MU '-. mad-z.“ - T113, 1 c (1‘ .. “.4”: ' a 4.1 . u on. .' ‘ A .j ‘ . Jim: .\ 4;:2..1J L‘h’f: w. 11‘: .:.'.’;'u:;:§ Lt; Aw- «may: «2 a Né ”was :2. 1. ~ mama s . mm :9»: iii 6‘... t . .‘u xx: 39%“! hr; : s .3 ~ ' ‘sos‘; : «a wa‘m‘sm ‘.\:}\3'ész "s‘ 5"». H: 329er or arr-2w: =2: ' we. - Luau «41’ 8’ «sun‘s: L g L-. «L.;. .L . 4.x.“ 3° .L.‘ . 13M ‘ w. 1,- c a a; -.‘ «fit; I ‘0‘“ 1““ . r‘& ,I (n {3}" , .l _ \ ‘. _ . .. .‘K‘n::: {\g \ ‘ . \‘L 1| ‘1 L.:7‘Lb This is to certify that the thesis entitled An Investigation of the Effects of Conditioning on the Ballistocardiogram of Varsity Basketball Players presented by Gordon C. Stauffer has been accepted towards fulfillment of the requirements for PE. A. degree in Health: Physical bducation and Recreation 6 Henry 3: liontoye firjor professor 0-169 AN INVESTIGATION or THE armors or COHDITIONI‘I—IG ON THE BALLISTOGLRDIOGBAM or VARSITY BASKETBALL PLAYERS By Gordon 0. Stauffer A THESIS Submitted to the School of Graduate Studies of Michigan State College of Agriculture and Applied Science in.partial fulfillment of the requirements for the degree of MASTER OF ARTS Department of Physical Education, Health, and Recreation for Men 1955 ACKNOWLEDGMENTS To the following persons whose cooperation and guidance have made this study possible, the author wishes to, express his gratitude: Dr. Henry Montoya, Dr. Wayne Van Hues, Forrest Anderson, and other members of the Physical Education Staff of Michigan State College; Dr. W. Doyne Collings of the Physiology Department of Michigan State College, and the members of the Michigan State varsity basketball team, who frequently. inconvenienced themselves in the interest of this Studio 6.0.8. AN INVESTIGATION OF THE EFFECTS OF CONDITIONING ON THE BALLISTOCARDIOGRAM OF VARSITY BASKETBALL PLAYERS By Gordon C. Stauffer AN'ABSTRAGT Submitted to the SChool of Graduate Studies of MiChigan State College of Agriculture and.Applied Science in partial fulfillment of the requirements for the degree of MASTER OF ARTS Department of Physical Education, Health, and Recreation for Men Year 1955 Approved Gordon C. Stauffer Abstract 1 STATEMENT Q§_ The chief question of this investigation is "Do the PROBLEM components of the ballistocardiogram.change signifi. cantly before and after exercise as a result of a conditioning program?" Secondary points of interest deal with the changes in relative stroke volume and the pulse rates as a result of conditioning. REVIEW’Q§_ Since ballistocardiography is new in the field of LITERATURE I physical education, literature pertaining to this subject is scarce. However, the ballistocardiogram has been estab- lished as a valid instrument to measure relative stroke volume. The effects of conditioning on the components of the ballistocardiogram following a standard exercise such as the Harvard Step Test are not known. EXPERIMENTAL Ten varsity basketball players were selected by PROCEDURE Forrest Anderson, basketball coach, Michigan State College, to take part in this experiment. They were tested five times during the l95H—55 season. Twice before the conditioning program began to obtain a control record.and three times during the season. Measurements of the components of the ballistocardiogram were recorded and later analysed. CONCLUSIONS After analyzing the data of this investigation the following conclusions were made. 1. The heights of I and.J waves did not change significantly with conditioning. 3. 5. b. 8. 9. Gordon C. Stauffer Abstract 2 The height of the I plus J wales was not a critical factor in determining the relative stroke volume de- rived by Molomut's formula.1 The cycles per second is the critical factor in.Molomut's formula.2 The pre—exercise pulse rates did not decrease signifi- cantly although the mean.values indicated a slight tendency to do so. The post-exercise pulse rates did decrease significantly during the conditioning program and increased.with the termination of conditioning. The post-exercise pulse rate is a good index of circula— tory fitness. The pro-exercise pulse rate does not indicate the condi- tion of the athlete. The pro-exercise stroke volume did.not change significantly. The post—exercise stroke volume did not change signifi- cantly Although the mean.values indicated a trend to in. crease with a decrease in pulse rate. 1 Norman Molomut and S. C. Allen, "Effect of Pressure Breathing on Cir- culation at High Altitudes as Measured by the Ballistocardiogram,” Journal g£.Aviation Medicine, 17-18: 361, June, 19M6. 21bid. TABLE OF CONTENTS CHAPTER I. II. III. INTRODUCTION . . . . . . . . . . . . . Justification of the Investigation Statement of the Problem . . . . . General Experimental Plan . . . . . Definition of Ballistocardiogram . Limitation of Investigation . . . . Summary . . . . . . . . . . . . . REVIEW OF THE LITERATURE . . . . . . . Introduction . . . . . . . . . . . History of the Ballistocardiogram.. validity of the Ballistocardiogram Harvard Step Test . . . . . . . . . Summary . . . . . . . . . . . . . METHODOLOGY . . . . . . . . . . . . . Subjects . . . . . . . . . . . . . Equipment . . . . . . . . . . . . . Three Week.Conditioning Program . . Testing Procedure . . . . . . . . . Measuring Procedure . . . . . . . . Computation of Stroke Vblume . . . PAGE N 10 13 16 17 17 17 2M CHAPTER PAGE IV. ANALYSIS OF DATA . . . . . . . . . . . . . . . 26 Introduction . . . . . . . . . . . . . . . 26 Height of I and J . . . . . . . . . . . . . 26 Pulse Rates . . . . . . . . . . . . . . . . 29 Stroke Vblume . . . . . . . . . . . . . . . 33 V. SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS . . 36 Summary . . . . . . . . . ...... . . 36 Conclusions . . . . . . . . . . . . . . . . 36 Recommendations . . . . . . . . . . . . . . 37 BIBLIOGRAPHY . . . . . . . . . . . . . . . . . . . . 39 APEJDIES O O O O O O O 0 0 O O O O o O O O O 0 O O ”1 TABLE I. II. III. IV. V. VII. VIII. :1: LIST OF TABLES Sample Recording Sheet For Both Pre- and Pbst— Exercise Ballistocardiogram.Measurements. . Analysis of variance Of Pre- and Post-Exercise Heights of I and J waves of the Varsity Basketball Players . . . . . . . . . . . . Analysis of Variance of Pro-Exercise Pulse Rates of Ten Varsity Basketball Players . . Analysis of Variance of Pest-Exercise Pulse Rates of Ten Varsity Basketball Players . . Significance of ”t" for Post-Exercise Pdlse Rates of Ten Varsity Basketball Players . . Analysis of variance of Pro-Exercise Stroke volume of Ten varsity Basketball Players. . Analysis of Variance of Post-Exercise Stroke volume of Ten varsity Basketball Players. . Raw Scores . . . . . . . . . . . . . . . . . . Raw Scores . . . . . . . . . . . . . . . . . . PAGE 2M 27 39 33 35 ’43 LIST OF FIGURES FIGURE 1. The Sanborn Ballistocardiograph Model 109. . . 2. Technique of Measuring I and.J wave Amplitude. 3. Mean Heights of I and.J Ballistocardiogram Waves Before and.After a Standard Exercise In Ten varsity Basketball Players . . . . . . M. Mean Pulse Rates Before and One Minute After.A Standard Exercise in Ten varsity Basketball Players . . . . . . . . . . . . . . . . . . 5. Mean values For Relative Stroke volume and Pulse Rates Before and.Five Minutes After a Standard Exercise in Ten varsity Basket- ball Players . . . . . . . . . . . . . . . 6. IA Pro-Exercise Ballistocardiogram. . . . . . . 7. A Post-Exercise Ballistocardiogram . . . . . . PAGE 23 32 3t 1+6 #7 CHAPTER I. INTRODUCTION ESTIFICATION 9_If'_ Physical Education is in need of better methods of INVESTIGATION measuring circulatory fitness. Instruments which reflect the circulatory changes during conditioning are essential to coaches as well as physical educators. Therefore a study dealing with the testing of circulatory fitness should be of some interest to the people connected with physical education. Ballistocardiography in physical education is Just beginning. The effects of conditioning on this type of recording are not known. The reliability of this instrument in measuring cardiac output is still questionable. However, Maséey and Huesman recommended in their ex- ploratory study that the effects of exercise on the ballistocardiogram be investigated further because it appeared. to be an especially profit- able area for further research.1 One of the outstanding problems confronting coaches today is that of conditioning. They are interested to find out if there is a peak of. conditioning beyond which physical performance diminishes. If there is such a peak, and a decrease in efficiency, what is the cause for this decrease in physical performance? There are a great number of 1Benjamin H. Massey, and 3. r. Hussman, "An Exploratory Study of the Ballistocardiogram As A Measure of Circulatory Fitness,“ Proceeding, 1954 National Convention, American Association for Health, Physical Education, and Recreation, New York, 1954, p. 119. 2 solutions to this question. .A decrease in cardiac efficiency may have an important effect on the performance of an individual. In other words a decrease in cardiac output may contribute to a decrease in performance. It is also possible that the number of capillaries may decrease with conditioning. If this is true then the amount of oxygen being delivered to the muscles and other parts of the body will be de- creased. This could result in a decrease in physical performance. Some people are of the opinion that this period of decreased.physical performance is purely psychological. This is only a small fraction of the total number of possible solutions to this question. In order to determine if this period of decreased efficiency, commonly referred to as 'staleness,‘ is a result of a decrease in circulatory efficiency physical educators must find a way to accurately measure relative changes in cardiac output before and after exercise. In recent years physicians and physiologists have attached considerable importance to the ballistocardiograph as a means of measuring these relative changes in cardiac output.2 STATEMENT 9!. The primary question of this investigation is "Do the PROBLEM components of the ballistocardiogram.change significantly before and after exercise as a result of a conditioning program?I Secondary points of interest deal with the relative changes in strOke volume and the pulse rates as a result of conditioning. 21bid. 3 GER Ten candidates for the Michigan State varsity baskeball EXPERIlel-TAL PLAN team were selected by head coach Forrest Anderson to participate in this study. Of the ten selected, six were considered as leading candidates for the first five. In order to establish a control two tests were given. The first test was given to acquaint the subject to the procedures he was to follow. In this study the second test was used as the control record. After a control had been established, a three week conditioning pro- gram was started. Following this three week conditioning program, a third test was given in the same nanner as the first and second test. Pollowing this conditioning program the ten subjects began their regular training program for the coming season. This consisted of regular practice sessions five days a week for about six weeks. Then I they began their regular season. The fourth test was administered after the team had completed half of the schedule. Following this test they continued to practice five days a week. Upon completion of the regular season the ten men were allowed to do whatever they wanted to in regards to training. Their equip- ment was collected so they could not work out to any great extent. Five of the ten were graduating seniors, and had no incentive to train since their eligibility was completed. The ten subJects were then tested for the last time about four or five weeks following the completion of the regular season. The data gathered from the records ' was handled statistically. u The heights and areas of the I and J waves were measured and the stroke volume was computed using Mole-ut's simplified formula for changes in relative stroke volume.3 The pulse rates were obtained by counting the number of "R" waves of the electrocardiOgram for thirty seconds and multiplying by two. All of these measurements were taken before and after exercise. After the data. were recorded on the tabulation sheets, an analysis of variance was computed on the relative stroke volume, pulse rate and heights of I and J waves. If there were significant changes occuring in these student's small “t" was then computed.” DEFINITION 0}; m The term ballistocardiogram was originated by BLLLISTOCARDIOQAM 5 Starr in 1939. It is a derivative of the Greek word ballein; meaning to throw; kardia meaning heart; and grams mean- ing a drawing. Therefore ballistocardiogram means a record of body movements produced by the beat of the heart.6 3Norman Molomut, and S. C. Allen, “The Effects of Pressure Breathing on Circulation at High Altitudes as Measured by the Ballistocardio- graph,‘ Journal g_i_'_ Aviation Medicine, 17-18: 361, August, 1946. 1"korge W. Sanders, Statistical Methods, (Ames, Iowa: State College Press, 19%) p. 238. 5Isaac Starr, and others, "Studies on the Estimation of Cardiac output in man and of abnormalities in cardiac function, From the Hearts Re- coil end the Bloods hpact; The Ballistocardiogram,“ American Journal gflsiologz, 127:1, August, 1939. 6Herbert Brown Jr., and others, Clinical Ballistocarddpgfiam (New York: The MacMillan Company, 19525 p. 3. 5 The ballistocardiograph complex makes up the pattern of movements of the body with each heart beat. A typical record can be found in Appendix B. Upward deflections represent movements toward the head and downward deflections are footward movements. The ballistocardio- gram begins with a headward deflection and begins during the QRS complex of'the electrocardiogram.7 This is designated as the H wave. Usually each beat is nade up of two groups of waves.8 The first group is composed of H, ‘I, J, and L9 The second group of waves is composed of L, M, N, and O.10 In this investigation the height of I and J waves was" studied since it is closely related to the output of the heart.n' LIL‘IITATION Q1: THIS The purpose of this investigation is to study INVESTIGATION the changes that occur in the ballistocardiogram both before and after exercise. In order to investigate these changes certain assumptions must be made. First of all we must assume that the loss of fat during a conditioning program will not effect the record- ing obtained by the Sanborn ballistocardiograph. The second assumption is that the omgen utilization ranains fairly constant. In other words the amount of oxygen being used by the muscles and other parts of the 79.1.4.- . p- 53- 81212: 91.2.1.9 101212: 11mm. , p. 56. 6 body is not increased or decreased by an increase or decrease in the number of capillaries but rather by an increase or decrease in cardiac output. Finally we must assume that the instrument we are using records accurately. With these assumptions in.mind, the following groups of measurements are of prime importance: (1) Pulse Rate, (2) Height of I and.J waves, and (3) Relative Stroke volume. Relative stroke volume is not the actual amount of blood ejected with each ventri- cular contraction but an arbitrary figure that is useful in deter- mining changes in stroke volume. SUMMARY In summarizing this chapter a presentation of some of the questions pertinent to this study seems quite proper. In the first place does a conditioning program decrease the post-exercise pulse rate? Secondly does the stroke volume, as determined with a Sanborn model ballistocardiograph, change during the conditioning period? Finally does the height of the I and J waves increase or decrease significantly? CHAPTER II. REVIEW OF LITERATURE INTRODUCTION The effects of conditioning on the ballistocardio- gram have not been studied and therefore literature pertinent to this subject is rather difficult to obtain. As a matter of fact ballisto- cardiography is so new that it has not been used to a significant ex- tent in research of physical activity or conditioning. HISTORY C_)§‘_ T__H_E_ Since this study is a pioneering effort in the BALLISTOCARDIOGRAPH present physical education department at Michigan State, a brief history of the ballistocardiogram seems necessary. Brown cites in his text that J. H. Gordon in 1887 demonstrated that with each heart beat there is a certain amount of body displace- ment.1 From this observation he designed two types of machines to record these movements.2 The first method used by Gordon to derive body movements was to allow the pointer of the weighing machine to trace out a figure.3 Later he developed a light frame table suspended by four ropes to record these movements.“ Following 188‘] Lsndois used this same principle to develop a vertical ballistocardiograph. lHerbert Brown Jr., and others, Clinical Ballistocardiog;_pgz_(New York: The Machillag— Company, 19525 p. 6. _ 2Ibid. 31bid. “Ibis. 8 Seventy years later Krahl was designing a simple ballistocardio— graph to be used as a teaching aid for his physiology 1aboratory.5 This consisted of an ordinary spring bathroom scale, a lever arrange- ment, and a kymograph drum.‘3 After a series of observations on the volume curve of the heart of the. dog, Henderson was led to consider the need for a method of obtaining similiar information as to human circulation under normal and pathological conditions], This study led.him to design the Hender- son table. In 1911, the Anglo-American Pikes Peak Expedition, reported by Douglas, Haldane, Henderson and Schneider, used a simplified form of recoil table in studying the effects of altitude on cardiac output.9 This table consisted of a plank supported on piles of cork.10 This 51bid., p. 7. 61bid., p. 28 7Yande11 Henderson, "The Mass Movements of the Circulation as Shown by a Recoil Curve,“ gerican Journal gt; Physiolog, 11+:287, September, 1905. 81bid., p. 290. 9Isaac Starr 22:21; "Studies On The Estimation of Cardiac Output in Man, and of Abnormalities In Cardiac Function, From the Hearts Re- coil and The Bloods Impact; The Ballistocardiogram," American Journal g_f_P_1_1ysiolog, 127:1, August, 1939. _ loIbid. was considered to be the first use of the ballistocardiograph in a field experiment.11 Harold and Tucker designed a ballistocardiograph that required the subject to stand on.a platform suspended.from.the diaphragm of a drum in 1922.12 Movement was recorded by changes in the current flowing through a hot wire placed in.the drum's air inlet.13 Normal respiratory activity did not interfere with the record of cardiac mobements and the effect of the respiratory cycle on these movements was clearly shown.1u Increased amplitude was demonstrated after era ercise.15 The next development in the field of ballistocardiography came from Germany in 1928. Here two Germans, Angenheister and.Laue pub- lished five records obtained from.a seismograph placed on a rigid table on which their subject lay.16 Four of these records were simp ilar to those records obtained by Starr in 1939.17 As a result of this study more foreign physiologists were becoming interested in the ballistocardiograph. In Sweden Abramson built a chair of aluminum alloy suspended from steel springs which were embedded in a cast steel 1lsroun, 92, 933,, p. 10. 12$tarr, 92. 231., p. l. 131bid. 1"‘naia. 15Ibid. 16Ibid. 17Ibid. 10 base on a concrete foundation.18 The movements were greatly magnified by a patented device and photographed.19 The new era of ballistographic research began in 1939 with the advent of Isaac Starr's wwork.2o Starr and his co—workers have in- vestigated the ballistocardiograph from both the theoretical and emper- ical vieWpoints.21 lheir contributions are numerous and significant. In 1939 Starr (gt. a_l_.) designed a table similar to that employed by Henderson in 19014.22 With this table they confirmed the findings of their predecessors in this field regarding the general shape of the normal cardiac ballistic curve and the effects of exercise, and certain drugs, upon its amplitude.23 From these explorations Starr (at. 21.) developed new theoretical concepts of the forces involved and derived new formulas for estimating cardiac output?“ These are but a few of Starr' s many contributions. VALIDITY 9_F_ fl Much has been said about the validity of the BALLI STOCARDIO GRAM 11$ MEASURING ballistocardiogram as a measurement of cardiac CARDIAC OUTPUT output. Most of the arguments against using 18Ibis. 19Ibid. 20Brown, Op. _C_i_1., p. 16. 211nd. ZZStarr, 92, 915,, p. 2. 23Ibid. 2nlbid. 11 this type of record as a measure of cardiac output stems from the fact that Starr's original formula required the assttion of some value for the size of the aorta.2‘3 However, Starr correlated the stroke volume as determined by his original formula with the ethyl iodide method. He found the coefficient of correlation to be 0.86 with a standard deviation of .05236 The results obtained from the ballisto- cardiogram averaged two c.c. per beat, 3.9 percent smaller, than those obtained by the ethyl iodide method. This amount was not considered significant. Cournand and Ranges correlated the cardiac output as determined by the direct Fick method and the ballistocardiogram.27 They found that the direct Fick method was much more difficult to per- form but the degree of accuracy was high. Any discrepancy between the results obtained by the direct Fick and by the Ballistocardiograph 28 were assumed to be due to error in the latter. Cardiac output as determined by the direct rick method was found to be 18.5 percent larger than the value calculated from the ballistocardiogram.29 Analysis of a large number of data and comparison with other methods, 25Carl J. Wiggers, Physiology In_Hsa1th and Disease, (Fifth edition; Philadelphia: Lea and Febiger Company, 195 26$tarr, Op. 2%., p. 21. 27Andre Courand, H. A. Ranges, and R. L. Riley, "Comparison of Results of the Normal Ballistocardiogram and a Direct Fick Method in Measur- ing the Cardiac Output in Man," Journal g Clinical Investigation, 21: 287, May, 191+2. 281bid., p. 291. 29Ihia., p. 292. 12 have sufficiently standardized the ballistocardiogram-to make it use- ful in measuring the changes in relative stroke volume in the same subject.30 If this is true then these changes should be evident during a training program. In other words if we assume that the oxygen utili- sation doesn't increase during a conditioning program and that the Sanborn ballistocardiograph is recording accurately, there should be an increase in the amount of blood being pumped out with each beat of the heart as conditioning progressed. Massey and Hussman conducted an exploratory study of the ballisto- cardiogram as a measure of circulatory fitness.31 Their objectives were to determine if the components of the ballistocardiogram differed significantly between two groups believed to differ ‘ in circulatory fitness.32 He concluded that the variabla of the ballistocardiogram were in the appropriate direction even if they were not quite statistic- .iiy significant.33 3°w1ggorc, 92, gig,, p. 711. 3:I'Benjamin H. Massey and B. F. Hussman, "An Exploratory Study of the Ballistocardiogram as a Measure of Circulatory Fitness," Proceedings, 1954 National Convention, American Association for Health, Elysical Education, and Recreation, New York, 1954, p. 119. 321hid. 33Ib1de, p. he 13 HARVARD A.pulse rate test is probably the easiest and simplest way §2§£ 2§§2. , 3n for physical educators to determine circulatory fitness. The chief factor determining the minute volume of the circulation is the control exerted by the respiratory metabolism over the venous return, that is, the volume of blood from the venous reservoirs of the body supplied to the right heart.35 Exact coordination of heart action and venous return occurs when the pulse rate is such that during bodily rest and moderate exertion these two factors vary proportionally.36 Sterling's "Law of the Heart" implies that the energy of contrac- tion is a function of the length of muscle fibers)7 Therefore a de- crease in pulse rate would allow for a longer diastolic filling time, distention of the muscle fibers of the heart and therefore an increase in output. A necessary condition of all muscular exercise is that the muscles shall be supplied with oxygen in proportion to their requirements}8 3“Thomee x. Cureton, Physical Fitness Appraisal and Guidance, (The c. V- Mosby Comrany. 19u7), p. 162- 35rendell Henderson, H. w. Haggard, and r. s. Dolley, ”The Efficiency of the Heart, and the Significance of Rapid.and Slow Pulse Rates," American Journal g£,ngsiology, 82:152, June, 1927. 3bIbid. 37Ernest H. Starling, Principles gggHuman Physiology, (Philadelphia: Lea and Febiger, 1936), p. 738. 331bid., p. 811. 11+ Since the arterial blood is almost saturated with oxygen, such increases in the oxygen.usage by the muscles implies a great increase in the blood supplied to them, though a certain amount of oxygen may be gained by a more complete utilization of the oxygen of the blood as it flows through the working tissues.39 Therefore it seems logical that an athlete undergoing a rigorous .conditioning program should lower his pulse rate and increase his, stroke volume. This trend of thinking is backed by an experiment by Henderson, Haggard, and Dolley in 1927.140 They were reporting on the. typical examples of the circulation and cardiac efficiency in fifty college students.“1 They found that in athletes the pulse rates tend to be much slower and the stroke volume much larger both during rest and during exercise than in none-athletes.“a With these basic physiOIOgical facts concerning the meaning of pulse rates in mind let us consider the Harvard Step Test.“3 This test consists of stepping up and down on a twenty inch stool thirty times a minute, (once every two seconds) for five minutes. Following the exercise, pulse rates are taken from one to one and.a.ha1f minutes, from two to two and a half minutes, and from three to three and a half minp 'utes. Taylor found that the latter two pulses are "dead wood" by correlat- ing the Johnsoanrouha "recovery indhx' computed in the recommended way 391m, noHenderson, Op, 213,, p. 513. “libid., p. 523. nelbid. l”Curaton, 92' gi_t_., p. 1714. 15 with one in which the latter two pulse counts are omitted.uu In thirty-four cases the r was 0.99.1+5 In the present study the one and five minute counts were taken. The recuperation of pulse rate after a standard exercise such as the Harvard Step Test is one of the most acceptable tests of circu1a~ tor fitness.1+6 The pro-exercise pulse rate is not a very good means of selecting individuals who are in superior athletic condition. Salit and Tuttle reported.that most cardiovascular measures do provide a good means of selecting individuals who are in superior condition.u7 Of all the scores obtained in their study, the post-exercise heart rate and the increase due to exercise, were found to be most promis— ing.u8 Montoye analyzed the results found by Gallagher and Brouha and found that the post exercise pulse rate was sensitive to a condition- ing program.)49 He found that as the conditioning progressed the maxa imum.pulse rates during exercise decreased and therefore the recovery EuCraig Taylor, "A.Maximal Pack Test of Exercise Tolerance," Research Quarterly, 15:201, December, 1944. - ”5Ihid. ”6Cureton, Op, 933,, p. 178. "7Hlizaheth Powell Salit and w. w. Tuttle, "The validity of Heart Rate and Blood Pressure Determinations as Measures of Physical Fitness?” Research Quarterly, 15:253. October, lguu. “SIbId. ”9Henry'J. Montoye, "Interrelation of Maximum.Pulse Rate During Moderate Exercise, Recovery Pulse and Post-Exercise Blood.Lactate," Research anrterly, 2h: “53-M58, December,.l953. 16 50 . time decreased. This seems to indicate that as conditioning pro— gressed the heart pumped out more blood and didn't have to work as hard during exercise. Therefore it took less time for it to recover. In view of these facts, it seems logical to assume that the ballisto- cardiogram would demonstrate an increase in relative stroke volume, heights of I and J waves and a decrease in pulse rate during a con- ditioning progam. SUMARY In summarizing this chapter a' review of the main points of this chapter is presented. hllistocardiography in physical education is an entirely new field. The effects of conditioning on the ballisto- cardiogram are not known. Analysis of a large number of data and com- parison with other methods, have sufficiently standardized the ballisto- cardiogram to make it useful in measuring the changes in relative stroke volume in the same subject.51 The recuperation pulse rate after a standard exercise is one of the most acceptable‘tests of circulatory fitness.52 Although a certain amount of oxygen may.be gained by a more complete utilization of the oxygen of the blood as it flows through the working tissues, an increase in oxygen usage by the muscles in- dicates a great increase in blood supplied to them.53 Therefore a de- crease in pulse rate my be an indication of a corresponding increase in stroke volume. 5°Ibid. 51Wiggers, 92. 311., p. 711. 52W8t0n. 22. Eli-t... p. 162e 53Starling, op. gi_t_., p. 738. CHAPTER III METHODOLOGY SUBJECTS The ten.men were selected for this study by the varsity coach Forrest Anderson. ‘He selected the boys who were most likely to make the first two teams. As it turned out five of these boys were considered as starters. Two were not considered starters but played a great deal. The last three were on the first ten for the whole season but did not see much.action. Each subject was instructed not to eat just prior to being tested. He was also told to walk.or ride to the place where he was to be tested. Upon arrival he rolled up his trouser legs, took off his shirt and reclined on a mattress covered table for the recording of the resting electrocardiogram, respiration and.heart sounds. Once his pulse rate was steady the recording was started. EQUIPMENT It has been found that a subject lying on,a rigid table with support under’his ankles will move in response to the cardiac beat.1 The motion of the patient's body with regard to the table is very complex and is determined by the thrust forces developed within the patient‘s body acting on a mechanical system made up of the patientb body and the supports between body and table.2 Therefore lsanborn Ballistocardiograph, Sanborn 00., Sec. 11., p. 1, Cambridge, 158.38., 1953. 2Ibid. 18 mattresses or sponge rubber pads should not be used. The Sanborn Ballistocardiograph is comprised of two units. One of these is the light projector and the other is the photo cell.3 The light projector is placed on the patient's shins and moves with the patient. It was discovered in this study that by placing the trans- ducer at different distances from.the ankle will cause a variation in the amplitude of the component parts of the ballistocardiogram. There- fore it was necessary to place the transducer in the same place as the previous test. This was done by measuring from.the subject's internal talus to the front of the transducer elanent and also to the ankle bar. The field of light that is transmitted to the photo-cell by the transducer is in the form of a rectangle. The photo-cell is placed about a quarter of an inch away from.the transducer element. It must not be touching. The motion of the transducer therefore moves the light back and forth across the face of the photo-cell. The relative (positions are adjusted so that approximately one quarter of the active area of the photo-cell is illuminated by the projected light. The patient's body is subject to motions which are not all of cardiac origin.” The most prominent of these is produced by normal respiration. One.method of overcoming this is to have the subject hold his breath. This is not advisable because Mueller or Vhlsalva effects 3Ihid. ”rein. 19 may be introduced.5 These variations may be reduced by introducing an.electrical filter between.the photo-cell and the recording system. This is done in the Sanborn instrument by throwing a switch located ’ on the photo-cell. The photo-cell is plugged into the Poly;Viso-Recorder model 109 and the electrocardiogram, respiration.and.ballistocardiogram.can be recorded simultaneously. By recording all three of these at once the electrocardiogram.can be used as an orienting point. The R.wave just proceeds the ballistocardiographic H wave. The Sanborn ballistocardiograph has the following components and controls as shown in Figure one.6 (See page 20.) I- ream A. iii—1.72.1; a_n_d w Volga Control. Turns to lamp (3) and to set meter needle on red line. B. £23253 Note red line for determination of standard intensity of light. C. Battegz g92g5_ Lifts off to expose battery. (Note: Do not attempt to lift or carry leg piece while grasping battery hood.) D. Lamp Holder. Lifts out for replacement of lamp bulb. 3. Light Slot. Directs rectangle of light to hood or photocell unit. 51bid. 6Ibid., Sect. III, p. l. igure 1. The Sanborn Ballistocardiogram Model 109 II. PHOTOCELL M F. Rectangular Hood. Receives rectangular light field from light slot of leg unit, and directs it to photoelectric cell. G. Eig!_§g§l£y For observation and correct setting of light field. H. £995 119.1. Hood and cell may be raised or lowered as required by pulling up or pressing down. Then locked into position by this nut. I. Binding Post. For connection of E. C. G. cable tips, as marked. THREE WEEK Once a control record was established.for the basis of BONDITIONING EROGRAM this study, the ten subjects began a three weeks train- ing program. This program was outlined by Forrest Anderson. .1 de- tailed outline is presented in.Appendix B. TESTING A.total of five tests were given during the l95h—55 PROCEDURE season. Each test was administered in nearly the same manner as the first. It was impossible to arrange for the subjects to be tested at the same time for every test due to their class schedp ule and also the availability of the physiology laboratory. However, each subject was tested sometime during the day prior to four o'clock; As the subject reported for the test he would roll up his trouser legs above his knees and remove his shirt and undershirt. He then pro- ceeded to the table and reclined for approximately ten to fifteen minutes until his pulse count would become steady. 22 While reclining at this table, he was wired to record the standard resting electrocardiogram. Electrodes were placed on the right and left leg above the leg muscle so they would not slip during exercise, on the right and left arm below the elbow, and six leads were placed on his chest. Care was taken to avoid strapping the electrodes on too tightly. He was also prepared to record respiration and heart sounds. The first part of the test was merely an electrocardiograph re- cording. These leads were recorded in this order. The three standard leads I, II, and III were recorded first. Then.AVR, AVL, and.ANF were recorded. nest the three chest leads V , Vé, V3. After shifting the cables to the last three chest leads, Vt, V5, V6, were recorded. The second part of the test involved a recording of lead II, heart sounds and respiration. The heart sounds were recorded by plac- ing a small microphone over the point where the heart sound was the loudest. This was determined by using a stethesCOpe. From here the subject moved to another table. Here a resting ballistocardiograph, lead II, and respiration were recorded. Following this he proceeded to do the Harvard Step Test. This consisted of stepping up on a stool with both feet and back down once every two seconds or thirty times a minute. The stool was approxi- mately seventeen inches high. The subject was assisted by one of the examiners by having the cycles counted.out loud to make sure of thirty complete cycles per minute. The fifth part of this test was the post-exercise. Following the Harvard Step Test the subject returned to a hard table and reclined. 23 One minute after exercise had stopped an electrocardiogram was re- corded. This lasted for thirty seconds. The subject was allowed to rest on the table and five minutes after thd end of exercise Lead II, respiration and the ballistocardiogram were recorded. MEASURING The records obtained in these tests were put together, 2mm . folded and filed. The date of the test, measurements for placing the transdncers and ankle support were written on the out- side of a mnila folder, along with the subject's name. Upon inspection of the record three sample ballistocardiogams were selected, both before and after exercise. These three all oc- curred dnring the inspiration phase throughout the test. This was done because the inspiration and expiration phases have a varied effect on the relative cardiac output. This helped to standardize the measure- ments througiout the testing program. After selecting the three ballistocardiograms a baseline was drawn using the standardization line. Then these measurements illus- trated in Table I were made, and the averages entered on the tabulation sheet. The areas were measured in square inches by using the Ott Gom- pensating planimeter. The heights were obtained by measuring from the base line to the insidsftip of the I and J waves. _fl;’al;; a! .T " I. ~ u -..___...A , n AV ea s: use my?“ eflI-JU V e I K Figure 2. Technique of fleasuring I and J Wave Amplitude. TABLE I. SAMPLE RECORDING SHEET FOR, BOTH PRE— AND POST-EXERCISE, DILLISTOGARDIOGRAM MEASUREMENTS First Second Third Mean Wave Wave wave ”08 (SQeine) (SQeine) (ageine) (Bq.1n.) I .07 .06 .05 .06 J .ou .05 .oo .05 I & J ' .11 .11 .11 .11 m Height (mm) (mm) (mm) (M) I 1.9 2.3 2.1; 2.2 J 10.5 9.“ 9.2 9.7 I d J 12.M 11.7 11.6 11.9 After these measurements had been recorded the pulse rates were then computed. Pulse rates were taken wile resting, one to one and a half minutes after exercise, and five to five and one half minutes after exercise. These were also counted from the records. COMPUTATION O_F_ Mth and Allen derived a formula for measuring RELATIVE STROKE VOLUME relative volumes while studying the effects of 7 pressure breathing on circulation at high altitude. Since this study is concerned with the relative changes in stroke volume, this formula Relative SV = vu + J) 03/2 7Molorrrut, Norman ands. C. Allen, "Effect of Pressure Breathing on Circulation at High Altitudes as Measured by the Balli stocardiograph," Journal 3; Aviation Medicine, 17-18: 361, June, 19%. was used!» 25 where I and J represents the height of I and J in millimeters. The factor C is the length of the cycle in seconds.8 After these data were recorded on tabulation sheets an analysis of variance was computed on the following three groups of measurements: (1) Pulse Rates - before and after exercise. (2) Relative Stroke volume - before and after exercise. (3) Height of “I and J" before and.after exercise. If the analysis of variance were significant the ”t" technique to test the significance of the difference between any two of the group means was anployed.9 8Ibid. 9George W. Sanders, Statistical Methods, (Ames, Iowa: State College Press, 19%), p. 238. CHAPTE IV ANALYS I S OF DATA INTRODUCTION The purpose of this investigation was to study the ef- fects of conditioning and the components of the ballistocardiogram. Ten subjects were tested five times during the basketball season. Here are the results. HE__I_____GHT T0_F Three complete cycles of the ballistocardiogram both '1- Q i before and after exercise were selected for measuring the I and J amplitudes. These six cycles occurred at approximately the same time during the inspiratery phase of respiration. Each set of three was: measured by using calipers and measuring from the stand- ardization line to the top of I and J respectively. An analysis of the pre- and post-exercise heights indicated that there were no significant changes in amplitude. Therefore the ”t" test was not applied. The mean values as plotted in Figure 3, indicate that instead of the amplitude increasing with conditioning it decreased. This did not affect the relative stroke volume as derived by Molomut's formula because it had a tendency to increase with conditioning:l It is evident that at this point the height of I and J in Molomut's formula does not play an important part in determining the increase lNorman, Molomut, and S. C. Allen, "The Effects of Hessure Breathing on Circulation At High Altitudes as Measured by the Ballistocardiograph,“ Journal of Aviatigpfifledicine, 17-18: 361, August, 1946. 27 TABLE II ANALYSIS OF VARIANCE OF PRE- AND POST-EXERCISE HEIGHTS OF I AND J WAVES OF THE VARSITY BASKETBALL PLAYERS Sum of Degrees Variance Variance Item. Squares of Free— Estimate Ratio Probability dom Pro- Exercise Between Greater Columns---- 16.80 3 5.60 .55 than .05 Within Columns--- 359.33 35 10.27 Greater than 005 Total w-- 376.13 38 Post- Exercise Between Greater Columns---- 59.28 3 19.76 .uo than .05 Within Columns-- 1731.20 35 H9.N6 Greater than e05 Tota1--- 1790.h8 38 or decrease in relative stroke volume.2 Therefore the cycles per second (C) in the formula seems-to be the controlling factor.3 The trend for the amplitudes to decrease with training instead of increase may be due to the decrease in body fat. It was pointed out earlier in the investigation that placing the transducer element at varying distances from the subject's internal talus altered.the amplitude of the waves and measurements were used to place the transducer element .muoasam Hasnuoamom apa.as> cos a“ omfioaoxm easesowm s poems and chomom eo>ss ememcweaseoumaaaem h was H mo up mom are: .m oasMwh w 05:02:00 05:23:00 ochEecooISa Izod «gonzo. 8.33m ecu , _ _ _ _ We I a \ol l I l lo/ aflozxououu \ / l m \\ / \ // ox xo 1 m l 0_ 03203158 I _ _ l N. l m. ("IDA unawrww U! r PUDI 40 U45!3H 29 in the same position each test. A.careful examination of this effect on.amplitudes should be conducted before further research is continued. 2Q§§!_ The pulse rates were computed by counting the R waves for a §é2§§, thirty second period and.multiplying by two to get the rate per minute. Both pre- and post-exercise counts were taken. Following an.analysis of variance of pre-exercise pulse rates, it was found that the changes were not statistically significant. Therefore further analysis was deemed.unnecessary. The mean values plotted in Figure )4 did not indicateadaflnite tendency to decrease TABLE III ANALYSIS OF VARIANCE OF PRE-EXERCISE PULSE RATES or TEN, BASKETBALL PLAYERS r r Sum of Degrees variance Variance Item Squares of Free— Estimate Ratio Probability dom Between Columns--- 285.28 3 95.09 .98 Greater than .05 Within Columnp—- 3383.50 35 96.67 Greater than 005 Total ---- 3665.78 38 ‘ “m-‘- min m«“~. -~‘m"-‘ with conditioning and increase with deconditioning. The first pre- conditioning pulse rate of 59.3 beats per minute increased to 69.3 beats per minute in the second pre-conditioning test. Following three weeks of conditioning the mean pulse rate decreased to 58.1 beats per minute. This decrease was followed.by a slight rise in pulse rates 30 following sixteen weeks of conditioning. One month after the end of the conditioning program the pulse rates rose to 63.6 beats per minute. The insignificance of the pro-exercise pulse rates tends to support the work of Salit and Tuttle.“ TABLE IV ANALYSIS OF VARIANCE OF POST-EXERCISE PULSE RATES OF TEN, BASKETBALL PLAYERS E .r— Sum of Degrees Variance Variance Item Squares of Free— Estimate Ratio Probability dom Between . Columns-- 3772.u8 3 1257.M9 10.n2 .001 Within Columns-- M222.50 35 120.6“ .001 Total--- 799#.98 38 TABLE V SIGNIFICANCE OF "t" FOR POST-EXERCISE PULSE RATES OF TEN VARSITY BASKETBALL PLAYERS _ -__ m 3 Weeks 16 Weeks Post Conditioning Conditioning Conditioning Pre- ,6 Conditioning--- 1.91 M.M7** 0.19 3 Weeks , Conditioning-- h.fl1** 5.16MI 16 Weeks . Conditioningb- 1.06 l"'"This figure is significant at .001 level of significance. EElizabeth Powell Salit and W. W. Tuttle, "The validity of Heart Rate and Blood Pressure Determinations as Measures of Physical Fitness,“ Research Qggrterly, 15: 253, October, 1944. flair-7,451.... s. y . . x it... 31 An analysis of variance of the post-exercise pulse rates indicated that changes occurring within the groups were significant at the 0.001 level of significance. Therefore a "t" test was computed to determine the significance occurring among the mean values of the four tests. Changes in the mean pulse rates from.the pre—conditioning test to the three-week conditioning test were found to be insignificant at the five percent level of significance. Also found insignificant were the changes occurring between the pro-conditioning test and post-condi- tioning and between the sixteen weeks test and post-conditioning test. The changes occurring between the pro-conditioning phase and sixteen weeks of conditioning were significant at the one tenth percent level. Also found significant at the one tenth percent level were the differ- ences between three weeks of conditioning and sixteen weeks of condi- tioning and between three weeks conditioning and post-condition. The mean values plotted in.Figure h also indicate the decrease of pulse rates with conditioning and an increase in rats following one month of inactivity. These results substantiate the work of Gallagher and Brouha, Brouha and Savage, as cited by Montoya.5 It also indicates that the recuperation pulse is one of the most acceptable tests of circulatoryb respiratory fitness.6 5Henry J. Montoya, "Interrelation of Maximum.Pulse Rate During Moder- ate Exercise, Recovery Pulse, and Post-Exercise Blood.Lactate,' Research Mrterlz, 21+: l+53--J+58, December, 1953. 6Thomas K. Cureton, Physical Fitness, Appgaisal, and Guidance, (The C. V; Mosby Company, l9h7), p. 178. .maomsam adenpoxmom haemam> see a“ omeoaexm careesum 4 aoomd case“: use use oaomom mopsm madam are: .: oaowam 0:22:33 9:22:33 ochEucouuoE luau £33m. excuse. Eu 3. 32 _ _ _ _ _ egouoxolouu \\. IIIAVIIII Ill. ,0 3.203138 00 oh. m a 0m w. / W .m. om ( oo. o: ssgonsxg nun smugm | puo ampq 93:03 sslnd “03W 33 STROKE The relative stroke volume was computed by using'Molomut's VOLUEE 7 formula for changes in relative stroke volume. The analysis of variance of the pro-exercise stroke volume was found to be insignificant. The mean values plotted in Figure 5 indi- cated that the stroke volume did not increase with a decrease in pulse rate. TABLE VI ANALYSIS OF VARIAECE 0F PRE-EXERCISE STROKE VOLUME OF TEN VARSITY BASKETBALL PLAYERS -‘ Sum.of Degrees Variance Variance Probabilityf' Item Squares of Free— Estimate Ratio dom Between CblumnIP-- 0.157 3 0.052 .115 Greater theme .05 Within Columns-- 15.95n 35 0.u55 Greater Than .05 To m--"-- 160111 38 m The changes occurring in post-exercise stroke volume were also insignificant. However, the mean values plotted inIFigure 5 indicated a definite tendency to increase with a decrease in pulse rates. The mean value for stroke volume increased from 2.39 to 2.52 following the three week conditioning program. After sixteen weeks of condi- tioning, it increased to 2.5M. A month after the end of conditioning it decreased to 2.h7. 7Nolomut, 2!, g;3,, p. 361. I q C) A“--A\ ,A - “‘1Cy-—--"'{§r"" l m (D A Pulse Rate 3‘ I-l % 0 Stroke Volume > —-- Pure-exercise j 5 § — Poet-exercise f I! a / / / \ \ \ ‘0 5 _ or e - "' O > U E 2 5 ” M N «‘5 0 II- .2 '5 .J a"? i l 0 1 1 I 1 1 I31 2 nd 3 weeks l6 weeks Poei- ‘ Pre-conditioninq Conditioning conditioning Figure 5. Mean Values for Relative Stroke Volume and Pulse Rates Before and Five Minutes After a Standard Exercise in Ten Varsity Basketball Players. I (D C) l o <3 (3 Mean Pulse Rates before and 5 minutes after Exercise (Beets/Min.) 31+ 35 TABLE v11 ANALYSIS OF VARIANCE OF POST-EXERCISE STROKE VOLUIE OF TEN BASKETBALL PIAYERS Sum of Degree Variance Variance Item Squares of Free— Estimate Ratio Probability dom Between Columns--- 0.131 3 .ouh .019 Greater than .05 Within Columns-- 16.816 35 .NSO Greater than .05 Total--—~ 16.9u7 3s Even though the results of the pre- and post-exercise stroke volume were insignificant, the mean values of the post-exercise stroke volume indicated a definite trend to increase with a lower pulse rate. This tendency follows the current trend of thought that as pulse rates decrease, stroke volume increases.8 It is quite possible that the insignificance of changes in stroke volume could be a result of an increase in oxygen utilization.9 This seems to be a profitable area for further research, It is also possible that had.a larger number of subjects been used the results may have been significant. 8Yandell Henderson, H. W. Haggard, and.F. S. Dolley, "The Efficiency of the Heart and the Significance of Rapid and Slow Pulse Rates," American Journal of msiolon, 82: 152, June, 1927. 9Ernest H. Starling, Principles giDHuman.Physiologz, (Philadelphia: Lea and Febiger, 1930), p. 738. v o ‘ a O o e e a PI? V’fu fight I; {nu-nth»! ED. . ,. . m . . _ n _ l i . étwyllr; . .‘lllr. H‘. CHAPTER V SIMMRY, CONCLUSIONS AND RECOMJENDATIONS smnmmr Ten members of the Michigan State varsity basketball team were tested to determine the effects of conditioning on the components of the ballistocardiogram. Three complete cycles of the ballistocardio- gram before and after exercise were selected for measurement. Each cycle occurred during the expiratory phase of respiration. The average values for these measurements, before and after exercise, were computed and recorded on tabulation sheets. An analysis of variance was then made to see if there were any significant changes within the group. If significant changes occurred, Student "t" test was computed to determine the significance between the individual mean values.1 COHCLUSIONS After analyzing the data of this investigation the fol- lowing conclusions can be made. 1. The heights of I and J waves did not change significantly with conditioning and the mean values did not indicate an increase with conditioning. 2. The height of the I and J wave is not a critical factor in determining the relative stroke volume derived by Molomut' s formula.2 1George W. Sanders, Statistical Methods, (Ames, Iowa: State College Press,1 19%)), p. 23?. 2Norman Molomut and S. C. Allen, "Effect of Pressure Breathing on Cir- culation at High Altitudes as Measured by the Ballistocardiogram," J_q______urnal 9__f Aviation Medicine, 17-18: 361, June, 19 6. 3. H. 5. 6. 7. 37 The cycles per second is the critical factor in Molo- mut's formula.3 The pre—exercise pulse rates did not decrease signifi- cantly although the mean values indicated a slight tends ency to do so. The post-exercise pulse rates did decrease significantly during the conditioning program and increased with the termination of conditioning. The post-exercise pulse rate is a good index of circulap tory fitness. The pro-exercise pulse rate does not indicate the condi- tion of the athlete. The pro-exercise stroke volume did not increase signif- icantly and.the mean values did not indicate a tendency to do so. The post-exercise stroke volume did not increase signif- icantly although.the mean values indicated a trend.to increase with.a decrease in pulse rate. RECOMMENDATIONS Since this investigation was exploratory in nature, experimentation in this field should be continued. An investigation similar to this combined with one dealing with oxygen utilization ap— pears to be a profitable area for further research for this reason. If the stroke volume doesn't increase with a decrease in pulse rate then the oxygen utilization to the working tissues may increase. If 31bid. 38 this can be demonstrated by a study similar to this, then the whole concept of an increase in stroke volume resulting from.a decrease in pulse rate may be altered. It is also recommended that the effect of body fat on the Sanborn Ballistocardiogram be investigated before research in this area is continued. BIBLIOGRAPHY Books Brown, Herbert, R. (and others). Clinical Ballistocardiography. New York: The MacMillan Company, 1952. Cureton, Thomas, K. Physical Fitness and Appraisal and Guidance. Boston: The C. V. Mosby Company, 19M]. Sanders, George, W. Statistical Egthods. Ames, Iowa: State College Press, 19H6. Starling, Ernest, H. Principles g£_Human Physiology. Philadelphia: Lea and Febiger, 1930. Wiggers, Carl J. Physiology Ig.Health and Disease. Fifth Edition. Philadelphia: Lea and.Febiger Company, 195“. Publications of the Government, Learned Societies, and Other Organizations Massey, Benjamin, H., and Burris F. Husman, "An Exploratory Study of the Ballistocardiogram as a Measure of Circulatory Fitness," Proceeding, 195” National Convention, American Association for Health, Physical Education, and Recreation, New York: 195”. Periodicals Courand, Andre, H. A. Ranges, and R. L. Riley. "Comparison of Results of the Normal Ballistocardiogram and a Direct Fick Method in Measuring the Cardiac Output in Man, "Journal g£_Clinical Igyestigatign, 21: 291, May, 1942. Henderson, Yandell. "The Mass Movements of the Circulation As Shown by a Recoil Curve," American Journal gf_Physiology, 1k: 287, Septeimber, 1905. Henderson, Yandell, H. W. Haggard, and.F. S. Dolley, "The Efficiency of the Heart, and the Significance of Rapid and Slow Pulse Rates", American Journal 3;,Physiology, 82: 152, June, 1927. ho Molomut, Norman, and S. C. Allen, "The Effects of Pressure Breathing 0n Circulation At High Altitudes As Measured By The Ballisto- cardiograph," Journal giAviation Medicine, 17-18: 361, June, 19u6. Montoya, Henry, J. "Interrelation 0f Maximum Pulse Rate During Moder- ate Exercise, Recovery Pulse and Post-Exercise Blood Lactate," Research Quarterly, 234: 163-458, December, 1953. Salit, Elizabeth and W. N. Tuttle, "The Validity of Heart Rate and Blood Pressure Determinations As Measures of Physical Fitness,“ Research anrterlz, 15: 253, October, 19th. Starr, Isaac, (and others), "Studies On The Estimation 0f Cardiac Out- put In Man And 0f Abnormalities In Cardiac Functions, From Hearts Record and Blood Impacts: The Ballistocardiogram,” AmaricanfiJournal of Physiology, 127: 1, August, 1939. Taylor, Craig, "A Maximal Pack Test of Exercise Tolerance," Research anrterlz, 15: 201, December, 19%. Unpubli shed Material s Sanborn, "Sanborn Ballistocardiograph (Model 109) and R—Wave Injector," Cambridge, Massachusetts, Sanborn Company, 1953. APPEIZ‘DIXES APPENDIX A 1. Raw Scores. 1": '1'!!!" lisl‘Il. Cl‘li1..“l- 1 1 - II‘ I'll!“ .I‘ -1‘I1qz'tl“o DI?! ialtq . mi m mi 3 mi. m 1 LNN\m 2 3S g JR . i . € .i. a . male is us saw as a he E321 8 e 3N a t \4 a 8 as E t a n t n m~ e u ON ss «N an \\ N~ .\ u .n t 8 a e 2 o. \\ .— 2 H hi. 2 1 1 1 em 2 AHMNVH e. e «Q .. z e >~ m 2 \x I!” n. N. \\ 1 -9 1 E : \\ . e .. .—I o_1|| \\ . . . . ... .. .. as 1 n U. .mxi xi. 9 \1§1 “Q. 3.14 «a -- was- 1 Ha. 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