Cardiovascular responses to treadmill and cycle
ergometer exercise in children and adults
KENNETH R. TURLEY AND JACK H. WILMORE
Human Performance Laboratory, Department of Kinesiology
and Health Education, The University of Texas at Austin, Austin, Texas 78712
Turley, Kenneth R., and Jack H. Wilmore. Cardiovascu-
lar responses to treadmill and cycle ergometer exercise in
children and adults. J. Appl. Physiol. 83(3): 948–957, 1997.—
This study was conducted to determine whether submaximal
cardiovascular responses at a given rate of work are different
in children and adults, and, if different, what mechanisms are
involved and whether the differences are exercise-modality
dependent. A total of 24 children, 7 to 9 yr old, and 24 adults,
18 to 26 yr old (12 males and 12 females in each group),
participated in both submaximal and maximal exercise tests
on both the treadmill and cycle ergometer. With the use of
regression analysis, it was determined that cardiac output
(Q̇) was significantly lower (P # 0.05) at a given O2 consump-
tion level (V̇O2, l/min) in boys vs. men and in girls vs. women
on both the treadmill and cycle ergometer. The lower Q̇ in the
children was compensated for by a significantly higher (P #
0.05) arterial-mixed venous O2 difference to achieve the same
or similar V̇O2. Furthermore, heart rate and total peripheral
resistance were higher and stroke volume was lower in the
children vs. in the adult groups on both exercise modalities.
Stroke volume at a given rate of work was closely related to
left ventricular mass, with correlation coefficients ranging
from r 5 0.89–0.92 and r 5 0.88–0.93 in the males and
females, respectively. It was concluded that submaximal
cardiovascular responses are different in children and adults
and that these differences are related to smaller hearts and a
smaller absolute amount of muscle doing a given rate of work
in the children. The differences were not exercise-modality
dependent.
submaximal exercise; cardiac output; blood pressure; left
ventricular mass
IT HAS BEEN REPORTED that both boys (2, 16, 30, 32, 42,
52) and girls (30, 32, 42, 52) have a lower cardiac output
(Q̇) than adults at a given absolute submaximal rate of
work or O2 uptake (V̇O2). This lower Q̇ at a given
submaximal rate of work is attributed to a lower stroke
volume (SV), which is only partially compensated for by
a higher heart rate (HR). A higher arterial-mixed
venous O2 difference (a-v)O2 in children then compen-
sates for their lower Q̇ to achieve the same or similar
V̇O2 (2, 15, 32, 42). Although the majority of studies
have reported a lower Q̇ in children vs. adults at a given
submaximal rate of work, others have reported similar
Q̇ values for adults and children (17–19).
A close examination reveals a number of weaknesses
in these studies that have reported comparisons of
cardiovascular responses to submaximal exercise in
children vs. adults. First, many of the studies did not
collect data on adults but instead have compared data
on children with adult values reported elsewhere (2,
16–18, 30). In addition, of all the studies that have
compared submaximal cardiovascular responses with
948 0161-7567/97 $5.00 Copyright r 1997 the American Physiological Society
exercise in children and adults, only one used children
with a mean age younger than 10 yr, and that study
used only three boys with a mean age of 9.7 yr (19).
Furthermore, all of these studies have used the cycle
ergometer as the exercise modality. Whether cardiovas-
cular response differences between children and adults
are attenuated, exacerbated, or the same on the tread-
mill is unknown. Finally, none of these studies has
attempted to determine the mechanism behind the
differences that are generally reported between chil-
dren and adults. Only one study measured submaximal
blood pressure (BP) (16), and none attempted to esti-
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mate heart size to see whether differences may be
related to either peripheral resistance or differing heart
sizes of the subjects.
The present study investigated cardiovascular re-
sponses to submaximal exercise using both the cycle
ergometer and treadmill with 7- to 9-yr-old children
and young adults to determine the differences, if any, in
responses between boys vs. men and girls vs. women
and to determine whether these relationships are af-
fected by the exercise modality. Left ventricular mass
(LVM) and submaximal BP were measured to define
the mechanism for any differences that may exist.
METHODS
Subjects. Twenty-four healthy 7- to 9-yr-old children (12
boys and 12 girls) and 24 healthy 19- to 26-yr-old adults (12
men and 12 women) agreed to participate in this study. The
children were recruited from a local private school. To be
included, the children filled out an activity questionnaire to
ensure that they were active but not participating in formal
training or organized sports. In addition, although pubertal
status was not assessed, parents of the children were asked
whether their child exhibited any overt signs of pubertal
onset (e.g., pubertal hair, breast development). If so, these
children were excluded from participation (2 girls were
excluded based on this criterion). Adult subjects volunteered
in response to flyers that were posted on the college campus.
Written informed consent was obtained from each of the
children and their parents and from each of the adult
subjects. After the children had completed all but their final
testing day, they were asked to sign a separate consent form
specifically for a blood draw. A separate consent form for the
blood draw in children was used so that they were not
discouraged from participating in the study solely based on
their fear of having their blood drawn. The study design and
consent forms had been previously approved by The Univer-
sity of Texas at Austin Institutional Review Board. All
subjects, both adults and children, were active but not
participating in formal training or organized sports.
Study design. All testing was conducted in the Human
Performance Laboratory at The University of Texas at Aus-
tin. Each subject visited the laboratory six times. During the
first visit maximal O2 consumption (V̇O2 max) was determined
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 CHILD AND ADULT CARDIOVASCULAR RESPONSES TO EXERCISE
(random draw of either treadmill or cycle ergometry),
anthropometric measurements were obtained, and a 10-min
accommodation period on the treadmill [5 min at both 3.0 and
5.0 miles/h (mph)] was provided. On the second visit for
children, a submaximal steady-state 4.0-mph walk on the
treadmill and a second maximal test on the ergometer
(whichever was not used in the first test) were conducted,
with the tests being separated by 20–30 min. On the second
visit for adults, only the second maximal test was conducted.
On each of the next four visits, one of four randomized
submaximal steady-state exercise tests was conducted (2
cycle and 2 treadmill tests). Both children and adults exer-
cised at three different submaximal rates of work on each
ergometer so that accurate regression lines could be devel-
oped through as wide a range of V̇O2 values as possible.
On the last visit, M-mode echocardiography was used to
determine the subject’s left ventricular dimensions at rest,
just before exercise, and a blood sample was drawn immedi-
ately after exercise (optional for the children) to determine
hemoglobin concentration ([Hb]) for use in the calculation of
Q̇. Testing for each subject was conducted within a 2- to 4-wk
period, with a minimum of 24 h between tests.
Maximal-exercise tests. Before the commencement of the
maximal tests on the motor-driven treadmill (Quinton Q65),
both children and adults practiced walking and running for
3–5 min, after which the protocol began. For children, the
protocol began with walking at 3.0 mph at 0% grade for 1 min,
with a 2.5% increase in grade at the beginning of both minute
2 and minute 3. At the start of minute 4, the speed was
increased to 5.0 mph, with an additional increase to 5.5 mph
at the beginning of minute 5. Grade was then increased 2.5%
at the start of both minutes 6 and 7, after which the speed was
increased 0.5 mph each minute until exhaustion. For safety
purposes, a spotter was positioned behind the children during
maximal treadmill testing. The adult protocol began with
walking at 3.0 mph for 1 min, with a subsequent 0.5 mph
increase in speed at the beginning of every minute up to
6.5–7.5 mph, dependent on the fitness level of the subject.
Once maximal speed was reached, grade was subsequently
increased 2.5% at the start of every minute until exhaustion.
Maximal tests on the electronically braked cycle ergometer
(Ergoline 800S, SensorMedics) used different continuous
incremental protocols for children and adults. The children
performed unloaded cycling at 65–75 revolutions/min (rpm)
for the first minute, after which the work rate was increased
to 20 W for the second minute, and then increased by 15-W
increments at the start of every minute until exhaustion. The
adults pedaled at 65–75 rpm at 50 W for the first minute,
after which the work rate was increased by 25 W at the
beginning of every minute until exhaustion. The cycle ergom-
eter was calibrated daily.
During maximal tests, the subjects exercised to volitional
fatigue. Tests were considered maximal in children when at
least two of the following criteria were achieved: 1) failure
to maintain the work rate, 2) respiratory exchange ratio
(RER) $1.00, and 3) maximal HR $95% of age-predicted
maximum. Because it has recently been reported that a
plateau in V̇O2 is seldom achieved in children (45, 46) or
adolescents (41), attainment of a plateau was not used as a
criterion for V̇O2 max in children. For adults, a test was
considered a valid maximal test when at least two of the
following criteria were achieved: 1) failure to maintain the
work rate, 2) RER $1.10, 3) maximal HR $ age-predicted
maximum, and 4) an increase in work rate with no further
increase in V̇O2. If two or more of these criteria were not
achieved, a second maximal test was performed.
949
Submaximal exercise tests. Submaximal exercise tests on
the treadmill were at 3.0, 4.0, and 5.0 mph for children and at
3.0 and 5.0 mph and ,60% of V̇O2 max for the adults. A relative
work rate was used in adults so that a similar physiological
stress was experienced by both the children and adults, thus
also allowing comparison of cardiovascular responses at
similar relative rates of work and increasing the range of V̇O2
values from which regression lines were developed. From the
results of pilot work, we found that children were just able to
complete steady-state cardiovascular measurements on the
treadmill when they exercised at both 3.0 and 5.0 mph on the
same day. Hence, the children completed the 4.0-mph portion
of their submaximal treadmill test on their second visit, as
described above. Children completed the 4.0-mph work rate
only once. One boy did not do the 4.0-mph work rate.
On the cycle, children exercised at 20, 40, and 60 W,
whereas adults exercised at 40 and 60 W and at ,60% of
V̇O2 max, both groups cycling at 65 6 5 rpm. One girl
was not able to complete the 60-W work rate. As with the
treadmill, a relative work rate was used in adults to in-
crease the range of V̇O2 values from which regression lines
were developed.
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Before the commencement of both the treadmill and cycle
ergometer submaximal tests, the children and adults were
allowed a 3–5 min warm-up period. The treadmill was
calibrated at each speed during each submaximal test to
ensure that the appropriate speed was maintained, and the
cycle ergometer was calibrated daily. Although the electroni-
cally braked cycle ergometer used in this study maintained
the work rate independent of rpm, rpm during submaximal
testing was the same for both children and adults (65 6 5) to
eliminate the possible effects that different pedaling speeds
might have on their metabolic and cardiovascular responses
(49). During all submaximal tests, subjects were allowed to
drink water ad libitum, and a fan was used for cooling at an
airflow rate of ,2.0–3.0 m/s.
Submaximal cardiovascular and metabolic data were col-
lected during steady-state exercise. Steady state for all
subjects was defined as a HR response within 65 beats/min,
and three consecutive 20-s values for both V̇O2 and CO2
production (V̇CO2) within 610%. On average, both children
and adults exercised for ,3–6 min before steady state was
achieved, and each steady-state work rate lasted ,14–18
min. Once steady state had been achieved, Q̇, HR, V̇O2, and
BP measurements were obtained in duplicate. For children, a
3- to 5-min rest period was allowed between each work rate
and between duplicate measurements at the highest work
rate when necessary. For adults, a 3- to 5-min rest period was
given between the two highest work rates.
Before the start of the submaximal treadmill and cycle
tests, subjects were connected to a Colin model STBP-780
semiautomated BP-measurement device (Colin Medical In-
struments, San Antonio, TX). The BP cuff was selected so that
the cuff bladder width was ,40% of the subject’s upper arm
circumference measured at midbicep (20, 26).
Once steady state was achieved, a BP measurement was
taken, followed by measurements of HR, V̇CO2, and V̇O2. The
HR and V̇O2 (collected as the rolling average of 3 consecutive
20-s intervals) used as steady-state values were a 1-min
average taken just before the CO2-rebreathing maneuver.
Once these steady-state values had been attained, end-tidal
CO2 pressure (PETCO2) values were collected and a CO2-
rebreathing Q̇ measurement was performed.
Measurements. Height, weight, and skinfold thicknesses
were measured during the subject’s first visit to the labora-
tory. Relative body fat in children was estimated from triceps
and subscapular skinfold thicknesses by using the equations
950 CHILD AND ADULT CARDIOVASCULAR RESPONSES TO EXERCISE
of Slaughter et al. (see Ref. 25). For adult men, abdominal,
chest, and thigh skinfolds were used to estimate body density
via the Jackson and Pollock equation (23), and the Brozek et
al. equation (6) was used to estimate relative body fat from
body density. Body density of the women was estimated from
the Jackson, Pollock, and Ward equation (24) by using the
triceps, abdominal, suprailium, and thigh skinfolds. The
Lohman equation (37) was then used to determine relative fat
in women. Fat mass (FM) was determined by relative body fat
(%) times body weight (kg) divided by 100. Fat-free mass
(FFM) was determined by body weight (kg) minus FM.
Relative body fat was estimated on two separate occasions in
six subjects of each group (boys, girls, men, and women) to
determine reliability of the measurement. Body surface area
(BSA, m2 ) was calculated by using the Haycock et al. formula
(21). Body mass index (BMI) was calculated by dividing body
weight (kg) by stature squared (m2 ).
Expired gases during both the maximal and submaximal
tests were collected and analyzed by using a SensorMedics
2900 metabolic cart (Yorba Linda, CA), which utilizes a
zirconium oxide cell for fractional percentage of expired O2
determination, an infrared absorption analyzer for fractional
percent of expired CO2 (FECO2) determination, and a mass
flowmeter for measuring minute ventilation. Both before and
after each test, the gas analyzers were calibrated with gases
of known concentration and the flowmeter was calibrated
with a known volume of air. V̇O2 max and maximal RER were
the average of the two highest consecutive 20-s values.
HR was monitored and recorded with a Polar HR monitor
at 5-s intervals throughout the treadmill and cycle maximal
tests and at 15-s intervals during the submaximal tests.
Q̇ was measured indirectly by using the CO2-rebreathing
equilibration method (7). The CO2-rebreathing apparatus
was modified for the children. A 2600 series Hans Rudolph
two-way valve (48-ml dead space) was connected to an 8200
series Hans Rudolph rebreathing switching system for the
children, whereas a 2700 series Hans Rudolph two-way valve
(108-ml dead space) was attached to the rebreathing switch
for the adults. In addition, a 3-liter bag was used for
CO2-rebreathing in children and small adults, and a 5-liter
bag was used in larger adults. Gas concentrations used
during rebreathing for children ranged from 8.0 to 10.0%
whereas values for adults ranged from 9.0 to 13.5%.
Of the variables used to calculate Q̇, V̇CO2 was obtained by
averaging three consecutive 20-s V̇CO2 values during steady-
state exercise. The partial pressure of CO2 in arterial blood
(PaCO2) was estimated from a 20-s average of PETCO2. The
partial pressure of CO2 in mixed venous blood (PvCO2) was
estimated from the equilibration method as described by
Jones (28, 29). The downstream correction was applied to the
partial pressure of equilibrium CO2 to adjust PvCO2 for the
alveolar-to-blood PCO2 difference (27, 40).
PvCO2 and PaCO2 were converted to content of CO2 in the
venous (CvCO2) and arterial blood (CaCO2), respectively,
through an equation derived from the CO2 dissociation curve
as described by Jones and Campbell (27) and as adapted from
McHardy (39). This content was then corrected for the effect
of [Hb] on CO2-carrying capacity of the blood (27, 39). The
[Hb] used for the children who did not consent to having their
blood drawn was the average value obtained in this study for
their gender.
SV (ml) was calculated as Q̇ (ml)/HR (beats/min). MBP
(mmHg) was determined as [systolic BP 1 (2 · diastolic BP)]/3.
Total peripheral resistance (TPR, units) was calculated
as MBP/Q̇. V̇O2 was divided by Q̇ to calculate (a-v)O2
(ml/100 ml).
Left ventricular dimensions were measured from standard
M-mode echocardiography obtained with a Johnson & Johnson
Ultrasound Imaging System with the use of a 3.0-mHz trans-
ducer. The subjects were measured in the left lateral decubi-
tus position. M-mode tracings were obtained at the level just
above the papillary muscle and recorded onto a standard
videocassette recorder tape for off-line measurements.
Left ventricle dimensions were measured off-line with a
digital imaging-acquisition system (Freeland Prism) accord-
ing to the American Society of Echocardiography (47) and
using leading edge-to-leading edge methodology. The intraven-
tricular septal wall thickness, left ventricular internal diam-
eter (LVIDd and LVIDs ), and left ventricular posterior wall
thickness were measured in both diastole (d) and systole (s),
respectively. Each dimension was measured from three differ-
ent cardiac cycles, and the average value was used. All
M-mode tracings and dimensions were measured by the
same technologist. M-mode tracings of 17 subjects were read
twice, once on each of two separate days to assess intraob-
server reliability (R 5 0.97). Interobserver reliability (R 5
0.98) was assessed on six subjects by comparing the measure-
ments of the primary technologist with those of a registered
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cardiac sonographer.
Shortening fraction (SF, %) was calculated as [(LVIDd 2
LVIDs )/LVIDd] 3100. LVM was calculated using the formula
proposed by the American Society of Echocardiography (47),
as described by Devereux et al. (13), which has been validated
in adult necrospy studies (12, 13), a child autopsy study (11),
and in a study of animals with heart sizes that were similar to
those of the children involved in this study (9).
Immediately after the last submaximal exercise test in
adults and children, blood was collected for [Hb] assessment.
A venipuncture in the antecubital vein was performed while
subjects were in the sitting position. [Hb] was measured in
quadruplicate by the cyanmethemoglobin method. An aver-
age of the four measurements was used as the [Hb]. To most
accurately adjust Q̇ for the change in [Hb] during exercise,
blood was drawn immediately after exercise.
Analysis. The differences in submaximal cardiovascular
responses to exercise between the boys and girls have been
reported elsewhere (51). Because the primary focus of this
paper is child vs. adult differences in submaximal cardiovas-
cular responses to exercise, the differences between the men
and women are presented but not discussed, and only the
differences between the boys vs. men and girls vs. women are
presented in detail. Differences in descriptive variables be-
tween groups were analyzed with an analysis of variance
(ANOVA). Test-retest reliability of submaximal metabolic
and cardiovascular variables for each modality was deter-
mined by intraclass correlation R calculated from a one-way
ANOVA model and is reported as the reliability of the mean of
the test scores (MS) for each subject [(MSb 2 MSw )/MSb],
while reliability for relative fat and LVM is reported as the
reliability of scores collected on 1 day (MSb 2MSw )/(MSb 1
MSw ) (3), where MSb is mean square between and MSw is
mean square within.
For the adult vs. child comparisons of the cardiovascular
variables measured during submaximal exercise, the mean of
the values collected on the first day and second day for both
the treadmill and cycle ergometer was used. Differences
between adults and children in metabolic and cardiovascular
variables at a given rate of work were determined with a
one-way ANOVA. Child vs. adult cardiovascular response
differences at a given V̇O2 were determined by regression
analysis. Analysis of covariance of heterogeneous regression
lines (SPSS) was used to determine whether significant
differences existed between the slopes and intercepts of the
 CHILD AND ADULT CARDIOVASCULAR RESPONSES TO EXERCISE 951

cardiovascular variables on V̇O2 (l/min) for children vs. adults. Table 2. Treadmill and cycle ergometer maximal data
All significant differences are at the P # 0.05 level unless
stated otherwise. Variable Boys Girls Men Women

RESULTS Treadmill
V̇O2 max , l/mina,f 1.60 6 0.21 1.51 6 0.23 4.23 6 0.52 2.95 6 0.44
The physical characteristics of the subjects are pre- V̇O2 max ,
21
ml · kg · min21
sented in Table 1. All values for the subjects’ physical a,d,e 54.4 6 5.5 53.1 6 4.4 53.2 6 5.3 46.9 6 4.3
characteristics were significantly lower in the children HR, beats/mind,e 200 6 11 202 6 9 198 6 10 192 6 6
(boys and girls) than in both the men and women except RERf 1.08 6 0.06 1.10 6 0.05 1.20 6 0.06 1.20 6 0.06
for relative fat and SF. Relative fat was significantly Cycle ergometer
higher in the women than in both the children (boys V̇O2 max , l/mina,f 1.49 6 0.20 1.33 6 0.26 3.93 6 0.64 2.66 6 0.52
V̇O2 max ,
and girls) and men. Furthermore, relative fat was 21
ml · kg · min21
significantly higher in the girls than men, but it was a,d,e 50.7 6 4.6 47.0 6 5.5 48.9 6 6.7 41.9 6 5.4
not significantly different between the boys and men. HR, beats/mind,e 195 6 10 199 6 8 192 6 10 185 6 8
The reliability coefficients for relative fat estimates in RER f 1.09 6 0.05 1.12 6 0.07 1.21 6 0.05 1.24 6 0.06
this study for 12 children and 12 adults were R 5 0.96 Values are means 6 SD. V̇O2 max , maximal O2 consumption; HR,
and R 5 0.98, respectively. SF was not different be- heart rate; RER, respiratory exchange ratio. Significant difference
tween any of the groups. (P # 0.05): a between men and women; b between men and boys;
c between men and girls; d between women and boys; e between women
Table 2 presents the V̇O2 max data from both the and girls; f between both men and women compared with both boys
treadmill and cycle ergometer for all groups. V̇O2 max and girls.

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(l/min) was significantly higher in the men vs. women,
boys, and girls and in the women vs. the boys and girls. on the treadmill, and between the boys and men on the
V̇O2 max relative to body mass (ml · kg21 · min21) was not cycle ergometer. Thus, to determine whether there
different between the children (boys and girls) and were significant differences in cardiovascular re-
men, but it was significantly lower in the women than sponses between the groups at equivalent V̇O2 (l/min)
in the boys, girls, and men on both the treadmill and levels, the regression lines of each of the cardiovascu-
cycle ergometer. Maximal HR in the women was signifi- lar variables on V̇O2 (l/min) were statistically compared.
cantly lower than in the boys and girls on both modali- Figures 1–5 present the mean cardiovascular data on
ties. Maximal RER was significantly higher on both V̇O2 (l/min) for each work rate for all groups on both the
modalities in both the men and women vs. both the boys cycle ergometer (A) and treadmill (B). The insets in
and girls. each of these figures present the regression equation
Day-to-day reliability for each of the steady-state for the specific cardiovascular variable and V̇O2 (l/min),
submaximal cardiovascular variables was moderately and the legends give the statistical significance of
high for both modalities in all groups (Table 3). V̇O2 differences, if any, in slopes and intercepts of the
(l/min) day-to-day reliability was also high on both the regression lines between the groups.
cycle ergometer and treadmill in all groups (Table 3). Figure 1, A and B, demonstrates that Q̇ at a given
The cycle ergometer and treadmill submaximal meta- V̇O2 was lower in boys vs. men and girls vs. women for
bolic and cardiovascular data for the boys vs. men and both the cycle ergometer and treadmill, respectively.
girls vs. women are summarized in Tables 4 and 5, When the regression lines of Q̇ on V̇O2 were compared,
respectively. There were significant differences in V̇O2 the intercept for the boys vs. men and girls vs. women
(l/min) at equivalent rates of work between both groups was significantly lower on both modalities. The slopes
of these relationships were not different between
Table 1. Physical characteristics of subjects the groups.
The mean HR responses for all groups for both the
Variable Boys Girls Men Women cycle ergometer and treadmill can be seen in Fig. 2, A
and B, respectively. There were no significant differ-
Age, yrf 9.1 6 0.7 8.8 6 0.7 22.8 6 2.0 23.6 6 2.1
Height, cma,f 134.4 6 6.3 132.6 6 6.3 180.6 6 4.2 166.0 6 3.1 ences in the intercepts of the regression lines of HR on
Weight, kga,f 29.5 6 4.3 28.5 6 4.8 80.0 6 5.0 63.3 6 8.2 V̇O2 between the boys vs. men or girls vs. women. The
BMI, kg/m2 f 16.2 6 1.5 16.2 6 2.0 24.6 6 1.4 22.9 6 2.5 slope of the HR-V̇O2 relationship in the boys vs. men
BSAa,f 1.04 6 0.10 1.02 6 0.11 2.01 6 0.08 1.71 6 0.13 and girls vs. women was significantly greater on both
Fat, %a,c,d,e 15.8 6 4.3 16.8 6 4.4 13.6 6 2.9 23.1 6 5.2
Fat massa,f 4.8 6 1.8 4.9 6 2.0 10.8 6 2.7 14.8 6 4.6
modalities. The significantly steeper slopes of this
FFM, kg a,f 24.7 6 3.1 23.6 6 3.1 69.3 6 4.6 48.5 6 5.3 relationship in children explain why the intercepts of
[Hb], g/dla,b,c 13.2 6 0.8* 13.5 6 0.7† 15.9 6 1.2 14.3 6 1.0 the HR-V̇O2 relationship in the children vs. adults are
LVM, ga,f 78.8 6 12.2 66.0 6 11.6 202.5 6 26.9 140.6 6 31.0 not significantly higher. However, Fig. 2, A and B,
SF, % 34.1 6 3.8 32.3 6 4.4 32.9 6 5.1 32.1 6 3.2 shows that HR in the children was higher than HR in
Values are means 6 SD. BMI, body mass index; BSA, body surface the adults at a given V̇O2 on both the cycle ergometer
area; FFM, fat free mass; [Hb], hemoglobin concentration; LVM, left and treadmill.
ventricular mass; SF, shortening fraction. * n 5 9; † n 5 8. Significant The comparison of SV-V̇O2 between the groups is
difference (P # 0.05): a between men and women; b between men and
boys; c between men and girls; d between women and boys; e between
presented in Fig. 3, A and B, for both the cycle
women and girls; f between both men and women compared with both ergometer and treadmill, respectively. The intercept of
boys and girls. SV on V̇O2 for the boys vs. men and girls vs. women was
952 CHILD AND ADULT CARDIOVASCULAR RESPONSES TO EXERCISE

Table 3. Cycle ergometer and treadmill reliability ranges

Boys Girls Men Women

Variable Cycle Treadmill Cycle Treadmill Cycle Treadmill Cycle Treadmill

Q̇, l/min 0.96–0.97 0.96–0.97 0.90–0.92 0.95–0.99 0.88–0.98 0.70–0.98 0.75–0.83 0.88–0.97
SV, ml 0.94–0.98 0.88–0.90 0.78–0.94 0.79–0.88 0.86–0.95 0.91–0.98 0.56–0.69 0.78–0.97
HR, beats/min 0.96–0.99 0.97–0.99 0.93–0.98 0.99 0.83–0.91 0.90–0.95 0.84–0.90 0.91–0.96
(a-v)O2, ml/100 ml 0.93–0.97 0.92–0.94 0.88–0.96 0.94–0.95 0.81–0.91 0.61–0.93 0.57–0.79 0.65–0.92
TPR, units 0.83–0.89 0.80–0.85 0.71–0.87 0.83–0.87 0.72–0.93 0.68–0.96 0.64–0.81 0.75–0.94
V̇O2 , l/min 0.97–0.99 0.99 0.97–0.99 0.99 0.85–0.95 0.93–0.98 0.80–0.99 0.97–0.99
Values are range of reliability for all rates of work. Cycle, cycle ergometer reliability; Treadmill, treadmill reliability. Q̇, cardiac output; SV,
stroke volume; (a-v)O2 , arterial-mixed venous O2 difference; TPR, total peripheral resistance; V̇O2 , O2 consumption.

significantly lower on both modalities, although the
slopes of these relationships were not different between
the groups.
Figure 4, A and B, present the (a-v)O2-V̇O2 re-
lationship for all groups on both the cycle ergometer
and treadmill, respectively. The slope of this relation-
ship was significantly greater in the boys vs. men and
cantly greater, in the boys vs. men and girls vs. women
on both modalities. Although the slope differences may
be primarily responsible for the significant differences
in intercepts between the children vs. adults, Fig. 5
demonstrates that TPR was higher in the boys and girls
at a given V̇O2.
The relationship between resting LVM and SV on the

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girls vs. women on both the cycle ergometer and tread-
mill. The reason that the (a-v)O2-V̇O2 intercept was not
significantly higher in the children is likely due to
the phenomenon discussed above for the HR-V̇O2 rela-
tionship. Figure 4, A and B, demonstrates that, at
a given V̇O2, the (a-v)O2 is higher in the boys vs. men
and girls vs. women on both the cycle ergometer
and treadmill, respectively.
The TPR-V̇O2 relationship for each group is pre-
sented in Fig. 5, A and B, for the cycle ergometer and
treadmill, respectively. The intercept of this relation-
ship was significantly higher, and the slope was signifi-
cycle ergometer at 40 W is presented in Fig. 6 for both
the males and females. LVM was closely related to SV
on both the cycle ergometer at 40 W (r 5 0.89 and 0.90)
and 60 W (r 5 0.91 and 0.88) and on the treadmill at 3
mph (r 5 0.92 and 0.93) and 5 mph (r 5 0.92 and 0.90)
in males and females, respectively.
DISCUSSION
The results of this study indicate that Q̇ in 7- to
9-yr-old boys and girls is significantly lower at a given
V̇O2 compared with adult men and women on both the

Table 4. Cycle ergometer and treadmill submaximal metabolic and cardiovascular data
by work rate for boys and men
V̇O2 , V̇O2 , V̇O2 , Q̇, HR, (a-v)O2, SBP, DBP,
Ergometer/Work Rate l/min ml · kg21 · min21 %V̇O2 max RER l/min SV, ml beats/min ml/100 ml TPR, units mmHg mmHg

Boys
Cycle 20 W 0.55 18.6 37.4 0.90 6.8 60.5 114.0 8.2 11.7 113.0 61.6
6 0.06 6 2.1 6 5.0 6 0.03 6 1.0 6 10.2 6 12.0 6 1.4 6 1.5 6 9.9 6 3.9
Cycle 40 W 0.78 26.5 53.1 0.91 8.3 61.7 135.8 9.6 10.2 122.8 62.9
6 0.06* 6 3.1* 6 6.9* 6 0.03* 6 1.2* 6 11.7* 6 14.7* 6 1.2* 6 1.4* 6 10.9* 6 6.3*
Cycle 60 W 1.02 34.7 69.5 0.93 9.4 61.9 153.1 11.1 9.8 131.7 68.7
6 0.06* 6 4.7* 6 9.0* 6 0.04 6 1.6* 6 13.1* 6 14.9* 6 1.4* 6 1.4* 6 8.9* 6 7.3
Tm 3 mph 0.57 19.3 35.7 0.90 6.7 57.7 116.0 8.7 12.6 122.0 62.5
6 0.07* 6 1.4* 6 3.6* 6 0.03 6 1.0* 6 9.3* 6 10.8* 6 0.8 6 1.6* 6 8.1* 6 4.4*
Tm 4 mph 0.86 30.1 54.7 0.91 8.6 60.7 142.9 10.1 10.4 134.8 66.2
6 0.10 6 5.1 6 8.5 6 0.05 6 0.9 6 7.5 6 15.6 6 1.1 6 1.0 6 14.1 6 10.8
Tm 5 mph 1.17 39.3 72.8 0.94 10.1 60.5 168.3 11.6 9.5 145.9 69.2
6 0.14* 6 2.6* 6 7.0* 6 0.03 6 1.2* 6 7.6* 6 13.7* 6 0.8* 6 1.2* 6 10.6* 6 9.4
Men
Cycle 40 W 0.93 11.6 24.0 0.89 11.4 129.4 91.8 8.2 8.5 140.5 72.4
6 0.07 6 0.9 6 3.6 6 0.02 6 1.4 6 22.2 6 9.6 6 1.0 6 1.0 6 13.1 6 5.2
Cycle 60 W 1.09 13.7 28.3 0.91 12.4 126.8 97.8 8.9 7.9 147.1 72.0
6 0.07 6 1.0 6 4.4 6 0.02 6 1.6 6 20.5 6 10.5 6 1.0 6 0.7 6 13.5 6 6.1
Cycle 60% 244 30.5 62.1 0.97 19.7 136.1 146.2 12.4 5.9 191.4 77.4
6 0.37 6 3.8 6 2.7 6 0.03 6 3.0 6 25.5 6 11.5 6 1.2 6 0.7 6 22.7 6 7.3
Tm 3 mph 1.02 12.8 24.1 0.89 12.3 135.7 92.0 8.4 7.9 144.4 70.1
6 0.10 6 0.8 6 2.4 6 0.03 6 1.6 6 24.6 6 10.4 6 0.9 6 1.0 6 11.6 6 6.1
Tm 5 mph 2.43 30.3 57.6 0.93 19.3 133.7 146.2 12.7 5.5 172.9 68.9
6 0.23 6 1.7 6 6.8 6 0.02 6 2.1 6 23.8 6 15.5 6 1.3 6 0.8 6 20.9 6 9.3
Tm 60% 2.61 32.7 61.7 0.93 19.8 128.0 153.5 13.3 5.4 171.8 69.8
6 0.23 6 2.2 6 3.4 6 0.02 6 2.6 6 26.7 6 12.2 6 1.0 6 1.0 6 13.7 6 12.3
Values are means 6 SD. Cycle, cycle ergometer; W, watts; Tm, treadmill; mph, miles/h; 60%, 60% maximal V̇O2 consumption (V̇O2 max ). SBP,
systolic blood pressure; DBP, diastolic blood pressure. *Significantly different (P # 0.05) from men at same work rate on same exercise modality.
 CHILD AND ADULT CARDIOVASCULAR RESPONSES TO EXERCISE 953

Table 5. Cycle ergometer and treadmill submaximal metabolic and cardiovascular data by work rate
for girls and women
V̇O2 , V̇O2 , HR, (a-v)O2,
Ergometer/Work Rate V̇O2 , l/min ml · kg21 · min21 %V̇O2 max RER Q̇, l/min SV, ml beats/min ml/100 ml TPR, units SBP, mmHg DBP, mmHg

Girls
Cycle 20 W 0.51 18.3 39.8 0.90 6.6 56.3 118.9 7.8 11.2 105.2 57.1
6 0.05 6 3.0 6 8.8 6 0.03 6 0.5 6 7.6 6 12.2 6 0.6 6 1.0 6 57.1 6 7.3
Cycle 40 W 0.75 26.7 57.9 0.91 8.1 57.8 140.8 9.3 9.6 115.1 57.6
6 0.06 6 5.0* 6 13.9* 6 0.03 6 0.4* 6 7.0* 6 15.9* 6 0.7* 6 0.9 6 6.4* 6 7.2*
Cycle 60 W 0.98 33.9 72.0 0.93 9.1 57.6 159.7 10.8 9.2 127.0 61.2
6 0.06 6 5.3* 6 8.0* 6 0.05 6 0.8* 6 9.2* 6 18.1* 6 0.7* 6 0.9 6 4.6 6 6.2*
Tm 3 mph 0.55 19.4 36.7 0.89 6.5 55.6 118.2 8.5 12.3 115.3 60.4
6 0.07* 6 2.0* 6 3.7* 6 0.03 6 0.8* 6 8.5* 6 11.9* 6 0.6 6 1.4* 6 8.7* 6 6.5*
Tm 4 mph 0.87 30.8 58.4 0.93 8.5 54.9 155.5 10.2 9.9 128.1 59.9
6 0.15 6 4.3 6 9.3 6 0.04 6 1.1 6 7.0 6 11.7 6 0.7 6 1.8 6 10.7 6 8.7
Tm 5 mph 1.13 39.5 74.7 0.93 9.7 57.1 171.5 11.6 8.9 136.5 59.3
6 0.14* 6 3.0* 6 5.2* 6 0.03 6 1.12* 6 7.9* 6 12.1* 6 0.7* 6 1.0* 6 12.8* 6 10.2
Women
Cycle 40 W 0.79 12.6 30.6 0.90 9.6 97.9 94.8 8.3 9.3 127.1 68.8
6 0.05 6 0.9 6 5.2 6 0.05 6 1.0 6 9.1 6 11.8 6 0.8 6 0.9 6 13.7 6 10.5
Cycle 60 W 0.97 15.4 37.6 0.92 10.6 102.1 106.0 9.2 8.8 135.0 70.8
6 0.05 6 1.4 6 7.0 6 0.04 6 1.1 6 10.7 6 11.5 6 0.8 6 1.1 6 12.3 6 9.6

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Cycle 60% 1.69 26.6 63.6 0.98 14.3 100.0 143.7 11.8 7.3 163.4 73.8
6 0.32 6 3.3 6 1.5 6 0.04 6 1.6 6 1.6 6 9.4 6 1.2 6 0.8 6 19.2 6 9.3
Tm 3 mph 0.81 12.8 27.6 0.88 9.6 100.4 96.3 8.5 9.5 132.1 68.5
6 0.13 6 0.9 6 3.8 6 0.04 6 1.4 6 14.8 6 13.9 6 0.7 6 1.4 6 15.3 6 10.1
Tm 5 mph 1.85 29.4 63.3 0.94 14.9 101.9 147.3 12.5 6.6 154.7 68.1
6 0.25 6 2.3 6 9.9 6 0.04 6 1.6 6 12.5 6 16.2 6 1.1 6 0.9 6 14.4 6 11.8
Tm 60% 1.81 28.6 61.0 0.92 14.7 98.6 149.3 12.3 7.0 158.5 71.5
6 0.26 6 3.1 6 2.1 6 0.02 6 1.8 6 13.6 6 10.5 6 1.0 6 1.3 6 17.2 6 13.4
Values are means 6 SD. Definitions as in Tables 1–4. * Significantly different (P # 0.05) from women at same work rate on same exercise
modality.

cycle ergometer and treadmill. The lower Q̇ is the result
of a lower SV in the children that is only partially
compensated for by a higher HR at a given absolute
V̇O2. The lower SV is related to the smaller heart size in
the children. The lower Q̇ in children at a given V̇O2 is
compensated for by a higher (a-v)O2.
Several methodological factors must be considered
when these data are interpreted. Both shorter (10) and
longer (52) recirculation times have been reported in

Fig. 1. Cardiac output (Q̇) on O2 consumption (vo2) for cycle ergom-

eter (A) and treadmill (B). Insets: regression equations used in Fig. 2. Heart rate (HR) on V̇O2 for cycle ergometer (A) and treadmill
statistical analysis. *Intercept significantly different from correspond- (B). Insets: regression equations used in statistical analysis. † Slope
ing adult value; P # 0.05. q Intercept significantly different from significantly different from corresponding adult value; P #0.05.
women; P # 0.05. D Slope significantly different from women; P #0.05.
954 CHILD AND ADULT CARDIOVASCULAR RESPONSES TO EXERCISE
Fig. 3. Stroke volume (SV) on V̇O2 for cycle ergometer (A) and
treadmill (B). Insets: regression equations used in statistical analy-
sis. * Intercept significantly different from corresponding adult value;
P # 0.05. q Intercept significantly different from women; P # 0.05.
children compared with adults. Differing recircula-
tion times could affect Q̇ estimations when the CO2-
rebreathing method is used. However, we did not see an
effect, as the rebreathing curves for both the children
and adults showed good equilibration and no signs of
Fig. 4. Arterial-mixed venous O2 difference [(a-v)O2] on V̇O2 for cycle
ergometer (A) and treadmill (B). Insets: regression equations used in
statistical analysis. † Slope significantly different from corresponding
adult value; P #0.05. D Slope significantly different from women;
P #0.05.
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Fig. 5. Total peripheral resistance (TPR) on V̇O2 for cycle ergometer
(A) and treadmill (B). Insets: regression equations used in statistical
analysis. * Intercept significantly different from corresponding adult
value; P # 0.05. † Slope significantly different from corresponding
adult value; P #0.05. q Intercept significantly different from women;
P # 0.05. D Slope significantly different from women; P #0.05.
recirculation. Furthermore, the accuracy of using a
single postexertional hemoglobin (Hb) measurement
for Q̇ calculation is not ideal. However, to best account
for the changes that occur in Hb levels during exer-
cise, while still limiting the invasiveness of the proce-
dures (which is necessary when working with young
children), a single postexertional measurement is most
appropriate.
In our study, Q̇ at a V̇O2 of 1.0 l/min was 2.5 and 1.5
l/min lower on the cycle ergometer and was 2.9 and 1.3
l/min lower on the treadmill in boys vs. men and in girls
vs. women, respectively. A lower Q̇ of a similar magni-
tude on the cycle ergometer in children vs. adults at a
given rate of work is supported by research literature
(2, 16, 30, 32, 42, 52) but is in conflict with others who
have reported Q̇ on the cycle ergometer to be the same
(17–19). The studies that have reported lower Q̇ in
Fig. 6. Relationship between left ventricular mass and SV in men
and women on cycle ergometer at 40 W.
 CHILD AND ADULT CARDIOVASCULAR RESPONSES TO EXERCISE
children vs. adults have reported similar absolute
values and age-related differences.
Of the studies that have reported no difference
between children and adults, Gadhoke and Jones (17)
determined Q̇ in two groups of 20 boys (mean ages of
11.1 and 13.5 yr) during cycling exercise at 200 and 400
kilopond m/min. They did not find a difference in Q̇
compared with values for adults reported by Higgs et
al. (22). Godfrey et al. (18) tested 117 boys and girls,
ages 6–16 yr, on the cycle ergometer at one-third and
two-thirds of their V̇O2 max. When they compared their
results to those of Bevegard et al. (5), they concluded
that there was no difference in Q̇ at a given V̇O2. Also,
Godfrey et al. (19) measured Q̇ during cycle ergometer
exercise at 40 and 80 W in three children (mean age, 9.7
yr) and three adults (mean age, 23.3 yr). Although they
did not compare their child vs. adult Q̇ differences
statistically, by comparing the Q̇-V̇O2 relationship in
their six subjects, combined with the data on children
from Godfrey et al. (18) and the adult data from Rowell
(43), they concluded that the child and adult Q̇ values
were not different. The reason for the discrepancies
between our findings and the findings of these earlier
studies (17–19) is uncertain.
Combining our results with the data from the remain-
ing research literature, it can be concluded that, during
exercise, Q̇ at a given V̇O2 (l/min) is ,1.0 to 2.9 l/min
lower in young children than adults on both the cycle
ergometer and treadmill. Additionally, our results indi-
cate (Figs. 2 and 3), and other studies agree (2, 19, 32,
42), that HR is higher and SV is lower at a given V̇O2 in
children vs. adults. The lower SV in children is gener-
ally attributed to their smaller body size. We found that
the significantly lower SV in children vs. adults was
eliminated or greatly reduced when SV was scaled to
BSA. We also found that resting estimated LVM was
closely correlated with both SV (see RESULTS ) and HR in
the males (r 5 20.85, 20.90, 20.73, 20.64) and females
(r 5 20.80, 20.82, 20.60, 20.60) at 40 W, 60 W, 3 mph,
and 5 mph, respectively. Because the adults did not do
the 20-W work rate and the children did not do the
60% work rate, these rates of work were not included in
this analysis.
It has been suggested that the lower Q̇-V̇O2 relation-
ship in children is an indicator of depressed myocardial
functional reserve or inability to generate SV (1). This
may not necessarily be the case. The increase in Q̇ with
increasing V̇O2 is met by changes in both SV and HR.
SV is related to body size (thus, it is higher in adults)
and increases very little beyond light work rates. Thus,
to complete the Fick equation, HR and (a-v)O2 increase
more in children, so that they have a V̇O2 similar to
adults. Thus the cardiovascular response of children
seems to be normal for their size. Our similar
Q̇-V̇O2 slopes in children and adults (Fig. 1) further
support this normal cardiovascular response of chil-
dren to exercise that is relative to their body size. Also,
there were no significant differences in LVM/FFM
between boys vs. men (3.21 6 0.49 vs. 2.92 6 0.29) or
girls vs. women (2.81 6 0.36 vs. 2.89 6 0.50), suggest-
955
ing that the heart mass available to generate SV during
exericse is not different.
Other factors may contribute to the lower SV in
children. It has been suggested that SV contributions to
Q̇ are higher with larger muscle mass activity (14). In
the following section, we suggest that children use a
smaller muscle mass to do a given amount of work. The
smaller muscle mass in children could result in an
attenuated venous return (preload) and thus contribute
to their lower SV. Additionally, the higher whole body
TPR (Fig. 5) may represent a higher afterload, one of
three primary factors that affect SV (14), and thus
contribute to a lower SV in children.
As previously mentioned, we suggest that for chil-
dren to do the same rate of work (V̇O2) as adults, the
children most likely use a smaller absolute amount of
muscle mass. A smaller absolute muscle mass is thus
stressed to a relatively greater extent, resulting in a
greater buildup of metabolites, thus providing more
feedback to the medulla to increase HR (8). The assump-
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tion of a smaller absolute muscle mass in children vs.
adults, during exercise using the same muscle group, is
based on the fact that adults have a significantly larger
body mass relative to muscle mass. Not only are
children smaller, but the percentage of their body
weight that is muscle is less. The total muscle mass of a
7- to 9-yr-old boy represents ,44% of his body weight,
whereas that of a 20- to 29-yr-old man is ,52% (38).
This trend is not found in girls and women, likely due to
their greater increase in FM with growth. The higher
HR and lower SV response associated with a smaller
muscle mass has been demonstrated in studies in
adults comparing large and small muscle masses dur-
ing exercise (4, 36, 50).
The possibility that children use a smaller absolute
amount of muscle mass than adults use to exercise at
the same rate of work has been proposed by others (30,
32) as a possible mechanism for the higher (a-v)O2 in
children, as found in the present study and others (2,
15, 32, 42). As stated above, the smaller muscle mass
would be stressed to a relatively greater extent and
thus would likely generate a larger amount of meta-
bolic by-products (36) and heat per unit of muscle,
which would then 1) increase O2 liberated from Hb by
decreasing its affinity for O2 at the muscle; 2) increase
vasodilatation of the arteries entering the muscle (36),
thus increasing muscle blood flow (33, 34); and 3)
increase feedback to the medulla via group III and IV
afferents to increase HR (8), as discussed earlier.
Furthermore, the higher (a-v)O2 in children may be
due to more of their blood flow going to active muscle.
This is supported by the work of Koch (33, 34), who
reported higher muscle blood flow in 12- to 14-yr-old
boys compared with 25-yr-old adults after ischemic
work and during maximal cycle ergometer exercise.
The possibility of higher muscle blood flow in children
is indirectly supported by work of Saltin et al. (48) in
adults. They reported that leg blood flow was inversely
related to [Hb]. However, Kurdak et al. (35) report that,
in maximally working canine muscle in situ, lower [Hb]
did not significantly change blood flow distribution.
956 CHILD AND ADULT CARDIOVASCULAR RESPONSES TO EXERCISE
The [Hb] of the children in the present study was
significantly lower (P # 0.05) than that of the adults
(see Table 1). When we scaled our Q̇ (l/min) and TPR
(units) to FFM (kg) we found that Q̇ · FFM21 · min21 was
higher and TPR/FFM was lower in the children vs.
adults at a given V̇O2 on both the cycle ergometer and
treadmill. Because muscle receives up to 80–85% of the
Q̇, or blood flow, during exercise (44), these results
suggest that for a given muscle mass (FFM) children
have a larger Q̇ or blood flow and a lower TPR (higher
conductance to accept the higher Q̇ at the muscle) than
adults have at a given rate of work, indirectly indicat-
ing higher muscle blood flow in children. Higher muscle
blood flow combined with a lower Q̇ at a given V̇O2
seems incongruent but may be explained by a smaller
muscle mass performing a given rate of work in chil-
dren vs. adults, as discussed above.
Finally, it has been reported that maximal (a-v)O2 in
boys is not different from that in men (16). Further-
more, the (a-v)O2 of children is higher at a given
submaximal V̇O2 (l/min). Thus the (a-v)O2 of children at
a given absolute submaximal V̇O2 (l/min) is nearer their
maximal value. This may partially explain the higher
(a-v)O2 values at a given submaximal V̇O2 (l/min) in
children compared with adults.
In this study, when cardiovascular responses to sub-
maximal exercise in children and adults are compared,
the differences in responses are strikingly similar to
differences seen in adult studies (4, 31, 50) when small
vs. large muscle mass exercise is compared at the same
rate of work (i.e., higher HR, lower SV, and higher
whole body TPR when using a small muscle mass). Q̇ at
a given V̇O2 has also been reported to be lower during
exercise with a smaller muscle mass (4, 31).
In conclusion, Q̇ in this group of 7- to 9-yr-old
children was significantly lower in boys vs. men and
girls vs. women at a given V̇O2 on both the cycle
ergometer and treadmill. The lower Q̇ at a given V̇O2 in
children is compensated for by a higher (a-v)O2. The
exact mechanisms responsible for the higher (a-v)O2 in
children are not known and will not likely be resolved
for some time because of the invasive nature of re-
search that would be required to answer such ques-
tions. We speculate that the higher (a-v)O2 in children
is caused by a combination of factors, including 1)
higher muscle blood flow, 2) enhanced O2 liberation
from Hb, and 3) the (a-v)O2 at a given V̇O2 being nearer
their maximal value. Also, HR is higher and SV is lower
at a given V̇O2 in children compared with adults. The
higher HR and lower SV in children are related to their
smaller hearts and lower blood volumes. In addition,
the higher HR of the children compared with adults is
related to a smaller absolute amount of muscle being
recruited to do the same amount of work (V̇O2) and the
fact that the children are exercising at a higher relative
intensity.
We thank Kelsie Turley, Bernard Chan, and Jill Long for their
dedication to the collection of this data; Dr. Timothy Bricker for
contributions to the study design and echocardiographic expertise;
Ken Peake for help with the echocardiographic data; the adult and
child subjects for their participation in this study; and the parents of
the children for the giving of their own time so their children could
participate.
Address for reprint requests: K. R. Turley, Dept. of Kinesiology,
Harding University, Box 2281, Searcy, AR 72149. (E-mail:
KRTurley@Harding.edu).
Received 23 January 1996; accepted in final form 5 May 1997.
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