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Rao AZ, Danish Mujib M, Abul Hasan M, Alokaily AO, Tahira T, Qazi SA. User Perspectives and Psychophysiological Manifestations of Fatigue with Trunk Orthosis for Dystrophinopathy Patients. Bioengineering (Basel) 2024; 11:780. [PMID: 39199738 PMCID: PMC11351144 DOI: 10.3390/bioengineering11080780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/26/2024] [Accepted: 07/29/2024] [Indexed: 09/01/2024] Open
Abstract
The chair-mounted passive trunk orthosis (CMPTO) is designed to enhance wheelchair safety for individuals with dystrophinopathy during their daily activities. Given the disease's progressive nature, it is crucial to ensure that assistive devices are carefully evaluated to prevent overexertion. This study aims to assess the CMPTO's user experience and its impact on fatigue-related psychophysiological measurements. We conducted electromyography (EMG) evaluations of four trunk muscles and assessed perceived exertion using the Borg CR-10 scale in 40 healthy subjects while they performed seated maximal reaching tasks with the CMPTO. Additionally, fifteen dystrophinopathy patients evaluated the CMPTO for usability with the System Usability Scale. Paired t-tests were employed to compare the median frequency (MDF) of EMG signals, the Wilcoxon signed-rank test for evaluating exertion, and the Mann-Whitney U test to compare the usability reported by patients to those of healthy subjects. The 4-way ANOVA revealed that MDF patterns were significantly influenced by task orientation for each muscle. The CMPTO did not cause a significant reduction in the MDF. Tasks requiring greater trunk rotation were perceived as more exhaustive. Patients reported acceptable usability with the CMPTO, with scores higher than those of healthy subjects. The CMPTO's usability was comprehensively evaluated in both healthy subjects and patients with dystrophinopathy. Our findings indicate that the CMPTO can be safely used by individuals with dystrophinopathy as an assistive device to improve seated comfort and functional abilities.
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Affiliation(s)
- Ahmad Zahid Rao
- Department of Biomedical Engineering, NED University of Engineering and Technology, Karachi 75270, Pakistan; (M.D.M.); (M.A.H.)
| | - Muhammad Danish Mujib
- Department of Biomedical Engineering, NED University of Engineering and Technology, Karachi 75270, Pakistan; (M.D.M.); (M.A.H.)
| | - Muhammad Abul Hasan
- Department of Biomedical Engineering, NED University of Engineering and Technology, Karachi 75270, Pakistan; (M.D.M.); (M.A.H.)
- Neurocomputation Lab, National Center of Artificial Intelligence, Islamabad 75270, Pakistan;
| | - Ahmad O. Alokaily
- Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia
- King Salman Center for Disability Research, Riyadh 11614, Saudi Arabia
| | - Tayyaba Tahira
- Operative Dentistry and Endodontics Department, Dow International Dental College, Dow University of Health Sciences, Karachi 74200, Pakistan;
| | - Saad Ahmed Qazi
- Neurocomputation Lab, National Center of Artificial Intelligence, Islamabad 75270, Pakistan;
- Department of Electrical Engineering, NED University of Engineering and Technology, Karachi 75270, Pakistan
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Kaçoğlu C, Kirkaya İ, Ceylan Hİ, de Assis GG, Almeida-Neto P, Bayrakdaroğlu S, Chaves Oliveira C, Özkan A, Nikolaidis PT. Pre-Exercise Caffeine and Sodium Bicarbonate: Their Effects on Isometric Mid-Thigh Pull Performance in a Crossover, Double-Blind, Placebo-Controlled Study. Sports (Basel) 2024; 12:206. [PMID: 39195582 PMCID: PMC11359456 DOI: 10.3390/sports12080206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/26/2024] [Accepted: 07/26/2024] [Indexed: 08/29/2024] Open
Abstract
Caffeine and sodium bicarbonate are extensively researched ergogenic aids known for their potential to enhance exercise performance. The stimulant properties of caffeine on the central nervous system, coupled with the buffering capacity of sodium bicarbonate, have been associated with improved athletic performance. This has led to investigations of their combined effects on strength. The aim of the present study is to investigate the effect of isolated and combined caffeine and sodium bicarbonate consumption on strength using the isometric mid-thigh pull test (IMTP). Nineteen male college students (age 23.6 ± 1.6 years) participated in this crossover, double-blind, placebo-controlled study. They were exposed to the following conditions: control (no supplement), placebo (20 g maltodextrin), caffeine (6 mg/kg), sodium bicarbonate (0.3 g/kg), and a combination of caffeine and sodium bicarbonate. Supplements and placebo were diluted in water and consumed 60 min prior to the IMTP tests. Two 5 s IMTP trials were performed at 40-60% and 60-80% of One Repetition of Maximum (1RM) with a 60 s rest between. Consumption of caffeine or Caf + NaHCO3 did not significantly change peak IMTP strength values at any intensity (p = 0.110). The peak IMTP values did not show significant differences between conditions or from control condition values (1091 ± 100 N) to Caf (1224 ± 92 N), NaHCO3 (1222 ± 74 N), and Caf ± NaHCO3 (1152 ± 109 N). However, the test of the results of the ANOVA analysis of repeated measures of effect within the caffeine condition was significant for the increase in IMTP relative strength compared to control (p < 0.05). Thus, the IMTP force values increased significantly from control to Caf (p = 0.016) and from Pla to Caf (p = 0.008), but not for other comparisons (p > 0.05). In summary, caffeine supplementation alone, taken 60 min before exercise, positively affects submaximal strength performance. In contrast, sodium bicarbonate, whether taken alone or in combination with caffeine, does not enhance submaximal strength in the IMTP tests.
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Affiliation(s)
- Celil Kaçoğlu
- Department of Coaching Education, Faculty of Sport Sciences, Eskişehir Technical University, Eskişehir 26555, Türkiye;
| | - İzzet Kirkaya
- Department of Coaching Education, Faculty of Sport Sciences, Yozgat Bozok University, Yozgat 66100, Türkiye; (İ.K.); (A.Ö.)
| | - Halil İbrahim Ceylan
- Department of Physical Education of Sports Teaching, Faculty of Sports Sciences, Atatürk University, Erzurum 25240, Türkiye;
| | - Gilmara Gomes de Assis
- Araraquara School of Dentistry, São Paulo State University (UNESP), Araraquara 01049-010, Brazil;
| | - Paulo Almeida-Neto
- Department of Physical Education, Federal University of Rio Grande do Norte, CCS-UFNR, Natal 59078-900, Brazil;
| | - Serdar Bayrakdaroğlu
- Department of Coaching Education, Movement and Training Sciences, School of Education and Sport, Gumushane University, Gumushane 29100, Türkiye;
| | - César Chaves Oliveira
- Polytechnic Institute of Viana do Castelo, School of Sports and Leisure, 4960-320 Viana do Castelo, Portugal;
| | - Ali Özkan
- Department of Coaching Education, Faculty of Sport Sciences, Yozgat Bozok University, Yozgat 66100, Türkiye; (İ.K.); (A.Ö.)
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Amato A, Proia P, Alioto A, Rossi C, Pagliaro A, Ragonese P, Schirò G, Salemi G, Caldarella R, Vasto S, Nowak R, Kostrzewa-Nowak D, Musumeci G, Baldassano S. High-intensity interval training improves bone remodeling, lipid profile, and physical function in multiple sclerosis patients. Sci Rep 2024; 14:16195. [PMID: 39003295 PMCID: PMC11246443 DOI: 10.1038/s41598-024-66448-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 07/01/2024] [Indexed: 07/15/2024] Open
Abstract
Multiple sclerosis (MS) is a demyelinating and neurodegenerative disease due to an autoimmune chronic inflammatory response, yet the etiology is currently not completely understood. It is already known that physical activity plays an essential role in improving quality of life, especially in neuropathological conditions. The study was aimed to investigate the possible benefits of high-intensity interval training (HIIT) in bone and lipid metabolism markers, and neuromotor abilities in MS patients. 130 participants were recruited; 16 subjects with MS met the inclusion criteria and were included in the data analysis. The patients were randomly assigned to two groups: a Control group (CG) (34.88 ± 4.45 yrs) that didn't perform any physical activity and the Exercise group (EG) (36.20 ± 7.80 yrs) that performed HIIT protocol. The training program was conducted remotely by a kinesiologist. It was performed three times a week for 8 weeks. At the beginning (T0) and the end of the study (T1) physical function tests, bone remodelling markers, and lipid markers analyses were performed. After 8 weeks of training the wall squat (s) (T0 = 27.18 ± 4.21; T1 = 41.68 ± 5.38, p ≤ 0.01) and Time Up and Go test (s) (T0 = 7.65 ± 0.43; T1 = 6.34 ± 0.38 p ≤ 0.01) performances improved; lipid markers analysis showed a decrease in Total (mg/dl) (T0 = 187.22 ± 15.73; T1 = 173.44 ± 13.03, p ≤ 0.05) and LDL (mg/dl) (T0 = 108 ± 21.08; T1 = 95.02 ± 17.99, p < 0.05) cholesterol levels. Additionally, the levels of osteocalcin (µg/L), a marker of bone formation increased (T0 = 20.88 ± 4.22; T1 = 23.66 ± 6.24, p < 0.05), 25-OH Vitamin D (µg/L) improved after 8 weeks (T0 = 21.11 ± 7.11; T1 = 27.66 ± 7.59, p < 0.05). HIIT had an effect on lower limb strength and gait control, improved bone formation, and lipid management, in MS patients.
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Affiliation(s)
- Alessandra Amato
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia No 97, 95123, Catania, Italy
| | - Patrizia Proia
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144, Palermo, Italy.
| | - Anna Alioto
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144, Palermo, Italy
| | - Carlo Rossi
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144, Palermo, Italy
| | - Andrea Pagliaro
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90144, Palermo, Italy
| | - Paolo Ragonese
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127, Palermo, Italy
| | - Giuseppe Schirò
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127, Palermo, Italy
| | - Giuseppe Salemi
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127, Palermo, Italy
| | - Rosalia Caldarella
- Department of Laboratory Medicine, "P. Giaccone" University Hospital, University of Palermo, 90127, Palermo, Italy
| | - Sonya Vasto
- Department of Biological Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90128, Palermo, Italy
| | - Robert Nowak
- Institute of Physical Culture Sciences, University of Szczecin, 17C Narutowicza St, 70-240, Szczecin, Poland
- Department of Pathology, Pomeranian Medical University in Szczecin, 1 Unii Lubelskiej St, 71-242, Szczecin, Poland
| | - Dorota Kostrzewa-Nowak
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, 72 Powstańców Wlkp. Al, 70-111, Szczecin, Poland
| | - Giuseppe Musumeci
- Department of Biomedical and Biotechnological Sciences, Section of Anatomy, Histology and Movement Science, School of Medicine, University of Catania, Via S. Sofia No 97, 95123, Catania, Italy
| | - Sara Baldassano
- Department of Biological Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90128, Palermo, Italy
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Lea JWD, O'Driscoll JM, Wiles JD. The implementation of a home-based isometric wall squat intervention using ratings of perceived exertion to select and control exercise intensity: a pilot study in normotensive and pre-hypertensive adults. Eur J Appl Physiol 2024; 124:281-293. [PMID: 37458822 PMCID: PMC10786991 DOI: 10.1007/s00421-023-05269-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/28/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE Isometric exercise (IE) and isometric wall squat (IWS) training have been shown to be effective methods of reducing arterial blood pressure. However, most IE interventions require methodologies and equipment that could present a barrier to participation. Therefore, this study aimed to examine the effectiveness of an accessible RPE prescribed IWS intervention. METHODS Thirty normotensive and pre-hypertensive adults were randomly assigned to a control group or one of two 4-week home-based IWS intervention groups: the first group conducted IWS exercise where intensity was prescribed and monitored using RPE (RPE-EX), whilst the other used a previously validated HR prescription method (HR-EX). Resting and ambulatory heart rate (HR) and blood pressure (BP) were measured pre- and post-intervention. RESULTS Minimum clinically important differences (MCID; - 5 mmHg) in SBP and/or DBP were shown in 100% of intervention participants. Statistically significant reductions were shown in resting seated BP (RPE-EX: SBP: - 9 ± 6, DBP: - 6 ± 4, MAP: - 6 ± 3 mmHg; HR-EX: SBP: - 14 ± 6, DBP: - 6 ± 4, MAP: - 8 ± 4 mmHg), supine BP (RPE-EX: SBP: - 8 (- 5), DBP: - 8 (- 7), MAP: - 8 (- 4) mmHg; HR-EX: SBP: - 5 (- 4), MAP - 5 (- 4) mmHg), and ambulatory SBP (RPE-EX: - 8 ± 6 mmHg; HR-EX: - 10 ± 4 mmHg) following the interventions. There were no statistically significant differences between intervention groups in the magnitude of BP reduction. CONCLUSION RPE prescribed IWS exercise can provide an effective and more accessible method for reducing BP at home, providing reductions comparable to the current HR-based prescription method.
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Affiliation(s)
- John W D Lea
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Jamie M O'Driscoll
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Jonathan D Wiles
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK.
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Armand A, Rochette E, Grèze V, Monzy S, Dualé C, Pereira B, Isfan F, Doré E, Girard-Monin P, Pegon C, Labraise E, Duché P, Kanold J. Fitness and metabolic response to exercise in young adult survivors of childhood lymphoma. Support Care Cancer 2023; 31:358. [PMID: 37247034 DOI: 10.1007/s00520-023-07812-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/13/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE Childhood lymphoma survivors (CLSs) are at high risk of reduced daily activity. This work studied metabolic substrate use and cardiorespiratory function in response to exercise in CLSs. METHODS Twenty CLSs and 20 healthy adult controls matched for sex, age, and BMI took an incremental submaximal exercise test to determine fat/carbohydrate oxidation rates. Resting echocardiography and pulmonary functional tests were performed. Physical activity level, and blood metabolic and hormonal levels were measured. RESULTS CLSs reported more physical activity than controls (6317 ± 3815 vs. 4268 ± 4354 MET-minutes/week, p = 0.013), had higher resting heart rate (83 ± 14 vs. 71 ± 13 bpm, p = 0.006), and showed altered global longitudinal strain (- 17.5 ± 2.1 vs. - 19.8 ± 1.6%, p = 0.003). We observed no difference in maximal fat oxidation between the groups, but it was reached at lower relative exercise intensities in CLSs (Fatmax 17.4 ± 6.0 vs. 20.1 ± 4.1 mL/kg, p = 0.021). At V̇O2 peak, CLSs developed lower relative exercise power (3.2 ± 0.9 vs. 4.0 ± 0.7 W/kg, p = 0.012). CONCLUSION CLSs reported higher levels of physical activity but they attained maximal fat oxidation at lower relative oxygen uptake and applied lower relative power at V̇O2 peak. CLSs may thus have lower muscular efficiency, causing greater fatigability in response to exercise, possibly related to chemotherapy exposure during adolescence and childhood. Long-term follow-up is essential and regular physical activity needs to be sustained.
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Affiliation(s)
- Alexandre Armand
- CHU Clermont-Ferrand, Pédiatrie, 63000, Clermont-Ferrand, France.
- Unité CRECHE (INSERM CIC1405), Université Clermont Auvergne, 63000, Clermont-Ferrand, France.
| | - Emmanuelle Rochette
- CHU Clermont-Ferrand, Pédiatrie, 63000, Clermont-Ferrand, France
- Unité CRECHE (INSERM CIC1405), Université Clermont Auvergne, 63000, Clermont-Ferrand, France
- Université de Toulon, Laboratoire IAPS, 83041, Toulon, France
| | - Victoria Grèze
- CHU Clermont-Ferrand, Pédiatrie, 63000, Clermont-Ferrand, France
- Unité CRECHE (INSERM CIC1405), Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| | | | - Christian Dualé
- CHU Clermont-Ferrand, Plateforme d'Investigation Clinique (INSERM CIC1405), F-63000, Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Délégation de La Recherche Clinique Et Innovations, 63000, Clermont-Ferrand, France
| | - Florentina Isfan
- CHU Clermont-Ferrand, Pédiatrie, 63000, Clermont-Ferrand, France
| | - Eric Doré
- CHU Clermont-Ferrand, Pédiatrie, 63000, Clermont-Ferrand, France
| | | | - Charline Pegon
- CHU Clermont-Ferrand, Pédiatrie, 63000, Clermont-Ferrand, France
| | - Emmanuelle Labraise
- CHU Clermont-Ferrand, Pédiatrie, 63000, Clermont-Ferrand, France
- Unité CRECHE (INSERM CIC1405), Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Pascale Duché
- Université de Toulon, Laboratoire IAPS, 83041, Toulon, France
| | - Justyna Kanold
- CHU Clermont-Ferrand, Pédiatrie, 63000, Clermont-Ferrand, France
- Unité CRECHE (INSERM CIC1405), Université Clermont Auvergne, 63000, Clermont-Ferrand, France
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Baffour-Awuah B, Pearson MJ, Dieberg G, Wiles JD, Smart NA. An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension and clinical implications. Clin Hypertens 2023; 29:9. [PMID: 36918919 PMCID: PMC10015931 DOI: 10.1186/s40885-022-00232-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/20/2022] [Indexed: 03/16/2023] Open
Abstract
More than 30 randomized controlled trials, supported by individual patient-level and group-level meta-analyses and a Delphi analysis of expert opinion, unequivocally show isometric resistance training (IRT) elicits antihypertensive benefits in healthy people and those with chronic illness. We aim to provide efficacy and safety evidence, and a guide for IRT prescription and delivery. Recommendations are made for the use of IRT in specific patient populations and appropriate methods for IRT delivery. Published data suggest IRT consistently elicits mean blood pressure reductions of 7.4/3.3 mmHg systolic blood pressure/diastolic blood pressure, equivalent to antihypertensive medication monotherapy. Blood pressure reductions of this size are associated with an approximate 13% to 22% reduction in major cardiovascular events. Moreover, IRT is safe in a range of patient populations. We suggest that IRT has the greatest potential benefit when used as an antihypertensive therapy in individuals unwilling and/or unable to complete aerobic exercise, or who have had limited adherence or success with it; individuals with resistant or uncontrolled hypertension, already taking at least two pharmacological antihypertensive agents; and healthy or clinical populations, as an adjunct to aerobic exercise and dietary intervention in those who have not yet attained control of their hypertension. IRT is efficacious and produces clinically meaningful blood pressure reductions (systolic blood pressure, 7 mmHg; diastolic blood pressure, 3 mmHg). IRT is safe and typical program delivery requires only about 17 min weekly. IRT should be used as an adjunct to other exercise modalities, in people unable to complete other types of exercise, or in resistant hypertension.
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Affiliation(s)
- Biggie Baffour-Awuah
- Clinical Exercise Physiology, School of Science and Technology, University of New England, Armidale, Australia
| | - Melissa J Pearson
- Clinical Exercise Physiology, School of Science and Technology, University of New England, Armidale, Australia
| | - Gudrun Dieberg
- Clinical Exercise Physiology, School of Science and Technology, University of New England, Armidale, Australia.
| | - Jonathan D Wiles
- Sports Sciences, School of Psychology and Life Sciences, Canterbury Christ Church University, Canterbury, UK
| | - Neil A Smart
- Clinical Exercise Physiology, School of Science and Technology, University of New England, Armidale, Australia
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The Effect of Spinal Muscle Fatigue and Psychosocial Factors on Pressure-Pain Threshold in Healthy Adults. Pain Res Manag 2023; 2023:7336477. [PMID: 36741677 PMCID: PMC9891829 DOI: 10.1155/2023/7336477] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/01/2022] [Accepted: 11/24/2022] [Indexed: 01/26/2023]
Abstract
Objective Pain sensitivity decreases following isometric exercise. It is not clear whether this exercise-induced hypoalgesia (EIH) occurs to the same extent in men and women. It is also unclear if the effect is systemic or local to the exercised musculature. The aim of our study was to investigate whether fatiguing isometric exercise of the spinal and hip extensors would result in increased pressure pain threshold (PPT) at sites local to and remote from the exercised muscles in healthy men and women and whether there is a relationship between central sensitization, psychosocial factors, and PPT. Subjects 35 healthy adults (age 27.1 ± 4.5 years, 22 women). Methods This was a within-subjects cohort study. Participants completed questionnaires quantifying central sensitization, pain catastrophizing, sleepiness/insomnia, anxiety, and depression. PPT was assessed at the lumbar and thoracic paraspinals, hamstrings, gastrocnemius, wrist, and third digit before and immediately after participants performed the Biering-Sorensen test to failure. Results PPT increased postexercise in the thoracic paraspinals, hamstrings, and gastrocnemius in men and women and in the lumbar paraspinals in men only but did not change at the wrist and digit sites. A lower average PPT at baseline was associated with a higher central sensitization scores. A greater increase in average PPT postfatigue was significantly associated with higher average PPT at baseline. Conclusions Exercise-induced hypoalgesia occurs at sites overlying the muscles involved in fatiguing exercise, but not at remote sites, and is more evident in males than females. The magnitude of EIH depends upon baseline PPT. Even in healthy individuals, greater central sensitization is associated with lower baseline PPT.
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8
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The effect of a 6-month intradialytic exercise program on hemodialysis adequacy and body composition: a randomized controlled trial. Int Urol Nephrol 2022; 54:2983-2993. [DOI: 10.1007/s11255-022-03238-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 05/04/2022] [Indexed: 12/25/2022]
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9
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Lea JWD, O'Driscoll JM, Hulbert S, Scales J, Wiles JD. Convergent Validity of Ratings of Perceived Exertion During Resistance Exercise in Healthy Participants: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2022; 8:2. [PMID: 35000021 PMCID: PMC8742800 DOI: 10.1186/s40798-021-00386-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 11/21/2021] [Indexed: 11/18/2022]
Abstract
Background The validity of ratings of perceived exertion (RPE) during aerobic training is well established; however, its validity during resistance exercise is less clear. This meta-analysis used the known relationships between RPE and exercise intensity (EI), heart rate (HR), blood lactate (BLa), blood pressure (BP) and electromyography (EMG) to determine the convergent validity of RPE as a measure of resistance exercise intensity and physiological exertion, during different forms of resistance exercise. Additionally, this study aims to assess the effect of several moderator variables on the strength of the validity coefficients, so that clearer guidance can be given on the use of RPE during resistance exercise. Methods An online search of 4 databases and websites (PubMed, Web of Science SPORTDiscus and ResearchGate) was conducted up to 28 February 2020. Additionally, the reference lists of the included articles were inspected manually for further unidentified studies. The inclusion criteria were healthy participants of any age, a rating scale used to measure RPE, resistance exercise of any type, one cohort receiving no other intervention, and must present data from one of the following outcome measures: EI, HR, BP, EMG or BLa. Weighted mean effect sizes (r) were calculated using a random-effects model. Heterogeneity was assessed using the τ2 and I2 statistics. Moderator analysis was conducted using random-effects meta-regression. Results One-hundred and eighteen studies were included in the qualitative synthesis, with 75 studies (99 unique cohorts) included in the meta-analysis. The overall weighted mean validity coefficient was large (0.88; 95% CI 0.84–0.91) and between studies heterogeneity was very large (τ2 = 0.526, I2 = 96.1%). Studies using greater workload ranges, isometric muscle actions, and those that manipulated workload or repetition time, showed the highest validity coefficients. Conversely, sex, age, training status, RPE scale used, and outcome measure no significant effect. Conclusions RPE provides a valid measure of exercise intensity and physiological exertion during resistance exercise, with effect sizes comparable to or greater than those shown during aerobic exercise. Therefore, RPE may provide an easily accessible means of prescribing and monitoring resistance exercise training. Trial Registration The systematic review protocol was registered on the PROSPERO database (CRD42018102640). Supplementary Information The online version contains supplementary material available at 10.1186/s40798-021-00386-8.
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Affiliation(s)
- John W D Lea
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK.
| | - Jamie M O'Driscoll
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Sabina Hulbert
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - James Scales
- Institute of Population and Health Sciences, Queen Mary University of London, London, E1 4NS, UK
| | - Jonathan D Wiles
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
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10
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Shushan T, McLaren SJ, Buchheit M, Scott TJ, Barrett S, Lovell R. Submaximal Fitness Tests in Team Sports: A Theoretical Framework for Evaluating Physiological State. Sports Med 2022; 52:2605-2626. [PMID: 35817993 PMCID: PMC9584880 DOI: 10.1007/s40279-022-01712-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2022] [Indexed: 02/01/2023]
Abstract
Team-sports staff often administer non-exhaustive exercise assessments with a view to evaluating physiological state, to inform decision making on athlete management (e.g., future training or recovery). Submaximal fitness tests have become prominent in team-sports settings for observing responses to a standardized physical stimulus, likely because of their time-efficient nature, relative ease of administration, and physiological rationale. It is evident, however, that many variations of submaximal fitness test characteristics, response measures, and monitoring purposes exist. The aim of this scoping review is to provide a theoretical framework of submaximal fitness tests and a detailed summary of their use as proxy indicators of training effects in team sports. Using a review of the literature stemming from a systematic search strategy, we identified five distinct submaximal fitness test protocols characterized in their combinations of exercise regimen (continuous or intermittent) and the progression of exercise intensity (fixed, incremental, or variable). Heart rate-derived indices were the most studied outcome measures in submaximal fitness tests and included exercise (exercise heart rate) and recovery (heart rate recovery and vagal-related heart rate variability) responses. Despite the disparity between studies, these measures appear more relevant to detect positive chronic endurance-oriented training effects, whereas their role in detecting negative transient effects associated with variations in autonomic nervous system function is not yet clear. Subjective outcome measures such as ratings of perceived exertion were less common in team sports, but their potential utility when collected alongside objective measures (e.g., exercise heart rate) has been advocated. Mechanical outcome measures either included global positioning system-derived locomotor outputs such as distance covered, primarily during standardized training drills (e.g., small-sided games) to monitor exercise performance, or responses derived from inertial measurement units to make inferences about lower limb neuromuscular function. Whilst there is an emerging interest regarding the utility of these mechanical measures, their measurement properties and underpinning mechanisms are yet to be fully established. Here, we provide a deeper synthesis of the available literature, culminating with evidence-based practical recommendations and directions for future research.
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Affiliation(s)
- Tzlil Shushan
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia
| | - Shaun J. McLaren
- Newcastle Falcons Rugby Club, Newcastle upon Tyne, UK ,grid.8250.f0000 0000 8700 0572Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Martin Buchheit
- HIIT Science, Revelstoke, BC Canada ,grid.418501.90000 0001 2163 2398French National Institute of Sport (INSEP), Laboratory of Sport, Expertise and Performance (EA 7370), Paris, France ,Kitman Labs, Performance Research Intelligence Initiative, Dublin, Ireland ,grid.1019.90000 0001 0396 9544Institute for Health and Sport, Victoria University, Melbourne, VIC Australia
| | - Tannath J. Scott
- Netball Australia, Melbourne, VIC Australia ,grid.10346.300000 0001 0745 8880Carnegie Applied Rugby Research (CARR) Centre, Institute for Sport, Physical Activity and Leisure, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Steve Barrett
- Department of Sport Science Innovation, Playermaker, London, UK
| | - Ric Lovell
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Sydney, NSW Australia
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Wiles J, Rees-Roberts M, O'Driscoll JM, Doulton T, MacInnes D, Short V, Pellatt-Higgins T, Saxby K, Gousia K, West A, Smith M, Santer E, Darby J, Farmer CK. Feasibility study to assess the delivery of a novel isometric exercise intervention for people with stage 1 hypertension in the NHS: protocol for the IsoFIT-BP study including amendments to mitigate the risk of COVID-19. Pilot Feasibility Stud 2021; 7:192. [PMID: 34711266 PMCID: PMC8551940 DOI: 10.1186/s40814-021-00925-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 09/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertension (HTN) affects approximately 25% of the UK population and is a leading cause of mortality. Associated annual health care costs run into billions. National treatment guidance includes initial lifestyle advice, followed by anti-hypertensive medication if blood pressure (BP) remains high. However, adoption and adherence to recommended exercise guidelines, dietary advice and anti-hypertensive medication is poor. Four short bouts of isometric exercise (IE) performed 3 days per week (d/wk) at home elicits clinically significant reductions in BP in those with normal to high-normal BP. This study will determine the feasibility of delivering personalised IE to patients with stage 1 hypertension for whom lifestyle changes would be recommended before medication within NHS primary care. METHODS This is a randomised controlled feasibility study. Participants were 18+ years, with stage 1 hypertension, not on anti-hypertensive medication and without significant medical contraindications. Trial arms will be standard lifestyle advice (control) or isometric wall squat exercise and standard lifestyle advice. Primary outcomes include the feasibility of healthcare professionals to deliver isometric exercise prescriptions in a primary care NHS setting and estimation of the variance of change in systolic BP. Secondary outcomes include accuracy of protocol delivery, execution of and adherence to protocol, recruitment rate, attrition, perception of intervention viability, cost, participant experience and accuracy of home BP. The study will last 18 months. Sample size of 100 participants (50 per arm) allows for 20% attrition and 6.5% incomplete data, based upon 74 (37 each arm) participants (two-sided 95% confidence interval, width of 1.33 and standard deviation of 4) completing 4 weeks. Ethical approval IRAS ID is 274676. DISCUSSION Before the efficacy of this novel intervention to treat stage 1 hypertension can be investigated in any large randomised controlled trial, it is necessary to ascertain if it can be delivered and carried out in a NHS primary care setting. Findings could support IE viability as a prophylactic/alternative treatment option. TRIAL REGISTRATION ISRCTN13472393 , registered 18 August 2020.
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Affiliation(s)
- Jonathan Wiles
- Faculty of Science, Engineering and Social Sciences, Canterbury Christ Church University, Canterbury, Kent, UK.
| | | | - Jamie M O'Driscoll
- Faculty of Science, Engineering and Social Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Timothy Doulton
- Renal Department East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, UK
| | - Douglas MacInnes
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Vanessa Short
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | | | - Katie Saxby
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | - Katerina Gousia
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | | | | | - Ellie Santer
- Faculty of Science, Engineering and Social Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | | | - Chris K Farmer
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
- Renal Department East Kent Hospitals University NHS Foundation Trust, Canterbury, Kent, UK
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12
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Lea JWD, O’Driscoll JM, Coleman DA, Wiles JD. Validity and reliability of RPE as a measure of intensity during isometric wall squat exercise. J Clin Transl Res 2021; 7:248-256. [PMID: 34104828 PMCID: PMC8177844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/24/2021] [Accepted: 02/28/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIMS Isometric exercise (IE), including wall squat training, has been shown to be effective at reducing resting blood pressure (BP). Rating of perceived exertion (RPE) is also widely used as an accessible additional measure of IE intensity. Despite this, no RPE scales have been specifically designed for use with IE and it is not clear whether RPE is sensitive enough to distinguish between different lower limb IE workloads. Therefore, the aims of this study were to assess the validity and reliability of RPE as a measure of IE intensity (workload) and physiological exertion (Heart rate and BP), and to examine whether RPE is able to discern differences in wall squat workload (knee angle) at a resolution of 10-degrees, as was previous shown for heart rate (HR) and BP. METHODS Twenty-nine male participants completed eight separate isometric wall squat testing sessions, separated by a minimum of 5-h. Each session consisted of a single 2-min isometric wall squat test, at one of five randomized workloads (knee joint angles). Three of the knee angles were repeated, a second time, to allow measurements of reliability. Throughout the exercise protocol, HR and BP were recorded continuously; values for each 30-s time-point were calculated as the mean of the proceeding 5-s, and peak values for the 2-min bout were taken as the mean results for the final 5-s of the bout. In addition, mean results for the full 2-min period were calculated. RPE was collected every 30 s. Concurrent validity was assessed by correlating RPE results with the criterion measures: Knee joint angle, HR, and BP. Differences in RPE were assessed across consecutive workloads and time-points. RESULTS There were significant increases in RPE at each consecutive wall squat workload (P<0.001) and between each consecutive 30-s time point (P<0.001). In addition, the RPE results produced a significant inverse relationship with knee angle (r=-0.79; P<0.001) and significant positive relationships with HR (r=0.53, P<0.001) and BP (systolic: r=0.77; diastolic: r=0.62; and mean arterial pressure: r=0.70, P<0.001). CONCLUSION RPE provides a valid and reliable measure of isometric wall squat intensity, physiological exertion and can discern between knee angles with a resolution of 10°. RELEVANCE FOR PATIENTS Patients and practitioners implementing isometric exercise training for arterial blood pressure reduction can use RPE to accurately monitor the intensity of the exercise and the physiological responses.
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Affiliation(s)
- John W. D. Lea
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, United Kingdom
| | - Jamie M. O’Driscoll
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, United Kingdom
| | - Damian A. Coleman
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, United Kingdom
| | - Jonathan D. Wiles
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, United Kingdom
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