1
|
Hebestreit H, Kriemler S, Schindler C, Stein L, Karila C, Urquhart DS, Orenstein DM, Lands LC, Schaeff J, Eber E, Radtke T. Effects of a Partially Supervised Conditioning Program in Cystic Fibrosis: An International Multicenter Randomized Controlled Trial (ACTIVATE-CF). Am J Respir Crit Care Med 2021; 205:330-339. [PMID: 34735776 PMCID: PMC8887001 DOI: 10.1164/rccm.202106-1419oc] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale The long-term effects of vigorous physical activity (PA) on lung function in cystic fibrosis are unclear. Objectives To evaluate effects of a 12-month partially supervised PA intervention using motivational feedback. Methods In a parallel-arm multicenter randomized controlled trial (ACTIVATE-CF), relatively inactive patients aged at least 12 years were randomly assigned (1:1 ratio) to an intervention group or control group. The intervention group consented to add 3 hours of vigorous PA per week, whereas the control group was asked not to change their PA behavior. Primary endpoint was change in percent predicted FEV1 (ΔFEV1) at 6 months. Secondary endpoints included PA, exercise capacity, exercise motives, time to first exacerbation and exacerbation rates, quality of life, anxiety, depression, stress, and blood glucose control. Data were analyzed using mixed linear models. Measurements and Main Results A total of 117 patients (40% of target sample size) were randomized to an intervention (n = 60) or control group (n = 57). After 6 months, ΔFEV1 was significantly higher in the control group compared with the intervention group (2.70% predicted [95% confidence interval, 0.13–5.26]; P = 0.04). The intervention group reported increased vigorous PA compared with the control group at each study visit, had higher exercise capacity at 6 and 12 months, and higher PA at 12 months. No effects were seen in other secondary outcomes. Conclusions ACTIVATE-CF increased vigorous PA and exercise capacity, with effects carried over for the subsequent 6 months, but resulted in better FEV1 in the control group.
Collapse
Affiliation(s)
| | | | - Christian Schindler
- Universitat Basel, 27209, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Lothar Stein
- Hannover Medical School, 9177, Hannover, Germany
| | - Chantal Karila
- Hopital universitaire Necker-Enfants malades, 246596, Paris, France
| | - Don S Urquhart
- Royal Hospital for Sick Children, Edinburgh, United Kingdom of Great Britain and Northern Ireland
| | - David M Orenstein
- Univ. of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Larry C Lands
- Montreal Children's Hospital - McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Ernst Eber
- Medical University of Graz, Department of Pediatrics and Adolescent Medicine, Graz, Austria
| | - Thomas Radtke
- University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | | |
Collapse
|
2
|
Gruet M, Saynor ZL, Urquhart DS, Radtke T. Rethinking physical exercise training in the modern era of cystic fibrosis: A step towards optimising short-term efficacy and long-term engagement. J Cyst Fibros 2021; 21:e83-e98. [PMID: 34493444 DOI: 10.1016/j.jcf.2021.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/18/2021] [Accepted: 08/04/2021] [Indexed: 12/17/2022]
Abstract
Exercise is considered as an important component of the package of care delivered to people with cystic fibrosis (pwCF). However, despite the well-known short-term physiological and psychological benefits, training effects are heterogenous and the transfer of structured exercise programmes to the daily life of pwCF is challenging. Training concepts and strategies developed over the last decades must be adapted to consider the aging population of pwCF with associated comorbidities, and also a new generation of young pwCF that are healthier than ever. In the present review we propose a new framework for optimising the choice among available exercise training procedures and we provide a theoretical and scientifically justified rationale for considering and testing new exercise training modalities. We propose a multidisciplinary approach, considering various physiological, psychological and logistical factors, with the aim to increase effects of exercise training and build positive long-term exercise behaviour.
Collapse
Affiliation(s)
- Mathieu Gruet
- IAPS Laboratory, University of Toulon, Toulon, France..
| | - Zoe L Saynor
- Physical Activity, Health and Rehabilitation Thematic Research Group, School of Sport, Health and Exercise Science, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK
| | - Don S Urquhart
- Department of Paediatric Respiratory and Sleep Medicine, Royal Hospital for Children and Young People, Edinburgh, Scotland, UK.; Department of Child Life and Health, University of Edinburgh, Scotland, UK
| | - Thomas Radtke
- Division of Occupational and Environmental Medicine, Epidemiology, Biostatistics and Prevention Institute, University of Zurich & University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
3
|
Schäfer C, Mayr B, Fernandez La Puente de Battre MD, Reich B, Schmied C, Loidl M, Niederseer D, Niebauer J. Health effects of active commuting to work: The available evidence before GISMO. Scand J Med Sci Sports 2021; 30 Suppl 1:8-14. [PMID: 32297362 PMCID: PMC7540011 DOI: 10.1111/sms.13685] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 01/27/2020] [Accepted: 04/03/2020] [Indexed: 11/28/2022]
Abstract
Sedentary lifestyle is a major modifiable risk factor for many chronic diseases. Global guidelines recommend for maintaining health in adults, at least 150 minutes of moderate intensity of physical activity throughout the week, but compliance is insufficient and health problems arise. One obvious way to overcome this is to integrate physical activity into the daily routine for example by active commuting to work. Scientific evidence, however, is scarce and therefore we set out to perform this systematic review of the available literature to improve understanding of the efficiency of active commuting initiatives on health. Literature searches were performed in PubMed and Cochrane database. Altogether, 37 studies were screened. Thereof, eight publications were reviewed, which included 555 participants. The mean study duration of the reviewed research was 36 ± 26 (8-72) weeks. Overall, active commuting in previously untrained subjects of both sexes significantly improved exercise capacity, maximal power, blood pressure, lipid parameters including cholesterol, high-density lipoprotein, and waist circumference. Improvement was independent of the type of active commuting. Despite relatively few studies that were previously performed, this review revealed that active commuting has health beneficial effects comparable to those of moderate exercise training.
Collapse
Affiliation(s)
- Christine Schäfer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Barbara Mayr
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Maria Dolores Fernandez La Puente de Battre
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Bernhard Reich
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Christian Schmied
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University of Salzburg, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
4
|
Reich B, Niederseer D, Loidl M, Fernandez La Puente de Battre MD, Rossi VA, Zagel B, Caselli S, Schmied C, Niebauer J. Effects of active commuting on cardiovascular risk factors: GISMO-a randomized controlled feasibility study. Scand J Med Sci Sports 2020; 30 Suppl 1:15-23. [PMID: 32335963 PMCID: PMC7496369 DOI: 10.1111/sms.13697] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 12/19/2022]
Abstract
A sedentary lifestyle is a major modifiable risk factor for many chronic diseases. Lifestyle modification in order to increase exercise capacity is key in the prevention and rehabilitation of chronic diseases. This could be achieved by active commute. The aim of this study was to assess the effects of daily active commuting on physical activity (PA) and exercise capacity. Seventy‐three healthy hospital employees (age: 46 ± 9 years, 38% male), with a predominantly passive way of commuting, were randomly assigned to two parallel groups, a control group (CG, N = 22) or an intervention group (IG, N = 51), which was further split into public transportation/active commuting (IG‐PT, N = 25) and cycling (IG‐C, N = 26). Both intervention groups were asked to reach 150 min/wk of moderate‐ to vigorous‐intensity exercise during their commute for 1 year. CG maintained a passive commuting mode. All participants underwent assessment of anthropometry, risk factor stratification, and exercise capacity by a medical doctor at the Institute of Sports Medicine, Prevention and Rehabilitation. Weekly physical activity, using the International Physical Activity Questionnaire and commuting behavior, using an online diary, were used to assess physical activity. At the end of the study, the change in exercise capacity did significantly differ between IG and CG (P = .003, ES = 0.82). Actively covered distances through commuting significantly differed between groups (walking P = .026; cycling P < .001). Therefore, active commuting improves exercise capacity and can be recommended to the working population to increase exercise capacity.
Collapse
Affiliation(s)
- Bernhard Reich
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| | - Maria Dolores Fernandez La Puente de Battre
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Valentina Alice Rossi
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Bernhard Zagel
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| | - Stefano Caselli
- Cardiovascular Center Zürich, Hirslanden Klinik im Park, Zürich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
5
|
Sareban M, Fernandez La Puente de Battre MD, Reich B, Schmied C, Loidl M, Niederseer D, Niebauer J. Effects of active commuting to work for 12 months on cardiovascular risk factors and body composition. Scand J Med Sci Sports 2020; 30 Suppl 1:24-30. [PMID: 32333707 PMCID: PMC7496505 DOI: 10.1111/sms.13695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
Active commuting has the potential to decrease cardiovascular risk by increasing physical activity. We aimed to investigate the effects of active commuting to work for 12 months on body composition and cardiovascular risk factors. Therefore, 73 hospital employees (age: 46 ± 9 years, 36% males), with a predominantly passive way of commuting, were randomly assigned to an intervention group (IG) and a control group (CG) in a 2:1 fashion. The IG was further divided into a public transportation plus active commuting group (IG‐PT) and a cycling group (IG‐C). Both IGs were prompted to reach 150 min/wk of moderate intensity exercise. Daily self‐reported commuting details were verified by GPS tracking. All subjects underwent assessment of body composition, resting blood pressure, glycemic control, and lipid profile at the beginning and end of the study. Data for final analyses were available in 62 subjects. Commuting details indicated that the subjects randomized to IG changed their commuting habits. HbA1c decreased by 0.2% [95%CI: −0.3, −0.2] in IG‐PT but was not statistically different between groups (P = .06). LDL cholesterol decreased in IG‐C by 0.8 mmol/L [−1.1, −0.4] and by 0.6 mmol/L [−1.2, 0.1] in IG‐PT which can be considered biologically relevant but did not yield statistical significance. Body composition and blood pressure did not differ between groups. Active commuting to work for 12 months did not change body composition but yielded relevant changes in lipid profile and glycemic control. Health benefits of active commuting should be addressed by healthcare professionals when counseling individuals that seek to improve their cardiovascular risk profile.
Collapse
Affiliation(s)
- Mahdi Sareban
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Maria Dolores Fernandez La Puente de Battre
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Bernhard Reich
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Christian Schmied
- Department of Cardiology, University Heart Centre, University Hospital Zürich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University of Salzburg, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Centre, University Hospital Zürich, Zürich, Switzerland
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| |
Collapse
|
6
|
Neumeier LM, Loidl M, Reich B, Fernandez La Puente de Battre MD, Kissel CK, Templin C, Schmied C, Niebauer J, Niederseer D. Effects of active commuting on health-related quality of life and sickness-related absence. Scand J Med Sci Sports 2020; 30 Suppl 1:31-40. [PMID: 32246792 DOI: 10.1111/sms.13667] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 02/19/2020] [Accepted: 03/24/2020] [Indexed: 01/19/2023]
Abstract
Increased physical activity is associated with numerous health benefits. This study investigated the effect of active commuting (walking and cycling to work) on health-related quality of life (HRQoL) and absence days from work due to sickness in healthy working adults. In total, 73 participants (age: 46 ± 9 years), all working at a tertiary university hospital in Salzburg, Austria, were randomized into an intervention group (IG, n = 51) and a control group (CG, n = 22). The IG was asked to commute actively for twelve months, whereas the CG did not have to change their usual commuting behavior. IG was divided into two subgroups: IG-C (cycling, n = 26) was asked to commute by bicycle and IG-PT (public transport, n = 25) partially using public transportation and walked the remaining distance to work. Significant positive changes in IG were observed in four subcomponents of the SF-36 (physical functioning (95 [10] to 100 [8.8], P = .023), mental health (82 [15] to 86 [15], P = .036), vitality (65 [20] to 70 [14], P = .005), and general health (70 [19] to 80 [24], P = .004)) as well as the physical component summary score (56.5 [9] to 59.2 [6.3], P = .002). IG-C showed greater and more statistically significant changes regarding HRQoL compared to IG-PT. Associations between active commuting and sick-leave days were only observed in IG-PT (7.5 [14.8] to 4.0 [11.3] days, P = .038). In conclusion, active commuting improves various components of HRQoL and might therefore be a possible strategy to increase quality of life in the workforce.
Collapse
Affiliation(s)
- Luis M Neumeier
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics-Z_GIS, University of Salzburg, Salzburg, Austria
| | - Bernhard Reich
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Maria Dolores Fernandez La Puente de Battre
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Christine K Kissel
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Christian Templin
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Centre, University Hospital Zurich, Zürich, Switzerland
| |
Collapse
|
7
|
Schmied C, Loidl M, Rossi V, Fernandez La Puente de Battre MD, Reich B, Niebauer J, Niederseer D. Dose-response relationship of active commuting to work: Results of the GISMO study. Scand J Med Sci Sports 2020; 30 Suppl 1:50-58. [PMID: 32003063 DOI: 10.1111/sms.13631] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 01/16/2020] [Accepted: 01/23/2020] [Indexed: 12/24/2022]
Abstract
The positive health benefits of regular exercise, particularly regarding cardiovascular risk and diseases, are well recognized and scientifically evident. However, a sedentary lifestyle is one of the most important cardiovascular risk factors that are still insufficiently addressed. Leisure-time active commuting like walking and biking is an ideal way to improve exercise behavior in the general population. The purpose of this substudy of the GISMO study was to assess dose-response relations in all commuters and the three subgroups of commuters (physically active by bicycle and/or walking, physically active by using public transportation (PT), and the controls using their own vehicles). As such, a positive dose-response relationship could be confirmed in all physically active commuters compared to the control group. Whether the commuters cycled, walked, or traveled by PT -the more the physical exercise they performed (measured in metabolic equivalent [MET]-hours), the larger their gain in physical fitness (measured in gained or "Delta" Watt during a maximal exercise test), and their physical fitness at the end of the study was P = .016 and P = .003, respectively. Health-related quality of life correlated in two out of eight subdomains of the SF-36 questionnaire with MET-hours achieved during the study period (General Health and Physical Functioning). No clearly significant dose-response could be observed regarding HDL(high-density lipoprotein)-cholesterol or body composition. Our results indicate a dose-response pattern of healthy commuting in exercise capacity and health-related quality of life to increase doses of physically active commuting.
Collapse
Affiliation(s)
- Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| | - Valentina Rossi
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Maria Dolores Fernandez La Puente de Battre
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Bernhard Reich
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation and Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| |
Collapse
|
8
|
Niederseer D, Schmied C, Niebauer J, Loidl M. Geographical Information Support for Health Mobility-Promoting active commuting as a novel option to counteract sedentary lifestyle. Scand J Med Sci Sports 2019; 30 Suppl 1:5-7. [PMID: 31389090 DOI: 10.1111/sms.13533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 07/25/2019] [Indexed: 12/23/2022]
Affiliation(s)
- David Niederseer
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Christian Schmied
- Department of Cardiology, University Heart Center Zurich, University of Zurich, Zürich, Switzerland
| | - Josef Niebauer
- Institute of Sports Medicine, Prevention and Rehabilitation, Research Institute of Molecular Sports Medicine and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Martin Loidl
- Department of Geoinformatics, Paris Lodron University Salzburg, Salzburg, Austria
| |
Collapse
|