Remember Billy Blanks, the guy behind the Tae Bo craze? Now his son, Billy Blanks, Jr. is getting in on the family business too. Along with his wife, Sharon Catherine Blanks, Billy Jr. will help you learn various types of dance styles in this fun-packed DVD. The duo takes you through six 5-minute cardio workouts utilizing dance styles from all over the world: hip-hop, Bollywood, African, disco, country, and "old-school" cardio. It's designed for the whole family so kids can join in too!
Along with prenatal vitamins and regular doctor’s appointment,The Bloom Method should be an essential part of your prenatal experience. Brooke’s knowledge and passion for pre-and-postnatal health and wellness is unmatched. Thanks to the regular workouts and the prenatal exercises that Brooke taught me, I feel amazing, and my belly is tight (no one can believe that I’m almost 7 months along!) The Bloom Method is a fundamental investment in baby and mommy’s health.

Since almost any exercise requires some strength and some level of aerobic fitness, I recommend a training program that is a mix of both strength training and conditioning; similar to what I do but on a smaller scale (to start). The Stronglifts 5x5 workout that I mentioned above is an excellent place to start and requires only three days a week. Assuming you can exercise five days a week, you can do some aerobic/anaerobic work on Tuesdays and Thursdays. If five days a week is too much, start with a three-day strength workout. If you also want to do conditioning, you can choose to perform it after your strength routine for 10–30 minutes, or just shift your focus after a few weeks of strength training and do conditioning only for a week or two.
KE EMG RMS corresponds to the sum of EMG RMS of the following muscles: Vastus Lateralis, Rectus Femoris and Vastus Medialis. Isokinetic KE MVCs were performed at 60 (panel, A), 100 (panel B) and 140 (panel C) deg/s. Isokinetic KE MVCs were measured pre-exercise (pre, average of all three sessions pre-exercise values), shortly after exhaustion (13 ± 4 s after exhaustion), 20 s following exhaustion test (P20) and 40 s following exhaustion test (P40). Data are presented as mean (SE).
Exercising stock options should not be a passive event that happens after a given amount of time. It's rather like playing a hand of cards: if your plays are strategic, you'll probably "know when to hold them and when to fold them." Many alternatives and trade-offs need to be considered. But, as always, rules, requirements, and regulations govern this area, and this is where we begin.
Because CFS/ME is often related to viral issues or co-infections in the body, the immune system is "working overtime". CFS can actually be more debilitating than fibromyalgia, depending on the pain levels within fibro on any given day. This is simply due to the complex nature of CFS within the immune system. In fact, my preferred reference to this illness is not CFS but rather CFIDS or ME (Chronic Fatigue Immune Deficiency Syndrome OR Myalgic Encephalomyelitis)
We have included step by step instructional guides for over 500 different resistance training exercises. This database covers a wide variety of different exercises including free weights, CrossFit, kettlebells, machines, bodyweight, medicine ball, elastic bands, exercise ball, Pilates and stretching movements. Choose from a list for a specific muscle group or select by exercise type to pick the best exercises for your workout. Each instructional page will show you how to properly perform a resistance training exercise with detailed photos and exercise advice for each movement. It’s like having your very own personal trainer. These exercise guides will help set you on the right track so you can get in the best shape of your life!
Dancer, choreographer, stunt woman and fitness expert Kelly Connolly says you can shrink your waist in 30 seconds a day with “salsa swivels.” “It’s no secret that dancing is a great way to trim down and tone without even realizing you’re exercising,” she says. “The high energy and twisting motions of Salsa dancing can have a significant impact on your body while giving you some new moves to take to the dance floor.”
Personal trainer James Shapiro has a tough yet effective way to get your triceps toned and defined with “body weight skull crushers.” He says to “start in a pushup position either on the floor or on an incline. Have your hands inside shoulder width and fingers point straight ahead of you. Focusing on only bending from your elbows—which should remain tucked into your sides and not flared out—go down feeling the stretch and focus on your triceps.”
The mental benefits of Pilates include an increase in the ability to focus. It takes a great deal of concentration to coordinate your breath and body position during workouts. In fact, Joseph Pilates often referred to his method as “the thinking man’s exercise” due to the improvement in memory and other cognitive functions that results from doing it. A clear mind also reduces stress levels, which translates to an improvement in your overall health.
The OLDE protocol and neuromuscular function tests were performed on a Cybex NORM isokinetic dynamometer (CMSi, Computer Sports Medicine Inc., Stoughton, USA). The axis of the dynamometer was aligned with the knee axis, and the lever arm was attached to the shank with a strap. Two shoulder harnesses and a belt across the abdomen limited extraneous movement of the upper body. Full description of the OLDE protocol can be found in Pageaux et al. [8]. Briefly, this protocol allows isolating the knee extensor muscles during a dynamic exercise involving an active isotonic knee extension (from 10 deg to 90 deg, 0 deg = knee fully extended) and a passive knee flexion. The passive flexion angular velocity was set up at 300 deg/s automatically cushioned by the dynamometer for safety purposes. Due to this cushion, the passive knee flexion angular velocity was ~ 180 deg/s. According to a previous study [8], a cadence of 50 contractions per minute (cpm) was chosen (knee extension angular velocity ~ 106°/s). Subjects maintained a cadence of 50 cpm at all visits via the use of a metronome. Power output produced by the subject was controlled according to the formula:

I've been strength training for over 15 years now. In college, between martial arts and four months of lifting weights for 6 hours per week I gave myself overuse injuries in my shoulders and knee. I've tried everything, including Mike Mentzer's books, Arnold Schwarzennegger's Bodybuilding Bible, Stuart McRobert's Beyond Brawn, Sisco and Little's Power Factor Training, routines from Men's Health, Flex, and Muscle & Fitness magazines - you name it. Super Slow (and its cousins Slow Burn and Power of 10) are the ONLY form of exercise I can handle for more than two months without having those pains flare up with a vengeance and force me to quit. I've done Super Slow for years without the slightest ache except for normal muscle soreness.

Perhaps one of the best benefits of barre is that it’s fun! It incorporates the use of upbeat music and engaging choreography. When working out is fun and enjoyable, your chances of staying with the program greatly increase. The barre method also offers quick results. Barre helps strengthen and tone your muscles without increasing bulk, and it improves your posture. It also increases cardiovascular endurance and metabolism, which helps to quickly burn calories.


Georgi A. A biographical sketch of the Swedish poet and gymnasiarch, P.H. Ling. London: H. Bailliere; 1854.  Ling founded the Royal Gymnastic Central Institute in Stockholm in 1822, was an elected member of the Swedish General Medical Association, member of the Swedish Academy, and a Titular Professor. However, Ling remained indifferent to these honors due to the lack of the establishment’s implementation of his methods.7 Georgi A. A biographical sketch of the Swedish poet and gymnasiarch, P.H. Ling. London: H. Bailliere; 1854. [Google Scholar]
10.  Work the whole body during one session. Exercising different muscle groups on different days is counterproductive. Your whole workout should take no longer than 45 minutes, and this includes time spent on a treadmill to move lymph fluid to prevent lactic acid pooling in muscles. (Forty-five minutes, once a week for a high level of fitness... who can't find time for that!)
^ Jump up to: a b McKee AC, Daneshvar DH, Alvarez VE, Stein TD (January 2014). "The neuropathology of sport". Acta Neuropathol. 127 (1): 29–51. doi:10.1007/s00401-013-1230-6. PMC 4255282. PMID 24366527. The benefits of regular exercise, physical fitness and sports participation on cardiovascular and brain health are undeniable ... Exercise also enhances psychological health, reduces age-related loss of brain volume, improves cognition, reduces the risk of developing dementia, and impedes neurodegeneration.
Stretching helps maintain flexibility. We often overlook that in youth, when our muscles are healthier. But aging leads to a loss of flexibility in the muscles and tendons. Muscles shorten and don't function properly. That increases the risk for muscle cramps and pain, muscle damage, strains, joint pain, and falling, and it also makes it tough to get through daily activities, such as bending down to tie your shoes.
Perhaps one of the best benefits of barre is that it’s fun! It incorporates the use of upbeat music and engaging choreography. When working out is fun and enjoyable, your chances of staying with the program greatly increase. The barre method also offers quick results. Barre helps strengthen and tone your muscles without increasing bulk, and it improves your posture. It also increases cardiovascular endurance and metabolism, which helps to quickly burn calories.
In London, the Medical Officer of Thorpe Coombe maternity hospital approved and implemented the St Thomas method in 1940, presented as ‘Training for Childbirth - and After.’26 Wellcome Library [Internet]. Rodway H. Training for childbirth - and after (1940). 2015 Sep 24 [cited 2015 Oct 3]. Available from: http://wellcomelibrary.org/player/b16729006#?asi=0&ai=0. [Google Scholar] There was also interest from the USA, but this option did not materialize.29 Sydney Morning Herald [Internet]. Thomas BM: Obituary (1940). 2014 Oct 23 [cited 2015 Aug 30]. Available from: http://www.tiveyfamilytree.com/Barbara-Mortimer-Thomas-Death-Article-SMH-11-9-1940.htm. [Google Scholar]
Not near our studio? That’s okay, The Bloom Method can be implemented into the fitness method or gym workout of your choice. While we offer our studio concept + cutting-edge classes through our online platform, Studio Bloom, we can also help customize our methodology into any way you choose to move your body. Reach out to use and we’ll connect you directly to one of our Bloom coaches for an optimal learning experience.
Video Abstract for the ESSR 45.2 article “Joint Loading in Runners Does Not Initiate Knee Osteoarthritis” from author Ross H Miller. Runners do not have a greater prevalence of knee osteoarthritis (OA) than non-runners. The hypothesis that joint loads in running do not cause OA is forwarded. Two mechanisms are proposed: 1) cumulative load, which is surprisingly low in running, is more important for OA risk than peak load, and 2) running conditions cartilage to withstand the mechanical stresses of running.
Whether you're allergic to the gym, want to save money or crave convenience, exercising at home is an easy choice to make. What's more difficult is figuring out what to do. How do you set up an effective home workout? What do you do if you don't have much equipment or space? The following series takes you through a variety of choices for exercising at home, whether you have nothing but your own body and a pair of shoes or a workout room tricked out with every piece of equipment imaginable.
All data are presented as means ± standard deviation (SD) unless stated. Assumptions of statistical tests such as normal distribution and sphericity of data were checked as appropriate. Greenhouse-Geisser correction to the degrees of freedom was applied when violations to sphericity were present. For reliability statistics, assumptions of homoscedasticity and heteroscedasticity were checked as appropriate. Reliability analysis was conducted following the guidelines provided by Atkinson and Nevill [19]. Our sample size of eight subjects is comparable to previous studies using high-intensity OLDE [8, 11, 17].

Major variants: reverse ~ (curling the pelvis towards the shoulders), twisting ~ or side ~ (lifting one shoulder at a time; emphasis is on the obliques), cable ~ (pulling down on a cable machine while kneeling), sit-up ~ (have [chest] touch your knees), vertical crunch (propping up to dangle legs and pulling knees to the [ chest] or keeping legs straight and pulling up legs to a 90 degree position). Reverse hanging crunch (using gravity boots or slings to hang head down and pulling to a 90 or 180 degree form)
How would you like to get more out of your workouts? If your main goal is to burn fat, many traditional exercises and training styles may not be the best route for you. Typically when I'm at the gym and I look around I see a bunch of people doing exercises that don't really match up with their goals. If you're trying to get some bigger biceps you shouldn't be on the eliptical doing hours of cardio and conversely if you're trying to lose some weight and burn some belly fat you shouldn't be smashing out set after set of bicep curls. Exercises and training styles are like tools and before you just assume that watching one or two rocky movies is all the knowledge you need on exercising let's make sure that you've chosen the right tool for the job or I should for your goal. If your goal is to lose belly fat I hate to break it to you, but there is no exercise that can directly target the fat on your belly, but there are plenty of exercise methods that can indirectly burn the fat from your belly, and in this video I'll be going over ten of these methods....These training methods will help you burn more fat during & after your workout. Let's start with the very first one & that's peripheral heart action training. This is my favorite way to do all my weight training workouts, and I highly suggest that if you're trying to lose some belly fat you incorporate this style of training right away. In general your workouts for the week should be a mixture of some more aerobic & some more anaerobic workouts, meaning some of them will be geared more towards lifting heavy weights & others should be geared towards improving your cardiovascular function. But what you'll notice is that during your heavy weight training days, you wind up taking longer breaks & not breathing quite as heavy. Sometimes after some weight training workouts besides the soreness that you might feel in your muscles you may not feel like you worked out at all. So that's where peripheral heart action training comes into play. It helps incorporate an element of cardio into your weight training workout without you having to sacrifice the amount of weight your lifting. So you won't get weaker, but you'll be able to burn much more calories & accomplish much more in a shorter period of time. The best way to do this is by combining an upper body & a lower body movement into one set. For example you can combine a bench press with a squat. So you would do six to eight reps on the bench press & then right away with no break you would do squats for six to eight reps. You would perform both of these exercises with a heavy weight load & you would only take a break after completing both of them. With peripheral heart action training what you're doing is taking the blood that your heart would normally just have to pump to your chest & arms if you were just doing bench press by itself & what your doing is your forcing your body to pull & pump all that blood back down to your legs right after your set of bench without any break or recovery. This makes your heart work much harder allowing you to get your heart rate & breathing rate higher & this will burn more calories & fat in the process. Now let's say that you don't want to work legs & upper body in the same day you want to focus on each on separate days. Well the good news is that peripheral heart action training doesn't only work only if you combine an upper & a lower body movement. It'll also work if you combine two movements that work opposing muscle groups. For example if you combine chest & back movements together with no break. Or if you do quad & hamstring movements together with no break your heart will still have to work much harder to push the blood from the anterior part of your body to the posterior part of your body. So peripheral heart action training try it out. The second exercise style that can help you burn a lot more belly fat is known as cardio acceleration training. We actually have a whole hour long class at our gyms dedicated to this type of training because it's so effective. Once again it involves super setting two exercises. Except this time instead of doing two weight training exercises back to back we're combining a weight training exercise with a cardio exercise with no break. So an example of this would be to perform a set of barbell squats with heavy weight for let's say six to ten reps & then immediately with no break once you rack the bar you go right into high knees for thirty to forty five seconds. Then take a break & repeat for three to four sets
With the right stimuli, bone density improves as well, says women’s health expert Belinda Beck, MD, an Arizona-based OB-GYN and researcher. In a recent study she conducted on postmenopausal women, Beck found that “even women with very low bone mass could tolerate the high loading required to increase bone mineral density as long as it was introduced gradually with close attention to technique.”
Hessel J [Internet]. Joseph H. Pilates biography. 2015 Jul 8 [cited 2015 Aug 30]. Available from: http://www.jillianhessel.com/pilates_biography.html.  He claimed that ‘sports are wonderful … but of little value for correcting whats wrong with you … corrective exercise is the only way to build a beautiful, strong, youthful body.’44 Readers Digest [Internet]. Ray MB. Cutting a fine figure (1934). 2012 Dec 13 [cited 2015 Aug 30]. Available from: http://www.isofit.com.hk/assets/files/193410_Readers_Digest_Joe_Pilates_Interview.pdf. [Google Scholar] He explained in his 1939 book ‘Your Health’: ‘Practically all human ailments are directly traceable to wrong habits which can only be corrected through the immediate adoption of right (natural, normal) habits’ … ‘the present day efforts of our so-called health departments are in vain so far as physical health is concerned’ … ‘this condition will prevail until such time as marks the recognition of a standard formation of sound and sane physical culture, based upon the natural laws of life.’45 Pilates J. Your health. Nevada: Presentation Dynamics; 1934. [Google Scholar] In his 1945 book ‘Return to Life Through Contrology,’ Pilates clearly supported Checkley, Müller, and Alexander stating that ‘Contrology is not a system of haphazard exercises designed to produce only bulging muscles’ … ‘Rather, it was conceived to limber and stretch muscles and ligaments so that your body will be as supple as that of a cat and not muscular like the body of a brewery-truck horse.’46 Pilates J, Miller WJ. Return to life through Contrology. Nevada: Presentation Dynamics; 1945. [Google Scholar] In this book, Pilates presented a list of 34 full-body equipment-free exercises, which if performed regularly at home, were promised to ‘give you suppleness, natural grace, and skill that will be unmistakably reflected in the way you walk, in the way you play, and in the way you work’ … ‘You will find your body development approaching the ideal, accompanied by renewed mental vigor and spiritual enhancement’. Pilates famously stated: ‘Physical fitness is the first requisite of happiness.’46 Pilates J, Miller WJ. Return to life through Contrology. Nevada: Presentation Dynamics; 1945. [Google Scholar] As with Müller,15 Müller JP. My system. London: Link House; 1904. [Google Scholar] Randell,25,26 Randell M. Training for childbirth from a mother's point of view. 4th ed. London: J. & A. Churchill Ltd.; 1949.
Element 5 Day Yoga offers five 15-minute sequences to pick and choose from based on your mood and motivation. "It's an easy way to get to the mat every day," one tester said, whether your body needs a Stretch & Restore session or more of an invigorating Energy & Flexibility set. Plus "the instructor provided just enough guidance, no unnecessary chatter." Namaste to that.
Choose clothes that suit your activity. In general, wear clothes that won’t restrict your movement or blood flow. For some forms of exercise, like biking, you might want to wear form-fitting clothes, but they still shouldn’t be too tight. Looser workout clothes are better for strength training, brisk walking, and sports such as basketball or soccer.[35]
Exercising stock options should not be a passive event that happens after a given amount of time. It's rather like playing a hand of cards: if your plays are strategic, you'll probably "know when to hold them and when to fold them." Many alternatives and trade-offs need to be considered. But, as always, rules, requirements, and regulations govern this area, and this is where we begin.
Check your company's stock plan for the allowed methods and procedures. Once you do give notice to exercise with payment as required under your stock plan, it is unlikely that you can then change your decision to exercise or the exercise method, at least for tax purposes. This is illustrated by the case of Walter v. Commissioner, decided by the US Tax Court (TC Memo 2007-2, January 3, 2007). The employee attempted to change his original exercise instructions from a same-day sale to a cash exercise/hold. The Tax Court did not let him, holding that he had beneficial ownership of the stock when he initially exercised the options following the conditions under his stock plan.
Physiological, psychological and EMG responses to the time to exhaustion tests are presented Figs 4 and 5. Leg RPE (Fig 4A), leg muscle pain (Fig 4B) and heart rate (HR, Fig 4C) increased over time (all P < 0.001). Cadence during the time to exhaustion decreased over time (P < 0.001). Planned comparisons for these aforementioned parameters are presented Fig 5. EMG RMS of the VL (Fig 5A), VM (Fig 5B), RF (Fig 5C) and the sum of these muscles (Fig 5D) increased over time (all P < 0.001). Planned comparisons for EMG parameters are presented Fig 5. Blood lactate concentration increased (from 1.3 ± 0.5 to 6.0 ± 1.1 mmol/L, P < 0.001) and blood glucose concentration decreased (from 5.3 ± 0.5 to 4.4 ± 0.3 mmol/L, P = 0.001) over time.
Remember Billy Blanks, the guy behind the Tae Bo craze? Now his son, Billy Blanks, Jr. is getting in on the family business too. Along with his wife, Sharon Catherine Blanks, Billy Jr. will help you learn various types of dance styles in this fun-packed DVD. The duo takes you through six 5-minute cardio workouts utilizing dance styles from all over the world: hip-hop, Bollywood, African, disco, country, and "old-school" cardio. It's designed for the whole family so kids can join in too!
In Week 1 you’ll perform three sets of every exercise per workout, which over the course of the week adds up to nine sets total for each bodypart, a good starting volume for your purposes. With the exception of crunches for abs, you’ll do 8–12 reps per set. This rep scheme is widely considered ideal for achieving gains in muscle size (the scientific term is hypertrophy) and is commonly employed by amateur and pro bodybuilders alike.
Not near our studio? That’s okay, The Bloom Method can be implemented into the fitness method or gym workout of your choice. While we offer our studio concept + cutting-edge classes through our online platform, Studio Bloom, we can also help customize our methodology into any way you choose to move your body. Reach out to use and we’ll connect you directly to one of our Bloom coaches for an optimal learning experience.
The daily practice of the mind–body exercises took only a few minutes, to blend in with modern life rather than to dominate it. The exercises could be performed in private with no competitive, commercial, or political emphasis or personal ignominy. The MMB pioneers were against unnatural purpose-made exercise machinery, which was viewed as unnecessary and even dangerous. An exception was Pilates and his equipment. However, the revolutionary devices were designed (and succeeded) to improve the effect of Contrology exercises and philosophy, and to enhance the method’s natural experience and acceptance.
Exercise videos are probably one of the most purchased items when it comes to fitness. They are also one of the most likely to end up on the shelves of users due to many different reasons. In many cases, it’s because the user didn’t know what they were getting into when they purchased the exercise videos, so once they got them home and watched them, it turned out it wasn’t what they were looking for at all.

Also, my favorite workouts might not be yours. “It's like asking someone for the best musician, or the best craft beer,” says Daniel Freedman, co-founder of online fitness site, BurnAlong. He recommends trying several of the apps out to see which one works best for you. “Who is going to inspire you?” Freedman says, “find who you'll stick with week in and week out.”


In 1988, Richard Simmons released his popular exercise video, Sweatin' to the Oldies, consisting of energy-packed workouts set to music by a live band. In his workouts, Simmons is so lively and enthusiastic that the workout seems less about grueling exercise and more about jovial fun. This is still the case for Simmons—as he said in a 2012 interview with the Chicago Tribune, " I try to be the clown and court jester and make people laugh. At the same time, you have people in the hospital who have had gastric bypass or lap-band surgery and they still have to work out." While Simmons's workouts have been successful, he takes a different approach than that of Fonda by not grouping any given set of his exercises with any one muscle group. You may not know what specific part of your body you're working out, but boy, you still feel it.
Rather than doing your meetings over coffee, why don’t you invite people to go for a walking meeting? Steve Jobs, Winston Churchill and many U.S. Presidents have been huge advocates of this practice for both health and camaraderie purposes. Even if you’re just taking a phone call, use it as an opportunity to take a walk around the block or to your next destination.
You probably already spend one to three minutes brushing and flossing your teeth at least once a day. Why not brush your teeth while holding a deep squat, or while doing side leg lifts? These things are perfectly doable and add no additional time to your tooth-brushing activities. Simply tell yourself that you have no excuse for brushing your teeth without holding a deep squat. No matter how tired you are.
The Bloom Method promises to always provide you with the most innovative tools to stay connected to your body as it changes, better prepare you for childbirth, and promote a speedy recovery helping you to achieve your post-birth goals. Our team of experts is constantly staying up to date on the most informative education + studies to ensure that what we provide is top-notch.
Get your shoulders looking svelte with hand/arm raises. Riggins says here’s how to do them: Raise your hand over head; hand is at a 90-degree angle to the body as if you’re doing shoulder press with no weights. Put your hands up and raise over head; raise up to sky and bring back down. Keep repeating for 30 seconds. We know it sounds too easy, but you’ll feel it start to burn about 20 seconds in!
“Foam rolling is a form of massage (or trigger point release) that you can do to loosen tight muscles to help improve your mobility,” says Lefkowith. Using a foam roller helps smooth out “knots” in your fascia (the layer of connective tissue surrounding your muscles), which can get in the way of your range of motion. This is crucial for performing exercises with correct form and making sure the right muscle fibers are firing away. While you can stop, drop, and foam roll anytime, it’s often recommended to spend a few minutes with the foam roller before your workout to help get the juices flowing.

Remember when the only thing your cell phone did was make phone calls? Now, you can waste all kinds of time with smartphone apps that allow you to do everything from playing Scrabble to exercising. Smartphones, iPads and MP3 players are excellent resources for home exercisers, particularly if you find yourself getting bored from doing the same old thing, day after day. With the right apps, you can find guided workouts, paced music, timers and more, all of which can add variety and fun to your home workouts.


Major variants: incline ~ (more emphasis on the upper pectorals), decline ~ (more emphasis on the lower pectorals), narrow grip ~ (more emphasis on the triceps), push-up (face down using the body weight), neck press (with the bar over the neck, to isolate the pectorals), vertical dips (using parallel dip bars) or horizontal dips (using two benches with arms on the near bench and feet on the far bench, and dropping the buttocks to the floor and pushing back up.)
This stands for rate of perceived exertion, and refers to intensity. It’s a point of reference that trainers often use to communicate how hard you should be working since what feels easy or challenging is different for everyone. On the RPE scale a 1 pretty much means zero effort while a 10 means you’re working harder than you thought you possibly could.

The severity of angina and the effects of therapeutic interventions in patients with coronary artery disease have been assessed by determining changes in both exercise performance and the triple product (TP) of heart rate, systolic pressure, and ejection time occurring at angina. However, the validity of conclusions based on such changes is uncertain since the effects of different exercise protocols on these variables have not been determined. Twelve patients with angina were studied during upright bicycle exercise; repeated bouts of exercise using a standard protocol of 20-w increments every three minutes produced no consistent changes in TP at angina. When exercise began 20 to 60 w above the work load of the standard protocol that produced angina, exercise capacity was reduced (average 1'40'' vs. 4'40'', P < 0.001), and triple product at angina exceeded control anginal values (average 4,840 vs. 4,150, P < 0.001). In the control studies nitroglycerin (TNG) and carotid sinus nerve stimulation (CSNS) enabled patients to exercise to a higher level, although the triple product at angina was unaltered. However, at the higher work load TNG and CSNS exerted only minimal effects on exercise capacity, indicating that if the work load is excessive, a reduction in myocardial oxygen consumption produced by a therapeutic intervention may be comparatively minor so that a potentially salutary effect would be masked. We conclude that work loads causing angina in less than three minutes cannot reliably be used for studying the effects of therapy. However, if progressive work loads are chosen which cause angina in the control studies in three to six minutes, exercise capacity and triple product at angina provide important information about the efficacy and mechanism of action of a therapeutic intervention.
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