AGE AND GENDER PATTERNS OF HUMAN CARDIORESPIRATORY FITNESS IN THE CONDITIONS OF THE URBANIZED SIBERIAN NORTH
Keywords:
Cardiorespiratory fitness, walking speed, men and women, age 18–75 years, oxygen consumption, pulmonary ventilation, urbanized Siberian North, KHMAO-Yugra.
Abstract
Aim. The aim of this article is to reveal consistent patterns of human cardiorespiratory system reaction to walking at different speeds depending on sex and age in the conditions of the urbanized Siberian North. Materials and Methods. We studied three groups of healthy volunteers. The group of young people (GY, 22.1 ± 2.6 years, n = 25: 12 men and 13 women), the group of middle-aged people (GM, 42.7 ± 9.3 years, n = 25: 12; 13) and the elderly group (GE, 66.2 ± 5.1 years, n = 24: 11, 13) performed walking on the treadmill at a speed of 2–7 km/h for 5 minutes at each speed. We used FitMet PRO analyzer (COSMED, Italy) to measure breathing frequency (FB, times/min), lungs ventilation (VE, l/min), oxygen consumption (PO2, ml/min), relative oxygen consumption (RPO2, ml/min/kg), heart rate (HR, bpm), and oxygen concentration in the exhaled air (KO2, %). Before the beginning of the study, we measured leg length (m), body length (m), and body weight (kg). Results. As walking speed increased from 2 to 7 km/h, relative oxygen consumption increased regularly in the young group by 14.6 ml/kg/min (2.46 times), in the middle-aged group by 17 ml/kg/min (2.72 times), and in the elderly group by 13.9 ml/kg/min (2.53 times). We registered the decrease in the slope of the dependence curves of relative oxygen consumption on heart rate in young and older women in comparison with young people and the people of middle and old age. Regression equations of the dependence of relative oxygen consumption on pulmonary ventilation (VO2 = –12.9 + 40.3Ve (r = .98, p = .0000) in young men and VO2 = 116.3 + 34.7Ve in girls (r = .97; p = .0000)) allow to determine oxygen consumption in the group of students in the classroom using a spirometer. Conclusion. The data obtained show that the reaction of the cardiorespiratory system of the persons of different ages in response to walking with a stepwise increasing rate is adequate. Decrease in the slope of the dependence curves of relative oxygen consumption on heart rate in young and elderly women in comparison with young people, middle-aged and elderly people indicates a possible decrease in the cardiorespiratory endurance of women from this sample.References
1. Vatutin N.T., Smirnova A.S. [Role of Cardiorespiratory Endurance in Clinical Practice]. Medychny aspektы zdorov‘ja cholovika [Medical Aspects of Human Health], 2017, no. 1, pp. 53–60. (in Russ.)
2. Loginov S.I., Kintyukhin A.S., Mal'kov M.N., Sagadeeva S.G. [Influence of Walking at Different Rates on Indicators of Cardiorespiratory System of Students in Yugra Conditions]. Teoriya i praktika fizicheskoy kul'tury [Theory and Practice of Physical Culture], 2016, no. 9, pp. 86–89. (in Russ.)
3. Seluyanov V.N., Kalinin E.M., Pak G.D. [Determination of Anaerobic Threshold for Ventilation Rate and Variability of Cardio Intervals]. Fiziologiya cheloveka [Physiology of Human], 2011, vol. 37, no. 6, pp. 106–110. (in Russ.)
4. Rebrova O.Yu. Statisticheskiy analiz meditsinskikh dannykh. Primenenie paketa prikladnykh programm STATISTICA [Statistical Analysis of Medical Data. Application of the STATISTICA Software Package]. Moscow, MediaSphere Publ., 2000. 312 p.
5. Astrand P.O., Saltin B. Maximal Oxygen Uptake and Heart Rate in Various Types of Muscular Activity. J. Appl. Physiol., 1961, vol. 16, pp. 977–981.
6. Astrand P.O. Measurement of Maximal Aerobic Capacity. Can. Med. Assoc. J., 1967, vol. 25, no. 96(12), pp. 732–735.
7. Blair S.N. Physical Inactivity. The Biggest Public Health Problem of the 21st Century. Br. J. Sports Med., 2009, vol. 43, no. 1, pp. 1–2.
8. Sawada S.S., Lee I.M., Naito H. Cardiorespiratory Fitness, Body Mass Index, and Cancer Mortality. A Cohort Study of Japanese Men. BMC Public Health, 2014, vol. 14, pp. 1012. DOI: 10.1186/1471-2458-14-1012
9. Gastinger S., Sorel A., Nicolas G. Comparison Between Ventilation and Heart Rate as Indicator of Oxygen Uptake during Different Intensities of Exercise. J. Sports Sci. Med., 2010, vol. 9, no. 1, pp. 110–118. (in Russ.)
10. Darter B.J., Rodriguez K.M., Wilken J.M. Test-Retest Reliability and Minimum Detectable Change Using the K4b2: Oxygen Consumption, Gait Efficiency, and Heart Rate for Healthy Adults During Submaximal Walking. Res. Q. Exerc. Sport, 2013, vol. 84, no. 2, pp. 223–231. DOI: 10.1080/02701367. 2013.784720
11. Bouchard C., Daw E.W., Riceet T. Familial Resemblance for VO2max in the Sedentary State: the HERITAGE Family Study. Med. Sci. Sports. Exerc., 1998, vol. 30, no. 2, pp. 252–258. DOI: 10.1097/00005768-199802000-00013
12. Ross R., Blair S.N., Arena R. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation. 2016, vol. 134, no. 24, pp. 653–699. DOI: 10.1161/CIR.0000000000000461
13. Jacobs R.A., Lundby C. Mitochondria Express Enhanced Quality as well as Quantity in Association with Aerobic Fitness Across Recreationally Active Individuals Up to Elite Athletes. J. Appl. Physiol., 2013, vol. 114, no. 3, pp. 344–350. DOI: 10.1152/japplphysiol.01081.2012
14. Freire R., Farinatti P., Cunha F. Locomotion Mode Affects the Physiological Strain during Exercise at Walk-Run Transition Speed in Elderly Men. Int. J. Sports Med., 2017, vol. 38, no. 7, pp. 515–520. DOI: 10.1055/s-0043-101913
15. Jackson A.S., Sui X., O’Connor D.P. Longitudinal Cardiorespiratory Fitness Algorithms for Clinical Settings. Am. J. Prev. Med., 2012, vol. 43, no. 5, pp. 512–519. DOI: 10.1016/j.amepre
16. Martinez-Gomez DG-CP., Hallal P.C., Lopez-Garcia E. Nonexercise Cardiorespiratory Fitness and Mortality in Older Adults. Med. Sci. Sports Exerc., 2014, vol. 47, no. 3, pp. 568–574. DOI: 10.1249/MSS.0000000000000435
17. Myers J., McAuley P., Lavie C.J. Physical Activity and Cardiorespiratory Fitness as Major Markers of Cardiovascular Risk: Their Independent and Interwoven Importance to Health Status. Prog. Cardiovasc. Dis., 2015, vol. 57, no. 4, pp. 306–314. DOI: 10.1016/j.pcad.2014.09.011
18. Coquart J.B., Garcin M., Parfitt G. Prediction of Maximal or Peak Oxygen Uptake from Ratings of Perceived Exertion. Sports Med., 2014, vol. 44, no. 5, pp. 563–578. DOI: 10.1007/s40279-013-0139-5
19. Coquart J.B., Tabben M., Farooq A. Submaximal, Perceptually Regulated Exercise Testing Predicts Maximal Oxygen Uptake: A Meta-Analysis Study. Sports Med., 2016, vol. 46, no. 6, pp. 885–897. DOI: 10.1007/s40279-015-0465-x
20. Sui X., La Monte M.J., Blair S.N. Cardiorespiratory Fitness as a Predictor of Nonfatal Cardiovascular Events in Asymptomatic Women and Men. Am. J. Epidemiol., 2007, vol. 165, no. 12, pp. 1413–1423. DOI: 10.1093/aje/kwm031
2. Loginov S.I., Kintyukhin A.S., Mal'kov M.N., Sagadeeva S.G. [Influence of Walking at Different Rates on Indicators of Cardiorespiratory System of Students in Yugra Conditions]. Teoriya i praktika fizicheskoy kul'tury [Theory and Practice of Physical Culture], 2016, no. 9, pp. 86–89. (in Russ.)
3. Seluyanov V.N., Kalinin E.M., Pak G.D. [Determination of Anaerobic Threshold for Ventilation Rate and Variability of Cardio Intervals]. Fiziologiya cheloveka [Physiology of Human], 2011, vol. 37, no. 6, pp. 106–110. (in Russ.)
4. Rebrova O.Yu. Statisticheskiy analiz meditsinskikh dannykh. Primenenie paketa prikladnykh programm STATISTICA [Statistical Analysis of Medical Data. Application of the STATISTICA Software Package]. Moscow, MediaSphere Publ., 2000. 312 p.
5. Astrand P.O., Saltin B. Maximal Oxygen Uptake and Heart Rate in Various Types of Muscular Activity. J. Appl. Physiol., 1961, vol. 16, pp. 977–981.
6. Astrand P.O. Measurement of Maximal Aerobic Capacity. Can. Med. Assoc. J., 1967, vol. 25, no. 96(12), pp. 732–735.
7. Blair S.N. Physical Inactivity. The Biggest Public Health Problem of the 21st Century. Br. J. Sports Med., 2009, vol. 43, no. 1, pp. 1–2.
8. Sawada S.S., Lee I.M., Naito H. Cardiorespiratory Fitness, Body Mass Index, and Cancer Mortality. A Cohort Study of Japanese Men. BMC Public Health, 2014, vol. 14, pp. 1012. DOI: 10.1186/1471-2458-14-1012
9. Gastinger S., Sorel A., Nicolas G. Comparison Between Ventilation and Heart Rate as Indicator of Oxygen Uptake during Different Intensities of Exercise. J. Sports Sci. Med., 2010, vol. 9, no. 1, pp. 110–118. (in Russ.)
10. Darter B.J., Rodriguez K.M., Wilken J.M. Test-Retest Reliability and Minimum Detectable Change Using the K4b2: Oxygen Consumption, Gait Efficiency, and Heart Rate for Healthy Adults During Submaximal Walking. Res. Q. Exerc. Sport, 2013, vol. 84, no. 2, pp. 223–231. DOI: 10.1080/02701367. 2013.784720
11. Bouchard C., Daw E.W., Riceet T. Familial Resemblance for VO2max in the Sedentary State: the HERITAGE Family Study. Med. Sci. Sports. Exerc., 1998, vol. 30, no. 2, pp. 252–258. DOI: 10.1097/00005768-199802000-00013
12. Ross R., Blair S.N., Arena R. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation. 2016, vol. 134, no. 24, pp. 653–699. DOI: 10.1161/CIR.0000000000000461
13. Jacobs R.A., Lundby C. Mitochondria Express Enhanced Quality as well as Quantity in Association with Aerobic Fitness Across Recreationally Active Individuals Up to Elite Athletes. J. Appl. Physiol., 2013, vol. 114, no. 3, pp. 344–350. DOI: 10.1152/japplphysiol.01081.2012
14. Freire R., Farinatti P., Cunha F. Locomotion Mode Affects the Physiological Strain during Exercise at Walk-Run Transition Speed in Elderly Men. Int. J. Sports Med., 2017, vol. 38, no. 7, pp. 515–520. DOI: 10.1055/s-0043-101913
15. Jackson A.S., Sui X., O’Connor D.P. Longitudinal Cardiorespiratory Fitness Algorithms for Clinical Settings. Am. J. Prev. Med., 2012, vol. 43, no. 5, pp. 512–519. DOI: 10.1016/j.amepre
16. Martinez-Gomez DG-CP., Hallal P.C., Lopez-Garcia E. Nonexercise Cardiorespiratory Fitness and Mortality in Older Adults. Med. Sci. Sports Exerc., 2014, vol. 47, no. 3, pp. 568–574. DOI: 10.1249/MSS.0000000000000435
17. Myers J., McAuley P., Lavie C.J. Physical Activity and Cardiorespiratory Fitness as Major Markers of Cardiovascular Risk: Their Independent and Interwoven Importance to Health Status. Prog. Cardiovasc. Dis., 2015, vol. 57, no. 4, pp. 306–314. DOI: 10.1016/j.pcad.2014.09.011
18. Coquart J.B., Garcin M., Parfitt G. Prediction of Maximal or Peak Oxygen Uptake from Ratings of Perceived Exertion. Sports Med., 2014, vol. 44, no. 5, pp. 563–578. DOI: 10.1007/s40279-013-0139-5
19. Coquart J.B., Tabben M., Farooq A. Submaximal, Perceptually Regulated Exercise Testing Predicts Maximal Oxygen Uptake: A Meta-Analysis Study. Sports Med., 2016, vol. 46, no. 6, pp. 885–897. DOI: 10.1007/s40279-015-0465-x
20. Sui X., La Monte M.J., Blair S.N. Cardiorespiratory Fitness as a Predictor of Nonfatal Cardiovascular Events in Asymptomatic Women and Men. Am. J. Epidemiol., 2007, vol. 165, no. 12, pp. 1413–1423. DOI: 10.1093/aje/kwm031
2. Loginov S.I., Kintyukhin A.S., Mal'kov M.N., Sagadeeva S.G. [Influence of Walking at Different Rates on Indicators of Cardiorespiratory System of Students in Yugra Conditions]. Teoriya i praktika fizicheskoy kul'tury [Theory and Practice of Physical Culture], 2016, no. 9, pp. 86–89. (in Russ.)
3. Seluyanov V.N., Kalinin E.M., Pak G.D. [Determination of Anaerobic Threshold for Ventilation Rate and Variability of Cardio Intervals]. Fiziologiya cheloveka [Physiology of Human], 2011, vol. 37, no. 6, pp. 106–110. (in Russ.)
4. Rebrova O.Yu. Statisticheskiy analiz meditsinskikh dannykh. Primenenie paketa prikladnykh programm STATISTICA [Statistical Analysis of Medical Data. Application of the STATISTICA Software Package]. Moscow, MediaSphere Publ., 2000. 312 p.
5. Astrand P.O., Saltin B. Maximal Oxygen Uptake and Heart Rate in Various Types of Muscular Activity. J. Appl. Physiol., 1961, vol. 16, pp. 977–981.
6. Astrand P.O. Measurement of Maximal Aerobic Capacity. Can. Med. Assoc. J., 1967, vol. 25, no. 96(12), pp. 732–735.
7. Blair S.N. Physical Inactivity. The Biggest Public Health Problem of the 21st Century. Br. J. Sports Med., 2009, vol. 43, no. 1, pp. 1–2.
8. Sawada S.S., Lee I.M., Naito H. Cardiorespiratory Fitness, Body Mass Index, and Cancer Mortality. A Cohort Study of Japanese Men. BMC Public Health, 2014, vol. 14, pp. 1012. DOI: 10.1186/1471-2458-14-1012
9. Gastinger S., Sorel A., Nicolas G. Comparison Between Ventilation and Heart Rate as Indicator of Oxygen Uptake during Different Intensities of Exercise. J. Sports Sci. Med., 2010, vol. 9, no. 1, pp. 110–118. (in Russ.)
10. Darter B.J., Rodriguez K.M., Wilken J.M. Test-Retest Reliability and Minimum Detectable Change Using the K4b2: Oxygen Consumption, Gait Efficiency, and Heart Rate for Healthy Adults During Submaximal Walking. Res. Q. Exerc. Sport, 2013, vol. 84, no. 2, pp. 223–231. DOI: 10.1080/02701367. 2013.784720
11. Bouchard C., Daw E.W., Riceet T. Familial Resemblance for VO2max in the Sedentary State: the HERITAGE Family Study. Med. Sci. Sports. Exerc., 1998, vol. 30, no. 2, pp. 252–258. DOI: 10.1097/00005768-199802000-00013
12. Ross R., Blair S.N., Arena R. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation. 2016, vol. 134, no. 24, pp. 653–699. DOI: 10.1161/CIR.0000000000000461
13. Jacobs R.A., Lundby C. Mitochondria Express Enhanced Quality as well as Quantity in Association with Aerobic Fitness Across Recreationally Active Individuals Up to Elite Athletes. J. Appl. Physiol., 2013, vol. 114, no. 3, pp. 344–350. DOI: 10.1152/japplphysiol.01081.2012
14. Freire R., Farinatti P., Cunha F. Locomotion Mode Affects the Physiological Strain during Exercise at Walk-Run Transition Speed in Elderly Men. Int. J. Sports Med., 2017, vol. 38, no. 7, pp. 515–520. DOI: 10.1055/s-0043-101913
15. Jackson A.S., Sui X., O’Connor D.P. Longitudinal Cardiorespiratory Fitness Algorithms for Clinical Settings. Am. J. Prev. Med., 2012, vol. 43, no. 5, pp. 512–519. DOI: 10.1016/j.amepre
16. Martinez-Gomez DG-CP., Hallal P.C., Lopez-Garcia E. Nonexercise Cardiorespiratory Fitness and Mortality in Older Adults. Med. Sci. Sports Exerc., 2014, vol. 47, no. 3, pp. 568–574. DOI: 10.1249/MSS.0000000000000435
17. Myers J., McAuley P., Lavie C.J. Physical Activity and Cardiorespiratory Fitness as Major Markers of Cardiovascular Risk: Their Independent and Interwoven Importance to Health Status. Prog. Cardiovasc. Dis., 2015, vol. 57, no. 4, pp. 306–314. DOI: 10.1016/j.pcad.2014.09.011
18. Coquart J.B., Garcin M., Parfitt G. Prediction of Maximal or Peak Oxygen Uptake from Ratings of Perceived Exertion. Sports Med., 2014, vol. 44, no. 5, pp. 563–578. DOI: 10.1007/s40279-013-0139-5
19. Coquart J.B., Tabben M., Farooq A. Submaximal, Perceptually Regulated Exercise Testing Predicts Maximal Oxygen Uptake: A Meta-Analysis Study. Sports Med., 2016, vol. 46, no. 6, pp. 885–897. DOI: 10.1007/s40279-015-0465-x
20. Sui X., La Monte M.J., Blair S.N. Cardiorespiratory Fitness as a Predictor of Nonfatal Cardiovascular Events in Asymptomatic Women and Men. Am. J. Epidemiol., 2007, vol. 165, no. 12, pp. 1413–1423. DOI: 10.1093/aje/kwm031
References on translit
1. Vatutin N.T., Smirnova A.S. [Role of Cardiorespiratory Endurance in Clinical Practice]. Medychny aspektы zdorov‘ja cholovika [Medical Aspects of Human Health], 2017, no. 1, pp. 53–60. (in Russ.)2. Loginov S.I., Kintyukhin A.S., Mal'kov M.N., Sagadeeva S.G. [Influence of Walking at Different Rates on Indicators of Cardiorespiratory System of Students in Yugra Conditions]. Teoriya i praktika fizicheskoy kul'tury [Theory and Practice of Physical Culture], 2016, no. 9, pp. 86–89. (in Russ.)
3. Seluyanov V.N., Kalinin E.M., Pak G.D. [Determination of Anaerobic Threshold for Ventilation Rate and Variability of Cardio Intervals]. Fiziologiya cheloveka [Physiology of Human], 2011, vol. 37, no. 6, pp. 106–110. (in Russ.)
4. Rebrova O.Yu. Statisticheskiy analiz meditsinskikh dannykh. Primenenie paketa prikladnykh programm STATISTICA [Statistical Analysis of Medical Data. Application of the STATISTICA Software Package]. Moscow, MediaSphere Publ., 2000. 312 p.
5. Astrand P.O., Saltin B. Maximal Oxygen Uptake and Heart Rate in Various Types of Muscular Activity. J. Appl. Physiol., 1961, vol. 16, pp. 977–981.
6. Astrand P.O. Measurement of Maximal Aerobic Capacity. Can. Med. Assoc. J., 1967, vol. 25, no. 96(12), pp. 732–735.
7. Blair S.N. Physical Inactivity. The Biggest Public Health Problem of the 21st Century. Br. J. Sports Med., 2009, vol. 43, no. 1, pp. 1–2.
8. Sawada S.S., Lee I.M., Naito H. Cardiorespiratory Fitness, Body Mass Index, and Cancer Mortality. A Cohort Study of Japanese Men. BMC Public Health, 2014, vol. 14, pp. 1012. DOI: 10.1186/1471-2458-14-1012
9. Gastinger S., Sorel A., Nicolas G. Comparison Between Ventilation and Heart Rate as Indicator of Oxygen Uptake during Different Intensities of Exercise. J. Sports Sci. Med., 2010, vol. 9, no. 1, pp. 110–118. (in Russ.)
10. Darter B.J., Rodriguez K.M., Wilken J.M. Test-Retest Reliability and Minimum Detectable Change Using the K4b2: Oxygen Consumption, Gait Efficiency, and Heart Rate for Healthy Adults During Submaximal Walking. Res. Q. Exerc. Sport, 2013, vol. 84, no. 2, pp. 223–231. DOI: 10.1080/02701367. 2013.784720
11. Bouchard C., Daw E.W., Riceet T. Familial Resemblance for VO2max in the Sedentary State: the HERITAGE Family Study. Med. Sci. Sports. Exerc., 1998, vol. 30, no. 2, pp. 252–258. DOI: 10.1097/00005768-199802000-00013
12. Ross R., Blair S.N., Arena R. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation. 2016, vol. 134, no. 24, pp. 653–699. DOI: 10.1161/CIR.0000000000000461
13. Jacobs R.A., Lundby C. Mitochondria Express Enhanced Quality as well as Quantity in Association with Aerobic Fitness Across Recreationally Active Individuals Up to Elite Athletes. J. Appl. Physiol., 2013, vol. 114, no. 3, pp. 344–350. DOI: 10.1152/japplphysiol.01081.2012
14. Freire R., Farinatti P., Cunha F. Locomotion Mode Affects the Physiological Strain during Exercise at Walk-Run Transition Speed in Elderly Men. Int. J. Sports Med., 2017, vol. 38, no. 7, pp. 515–520. DOI: 10.1055/s-0043-101913
15. Jackson A.S., Sui X., O’Connor D.P. Longitudinal Cardiorespiratory Fitness Algorithms for Clinical Settings. Am. J. Prev. Med., 2012, vol. 43, no. 5, pp. 512–519. DOI: 10.1016/j.amepre
16. Martinez-Gomez DG-CP., Hallal P.C., Lopez-Garcia E. Nonexercise Cardiorespiratory Fitness and Mortality in Older Adults. Med. Sci. Sports Exerc., 2014, vol. 47, no. 3, pp. 568–574. DOI: 10.1249/MSS.0000000000000435
17. Myers J., McAuley P., Lavie C.J. Physical Activity and Cardiorespiratory Fitness as Major Markers of Cardiovascular Risk: Their Independent and Interwoven Importance to Health Status. Prog. Cardiovasc. Dis., 2015, vol. 57, no. 4, pp. 306–314. DOI: 10.1016/j.pcad.2014.09.011
18. Coquart J.B., Garcin M., Parfitt G. Prediction of Maximal or Peak Oxygen Uptake from Ratings of Perceived Exertion. Sports Med., 2014, vol. 44, no. 5, pp. 563–578. DOI: 10.1007/s40279-013-0139-5
19. Coquart J.B., Tabben M., Farooq A. Submaximal, Perceptually Regulated Exercise Testing Predicts Maximal Oxygen Uptake: A Meta-Analysis Study. Sports Med., 2016, vol. 46, no. 6, pp. 885–897. DOI: 10.1007/s40279-015-0465-x
20. Sui X., La Monte M.J., Blair S.N. Cardiorespiratory Fitness as a Predictor of Nonfatal Cardiovascular Events in Asymptomatic Women and Men. Am. J. Epidemiol., 2007, vol. 165, no. 12, pp. 1413–1423. DOI: 10.1093/aje/kwm031
Published
2017-12-01
How to Cite
Loginov, S., Kintyukhin, A., & Logvinova, S. (2017). AGE AND GENDER PATTERNS OF HUMAN CARDIORESPIRATORY FITNESS IN THE CONDITIONS OF THE URBANIZED SIBERIAN NORTH. Human. Sport. Medicine, 17(S), 12-24. https://doi.org/10.14529/hsm17s02
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Physiology
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