Exercise physiology is the study of effect of exercise on the body systems. Exercise is beneficial for the health. However as a result, oxygen and nutrient demand increases several folds, a lot of energy is required, which comes from the stored energy resources of the body. In order to provide sufficient oxygen for respiration to occur, the workload on the lungs and the heart increases several folds. The blood supply to other organs is also compromised; for example during exercise, the blood flow to the digestive tract is reduced. This is to allow sufficient blood flow to the skeletal muscles.
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running woman

Image: “Running woman.” by Peter van der Sluijs – Own work. License: CC BY-SA 3.0


The cardiovascular system responds to exercise in different ways depending on the type of exercise.

Isometric and Isotonic Resistance Exercise

Isotonic resistance exercise, also known as dynamic constant external resistance (DCER) is the one in which the length of the muscle changes while the tone and resistance remains the same. It builds both muscle strength as well as endurance. Examples include squatting, weight lifting, running etc.

Isometric resistance exercise is when the length of the muscle remains constant. The resistance is due to the force of gravity. It is often referred to as ‘static strength training’ as the person only holds a certain position rather than moving. Such types of exercises are often done in physiotherapy. Examples include yoga, gymnastics, etc.

Blood Pressure Effects of the Valsalva Maneuver

Valsalva maneuver is an attempt of forceful exhalation against closed airways. The person is asked to inhale air and then close their mouth and pinch their nose while trying to exhale out.

The blood pressure changes occurring as a result of this maneuver are:

Systolic blood pressure and pulse rate changes during Valsalva maneuver

Image: “Systolic blood pressure and pulse rate changes during Valsalva maneuver.” by T.torda at English Wikipedia – Own work. License: Public Domain

  • On application of full expiratory force, the blood from the pulmonary circulation shifts into the left atrium. This increases the stroke volume and an initial rise in systolic blood pressure, at 5 seconds, labelled as 1 in the graph.
  • Due to increased intrathoracic pressure, the venous return decreases. This results in decrease in the stroke volume. The blood pressure initially drops at 5-15 seconds (labelled as 2) but soon vasoconstriction occurs, which causes a slight rise in the blood pressure. The decrease in the stroke volume causes reflex tachycardia shown in the graph.
  • As the pressure of the chest cavity decreases after exhalation, the pulmonary vessels fill with blood again. This causes decreased return of blood to the left atrium causing decrease in blood pressure at 20-23 seconds (labelled as 3). The decrease in the stroke volume is soon compensated by an increase in the venous return. The blood pressure begins to rise again from 23-27 seconds.
  • The stroke volume initially rises above normal (labelled 4) due to rush of blood into the ventricle and returns to normal value at 30 seconds. The pulse rate, which was increased due to decreased cardiac output also returns to the normal value.

Endurance Training

When a person engages in daily or regular exercise, certain responses are produced in their body to increase its efficiency and capacity.

The cardiac output increases as the rate of oxygen demand increases. However, this linear relationship has a certain limit after which the cardiac output stays constant. The heart rate increases as the oxygen demand increases in order to maintain a constant cardiac output.

When a person is at rest, only 20% of the cardiac output goes to the skin and the skeletal muscles. However, when they are exercising, more blood needs to flow toward the highly metabolic skeletal muscles. This is to allow provision of more oxygen and removal of waste products such as carbon dioxide. It is estimated that up to 80% of the cardiac output is supplied to the skeletal muscles and the skin in exercise.

If the external temperature is higher, then more blood flows to the skin in order to keep the internal body temperature constant.

The long-term cardiovascular changes occuring as a result of endurance training include little change in the cardiac output at rest and sub-maximal exercises.

At maximal level of exercise, the cardiac output increases by up to 30%. After training, the stroke volume is increased at rest, during sub-maximal and at maximal training. The heart rate on the other hand is decreased at rest and sub-maximal training. It may remain unchanged during maximal training.

The increase in stroke volume in endurance training is due to an increase in the blood volume. This increases the venous return and end-diastolic volume. In addition hypertrophy of the cardiac muscles also occurs, which increases the overall force of contraction.

Endurance training also increases the number of capillaries in the skeletal muscles. Therefore, more blood can flow. As the capacitance of the blood increases because of new capillaries formed, the total peripheral resistance decreases. The left ventricle can pump more blood into the aorta.

ABP Response to Endurance Training

The arterial blood pressure decreases as a result of endurance training in normotensive persons. After training, the blood pressure at rest, during sub-maximal exercise and maximal exercise is lower than before. This decrease is greater in hypertensive patients. For instance, if the decrease in normotensive person is 3 mmHg, the decrease in hypertensive patients is 10mmHg.

Skeletal Muscle Effects of Chronic Endurance Training

Long term exercise results in hypertrophy of a specific group of muscles. Sometimes the opposite group of muscles also undergoes increase in muscle mass, a phenomenon known as cross education.

aerobic and anaerobic exercise adaptations

Image: “Summary of adaptations to long-term aerobic and anaerobic exercise.” by Plin7 at English Wikipedia. License: CC BY-SA 3.0

The metabolic capacity of the muscles also changes with endurance exercise. The muscles specified for anaerobic exercise (white fibers) will start producing more glycolytic enzymes. Similarly, the muscles specified for aerobic exercise (red fibers) will develop more blood capillaries and mitochondria.

The oxygen extraction capacity from the blood increases, resulting in prompt supply of energy.

The type of muscle fibers remains unchanged and the presence of certain type of muscle fibers in certain athletes is because of genetic reasons.

Aerobic exercise training results in an increase in oxygen consumption and stroke volume while the resting heart rate decreases. Similarly, the anaerobic exercise training results in an increase in muscle strength, neural drive and physiologic cross-sectional area. After anaerobic training such as sprinting and weight lifting the heart rate stays elevated for several hours.

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