Service de Physiologie Clinique et de lExercice

Saint-Étienne, France

Service de Physiologie Clinique et de lExercice

Saint-Étienne, France
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PubMed | Service de Physiologie Clinique et de lExercice, Service de Neurologie CHU St Etienne, Service de Pneumologie et Oncologie Thoracique CHU St Etienne, French Institute of Health and Medical Research and Jean Monnet University
Type: | Journal: Respiratory physiology & neurobiology | Year: 2016

Respiratory Muscle Endurance (RME) is an alternative way to assess respiratory muscle impairment but normal values are lacking to use this test in a clinical perspective. Our objective was then to determine reference values of RME in healthy subjects. We recruited 161 healthy subjects (25-80 years old) who were distributed within 5 groups with a 10-year range. We measured vital capacity (VC) and maximal respiratory pressure (MIP, MEP). The RME test consisted of isocapnic hyperpnea at increasing levels of ventilation until exhaustion to determine Tlim (expressed in minutes and as percentage of maximal voluntary ventilation, MVV). A significant difference between age-groups was observed for both VC and MEP expressed as percentage of predicted value. Mean Tlim was 21.85.9min [95% confidence interval 20.9-22.8], 74.415.9% of predicted MVV [95% CI 71.8-76.9]. Tlim was similar among age groups. Tolerance to the RME test was excellent. This study provides normal values of RME in a large age range of healthy subjects and demonstrates that RME is preserved in the elderly.

Avet J.,Service de Physiologie Clinique | Pichot V.,Service de Physiologie Clinique et de lExercice | Pichot V.,Jean Monnet University | Barthelemy J.-C.,Service de Physiologie Clinique et de lExercice | And 9 more authors.
International Journal of Cardiology | Year: 2014

Background Old age and hypertension are consistently reported to be the main risk factors of leukoaraiosis. The association between white matter lesions (WMLs) and other cardiovascular risk factors (CVRF) remains controversial. We evaluated the association between CVRF and WMLs in a cohort study and determined the blood pressure variables that could predict WML severity. Methods 830 subjects (65 +/- 1 years of age, 60% women) from the PROOF study, with a reliable ABPM and brain MRI, were included. The exclusion criteria included prior myocardial infarction, stroke, heart failure, atrial fibrillation, type 1 diabetes mellitus, and pacing. White matter changes on MRI were defined as hyperintensities > 5 mm on FLAIR images. We used the total degree of WML (range: 0-30) by adding the region-specific scores of both hemispheres. Results Linear regression analyses demonstrated a significant relationship between total leukoaraiosis score and 24 h systolic blood pressure (SBP), 24 h diastolic BP, daytime SBP and DBP and nighttime SBP. No significant relationship was found between leukoaraiosis score and clinical SBP, clinical DBP, or nocturnal DIP. There was also no significant relationship between leukoaraiosis and other recognized cardiovascular risk factors. Based on a ROC curve analysis, we identified the optimal threshold separating high-risk WML patients for a mean 24 h SBP above 123 mm Hg (p < 0.05). Conclusions Even moderate increases in 24 h SBP promote arteriolar fragility of the cerebral white matter in a population aged 65. The prognostic implications of such abnormalities in asymptomatic and moderate cardiovascular risk populations remain to be evaluated.

Beauchet O.,University of Angers | Annweiler C.,University of Angers | Annweiler C.,University of Western Ontario | Celle S.,Service de Physiologie Clinique et de lExercice | And 6 more authors.
Brain Topography | Year: 2014

The objectives of this study were to examine the association of stride time variability (STV) with gray and white matter volumes in healthy older adults, and to determine the specific location of any parenchymal loss associated with higher STV. A total of 71 participants (mean age 69.0 ± 0.8 years; 59.7 % female) were included in this study. All participants had a 1.0 Tesla 3D T 1-weighted MRI of the brain to measure gray and white matter volumes. STV was measured at steady-state self-selected walking speed using an electronic footswitch system. We found an association between higher STV and lower gray matter volume in the right parietal lobe (e.g., angular gyrus, Brodmann area 39, cluster corrected pFWE = 0.035). There were no significant associations between STV and higher gray matter volume or change in white matter volume. To the best of our knowledge this study is the first to identify a significant association of higher STV with lower right parietal gray matter volume in healthy older adults. © 2013 Springer Science+Business Media New York.

Theije C.D.,Maastricht University | Costes F.,Service de Physiologie Clinique et de lExercice | Costes F.,Jean Monnet University | Langen R.C.,Maastricht University | And 4 more authors.
Current Opinion in Clinical Nutrition and Metabolic Care | Year: 2011

Purpose of Review: Muscle wasting and impaired muscle oxidative metabolism are common extrapulmonary features of chronic respiratory failure (CRF) that significantly increase disease burden. This review aims to address the question whether hypoxia, an obvious consequence of this disease, actually plays a causal role in these muscle impairments. Recent Findings: In experimental models, a causal role for hypoxia in muscle atrophy and metabolic impairments has clearly been shown. Although the hypoxia-inducible factors and nuclear factor kappa B are putative mediators of these hypoxia-induced alterations, their true involvement remains to be proven. Molecular signatures of disrupted regulation of muscle mass and oxidative metabolism observed in these experimental models also have been shown in muscles of patients suffering from CRF, suggestive of but not conclusive for a causal role of hypoxia. Therapies, including but not restricted to those aimed at alleviating hypoxia, have been shown to partially but not completely restore muscle mass and oxidative capacity in CRF patients, which may imply an additive effect of nutritional modulation of substrate metabolism. Summary: Although hypoxia clearly affects skeletal muscle maintenance, it remains to be confirmed whether and by which underlying molecular mechanisms hypoxia is causally involved in CRF-related muscle atrophy and impaired oxidative capacity. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Costes F.,Service de Physiologie Clinique et de lExercice | Costes F.,Jean Monnet University | Gosker H.,Maastricht University | Feasson L.,Service de Physiologie Clinique et de lExercice | And 6 more authors.
Journal of Applied Physiology | Year: 2015

Exercise training (ExTr) is largely used to improve functional capacity in patients with chronic obstructive pulmonary disease (COPD). However, ExTr only partially restores muscle function in patients with COPD, suggesting that confounding factors may limit the efficiency of ExTr. In the present study, we hypothesized that skeletal muscle adaptations triggered by ExTr could be compromised in hypoxemic patients with COPD. Vastus lateralis muscle biopsies were obtained from patients with COPD who were either normoxemic (n = 15, resting arterial Po2 = 68.5 ±1.5 mmHg) or hypoxemic (n = 8, resting arterial Po2 = 57.0 ± 1.0 mmHg) before and after a 2-mo ExTr program. ExTr induced a significant increase in exercise capacity both in normoxemic and hypoxemic patients with COPD. However, ExTr increased citrate synthase and lactate dehydrogenase enzyme activities only in skeletal muscle of normoxemic patients. Similarly, muscle fiber cross-sectional area and capillary-to-fiber ratio were increased only in patients who were normoxemic. Expression of atrogenes (MuRF1, MAFbx/Atrogin-1) and autophagy-related genes (Beclin, LC3, Bnip, Gabarapl) remained unchanged in both groups. Phosphorylation of Akt (Ser473), GSK-3β (Ser9), and p70S6k (Thr389) was nonsignificantly increased in normoxemic patients in response to ExTr, but it was significantly decreased in hypoxemic patients. We further showed on C2C12 myotubes that hypoxia completely prevented insulin-like growth factor-1-induced phosphorylation of Akt, GSK-3β, and p70S6K. Together, our observations suggest a role for hypoxemia in the adaptive response of skeletal muscle of patients with COPD in an ExTr program. © 2015 the American Physiological Society.

Celle S.,Service de Physiologie Clinique et de lExercice | Roche F.,Service de Physiologie Clinique et de lExercice | Kerleroux J.,Service de Physiologie Clinique et de lExercice | Thomas-Anterion C.,Jean Monnet University | And 5 more authors.
Journals of Gerontology - Series A Biological Sciences and Medical Sciences | Year: 2010

BackgroundThe occurrence of restless legs syndrome (RLS) in elderly individuals is well known but the incidence and the clinical correlates in these subjects are still unclear. The present study explores the prevalence of and assesses symptoms associated with RLS in an older French population.MethodsThe study sample for this study comprised 318 subjects (219 women and 99 men), aged 68.6 ± 0.8 years. All subjects underwent clinical assessment, nocturnal polygraphy, and cognitive and mood disorders evaluation. RLS was assessed with the standard validated criteria and severity was evaluated by the use of International Restless Legs Syndrome Study Group (IRLS) questionnaire.ResultsRLS was present in 24.2% of the sample, prevalence being greater in women (29.7%) than in men (12.1%). The mean IRLS score was 16.6 ± 4.8, 67% of cases having mild to moderate range. Participants with RLS reported greater hypnotic (p <. 001) and antidepressant medication intake (p <. 001) and had higher anxiety (p <. 001) and depression (p <. 001) scores. Participants with RLS had lower cognitive performances at Stroop and Verbal fluency tests than participants without RLS (p <. 05 and p =. 002, respectively). These associations remained significant after multivariate adjustment for medication, depression, and subjective sleep.ConclusionsPresence of undiagnosed RLS is higher in healthy elderly participants without previously diagnosed sleep disorders, affecting women more often than men. The presence of RLS increased the risk of anxiety and mood disorders and predispose to preclinical cognitive decline independently of anxiety, mood disorders, duration and quality of sleep, and medication.

Beauchet O.,University of Angers | Herrmann F.R.,University of Geneva | Annweiler C.,University of Angers | Kerlerouch J.,Service de Physiologie Clinique et de lExercice | And 5 more authors.
Rejuvenation Research | Year: 2010

Objective: The aim of this study was to examine the cross-sectional association between ambulatory 24-h blood pressure levels and cognitive performance while considering the effects of potential confounders among community-dwelling adults aged 65 years and older. Methods: Based on a cross-sectional design, 1011 subjects (mean age 66.2±0.8 years; 60.2% women) were recruited prospectively. Average levels of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were computed for a 24-h period. Cognitive performance was assessed by Folstein's Mini-Mental State Examination, immediate and delay recall subtests of the French version of the Free and Cued Selective Reminding Test, and Trail Making Test A and B. Age at baseline evaluation, gender, education level, anxiety, depression, cardiovascular risk factors, antihypertensive drugs use, and body mass index were used as confounders in data analysis. Results: Multivariate logistic regression showed that, compared with low DBP level (i.e., <80mmHg) used as reference value, only a high DBP level (i.e., ≥90mmHg) was significantly associated with lower performance in immediate recall (adjusted odds ratio [OR]=2.7 [1.3;5.9] for full model, and adjusted OR=2.6 [1.2;5.4] for the stepwise backward model). Furthermore, the stepwise backward selection showed that male gender (adjusted OR=2.2 [1.4;3.3]) and depression (adjusted OR=2.4 [1.3;4.6]) were also significantly associated with low performance in immediate recall, whereas a high education level was associated with high performance (adjusted OR=0.9 [0.8;0.9]). Conclusions: The findings show that only high DBP was associated with lower episodic memory performance compared with low DBP level in the studied sample. Further research is needed to corroborate and explain this finding. © Mary Ann Liebert, Inc.

Celle S.,Service de Physiologie Clinique et de lExercice | Annweiler C.,University of Angers | Annweiler C.,University of Western Ontario | Camicioli R.,University of Alberta | And 3 more authors.
BMC Pulmonary Medicine | Year: 2014

Background: Sleep-related breathing disorders (SRBDs) provoke cognitive and structural brain disorders. Because these disorders have been associated with unsafe gait characterized by an increase in stride-to-stride variability of stride time (STV), we hypothesised that SRBDs could be associated with an increased STV. The aim of this study was to examine the association between SRBDs and STV in French healthy older community-dwellers.Methods: A total of 49 participants (mean age 69.6 ± 0.8years; 65.2% female) were included in this cross-sectional study. All participants, who were free of clinically diagnosed SRBDs before their inclusion, had a nocturnal unattended home-sleep assessment. There were separated in three group based on apnea + hypopnea index (AHI): AHI <15 defining the absence of SRBD, AHI between 15-30 defining mild SRBD, and AHI >30 defining moderate-to-severe SRBD. Coefficient of variation of stride time, which is a measure of STV, was recorded while usual walking using SMTEC® footswitches system. Digit span score was used as a measure of executive performance. Age, gender, body mass index (BMI), number of drugs daily taken, vision, proprioception, history of falls, depression symptoms, global cognitive functioning were also recorded.Results: STV and BMI were higher in participants with mild SRBDs (P = 0.031 and P = 0.020) and moderate-to-severe SRBDs (P = 0.004 and P = 0.002) compared to non-SRBDs. STV positively correlated with AHI (P = 0.036). Lower (i.e., better) STV was associated with the absence of SRBDs (P = 0.021), while greater (i.e., worse) STV was associated with moderate-to-severe SRBD (P < 0.045) but not with mild SRBD (P > 0.06).Conclusion: Our results show a positive association between STV and SRBDs, with moderate-to-severe SRBD being associated with greater gait variability. This association opens new perspectives for understanding gait disorders in older adults with SRBDs and opens the door to treatments options since SRBDs are potential treatable factors. © 2014 Celle et al.; licensee BioMed Central Ltd.

Bruel Tronchon N.,Service de Physiologie Clinique et de lExercice | Frappe E.,Service de Physiologie Clinique et de lExercice | Chomette Ballereau S.,Service de Physiologie Clinique et de lExercice | Barthelemy J.C.,Service de Physiologie Clinique et de lExercice | Costes F.,Service de Physiologie Clinique et de lExercice
Lung | Year: 2014

Introduction: The prevalence of pulmonary restriction increases in the elderly and detection could be challenging due to the difficulty in measuring lung volumes in older patients. The recently published Global Lung Function Initiative (GLI) equations were found to predict better restriction in middle-aged patients compared to ERS'93 norms. However, the ability of the GLI equations to detect pulmonary restriction in older patients has not been investigated. Patients and Methods: We extracted spirometric data in patients older than 85 years from the database of our pulmonary function testing laboratory. The population with pulmonary restriction was defined as those having a total lung capacity value (TLC) below the lower limit of normal (LLN) using ERS'93 equations. We then compared the ability of the ERS'93 and GLI equations to detect this when the forced vital capacity (FVC) was below the LLN. Results: We analyzed data from 285 patients. A true restrictive defect was found in 66 patients (23 %). Sensitivity to detect a reduced TLC was higher when calculated from the GLI than the ERS'93 equations, (70 vs 45 %). By contrast, specificity was lower (74 vs 89 %, respectively); there was no difference in the negative predictive value (89 and 84 %). Using receiver operating curves, both sets of equations performed similarly to detect spirometric restriction. Conclusions: In conclusion, both sets of equations similarly predicted a pulmonary restriction in older subjects. The high negative predictive value of the GLI equations thus allows for static lung volume measurement to be avoided in older patients when the FCV exceeds the LLN whatever the predicted equation used. © 2014 Springer Science+Business Media New York.

Costes F.,Service de Physiologie Clinique et de lExercice | Costes F.,University nnet | Celle S.,University nnet | Garet M.,University nnet | And 5 more authors.
Clinical Nutrition | Year: 2016

Background: A severe weakness of peripheral muscles occurs in half of the persons aged 80 years or older. The common factors between muscle depletion and reduced respiratory strength have not yet been established. Objective: In the subjects of the Proof cohort, we aimed to identify, among body composition, pulmonary function and energy expenditure parameters, the predictors of maximal inspiratory pressure (MIP) as an index of respiratory muscle strength and handgrip (HG) as an index of peripheral muscle strength. Subjects and methods: In 375 healthy elderly subjects aged 72 ± 1 years, fat mass (FM) and fat free mass (FFM) were assessed by DEXA, the last being also indexed to height (FFMI). Spirometry was performed and daily energy expenditure (DEE) was estimated by a questionnaire. After three years, MIP and HG of the dominant arm were determined and the predicting value of pulmonary function tests, body composition and DEE on these parameters was tested. Results: Mean MIP and HG were 77 ± 26% and 106 ± 19% of the predicted value (%pred) with 90 (24%) and 30 (8%) subjects below standards, respectively. There was a significant but weak correlation between MIP%pred and HG%pred (r = 0.175, p < 0.001). Logistic regression showed that low MIP was predicted by trunk FFM and FFMI in women, and DEE in men. Low HG was predicted by trunk FM in men only. Conclusions: The predictors of a reduction of MIP in the elderly differ from those of HG, suggesting a differential regulation of respiratory muscle and arm strength. © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism.

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