 .15
*19
.20 .12
•17 .17
.21 .21* .21* .18 .18 .17
.20 .18 .16 .18 .16
.19 .19
.18 .18 .21 .20 .16 .18 .20 .21
.18 .18
.18
.15
.18
.19
.20 ,1k .23
.19 .19
.22 .18
.19
.18 .20 .20 .18 .18 .21 .20
.18
.17
.18
.15 .11*
.21 .20 .21* .22
.17
.21 .18
.26 .21 .16 .20 .16 .18 .18 .18
.19 .15 .19
.18 .21
.17 .17
.17 •13
.18
.18 .18 .20
.17
.16 .22 .19 ,1k
.19
•15
.16 .18 .21* .20 .16
.19
.18 .19
.18
.19
.18 .22
.17
101 TABLE XXVI (continued) ELECTROCARDIOGRAPHIC MEASUREMENTS IN SECONDS FOR THE LENGTH OF THE T DURATION, LEAD I, TEST PERIODS I, II, AND III
Subject I
Resting II III
.18 .18 .22
36 37 38 39
.16 .16 .18 ..18
1*0
.18 .20 .11* ♦17 .20 ♦13 .16 .1JU- .22 .16
hi h2 h3 hh h$ h6 hi h8 1*9 50 51 52 53 5^
.2h
.25 .19
.13
.20 •15
Immediately After Exercise I II III .11* .17 .16 .16 .15 .18 .19 ♦13
.21 .12 .10 .17
.19
.16
.16 .12
.23 .19
.21 .16 .18 .18
.15
.16
.13
.22 .23
.20
.18 .13
.16
.11* .11*
.16
.20
..lh .19
.15
.20 .21 .18
.16 ♦13
.13 .19
•09
.20 .22 .22 .22 .18 .20 .20
.22 .16
.18
.16
.17
.18 .16
.20 .18 .20 .18
.19
.18 .16
.19 .11* .15
.16
.17
.15
.17
.18 .18
.19
.16 .22
.20 .18
.23 .27 .17
.23
.13
.12 .20
.15
.17 .19
.32 .17
.18 .16
.15
.16
.19
.21
.19
.18
.19
.18 .20
.11* .17
.22 .18
.22
.20 .11*
.11* .22
.20 .18 .22 .16
.19 .11*
.18
.18
.15
.16 .22
.21
.15 .13
♦15
.23
.19 ,lh
.22 .16
3* After 8* After Exercise______ Exercise I II III I II III
.21 .22 .19
.20 .11*
.21 .18 .19 .13
.16 .17
.16
.21 .20 .20 .20 .18 .11* .16
102 TABLE XXVII ELECTROCARDIOGRAPHIC MEASUREMENTS IN MILLIVOLTS FOR THE HEIGHT OF THE T WAVE, LEAD I, TEST PERIODS I, II, AND III
Subject 1 2 3 k 5 6 7 8 9 10 11 12 13
Immediately Resting____ After Exercise I I II III II III .20 .20 .19 .19 .10 .36 .21 .15 .15 .20 .25 .20 .19 .17 .25 .20 •50 .k2 .22 .35 .21
.18 .21 .21 .22 .17 .35
.18 .29
.28 .19 Ao
.28
26
-,1k .20 .31 A5
27
.18
.20 •32 .25 .25 •35 .29 .20 .35 .25 .22 .15 .15 .32 .36 .32
•30 .07
.20 .20
.22 .20 .2k
.36
1*4-
15
16 17
18 19 20 21 22 23 2k 25
.18
28 29 30 31 32 33 3^ 35
‘
.36 .19 .3^
.22 .18 .26 .20 .20
.22 .20 .18 .20 .11 .11 -.33 .11 .36 •15 .23 .2k -.10 .38 •33 .28 .17 .20 •37 .17 .26 .22 .32 .32 .k9 •38 .k6 .17 .2k •19 .29 .16 .12
.26 .26 .16 -.15 .27
.2k .17 .23
.22 .20
.11 .30 •3k
.10 .18 .17 .27 .30 .26 .25 .18 -.10
.20 •31 .23 .22 .19 •38 •23 .32 .23 .38 .22 .18 .28 .21 .22 •38 •35 .20 .18 .22 .20 .22 .10 .22 .15 .2*1 .25 .25
.22 .20 .22 .22 .22 •22
.18
.23 .19 •30 .12 .32 .18 .2k
3* After 8 * After Exercise_____ Exercise I III II III I II .23 .21 .25 .11 .11 .38 .10 .20 .22
.18 .27 .21 .23
.18 .29 •32 •50 M
.30 .22 .19 .23 .35 •32 .22 .18 .19 •22 -.13
.22 •29 .19
.20 .26 .20 •30
•3** .kl
.08 .20 .10 .ko
•13 •19 .20
.18 .20 •35
.26
.18
.18
.21
.11 ,k2 •13 .18 .20 .10 .32 •30 .20 •17 •30 •30 •39 .ko
.22 •35 .2*4.27 •29 .18 •36 •25 .20 .29 •30 .2^ .ko •32 .1*4•32 •25 .22 •25
.15 .2** .31
.28 .21
.28
.28
.20 .22 .20
.29
.11
.22
•32
•30
.22
•30
•35 .18 •35 •32 .20 •31 .2k •25 .38 •32 .20 .25 •29 .22 .30 .18 .ko •30
•32 •30 •25 •30
•27
.22
.21 •32 .17 •32 .27 .2k •37 •15
.08
.18 •5k .22 •23 .20 •19 .12 -.10
.Ik
.27 •25
.kl •17 •35 .2*4-
.16 .Mj.18 .20 •19
.18 .1*4-
.18
.21 .16
.19 .39 .36 .12 .2k .10
.18
•36
•32
.22 .22
.28 .20
.17
.31 •19 •25
.38 .20 .28
•38 •39 .2*4.2k
.25 •29
.27 •25 •17 •15
.18 .18
103 TABLE XXVII (continued) ELECTROCARDIOGRAPHIC MEASUREMENTS IN MILLIVOLTS FOR THE HEIGHT OF THE T WAVE, LEAD I, TEST PERIODS I, II, AND III
Subject I 36 37 38 39 ko kl k2 k3 kk k5 k6 kl k& k9 50 51 52 53 9k
.15 •29 .13 .k$
Resting II III .15
.28
.18
.32 .32 .30
•32
.20
.21
.25
.2*4-
.18
.22
.30
,1k ,2k
.12 •3^ .15 •39 .23 •3^ •3^ .30
.20 .20 .18 .kk •15 •35 .31 •3k
.30 .22
Immediately After Exercise II I III
.18 .20
.15 -.2k .*4-5 .19 .22 .1*0
•35 .25
.08
.22
.2k .12
•35 .19
.20 .28
.26
.16 .22 .18
.25
.23
.19 .19
.16
.21 .12
.56
.29
•32
.15
.18 •39
.20 -36 •35 .2*4-
.k2 .2k
.22 .12 .21 .2k
.32 .ko
.16
.19
.18
.21
.32
.28
•39
•32
.20
.19 .*4-0 •15 .ko .23 .25
.18
.22
•36
.17 .29
.12 •57
.16 .28 .16
3» After Exercise III I II
.29 .Ik •39
.26 .ko *30 .2k
8 * After Exercise I II III .16 .1*4.23 •32 .20 .30 •3k .26 .2*4.28
.22
.26
.38 .2k
.28 .12
.20
.26
.2k .12 •k9
.29
•k5 •30 .35
.38 .21
•55 .1*4-
.22 .3k
.28 .18
.26 .38 .18 - .18 .31 .26 .21 .13 .25 •15 •39 .27 .36 •29 .23
.28 .12 .20 .2*4^
•38 .13 .32 .2k
.38 .31
.22
10k TABLE XXVIII ELECTROCARDIOGRAPHIC MEASUREMENTS IN MILLIVOLTS FOR THE HEIGHT OF THE T WAVE, LEAD II, TEST PERIODS I, II, AND III
Resting bjects
1 2
II
I .19 .25 .05 .29
III
.26 •32 .25 .23
Immediately 3* After After Exercise Exercise I I III II III II .25 .19
3 if 5
.16
6
.25
.20 .28
.21 .20 .18 .28
7
.20 .16
•30
.19
8
.28
9
.lif
.31
10 11 12
.10 .18
.18
•39 •30
.22
13 lif 15
16
.28 .25
.21 •53
19
.22
20 21 22
•5k •13
23 2if 25
26 27
28 29 30 31 32 33 3if 35
.36
.25 .09
17
.12 -.08 .lif
.26 .60 .12 .32 -.06 .30 .28 .20 .Oif .09 .27
.25
.09
.20
.15 .15
.21
.38
.18
18
.28
.26 .25 •3* .15
.28 .28 .20 .2if .18 .22
.29 .31
.26 .28 .18 .38 .13 .27 .17 .27 .25
.36 .15 .25
•30
.10
.08
•35 .if2
.31 .38 .15
.21
.29
.ifO .05
.28
.20
.30 •37 •19
.20 .29 .25 .56 •30 •38
.18 .07
.10 .13 •3k
.28 .30 •31 .30 •32
.28
.21
.28 .25 .23 .29 •22 .3^
.25 .19
.22 .19 .30
.20 .18 .if6
.20 .29 .25 .25 >5 .2if
.30
.22 .19 •31
.26
.if3 •3^ .09 .15 .27 •38 .11 .-.15 .29 .30 .36
.29
.26
.20
.10
.12 .36 .15 •39 .36
.22
.20
•35 .30 .25
.30
.ifO
.16 .28
.12
.12
.05
.29
.28
.17
.10 .21 .11
.25 •30 .29 .11 •30 .21 .2if .ifO .28 •17 .15 .32 •15 .10 .lif .22 .10 .18 .31 .21 .31 •25 •31 .28 .09 .32 .18 .28 .13 .22 •30 .26 .25 .21 .25 •30 .17 •25 •30 .25 .28 .52 •38 •^7 .if9 •19 .18 .11 .12 .if6 •39 •25 .60 .12 .25 .18 •13 .20 *25 .22 .18 .08 •35 .17 -.07 .16 .15 .16 .ifif .30 •30 .ifif •k 2 .30 .if8
.28 .25 .10 -.Oif .28 •3k .29 .10 .22
.23
I •13 •15
-15 .19
.28 .32 .31 .32 •13 •39 .30
.2if .2if .18 •.20 .17 .19
8* After Exercise
.10 .30 .20 .08 -.02 •36 •33
•29
.12
.20
III
•36 •3^
.2if
.20 •25 •25 •3^ •31 •30 •17 •33
.28 •31
.28
.2if
.20 •35 .27 .27
.22 .18
•30 •30 •30 •30 •15 •35 •25 .2if
•19
.26
.18
.ifO •13 .2if
•15 •35 •15 •31
.10
.12
•31 •29 •15 •38 .05
.27
.20
.if9
.21
II
•3 k
.26 •05 •31
.28 .16 .18
105 TABLE XXVIII (continued) ELECTROCARDIOGRAPHIC MEASUREMENTS IN MILLIVOLTS FOR THE HEIGHT OF THE T WAVE, LEAD II, TEST PERIODS I, II, AND III
Immediately 3 1 After After Exercise Exercise
Resting Subjects
I
.30
.15 .15 .21 .12 .27 .1*6
37 38 39 ko kl k2 k3 kk k$ k6 kl
1*8 k9
50 51 52 53 5^
.kk .1 8 ,1k
.21 .1 6
-27 .08 .37 .20 .32 .30 .29
II
III
.10 .21* .2 8
.2k
.35
*27
.1 6
.12 .10 .29 .22 .1 8
.20 .15 .28 .05 •35 .27 .2k
•36 .20
I
.26 •3^ .25 .51 .12 .1*3
.0** .18
.Ik .k2
.15 .22
.1 6
.10 .31 .12 .k2 .Ik
.3^ .10 .1*9 .27 •3^ .28 .22
II
III
.18
I
.17 .28
.2 8
.2 8
.31 .30 .20 .12
.32 •33
.1 8
.0 8
•57 .06 .55 •05
•32 .30 .18
.20
.kl
.15 .32
.13 .12 .39
,2k .0 8 .3 6
•55 .01*
.31 .09
.2 8
.k2
.20 .29 .36 .12
.23 .31 .29 .20
II
.10 .30 .20 .2 8 .16
8* After Exercise III
I
.2 6
.23 .21
.11
.29 .12 •50
.10 .1 8
.08
.29 .25
.1 6
.1 8 ,2k
.12 •3^ .32 .22 .35 .31 .22
•15 .2k
.10 .25 .20 -25 .12
III
.2 6 •3k
.0 6
.Ok ,k2
.15
.11 .12 •30
.1 6
.18
.15 .08 -31
.1 6
.1 6 .kl .Ok
II
.28
.09 .kl
•27 .23 .30 .22
•05 .Ik
.32 •31 .25 •3^ .20
.1*0 .01*
io6
TABLE XXIX ELECTROCARDIOGRAPHIC MEASUREMENTS IN MILLIVOLTS FOR THE HEIGHT OF THE T WAVE, LEAD III, TEST PERIODS I, II, AND III
Immediately 3 ’ After After Exercise Exercise
Resting
16 17
18 19 20 21 22 23 24 25
26 27
28 29 30 31 32 53 34 35
.09 .12 -.05 .13 .05 -.11 .12 -.08 .20 -.10 -.10 .Ik
II .10 .10 .10 .10 -.04
-.15 .20
III
I
II
III
.09 .14 •13 .10 -.02 .10 •15 .13 .11 -.03 -.11 -.10 .14 .15
I •05 .14 -.10
II
III
.08 .10
.08 -.08 .16 .17 .10 “.05
-.09 -.10 .10 .18
-.06 -.12 -.05 -.06 -.04 -.05 .16 .20 -.15 -.10 -.17 -.10 -.12 -.10 -.05 -.15 -.09 .10 .05 -.08 .10 .12 .21 .20 .12 .18 .08 -.10 .08 -.05 -.07 - .06 .05 -.08 -.08 .08 -.08 -.12 •15 .20 -.12 .12 .15 -.11 -.09 -.12 .10 .21 -.10 --05 .12 -.20 .15 -.10 .05 -.05 .05 .05
-.06 -.06 “.15 -.08 -.08 -.05 .10 .00 .10 .12 -.10 ■ -.10
-.05
I .10 .13
II
III
.08
.12 .10 .05 -.04 -.09 -.10 .05 .20 -.08 -.95 •17 -.10 -.14 -.10 -.10 -.05 .10 .10 .10 .20 -.10 -.06 -.10 .16 .10 -.10 -.16 -.12 .10 .01 “.15 .10 .10 -.08 -.05
.10 ■-.10 .18 -.15 -.15 -.17 .18 .14 -.17 .12 .10 .00 .10 -.12 •05 -.10 •-.07 .08 .08 .06 .15 .12 .04 .10 .08 -.10 -.08 .10 -.08 -.08 -.05 -.05 ■-.09 .05 .05 .05 .19 .06 .05 .16 .20 .08 .10 .15 .08 .06 -.05 -.05 -.08 -.05 -.05 -.05 -.18 -.05 -.15 -.05 -.15 -.05 .13 .06 •05 .07 -.07 .05 .07 .05 .10 •05 .06 •03 .12 •15 .06 .12 .16 .07 .08 .16 .08 .13 -.20 -.18 -.15 -.11 -.15 -.08 -.20 .06 .08 -.04 .12 -.05 .19 -.05 .16 .22 .08 -.05 .15 .14 .10 .15 .12 .05 -.05 -.10 -.07 -.07 -.05 -.15 -.04 -.15 --.06 -.05 .16 .15 .17 .18 .18 .15 .19 .10 .08 -.15 .10 -.20 •17 -.12 -.08 -.05 -.05 -.06 -.05 -.10 -.08 --.10 -.06 .22 -.12 .02
1
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
I
10 CD
Subjects
8* After Exercise
-.05 -.10 .00
.08 -.06 .08 -.10 .14
-.08 .08
.05 .15
.05
.05
.08
.15 -.15 -.05 .15
.08
.08
.10 -.12 -.06 •32 -.15 -.10 -.08
107 TABLE XXIX (continued) ELECTROCARDIOGRAPHIC MEASUREMENTS IN MILLIVOLTS FOR THE HEIGHT OF THE T WAVE, LEAD III, TEST PERIODS I, II, AND III
Immediately 3 f After After Exercise Exercise
Resting Subjects
I
II
36
.0 5 - .0 5
37
-.12 -.12
38 39
40 41 42 43
44 45 46 47
48 49 50 51 52
53
III I
- . 0 8 - .1 5 - .1 5 .0 6 .1 0 .14 -.07 - .1 8 .1 0 .30 - .2 1 - .2 0 - .2 5 .14 .2 0 .04 - .2 0 -.15 - . 1 0 -.04 - .0 5 - .0 6 .0 8 -.0 8 -.1 0 .0 7 - . 1 8 - .1 3 -.10 - . 0 6 -.10 - .0 5 .0 8 - .1 0
-.12 -.12 -.10 -.12
II
Hi
.0 6 -.05 -.08 -.12 .0 6 - . 1 0 .1 1 .0 8 .0 8 - . 2 0 .1 1 .3 2 .2 0
.1 6
.1 0
-.13 - . 1 0 .10 - . 0 5
.14 - . 1 0
.15 .1 0 - . 0 8 .12 - . 1 8 -.12 - .0 8 -.09 -.1 0 .0 5 - . 1 0
-.10 -.10 -.10 -.12
II
.05 - . 1 0 -.09 -.10
-.13 --15 - . 1 2 ,1 7
I
8 f After Exercise III
I
II
III
.05 - . 1 0
-.11 -.08
- .0 5 - . 1 5 - . 1 0 - . 0 6 - . 1 5 - . 1 2 .05 .15 -10 .1 2 -.1 0 - .1 6 - . 0 7 -.17 .0 6 .2 8 .0 6 .27 18 - . 2 1 - . 1 8 .1 8 - . 1 8 - .2 1 .1 1 .24 .1 0 .05 .0 6 -.17 - . 1 2 - . 1 8 -.15 - .1 2 -.0 5 - . 1 2 - 05 - . 0 8 - . 0 9 .0 8 - . 0 8 - . 0 7 .0 7 - .0 6 - .0 8 - .0 5 - . 0 8 .0 6 - . 1 6 - . 1 7 - .1 8 -.1 3 -.0 7 - . 1 3 -.05 -.12 - .0 5 - .0 5 - .0 5 - . 1 6 -.12 - . 1 6 -.21 - . 0 5 -.10 - . 0 8 -.18
108 TABLE XXX ELECTROCARDIOGRAPHIC MEASUREMENTS IN MILLIVOLTS FOR THE DEPTH OF THE Q WAVE, LEAD I, TEST PERIODS I, II,-AND III
.00 .00
.00 .00 .00 .00 .00 .00 .02 .00 .00 .04 .00 o o
.00 .00
.00 .00 .00 .00 o q
•
o
o o
.00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .05 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .08 .00 .00 .00 .00 .00 .08 .00 .05 .00 •05 .05 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00
III
o o
.00 .04 .00 .00 .04 .00
II
o o•
.00 .00 .00 .00 .00
.00 .00 .00 .00 .00 •05 .00 00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .08 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00
I
o q
.00
III
o o
.00 .00
.00 .00 .00 .00 .05 .00 .00 .00 .00 00 .00 .04 .00 .00 .00 .08 .00 .00 .10 .05 .00 .00 .00 .00 .00 .00 .00 .00 .00
II
Exercise
o q
.00 .00
.06
.00 .00 .00 .00 .10 .00 .00 .00 .00
.00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .05 .00 .00 .00 .00 .10 .00 .00 .00 .00 .00 .00 .00 .00
o o
.08
.00 .00 .00 .00 .00 *00 .00 .00 .00
.00 .04 .00 .00 .05 .00
.05
o o
26
27 28 29 30 31 32 33 3^ 35
.00 .00 .00 .00 .00
.00
.00 .00 .00 .00 .00
.00 .00 .00
o o
.05
.00 .10 .11
.00
I
o o
17 18 19 20 21 22 23 2k 25
.00 .02 .00 .00 .00 .00 .00 .00 .00 .00 .00 .10 .00 .00 .00
II
ir\
16
.0 5
.00 .00 .00 .00 .00 .ok .00 .02 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00
III
q
.00 .00 .00 .00 .00 .05 .00 .05 .00 .00 .00 .00 .00 .00 .00 .00 .00 00 •05 .00 .00 .00 .00 .00 .05 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00
I
o o•
.00 .00 .00 .00 .00
o o
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
III
o o
II
o o•
r
o o•
bject
8* After
G
Resting
Immediately 3' After After Exercise Exercise
109 TABLE XXX (continued) ELECTROCARDIOGRAPHIC MEASUREMENTS IN MILLIVOLTS FOR THE DEPTH OF THE Q WAVE, LEAD I, TEST PERIODS I, II, AND III
Immediately 3 ‘ After After Exercise Exercise
Resting aject
.00 .00 .00 .04
II .00 .00 .00 .00
.02
.08
43
.00 .04 .00
44
.05
.00 .00 .00 .00 .00 .00 .00 .00 .00 00 .00 .00 .00 .00
45 46
.00
47
.05
48
.00 .00 .00
49 50 51 52 53 54
.08 .09 .00 .00
III
.00 .00
.00 .00 .00 .00 .00 .00
I .00 .00 .00 .00 .04 .00 .00 .00 .00 .00 .00 .10 .00 .00 .00
.05 .08 .00 .00
II .00 .00 .00 .00
III
I
.00 .00
.00 .00 .00 .00
.08
.05 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00
.00 .00 .00 .00
.00 .04 .00 .00 .00 .00
.05 .00 .00
.00 .00
.05 .05 .05 .00
.00
II
III
.00 .00 .00 .00 .00
■.00 .00 .00 .00 .00 .04 .00 .00 .02 .00 .00 .00 .00 .00 .00 .00
.00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00
I
.05 .00 .00
.00 .00 .00
II
III
.00 .00 .00 .00
.00 .00
.05 .00 .00 .00 .00 .00 .00 .00 .00 .00
.05 .05
.00
.00 .00
.00 .00
0 0
36 37 38 39 ko hi k2
1
8' After Exercise
.00 .00 .00 .00 .00
110 TABLE XXXI ELECTROCARDIOGRAPHIC MEASUREMENTS IN MILLIVOLTS FOR THE HEIGHT OF THE QRS COMPLEX, LEAD I, TEST PERIODS I, II, AND III
Resting bjects
I
1
.85 • 55
2 3 b 5
6 7 8 9 10 11 12 13 lb
15 16
17 18 19 20 21 22 23 2b
25 26 27 28
29 30 31 32 33 3^ 35
II .9 2
.82
.60 1 .0 0
•57 .80
1.20 • 50
III
•52
.56 • 55 1.30 •32
Immediately 3 1 After After Exercise Exercise I
II .6 2 .65
• 59 • 35 .68 A 5 .31 .88
•75 .6 1 .52 .85
.bo ,9b 1 .1 0 1.0b .91 Al .b2 • 52 .60 .38 .09 .6 0 .52 1 A 9 1.30 1 .2 9 .69 .70 1.03 .6 1 .9 8 •30 ,b2 .1 8 .29 .2 8 .82 l.ho 1 .0b .66 l A o
.89 •75 .78 .89 •90 1.02 .78 1.28 .83 .72 .96 1.25 1.2*41.18 •85 1-37 .78 .65 •50 .88 .b6 .bo .52 1.22 .5 8 1.12 .75 .8 0 :1 .10 1.36 .8 2 1.15 •78 .91 .79 1.12 1.0 0 .7 6 .51 •5b .6 2 1 .5 0 :L.05 1 .2 6 1 .1 8 .81 .90 .6 7 1.0 1 .Qb
.9 0
.68 ‘L.10 .51 ■ •36 50 •78 .65 ■65
.72
.6 7
.50 ,b6
.8 1
•50 .80 .72
.6 0 .bi
.6 0
•9 6
.82
.8 0
.7 7 .65 A7 .6 7 A7
•87 A2 .71 .66 .6 1
.72
.50
.6 0
•63
.63
A9 •32 •37
III
.52 •
5b
• 50 .80
•3^
I
II
.8 6
.8 9
.53
.82
.80
.90
.88 •78 1 .36 • 39
8* After Exercise III
I
II
.lb .88 .50 .85 A8 •79 .9 6 • 59 .66 .71 .86 1 .00 1 .1 0 A l AO 1.02 .89 .68
III
A8
A9 •71 1.05 • 38 .6 0 .9 2 •9b •75 .bb •51 .08 •55 .56 .0 8 .58 •55 .08 1. b2 1.10 1 .6 1 1 A 9 1.00 •19 .8 2 •90 .90 •79 1 .2 0 .*A .32 .lb • 32 .30 .15 .1 3 .8 7 •71 1 A 5 .92 •79 1 .*A 1 .0 8 .8 7 .63 •95 .91 .88 .88 .90 1.00 1.00 A 9 1.1*4- •93 1 .3 0 .9 8 .9 8 1.18 •99 l . l l 1.0^ • 78 .90 .89 .95 .89 .92 •38 A 7 •75 .bb A 6 A 9 Ao .59 1.40 • 55 • 52 1 AO •75 .50 1 .1 8 1.02 1.05 1 .0 5 •95 :L .l l 1.2*1.87 1.10 .78 .88 1 .0 1 .9 6 .86 •57 .66 •15 .20 .79 .8 0 •32 1 A 5 1 .1 0 1 A 5 .8 0 .8*4- .96 .7^ :L.00 •75 .8 0 .80 .68 .83 :L.12 .70 .6 2 1.02 .78 .78 .32 A 5 .52 •35 .5 2 .65 A 9 A 8 .63 •75 A6 .6 2 •75 A 2 .Qb :L.05 .76 .6b • 55 •72 .65) .65 .65 .72 •5b .6 0 .8 1 •70 .6 1 .80 •90 .61 59 .70 A 9 •55 .bb .6 2 A 7 .62 •70 .79 •92 .Qb .7 0 ]L.00 .6 0
Ill
TABLE XXXI (continued) ELECTROCARDIOGRAPHIC MEASUREMENTS IN MILLIVOLTS FOR THE HEIGHT OF THE QRS COMPLEX, LEAD I, TEST PERIODS I, II, AND III
Resting
bjects 36 37 38 39 40 4l h2 43 hh 45 h6 47
48 h9 50 51 52 53 54
I
II
III
•52
1.00 1 08 1.25 .24 .27 1 .7 1 .96 .80
1.40 1.05 1.22 .46 •32 .48 .6 2 .65 .68 .78 .80 1 .0 1 .68 1.08 1 .0 0 1 .1 6 1 .1 2 .61 .48 1 .1 6 1.32 1 .0 6 1.01
1.14 1.22 •73 .80 .82 l.l4
I
II.
.6 0 82 1.02
.6 0 •59 .92 1.22
.55 .70
Immediately 3 f After After Exercise Exercise
.85 .6 0
III
I
II
.6 9
.50 1.82
•79 .86 •70 .59 .86 1.21 .88 .54 •77 1.25 •92 •99 •59
.8' After Exercise III
I
II
III
.68 .56 .87 1.25 .8 9 1.00 1.10 -25 .35
1 .0 6 1 .0 6 .82 1.00 1.15 .42 .20 •50 .39 .22 .4 9 .6 0 .9 0 .85 .79 .78 •71 1.00 1.10 1 .1 7 1.10 1.40 1.12 1 .1 8 1.04 .4o .4 7 •38 .36 .82 .29 .46 •73 .68 .50 .6 0 .7 2 .49 .4i 52 .72 .82 .85 .62 .65 .69 1.02 .72 .68 1.00 .6 7 1 48 1.02 •79 1.02 1.02 .96 •87 .9 2 •78 1.20 1.02 1.25 1.00 1 .0 3 1 .1 8 •96 .6 0 .52 .72 •58 •57 1 .1 6 1.15 1.02 1.20 •92 1 .0 6 1.00 1 .0 8 .76 .48 •77 .8 0 1.04 1.15 1.10 1 08 1.18 .92 .6 2 .81 • 72 .6 9 1.05 •57 2.01 .96 •52 •55 .8 5 -95
112 TABLE XXXII ELECTROCARDIOGRAPHIC MEASUREMENTS IN SECONDS FOR THE LENGTH OF THE P-R INTERVAL, LEAD I, TEST PERIODS I, II, AND III
Immediately 3 1 After After Exercise Exercise
Resting Subjects
I
II
1 2
.14
3. 4 5 7
.15 •15 ■13 •15 .19
.16 .16 .12 ‘16
8
.1 2
9
15 .13
6
10 11 12
.16
.16 .16
.16
.15
.16
.14 .14 •13
.16 .1 2 .1 2 .10 .1 6 .16 •12
.16
.1 8
19
.14 .14
.14
26
27 28
29 30 31 32 33 34 35
.17 .1 2 .12 .16
.17 .14 .11 .16
•13 •13 .14 .11
.14
16 .16 .12
•13 .14
.14
.16 16 .16
.10 .16
•13
.14
.1 1
13
15
.16
.20 .1 2
.1 6
.13 .12 .10
.1 8
.11
.11
.1 2
.1 2
•13
.17 .14
•15 •17 •13
.18
.16
.1 6
.14 .2 1
.14 .14
.14 .14 .14
•15 .14 .14 .15
.11
.1 2
.14
.17
.10
.11 .16
.16
.11
.15
•17
.14
.12
.1 2 .16
.1 2
.14 •13 .15 .13 .13
.14 •15
.16 12 .12
.12
.15
.1 8
.16
.1 1
.17
.14
.12
.14 .14 17 .15 .13 .14 .14
.12
.1 8
.14
•17
.14
.1 2
•17 .12 .1 2
13 •15 .14 .17 .14
.1 6 12 .16 .1 2
.11
.1 2 .1 0
.12
.13
.1 1
.1 8 .1 2
.1 8 .16 .1 2 .16
14 .13 .15 .14 •13 .14
18
•15 .13
.1 2
•13 .13
.1 2
14
.1 2
•13
.13
14 .14 .15- .14
.11
.1 2 .16 .1 8
.16
.16
•13
.14
•15
.15 •17 .14
.1 2
14 .15 .15 .13
•13 .15 •17 •13 .14 .14
III
.17 .14
.16
15
.1 8
11
II
.12 .1 0 .1 6 .16
.16
•13 .14
*17 .13
.14 .15
14 .14 .14 .14 •13 •.12
l4 .14
.14
•17
.14 •15 .14 *13 •19 .14 .14 13
•15
.12
.14 .15
.15 .14 .14 .14 .13
.14
.16
I
.16
.15
.14
III
.15
.1 2 .1 2
,16
.14 •15 14 13 .14
II
.14 .13
•17 •13
17
I
•13 09 .14 *15 •15 •17 •13
.10
18
23 24 25
.14
.12 .16
.13
.16 .12
•13
III
.1 6 .1 2
•13
16
20 21 22
•17
II
.15 .15 .09
.16 .12 .11
.14
I .16 .1 6 .12 .1 2
.14 •13 .19 .13 .14 .15
13 14 15
III
8 1 After Exercise
•15 .1 1
.14 •13 .1 8
.13
.12
.15 .14 .14 .17 .14
•17 .14 .10
.13
.12
.14
.17
.1 6
.12
.13
•13 .17 •13 .14
.15
.14
.16 .16
.14
16
.1 2 - .14 17 .1 8 .14 .1 2
.14 .14 .13 .15
.14 •15
.10 .16
.14
.1 2
13
.1 2
113 TABLE XXXII (continued) ELECTROCARDIOGRAPHIC MEASUREMENTS IN SECONDS FOR THE LENGTH OF THE P-R INTERVAL, LEAD I, TEST PERIODS I, II, AND III *
Immediately 3 f After After Exercise Exercise
Resting bjects
36 37 38 39 40 41 42 43
44
I
.14 .11 .14 .13 .16
.13 .18 •15 .12
45
46
.16
47
.15
48
.16
49
.11 .17
50 51 52 53 54
II
III
.12 .14
.14 11 .16 •13 .12 12 .10 •15 .16 .12 •15' .13 .12
.1 6
.14 .12 .1 3 -19 .13
.1L.18 .12 •15 •15 •13 .1 8
I
.14 .14 .17 •15 .14 .16
.15 .12
III
I
18 ■13
.14 .11 .13 .13
.14 .12
.16
.1 6
.1 6
.16
•13
.12 .12 17 .13 •17 15
•13
12
.1 6
.11
.18
.19
.15 •13
.1 8
.16
.13 .13
.12 .14
.1 6
II
.1 6
.11 .1 6 .16
.18 .13 14
.15 .11
II
.1 6
.16
.12 .17
.1 6
.12 •17 10 •17 .15 .14 .18 .14 18 .10 .16
III
14 .13 .17 .12
.1 6
8 f After Exercise
.12 .13 .15 .11 .15 .1 6
.15 .19 .14 .12 .14
.14 •13
I
.14 .13 .12
II
III
.12 .15 .18
.16
•13
.16 •13 .20 .13 .11
.14 .13 .20 •13 .15
.1 8
.1 6
.1 8
.1 6
.11
.12 .15
.10 .14
.18 .11
.1 6
.1 6
.12 .18 •17 17 .13
.14 .17 .15 .12
.16
.1 6
.17 13
.12 .17 .12 .10
114
TABLE XXXIII ELECTROCARDIOGRAPHIC MEASUREMENTS IN SECONDS FOR THE LENGTH OF THE T-P INTERVAL, LEAD I, TEST PERIODS I, II, AND III
Subject 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
16 17
18 19 20 21 22 23 2k 25
26 27 28 29 30 31 32 33 3^ 35
I .6k .26 •50 .25 .2k •51 .08 .20 .14 .24 15 .27 •45 •38 •32 .11 •52 .21 .*1-2 .46 .39 .39 .23 •k l .25 .22 .16 .*1-0 .52 .36 •31 .30 .37 .32 .38
Resting II III .33 .20 .19 .23 .32 l4 .37
.18 ,1k .20 .*1-8 •35 .25 ,k6 •38 .27 .28 .32 .2*1.20 •^3 •3 k .39 .*1-1 .05 .kk .25 .18 .26 .26 .38 .56 .17 .23 •^3 •45
.22 .3^ .32 •32 .kl
.26 .16 .18
.26 •38 .24 .*1-9 .18
.27
.36 .5*1.3^ .21
.24
Immediately After Exercise I II III .70 .*+0 .09 .20 .*1-0 •l4 .28 .05 .16 12 .06 •35 .61 .11 .19 •17 .22 .19 .26 .31 •*4-3 .18 .18 .22 .16 •19 .16 .26 •3k •*4-3 .kl ,22 .26 .25 •23 .28 .12 •23 .10 .32 •30 .20 •19 .16 .29 .kk .46 .27 .49 •36 .16 .20 .10 i20 .20 •32 .20 .48 .28 .24 •38 .20 •30 .15 .22 •29 .10 .11 •32 .18 •51 .57 .20 .60 .*1-9 •36 .20 •31 •31 .21 •13 •17 .*1-0 .12 .*+8 .26 s40 •31 .18
3* After Exercise_____ I II III .58 •59 .26 .22 •55 .12 •29 .14 .22 •25 •13 •39 •36 .08 .24 .22 •15 •27 •15 •31 .20 •3i4- •33 .16 .20 .20 .30 •36 .41 •37 •32 •39 .48 .50 •29 .20 •29 .22 .24 .14 .43 •32
.18
.16
.22 •55 .20 •27 •13 .43 .28
.22 •55 •23
.16 .08 .26 .42
.60 •23 •23 .20 •38 •38
.26 •31
.18 .28 •36 •30 •3k .34
.30 •37 .21 •13 .20 •^5 .24 *32 .20
.20 '•23 .42 •34 .21
.26 •23 ;.4l
•19
8 1 After Exercise I II III •57 .50 •13 •15 •57 .24 .34 .18 •17 •15 •15 •23 .41 .14 .23 .20 .20 .20 .20 •30 .24 .41 •38 •15 .40 •23 •23 •29 .28 •38 .44 •38 .40 .47 .26 •29 .22 •17 .28 •19 .45 •38 .20 .18 .22 •35 •15 •56 .60 •50 •29 .22 .30 •23 .20 .24 .26 •17 •30 •29 •37 •39 •38 .30 .18 .20 .24 •13 .16 •39 •19 •30 .47 •30 .36 .60 •31 .18 •33 .21 •17 .16 •23 •35 •19 •38 •32 •25 •52 .20
11L5
TABLE XXXIII (continued) ELECTROCARDIOGRAPHIC MEASUREMENTS IN SECONDS FOR THE LENGTH OF THE T-P INTERVAL, LEAD I, TEST PERIODS I, II, AND III
Immediately 3 1 After After Exercise Exercise
Resting ojects
36 37 38 39 1*0
4l k2 k3 44 ^5 46 47
48 49
50 51 52 53 5k
I
.24 .27 .07 .2 8
•33 .31 .21 .42 •36 .1 6
.27 •52 .41 .51 .23 •63 .18 .21
II
III
.14 .19
•19 .1 8
.32 .^7 .19 •37 .38 .31 •31 .15 .22 .42 •35 .23 •k 5 .42 .6 0 .1 8
.20
I
•33 .29 .20 .30 .15 .17
.1 6
•35 .29 .18 .2 8
.51 .20 .13 .12 .1 8
•57 .1 6
.42 .27 .25 .22 •33 .34 .17
II
.19 .20 .20 .2 6
III
I
•31 •07
•19 .14 .17 •35 .3 4
.24
It
8 * After Exercise III
.16
.22 .24 •38 •30
•27 •31
•31 .41 .22
•29 .20
.0 8 .1 6 .16
.11 •25
.23
.43 .14
.23 •30 •57 .18 .18
.2 6
.41 •33 .15 .14 •38 .44 .48 .41 •15 .40 •35 •17
•3^ •35 .48 .12 .20 .49 .42 .41 .21 .46 .42 .1 8
.28 .12 .18 .21 .42 •17
I
II
•27 •15 •23 ^26 .18 .25 .4 7
.22 •36 •27 •35 •39 .1 6
.23 •43 •31 .44
III
•37 •32
.20 •36 .20 .46 .11 •27 .54 .48
•29 .22 •15 •27 •52 .1 6
.4 7 •19 •37
•33
•32 •19
•32 .20
•27 •53
116 TABLE XXXIV ELECTROCARDIOGRAPHIC "MEASUREMENTS IN SECONDS FOR THE LENGTH OF THE P-P INTERVAL, LEAD I, TEST PERIODS I, II, AND III
Immediately 3* After After Exercise Exercise
Resting
ibjects 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
17 18 19 20 21 22 23 2k
25 26
27 28 29 30 31 32 33 3k 35 36
I
II
•99 1 .0 6 .76 .70 .80 .6k .89 .87 •71 •54 1.04 .88 .57 •75 .66 .66 .6 7
III
I
11
1.02 .56 .74 .67 •^5
.91 .68 .57 •59 .k6 •39 .Qk 1.17
III
•73
.3k
.6 9
.6 7
•72 1 .0 6 •79 .66 .87 .76 .82 .84 .9 4 •98 .84 .93 .9k 1.04 .80 .7 2 •73 .56 .7 8 .62 1.03 .86 •93 .70 .66 •90 •77 .7 8 .9 0 .98 .86 .9 0 .88 •75 .9 0 .88 •95 .74 .95 .71
•59 .6 0 .70 •63 .6 2
.68 .88 .68 •59 .7 8 .65
.66
.65 .6 0
•90
.58
.64 .64
.7 0 .6 5 .8 1
•7^ .66 .65
•77 .5 8
.6 5
.58 •93 .82 .79 .7^ .*4-6
11
•92 1.13 .71 .7 1 .83 •59 •59 •7** .68 .5 0 .91 .9 0 •53 •72
.6 0 .67
•9*4- .9 6 .68 1.09 .60 .65 •59 .6 0
I
.62 .7 8 .8 2
8* After Exercise III
I
II
•91 1108 •58 .6 2 .8 5 •79 .66 .86 .59 •57 .76 1.02 .6 1 •75 .65 .67 .6 5 •75 .88 .6 5
•75
•73 .82
.8 2
.66 .82
.9 0
.6 7 •99 .8 1 .90 •7^ •75 .82 .6 7 .9 *4- .82 .86 .80 .85 •97 .9 2 •77 .9 2 1 .0 5 1.07 .91 1.00 1 .0 5 .72 .7 7 .63 .76 .70 .76 .66 .46 .6 7 •70 •55 •79 .7 7 .63 .9 8 .81 .96 .9 2 .5 *+ .65 .60 .6 1 •74 .6 2 .6 9 •95 .7 0 .76 .81 .9 0 .63 1.10 .80 1.0*4- I .0 3 .8 3 1.10 .9 8 .80 •k9 .6 2 .70 .82 .71 .7 9 .71 .7k .71 .6 9 .8 2 .68 .6 9 .69 .84 .6 1 .86 •77 .8 2 .65 •75
.66
.82 .74 .96 .80 •93 1.00 .82 .96 .78 .67 .91 .91 .72 .7 4 •77 .6 0 .78 •7^ .6 7 .6 9 •70 .66 .66 .66 .6 0 .6 0 .52 •55 •55 .72 .89 .8 2 .6 1 .9 8 .76 .67 •72 .87 .64 .9 1 1.04 •79 1.02 1 .0 0 .64 1.11 .89 1.00 .97 •99 .82 1 .0 1 1 .1 6 1 .0 8 .8 2 .89 •9^ •93 •99 .82 1.09 .86 •57 •77 •77 .70 .Qk .84 .67 .80 .76 .6 2 .6 9 .61 .53 .6 0 .66 .68 .66 .6 3 .6 0 .8*4- .65 •72 .70 •70 .89 •29 .83 .84 .80 .8 0 .7 8 .96 .63 .92 .6 7 .90 •95 .73 .85 .7 6 •59 .8 2 .9 2 .6 2 .7 6 1.04 .70 .62 74 .54 •52 .6 0 .67 •55 .9 2
III
•
•73 .80 .86 .74 •70 .6 2
117 TABLE XXXIV (continued) ELECTROCARDIOGRAPHIC MEASUREMENTS IN SECONDS FOR THE LENGTH OF THE P-P INTERVAL, LEAD I, TEST PERIODS I, II, AND III
Subjects 37 38 39 ko kl k2 k3 kk k5 k6 kj k& k9 50 51 52 53 5^
Resting I II III •70 .72 .66 .90 .90 .80 1.05 •73 .Qk .68 •79 .83 .82 .98 •75 .87 ..7^ .70 .8* 1.02 .66 .63 •57 .65 .6k .75 .97 1 . 0 k .90 1.10 •92 •59 .98 •91 .77 .98 1*13 1.16 .65 .88 .66 .62
Immediately After Exercise I II • III •57 .62 .83 .7^ .65 .77 •57 .68 •58 .k9 •5^
.70 .72 .80
.69 .82 .76
.60
.62 .67 •77 .71
3* After Exercise I 11 ill .58
.90 •1 *
.63 .82 .80
.76 .76 •90 .76
.78 .78
.69
1.03
.98 .62 .93 .30 .55 .66 .66
.85
.81
.8^ •78 .80 1 .0^
•53
.35 .6^
.61 •53 .61 .83 1.00
.65 .60
.9^
•97
.76 .58
.85 .65
.93
.50 1.02 .70 .80 .92 .Qk .61
•99 .66 .92 •79
.63
.95 .75 .95
.92 .58
8 * After Exercise II III I .78
.65
.75 1.00 .7^ .68 .90 .8^ .91 •77 .60 .Qk .97
.91
.60
.6k .Ik
.67 .62
.70 •93 I .07 1 . 0 k .83 .97 .58 .9^ 1.13 .87 •73 .88 .92 1.03
.81 .65
.80 .6k
.78 .87 .60
.5^