Effects of Concurrent Training with Elastic Tubes in Hypertensive Patients: A Blind Controlled Randomized Clinical Trial

BACKGROUND

Concurrent training (CT) has been recommended to minimize the deleterious effects of aging. However, few studies have investigated whether this type of training reduces blood pressure in the elderly. Therefore, our objective was to evaluate the effects of CT on the hemodynamic, cardiorespiratory, and muscle strength responses in medicated hypertensive patients.

METHODS

Twenty-three hypertensives (62.65 ± 6.4 years) of both sexes were allocated to the concurrent training group (CTG) or control group (CG). The CTG performed aerobic training (70-85% of reserve heart rate) combined with resistance training with elastic tubes (2sets × 15 repetitions) for 8 weeks. Resting blood pressure (BP), peak oxygen consumption (VO₂peak), and right knee and elbow flexion strength were evaluated.

RESULTS

A reduction of 6.37% was observed in BP and increases of 16.68% in VO₂peak and 16% in muscle strength for right elbow flexion in the CTG compared to CG (p < .05). Intragroup comparisons showed reduction of 5% for BP, and increases of 6.79% for VO₂peak, 24.79% for elbow flexion, and 16.47% for knee flexion in the CTG (p < .05), without significant improvement in the CG.

CONCLUSION

CT promoted a reduction in BP, and increased cardiorespiratory fitness and muscular strength of the upper limbs in the hypertensive older adults.

Reliability of the 10RM test in the supine vertical press and leg extension machines

Abstract Introduction: Several tests can predict the maximum weight an individual can lift using submaximal weights, which has been widely used in resistance training and clinical rehabilitation, but the reliability of these tests is not well documented. Objective: To analyze the test relative and absolute reliability of 10 maximum repetitions in the supine vertical bench press and leg extension machines. Method: Twenty-three healthy, untrained, and sedentary adults participated in the study. The test and retest evaluations were performed on the supine vertical press and leg extension machines. The retest was performed seven, 14 or 21 days after the test. Results: Intra-class correlation coefficient (ICC) was classified as very high (0.99) for upper limbs and (0.98) for lower limbs. The results for minimum detectable change (MDC) for the bench press resulted in a total of 2.77 kgf of actual change between test and retest, with an MDC% of 11.46%. For the leg extension, we found 3.15 kgf with MDC% of 8.94%. In both exercises, we obtained an MDC% below 30%, therefore acceptable. Conclusion: The 10RM test with the supine vertical press and leg extension has a very high relative reliability and an MDC acceptable for young, untrained and sedentary adults.

Test-retest reliability of knee extensors endurance test with elastic resistance

Background

Reliable clinical tests capable of measuring resistance are important tools for rehabilitation. One alternative that has recently increased in popularity is the use of elastic tubes, which stand out for being easy to handle, low cost, practical, and feasible.

Objective

Analyze the test-retest reliability of the knee extensors muscle fatigue resistance test (FRT) with elastic tubes.

Methods

A total of 116 healthy young males, aged between 18 and 30 years old, participated in the study. Participants performed three pre-test stages: orientation, load presentation, and familiarization with equipment, lasting two weeks. Subsequently, they performed the FRT on two occasions (test and retest), with an interval of seven days. The reliability analyzes were performed using the intraclass correlation coefficient (ICC) with 95% confidence interval and typical measurement error (TME), also expressed as coefficient of variation (CV%).

Results

The findings regarding the reliability of the test demonstrated satisfactory values (time: ICC = 0.66; 95%CI [0.50; 0.76]; CV(%) = 9.34; repetition: ICC = 0.61; 95%CI [0.46; 0.73], CV(%) = 13.66; rhythm: ICC = 0.52; 95%CI [0.35; 0.67], CV(%) = 10.29.

Conclusion

From the findings presented, it is concluded that the proposed clinical test with elastic tubes demonstrates evidence of acceptable values.

Concurrent validation of the OMNI-Resistance Exercise Scale of perceived exertion with elastic bands in the elderly

PURPOSE

To examine the concurrent validity of the OMNI-Resistance Exercise Scale of perceived exertion using elastic bands in elder population.

METHODS

Twenty-six participants performed three separate sets of 15 repetitions (low- medium- and high-intensity) for 4 different exercises (2 for the upper-limb and 2 for the lower limb), over two different testing sessions. The criterion variables were heart rate and applied force (average and maximum). In addition to these dependent variables, the active muscle and overall body OMNI-RES for elastic bands scores were collected at the end of each repetition.

RESULTS

Significant differences in heart rate, applied force and OMNI-RES scores between the low- and high-intensity sets were observed. For all the four exercises, high intensity sets elicited higher heart rate, applied force, and RPE compared to the medium and the low overloads. Intraclass correlation coefficient was 0.79 in heart rate and ranged 0.69-0.80 in OMNI-RES Scale and 0.76-0.86 for the applied force.

CONCLUSION

A strong positive and linear relationship was observed between the rating of perceived exertion and both heart rate and applied force. The OMNI-RES scale with elastic bands demonstrated to be a valid method for assessing the perceived exertion during resistance exercises and consequently represent a useful tool for prescribing exercise intensity to the elderly.

Preoperative exercise training prevents functional decline after lung resection surgery: a randomized, single-blind controlled trial

OBJECTIVES

To investigate the effects of a preoperative pulmonary rehabilitation programme in patients with lung cancer undergoing video-assisted thoracic surgery.

DESIGN

Randomized, single-blind controlled trial.

SETTING

Teaching hospital.

SUBJECTS

Patients with suspected or confirmed lung cancer undergoing video-assisted thoracic surgery.

INTERVENTION

Participants were randomized to either a prehabilitation group or a control group. Participants in the prehabilitation group underwent a combination of moderate endurance and resistance training plus breathing exercises three to five times per week.

MAIN MEASURES

The primary outcome of the study was exercise capacity. Secondary outcomes were muscle strength (Senior Fitness Test), health-related quality of life (Short-Form 36) and the postoperative outcomes. Patients were evaluated at baseline (before randomization), presurgery (only the prehabilitation group), after surgery and three months post-operatively.

RESULTS

A total of 40 patients were randomized and 22 finished the study (10 in the prehabilitation group and 12 in the control group). Three patients were lost to follow-up at three months. After the training, there was a statistically significant improvement in exercise tolerance (+397 seconds, p = 0.0001), the physical summary component of the SF-36 (+4.4 points, p = 0.008) and muscle strength ( p < 0.01). There were no significant differences between groups after surgery. However, three months postoperatively, significant differences were found in the mean change of exercise capacity ( p = 0.005), physical summary component ( p = 0.001) and upper and lower body strength ( p = 0.045 and p = 0.002).

CONCLUSIONS

A pulmonary rehabilitation programme before video-assisted thoracic surgery seems to improve patients' preoperative condition and may prevent functional decline after surgery. Clinical Registration Number: NCT01963923 (Registration date 10/10/2013).

Assessing the effect of high-repetitive single limb exercises (HRSLE) on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD): study protocol for randomized controlled trial

Background

Single-limb knee extension exercises have been found to be effective at improving lower extremity exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Since the positive local physiological effects of exercise training only occur in the engaged muscle(s), should upper extremity muscles also be included to determine the effect of single limb exercises in COPD patients.

Methods/design

Trial design: a prospective, assessor-blind, block randomized controlled, parallel-group multicenter trial. Participants: stage II-IV COPD patients, > 40 years of age, ex-smokers, with stable medical treatment will be included starting May 2011. Recruitment at three locations in Sweden. Interventions: 1) high-repetitive single limb exercise (HRSLE) training with elastic bands, 60 minutes, three times/week for 8 weeks combined with four sessions of 60 minutes patient education, or 2) the same patient education alone. Outcomes: Primary: determine the effects of HRSLE on local muscle endurance capacity (measured as meters walked during 6-minute walk test and rings moved on 6-minute ring and pegboard test) and quality of life (measured as change on the Swedish version of the Chronic Respiratory Disease Questionnaire). Secondary: effects on maximal strength, muscular endurance, dyspnea, self-efficacy, anxiety and depression. The relationship between changes in health-related variables and changes in exercise capacity, sex-related differences in training effects, feasibility of the program, strategies to determine adequate starting resistance and provide accurate resistance for each involved movement and the relationship between muscle fatigue and dyspnea in the different exercise tests will also be analyzed. Randomization: performed by a person independent of the recruitment process and using a computer random number generator. Stratification by center and gender with a 1:1 allocation to the intervention or control using random block sizes. Blinding: all outcome assessors will be blinded to group assignment.

Discussion

The results of this project will contribute to increase the body of knowledge regarding COPD and HRSLE.

Trial registration

ClinicalTrials.gov Identifier: NCT01354067. Registration date: 2011-05-11. First participant randomized: 2011-09-02

Strengthening and optimal movements for painful shoulders (STOMPS) in chronic spinal cord injury: a randomized controlled trial

BACKGROUND

Shoulder pain is a common problem after spinal cord injury (SCI), with negative effects on daily activities and quality of life (QOL).

OBJECTIVE

The purpose of this study was to determine the effect of an exercise program and instruction to optimize performance of upper-extremity tasks on shoulder pain in people with paraplegia from SCI.

METHODS

Design Eighty individuals with paraplegia from SCI and shoulder pain were randomly assigned to receive either an exercise/movement optimization intervention or an attention control intervention. The exercise/movement optimization intervention consisted of a 12-week home-based program of shoulder strengthening and stretching exercises, along with recommendations on how to optimize the movement technique of transfers, raises, and wheelchair propulsion. The attention control group viewed a 1-hour educational video. Outcome measures of shoulder pain, muscle strength (force-generating capacity), activity, and QOL were assessed at baseline, immediately after intervention, and 4 weeks later.

RESULTS

Shoulder pain, as measured with the Wheelchair User's Shoulder Pain Index, decreased to one third of baseline levels after the intervention in the exercise/movement optimization group, but remained unchanged in the attention control group. Shoulder torques, most 36-Item Short-Form Health Survey questionnaire (SF-36) subscale scores, and QOL scores also were improved in the exercise/movement optimization group, but not in the attention control group. Improvements were maintained at the 4-week follow-up assessment. Limitations Many of the outcome measures were self-reported, and the participant dropout rate was high in both groups. Additional studies are needed to determine whether the results of this study can be generalized to individuals with tetraplegia.

CONCLUSIONS

This home-based intervention was effective in reducing long-standing shoulder pain in people with SCI. The reduction in pain was associated with improvements in muscle strength and health-related and overall QOL.