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Pereira-Neto, Elisio A., Hayley Lewthwaite, Terry Boyle, Kylie Johnston, Hunter Bennett, and Marie T. Williams. "Effects of exercise training with blood flow restriction on vascular function in adults: a systematic review and meta-analysis." PeerJ 9 (July 7, 2021): e11554. http://dx.doi.org/10.7717/peerj.11554.
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Background Blood flow restricted exercise (BFRE) improves physical fitness, with theorized positive effects on vascular function. This systematic review and meta-analysis aimed to report (1) the effects of BFRE on vascular function in adults with or without chronic health conditions, and (2) adverse events and adherence reported for BFRE. Methodology Five electronic databases were searched by two researchers independently to identify studies reporting vascular outcomes following BFRE in adults with and without chronic conditions. When sufficient data were provided, meta-analysis and exploratory meta-regression were performed. Results Twenty-six studies were included in the review (total participants n = 472; n = 41 older adults with chronic conditions). Meta-analysis (k = 9 studies) indicated that compared to exercise without blood flow restriction, resistance training with blood flow restriction resulted in significantly greater effects on endothelial function (SMD 0.76; 95% CI [0.36–1.14]). No significant differences were estimated for changes in vascular structure (SMD −0.24; 95% CI [−1.08 to 0.59]). In exploratory meta-regression analyses, several experimental protocol factors (design, exercise modality, exercised limbs, intervention length and number of sets per exercise) were significantly associated with the effect size for endothelial function outcomes. Adverse events in BFRE studies were rarely reported. Conclusion There is limited evidence, predominantly available in healthy young adults, on the effect of BFRE on vascular function. Signals pointing to effect of specific dynamic resistance exercise protocols with blood flow restriction (≥4 weeks with exercises for the upper and lower limbs) on endothelial function warrant further investigation.
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Simonelli, Carla, Michele Vitacca, Nicolino Ambrosino, Simonetta Scalvini, Francesca Rivadossi, Manuela Saleri, Aubin G. Fokom, Ilaria Speltoni, Riccardo Ghirardi, and Mara Paneroni. "Therapist Driven Rehabilitation Protocol for Patients with Chronic Heart and Lung Diseases: A Real-Life Study." International Journal of Environmental Research and Public Health 17, no. 3 (February 5, 2020): 1016. http://dx.doi.org/10.3390/ijerph17031016.
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Therapist driven protocols may help to tailor rehabilitation programs to individual patients. We aimed to test the feasibility, safety, and clinical usefulness of a therapist driven protocol for rehabilitation including exercise training of patients with heart or lung diseases. An internal audit elaborated the Cardio-Respiratory Exercise Maugeri Algorithm (CREMA) based on: (a) standardized baseline assessments, (b) decision-making pathways, and (c) frequency/intensity/time/type (FITT) of prescription for each exercise. Outpatients (n = 620) with chronic heart disease (CHD), recent myocardial revascularization (REVASC), chronic airway (Obstructive), and restrictive lung (Restrictive) diseases underwent exercise training according to CREMA during 4 years. Peripheral muscle strengthening was the most prescribed exercise (83.6%), while arm endurance training was the least frequently (0.75%). Exercise prescription varied widely among the disease groups (interval training 19–47%, balance 35–49%, lower limb muscle training 6–15%). After training, REVASC patients were the best improvers in the 6 min walking distance (+48.7 (56.1) m), maximal inspiratory pressure (+9.6 (15.4) cmH2O), and daily steps (+1087.2 (3297.1) n/day). Quadriceps and biceps strength, maximal expiratory pressure, and balance improved in all groups, without significant differences. Minor side effects were observed in 11.2% of the patients. The CREMA therapist driven protocol was feasible, safe, and useful for prescribing tailored training programs. Exercise prescriptions and training response differed among diseases.
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Meyer, Philippe, Eve Normandin, Mathieu Gayda, Guillaume Billon, Thibaut Guiraud, Laurent Bosquet, Annick Fortier, Martin Juneau, Michel White, and Anil Nigam. "High-Intensity Interval Exercise in Chronic Heart Failure: Protocol Optimization." Journal of Cardiac Failure 18, no. 2 (February 2012): 126–33. http://dx.doi.org/10.1016/j.cardfail.2011.10.010.
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Borel, Benoit, Steeve Provencher, Didier Saey, and François Maltais. "Responsiveness of Various Exercise-Testing Protocols to Therapeutic Interventions in COPD." Pulmonary Medicine 2013 (2013): 1–11. http://dx.doi.org/10.1155/2013/410748.
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Exercise intolerance is a key element in the pathophysiology and course of Chronic Obstructive Pulmonary Disease (COPD). As such, evaluating exercise tolerance has become an important part of the management of COPD. A wide variety of exercise-testing protocols is currently available, each protocol having its own strengths and weaknesses relative to their discriminative, methodological, and evaluative characteristics. This paper aims to review the responsiveness of several exercise-testing protocols used to evaluate the efficacy of pharmacological and nonpharmacological interventions to improve exercise tolerance in COPD. This will be done taking into account the minimally important difference, an important concept in the interpretation of the findings about responsiveness of exercise testing protocols. Among the currently available exercise-testing protocols (incremental, constant work rate, or self-paced), constant work rate exercise tests (cycle endurance test and endurance shuttle walking test) emerge as the most responsive ones for detecting and quantifying changes in exercise capacity after an intervention in COPD.
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De Lacerda, Filipe Ferrari Ribeiro, Marvyn de Santana Do Sacramento, Diego Passos Diogo, Alan Carlos Nery Dos Santos, Marcelo Trotte Motta, and Jefferson Petto. "Physical exercise in individuals in hemodialysis: benefits and best indications - systematic review." Revista Pesquisa em Fisioterapia 8, no. 3 (September 17, 2018): 404–19. http://dx.doi.org/10.17267/2238-2704rpf.v8i3.1933.
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INTRODUCTION: The number of patients with chronic chronic disease (CKD) on hemodialysis (HD) has increased. In Brazil, in 2012, the number of patients in HD was 97,586, with a mortality rate of 19%. Physical exercise (PE) is an adjuvant therapy capable of promoting glycemic control, blood pressure and other gains relevant to CKD control. OBJECTIVE: To describe the benefits of quality of life, care and the most effective protocols of physical exercise for the individual on hemodialysis. METHODS: Systematic review study. Consultations of the SciELO and PubMed databases between 2005 and 2016 on the physiological effects of exercise and the quality of life of the individual on hemodialysis. The cross-over descriptors used were: "hemodialysis" and "exercises", "hemodialysis" and "exercises" and "intradialitic" and "exercises". RESULTS: 23 articles were selected with different EF programs, 8 exercises, 6 resisted, 5 composed by the association of both, and 1 of a comparison between aerobic and resisted. A sample ranged from 6 to 103 patients. Intervention time of 2 to 4 months. All programs should be improved in relation to functional capacity, reduction of inflammation, improvement of arterial compliance and others. In resisted PE, one of the studies reported deleterious effects for the patients, while those with resisted and aerobic PE showed benefits. CONCLUSION: EF was able to prevent oxidative stress, reduce blood pressure and increase blood glucose, increase muscle volume and strength, and gain quality in life, but there was no agreement on the best protocol.
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Capogrosso, Roberta Francesca, Paola Mantuano, Anna Cozzoli, Francesca Sanarica, Ada Maria Massari, Elena Conte, Adriano Fonzino, et al. "Contractile efficiency of dystrophic mdx mouse muscle: in vivo and ex vivo assessment of adaptation to exercise of functional end points." Journal of Applied Physiology 122, no. 4 (April 1, 2017): 828–43. http://dx.doi.org/10.1152/japplphysiol.00776.2015.
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Progressive weakness is a typical feature of Duchenne muscular dystrophy (DMD) patients and is exacerbated in the benign mdx mouse model by in vivo treadmill exercise. We hypothesized a different threshold for functional adaptation of mdx muscles in response to the duration of the exercise protocol. In vivo weakness was confirmed by grip strength after 4, 8, and 12 wk of exercise in mdx mice. Torque measurements revealed that exercise-related weakness in mdx mice correlated with the duration of the protocol, while wild-type (WT) mice were stronger. Twitch and tetanic forces of isolated diaphragm and extensor digitorum longus (EDL) muscles were lower in mdx compared with WT mice. In mdx, both muscle types exhibited greater weakness after a single exercise bout, but only in EDL after a long exercise protocol. As opposite to WT muscles, mdx EDL ones did not show any exercise-induced adaptations against eccentric contraction force drop. qRT-PCR analysis confirmed the maladaptation of genes involved in metabolic and structural remodeling, while damage-related genes remained significantly upregulated and angiogenesis impaired. Phosphorylated AMP kinase level increased only in exercised WT muscle. The severe histopathology and the high levels of muscular TGF-β1 and of plasma matrix metalloproteinase-9 confirmed the persistence of muscle damage in mdx mice. Therefore, dystrophic muscles showed a partial degree of functional adaptation to chronic exercise, although not sufficient to overcome weakness nor signs of damage. The improved understanding of the complex mechanisms underlying maladaptation of dystrophic muscle paves the way to a better managment of DMD patients. NEW & NOTEWORTHY We focused on the adaptation/maladaptation of dystrophic mdx mouse muscles to a standard protocol of exercise to provide guidance in the development of more effective drug and physical therapies in Duchenne muscular dystrophy. The mdx muscles showed a modest functional adaptation to chronic exercise, but it was not sufficient to overcome the progressive in vivo weakness, nor to counter signs of muscle damage. Therefore, a complex involvement of multiple systems underlies the maladaptive response of dystrophic muscle.
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Reis, Aline S., Laisa L. Paineiras-Domingos, Eloá Moreira-Marconi, Márcia C. Moura-Fernandes, Hervé Quinart, François Constant Boyer, Mario Fristh Neves, Redha Taiar, Mario Bernardo-Filho, and Danúbia C. Sá-Caputo. "Composição corporal na síndrome metabólica: Proposta de um protocolo de ensaio clínico randomizado avaliando o efeito do exercício de vibração de corpo inteiro." Brazilian Journal of Health and Biomedical Sciences 18, no. 1 (June 3, 2019): 33–40. http://dx.doi.org/10.12957/bjhbs.2019.53058.
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Introduction: Metabolic syndrome (MetS) is characterized bya group of cardiovascular risk factors, such as hypertension,hyperglycemia, hypercholesterolemia, low high-density cholesteroland increased abdominal fat. Over the years, changesin body composition occur, with accelerated loss of lean massand increased fat mass, favoring cardiometabolic disorders.A strong relationship exists between physical inactivity andthe presence of multiple risk factors for MetS. Thus, physicalexercise has been recommended for the prevention of cardiovascular,chronic and MetS diseases. Whole-body vibration(WBV) exercise can be considered to be an exercise modalitythat benefits the muscular strength and cardiovascular healthof elderly, sick and healthy people. Individuals with MetSare unmotivated to perform physical exercise regularly and,therefore, new approaches to intervention for this populationare desirable. Objectives: The aim of this study is to presenta protocol to verify the effect of WBV exercise on the bodycomposition of MetS individuals. Methods: Randomized controlledtrial with MetS individuals that will be allocated to anintervention group (WBVG) and a control group (CG). Participantswill be placed barefoot on the base of a side alternatingvibrating platform, with 130º knee flexion. Individuals (WBVGand CG) will perform the protocol for 12 weeks, twice a week.The CG subjects will perform the exercises at 5Hz throughoutthe intervention and those from the WBVG will perform the5Hz exercises in the first session, adding 1Hz per session, endingthe protocol at 16Hz. The body composition will be evaluatedbefore and after the protocol using bioelectrical impedanceanalysis. Discussion: Studies involving WBV exercise haveshown improvement in composition in individuals withdifferent conditions (healthy and unhealthy). Conclusion: Theproposed protocol will permit the acquisition of findings thatwill be relevant in the evaluation of the effect of the WBV onthe body composition of MetS individuals due to its ease ofrealization, low cost and safety.Keywords: Whole body vibration exercise; Metabolic syndrome;Physical activity.
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Rodríguez-Sanz, Jacobo, Miguel Malo-Urriés, Jaime Corral-de-Toro, Carlos López-de-Celis, María Orosia Lucha-López, José Miguel Tricás-Moreno, Ana I. Lorente, and César Hidalgo-García. "Does the Addition of Manual Therapy Approach to a Cervical Exercise Program Improve Clinical Outcomes for Patients with Chronic Neck Pain in Short- and Mid-Term? A Randomized Controlled Trial." International Journal of Environmental Research and Public Health 17, no. 18 (September 10, 2020): 6601. http://dx.doi.org/10.3390/ijerph17186601.
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Chronic neck pain is one of today’s most prevalent pathologies. The International Classification of Diseases categorizes four subgroups based on patients’ associated symptoms. However, this classification does not encompass upper cervical spine dysfunction. The aim is to compare the short- and mid-term effectiveness of adding a manual therapy approach to a cervical exercise protocol in patients with chronic neck pain and upper cervical spine dysfunction. Fifty-eight subjects with chronic neck pain and upper cervical spine dysfunction were recruited (29 = Manual therapy + Exercise; 29 = Exercise). Each group received four 20-min sessions, one per week during four consecutive weeks, and a home exercise regime. Upper flexion and flexion-rotation test range of motion, neck disability index, craniocervical flexion test, visual analogue scale, pressure pain threshold, global rating of change scale, and adherence to self-treatment were assessed at the beginning, end of the intervention and at 3- and 6-month follow-ups. The Manual therapy + Exercise group statistically improved short- and medium-term in all variables compared to the Exercise group. Four 20-min sessions of Manual therapy + Exercise along with a home-exercise program is more effective in the short- to mid-term than an exercise protocol and a home-exercise program for patients with chronic neck pain and upper cervical dysfunction.
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Gutmann, Boris, Andreas Mierau, Thorben Hülsdünker, Carolin Hildebrand, Axel Przyklenk, Wildor Hollmann, and Heiko Klaus Strüder. "Effects of Physical Exercise on Individual Resting State EEG Alpha Peak Frequency." Neural Plasticity 2015 (2015): 1–6. http://dx.doi.org/10.1155/2015/717312.
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Previous research has shown that both acute and chronic physical exercises can induce positive effects on brain function and this is associated with improvements in cognitive performance. However, the neurophysiological mechanisms underlying the beneficial effects of exercise on cognitive processing are not well understood. This study examined the effects of an acute bout of physical exercise as well as four weeks of exercise training on the individual resting state electroencephalographic (EEG) alpha peak frequency (iAPF), a neurophysiological marker of the individual’s state of arousal and attention, in healthy young adults. The subjects completed a steady state exercise (SSE) protocol or an exhaustive exercise (EE) protocol, respectively, on two separate days. EEG activity was recorded for 2 min before exercise, immediately after exercise, and after 10 min of rest. All assessments were repeated following four weeks of exercise training to investigate whether an improvement in physical fitness modulates the resting state iAPF and/or the iAPF response to an acute bout of SSE and EE. The iAPF was significantly increased following EE (P=0.012) but not following SSE. It is concluded that the iAPF is increased following intense exercise, indicating a higher level of arousal and preparedness for external input.
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van Campen, C. (Linda) M. C., and Frans C. Visser. "Comparing Idiopathic Chronic Fatigue and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in Males: Response to Two-Day Cardiopulmonary Exercise Testing Protocol." Healthcare 9, no. 6 (June 5, 2021): 683. http://dx.doi.org/10.3390/healthcare9060683.
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(1) Introduction: Multiple studies have shown that peak oxygen consumption is reduced in the majority of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS )patients, using the gold standard for measuring exercise intolerance: cardiopulmonary exercise testing (CPET). A 2-day CPET protocol has shown different results on day 2 in ME/CFS patients compared to sedentary controls. No comparison is known between ME/CFS and idiopathic chronic fatigue (ICF) for 2-day CPET protocols. We compared ME/CFS patients with patients with chronic fatigue who did not fulfill the ME/CFS criteria in a male population and hypothesized a different pattern of response would be present during the 2nd day CPET. (2) Methods: We compared 25 male patients with ICF who had completed a 2-day CPET protocol to an age-/gender-matched group of 26 male ME/CFS patients. Measures of oxygen consumption (VO2), heart rate (HR), systolic and diastolic blood pressure, workload (Work), and respiratory exchange ratio (RER) were collected at maximal (peak) and ventilatory threshold (VT) intensities. (3) Results: Baseline characteristics for both groups were similar for age, body mass index (BMI), body surface area, (BSA), and disease duration. A significant difference was present in the number of patients with fibromyalgia (seven ME/CFS patients vs. zero ICF patients). Heart rate at rest and the RER did not differ significantly between CPET 1 and CPET 2. All other CPET parameters at the ventilatory threshold and maximum exercise differed significantly (p-value between 0.002 and <0.0001). ME/CFS patients showed a deterioration of performance on CPET2 as reflected by VO2 and workload at peak exercise and ventilatory threshold, whereas ICF patients showed improved performance on CPET2 with no significant change in peak workload. (4) Conclusion: This study confirms that male ME/CFS patients have a reduction in exercise capacity in response to a second-day CPET. These results are similar to published results in male ME/CFS populations. Patients diagnosed with ICF show a different response on day 2, more similar to sedentary and healthy controls.
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van Campen, C. (Linda) M. C., and Frans C. Visser. "Female Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome or Idiopathic Chronic Fatigue: Comparison of Responses to a Two-Day Cardiopulmonary Exercise Testing Protocol." Healthcare 9, no. 6 (June 5, 2021): 682. http://dx.doi.org/10.3390/healthcare9060682.
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Introduction: Multiple studies have shown that peak oxygen consumption is reduced in the majority of ME/CFS patients, using the golden standard for measuring exercise intolerance: cardiopulmonary exercise testing (CPET). A 2-day CPET protocol has shown different results on day 2 in ME/CFS patients compared to sedentary controls. No comparison is known between ME/CFS and idiopathic chronic fatigue (ICF) for 2-day CPET protocols. We compared ME/CFS patients with patients with chronic fatigue who did not fulfil the ME/CFS criteria in a male population and hypothesized a different pattern of response would be present during the 2nd day CPET. Methods: Fifty-one female patients with ICF completed a 2-day CPET protocol and were compared to an age/sex-matched group of 50 female ME/CFS patients. Measures of oxygen consumption (VO2), heart rate (HR), systolic and diastolic blood pressure, workload (Work), and respiratory exchange ratio (RER) were collected at maximal (peak) and ventilatory threshold (VT) intensities. Results: Baseline characteristics for both groups were similar for age, BMI, BSA, and disease duration. A significance difference was present in the number of patients with fibromyalgia (seven ME/CFS patients vs zero ICF patients). Heart rate at rest and the RER did not differ significantly between CPET 1 and CPET 2. All other CPET parameters at the ventilatory threshold and maximum exercise differed significantly (p-value between 0.002 and <0.0001). ME/CFS patients showed a deterioration of performance on CPET2 as reflected by VO2 and workload at peak exercise and ventilatory threshold, whereas ICF patients showed improved performance on CPET2 with no significant change in peak workload. Conclusion: This study confirms that female ME/CFS patients have a reduction in exercise capacity in response to a second day CPET. These results are similar to published results in female ME/CFS populations. Patients diagnosed with ICF show a different response on day 2, more similar to sedentary and healthy controls.
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Gianesini, Sergio, Mirko Tessari, Primo Bacciglieri, Anna Maria Malagoni, Erica Menegatti, Savino Occhionorelli, Nino Basaglia, and Paolo Zamboni. "A specifically designed aquatic exercise protocol to reduce chronic lower limb edema." Phlebology: The Journal of Venous Disease 32, no. 9 (October 18, 2016): 594–600. http://dx.doi.org/10.1177/0268355516673539.
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Objective Despite the fact that muscle pump activation is known to positively impact chronic lower limb edema, objective measurements of standardized exercises for venous-lymphatic rehab are lacking. The aim of this investigation is to determine the effectiveness of an addressed physical activity exploiting the advantages of an aquatic environment. Material and methods Thirty-two lower limbs of 16 patients affected by bilateral chronic leg swelling were included (12 females, 4 males). All the patients underwent a protocol of five sessions of physical exercises specifically conceived inside a pool. Volumetry, subcutaneous thickness, ankle range of motion and symptomatology were assessed as outcome measures. Results One week after the end of the protocol, the average reduction in lower limb volume was 303.13 ± 69.72 ml ( p = 0.00002) and 334.38 ± 62.50 ml ( p = 0.000003) in the right and left legs, respectively. Ankle range of motion and feeling of heaviness significantly improved. Conclusion A specifically designed aquatic protocol is able to positively impact chronic leg swelling offering a first line rehab for this medical condition.
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Radtke, Thomas, Sarah Crook, Georgios Kaltsakas, Zafeiris Louvaris, Danilo Berton, Don S. Urquhart, Asterios Kampouras, et al. "ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases." European Respiratory Review 28, no. 154 (December 18, 2019): 180101. http://dx.doi.org/10.1183/16000617.0101-2018.
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The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2–3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.
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Akodu, A. K., T. O. Ajepe, and J. O. Onwuazombe. "Effects of core-stabilization and dynamic strengthening exercises on patients with non-specific chronic low back pain in Lagos: A pilot study." Research Journal of Health Sciences 8, no. 2 (July 10, 2020): 113–23. http://dx.doi.org/10.4314/rejhs.v8i2.7.
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Objectives: Exercise is the most widely used form of treatment adopted for gaining relief from low back pain. But the efficacy of core stabilization and dynamic strengthening exercise on cardiopulmonary parameters of non-specific chronic low back pain patients needs to be established. This study therefore compared the effects of core stabilization and dynamic strengthening exercises on pain related disability and selected cardiopulmonary parameters in patients with non-specific chronic low back pain (NSCLBP).Methods: A total of 20 (44.55±10.78years) NSCLBP patients participated in this study. They were assigned into two different groups. Group A and B received core stabilization exercise and dynamic strengthening exercise respectively. Participants went through this protocol twice weekly for 4 consecutive weeks and were thereafter assessed for pain-related disability, and selected cardiopulmonary parameters.Results: The result of this study revealed that both exercises (core stabilization and dynamic) improved pain–related disability (p=0.011; p=0.004) and some cardiopulmonary parameters in peak expiratory flow rate (PEFR) (p= 0.001, P=0.034) and rate of perceived exertion (RPE) (P=0.001, P=0.001) Pulse rate (PR) (P=0.042, P=0.005).Conclusions: This study showed that both interventions (core stabilization and dynamic strengthening exercise) led to similar result in managing pain-related disability and selected cardiopulmonary parameters except in systolic blood pressure (SBP), Diastolic blood pressure (DBP) and peak expiratory flow rate (PEFR) in patients with NSCLBP when between groups comparison was done.
Keywords: Exercise, cardiopulmonary assessment, chronic low back pain, pilot study
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Lozano, Wilson M., Germán Parra, Oscar J. Arias-Mutis, and Manuel Zarzoso. "Exercise Training Protocols in Rabbits Applied in Cardiovascular Research." Animals 10, no. 8 (July 24, 2020): 1263. http://dx.doi.org/10.3390/ani10081263.
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Rabbit exercise protocols allow for the evaluation of physiological and biomechanical changes and responses to episodes of acute or chronic exercise. The observed physiological changes are normal responses to stress, that is, adaptive responses to maintain or restore homeostasis after acute exercise. Indeed, the rabbit model is advantageous since (a) it has important physiological similarities in terms of the functioning of multiple organ systems, and can quickly induce alterations in pathophysiological conditions that resemble those of humans, and (b) it allows the implementation of a low-cost model in comparison with other large animals. When designing an exercise training protocol for rabbits, it is important to consider variables such as race, gender, age and, especially, training parameters such as volume, intensity, or rest, among others, to determine the outcome of the research. Therefore, the objective of this review is to identify and analyze exercise training protocols in rabbits in different experimental applications and the various physiological adaptations that are presented, with special focus in cardiovascular adaptations.
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Malfliet, Anneleen, Jeroen Kregel, Mira Meeus, Barbara Cagnie, Nathalie Roussel, Mieke Dolphens, Lieven Danneels, and Jo Nijs. "Applying contemporary neuroscience in exercise interventions for chronic spinal pain: treatment protocol." Brazilian Journal of Physical Therapy 21, no. 5 (September 2017): 378–87. http://dx.doi.org/10.1016/j.bjpt.2017.06.019.
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Wallman, Karen E., and Paul Sacco. "Sense of Effort During a Fatiguing Exercise Protocol in Chronic Fatigue Syndrome." Research in Sports Medicine 15, no. 1 (March 2007): 47–59. http://dx.doi.org/10.1080/15438620601184331.
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Price, Jonathan, Alison Rushton, Vasileios Tyros, and Nicola R. Heneghan. "Consensus on the exercise and dosage variables of an exercise training programme for chronic non-specific neck pain: protocol for an international e-Delphi study." BMJ Open 10, no. 5 (May 2020): e037656. http://dx.doi.org/10.1136/bmjopen-2020-037656.
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IntroductionClinical guidelines and systematic reviews recommend exercise in the management of chronic non-specific neck pain. Although exercise training programmes that consist of both motor control exercise and exercises for the superficial cervical muscles (segmental exercises) are effective, the exercise variables including dosage vary considerably across trials or are poorly reported. This study aims to gain expert consensus on these exercise variables so that they can be described clearly using intervention reporting checklists to inform clinical practice and future clinical trials.Methods and analysisThis protocol for an international Delphi study is informed by the Guidance on Conducting and REporting DElphi Studies recommendations and published to ensure quality, rigour and transparency. The study will consist of three rounds using anonymous online questionnaires. Expert exercise professionals (physiotherapists, strength and conditioning coaches and so on) and academics in neck pain management will be identified through literature searches, peer referral and social media calls for expression of interest. In round 1, participants will answer open-ended questions informed by intervention and exercise reporting checklists. Responses will be analysed thematically by two independent reviewers. In round 2, participants will rate their level of agreement with statements generated from round 1 and previous clinical trials using a 5-point Likert scale where 1=strongly disagree and 5=strongly agree. In round 3, participants will re-rate their agreement with statements that achieved consensus in round 2. Statements reaching consensus among participants must meet progressively increased a priori criteria at rounds 2 and 3, measured using descriptive statistics: median, IQR and percentage agreement. Inferential statistics will be used to evaluate measures of agreement between participants (Kendall’s coefficient of concordance) and stability between rounds (Wilcoxon rank-sum test). Statements achieving consensus in round 3 will provide expert recommendations of the key exercise and dosage variables in the management of chronic non-specific neck pain.Ethics and disseminationEthical approval was provided by the University of Birmingham Ethics Committee (Ref:ERN_19–1857). Results will be disseminated through peer-reviewed publications and conference presentations.
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Oliveira, Fabiano Santana de, Mauro José De Deus Morais, Luiz Carlos De Abreu, Andrés Ricardo Pérez-Riera, Vitor E. Valenti, Laércio Da Silva Paiva, and Rodrigo Daminello Raimundo. "The effects of aerobic exercise on biochemical parameters in individuals with CKD on hemodialysis: A longitudinal study." Journal of Human Growth and Development 30, no. 2 (June 17, 2020): 251–59. http://dx.doi.org/10.7322/jhgd.v30.10374.
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Background: Chronic kidney disease is directly related to cardiovascular disorders. Guided physical exercises significantly improve the adverse effects of dialytic treatment.
Objective: To analyze changes in biochemical parameters of subjects with chronic kidney disease undergoing moderate exercise during hemodialysis.
Methods: This is an experimental study composed of 54 subjects submitted to hemodialysis, split into a control group and a group with intervention. The experimental group underwent three weekly sessions of aerobic exercise, performed during hemodialysis sessions, with a duration of 30 minutes, for 12 weeks. The blood parameters of both groups were compared.
Results: Statistically significant differences were observed between pre (p=0.001) and post-exercise protocol for urea (p=0.006), calcium (p=0.001), alanine aminotransferase (p=0.020) and sodium (p=<0.001). In the control group, we observed significant differences for the calcium variable (p<0.001), alanine aminotransferase (p=0.024), hematocrit (p=0.015), calcium vs phosphorus (p=0.018), and sodium (p=0.023), before and after the period.
Conclusion: Aerobic training during hemodialysis was able to maintain blood level stability in patients with chronic kidney disease, both during and at the end of the protocol, even considering increased blood flow. This trial is registered in the Brazilian registry of clinical Trials - number RBR-7354r6. Registration date: July 5, 2018 at 12:59 PM. Last Update: July 24, 2018 at 10:24 AM. Identification of the test - UTN Number: U1111-1216-8272.
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Farragher, Joshua Brodie, Adrian Pranata, Gavin Williams, Doa El-Ansary, Selina M. Parry, Jessica Kasza, and Adam Bryant. "Effects of lumbar extensor muscle strengthening and neuromuscular control retraining on disability in patients with chronic low back pain: a protocol for a randomised controlled trial." BMJ Open 9, no. 8 (August 2019): e028259. http://dx.doi.org/10.1136/bmjopen-2018-028259.
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IntroductionChronic low back pain (CLBP) is the leading cause of disability worldwide. However, there is no consensus in the literature regarding optimal management. Exercise intervention is the most widely used treatment as it likely influences contributing factors such as physical and psychological. Literature evaluating the effects of exercise on CLBP is often generalised, non-specific and employs inconsistent outcome measures. Moreover, the mechanisms behind exercise-related improvements are poorly understood. Recently, research has emerged identifying associations between neuromuscular-biomechanical impairments and CLBP-related disability. This information can be used as the basis for more specific and, potentially more efficacious exercise interventions for CLBP patients.Methods and analysisNinety-four participants (including both males and females) with CLBP aged 18–65 who present for treatment to a Melbourne-based private physiotherapy practice will be recruited and randomised into one of two treatment groups. Following baseline assessment, participants will be randomly allocated to receive either: (i) strengthening exercises in combination with lumbar force accuracy training exercises or (ii) strengthening exercises alone. Participants will attend exercise sessions twice a week for 12 weeks, with assessments conducted at baseline, midway (ie, 6 weeks into the trial) and at trial completion. All exercise interventions will be supervised by a qualified physiotherapist trained in the intervention protocol. The primary outcome will be functional disability measured using the Oswestry Disability Index. Other psychosocial and mechanistic parameters will also be measured.Ethics and disseminationThis study was given approval by the University of Melbourne Behavioural and Social Sciences Human Ethics Sub-Committee on 8 August 2017, reference number 1 749 845. Results of the randomised controlled trial will be published in peer-reviewed journals.Trial registration numberACTRN12618000894291.
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Ponde –Ponkshe, Ketki, Ronika Agrawal, and Shimaz Khan. "Comparative Study of Effect of Resistance Exercises versus Aerobic Exercises on Exercise Performance and Pulmonary Function in Adult Chronic Smokers." International Journal of Health Sciences and Research 11, no. 6 (June 22, 2021): 312–17. http://dx.doi.org/10.52403/ijhsr.20210646.
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Background: Cigarette smoking is the major cause of premature death. It accounts for 28% of all cardio vascular diseases and 40% of respiratory diseases as it is associated with impaired pulmonary function. Exercise is an effective and low cost of treatment which can promote good health of a smoker. Research indicates that individuals who maintain an exercise program are more likely to give up smoking than those who quit exercising. Methodology: 150 subjects were included in the study and divided into two groups Group A (resistance exercises) and Group B (Walking). The exercises protocol was given for six weeks. Pre post PEFR and VO2 max was calculated. Results: both the groups showed improvement post intervention (p<0.05) whereas resistance group showed better improvement than the walking group (p<0.05). Conclusion: Aerobic and Resistance exercises both showed significant improvement in PEFR and VO2 max in smokers, however the resistance exercises showed better improvement in the cardiovascular and pulmonary function. Key words: Smoking, Aerobic exercises, Resistance exercises, Theraband.
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Dragusin, Iulian B., and Craig A. Horswill. "Does Sport-Drink Use During Exercise Promote an Acute Positive Energy Balance?" International Journal of Sport Nutrition and Exercise Metabolism 26, no. 5 (October 2016): 428–34. http://dx.doi.org/10.1123/ijsnem.2015-0254.
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Sports drinks have been implicated in contributing to obesity and chronic diseases by providing surplus calories and excess sugars. Using existing literature we compared energy intake from sports drinks consumed during exercise with the exercise-induced calorie expenditure to determine whether sports drink use might eliminate the energy deficit and jeopardize conditions for improved metabolic fitness. We identified 11 published studies that compared sport drink consumption to placebo during exercise with a primary focused on the effect of sport drinks or total carbohydrate content on enhancing physical performance. Energy expenditure (EE) was calculated using VO2, RER, and exercise duration for the exercise protocol. Energy ingestion (EI) was determined using the carbohydrate dosing regimen administered before and during the exercise protocol. A two-tailed t test was used to test whether the energy balance (EI-EE) was different from zero (alpha level = 0.05). Sport drink consumption during aerobic exercise of sufficient duration (≥ 60 min) did not abolish the energy deficit (p < .001). Mean ± SD were EE, 1600 ± 639 Cal; EI, 394 ± 289 Cal; and EI-EE,-1206+594 Cal; VO2, 3.05 ± 0.55 L/min; RER, 0.91 ± 0.04; exercise duration 110 ± 42 min. Ingesting sports drinks to enhance performance did not abolish the caloric deficit of aerobic exercise. Sports drinks can be used in accordance with research protocols that typically provide 30–60 g of carbohydrate per hour when exercising at adequate durations for moderate to high intensity and still maintain a substantive caloric deficit.
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Kan, Shun-Li, Ling-Xiao Chen, Zhi-Fang Yuan, Wei Hu, and Ru-Sen Zhu. "Exercise interventions for ankylosing spondylitis: a protocol for a Bayesian network meta-analysis." BMJ Open 9, no. 6 (June 2019): e029991. http://dx.doi.org/10.1136/bmjopen-2019-029991.
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IntroductionAnkylosing spondylitis (AS) is a universal chronic inflammatory rheumatic disease which predominantly results in chronic back pain and stiffness. However, some patients suffering from AS do not react well to pharmacological interventions. Exercise intervention has been employed for the treatment of AS and works as a complementary part of the management of AS. However, the effect of different types of exercise interventions remains unclear. The purpose of this study is to determine the relative efficacy of different types of exercise interventions for individuals with AS using a Bayesian network meta-analysis.Methods and analysisWe will conduct a systematic literature review of randomised controlled trials that compare different types of exercise interventions for individuals with AS. PubMed, EMBASE and the Cochrane Library will be searched up to February 2019. The primary outcomes are functional capacity, pain and disease activity. The risk of bias for individual studies will be evaluated according to the Cochrane Handbook. A Bayesian network meta-analysis will be performed to compare the efficacy of different types of exercise interventions. The quality of evidence will be assessed by the Grading of Recommendations, Assessment, Development and Evaluation approach.Ethics and disseminationEthical approval and patient consent are not required as this study is a meta-analysis based on published studies. The results of this network meta-analysis will be submitted to a peer-reviewed journal for publication.PROSPERO registration numberCRD42019123099.
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Shephard, Roy J. "Qualified Fitness and Exercise as Professionals and Exercise Prescription: Evolution of the PAR-Q and Canadian Aerobic Fitness Test." Journal of Physical Activity and Health 12, no. 4 (April 2015): 454–61. http://dx.doi.org/10.1123/jpah.2013-0473.
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Background:Traditional approaches to exercise prescription have included a preliminary medical screening followed by exercise tests of varying sophistication. To maximize population involvement, qualified fitness and exercise professionals (QFEPs) have used a self-administered screening questionnaire (the Physical Activity Readiness Questionnaire, PAR-Q) and a simple measure of aerobic performance (the Canadian Aerobic Fitness Test, CAFT). However, problems have arisen in applying the original protocol to those with chronic disease. Recent developments have addressed these issues.Methods:Evolution of the PAR-Q and CAFT protocol is reviewed from their origins in 1974 to the current electronic decision tree model of exercise screening and prescription.Results:About a fifth of apparently healthy adults responded positively to the original PAR-Q instrument, thus requiring an often unwarranted referral to a physician. Minor changes of wording did not overcome this problem. However, a consensus process has now developed an electronic decision tree for stratification of exercise risk not only for healthy individuals, but also for those with various types of chronic disease.Conclusions:The new approach to clearance greatly reduces physician referrals and extends the role of QFEPs. The availability of effective screening and simple fitness testing should contribute to the goal of maximizing physical activity in the entire population.
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Gaudreault, Nathaly, and Pierre Boulay. "Cardiorespiratory fitness among adults with fibromyalgia." Breathe 14, no. 2 (June 2018): e25-e33. http://dx.doi.org/10.1183/20734735.019717.
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This review presents and addresses the conflicting results on cardiorespiratory fitness among adults with fibromyalgia. The heterogeneity in study designs, symptom severity and the assessment protocols might partly explain these conflicting results. It also presents the possible relationship between cardiorespiratory fitness and exercise prescription, attrition from exercise/rehabilitation programmes and independence with activities of daily living.Cardiorespiratory fitness might impact aerobic exercise and independence in daily activities of patients with fibromyalgia, which is often concomitantly diagnosed in patients with sleep disordered breathing, including patients with obstructive sleep apnoea. Therefore, cardiorespiratory fitness evaluation should be considered by general and respiratory physicians as well as physiotherapists who treat patients diagnosed with fibromyalgia for more accurate diagnosis, exercise prescription and monitoring of patients’ status.Key pointsAdults with fibromyalgia often present with reduced cardiorespiratory fitness.Reduced cardiorespiratory fitness might have an important impact on functional capacity and quality of life.Adults with fibromyalgia who have a secondary condition affecting their ventilatory anaerobic threshold and/or V′O2peak, for example chronic obstructive pulmonary disease, might present with a greater reduction of their cardiorespiratory fitness which may not be entirely related to their lung disease.Educational aimsTo better understand the cardiorespiratory fitness results among adults with fibromyalgia in general, and when taking into account differences in assessment protocol (maximal versus submaximal testing protocol; cycle ergometer versus treadmill testing protocol) and symptom severity (fibromyalgia severity level).To better understand how cardiorespiratory fitness among adults with fibromyalgia could: 1) assist in exercise prescription; 2) minimise dropout rates from exercise/rehabilitation programmes; and 3) promote independence with activities of daily living.To learn why fibromyalgia might be important to consider in adults who have concurrent fibromyalgia and lung disease.
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Boyne, Pierce, Colleen Meyrose, Jennifer Westover, Dustyn Whitesel, Kristal Hatter, Darcy S. Reisman, Daniel Carl, et al. "Effects of Exercise Intensity on Acute Circulating Molecular Responses Poststroke." Neurorehabilitation and Neural Repair 34, no. 3 (January 24, 2020): 222–34. http://dx.doi.org/10.1177/1545968319899915.
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Background. Exercise intensity can influence functional recovery after stroke, but the mechanisms remain poorly understood. Objective. In chronic stroke, an intensity-dependent increase in circulating brain-derived neurotrophic factor (BDNF) was previously found during vigorous exercise. Using the same serum samples, this study tested acute effects of exercise intensity on other circulating molecules related to neuroplasticity, including vascular-endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF1), and cortisol, with some updated analyses involving BDNF. Methods. Using a repeated-measures design, 16 participants with chronic stroke performed 3 exercise protocols in random order: treadmill high-intensity interval training (HIT-treadmill), seated-stepper HIT (HIT-stepper), and treadmill moderate-intensity continuous exercise (MCT-treadmill). Serum molecular changes were compared between protocols. Mediation and effect modification analyses were also performed. Results. VEGF significantly increased during HIT-treadmill, IGF1 increased during both HIT protocols and cortisol nonsignificantly decreased during each protocol. VEGF response was significantly greater for HIT-treadmill versus MCT-treadmill when controlling for baseline. Blood lactate positively mediated the effect of HIT on BDNF and cortisol. Peak treadmill speed positively mediated effects on BDNF and VEGF. Participants with comfortable gait speed ≥0.4 m/s had significantly lower VEGF and higher IGF1 responses, with a lower cortisol response during MCT-treadmill. Conclusions. BDNF and VEGF are promising serum molecules to include in future studies testing intensity-dependent mechanisms of exercise on neurologic recovery. Fast training speed and anaerobic intensity appear to be critical ingredients for eliciting these molecular responses. Serum molecular response differences between gait speed subgroups provide a possible biologic basis for previously observed differences in training responsiveness.
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ABU TALIP, NUR KHAIRUNISA, ZULKIFLI ABDUL KADIR, ZULKIFLI ISMAIL, SHAHREN AHMAD ZAIDI ADRUCE, and DAYANG SITI AISAH ABANG SUHAILI. "Blood Glucose Response to Unilateral and Bilateral Resistance Training Among Trained Women." Jurnal Sains Kesihatan Malaysia 19, no. 01 (January 25, 2021): 89–95. http://dx.doi.org/10.17576/jskm-2021-1901-10.
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Exercise selection is one of the crucial factors in designing a comprehensive training program. The exposure of different exercise selection may stimulate the specific adaptation imposed demand. In the construction of any resistance training (RT) program, it is important to choose whether to apply bilaterally (BI) or unilaterally (UNI) exercise. The present study aimed to look into the physiological responses of blood glucose (BG) between UNI and BI RT. The quantitative research method was used, RT (UNI versus BI training) as the independent variables whereas BG set as the dependent variable. In order to measure training effects following a single bout of different training intervention (UNI versus BI), a crossover experimental pre and post-test design were implemented. A total of sixteen (n = 16) trained women with a mean age of 23 (SD = 1.35) years old went through a single bout of RT involved a total body exercise using major muscles group with 80% of 1RM for each protocol (UNI and BI) for 10 repetitions to maximal effort (for 3 sets). Crossover design would be more accurate in exposing different training protocol to a similar characteristic of individuals as compared using different individuals. The results revealed that blood glucose (BG) was statistically changed (p < .001) across times, and finding shows there is no difference between training protocols (p = .39). Based on the results, it would be interesting to observe the blood glucose and/or energy metabolism between UNI versus BI RT during exercise as well as to investigate the relationship between BG and calories expenditure during exercises. Future research on UNI versus BI RT could venture onto other populations such as the untrained women, men population, elderly and specific population such as diabetic population in order to further understand the physiology of human body responded towards exercise. Other types of hormones analysis including insulin, growth hormone, and cortisol can be included. Besides, future research should consider a long run study that involves chronic adaptation of RT on the human body in order to prevent and alleviate disease.
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Cavalcante, Polyanna Gomes Lacerda, Abrahão Fontes Baptista, Vinícius Saura Cardoso, Marcelo de Carvalho Filgueiras, Renata Hydee Hasue, Silvia Maria Amado João, and Fuad Ahmad Hazime. "Transcranial Direct Current Stimulation Combined With Therapeutic Exercise in Chronic Low Back Pain: Protocol of a Randomized Controlled Trial." Physical Therapy 100, no. 9 (June 11, 2020): 1595–602. http://dx.doi.org/10.1093/ptj/pzaa105.
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Abstract Objective Although some studies have shown the clinical benefits of therapeutic exercise in chronic nonspecific low back pain, the effect sizes are generally small to moderate and recurrence rates are high. Transcranial direct current stimulation (tDCS) has been used to modulate pain-processing systems and motor outputs and has the potential to optimize the clinical benefits of therapeutic exercise. However, evidence for this combination is still lacking. The purpose of this protocol for a randomized clinical trial is to investigate whether the combination of tDCS and therapeutic exercise is more effective in relieving pain than therapeutic exercise alone. Methods This 2-arm, randomized controlled clinical trial will take place at the Federal University of Piauí, Brazil. Sixty patients will be randomized into 2 groups to receive tDCS (real/sham) + exercise therapies for 12 sessions over a period of 4 weeks. Pain intensity, sensory and affective aspects of pain, physical functioning, kinesiophobia, and global perceived effect will be recorded before treatment and at 4 weeks, 3 months, and 6 months after randomization. Data will be collected by an examiner unaware of (blind to) the treatment allocation. Impact This trial can potentially provide important information and assist in clinical decision-making on the combined use of tDCS to optimize the clinical benefits of therapeutic exercise in patients with chronic nonspecific low back pain.
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Castellino, P., D. C. Simonson, and R. A. DeFronzo. "Adrenergic modulation of potassium metabolism during exercise in normal and diabetic humans." American Journal of Physiology-Endocrinology and Metabolism 252, no. 1 (January 1, 1987): E68—E76. http://dx.doi.org/10.1152/ajpendo.1987.252.1.e68.
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The effect of acute and chronic beta- and alpha-adrenergic blockade on potassium homeostasis during moderate intensity exercise (40% VO2max) was investigated in control and insulin-dependent diabetic subjects. In protocol I, subjects were studied during exercise alone, exercise plus intravenous propranolol, and exercise plus intravenous phentolamine. In both the control and diabetic groups, exercise alone produced a modest increase in the plasma potassium concentration (0.31 +/- 0.06 meq/l), while propranolol exacerbated this hyperkalemic response. In contrast, the increment in plasma potassium during phentolamine was similar to exercise alone in normals but was 26% (P less than 0.05) lower in the diabetic group. In protocol II, the effect of chronic (5 days) beta-adrenergic blockade on potassium homeostasis was examined. Subjects participated in three studies: exercise alone, exercise plus propranolol (beta 1/beta 2-antagonist), and exercise plus metoprolol (beta 1 antagonist). In the nondiabetic group, both propranolol and metoprolol were associated with a 40% greater increase in potassium compared with exercise alone. In the diabetic group, propranolol, but not metoprolol, was associated with a deterioration in potassium tolerance. In no study could the alterations in potassium homeostasis be explained by a change in urinary potassium excretion. In summary, alpha-adrenergic blockade ameliorates exercise-induced hyperkalemia in diabetic but not in control subjects, nonspecific beta-adrenergic blockade causes a greater increment in potassium when compared with exercise alone, and specific beta 1-adrenergic blockade exacerbates exercise-induced hyperkalemia in control, but not in diabetic subjects. These results indicate that both alpha- and beta-adrenergic regulation of extrarenal potassium metabolism is altered in insulin-dependent diabetes mellitus.
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Ruigrok, Dieuwertje, Lilian J. Meijboom, Esther J. Nossent, Anco Boonstra, Natalia J. Braams, Jessie van Wezenbeek, Frances S. de Man, et al. "Persistent exercise intolerance after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension." European Respiratory Journal 55, no. 6 (May 4, 2020): 2000109. http://dx.doi.org/10.1183/13993003.00109-2020.
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AimHaemodynamic normalisation is the ultimate goal of pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH). However, whether normalisation of haemodynamics translates into normalisation of exercise capacity is unknown. The incidence, determinants and clinical implications of exercise intolerance after PEA are unknown. We performed a prospective analysis to determine the incidence of exercise intolerance after PEA, assess the relationship between exercise capacity and (resting) haemodynamics and search for preoperative predictors of exercise intolerance after PEA.MethodsAccording to clinical protocol all patients underwent cardiopulmonary exercise testing (CPET), right heart catheterisation and cardiac magnetic resonance (CMR) imaging before and 6 months after PEA. Exercise intolerance was defined as a peak oxygen consumption (V′O2) <80% predicted. CPET parameters were judged to determine the cause of exercise limitation. Relationships were analysed between exercise intolerance and resting haemodynamics and CMR-derived right ventricular function. Potential preoperative predictors of exercise intolerance were analysed using logistic regression analysis.Results68 patients were included in the final analysis. 45 (66%) patients had exercise intolerance 6 months after PEA; in 20 patients this was primarily caused by a cardiovascular limitation. The incidence of residual pulmonary hypertension was significantly higher in patients with persistent exercise intolerance (p=0.001). However, 27 out of 45 patients with persistent exercise intolerance had no residual pulmonary hypertension. In the multivariate analysis, preoperative transfer factor of the lung for carbon monoxide (TLCO) was the only predictor of exercise intolerance after PEA.ConclusionsThe majority of CTEPH patients have exercise intolerance after PEA, often despite normalisation of resting haemodynamics. Not all exercise intolerance after PEA is explained by the presence of residual pulmonary hypertension, and lower preoperative TLCO was a strong predictor of exercise intolerance 6 months after PEA.
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Khakroo Abkenar, Iman, Farhad Rahmani-nia, and Giovanni Lombardi. "The Effects of Acute and Chronic Aerobic Activity on the Signaling Pathway of the Inflammasome NLRP3 Complex in Young Men." Medicina 55, no. 4 (April 15, 2019): 105. http://dx.doi.org/10.3390/medicina55040105.
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Background and Objectives: The results of the studies show that the intensity and volume of aerobic exercise activity produce different responses of the immune system. This study aims to show how the signaling pathway of the inflammatory NLRP3 complex is influenced by the acute and chronic effects of moderate and high-intensity aerobic exercises in young men. Materials and Methods: Accordingly, 60 healthy (BMI = 23.56 ± 2.67) young (24.4 ± 0.4) students volunteered to participate in the study that was randomly divided into two experimental (n = 20) groups and one control (n = 20) group. The training protocol started with two intensity levels of 50% for a moderate group and 70% of maximum heart rate for high group for 30 min and then continued until reaching 70% (moderate group) and 90% (high group) of the maximum heart rate, respectively. Using Real Time-PCR method, the expression of NLRP3 gene and ELISA- were measured by IL-1β, IL-18. Results: The results showed that acute aerobic exercise with moderate intensity had no significant effect on the expression of NLRP3 gene and serum levels of IL-1β and IL-18 cytokines (p > 0.05) when acute exercise, with high intensity, begins an initiation of the activity of the inflammatory complex with elevated serum levels of IL-1β, IL-18, and NLRP3 gene expression (p < 0.05). In addition, chronic exercise with moderate intensity significantly reduced the expression of NLRP3 gene and serum levels of IL-1β, IL-18 cytokines (p < 0.05). In the case of chronic exercise with high intensity, a significant increase in expression of gene, NLRP3 and serum levels of IL-1β, IL-18 cytokines were observed (p < 0.05). Conclusions: Generally, it can be concluded that chronic exercise with moderate intensity is effective in decreasing the expression of the inflammasome and inflammation.
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Zuk, Emma F., Gyujin Kim, Jacqueline Rodriguez, Brandon Hallaway, Amanda Kuczo, Shayna Deluca, Kirsten Allen, Neal R. Glaviano, and Lindsay J. DiStefano. "The Utilization of Core Exercises in Patients With Patellofemoral Pain: A Critically Appraised Topic." Journal of Sport Rehabilitation 30, no. 7 (September 1, 2021): 1094–97. http://dx.doi.org/10.1123/jsr.2020-0350.
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Clinical Scenario: Patellofemoral pain (PFP) is characterized by general anterior knee pain around the patella and is one of the most prevalent knee conditions. PFP is challenging to treat due to a wide range of contributing factors and often has chronic, reoccurring symptoms. Traditional treatment focuses on quadriceps and gluteal strengthening with minimal emphasis on deep trunk musculature. Recently, there has been a growing body of literature supporting the beneficial effects of core stability exercises as a treatment option for PFP. Clinical Question: Are core stability exercises coupled with traditional rehabilitation more effective than only traditional rehabilitation techniques for decreasing pain in patients with PFP? Summary of Key Findings: Three articles met the inclusion criteria and investigated core strengthening exercises as a treatment for PFP. Two studies investigated a 4-week exercise protocol and demonstrated a greater decrease in pain when compared to the control group. The third study examined the effects of a 6-week program where both the intervention and control groups resulted in similar reduction of pain. All articles included received a minimum of 6 on the PEDro scale. Clinical Bottom Line: There is evidence that supports core stability exercise protocols coupled with traditional rehabilitation as being more effective in reducing pain in patients with PFP when compared to traditional rehabilitation alone. Strength of Recommendation: The grade of A is recommended based on the Strength of Recommendation Taxonomy.
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Chalari, Methenitis, Arnaoutis, Stergiou, Kampouropoulou, Karampelas, Prousinoudi, Argyropoulou, and Nomikos. "Different Kinetics of Oxidative Stress and Inflammatory Markers after Eccentric Exercise in Upper and Lower Limbs." Proceedings 25, no. 1 (September 2, 2019): 17. http://dx.doi.org/10.3390/proceedings2019025017.
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AIM: Subclinical, low-grade, inflammation is one of the main pathophysiological mechanisms underlying the majority of chronic diseases. Ιt is therefore obvious that an inflammatory model, inducing inflammatory responses to humans in a regulated, specific, and non-harmful way, could greatly facilitate the assessment of redox and immune status. Exercise-induced muscle damage (EIMD) could serve as such a model; however, the kinetics of biomarkers may be substantially different according to the muscle groups examined. Therefore, the aim of this study was to assess the responses of selected inflammatory and redox biomarkers after eccentric-induced muscle damage in upper and lower limbs. MATERIAL & METHOD: Ten healthy, sedentary volunteers (5 males) performed, in a randomized and cross-over fashion, two discrete exercise protocols in lower (10 sets × 10 drop jumps from a height of 40 cm) and upper extremities (8 sets × 10 eccentric muscle contractions of the biceps at 90% of 1RM) separated by 6 weeks. Venous blood samples were collected pre-, immediately post-, 2, 24 and 48 h after the exercise protocols. Body composition was evaluated with dual-energy X-ray absorptiometry, blood cell count analysis by an automated hematology analyzer, CK, CRP and IL-6 by commercially available kits, while serum glutathione peroxidase (GPX3) by enzymatic assays adapted for microwell plates. RESULTS: A different pattern of response (time x protocol p < 0.05) was observed for CK, IL-6 and CRP, with lower limbs reaching the highest increases at 2 h post-exercise, while upper limbs at 24 and 48 h. A similar response between the two protocols was observed for WBC and neutrophils, with a transient 30% increase at 2 h (time p < 0.05). No effect of time or protocol was observed for GPX3. CONCLUSIONS: Kinetics of selected inflammatory and redox biomarkers follow different patterns depending on the muscle group tested. Thus, depending on the targeted muscle group, blood samples should be obtained at specific time points. The higher levels of CK, IL-6 and CRP at 24–48 h implies an augmented inflammatory response at upper limbs, probably due to a lower adaptation to eccentric exercise, indicating that EIMD of upper limbs is a better protocol for the assessment of the inflammatory status in humans.
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Pinto, Ana P., Alisson L. da Rocha, Eike B. Kohama, Rafael C. Gaspar, Fernando M. Simabuco, Fabiani G. Frantz, Leandro P. de Moura, et al. "Exhaustive acute exercise-induced ER stress is attenuated in IL-6-knockout mice." Journal of Endocrinology 240, no. 2 (February 2019): 181–93. http://dx.doi.org/10.1530/joe-18-0404.
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The endoplasmic reticulum (ER) stress and inflammation relationship occurs at different levels and is essential for the adequate homeostatic function of cellular systems, becoming harmful when chronically engaged. Intense physical exercise enhances serum levels of interleukin 6 (IL-6). In response to a chronic exhaustive physical exercise protocol, our research group verified an increase of the IL-6 concentration and ER stress proteins in extensor digitorium longus (EDL) and soleus. Based on these results, we hypothesized that IL-6-knockout mice would demonstrate a lower modulation in the ER stress proteins compared to the wild-type mice. To clarify the relationship between exercise-induced IL-6 increased and ER stress, we studied the effects of an acute exhaustive physical exercise protocol on the levels of ER stress proteins in the skeletal muscles of IL-6-knockout (KO) mice. The WT group displayed a higher exhaustion time compared to the IL-6 KO group. After 1 h of the acute exercise protocol, the serum levels of IL-6 and IL-10 were enhanced in the WT group. Independent of the experimental group, the CHOP and cleaved caspase 12/total caspase 12 ratio in EDL as well as ATF6 and CHOP in soleus were sensitive to the acute exercise protocol. Compared to the WT group, the oscillation patterns over time of BiP in EDL and soleus as well as of peIF2-alpha/eIF2-alpha ratio in soleus were attenuated for the IL-6 KO group. In conclusion, IL-6 seems to be related with the ER stress homeostasis, once knockout mice presented attenuation of BiP in EDL and soleus as well as of pEiF2-alpha/EiF2-alpha ratio in soleus after the acute exhaustive physical exercise protocol.
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Loizidis, T., A. Sioga, L. Economou, A. Frosinis, A. Kyparos, A. Zotou, and M. Albani. "The role of ascorbic acid and exercise in chronic ischemia of skeletal muscle in rats." Journal of Applied Physiology 102, no. 1 (January 2007): 321–30. http://dx.doi.org/10.1152/japplphysiol.00251.2005.
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This study was designed to investigate the effects of peripheral arterial insufficiency, exercise, and vitamin C administration on muscle performance, cross-sectional area, and ultrastructural morphology in extensor digitorum longus (EDL) and soleus (Sol) muscles in rats. Adult Wistar rats were assigned to ischemia alone (isch), ischemia-exercised (exe), ischemia-vitamin C (vit C), and ischemia-exercise-vitamin C (vit C + exe) groups. Ischemia was achieved via unilateral ligation of the right common iliac artery. Contralateral muscles within the same animal served as controls. Exercise protocol consisted of 50-min intermittent level running performed every other day for 5 days. Vitamin C (100 mg/kg body wt) was administered intraperitoneally on a daily basis throughout the 14 days of the experiment. With regard to the EDL muscle, ischemia alone reduced muscle strength, which was not recovered after vitamin C administration. Exercise alone following ischemia induced the most severe structural damage and cross-sectional area decrease in the muscle, yet the reduction in tetanic tension was not significant. Exercise in conjunction with vitamin C administration preserved ischemia-induced EDL muscle tetanic tension. In the Sol muscle, a significant reduction in single twitch tension after vitamin C administration was found, whereas the tetanic force of the ischemic Sol was not significantly decreased compared with the contralateral muscles in any group. Ischemic Sol muscle cross-sectional area was reduced in all but the exe groups. In Sol, muscle strength was reduced in the vit C group, and mean cross-sectional area of ischemic Sol muscles was reduced in all groups except the exe group. These results illustrate that mild exercise, combined with a low dose of vitamin C supplementation, may have beneficial effects on ischemic EDL muscle with a smaller effect on the Sol muscle.
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Chakraborty, Manoj Kumar, Pratendra Raj Onta, and Brijesh Sathian. "Efficacy of Stretching Exercises in the Treatment of Chronic Plantar Fasciitis: A Prospective Study in Manipal Teaching Hospital, Pokhara, Nepal." Asian Journal of Medical Sciences 2, no. 2 (September 17, 2011): 97–101. http://dx.doi.org/10.3126/ajms.v2i2.4218.
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Objective: Chronic plantar fasciitis developed in ten percent of cases with poor response. Specific plantar stretching exercises alone improves the patient with better outcome. It is self limited process with resolution of symptoms within one year but five percent cases may require surgical intervention in intractable cases. The purpose of this study was to evaluate the long term outcomes of the plantar fascia specific stretching exercise only for chronic plantar fasciitis. Material & Methods: 50 patients with chronic plantar fasciitis for more than three month duration were enrolled in our study for post treatment follow up with effect from Jan 2010 to Jan 2011 in Department of Orthopedics of Manipal College of Medical Sciences. All patients received plantar specific stretching exercise protocol for twelve months interval of one week, three week, two months, six months and twelve months. Results: Out of 50 patients, 36(72%) were female and 14 (28%) were male. 36(72%) were left sided and 14 (28%) were right. Mean age of patients were 46.12±SD7.11 years. The pre treatment mean visual analogue scale score for all patients is significantly higher than every follow up (p=0.0001). Conclusion: This stretching of the plantar fascia is a modification of the traditional stretch weight bearing to tissue specific plantar fascia stretching protocol to optimize tissue tension through a controlled stretch of plantar fascia by recreation of windlass mechanism with high rate of satisfaction in regards to decrease of pain and functional limitations. Key Words: Chronic plantar fasciitis; stretching; windlass mechanism DOI: http://dx.doi.org/10.3126/ajms.v2i2.4218 Asian Journal of Medical Sciences 2 (2011) 97-101
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Post, Andrew A., Ebonie K. Rio, Kathleen A. Sluka, G. Lorimer Moseley, Emine O. Bayman, Mederic M. Hall, Cesar de Cesar Netto, Jason M. Wilken, Jessica F. Danielson, and Ruth Chimenti. "Effect of Pain Education and Exercise on Pain and Function in Chronic Achilles Tendinopathy: Protocol for a Double-Blind, Placebo-Controlled Randomized Trial." JMIR Research Protocols 9, no. 11 (November 3, 2020): e19111. http://dx.doi.org/10.2196/19111.
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Background Achilles tendinopathy (AT) rehabilitation traditionally includes progressive tendon loading exercises. Recent evidence suggests a biopsychosocial approach that incorporates patient education on psychosocial factors and mechanisms of pain can reduce pain and disability in individuals with chronic pain. This is yet to be examined in individuals with AT. Objective This study aims to compare the effects on movement-evoked pain and self-reported function of pain education as part of a biopsychosocial approach with pathoanatomical education for people with AT when combined with a progressive tendon loading exercise program. Methods A single-site, randomized, double-blind, placebo-controlled clinical trial will be conducted in a university-based hospital in a laboratory setting and/or by telehealth. A total of 66 participants with chronic (>3 months) midportion or insertional AT will be randomized for the Tendinopathy Education of the Achilles (TEAch) study. All participants will complete progressive Achilles tendon loading exercises over 12 weeks and will be encouraged to continue with self-selected exercises as tolerated. All participants will complete 6-7 one-to-one sessions with a physical therapist to progress exercises in a standardized manner over 8 weeks. During the last 4 weeks of the intervention, participants will be encouraged to maintain their home exercise program. Participants will be randomized to 1 of 2 types of education (pain education or pathoanatomic), in addition to exercise. Pain education will focus on the biological and psychological mechanisms of pain within a biopsychosocial framing of AT. Pathoanatomic education will focus on biological processes within a more traditional biomedical framework of AT. Evaluation sessions will be completed at baseline and 8-week follow-up, and self-reported outcome measures will be completed at the 12-week follow-up. Both groups will complete progressive Achilles loading exercises in 4 phases throughout the 12 weeks and will be encouraged to continue with self-selected exercises as tolerated. Primary outcomes are movement-evoked pain during heel raises and self-reported function (patient-reported outcome measure information system—Physical Function). Secondary outcomes assess central nervous system nociceptive processing, psychological factors, motor function, and feasibility. Results Institutional review board approval was obtained on April 15, 2019, and study funding began in July 2019. As of March 2020, we randomized 23 out of 66 participants. In September 2020, we screened 267 individuals, consented 68 participants, and randomized 51 participants. We anticipate completing the primary data analysis by March 2022. Conclusions The TEAch study will evaluate the utility of pain education for those with AT and the effects of improved patient knowledge on pain, physical function, and clinical outcomes. International Registered Report Identifier (IRRID) DERR1-10.2196/19111
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Gottschall, Jinger S., Joshua J. Davis, Bryce Hastings, and Heather J. Porter. "Exercise Time and Intensity: How Much Is Too Much?" International Journal of Sports Physiology and Performance 15, no. 6 (July 1, 2020): 808–15. http://dx.doi.org/10.1123/ijspp.2019-0208.
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The growing prevalence and popularity of interval training necessitate additional guidelines in regard to maximal levels of time and intensity. Purpose: To correlate salivary hormones and time in varying heart-rate (HR) zones. The hypothesis was that chronic exercise durations >9% of total exercise time in the >90% maximum HR zone would lead to decreased variation in salivary cortisol concentration after exercise in a 2-bout high-intensity protocol compared with less or more time in this zone. Methods: A total of 35 healthy adults who regularly exercised for an average of 8 hours per week recorded their HR during every training session for 3 weeks. Later, they completed an experimental day composed of two 30-minute high-intensity interval sessions separated by 4 hours of nonactive recovery. The authors collected saliva samples before, immediately following, and 30 minutes after each exercise session to assess changes in cortisol concentrations. Results: There was a correlation between weekly time training at an intensity >90% maximum HR and the variables associated with overtraining. Salivary cortisol concentration fluctuated less in the participants who exercised in this extreme zone for >40 minutes per week (P < .001). Conclusion: Based on the current study data, for individuals who regularly exercise, 4% to 9% total training time above 90% maximum HR is the ideal duration to maximize fitness and minimize symptoms related to overreaching.
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Billinger, Sandra A., Benjamin Y. Tseng, and Patricia M. Kluding. "Modified Total-Body Recumbent Stepper Exercise Test for Assessing Peak Oxygen Consumption in People With Chronic Stroke." Physical Therapy 88, no. 10 (October 1, 2008): 1188–95. http://dx.doi.org/10.2522/ptj.20080072.
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Background Assessment of peak oxygen consumption (V̇o2peak) using traditional modes of testing such as treadmill or cycle ergometer can be difficult in individuals with stroke due to balance deficits, gait impairments, or decreased coordination. Objective The purpose of this study was to quantitatively assess the validity and feasibility of a modified exercise test using a total-body recumbent stepper (mTBRS-XT) in individuals after stroke. Design A within-subject design, with a sample of convenience, was used. Participants Eleven participants (7 male, 4 female) with a mean of 40.1 months (SD=32.7) after stroke, a mean age of 60.9 years (SD=12.0), and mild to severe lower-extremity Fugl-Myer test scores (range=13–34) completed the study. Methods Participants performed 2 maximal-effort graded exercise tests on separate days using the mTBRS-XT and a cycle ergometer exercise protocol to assess cardiorespiratory fitness. Measurements of V̇o2peak and peak heart rate (peak HR) were obtained during both tests. Results A strong relationship existed between the mTBRS-XT and the cycle ergometer exercise test for V̇o2peak and peak HR (r=.91 and .89, respectively). Mean V̇o2peak was significantly higher for the mTBRS-XT (16.6 mL×kg−1×min−1[SD=4.5]) compared with the cycle ergometer exercise protocol (15.4 mL×kg−1×min−1 [SD=4.5]). All participants performed the mTBRS-XT. One individual with severe stroke was unable to pedal the cycle ergometer. No significant adverse events occurred. Conclusion The mTBRS-XT may be a safe, feasible, and valid exercise test to obtain measurements of V̇o2peak in people with stroke. Health care professionals may use the mTBRS-XT to prescribe aerobic exercise based on V̇o2peak values for individuals with mild to severe deficits after stroke.
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Paineiras-Domingos, Laisa Liane, Danúbia da Cunha Sá-Caputo, Arlete Francisca-Santos, Aline Reis-Silva, Rafaelle Pacheco Carvalho-Lima, Mario Fritsch T. Neves, Vinicius Layter Xavier, et al. "Can whole body vibration exercises promote improvement on quality of life and on chronic pain level of metabolic syndrome patients? A pseudorandomized crossover study." Journal of Applied Physiology 128, no. 4 (April 1, 2020): 934–40. http://dx.doi.org/10.1152/japplphysiol.00068.2019.
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Quality of life (QoL) is one of the most important health outcome concepts expressed subjectively. Chronic pain (CP) is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Taking into account the poor QoL and the CP already described in metabolic syndrome (MSy) individuals, this study aimed to evaluate the effects of whole body vibration exercises (WBVE) on these parameters in this population. Thirty-three MSy patients were divided in subgroups A [whole body vibration exercise group (WBVeG), n = 17, 15 females/2 males, 61.1 ± 8.4 yr] and B (control group, n = 16, 14 females/2 males, 58.2 ± 9.1 yr). Subgroup A performed 10 sessions (2 times/wk) of WBVE (18 min/session, with a frequency from 5 up to 14 Hz and a peak-to-peak displacement of 2.5, 5.0, and 7.5 mm) on a side-alternating vibrating platform (VP). Subgroup B did the same protocol, but the VP was turned off. The individuals answered the World Health Organization Quality of Life bref (WHOQoL-bref) questionnaire before the first and after the 10th session. The chronic pain level (CPL) was measured by a numeric rating scale (0–10) before and at the end of each session. Significant improvements were found in physical health ( P = 0.05) and psychological health ( P = 0.04) domains of WHOQoL-bref in WBVeG. A significant acute reduction of the CPL was found in the WBVeG after the protocol, considering the first session and at the last session. WBVE marginally improved physical health and psychological health and decrease the CPL in acute interventions. NEW & NOTEWORTHY Metabolic syndrome patients experience poor quality of life, frequently associated with lack of exercise and bad dietary habits. Additionally, factors such as obesity, neuromusculoskeletal impairment, and peripheral endothelial dysfunction result in a chronic pain level. Whole body vibration exercise might represent a suitable physical therapy, since it is easy to perform, low cost, safe, and capable of promoting an improvement of quality of life and reducing chronic pain level during acute interventions in metabolic syndrome individuals.
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Loprinzi, Paul D., Emily Frith, Meghan K. Edwards, Eveleen Sng, and Nicole Ashpole. "The Effects of Exercise on Memory Function Among Young to Middle-Aged Adults: Systematic Review and Recommendations for Future Research." American Journal of Health Promotion 32, no. 3 (November 6, 2017): 691–704. http://dx.doi.org/10.1177/0890117117737409.
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Objective: To systematically summarize the experimental effects of exercise on cognitive-related memory function among young to middle-aged adults, which has yet to be done in the literature. Data Source: PubMed. Study Inclusion and Exclusion Criteria: Studies were included if they were published in the English language, indexed in PubMed, employed an experimental study design (eg, traditional parallel group randomized controlled trial: either acute intervention or chronic/training intervention study), and conducted among human adults. Studies were excluded if nonhumans (ie, animal models) were studied, if children/adolescents (<18 years) or older adults (>50 years) were evaluated, and if select chronic diseases (eg, diabetes and dementia) were present. Data Extraction: A systematic review approach was employed. Data Synthesis: An extraction table was created synthesizing the key results, and recommendations for future research are emphasized. Results: Among the 17 evaluated studies, 2 were published before the year 2000 (ie, 1998 and 1999), 2 were published in 2007, and the remaining 13 were published in the years 2011 and beyond. This highlights the emergence of this research topic within this age-group (young to middle-aged adults). Among the 17 evaluated studies, 14 were conducted among healthy samples, with 3 conducted among those with a diagnosis of depression. Among the 17 studies, 4 employed a chronic training protocol, with 13 utilizing an acute exercise protocol. Among the 3 experimental studies in the depressed population, all demonstrated a favorable effect of exercise on memory function. Among the 14 trials in the nondepressed population, 10 (71%) demonstrated a favorable effect of exercise on some aspect of memory function. Conclusion: Acute and chronic exercise appears to play a pronounced effect on memory function among young to middle-aged adults. Implications and recommendations for future research are outlined in this systematic review.
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Xu, Jianglin, Zhuo Zhang, Jing Liu, Yan Li, Jie Wan, Ruli Feng, Jialin Jin, et al. "Effect of traditional Asian exercise on patients with chronic heart failure: a protocol for network meta-analysis of randomised controlled trials." BMJ Open 11, no. 8 (August 2021): e048891. http://dx.doi.org/10.1136/bmjopen-2021-048891.
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IntroductionChronic heart failure (CHF) is a common disease worldwide, and imposes a substantial burden to the healthcare system. In CHF, limited exercise capacity and affected mental well-being leads to a reduced quality of life (QOL). How to improve the QOL and exercise endurance is critical for patients with CHF. Exercise therapy, such as some traditional Asian exercises (TAEs) including Taichi, Baduanjin and Yoga, plays an important role in the rehabilitation of patients with CHF. TAE is suitable for the rehabilitation of patients with CHF because of its soft movements and can relax the body and mind. Studies have shown that TAE can regulate the overall health status of the body and exercise tolerance, improve QOL and reduce rehospitalisation rate in patients with CHF. However, the difference in efficacy of TAE in patients with CHF is not yet clear. The main purpose of this study is to conduct a network meta-analysis (NMA) of randomised trials to determine the impact of TAE on patients with CHF of different types, different causes and different New York Heart Association (NYHA) heart function classifications and to provide references for different types of patients with CHF to choose appropriate exercise rehabilitation therapy.Methods and analysisThe literature search will be retrieved from PubMed, the Cochrane Library, Embase, Web of Science, Chinese National Knowledge Infrastructure, Wanfang database, Chinese biomedical literature service system (SinoMed) and Chinese Scientific Journals Database (VIP) from the date of their inception until 1 August 2021. All randomised controlled trials that evaluated the effects of three different TAE therapies (Taichi, Baduanjin and Yoga) on patients with CHF will be included. The primary outcomes are peak oxygen uptake (peak VO2), exercise capacity (6-min walking distance) and QOL tested with the Minnesota Living with Heart Failure Questionnaire. Secondary outcomes include the levels of N-terminal pro brain natriuretic peptide, left ventricular ejection fraction, systolic blood pressure and diastolic blood pressure. For included articles, two reviewers will independently extract the data, and Cochrane Collaboration’s tool will be used to assess risk of bias. We will perform the Bayesian NMA to pool all treatment effects. The ranking probabilities for the optimal intervention of various treatments (Taichi, Baduanjin or Yoga) will be estimated by the mean ranks and surface under the cumulative ranking curve. Subgroup analysis for different types, different causes and different NYHA heart function classifications of CHF will be performed. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence contributing to each network estimate.Ethics and disseminationThe results will be disseminated through peer-reviewed publications. They will provide useful information to inform clinicians on the potential functions of TAE in CHF, and to provide consolidated evidence for clinical practice and further research of TAE.PROSPERO registration numberCRD42020179304.
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Page, Stephen J., Peter Levine, Anthony Leonard, Jerzy P. Szaflarski, and Brett M. Kissela. "Modified Constraint-Induced Therapy in Chronic Stroke: Results of a Single-Blinded Randomized Controlled Trial." Physical Therapy 88, no. 3 (March 1, 2008): 333–40. http://dx.doi.org/10.2522/ptj.20060029.
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Background and Purpose This single-blinded randomized controlled trial compared the efficacy of a reimbursable, outpatient, modified constraint-induced therapy (mCIT) protocol (half-hour therapy sessions occurring 3 days per week in which subjects used the more affected arm combined with less affected arm restriction 5 days per week for 5 hours; both of these regimens were administered during a 10-week period) with that of a time-matched exercise program for the more affected arm or a no-treatment control regimen. Subjects Thirty-five subjects with chronic stroke participated in the study. Methods The Action Research Arm Test (ARAT), Fugl-Meyer Assessment of Motor Recovery After Stroke (FM), and Motor Activity Log (MAL) were administered to the subjects. Results After intervention, significant differences were observed on the ARAT and MAL Amount of Use and Quality of Movement scales, all in favor of the mCIT group. Discussion and Conclusion The data affirm previous findings suggesting that this reimbursable, outpatient protocol increases more affected arm use and function. Magnitude of changes was consistent with those reported in more intense protocols, such as constraint-induced therapy.
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Macedo, Luciana G., Paul W. Hodges, Geoff Bostick, Mark Hancock, Maude Laberge, Steven Hanna, Greg Spadoni, Anita Gross, and Julia Schneider. "Which Exercise for Low Back Pain? (WELBack) trial predicting response to exercise treatments for patients with low back pain: a validation randomised controlled trial protocol." BMJ Open 11, no. 1 (January 2021): e042792. http://dx.doi.org/10.1136/bmjopen-2020-042792.
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IntroductionExercise therapy is the most recommended treatment for chronic low back pain (LBP). Effect sizes for exercises are usually small to moderate and could be due to the heterogeneity of people presenting with LBP. Thus, if patients could be better matched to exercise based on individual factors, then the effects of treatment could be greater. A recently published study provided evidence of better outcomes when patients are matched to the appropriate exercise type. The study demonstrated that a 15-item questionnaire, the Lumbar Spine Instability Questionnaire (LSIQ), could identify patients who responded best to one of the two exercise approaches for LBP (motor control and graded activity). The primary aim of the current study isill be to evaluate whether preidentified baseline characteristics, including the LSIQ, can modify the response to two of the most common exercise therapies for non-specific LBP. Secondary aims include an economic evaluations with a cost-effectiveness analysis.Methods and analysisParticipants (n=414) will be recruited by primary care professionals and randomised (1:1) to receive motor control exercises or graded activity. Participants will undergo 12 sessions of exercise therapy over an 8-week period. The primary outcome will be physical function at 2 months using the Oswestry Disability Index. Secondary outcomes will be pain intensity, function and quality of life measured at 2, 6 and 12 months. Potential effect modifiers will be the LSIQ, self-efficacy, coping strategies, kinesiophobia and measures of nociceptive pain and central sensitisation. We will construct linear mixed models with terms for participants (fixed), treatment group, predictor (potential effect modifier), treatment group×predictor (potential effect modifier), physiotherapists, treatment group×physiotherapists and baseline score for the dependent variable.Ethics and disseminationThis study received ethics approval from the Hamilton Integrate Research Ethics Board. Results will be submitted for publication in peer-reviewed journals.Trial registration numberNCT04283409.
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Malfliet, Anneleen. "Cerebral Blood Flow and Heart Rate Variability in Chronic Fatigue Syndrome: A Randomized Cross-Over Study." January 2018 1, no. 21;1 (January 15, 2018): E13—E24. http://dx.doi.org/10.36076/ppj.2018.1.e13.
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Background: Pain, fatigue, and concentration difficulties are typical features of chronic fatigue syndrome (CFS). The exact underlying mechanisms of these symptoms are still unknown, but available evidence suggests an important role for impaired pain modulation. As evidence also suggests that pain modulation is related to cardiovascular mechanisms, it seems logical to investigate whether cerebral blood flow (CBF) and heart rate variability (HRV) are altered in these patients. Objectives: We aimed to investigate the role of the cardiovascular system in pain modulation and symptoms of CFS; the response of CBF and HRV to physical stress and their relation to the change in temporal summation (TS) of pressure pain and selfreported symptoms was evaluated. Study Design: A controlled, randomized cross-over trial. Setting: University Hospital Brussels. Methods: Twenty CFS patients and 20 sedentary healthy controls were included in this study. In both of the groups, the change in TS of pressure pain, CBF (using transcranial Doppler), and HRV (using finger plethysmography) was examined during physical and emotional stress (to control for potential bias), as well as their association mutually and with self-reported symptoms of pain, fatigue, and concentrations difficulties. Results: There was no significant interaction or group (F-values ranging from .100 to 1.862, P-values ranging from .754 to .181) effect in CBF or HRV parameters. HRV and CBF did change during physical exercise, but the changes did not differ between patients and controls. While pain scores during TS at the trapezius site reduced in the control group after the physical exercise protocol (P = .037), they did not change in the CFS group (P = .108), suggesting impaired pain modulation. There were no significant correlations between CBF, HRV, TS, and self-reported symptoms (all P-values of correlation analyses > .01). Limitations: Although effect sizes were medium to large, the study sample was relatively low. Also, the mild nature of the exercise bout is discussable. Nonetheless, this mild exercise was able to provoke endogenous pain modulation in the control group, which endorsed a proper execution of the cycling exercise. Moreover, mild exercises are more applicable to daily physical activities in CFS patients than vigorous exercises. Conclusion: These results seem to refute the previously suggested alterations of CBF/ HRV in CFS patients. These cardiovascular parameters appear not to explain pain before, during, and following exercise. Key words: Chronic pain, physical exercise, emotional stress, pain modulation, cardiovascular systems, temporal summation, pain pressure thresholds, transcranial Doppler, plethysmography
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Giannotti, Erika, Konstantinos Koutsikos, Maurizia Pigatto, Maria Elisa Rampudda, Andrea Doria, and Stefano Masiero. "Medium-/Long-Term Effects of a Specific Exercise Protocol Combined with Patient Education on Spine Mobility, Chronic Fatigue, Pain, Aerobic Fitness and Level of Disability in Fibromyalgia." BioMed Research International 2014 (2014): 1–9. http://dx.doi.org/10.1155/2014/474029.
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Objective. To propose a rehabilitation protocol able to produce immediate and long-term beneficial effects on level of disability and overall performance in ADLs.Materials and Methods. Forty-one FM patients were randomized to an exercise and educational-behavioral programme group (experimental group, EG = 21) or to a control group (CG = 20). Each subject was evaluated before, at the end (T1), and after 6 months (T6) from the conclusion of the rehabilitation treatment using the Fibromyalgia Impact Questionnaire (FIQ), the visual analogue scale (VAS), the Health Assessment Questionnaire (HAQ), the fatigue severity scale (FSS), the 6-minute walking test (6MWT), tender points count (TPC), and spinal active range of motion. The exercise protocol included 20 sessions consisting in self-awareness, stretching, strengthening, spine flexibility, and aerobic exercises, which patients were subsequently educated to perform at home.Results. The two groups were comparable at baseline. At T1, the EG showed a positive trend in FIQ, VAS, HAQ, and FSS scales and significant improvement in 6MWT and in most spinal active range of motion measurements (Pbetween 0.001 and 0.04). The positive results were maintained at the follow-up.Conclusion. The proposed programme was well tolerated and produced immediate and medium-term beneficial effects improving function and strain endurance. This trial is registered withDRKS00005071on DRKS.
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Menegatti, Erica, Anselmo Pagani, Giampiero Avruscio, Marianna Mucignat, and Sergio Gianesini. "The Effects of Thermal Water Physical Exercise in Patients with Lower Limb Chronic Venous Insufficiency Monitored by Bioimpedance Analysis." Diagnostics 10, no. 11 (October 31, 2020): 889. http://dx.doi.org/10.3390/diagnostics10110889.
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Background: Lower limb chronic venous diseases (CVD) lead to possible edema. The aim of the present investigation was to study the effect of thermal aquatic standardize exercise on lower limb edema control in CVD patients assessed by bioimpedance analysis (BIA). Methods: Seventeen patients (34 legs) affected by CVD clinical class CEAP C3, 4c, Ep, As, Pr were included. All the cohort performed a standardized exercise protocol in thermal water environment for a total of five sessions. BIA, leg volume, and heart rate at rest were measured. Results: After the five exercise sessions, BIA showed a significant percentage of extracellular water (ECW) reduction from 42.1 ± 5.8 to 41.24 ± 5.5%; p < 0.001. Moreover, an improvement of resistance (p < 0.0009) and reactance (p < 0.009) was assessed. At the same time, the leg volume reduction rate was 15.7%, p <0.0001. A moderate-strong correlation was found between % ECW and leg volume variation (R = 0.59, p < 0.01). Finally, a significant HR at rest reduction was recorded, p < 0.0001. Conclusion: The investigated exercise protocol significantly affects the lower limb volume, and BIA parameters related to the tissue drainage improvement. The correlation founded between the ECW rate and volume variations suggest the possible use of BIA as a biomarker for monitoring the treatments aimed to reduce edema in CVD.
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Boluyt, M. O., A. M. Loyd, M. H. Roth, M. J. Randall, and E. Y. M. Song. "Activation of JNK in rat heart by exercise: effect of training." American Journal of Physiology-Heart and Circulatory Physiology 285, no. 6 (December 2003): H2639—H2647. http://dx.doi.org/10.1152/ajpheart.00596.2003.
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The purpose of the study was to determine whether exercise would activate JNK in the heart and whether chronic exercise training would alter the response. Untrained rats were familiarized with the treadmill and assigned to one of four groups: low intensity (LI), 10 min, 0%, 15 m/min; medium intensity (MI), 10 min, 0%, 33 m/min; high intensity (HI), 10 min, 25%, 33 m/min; long duration (LD), 30 min, 0%, 15 m/min. Another cohort of rats was subjected to a progressive 6 wk high-intensity training protocol that produced a 12% increase in heart mass. In untrained rats, JNK activity was LI: 1.5 (fold nonrun control), MI: 2.0, HI: 2.5, LD: 1.25 immediately after a single bout of exercise. In trained rats, no activation of JNK above baseline was detected after either a 10-min or 1-h bout of exercise. We concluded that treadmill exercise activates JNK in the rat heart in an intensity-dependent manner and that chronic training abrogates the myocardial JNK response to a bout of exercise.
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Arazi, H., M. Poursardar, B. Taati, and K. Suzuki. "Does regular resistance exercise improve resting and intradialytic pain and haemodynamic measures in sedentary chronic haemodialysis women?" Comparative Exercise Physiology 17, no. 3 (April 12, 2021): 235–41. http://dx.doi.org/10.3920/cep200057.
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Pain is one of the major problems in haemodialysis patients. Regular resistance exercise (RE), as an effective lifestyle modification, may play a role in reducing pain through changes in blood pressure (BP). Therefore, we aimed to evaluate the effect of RE training on pain, BP, and heart rate. In a randomised controlled trial, eighteen sedentary women completed the study in RE (n=10) or control (n=8) groups. In the exercise group, the patients had a circuit RE program in non-dialysis days, two times a week, for six weeks. The RE protocol consisted of six exercises performing with 10 repetitions at 50-60% of 1-repetition maximum. Resting and intradialytic pain threshold (algometer using a 1 kg pressure load), BP, and heart rate were measured 48 h before and after the intervention. There were no significant differences from pre- to post-intervention, or between the groups regarding pain threshold, systolic and diastolic BP, and heart rate at rest and during the haemodialysis process (P>0.05). Although the 6-week low-intensity RE training in non-dialysis days was safe for chronic haemodialysis women, it could not change resting and intradialytic pain and hemodynamic measures.
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Wang, Xue-Qiang, Wei Gu, Bing-Lin Chen, Xin Wang, Hao-Yu Hu, Yi-Li Zheng, Juan Zhang, Han-Yu Zhang, and Pei-Jie Chen. "Effects of whole-body vibration exercise for non-specific chronic low back pain: an assessor-blind, randomized controlled trial." Clinical Rehabilitation 33, no. 9 (May 17, 2019): 1445–57. http://dx.doi.org/10.1177/0269215519848076.
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Objective: To confirm the benefits of whole-body vibration exercise for pain intensity and functional disability in patients with non-specific chronic low back pain. Design: Single-blind randomized controlled trial. Setting: Outpatient. Subjects: Eighty-nine patients with non-specific chronic low back pain met the inclusion criteria, they were randomly allocated to either the intervention group ( n = 45) or the control group ( n = 44). Intervention: The intervention group received whole-body vibration exercises three times a week for 12 weeks. The control group received general exercise protocol three times a week for 12 weeks. Main outcomes: The primary outcome measures were pain intensity and functional disability measured by the visual analog scale scores and Oswestry Disability Index. The secondary outcome measures included lumbar joint position sense, quality of life (Short Form Health Survey 36) and overall treatment effect (Global Perceived Effect). Results: A total of 84 subjects completed the 12-week study program. After 12 weeks, compared with the control group, the mean visual analog scale and Oswestry Disability Index scores decreased by additional 1 point (95% confidence interval (CI) = –1.22 to −0.78; P < 0.001), 3.81 point (95% CI, −4.98, −2.63; P < 0.001) based on adjusted analysis in the intervention group. And the intervention group provided additional beneficial effects for in terms of lumbar joint position sense ( P < 0.05), quality of life ( P < 0.05), and Global Perceived Effect ( P = 0.012). Conclusion: The study demonstrated that whole-body vibration exercise could provide more benefits than general exercise for relieving pain and improving functional disability in patients with non-specific chronic low back pain.