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Marafon BB, Pinto AP, de Sousa Neto IV, da Luz CM, Pauli JR, Cintra DE, Ropelle ER, Simabuco FM, Pereira de Moura L, de Freitas EC, Rivas DA, da Silva ASR. The role of interleukin-10 in mitigating endoplasmic reticulum stress in aged mice through exercise. Am J Physiol Endocrinol Metab 2024; 327:E384-E395. [PMID: 39082901 DOI: 10.1152/ajpendo.00204.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/25/2024] [Accepted: 07/25/2024] [Indexed: 09/06/2024]
Abstract
Although unfolded protein response (UPR) is essential for cellular protection, its prolonged activation may induce apoptosis, compromising cellular longevity. The aging process increases the endoplasmic reticulum (ER) stress in skeletal muscle. However, whether combined exercise can prevent age-induced ER stress in skeletal muscle remains unknown. Evidence suggests that ER stress may increase inflammation by counteracting the positive effects of interleukin-10 (IL-10), whereas its administration in cells inhibits ER stress and apoptosis. This study verified the effects of aging and combined exercise on physical performance, ER stress markers, and inflammation in the quadriceps of mice. Moreover, we verified the effects of IL-10 on ER stress markers. C57BL/6 mice were distributed into young (Y, 6 mo old), old sedentary (OS, sedentary, 24 mo old), and old trained group (OT, submitted to short-term combined exercise, 24 mo old). To clarify the role of IL-10 in UPR pathways, knockout mice lacking IL-10 were used. The OS mice presented worse physical performance and higher ER stress-related proteins, such as C/EBP homologous protein (CHOP) and phospho-eukaryotic translation initiation factor 2 alpha (p-eIF2α/eIF2α). The exercise protocol increased muscle strength and IL-10 protein levels in OT while inducing the downregulation of CHOP protein levels compared with OS. Furthermore, mice lacking IL-10 increased BiP, CHOP, and p-eIF2α/eIF2α protein levels, indicating this cytokine can regulate the ER stress response in skeletal muscle. Bioinformatics analysis showed that endurance and resistance training downregulated DNA damage inducible transcript 3 (DDIT3) and XBP1 gene expression in the vastus lateralis of older people, reinforcing our findings. Thus, combined exercise is a potential therapeutic intervention for promoting adjustments in ER stress markers in aged skeletal muscle.NEW & NOTEWORTHY Aging elevates endoplasmic reticulum (ER) stress in skeletal muscle, potentially heightening inflammation by opposing interleukin-10 (IL-10) effects. This study found that short-term combined exercise boosted strength and IL-10 protein levels while reducing CHOP protein levels in older mice. In addition, IL-10-deficient mice exhibited increased ER stress markers, highlighting IL-10's role in regulating ER stress in skeletal muscle. Consequently, combined exercise emerges as a therapeutic intervention to elevate IL-10 and adjust ER stress markers in aging.
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Affiliation(s)
- Bruno Brieda Marafon
- Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
| | - Ana Paula Pinto
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
| | - Ivo Vieira de Sousa Neto
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
| | - Caroline Mantovani da Luz
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
| | - José Rodrigo Pauli
- School of Applied Sciences, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Dennys Esper Cintra
- School of Applied Sciences, University of Campinas (UNICAMP), São Paulo, Brazil
| | | | | | | | - Ellen Cristini de Freitas
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
- Department of Health Science, Ribeirao Preto, Medical School, University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Donato Americo Rivas
- Center for Exercise Medicine Research, Fralin Biomedical Research Institute, Virginia Tech Carilion, Roanoke, Virginia, United States
| | - Adelino Sanchez Ramos da Silva
- Postgraduate Program in Rehabilitation and Functional Performance, Ribeirão Preto Medical School, University of São Paulo (USP), São Paulo, Brazil
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo (USP), São Paulo, Brazil
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Callow DD, Spira AP, Bakker A, Smith JC. Sleep Quality Moderates the Associations between Cardiorespiratory Fitness and Hippocampal and Entorhinal Volume in Middle-Aged and Older Adults. Med Sci Sports Exerc 2024; 56:1740-1746. [PMID: 38742864 PMCID: PMC11326995 DOI: 10.1249/mss.0000000000003454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
INTRODUCTION/PURPOSE As individuals age, the entorhinal cortex (ERC) and hippocampus-crucial structures for memory-tend to atrophy, with related cognitive decline. Simultaneously, lifestyle factors that can be modified, such as exercise and sleep, have been separately linked to slowing of brain atrophy and functional decline. However, the synergistic impact of fitness and sleep on susceptible brain structures in aging adults remains uncertain. METHODS We examined both independent and interactive associations of fitness and subjective sleep quality with regard to ERC thickness and hippocampal volume in 598 middle-aged and older adults from the Human Connectome Lifespan Aging Project. Cardiorespiratory fitness was assessed using the 2-min walk test, whereas subjective sleep quality was measured with the continuous Pittsburgh Sleep Quality Index global score. High-resolution structural magnetic resonance imaging was used to examine mean ERC thickness and bilateral hippocampal volume. Through multiple linear regression analyses, we investigated the moderating effects of subjective sleep quality on the association between fitness and brain structure, accounting for age, sex, education, body mass index, gait speed, and subjective physical activity. RESULTS We found that greater cardiorespiratory fitness, but not subjective sleep quality, was positively associated with bilateral hippocampal volume and ERC thickness. Notably, significant interaction effects suggest that poor subjective sleep quality was associated with a weaker association between fitness and both hippocampal volume and ERC thickness. CONCLUSIONS Findings suggest the potential importance of both cardiorespiratory fitness and subjective sleep quality in preserving critical, age-vulnerable brain structures. Interventions targeting brain health should consider potential combined effects of sleep and fitness on brain health.
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Affiliation(s)
- Daniel D Callow
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | | | - J Carson Smith
- Department of Kinesiology, University of Maryland, College Park, MD
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Almutairi AH, Almutairi NS, Mousa N, Elsayed A, El-Sehrawy A, Elmetwalli A. Aerobic exercise as a non-pharmacological intervention for improving metabolic and hemodynamic profiles in type 2 diabetes. Ir J Med Sci 2024:10.1007/s11845-024-03783-6. [PMID: 39158674 DOI: 10.1007/s11845-024-03783-6] [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: 06/22/2024] [Accepted: 08/08/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Type 2 Diabetes Mellitus (T2DM) is a global health concern associated with numerous complications. Aerobic exercise is recognized as a crucial non-pharmacological intervention for T2DM management, but its specific effects on key health parameters warrant further investigation. OBJECTIVE This study aimed to evaluate the impact of a structured 8-week aerobic exercise program on fasting blood glucose (FBG), glycated haemoglobin (HbA1c), body mass index (BMI), blood pressure (BP), and resting heart rate (RHR) in individuals with T2DM. METHODS A prospective study was conducted with 100 participants diagnosed with T2DM. The intervention group (n = 50) underwent a supervised aerobic exercise program for eight weeks, while the control group (n = 50) received no structured exercise intervention. Pre- and post-intervention assessments were conducted to measure FBG, HbA1c, BMI, BP, RHR, and VO₂ max were taken. RESULTS The aerobic group exhibited a significant reduction in FBG, declining from 141 to 132 mg/dl. Correspondingly, HbA1c decreased from 7.93 to 7.15%. Additionally, the aerobic group demonstrated a notable decrease in RHR from 72 to 66 bpm, indicating improved cardiovascular fitness. Concurrently, VO2 max increased from 22 to 26 mL/kg/min, further supporting the enhancement of cardiorespiratory capacity. Trends toward improvement were also observed in SBP and DBP. Correlation analysis revealed significant relationships between various health parameters, highlighting the interconnectedness of these variables in T2DM management. CONCLUSIONS This study provides robust evidence supporting the benefits of aerobic exercise in individuals with T2DM. The improvements in glycemic control, blood pressure, and cardiorespiratory fitness underscore the importance of incorporating structured exercise programs into diabetes management protocols. The results emphasize the importance of incorporating regular physical activity into diabetes management strategies to optimize health outcomes and reduce the risk of complications.
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Affiliation(s)
- Aeshah Hamdan Almutairi
- Public Health Department, Health Sciences College at Al Leith, Umm Al Qura University, 24382, Mecca, Saudi Arabia
| | - Nayef Shabbab Almutairi
- Public Health Department, Health Sciences College at Al Leith, Umm Al Qura University, 24382, Mecca, Saudi Arabia
| | - Nasser Mousa
- Tropical Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Department of Clinical Trial Research Unit and Drug Discovery, Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt
| | - Ashraf Elsayed
- Botany Department, Faculty of Science, Mansoura University, Mansoura, Egypt
| | - Amr El-Sehrawy
- Internal Medicine Department, Mansoura University, Mansoura, Egypt
| | - Alaa Elmetwalli
- Department of Clinical Trial Research Unit and Drug Discovery, Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt.
- Microbiology Division, Higher Technological Institute of Applied Health Sciences, Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt.
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Azizan A, Fadzil NHM. What stops us and what motivates us? A scoping review and bibliometric analysis of barriers and facilitators to physical activity. Ageing Res Rev 2024; 99:102384. [PMID: 38914263 DOI: 10.1016/j.arr.2024.102384] [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: 02/19/2024] [Revised: 05/12/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024]
Abstract
INTRODUCTION Physical inactivity is a major global health concern, contributing to the rising non-communicable disease burden. Elucidating barriers and facilitators influencing participation is critical to promoting activity. This study aimed to synthesize the literature and analyze the extent of research on determinants of physical activity engagement. METHODS Scoping review methodology guided the synthesis of 272 publications on factors influencing physical activity. Bibliometric analysis examined publication trends, productivity, influential studies, content themes, and collaboration networks. RESULTS Since 2010, the United States has led a significant increase in research output. Highly cited articles identified physiological limitations and psychosocial determinants as key barriers and facilitators. Extensive focus was seen in clinical medicine and exercise science journals. Analysis revealed predominant attention to psychosocial factors, physiological responses, and applications in respiratory disease. Gaps remain regarding policy and environmental factors. CONCLUSION This review showed major advances in elucidating determinants while revealing the remaining needs to curb the pandemic of inactivity globally. Expanding international collaboration, contemporary theoretical models, and tailored mixed-methods approaches could promote progress through greater global participation. Addressing knowledge gaps across populations and disciplines should be a priority.
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Affiliation(s)
- Azliyana Azizan
- Centre of Physiotherapy, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Selangor 42300, Malaysia; Clinical and Rehabilitation Exercise Research Group, Faculty of Health Sciences, Universiti Teknologi MARA, Puncak Alam, Selangor 42300, Malaysia.
| | - Nurul Hidayah Md Fadzil
- Center for Healthy Ageing and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Domaradzki J, Koźlenia D. Cardiovascular and cardiorespiratory effects of high-intensity interval training in body fat responders and non-responders. Sci Rep 2024; 14:14631. [PMID: 38918508 PMCID: PMC11199575 DOI: 10.1038/s41598-024-65444-z] [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: 07/17/2023] [Accepted: 06/20/2024] [Indexed: 06/27/2024] Open
Abstract
This study aimed to investigate cardiovascular and cardiorespiratory adaptations to exercise intervention among participants who showed higher (responders-RSBFP) and lower (non-responders-NRSBFP) levels of body fat percentage (BFP) responsiveness. Adolescents (42.5% males) participated in a ten-week school-based high-intensity interval training (HIIT), followed by a comparison of BFP, blood pressure (BP), and cardiorespiratory fitness (CRF). RSBFP age of 16.15 ± 0.36 years, body height 170.82 ± 8.16 cm, weight 61.23 ± 12.80 kg, and BMI 20.86 ± 3.29 kg/m2. Meanwhile, NRSBFP age of 16.04 ± 0.36 years, body height 168.17 ± 8.64 cm, weight 57.94 ± 8.62 kg, and BMI 20.47 ± 2.24 kg/m2. HIIT intervention impacted BFP, with a higher decrease in the RSBFP than the NRSBFP (ΔBFPRs = - 2.30 ± 3.51(10.34%) vs. ΔBFPNRs = 1.51 ± 1.54(6.96%) p < 0.001). The primary comparison showed a statistically significant interaction effect in relation to CRF (F(1,71) = 14.12; p < 0.001). Detailed comparisons showed large and significant CRF changes in RSBFP (7.52%; d = 0.86; p < 0.001) but not in NRSBFP (2.01%; d = 0.11; p = 0.576). In addition, RSBFP and NRSBFP benefited equally in SBP (5.49%, d = 0.75; p < 0.001; 4.95%, d = 0.74; p < 0.001, respectively). These findings highlight that exercise benefits on body fat may be mainly related to gains in CRF. Due to substantial intra-individual variability in adaptation, there is a need for personalized intervention tailored for those with different reaction thresholds in body mass components.
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Affiliation(s)
- Jarosław Domaradzki
- Unit of Biostructure, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, al. I.J. Paderewskiego 35, 51-612, Wroclaw, Poland
| | - Dawid Koźlenia
- Unit of Biostructure, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, al. I.J. Paderewskiego 35, 51-612, Wroclaw, Poland.
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Domaradzki J, Koźlenia D. Muscular fitness profiles in relation to the response in body fat during school-based high-intensity intervention. J Sports Med Phys Fitness 2024; 64:550-559. [PMID: 38358366 DOI: 10.23736/s0022-4707.24.15586-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
BACKGROUND We aimed to assess the equivalence of the muscular fitness (MF) between body fat percentage (BFP) responders (RsBFP) and non-responders (NRsBFP) to school-based high-intensity interval training (HIIT). Adolescents aged 16 (N.=73, 42.5% of males) were identified as RsBFP (N.=45) or NRsBFP (N.=28). MF was assessed based on hand strength (HS), abdominal muscle strength (ABS), and leg power (VJ). METHODS Profile analysis showed distinct patterns of MF changes in both response categories. Despite the presence of parallelism (Wilks' Λ=0.979, Pillai's V=0.212, P=0.473), a gradient of increasing changes (HS-ABS-VJ) was found in the RsBFP, while a gradient of decreasing changes was shown in the NRsBFP, and a significant level of inequality (F(1,71)=7.823, P=0.047, partial eta-squared [η2p] 0.041). RESULTS One-way analysis showed a significant and moderate effect on VJ (F(1,71)=7.080, P=0.010, η2P=0.091), a close to significant effect on ABS (F(1,71)=3.300, P=0.074, η2P=0.044) and lack of an effect on HS (F(1,71)=0.699, P=0.406, η2P=0.010). The test of equal means across the condition categories (separately for RsBFP and NRsBFP) indicated that there was no multivariate statistically significant within-group effect (F(2, 70)=0.517, P=0.599). CONCLUSIONS The findings may help teachers assess the potential and indirect changes in muscle performance after employing a body weight intervention (based on the HIIT program). A more targeted approach to treating adolescents with excessive BF, in parallel with improving MF, can be individually tailored.
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Affiliation(s)
- Jarosław Domaradzki
- Faculty of Physical Education and Sport, Wrocław University of Health and Sport Sciences, Wroclaw, Poland
| | - Dawid Koźlenia
- Faculty of Physical Education and Sport, Wrocław University of Health and Sport Sciences, Wroclaw, Poland -
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Wheatley-Guy CM, Shea MG, Parks JK, Scales R, Goodman BP, Butterfield RJ, Johnson BD. Semi-supervised exercise training program more effective for individuals with postural orthostatic tachycardia syndrome in randomized controlled trial. Clin Auton Res 2023; 33:659-672. [PMID: 37598401 PMCID: PMC10751269 DOI: 10.1007/s10286-023-00970-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE Exercise like any medication requires the correct dose; to be effective the appropriate frequency, duration, and intensity are necessary. This study aimed to assess if a semi-supervised exercise training (ET) program would be more effective at improving aerobic fitness (VO2PEAK), exercise tolerance, and symptoms in individuals with postural orthostatic tachycardia syndrome (POTS) compared to the standard of care (SOC). METHODS Subjects were randomized to either the ET or SOC groups (n 26 vs. 23; age 33 ± 11 vs. 37 ± 10 years; VO2PEAK 66 ± 15 vs. 62 ± 15% predicted, ET vs. SOC respectively, p > 0.05). Composite Autonomic Symptom Score (COMPASS 31), 10 min stand test, and cardiopulmonary exercise test were performed at baseline and following 12 weeks. The ET group received an exercise consultation and eight semi-supervised in-person or virtual exercise sessions. RESULTS The ET group demonstrated a greater improvement in VO2PEAK, higher or longer tolerance for baseline peak workload, and more often had a delayed symptom onset with exercise than the SOC group (ΔVO2PEAK 3.4 vs. - 0.2 mL/min/kg, p < 0.0001, ΔWorkload 19 ± 17 vs. 0 ± 10 W; Workload time 63 ± 29 vs. 22 ± 30 s; onset-delay 80% vs. 30%, p < 0.05). Individuals in the ET group reported a significant improvement in orthostatic intolerance domain score (p = 0.02), but there was not a significant difference in the improvement in total COMPASS score (- 11.38 vs. - 6.49, p = 0.09). CONCLUSION Exercise training was more effective with greater improvements in aerobic fitness, orthostatic symptoms, and exercise tolerance for individuals with POTS when intensity and progression were personalized and delivered with minimal supervision compared to the SOC.
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Affiliation(s)
- Courtney M Wheatley-Guy
- Division of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA.
| | - Meredith G Shea
- Division of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Jordan K Parks
- Division of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Robert Scales
- Division of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
| | | | | | - Bruce D Johnson
- Division of Cardiovascular Diseases, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA
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Lamoureux NR, Lansing J, Welk GJ. An observational pilot evaluation of the Walk with Ease program for reducing fall risk among older adults. Arch Public Health 2023; 81:203. [PMID: 37986196 PMCID: PMC10662528 DOI: 10.1186/s13690-023-01219-8] [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: 07/19/2023] [Accepted: 11/13/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Physical activity is an effective method of reducing fall risk among older adults. Previous evaluations of the six-week Walk with Ease (WWE) program have documented benefits to functional outcomes, but the potential effects on reducing fall risk have not been evaluated. This pilot study evaluates outcomes of a community delivered WWE program for potential suitability as a fall risk reduction program. METHODS A total of 59 older adults (age > 60) enrolled in a group version of WWE delivered by trained community-based leaders. Complete data (pre- and post-program) from functional fitness tests and behavioral instruments were obtained from 41 participants (aged 74.4 ± 6.6 years, 70% female). Functional outcomes included the 10-foot timed up and go (TUG), 30-second chair stand (CST) and 4-stage balance test (BT) included as part of STEADI, as well as a two-minute step test (ST) and normal gait speed test (GST). Survey assessments included STEADI fall risk screening, self-reported physical activity, and fear of falling measures. Analyses focused on reporting pre-post effect sizes, but paired t-tests were used to test statistical significance of differences. RESULTS Improvements in functional performance approached significance for both CST (d = 0.31, p = 0.06) and ST (d = 0.26, p = 0.12), but all other tests were nonsignificant. Survey results demonstrated significant increases in self-reported walking (d = 0.54, p = 0.02) and moderate-to-vigorous physical activity (MVPA; d = 0.56, p = 0.004), but perceived fear of falling and overall fall risk scores had smaller, non-significant, effects (d ranging from 0.01 to 0.31). Stratified analysis suggested that participants screened at an elevated risk for falls at baseline consistently had larger effects on all functional and survey assessments, though the analysis was underpowered to test significance. CONCLUSIONS Walk with Ease participation significantly increased self-reported physical activity but did not significantly improve physical function or reduce fall risk. However, consistently larger effect sizes among participants screened as at-risk for falls suggest that the program may be beneficial for those with elevated risk for falls or functional limitations. Further research is needed to document the consistency of these effects among participants with elevated fall risk status.
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Affiliation(s)
- Nicholas R Lamoureux
- Department of Kinesiology and Sport Sciences, University of Nebraska at Kearney, Cushing Coliseum W220, 1410W 26th St, Kearney, NE, 68849, USA.
| | - Jeni Lansing
- Department of Kinesiology and Health, Iowa State University, Ames, IA, USA
| | - Gregory J Welk
- Department of Kinesiology and Health, Iowa State University, Ames, IA, USA
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Katsoulis K, Amara CE. The Effects of Power Training Frequency on Muscle Power and Functional Performance in Older Women: A Randomized Controlled Trial. J Strength Cond Res 2023; 37:2289-2297. [PMID: 37335760 DOI: 10.1519/jsc.0000000000004527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
ABSTRACT Katsoulis, K and Amara, CE. The effects of power training frequency on muscle power and functional performance in older women: a randomized controlled trial. J Strength Cond Res 37(11): 2289-2297, 2023-Low-intensity power training (PT) has emerged as an effective method for improving muscle power and functional performance in older adults. However, effects of low training frequencies are less understood and could expand the repertoire of exercise prescription, particularly in older women who experience greater functional disability with age compared with men. This study investigated the impact of frequency of low-intensity (40% of 1 repetition maximum, 1RM) PT on lower-body power and functional performance in healthy older women. Women (74 ± 4 years) were randomized to 12 weeks of PT of 1 (PT1, n = 14), 2 (PT2, n = 17), or 3 (PT3, n = 17) d·wk -1 or wait control (CON, n = 15). Measures included leg press 1RM, knee extension power (KEP), and functional performance (stair climb power, stair climb time, 30-second chair stands, 400-m walk, Short Physical Performance Battery). There were no differences between the frequency of training in changes in leg press 1RM, KEP, or functional performance after 12 weeks. Pre-post data for individual training groups revealed that leg press 1RM improved in all PT groups (20-33%, p < 0.05). Furthermore, KEP improved in PT2 and PT3 by 10 and 12%, respectively, and all PT groups improved in the 30-second chair stands and Short Physical Performance Battery (6-22%), whereas PT1 and PT3 improved in the 400-m walk and PT2 improved in stair climb power and stair climb time after training (4-7%, p < 0.05). One to 3 weekly low-intensity PT sessions can improve functional performance, although improvements in both functional performance and power might require 2 or 3 sessions per week in older healthy women.
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Affiliation(s)
- Konstantina Katsoulis
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Leach HJ, Fairman CM, Gomes EL, Marker RJ. Evaluating individual level change in physical function response following an exercise program for cancer survivors. Support Care Cancer 2023; 31:353. [PMID: 37233792 DOI: 10.1007/s00520-023-07814-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/13/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE Cancer survivors physical function response to exercise programs at the group level is well-established. However, to advance toward a more personalized approach in exercise oncology, a greater understanding of individual response is needed. This study utilized data from a well-established cancer-exercise program to evaluate the heterogeneity of physical function response and explore characteristics of participants who did vs. did not achieve a minimal clinically important difference (MCID). METHODS Physical function measures (grip strength, 6-min walk test (6MWT), and sit-to-stand) were completed pre/post the 3-month program. Change scores for each participant and the proportion achieving the MCID for each physical function measure were calculated. The independent t-tests, Fisher's exact test, and decision tree analyses were used to explore differences in age, body mass index (BMI), treatment status, exercise session attendance, and baseline value between participants who achieved the MCID vs. those who did not. RESULTS Participants (N = 250) were 55 ± 14 years old, majority female (69.2%), white (84.1%), and diagnosed with breast cancer (36.8%). Change in grip strength ranged from - 42.1 to + 47.0 lb, and 14.8% achieved the MCID. Change in 6MWT ranged from - 151 to + 252 m, and 59% achieved the MCID. Change in sit-to-stand ranged from - 13 to + 20 reps, and 63% achieved the MCID. Baseline grip strength, age, BMI, and exercise session attendance were related to achieving MCID. CONCLUSIONS Findings illustrate wide variability in the magnitude of cancer survivors' physical function response following an exercise program, and that a variety of factors predict response. Further investigation into the biological, behavioral, physiological, and genetic factors will inform tailoring of exercise interventions and programs to maximize the proportion of cancer survivors who can derive clinically meaningful benefits.
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Affiliation(s)
- Heather J Leach
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, 80523, USA.
- Department of Community and Behavioral Health, Colorado School of Public Health at CSU, Fort Collins, CO, USA.
| | - Ciaran M Fairman
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Emma L Gomes
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO, 80523, USA
| | - Ryan J Marker
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Custodero C, Pahor M, Mazzoccoli C, Manini TM, Anton SD, Mazzocca A, Lozupone M, Panza F, Sabbà C, Solfrizzi V. Effect of change of interleukin-6 over time on gait speed response: Results from the lifestyle interventions and independence for elders study. Mech Ageing Dev 2023; 210:111763. [PMID: 36526102 DOI: 10.1016/j.mad.2022.111763] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 11/27/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022]
Abstract
Interleukin (IL)-6 is a well-accepted biomarker of chronic low-grade inflammation possibly conditioning the effect of physical activity (PA) intervention on physical performance in mobility-limited older adults. We evaluated PA intervention effects on 400 m gait speed by yearly change of IL-6 levels in a post-hoc analysis from Lifestyle Interventions and Independence for Elders (LIFE) Study, a multicenter single-blind randomized clinical trial on 1300 sedentary older adults (mean age:78.85 ± 5.23,65.85 % women) at risk for mobility disability. We compared the intervention effects on 400 m gait speed at 12 months follow-up, according to yearly IL-6 change categorized for 1 pg/ml increase or decrease, and subsequently for larger range of yearly variation. Among subjects with yearly IL-6 change between -1 and + 2 pg/ml, we observed a significant difference of gait speed in PA intervention group compared to healthy educational intervention group [0.041 m/s,95 % confidence interval (CI):0.008-0.074,p = 0.006;Cohen's d:0.26, 95 % CI:0.12-0.41). No effects were observed on 400 m gait speed for wider range of variation of plasma IL-6 levels. Limiting change of IL-6 levels under this specific hormetic window could be an important goal to achieve better benefit from PA intervention in terms of gait speed change and prevention of mobility disability.
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Affiliation(s)
- Carlo Custodero
- Dipartimento Interdisciplinare di Medicina, University of Bari Aldo Moro, Bari, Italy
| | - Marco Pahor
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Carmela Mazzoccoli
- Dipartimento Interdisciplinare di Medicina, University of Bari Aldo Moro, Bari, Italy
| | - Todd M Manini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Stephen D Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Antonio Mazzocca
- Dipartimento Interdisciplinare di Medicina, University of Bari Aldo Moro, Bari, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy.
| | - Carlo Sabbà
- Dipartimento Interdisciplinare di Medicina, University of Bari Aldo Moro, Bari, Italy
| | - Vincenzo Solfrizzi
- Dipartimento Interdisciplinare di Medicina, University of Bari Aldo Moro, Bari, Italy.
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12
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Formighieri C, Müller DC, Sáez de Asteasu ML, Mello A, Teodoro JL, Boeno F, Grazioli R, Cunha GDS, Pietta-Dias C, Izquierdo M, Pinto RS, Cadore EL. Interindividual variability of adaptations following either traditional strength or power training combined to endurance training in older men: A secondary analysis of a randomized clinical trial. Exp Gerontol 2022; 169:111984. [PMID: 36270544 DOI: 10.1016/j.exger.2022.111984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/08/2022] [Accepted: 10/13/2022] [Indexed: 12/15/2022]
Abstract
This study aimed to investigate the interindividual responses following two different concurrent training (CT) regimens in neuromuscular, cardiorespiratory and functional outcomes of older men. Thirty-five older men (65.8 ± 3.9 years) were randomly allocated into one of two CT groups: power training (PT) + high-intensity interval training (HIIT) (n = 17); or traditional strength training (TST) + HIIT (n = 18). Maximal dynamic strength (one-repetition maximum, 1RM), rate of force development at 100 milliseconds (RDF100), countermovement jump power (CMJ), quadriceps femoris muscle thickness (QF MT), functional tests (sit-to-stand, timed-up-and-go, and stair climbing), and peak oxygen consumption (VO2peak) were assessed pre-, post-8 and post-16 weeks of training. The Chi-squared test was used for assessing differences in the prevalence of responders (Rs), non-responders (NRs), and adverse responders (ARs). Similar prevalence of individual responses (Rs, NRs and ARs) between groups were observed after intervention in almost all outcomes: 1RM; power at CMJ; QF MT, and functional tests (P > 0.05). However, a significant difference in the distribution of Rs, NRs and ARs between groups was observed in the RFD100 after 16 weeks (p = 0.003), with PT + HIIT group presenting high prevalence of Rs than TST + HIIT (100 % vs. 50 %). The inclusion of explosive-type of contractions in a concurrent training regime induces greater responsiveness in the RFD100 in older men, while no differences compared to traditional strength training are observed in maximal strength, muscle size, VO2peak, and functional performance.
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Affiliation(s)
- Carolina Formighieri
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Brazil
| | - Diana C Müller
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Brazil
| | - Mikel L Sáez de Asteasu
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IDISNA, Pamplona, Navarra, Spain
| | - Alexandre Mello
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Brazil
| | - Juliana L Teodoro
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Brazil
| | - Francesco Boeno
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Brazil
| | - Rafael Grazioli
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Brazil
| | - Giovani Dos S Cunha
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Brazil
| | - Caroline Pietta-Dias
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Brazil
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IDISNA, Pamplona, Navarra, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Ronei S Pinto
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Brazil
| | - Eduardo L Cadore
- Exercise Research Laboratory, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Brazil.
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13
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La Gerche A, Howden EJ, Haykowsky MJ, Lewis GD, Levine BD, Kovacic JC. Heart Failure With Preserved Ejection Fraction as an Exercise Deficiency Syndrome: JACC Focus Seminar 2/4. J Am Coll Cardiol 2022; 80:1177-1191. [PMID: 36075837 DOI: 10.1016/j.jacc.2022.07.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 10/14/2022]
Abstract
Across differing spectrums of cardiac function and cardiac pathologies, there are strong associations between measures of cardiorespiratory fitness and burden of symptoms, quality of life, and prognosis. In this part 2 of a 4-part series, we contend that there is a strong association among physical activity, cardiorespiratory fitness, and cardiac function. We argue that a chronic lack of exercise is a major risk factor for heart failure with preserved ejection fraction in some patients. In support of this hypothesis, increasing physical activity is associated with greater cardiac mass, greater stroke volumes, greater cardiac output and peak oxygen consumption, and fewer clinical events. Conversely, physical inactivity results in cardiac atrophy, reduced output, reduced chamber size, and decreased ability to augment cardiac performance with exercise. Moreover, physical inactivity is a strong predictor of heart failure risk and death. In sum, exercise deficiency should be considered part of the broad heart failure with preserved ejection fraction phenotype.
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Affiliation(s)
- Andre La Gerche
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; National Centre for Sports Cardiology, Fitzroy, Victoria, Australia; Cardiology Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
| | - Erin J Howden
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Mark J Haykowsky
- Clinical Research Domain, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Gregory D Lewis
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, Texas, USA; University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jason C Kovacic
- Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Cardiovascular Research Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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14
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Bell LR, Gabbett TJ, Davis GM, Wallen MP, O’Brien BJ. Stubborn Exercise Responders-Where to Next? Sports (Basel) 2022; 10:sports10060095. [PMID: 35736835 PMCID: PMC9229615 DOI: 10.3390/sports10060095] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022] Open
Abstract
There is a wide variance in the magnitude of physiological adaptations after resistance or endurance training. The incidence of “non” or “poor” responders to training has been reported to represent as high as 40% of the project’s sample. However, the incidence of poor responders to training can be ameliorated with manipulation of either the training frequency, intensity, type and duration. Additionally, global non-response to cardio-respiratory fitness training is eliminated when evaluating several health measures beyond just the target variables as at least one or more measure improves. More research is required to determine if altering resistance training variables results in a more favourable response in individuals with an initial poor response to resistance training. Moreover, we recommend abandoning the term “poor” responders, as ultimately the magnitude of change in cardiorespiratory fitness in response to endurance training is similar in “poor” and “high” responders if the training frequency is subsequently increased. Therefore, we propose “stubborn” responders as a more appropriate term. Future research should focus on developing viable physiological and lifestyle screening tests that identify likely stubborn responders to conventional exercise training guidelines before the individual engages with training. Exerkines, DNA damage, metabolomic responses in blood, saliva and breath, gene sequence, gene expression and epigenetics are candidate biomarkers that warrant investigation into their relationship with trainability. Crucially, viable biomarker screening tests should show good construct validity to distinguish between different exercise loads, and possess excellent sensitivity and reliability. Furthermore “red flag” tests of likely poor responders to training should be practical to assess in clinical settings and be affordable and non-invasive. Early identification of stubborn responders would enable optimization of training programs from the onset of training to maintain exercise motivation and optimize the impact on training adaptations and health.
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Affiliation(s)
- Leo R. Bell
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC 3350, Australia; (L.R.B.); (T.J.G.); (G.M.D.); (M.P.W.)
| | - Tim J. Gabbett
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC 3350, Australia; (L.R.B.); (T.J.G.); (G.M.D.); (M.P.W.)
- Gabbett Performance Solutions, Brisbane, QLD 4011, Australia
| | - Gregory M. Davis
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC 3350, Australia; (L.R.B.); (T.J.G.); (G.M.D.); (M.P.W.)
| | - Matthew P. Wallen
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC 3350, Australia; (L.R.B.); (T.J.G.); (G.M.D.); (M.P.W.)
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5000, Australia
| | - Brendan J. O’Brien
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC 3350, Australia; (L.R.B.); (T.J.G.); (G.M.D.); (M.P.W.)
- Correspondence:
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15
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Beavers DP, Hsieh KL, Kitzman DW, Kritchevsky SB, Messier SP, Neiberg RH, Nicklas BJ, Rejeski WJ, Beavers KM. Estimating heterogeneity of physical function treatment response to caloric restriction among older adults with obesity. PLoS One 2022; 17:e0267779. [PMID: 35511858 PMCID: PMC9070937 DOI: 10.1371/journal.pone.0267779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 04/14/2022] [Indexed: 11/18/2022] Open
Abstract
Clinical trials conventionally test aggregate mean differences and assume homogeneous variances across treatment groups. However, significant response heterogeneity may exist. The purpose of this study was to model treatment response variability using gait speed change among older adults participating in caloric restriction (CR) trials. Eight randomized controlled trials (RCTs) with five- or six-month assessments were pooled, including 749 participants randomized to CR and 594 participants randomized to non-CR (NoCR). Statistical models compared means and variances by CR assignment and exercise assignment or select subgroups, testing for treatment differences and interactions for mean changes and standard deviations. Continuous equivalents of dichotomized variables were also fit. Models used a Bayesian framework, and posterior estimates were presented as means and 95% Bayesian credible intervals (BCI). At baseline, participants were 67.7 (SD = 5.4) years, 69.8% female, and 79.2% white, with a BMI of 33.9 (4.4) kg/m2. CR participants reduced body mass [CR: -7.7 (5.8) kg vs. NoCR: -0.9 (3.5) kg] and increased gait speed [CR: +0.10 (0.16) m/s vs. NoCR: +0.07 (0.15) m/s] more than NoCR participants. There were no treatment differences in gait speed change standard deviations [CR–NoCR: -0.002 m/s (95% BCI: -0.013, 0.009)]. Significant mean interactions between CR and exercise assignment [0.037 m/s (95% BCI: 0.004, 0.070)], BMI [0.034 m/s (95% BCI: 0.003, 0.066)], and IL-6 [0.041 m/s (95% BCI: 0.009, 0.073)] were observed, while variance interactions were observed between CR and exercise assignment [-0.458 m/s (95% BCI: -0.783, -0.138)], age [-0.557 m/s (95% BCI: -0.900, -0.221)], and gait speed [-0.530 m/s (95% BCI: -1.018, -0.062)] subgroups. Caloric restriction plus exercise yielded the greatest gait speed benefit among older adults with obesity. High BMI and IL-6 subgroups also improved gait speed in response to CR. Results provide a novel statistical framework for identifying treatment heterogeneity in RCTs.
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Affiliation(s)
- Daniel P. Beavers
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- * E-mail:
| | - Katherine L. Hsieh
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Dalane W. Kitzman
- Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Stephen B. Kritchevsky
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Stephen P. Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States of America
| | - Rebecca H. Neiberg
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Barbara J. Nicklas
- Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - W. Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States of America
| | - Kristen M. Beavers
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, United States of America
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16
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Carrick-Ranson G, Howden EJ, Levine BD. Exercise in Octogenarians: How Much Is Too Little? Annu Rev Med 2021; 73:377-391. [PMID: 34794323 DOI: 10.1146/annurev-med-070119-115343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The global population is rapidly aging, with predictions of many more people living beyond 85 years. Age-related physiological adaptations predispose to decrements in physical function and functional capacity, the rate of which can be accelerated by chronic disease and prolonged physical inactivity. Decrements in physical function exacerbate the risk of chronic disease, disability, dependency, and frailty with advancing age. Regular exercise positively influences health status, physical function, and disease risk in adults of all ages. Herein, we review the role of structured exercise training in the oldest old on cardiorespiratory fitness and muscular strength and power, attributes critical for physical function, mobility, and independent living. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Graeme Carrick-Ranson
- Surgical and Translational Research (STaR) Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Erin J Howden
- Baker Heart and Diabetes Institute, Melbourne, Victoria 3004 Australia
| | - Benjamin D Levine
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Dallas, and the University of Texas Southwestern Medical Center, Dallas, Texas 75213, USA;
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17
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Response and Adherence of Nursing Home Residents to a Nutrition/Exercise Intervention. J Am Med Dir Assoc 2021; 22:1939-1945.e3. [PMID: 33961812 DOI: 10.1016/j.jamda.2021.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Interindividual response variability to nutrition and exercise interventions is extensive in older adults. A group of nursing home (NH) residents participated in a combined intervention. The objective of this post-hoc analysis was to identify factors associated with intervention response measured by change in physical function and body composition. DESIGN Post-hoc analyses in the Older Person's Exercise and Nutrition study, a 2-arm randomized trial. The primary outcomes were 30-second Chair Stand Test and composite scores combining physical function and fat-free mass. A secondary outcome was intervention adherence. A 12-week intervention of sit-to-stand exercises and protein-rich nutritional supplements did not improve chair-stand capacity vs control on intention-to-treat basis. SETTING AND PARTICIPANTS Residents ≥75 years of age from dementia and somatic units in eight NHs in Sweden. METHODS Logistic regressions were performed to define factors associated with response (maintenance/improvement) or nonresponse (deterioration) in 30-second Chair Stand Test, and with intervention adherence. Linear regressions were performed to explore factors associated with response in composite scores. RESULTS Mean age of participants (n = 52 intervention, n = 49 control) was 85.8 years. Sarcopenia was occurring in 74%. Sarcopenia at baseline (P = .005) and high adherence to nutritional supplements (P = .002) increased the odds of response. Higher independence in daily activities increased the odds of adherence to sit-to-stand exercises (P = .027) and the combined intervention (P = .020). Allocation to the intervention group and higher self-perceived health were associated with higher composite scores. CONCLUSIONS AND IMPLICATIONS NH residents with baseline sarcopenia, better self-perceived health, and high adherence to nutritional supplements benefitted most from a combined nutrition and exercise intervention regarding chair-stand capacity and composite scores of function and fat-free mass. Adherence was related to higher grade of independence. Understanding factors associated with response and adherence to an intervention will help target susceptible residents in most need of support and to optimize the outcome.
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18
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Bonet JB, Magalhães J, Viscor G, Pagès T, Ventura JL, Torrella JR, Javierre C. Inter-Individual Different Responses to Continuous and Interval Training in Recreational Middle-Aged Women Runners. Front Physiol 2020; 11:579835. [PMID: 33192585 PMCID: PMC7642248 DOI: 10.3389/fphys.2020.579835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/30/2020] [Indexed: 12/19/2022] Open
Abstract
A crucial subject in sports is identifying the inter-individual variation in response to training, which would allow creating individualized pre-training schedules, improving runner’s performance. We aimed to analyze heterogeneity in individual responses to two half-marathon training programs differing in running volume and intensity in middle-aged recreational women. 20 women (40 ± 7 years, 61 ± 7 kg, 167 ± 6 cm, and VO2max = 48 ± 6 mL⋅kg–1⋅min–1) underwent either moderate-intensity continuous (MICT) or high-intensity interval (HIIT) 12-week training. They were evaluated before and after training with maximal incremental tests in the laboratory (VO2max) and in the field (time to exhaustion, TTE; short interval series and long run). All the women participated in the same half-marathon and their finishing times were compared with their previous times. Although the improvements in the mean finishing times were not significant, MICT elicited a greater reduction (3 min 50 s, P = 0.298), with more women (70%) improving on their previous times, than HIIT (reduction of 2 min 34 s, P = 0.197, 50% responders). Laboratory tests showed more differences in the HIIT group (P = 0.008), while both groups presented homogeneous significant (P < 0.05) increases in TTE. Both in the short interval series and in the long run, HIIT induced better individual improvements, with a greater percentage of responders compared to MICT (100% vs 50% in the short series and 78% vs 38% in the long run). In conclusion, variability in inter-individual responses was observed after both MICT and HIIT, with some participants showing improvements (responders) while others did not (non-responders) in different performance parameters, reinforcing the idea that individualized training prescription is needed to optimize performance.
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Affiliation(s)
- Jèssica B Bonet
- Secció de Fisiologia, Departament de Biologia Cel⋅lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - José Magalhães
- LaMetEx-Laboratory of Metabolism and Exercise, Faculdade de Desporto, Centro de Investigação em Atividade Física e Lazer, Universidade do Porto, Porto, Portugal
| | - Ginés Viscor
- Secció de Fisiologia, Departament de Biologia Cel⋅lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Teresa Pagès
- Secció de Fisiologia, Departament de Biologia Cel⋅lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Josep L Ventura
- Departament de Ciències Fisiològiques, Facultat de Medicina i Ciències de la Salut, Campus de Bellvitge, Universitat de Barcelona, Barcelona, Spain
| | - Joan R Torrella
- Secció de Fisiologia, Departament de Biologia Cel⋅lular, Fisiologia i Immunologia, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
| | - Casimiro Javierre
- Departament de Ciències Fisiològiques, Facultat de Medicina i Ciències de la Salut, Campus de Bellvitge, Universitat de Barcelona, Barcelona, Spain
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19
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Ptomey LT, Szabo-Reed AN, Vidoni ED, Washburn RA, Gorczyca AM, Little TD, Lee J, Helsel BC, Williams KN, Donnelly JE. A dyadic approach for a remote physical activity intervention in adults with Alzheimer's disease and their caregivers: Rationale and design for an 18-month randomized trial. Contemp Clin Trials 2020; 98:106158. [PMID: 32979515 PMCID: PMC7686020 DOI: 10.1016/j.cct.2020.106158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022]
Abstract
Adults with Alzheimer's disease and related dementia (ADRD) and their caregivers represent a sizeable and underserved segment of the population with low levels of moderate physical activity (MPA). Options for increasing MPA in community dwelling adults with ADRD and their caregivers are limited. A home-based physical activity intervention delivered remotely via video conferencing to groups of adults with ADRD and their caregivers (RGV), represents a potentially effective approach for increasing MPA in this group. We will conduct an 18-month randomized trial (6 mos. Active intervention, 6 mos. Maintenance, 6 mos. no contact) to compare the effectiveness of the RGV approach with usual care, enhanced with caregiver support (EUC), for increasing MPA in 100 community dwelling adults with ADRD and their caregiver. The primary aim is to compare MPA (min/wk.), assessed by accelerometer, across the 6-mo. active intervention in adults with ADRD randomized to RGV or EUC. Secondarily, we will compare adults with ADRD and their caregivers randomized to RGV or ECU on the following outcomes across 18 mos.: MPA (min/wk.), sedentary time (min/wk.), percentage meeting 150 min/wk. MPA goal, functional fitness, activities of daily living, quality of life, residential transitions, cognitive function, and caregiver burden. Additionally, we will evaluate the influence of age, sex, BMI, attendance (exercise/support sessions), use of recorded sessions, self-monitoring, peer interactions during group sessions, caregiver support, type and quality of dyadic relationship, and number of caregivers on changes in MPA in adults with ADRD and their caregiver across 18 mos.
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Affiliation(s)
- Lauren T Ptomey
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Amanda N Szabo-Reed
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Eric D Vidoni
- Department of Neurology, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Richard A Washburn
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Anna M Gorczyca
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Todd D Little
- Department of Educational Psychology and Leadership, Texas Tech University, 2500 Broadway, Lubbock, TX 79409, USA.
| | - Jaehoon Lee
- Department of Educational Psychology and Leadership, Texas Tech University, 2500 Broadway, Lubbock, TX 79409, USA.
| | - Brian C Helsel
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Kristine N Williams
- School of Nursing, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
| | - Joseph E Donnelly
- Department of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
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20
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Khadir A, Kavalakatt S, Madhu D, Devarajan S, Abubaker J, Al-Mulla F, Tiss A. Spexin as an indicator of beneficial effects of exercise in human obesity and diabetes. Sci Rep 2020; 10:10635. [PMID: 32606431 PMCID: PMC7327065 DOI: 10.1038/s41598-020-67624-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/07/2020] [Indexed: 12/20/2022] Open
Abstract
Spexin is a novel neuropeptide playing an emerging role in metabolic diseases such as obesity and diabetes via involvement in energy homeostasis and food intake. The present study investigated the effects of obesity and type 2 diabetes (T2D) on circulating levels of spexin and its modulation by physical exercise. Normal-weight (n = 50) and obese adults with and without T2D (n = 69 and n = 66, respectively) were enrolled in the study. A subgroup of obese participants (n = 47) underwent a supervised 3-month exercise programme. Plasma spexin levels were measured by ELISA and correlated with various markers. Plasma spexin levels decreased in obese participants with or without T2D compared with those of normal-weight participants (0.43 ± 0.11, 0.44 ± 0.12 and 0.61 ± 0.23 ng/ml, respectively; P < 0.001). Spexin levels negatively correlated with adiposity markers and blood pressure in the whole study population (P < 0.05). Multiple regression analysis revealed blood pressure was the greatest predictive determinant of plasma spexin levels, which significantly increased in response to physical exercise in obese participants without and with T2D (P < 0.05). Spexin levels significantly increased only in responders to exercise (those with increased oxygen consumption, VO2 max) with a concomitant improvement in metabolic profile. In conclusion, plasma spexin levels may be an indicator of response to physical exercise.
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Affiliation(s)
- Abdelkrim Khadir
- Biochemistry and Molecular Biology Department, Research Division, Dasman Diabetes Institute, P.O. Box1180, 15462, Dasman, Kuwait
| | - Sina Kavalakatt
- Biochemistry and Molecular Biology Department, Research Division, Dasman Diabetes Institute, P.O. Box1180, 15462, Dasman, Kuwait
| | - Dhanya Madhu
- Biochemistry and Molecular Biology Department, Research Division, Dasman Diabetes Institute, P.O. Box1180, 15462, Dasman, Kuwait
| | | | - Jehad Abubaker
- Biochemistry and Molecular Biology Department, Research Division, Dasman Diabetes Institute, P.O. Box1180, 15462, Dasman, Kuwait
| | - Fahd Al-Mulla
- Research Division, Dasman Diabetes Institute, Dasman, Kuwait
| | - Ali Tiss
- Biochemistry and Molecular Biology Department, Research Division, Dasman Diabetes Institute, P.O. Box1180, 15462, Dasman, Kuwait.
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21
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Interindividual Balance Adaptations in Response to Perturbation Treadmill Training in Persons With Parkinson Disease. J Neurol Phys Ther 2020; 43:224-232. [PMID: 31517749 DOI: 10.1097/npt.0000000000000291] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE Perturbation training is a promising approach to reduce fall incidence in persons with Parkinson disease (PwPD). This study aimed to evaluate interindividual differences in balance adaptations in response to perturbation treadmill training (PTT) and identify potential outcome predictors. METHODS PwPD (n = 43, Hoehn & Yahr stage 1-3.5) were randomly assigned to either 8 weeks of PTT or conventional treadmill training (CTT) without perturbations. At baseline and following intervention, data from 4 domains of balance function (reactive, anticipatory, dynamic postural control, and quiet stance) were collected. Using responder analysis we investigated interindividual differences (responder rates and magnitude of change) and potential predictive factors. RESULTS PTT showed a significantly higher responder rate in the Mini Balance Evaluation Systems Test (Mini-BESTest) subscore reactive postural control, compared with CTT (PTT = 44%; CTT = 10%; risk ratio = 4.22, confidence interval = 1.03-17.28). Additionally, while between-groups differences were not significant, the proportion of responders in the measures of dynamic postural control was higher for PTT compared with CTT (PTT: 22%-39%; CTT: 5%-10%). The magnitude of change in responders and nonresponders was similar in both groups. PTT responders showed significantly lower initial balance performance (4/8 measures) and cognitive function (3/8 measures), and were older and at a more advanced disease stage, based on descriptive evaluation. DISCUSSION AND CONCLUSIONS Our findings suggest that PTT is beneficial to improve reactive balance in PwPD. Further, PTT appeared to be effective only for a part of PwPD, especially for those with lower balance and cognitive function, which needs further attention.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A1).
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22
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Custodero C, Saini SK, Shin MJ, Jeon YK, Christou DD, McDermott MM, Leeuwenburgh C, Anton SD, Mankowski RT. Nicotinamide riboside-A missing piece in the puzzle of exercise therapy for older adults? Exp Gerontol 2020; 137:110972. [PMID: 32450270 DOI: 10.1016/j.exger.2020.110972] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 02/06/2023]
Abstract
Maintaining physical mobility is important for preventing age-related comorbidities in older adults. Endurance and resistance training prevent mobility loss in aging, but exercise alone does not always achieve the expected improvements in physical and cardiopulmonary function. Recent preclinical evidence suggests that a reason for the variability in exercise training responses may be the age-related dysregulation of the nicotinamide adenine dinucleotide (NAD+) metabolome. NAD+ is an essential enzymatic cofactor in energetic and signaling pathways. Endogenous NAD+ pool is lower in several chronic and degenerative diseases (e.g., cardiovascular diseases, Alzheimer's and Parkinson's diseases, muscular dystrophies), and also in aging. Exercise requires a higher energy expenditure than a resting state, thus a state of NAD+ insufficiency with reduced energy metabolism, could result in an inadequate exercise response. Recently, the NAD+ precursor nicotinamide riboside (NR), a vitamin B3 derivate, showed an ability to improve NAD+ metabolome homeostasis, restoring energy metabolism and cellular function in various organs in animals. NR has also been tested in older humans and is considered safe, but the effects of NR supplementation alone on physical performance are unclear. The purpose of this review is to examine the preclinical and clinical evidence on the effect of NR supplementation strategies alone and in combination with physical activity on mobility and skeletal muscle and cardiovascular function.
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Affiliation(s)
- Carlo Custodero
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA.; Dipartimento Interdisciplinare di Medicina, Clinica Medica Cesare Frugoni, University of Bari Aldo Moro, Bari, Italy
| | - Sunil K Saini
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Myung J Shin
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA.; Department of Rehabilitation Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Yun K Jeon
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA.; Division of Endocrinology and Metabolism, Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Demetra D Christou
- Department of Applied Physiology in Kinesiology, University of Florida, Gainesville, FL, USA
| | - Mary M McDermott
- Department of Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Stephen D Anton
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Robert T Mankowski
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA..
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23
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Netz Y, Lidor R, Ziv G. Small samples and increased variability - discussing the need for restricted types of randomization in exercise interventions in old age. Eur Rev Aging Phys Act 2019; 16:17. [PMID: 31673298 PMCID: PMC6815362 DOI: 10.1186/s11556-019-0224-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 09/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background Randomization provides an equal chance for participants to be allocated to intervention groups, in order to create an equal distribution of all variables at baseline in all groups. However, this is not guaranteed, particularly if the groups are too small, or if the researched groups consist of older adults. The aims of this commentary are to discuss the increased variability in old age which intensifies the risk of baseline inequalities, to elaborate on the need to estimate potential baseline group differences in small samples of older participants in exercise intervention, to discuss alternative procedures for creating equal groups at baseline and to provide specific guidelines for selecting the design of small studies. Main body Small groups with increased inter-individual differences may lead to reduced power, thus differences that truly exist may not be detected, or false group differences may appear in the outcome following the treatment. Studies that focused exclusively on older adults have found increased variability in advanced age. Therefore, baseline group differences are more common in older adults as compared to younger persons, and may lead to misinterpretation of the intervention′s results. Imbalances can be reduced by covariate-adaptive randomization procedures, such as stratified permuted-block randomization or minimization. Specific guidelines are provided for selecting a randomization procedure by assessing the probability of unequal groups at baseline in typical, widely used functional tests in old age. A calculation of the required number of participants for creating equal groups for these functional tests is provided, and can be used when increasing the number of participants is possible. R-scripts specifically created for assessing the probability of unequal groups, or for determining the sample size assuring equal groups, are recommended. Conclusions In exercise interventions assessing older adults, it is recommended to have a sample large enough for creating equal groups. If this is not possible, as is the case quite often in intervention studies in old age, it is recommended to assess the probability of inequality in the study groups and to apply an alternative randomization.
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Affiliation(s)
- Yael Netz
- The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Ronnie Lidor
- The Academic College at Wingate, Wingate Institute, Netanya, Israel
| | - Gal Ziv
- The Academic College at Wingate, Wingate Institute, Netanya, Israel
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24
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Piccirillo F, Carpenito M, Verolino G, Chello C, Nusca A, Lusini M, Spadaccio C, Nappi F, Di Sciascio G, Nenna A. Changes of the coronary arteries and cardiac microvasculature with aging: Implications for translational research and clinical practice. Mech Ageing Dev 2019; 184:111161. [PMID: 31647940 DOI: 10.1016/j.mad.2019.111161] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 12/28/2022]
Abstract
Aging results in functional and structural changes in the cardiovascular system, translating into a progressive increase of mechanical vessel stiffness, due to a combination of changes in micro-RNA expression patterns, autophagy, arterial calcification, smooth muscle cell migration and proliferation. The two pivotal mechanisms of aging-related endothelial dysfunction are oxidative stress and inflammation, even in the absence of clinical disease. A comprehensive understanding of the aging process is emerging as a primary concern in literature, as vascular aging has recently become a target for prevention and treatment of cardiovascular disease. Change of life-style, diet, antioxidant regimens, anti-inflammatory treatments, senolytic drugs counteract the pro-aging pathways or target senescent cells modulating their detrimental effects. Such therapies aim to reduce the ineluctable burden of age and contrast aging-associated cardiovascular dysfunction. This narrative review intends to summarize the macrovascular and microvascular changes related with aging, as a better understanding of the pathways leading to arterial aging may contribute to design new mechanism-based therapeutic approaches to attenuate the features of vascular senescence and its clinical impact on the cardiovascular system.
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Affiliation(s)
| | | | | | - Camilla Chello
- Dermatology, Università "La Sapienza" di Roma, Rome, Italy
| | | | - Mario Lusini
- Cardiovascular surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | | | - Francesco Nappi
- Cardiac surgery, Centre Cardiologique du Nord de Saint Denis, Paris, France
| | | | - Antonio Nenna
- Cardiovascular surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
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25
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Mateus A, Rebelo J, Silva AG. Effects of a Multimodal Exercise Program Plus Neural Gliding on Postural Control, Pain, and Flexibility of Institutionalized Older Adults: A Randomized, Parallel, and Double-Blind Study. J Geriatr Phys Ther 2019; 43:3-11. [PMID: 31569173 DOI: 10.1519/jpt.0000000000000249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE The effect of adding neural mobilization to a multimodal program of exercises has not been investigated, despite its potential positive effects. The aim of this study was to compare the acute effects of a multimodal exercise program and neural gliding against a multimodal exercise program only, on pain intensity, gait speed, Timed Up and Go (TUG) test, lower limb flexibility, and static balance of institutionalized older adults. METHODS Older adults who were institutionalized (n = 26) were randomized to receive a multimodal exercise program plus neural gliding or a multimodal exercise program only. Both interventions were delivered twice a week for 8 weeks. Participants were assessed for pain, gait velocity, balance, flexibility, and TUG at baseline and postintervention. RESULTS A significant main effect of time for pain intensity (F1,24 = 8.95, P = .006), balance (F1,24 = 10.29, P = .004), and gait velocity (F1,24 = 5.51, P = .028) was observed, indicating a positive impact of both interventions. No other significant effects were found (TUG and flexibility; P > .05). DISCUSSION A 45-minute multimodal exercise program, twice a week for 8 weeks, has a positive impact on pain intensity, balance, and gait velocity, but neural gliding has no additional benefit. It is unclear whether dose and type of neural mobilization may have had an impact on results. Considering the structural and physiological changes that tend to occur with age, future studies could explore the effects of neural tensioning or of higher doses of neural mobilization. CONCLUSIONS This study suggests that adding neural gliding to a multimodal exercise program has no additional benefit.
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Affiliation(s)
- Ana Mateus
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Portugal
| | - Jessica Rebelo
- Lar Santa Catarina do Reboleiro, Avenida da Ribeirinha, Trancoso, Portugal
| | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Portugal.,CINTESIS.UA, University of Aveiro, Campus Universitário de Santiago, Portugal
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26
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de Oliveira NTB, Ricci NA, Dos Santos Franco YR, Salvador EMES, Almeida ICB, Cabral CMN. Effectiveness of the Pilates method versus aerobic exercises in the treatment of older adults with chronic low back pain: a randomized controlled trial protocol. BMC Musculoskelet Disord 2019; 20:250. [PMID: 31122227 PMCID: PMC6533704 DOI: 10.1186/s12891-019-2642-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 05/17/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Chronic low back pain is potentially disabling for older adults, and exercise is considered the best treatment. The Pilates method and aerobic exercises have been proven to be effective in pain and function improvement in patients with low back pain, but evidence in the treatment of older adults with low back pain is scarce. Therefore, the objective of this study is to investigate the effectiveness of the Pilates method compared to aerobic exercises in the treatment of older adults with chronic nonspecific low back pain. METHODS This is a randomized controlled trial with blinded assessor, to be held in a physical therapy clinic in Sao Paulo, Brazil. Seventy four patients aged 65 to 85 years with chronic nonspecific pain will be randomized into Pilates Group (n = 37) with exercises based on the Pilates method and Aerobic Group (n = 37) with treadmill aerobic exercise. The primary outcomes will be pain intensity and general disability, assessed eight weeks after randomization. The secondary outcomes will be: pain intensity and general disability, assessed six months after randomization; and global perceived improvement, specific disability, dynamic balance, muscle strength (gluteus maximus, gluteus medius, and lateral hip rotators), and pressure pain threshold, assessed eight weeks and six months after randomization. Therapists and patients will not be blinded. DISCUSSION This study has the potential to reduce pain and, consequently, improve balance and function of older adults with chronic low back pain with both therapies. However, Pilates may be more effective because the exercises are more targeted to the trunk stabilization muscles. The results of this study may provide valuable information on the effects of Pilates and aerobic exercise in older adults with chronic low back pain and contribute to a better selection of the treatment program according to the patient preference. TRIAL REGISTRATION ClinicalTrials.gov NCT02729779 , April 6, 2016.
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Affiliation(s)
- Naiane Teixeira Bastos de Oliveira
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, São Paulo, CEP, 03071-000, Brazil
| | - Natalia Aquaroni Ricci
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, São Paulo, CEP, 03071-000, Brazil
| | - Yuri Rafael Dos Santos Franco
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, São Paulo, CEP, 03071-000, Brazil
| | - Evany Maira Espirito Santo Salvador
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, São Paulo, CEP, 03071-000, Brazil
| | | | - Cristina Maria Nunes Cabral
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno 475, Tatuapé, São Paulo, CEP, 03071-000, Brazil.
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