Perspectives on exercise and wasting

Recommendations for endpoints in clinical trials of wasting that involve exercise should involve selection that clearly identifies the effects of exercise. Broad endpoints such as morbidity and mortality must be corrected for the effects of age, smoking, hypertension, etc. in order to gain adjusted information pertinent to exercise. Selection of variables related to physiological function although more specific i.e., maximal oxygen uptake, must still be viewed from the perspective that other variables may contribute to the values measured. Nevertheless, physiological information obtained from performance tests may well provide useful endpoints. In this regard, V02 max, heartrate and pulmonary ventilation at fixed work loads, muscular strength, reaction time, flexibility, blood gases, cardiac output, stroke volume, serum lactate, and properties of skeletal muscle such as mitochondria concentration and components related to muscle energetics, e.g., adenosine triphosphate. In addition exercise will definitely impact body mass and composition as well as configuration. The latter is assessable through utilization of somatogramography. Analysis of muscle depends on muscle biopsy and magnetic resonance spectroscopy. Neither of these methods has been employed in clinical trials to the best of our knowledge. Thus, one needs evidence that exercise in the clinical trial provides a discrete effect on performance capabilities, body status and biologically important variables.