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Cruz-Montecinos C, López-Bueno L, Núñez-Cortés R, López-Bueno R, Suso-Martí L, Méndez-Rebolledo G, Morral A, Andersen LL, Casaña J, Calatayud J. Enhanced Muscle Endurance Through Self-regulated Dual-Task Exercises in Elbow Fracture Rehabilitation: A Cross-sectional Study. Am J Phys Med Rehabil 2024; 103:883-889. [PMID: 38466199 DOI: 10.1097/phm.0000000000002462] [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: 03/12/2024]
Abstract
OBJECTIVE The main objective of this study was to investigate the effect of a self-regulated dual task on muscle endurance within a single rehabilitation session in patients recovering from an elbow fracture. DESIGN This is a cross-sectional study of individuals recovering from elbow fractures ( N = 20). Muscle endurance was tested using elastic bands at Borg's CR10 intensity 3-during four conditions: single-task and dual-task for elbow flexion and extension. RESULTS The cognitive condition significantly influenced muscle endurance ( P < 0.001), while the type of elbow exercise (flexion or extension) did not show significant differences ( P = 0.592). The perceived difficulty of the tasks showed a significant interaction effect ( P = 0.032). The dual-task condition showed an average increase of about 15 repetitions. A moderate negative correlation was found between the differences in repetitions and the perceived difficulty of the flexion exercise ( r = 0.677, P = 0.001). CONCLUSIONS Dual-task with self-regulation enhances muscle endurance among patients recovering from an elbow fracture. However, the improvements seem to depend on the perceived difficulty of the cognitive task. Future randomized controlled trials are required to understand the therapeutic implications of dual-tasking.
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Affiliation(s)
- Carlos Cruz-Montecinos
- From the Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile (CC-M, RN-C); Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain (RN-C); Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain (LL-B, RL-B, LS-M, JCas, JCal); Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain (RL-B); National Research Centre for the Working Environment, Copenhagen, Denmark (RL-B, LLA, JCal); Laboratorio de Investigación Somatosensorial y Motora, Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile (GM-R); and Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain (AM)
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Ponce-Fuentes F, Cuyul-Vásquez I, Ó Conaire E. Postoperative rehabilitation exercises with addition of blood flow restriction therapy following olecranon fracture: A case report. Physiother Theory Pract 2024:1-9. [PMID: 39277844 DOI: 10.1080/09593985.2024.2402305] [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: 03/04/2024] [Revised: 09/02/2024] [Accepted: 09/02/2024] [Indexed: 09/17/2024]
Abstract
BACKGROUND The addition of blood flow restriction therapy (BFRT) to exercise in patients with olecranon fracture treated surgically has not been described in the literature. PURPOSE To describe the effects and safety of BFRT exercises in the postoperative rehabilitation of a patient with olecranon fracture. CASE PRESENTATION A 27-year-old male with a surgically treated olecranon fracture completed a 12-week postoperative physical therapy programme. The assessment was performed at the start of rehabilitation, 4 and 12 weeks. The patient had elbow pain, decreased active range of motion (AROM), reduced handgrip strength, and limited physical function. The patient was treated with low-intensity resistance exercises with BFRT. The BFRT was applied with three exercises per stage, at 50% of the limb occlusion pressure and 75 repetitions per exercise. At discharge from physical therapy, improvements were observed in pain intensity (5.9-1.4 cm), AROM of elbow flexion (88°-137°) and extension (-22°--2°), AROM of forearm pronation (18°-68°) and supination (34°-78°), handgrip strength (8 kg-47 kg), physical function (22.9%-89.6%), and disability (72.7%-13.6%). These changes reached the minimal clinically important difference at the time of discharge for all measures, except for extension, pronation, and supination AROM. CONCLUSION The addition of BFRT to exercise was effective in improving pain, elbow, and wrist AROM, handgrip strength, function, and disability in a patient with surgically treated olecranon fracture. Despite the inherent limitations of our design, we believe these preliminary findings are compelling to warrant future investigations.
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Affiliation(s)
- Felipe Ponce-Fuentes
- Escuela de Kinesiología, Facultad de Medicina y Ciencias de la Salud, Universidad Mayor, Temuco, Chile
| | - Iván Cuyul-Vásquez
- Departamento de Procesos Terapéuticos, Facultad de Ciencias de la Salud, Universidad Católica de Temuco, Temuco, Chile
- Facultad de las Ciencias de la Salud, Universidad Autónoma de Chile, Temuco, Chile
| | - Eoin Ó Conaire
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Physiotherapy Department, Evidence-Based Therapy Centre, Galway, Ireland
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Ogrezeanu DC, Calatayud J, Rodríguez S, Carrasco JJ, Martinez-Valdes E, Casaña J, Cruz-Montecinos C, Andersen LL, Aagaard P, López-Bueno R, Pérez-Alenda S. Acute neuromuscular and perceptual responses to blood flow restriction exercise in adults with severe haemophilia: A pilot study. Haemophilia 2024. [PMID: 39099074 DOI: 10.1111/hae.15084] [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: 10/20/2023] [Revised: 06/14/2024] [Accepted: 07/16/2024] [Indexed: 08/06/2024]
Abstract
INTRODUCTION No previous studies have implemented a standard blood flow restriction (BFR) training session in people with severe haemophilia (PwH), where this type of training has been contraindicated. AIMS The purpose of this study was to evaluate the tolerability, adverse events, and neuromuscular and perceptual responses to an acute session of low load (LL) knee extensions with BFR in PwH under prophylaxis. METHODS Eight PwH performed one LL-BFR session with 40% arterial occlusion pressure (AOP). Perceptual responses and adverse effects were assessed, together with high-density surface electromyography of vastus medialis (VM) and lateralis (VL). RESULTS Significant normalized root mean square differences were found within each set, but not between sets. Spatial distribution (centroid displacement (p > .05), modified entropy (VM, set two, cycles three and five, p = .032) and coefficient of variation (VM, set two, cycles four and five lower than cycle three (p = .049; p = .036)) showed changes within each set. Median frequency showed a slight increase during cycle four of set four (p = .030). Rate of perceived exertion slightly increased with each set while tolerability slightly decreased in the last set and fear of training with BFR generally decreased after the session. CONCLUSIONS In PwH, a LL-BFR session at 40% AOP is safe and feasible. Our results suggest that potential muscle impairments may blunt neuromuscular adaptations induced by BFR.
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Affiliation(s)
- Daniel C Ogrezeanu
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Sergi Rodríguez
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Juan J Carrasco
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
- Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - José Casaña
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain
| | - Carlos Cruz-Montecinos
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
- Department of Physical Therapy, Laboratory of Clinical Biomechanics, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Health Science and Technology, Aalborg University, Aalborg East, Denmark
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, Research Unit for Muscle Physiology and Biomechanics, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Aragón, Spain
| | - Sofía Pérez-Alenda
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, Valencia, Spain
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Türksan HE, Yeşilyaprak SS, Erduran M, Özcan C. Novel Posterior Shoulder Stretching With Rapid Eccentric Contraction and Static Stretching in Patients With Subacromial Pain Syndrome: A Randomized Trial. Sports Health 2024; 16:315-326. [PMID: 37377154 PMCID: PMC11025518 DOI: 10.1177/19417381231181127] [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] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND In subacromial pain syndrome (SPS), it is unknown whether posterior shoulder stretching exercises (PSSE) with rapid eccentric contraction, a muscle energy technique, improve clinical and ultrasonographic outcomes more than no stretching or static PSSE. HYPOTHESIS PSSE with rapid eccentric contraction is superior to no stretching and static PSSE in improving clinical and ultrasonographic outcomes in SPS. STUDY DESIGN Randomized controlled trial. LEVEL OF EVIDENCE Level 1. METHODS Seventy patients with SPS and glenohumeral internal rotation deficit were randomized into the modified cross-body stretching with rapid eccentric contraction group (EMCBS; n = 24), static MCBS group (SMCBS; n = 23), or control group (CG; n = 23). In addition to 4-week physical therapy, EMCBS received PSSE with rapid eccentric contraction, SMCBS static PSSE, and CG no PSSE. The primary outcome was internal rotation range of motion (ROM). Secondary outcomes were posterior shoulder tightness, external rotation ROM (ERROM), pain, modified Constant-Murley score, short form of the disabilities of the arm, shoulder, and hand questionnaire (QuickDASH), rotator cuff strength, acromiohumeral distance (AHD), supraspinatus tendon thickness, and supraspinatus tendon occupation ratio (STOR). RESULTS Shoulder mobility, pain, function and disability, strength, AHD, and STOR improved in all groups (P < 0.05). CONCLUSION In patients with SPS, PSSE with rapid eccentric contraction and static PSSE were superior to no stretching in improving clinical and ultrasonographic outcomes. Stretching with rapid eccentric contraction was not superior to static stretching, but improved ERROM compared with no stretching. CLINICAL RELEVANCE In SPS, both PSSE with rapid eccentric contraction and static PSSE included in physical therapy program are beneficial to improve posterior shoulder mobility and other clinical and ultrasonographic outcomes. In the case of ERROM deficiency, rapid eccentric contraction might be preferred.
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Affiliation(s)
- Halime Ezgi Türksan
- Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | | | - Mehmet Erduran
- Department of Orthopedics and Traumatology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Cem Özcan
- Department of Orthopedics and Traumatology, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey
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Pooryamanesh L, Daneshmandi H, Hadžić V, Sekulić D, Kondrič M. Eight-week exercise intervention improves shoulder pain and body posture of wheelchair athletes with spinal cord injury. J Sports Med Phys Fitness 2024; 64:483-489. [PMID: 38305007 DOI: 10.23736/s0022-4707.23.15414-4] [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: 02/03/2024]
Abstract
BACKGROUND Wheelchair athletes, as a group of elite athletes who participate in high-level sports activities, are constantly exposed to musculoskeletal injuries and disorders due to their frequent use of wheelchairs and overworked upper limbs. In this study, we investigated the effect of elastic band exercises on the extent of athletes' forward head angle, kyphosis, rounded shoulder, and pain scores. METHODS Twenty-six male and female wheelchair athletes with spinal cord injuries (age: 27.11±6.67), active in table tennis, basketball and pétanque, were selected and randomly divided into either a control or training group. The Wheelchair User's Shoulder Pain Index (WUSPI) questionnaire was used to investigate the level of shoulder pain. A sagittal view photogrammetry method was used to measure the forward head angle and round shoulder angle, and a flexible ruler was used to measure the thoracic kyphosis angle. For our statistical analysis, a covariance test (ANCOVA) and independent and dependent T tests were used. RESULTS After eight weeks of training, there was a significant decrease in the angle of the forward head tilt, kyphosis, round shoulder, and pain questionnaire scores in the training group (P<0.05). CONCLUSIONS Changes in the forward head angle, rounded shoulder and kyphosis angle, and pain scores show the desirable effect of resistance training with an elastic band. Therefore, this exercise program is recommended for wheelchair athletes with spinal cord injuries.
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Affiliation(s)
- Lale Pooryamanesh
- Faculty of Physical Education and Sports Sciences, University of Guilan, Rasht, Iran -
| | - Hassan Daneshmandi
- Faculty of Physical Education and Sports Sciences, University of Guilan, Rasht, Iran
| | - Vedran Hadžić
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
| | - Damir Sekulić
- Faculty of Kinesiology, University of Split, Split, Croatia
| | - Miran Kondrič
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Núñez-Cortés R, López-Bueno L, López-Bueno R, Cuenca-Martínez F, Suso-Martí L, Silvestre A, Casaña J, Cruz-Montecinos C, Andersen LL, Calatayud J. Acute Effects of In-Hospital Resistance Training on Clinical Outcomes in Patients Undergoing Total Knee Arthroplasty: A Randomized Controlled Trial. Am J Phys Med Rehabil 2024; 103:401-409. [PMID: 38063321 DOI: 10.1097/phm.0000000000002366] [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: 04/20/2024]
Abstract
OBJECTIVE The aim of the study is to evaluate the acute responses, in the in-hospital setting, of intensive elastic resistance training on physical function, pain, psychosocial variables, and inflammatory markers in patients undergoing total knee arthroplasty. DESIGN In a randomized controlled trial, 40 patients with total knee arthroplasty (≥55 yrs) were assigned to either (1) the intervention group (elastic resistance strengthening) or (2) a control group (conventional protocol). Patients performed three sessions in the hospital at 24, 48, and 72 hrs after total knee arthroplasty. Outcome measures included: self-administered physical function, pain intensity, kinesiophobia, catastrophizing, self-efficacy, range of motion, perceived change, test timed up and go, knee joint effusion, isometric strength, pressure pain thresholds, and inflammatory markers (levels of procalcitonin and C-reactive protein). RESULTS The mixed analysis of variance model showed a significant group*time interaction in favor of the intervention group with a large effect size for kinesiophobia (ηp 2 = 0.308, P < 0.001), catastrophizing (ηp 2 = 0.242, P < 0.001), and passive range of motion flexion (ηp 2 = 0.167, P < 0.001) and a moderate effect size for physical function (ηp 2 = 0.103, P = 0.004), pain intensity (ηp 2 = 0.139, P < 0.001), timed up and go (ηp 2 = 0.132, P = 0.001), self-efficacy (ηp 2 = 0.074, P = 0.016), active range of motion flexion (ηp 2 = 0.121, P = 0.002), levels of procalcitonin (ηp 2 = 0.099, P = 0.005), and C-reactive protein (ηp 2 = 0.106, P = 0.004). CONCLUSIONS Three sessions of intensive elastic resistance training improve physical function, perceived pain, psychosocial variables, and inflammatory markers during the hospitalization period after total knee arthroplasty.
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Affiliation(s)
- Rodrigo Núñez-Cortés
- From the Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain (RN-C, CC-M); Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile (RN-C, CC-M); Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain (LL-B, RL-B, FC-M, LS-M, JCas, JCal); Physiotherapy Service, University Clinical Hospital of Valencia, Valencia, Spain (LL-B); Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain (RL-B); National Research Centre for the Working Environment, Copenhagen, Denmark (RL-B, LLA, JCal); Department of Orthopaedic Surgery, Clinic Hospital of Valencia, Valencia, Spain (AS); Department of Orthopaedic Surgery, School of Medicine, University of Valencia, Valencia, Spain (AS); and Section of Research, Innovation and Development in Kinesiology, Kinesiology Unit, San José Hospital, Santiago, Chile (CC-M)
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Biggin K, Marian IR, Lamb SE, Morris A, Murphy C, Carver A, Croft N, Williamson E. Mobility and strength training with and without protein supplements for pre-frail or frail older adults with low protein intake: the Maximising Mobility and Strength Training (MMoST) feasibility randomised controlled trial protocol. NIHR OPEN RESEARCH 2024; 3:62. [PMID: 39139274 PMCID: PMC11319903 DOI: 10.3310/nihropenres.13507.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/13/2024] [Indexed: 08/15/2024]
Abstract
Background Frailty is a common syndrome affecting older people and puts them at risk of hospitalisation, needing care or death. First signs of frailty include reduced muscle strength and mobility decline. A key cause of mobility decline as we age is sarcopenia (age related reduction in muscle strength and mass). Poor nutrition contributes to sarcopenia. A shortfall in protein is associated with reduced muscle mass and strength. This may be due to inadequate intake but also because older people have higher protein needs, especially those with multimorbidity. We need to develop effective treatment to reduce or slow the onset of frailty and mobility decline. Exercise is a recommended treatment. Protein supplements to address the shortfall in protein have the potential to enhance the benefit of regular exercise in frail or pre-frail older adults. This has yet to be definitively demonstrated. Aim To establish the feasibility of conducting an RCT evaluating mobility and strength training with or without protein supplements for people over 60 years old who are frail or pre-frail with a low protein intake. Methods A multicentre, parallel, 2-group, feasibility RCT. Participants (recruitment target = 50) with problems walking, low protein intake and classified as frail or pre-frail will be recruited from four NHS Physiotherapy community services. Participants will be randomised (secure computer-generated: 1:1) to receive 24 weeks of mobility and strength training (delivered in 16 group sessions plus home exercises) or 24 weeks of mobility and strength training with daily protein supplements. Primary feasibility objectives are to estimate 1) ability to screen and recruit eligible participants, 2) intervention fidelity, adherence, and tolerance and 3) retention of participants at follow up. Secondary objectives are to 1) test data collection procedures, 2) assess data completeness and 3) confirm sample size calculation for a definitive RCT. Registration ISRCTN Registry (ISRCTN30405954; 18/10/2022).
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Affiliation(s)
- Kavita Biggin
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford, England, UK
| | - Ioana R. Marian
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford, England, UK
| | - Sarah E. Lamb
- Faculty of Health and Life Science, University of Exeter, Exeter, England, UK
| | - Alana Morris
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford, England, UK
| | - Caoileann Murphy
- Australian Catholic University, Fitzroy, Victoria, Australia
- Teagasc Food Research Centre, Ashtown, Dublin, Ireland
| | - Andrew Carver
- Patient and Public Involvement Representative, University of Oxford, Oxford, England, UK
| | - Nirvana Croft
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford, England, UK
| | - Esther Williamson
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford, England, UK
- Faculty of Health and Life Science, University of Exeter, Exeter, England, UK
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Godhe M, Rönquist G, Nilsson J, Ekblom Ö, Nyberg L, Edman G, Andersson E. Reliability in Novel Field-Based Fitness Measurements and Postexercise Scores from a Physical Fitness Test Battery in Older Adults. Gerontology 2024; 70:639-660. [PMID: 38565082 PMCID: PMC11177894 DOI: 10.1159/000538446] [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: 08/30/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION Physical fitness is strongly associated with daily physical function, health, and longevity in older adults. Field-based tests may provide a reasonable alternative compared to advanced laboratory testing. Separating postexercise test scores from reactivity measurements requires sufficient test-retest reliability. Postexercise test scores with reliability analyses of field-based fitness tests in older adults are lacking. The present study aimed to examine the test-retest reliability of some novel easily accommodated fitness test measurements and compare pretest scores with postexercise results in these tests along with other field-based fitness tests in older adults. METHODS Totally 1,407 community-dwelling older adults (69% female), x̄ = 71.5 ± 5.0 (65-84 years), performed twelve field-based fitness tests at pretest 1, pretest 2 and a posttest after an 8-week exercise period (twice weekly 1 h of combined strength and aerobic training). T tests, intra-class correlation, limits of agreement, standard error of measurement, and coefficient of variance were performed between pre-1 and pre-2 tests, and repeated measures ANOVA and partial eta squared effect size for postexercise differences for men and women in 5-year age groups ranging from 65 to 84 years. RESULTS Between pre-1 and pre-2 tests a significant difference was noted in some of the novel fitness test measurements but generally not, e.g., in isometric trunk flexion and step-up height on either leg among all sex and age groups. In most of these novel fitness test measurements, no significant differences occurred between the two pretests. Examples of results from the pre-2 test to the posttest were isometric trunk flexion 45° endurance and isometric trunk extension endurance improved significantly for both sexes in age groups 65-74 years. Women, but not men, improved the maximal step-up height for both legs in most age groups. The speed in the 50 sit-to-stand improved significantly for most age groups in both sexes. Six-min walk distance improved significantly for most age groups in women but among men only in 65-69 years. In the timed-up-and-go test, significant improvements were seen for all age groups in women and in men 70-79 years. No postexercise improvements were generally observed for grip strength or balance. CONCLUSIONS In most of the novel fitness test measures, no significant difference was noted between the two pretests in the assessed sex and age groups. Results after the 8-week exercise period varied between sex and age groups, with significant improvements in several of the twelve studied fitness tests. These findings may be valuable for future projects utilizing easily accommodated physical fitness tests in older adults.
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Affiliation(s)
- Manne Godhe
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Gustaf Rönquist
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Johnny Nilsson
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Örjan Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Lillemor Nyberg
- Department of Medicine and School of Health Sciences, Örebro University, Örebro, Sweden
| | - Gunnar Edman
- Research and Development, Norrtälje Hospital, Tiohundra AB, Norrtälje, Sweden
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Eva Andersson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Ogrezeanu DC, López-Bueno L, Sanchís-Sánchez E, Carrasco JJ, Cuenca-Martínez F, Suso-Martí L, López-Bueno R, Cruz-Montecinos C, Martinez-Valdes E, Casaña J, Calatayud J. Neuromuscular Responses and Perceptions of Health Status and Pain-Related Constructs in End-Stage Knee Osteoarthritis During Resistance Training With Blood Flow Restriction. J Strength Cond Res 2024; 38:762-772. [PMID: 38090743 DOI: 10.1519/jsc.0000000000004680] [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: 03/23/2024]
Abstract
ABSTRACT Ogrezeanu, DC, López-Bueno, L, Sanchís-Sánchez, E, Carrasco, JJ, Cuenca-Martínez, F, Suso-Martí, L, López-Bueno, R, Cruz-Montecinos, C, Martinez-Valdes, E, Casaña, J, and Calatayud, J. Neuromuscular responses and perceptions of health status and pain-related constructs in end-stage knee osteoarthritis during resistance training with blood flow restriction. J Strength Cond Res 38(4): 762-772, 2024-We aimed to evaluate the neuromuscular responses and their relationship with health status, kinesiophobia, pain catastrophizing, and chronic pain self-efficacy in patients with end-stage knee osteoarthritis during acute resistance training with different levels of blood flow restriction (BFR). Seventeen patients with end-stage knee osteoarthritis participated in 3 experimental sessions separated by 3 days, performing 4 sets of knee extensions with low load and 3 levels of concurrent BFR performed in a random order: control (no BFR), BFR at 40% arterial occlusion pressure (AOP), and BFR at 80% AOP. Normalized root-mean-square (nRMS), nRMS spatial distribution (centroid displacement, modified entropy, and coefficient of variation), and normalized median frequency (nFmed) were calculated from the vastus medialis (VM) and lateralis (VL) using high-density surface electromyography. Subjects were asked to report adverse effects after the sessions. In the VM, nRMS was higher with 80% AOP than with 40% AOP ( p = 0.008) and control ( p < 0.001), whereas there were no differences between conditions in the VL. Normalized root-mean-square also showed an association with pain catastrophizing, chronic pain self-efficacy, and health status (VM: -0.50, 0.49, -0.42; VL: -0.39, 0.27, -0.33). Spatial distribution varied between conditions but mostly in the VL. Overall, nFmed did not vary, with only a slight increase in the VL with 40% AOP, between set 3 and 4. BFR during knee extensions at 80% AOP increases VM activity and VL amplitude distribution more than 40% AOP and control. Importantly, muscle activity increases are modulated by pain catastrophizing, chronic pain self-efficacy, and health status in these patients, and kinesiophobia seems to especially modulate entropy.
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Affiliation(s)
- Daniel C Ogrezeanu
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Laura López-Bueno
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Enrique Sanchís-Sánchez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Juan J Carrasco
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
- Intelligent Data Analysis Laboratory, University of Valencia, Valencia, Spain
| | - Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | - Carlos Cruz-Montecinos
- Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain
- Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; and
| | - Eduardo Martinez-Valdes
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain
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10
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Lea JWD, O'Driscoll JM, Wiles JD. The implementation of a home-based isometric wall squat intervention using ratings of perceived exertion to select and control exercise intensity: a pilot study in normotensive and pre-hypertensive adults. Eur J Appl Physiol 2024; 124:281-293. [PMID: 37458822 PMCID: PMC10786991 DOI: 10.1007/s00421-023-05269-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 06/28/2023] [Indexed: 01/13/2024]
Abstract
PURPOSE Isometric exercise (IE) and isometric wall squat (IWS) training have been shown to be effective methods of reducing arterial blood pressure. However, most IE interventions require methodologies and equipment that could present a barrier to participation. Therefore, this study aimed to examine the effectiveness of an accessible RPE prescribed IWS intervention. METHODS Thirty normotensive and pre-hypertensive adults were randomly assigned to a control group or one of two 4-week home-based IWS intervention groups: the first group conducted IWS exercise where intensity was prescribed and monitored using RPE (RPE-EX), whilst the other used a previously validated HR prescription method (HR-EX). Resting and ambulatory heart rate (HR) and blood pressure (BP) were measured pre- and post-intervention. RESULTS Minimum clinically important differences (MCID; - 5 mmHg) in SBP and/or DBP were shown in 100% of intervention participants. Statistically significant reductions were shown in resting seated BP (RPE-EX: SBP: - 9 ± 6, DBP: - 6 ± 4, MAP: - 6 ± 3 mmHg; HR-EX: SBP: - 14 ± 6, DBP: - 6 ± 4, MAP: - 8 ± 4 mmHg), supine BP (RPE-EX: SBP: - 8 (- 5), DBP: - 8 (- 7), MAP: - 8 (- 4) mmHg; HR-EX: SBP: - 5 (- 4), MAP - 5 (- 4) mmHg), and ambulatory SBP (RPE-EX: - 8 ± 6 mmHg; HR-EX: - 10 ± 4 mmHg) following the interventions. There were no statistically significant differences between intervention groups in the magnitude of BP reduction. CONCLUSION RPE prescribed IWS exercise can provide an effective and more accessible method for reducing BP at home, providing reductions comparable to the current HR-based prescription method.
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Affiliation(s)
- John W D Lea
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Jamie M O'Driscoll
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Jonathan D Wiles
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK.
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11
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Xu D, Zhou H, Quan W, Gusztav F, Wang M, Baker JS, Gu Y. Accurately and effectively predict the ACL force: Utilizing biomechanical landing pattern before and after-fatigue. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 241:107761. [PMID: 37579552 DOI: 10.1016/j.cmpb.2023.107761] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND AND OBJECTIVE As a fundamental exercise technique, landing can commonly be associated with anterior cruciate ligament (ACL) injury, especially during after-fatigue single-leg landing (SL). Presently, the inability to accurately detect ACL loading makes it difficult to recognize the risk degree of ACL injury, which reduces the effectiveness of injury prevention and sports monitoring. Increased risk of ACL injury during after-fatigue SL may be related to changes in ankle motion patterns. Therefore, this study aims to develop a highly accurate and easily implemented ACL force prediction model by combining deep learning and the explored relationship between ACL force and ankle motion pattern. METHODS First, 56 subjects' during before and after-fatigue SL data were collected to explore the relationship between the ankle initial contact angle (AIC), ankle range of motion (AROM) and peak ACL force (PAF). Then, the musculoskeletal model was developed to simulate and calculate the ACL force. Finally, the ACL force prediction model was constructed by combining the explored relationship and sparrow search algorithm (SSA) to optimize the extreme learning machine (ELM) and long short-term memory (LSTM). RESULTS There was almost a stronger linear relationship between the PAF and AIC (R = -0.70), AROM (R2 = -0.61). By substituting AIC and AROM as independent variables in the SSA-ELM prediction model, the model shows excellent prediction performance because of very strong correlation (R2 = 0.9992, MSE = 0.0023, RMSE = 0.0474). Based on the equal scaling by combining results of SSA-ELM and SSA-LSTM, the prediction model achieves excellent performance in ACL force prediction of the overall waveform (R2 = 0.9947, MSE = 0.0076, RMSE = 0.0873). CONCLUSION By increasing the AIC and AROM during SL, the lower limb joint energy dissipation can be increased and the PAF reduced, thus reducing the impact loads on the lower limb joints and reducing ACL injuries. The proposed ACL dynamic load force prediction model has low input variable demands (sagittal joint angles), excellent generalization capabilities and superior performance in terms of high accuracy. In the future, we plan to use it as an accurate ACL injury risk assessment tool to promote and apply it to a wider range of sports training and injury monitoring.
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Affiliation(s)
- Datao Xu
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; Faculty of Engineering, University of Pannonia, Veszprém, 8201, Hungary; Savaria Institute of Technology, Eötvös Loránd University, Szombathely, 9700, Hungary
| | - Huiyu Zhou
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; School of Health and Life Sciences, University of the West of Scotland, Scotland, G72 0LH, United Kingdom
| | - Wenjing Quan
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; Faculty of Engineering, University of Pannonia, Veszprém, 8201, Hungary; Savaria Institute of Technology, Eötvös Loránd University, Szombathely, 9700, Hungary
| | - Fekete Gusztav
- Faculty of Engineering, University of Pannonia, Veszprém, 8201, Hungary; Savaria Institute of Technology, Eötvös Loránd University, Szombathely, 9700, Hungary
| | - Meizi Wang
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China; Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, 999077, Hong Kong, China
| | - Julien S Baker
- Department of Sport and Physical Education, Hong Kong Baptist University, Hong Kong, 999077, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, 315211, China.
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12
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Festa RR, Jofré-Saldía E, Candia AA, Monsalves-Álvarez M, Flores-Opazo M, Peñailillo L, Marzuca-Nassr GN, Aguilar-Farias N, Fritz-Silva N, Cancino-Lopez J, Soto-Sánchez J, Sepulveda C, Huerta Ojeda Á, Núñez-Espinosa C, Valladares-Ide D, Jannas-Vela S. Next steps to advance general physical activity recommendations towards physical exercise prescription: a narrative review. BMJ Open Sport Exerc Med 2023; 9:e001749. [PMID: 37920278 PMCID: PMC10619125 DOI: 10.1136/bmjsem-2023-001749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/04/2023] Open
Abstract
Physical inactivity is a major health concern, associated with the development of several non-communicable diseases and with an increased mortality rate. Therefore, promoting active lifestyles has become a crucial public health necessity for enhancing overall health and quality of life. The WHO guidelines for physical activity (PA) present valuable contributions in this respect; however, we believe that greater specificity should be added or complemented towards physical exercise (PE) testing, prescription and programming in future recommendations. In this review article, we suggest simple and practical tools accessible to the entire population to improve the specificity of this approach, highlighting aspects of PE programming used by trained subjects. By adopting these suggestions, exercise professionals, clinicians and physical trainers can optimise the current general PA recommendations towards PE prescription to improve fitness status and encourage PE adherence in the general population.
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Affiliation(s)
| | - Emilio Jofré-Saldía
- Instituto de Ciencias de la Salud, Universidad de O'Higgins, Rancagua, Chile
- Interuniversity Center for Healthy Aging RED21993, Santiago, Chile
| | - Alejandro A Candia
- Instituto de Ciencias de la Salud, Universidad de O'Higgins, Rancagua, Chile
| | - Matías Monsalves-Álvarez
- Instituto de Ciencias de la Salud, Universidad de O'Higgins, Rancagua, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | | | - Luis Peñailillo
- Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andrés Bello, Santiago, Chile
| | - Gabriel Nasri Marzuca-Nassr
- Interuniversity Center for Healthy Aging RED21993, Santiago, Chile
- Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
| | - Nicolas Aguilar-Farias
- Department of Physical Education, Sports and Recreation, Universidad de La Frontera, Temuco, Chile
| | - Nicole Fritz-Silva
- Interuniversity Center for Healthy Aging RED21993, Santiago, Chile
- Health Department, Universidad de Los Lagos, Puerto Montt, Chile
- Research Group in Prevention and Health in Exercise and Sport, University of Valencia, Valencia, Spain
| | - Jorge Cancino-Lopez
- Exercise Physiology and Metabolism Laboratory, Escuela de Kinesiología, Universidad Finis Terrae, Santiago, Chile
| | - Johana Soto-Sánchez
- Laboratorio de Actividad Física, Ejercicio y Salud, Centro de Biomedicina Aplicada, Universidad Mayor, Santiago, Chile
| | - Carlos Sepulveda
- Laboratory of Exercise Science, Innovation Center, Clinica MEDS, Las Condes, Chile
- Laboratory of Research in Nutrition and Physical Activity, Institute of Nutrition and Technology of Food, University of Chile, Santiago de Chile, Chile
| | - Álvaro Huerta Ojeda
- Núcleo de Investigación en Salud, Actividad Física y Deporte ISAFYD, Universidad de Las Americas, Viña del Mar, Chile
| | - Cristian Núñez-Espinosa
- Interuniversity Center for Healthy Aging RED21993, Santiago, Chile
- Escuela de Medicina, Universidad de Magallanes, Punta Arenas, Chile
- Centro Asistencial Docente y de Investigación, Universidad de Magallanes, Punta Arenas, Chile
| | - Denisse Valladares-Ide
- Instituto de Ciencias de la Salud, Universidad de O'Higgins, Rancagua, Chile
- Interuniversity Center for Healthy Aging RED21993, Santiago, Chile
| | - Sebastian Jannas-Vela
- Instituto de Ciencias de la Salud, Universidad de O'Higgins, Rancagua, Chile
- Interuniversity Center for Healthy Aging RED21993, Santiago, Chile
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13
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Smeuninx B, Elhassan YS, Sapey E, Rushton AB, Morgan PT, Korzepa M, Belfield AE, Philp A, Brook MS, Gharahdaghi N, Wilkinson D, Smith K, Atherton PJ, Breen L. A single bout of prior resistance exercise attenuates muscle atrophy and declines in myofibrillar protein synthesis during bed-rest in older men. J Physiol 2023. [PMID: 37856286 DOI: 10.1113/jp285130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
Impairments in myofibrillar protein synthesis (MyoPS) during bed rest accelerate skeletal muscle loss in older adults, increasing the risk of adverse secondary health outcomes. We investigated the effect of prior resistance exercise (RE) on MyoPS and muscle morphology during a disuse event in 10 healthy older men (65-80 years). Participants completed a single bout of unilateral leg RE the evening prior to 5 days of in-patient bed-rest. Quadriceps cross-sectional area (CSA) was determined prior to and following bed-rest. Serial muscle biopsies and dual stable isotope tracers were used to determine rates of integrated MyoPS (iMyoPS) over a 7 day habitual 'free-living' phase and the bed-rest phase, and rates of acute postabsorptive and postprandial MyoPS (aMyoPS) at the end of bed rest. Quadriceps CSA at 40%, 60% and 80% of muscle length significantly decreased in exercised (EX) and non-exercised control (CTL) legs with bed-rest. The decline in quadriceps CSA at 40% and 60% of muscle length was attenuated in EX compared with CTL. During bed-rest, iMyoPS rates decreased from habitual values in CTL, but not EX, and were significantly different between legs. Postprandial aMyoPS rates increased above postabsorptive values in EX only. The change in iMyoPS over bed-rest correlated with the change in quadriceps CSA in CTL, but not EX. A single bout of RE attenuated the decline in iMyoPS rates and quadriceps atrophy with 5 days of bed-rest in older men. Further work is required to understand the functional and clinical implications of prior RE in older patient populations. KEY POINTS: Age-related skeletal muscle deterioration, linked to numerous adverse health outcomes, is driven by impairments in muscle protein synthesis that are accelerated during periods of disuse. Resistance exercise can stimulate muscle protein synthesis over several days of recovery and therefore could counteract impairments in this process that occur in the early phase of disuse. In the present study, we demonstrate that the decline in myofibrillar protein synthesis and muscle atrophy over 5 days of bed-rest in older men was attenuated by a single bout of unilateral resistance exercise performed the evening prior to bed-rest. These findings suggest that concise resistance exercise intervention holds the potential to support muscle mass retention in older individuals during short-term disuse, with implications for delaying sarcopenia progression in ageing populations.
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Affiliation(s)
- Benoit Smeuninx
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- Cellular & Molecular Metabolism Laboratory, Monash University, Melbourne, Victoria, Australia
| | - Yasir S Elhassan
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - Elizabeth Sapey
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Alison B Rushton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Paul T Morgan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Marie Korzepa
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Archie E Belfield
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Andrew Philp
- Centre for Healthy Ageing, Centenary Institute, Camperdown, New South Wales, Australia
| | - Matthew S Brook
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, UK
| | - Nima Gharahdaghi
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, UK
| | - Daniel Wilkinson
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, UK
| | - Kenneth Smith
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, UK
| | - Philip J Atherton
- Centre Of Metabolism, Ageing and Physiology (COMAP), School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, UK
- MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, UK
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
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14
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Ennis S, Sandhu HK, Bruce J, Seers K, Pincus T, Underwood M, McGregor G. Development of a complex exercise rehabilitation intervention for people with pulmonary hypertension: the supervised pulmonary hypertension exercise rehabilitation (SPHERe) trial. BMJ Open 2023; 13:e066053. [PMID: 37536964 PMCID: PMC10401230 DOI: 10.1136/bmjopen-2022-066053] [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: 01/27/2023] [Accepted: 06/29/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND People with pulmonary hypertension (PH) are not routinely referred for exercise rehabilitation despite the potential for reducing breathlessness and improving quality of life. We describe the development of a supervised pulmonary hypertension exercise rehabilitation (SPHERe) programme for people with PH. METHODS Development was completed in three phases: (1) systematic review, (2) stakeholder engagement with consensus from patients and experts and (3) prepilot intervention acceptability testing. We completed systematic reviews to identify international cardiopulmonary rehabilitation guidance and trials of exercise-based interventions for people with PH. Evidence from systematic reviews and stakeholder consensus shaped the SPHERe intervention, including addition of individual behavioural support sessions to promote exercise adherence. The draft SPHERe intervention was ratified through discussions with multidisciplinary professionals and people living with PH. We acceptability tested the centre-based intervention with eight participants in a prepilot development phase which identified a number of condition-specific issues relating to safety and fear avoidance of activity. Comprehensive intervention practitioner training manuals were produced to ensure standardised delivery. Participant workbooks were developed and piloted. Trial recruitment began in January 2020 but was subsequently suspended in March 2020 further to COVID-19 pandemic 'lockdowns'. In response to the pandemic, we undertook further development work to redesign the intervention to be suitable for exclusively home-based online delivery. Recruitment to the revised protocol began in June 2021. DISCUSSION The final SPHERe intervention incorporated weekly home-based online group exercise and behavioural support 'coaching' sessions supervised by trained practitioners, with a personalised home exercise plan and the optional loan of a stationary exercise bike. The intervention was fully manualised with clear pathways for assessment and individualised exercise prescription. The clinical and cost-effectiveness of the SPHERe online rehabilitation intervention is currently being tested in a UK multicentre randomised controlled trial. TRIAL REGISTRATION NUMBER ISCRTN10608766.
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Affiliation(s)
- Stuart Ennis
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Cardiovascular Rehabilitation, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | | | - Julie Bruce
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Kate Seers
- Royal College of Nursing Research Institute, Warwick Medical School, University of Warwick, Coventry, UK
| | - Tamar Pincus
- Department of Psychology, Royal Hollaway University, London, UK
| | - Martin Underwood
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Gordon McGregor
- Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Cardiovascular Rehabilitation, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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15
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Schneider VM, Domingues LB, Umpierre D, Tanaka H, Ferrari R. Exercise characteristics and blood pressure reduction after combined aerobic and resistance training: a systematic review with meta-analysis and meta-regression. J Hypertens 2023; 41:1068-1076. [PMID: 37115856 DOI: 10.1097/hjh.0000000000003455] [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: 04/29/2023]
Abstract
OBJECTIVE The purpose of this systematic review with meta-analysis was to determine the efficacy of combined aerobic and strength training in adults with hypertension and the influence of exercise training characteristics on blood pressure (BP) reduction. METHODS Randomized clinical trials of interventions involving combined aerobic and strength training versus nonexercise control groups (Control) in adults with hypertension were included. The literature search was conducted on PubMed, Cochrane Central, EMBASE, Scopus, and LILACS until December 2021. A random effects meta-analysis was performed using the mean difference in BP changes from baseline, comparing combined aerobic and strength training vs. Control as the effective measure. A multivariate meta-regression analysis was also performed to evaluate the relationship between exercise training characteristics and magnitudes of BP reductions. RESULTS Thirty-seven studies with 41 exercise interventions (1942 participants) were analyzed. The pooled mean differences with a 95% confidence interval (95% CI) showed significant reductions in SBP (-6.4 mmHg; 95% CI, -9.1 to -3.6) and DBP (-3.7 mmHg; 95% CI, -4.9 to -2.4). Meta-regression analysis revealed that greater exercise intensity and a greater number of sets in resistance training were associated with greater reductions in SBP. Greater exercise intensity was also associated with greater decreases in DBP. CONCLUSION Combined aerobic and resistance training is an effective intervention in reducing both SBP and DBP in adults with hypertension, with greater hypotensive effects expected with higher intensity and more volume.
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Affiliation(s)
- Vinícius M Schneider
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas B Domingues
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Daniel Umpierre
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul
| | - Hirofumi Tanaka
- Cardiovascular Aging Research Laboratory, The University of Texas at Austin, Austin, Texas, USA
| | - Rodrigo Ferrari
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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16
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Machado P, Pimenta S, Garcia AL, Nogueira T, Silva S, Oliveiros B, Martins RA, Cruz J. Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility Trial. J Clin Med 2023; 12:jcm12082971. [PMID: 37109307 PMCID: PMC10146369 DOI: 10.3390/jcm12082971] [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: 02/23/2023] [Revised: 03/16/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Clinical guidelines recommend prehabilitation with exercise training to optimize recovery after lung cancer surgery. However, the lack of access to facility-based exercise programs is a major barrier to routine participation. This study aimed to assess the feasibility of a home-based exercise intervention before lung cancer resection. METHODS We conducted a prospective, two-site feasibility study, including patients scheduled for lung cancer surgery. Exercise prescription involved aerobic and resistance training with telephone-based supervision. The primary endpoint was overall feasibility (recruitment rate, retention rate, intervention adherence and acceptability). Secondary endpoints included safety and effects on health-related quality of life (HRQOL) and physical performance, evaluated at baseline, after the exercise intervention and 4-5 weeks after surgery. RESULTS Over three months, 15 patients were eligible, and all agreed to participate (recruitment rate: 100%). A total of 14 patients completed the exercise intervention, and 12 patients were evaluated postoperatively (retention rate: 80%). The median length of the exercise intervention was 3 weeks. Patients performed an aerobic and resistance training volume higher than prescribed (median adherence rates of 104% and 111%, respectively). A total of nine adverse events occurred during the intervention (Grade 1, n = 8; Grade 2, n = 1), the most common being shoulder pain. After the exercise intervention, significant improvements were observed in the HRQOL summary score (mean difference, 2.9; 95% confidence interval [CI], from 0.9 to 4.8; p = 0.049) and the five-times sit-to-stand test score (median difference, -1.5; 95% CI, from -2.1 to -0.9; p = 0.001). After surgery, no significant effects on HRQOL and physical performance were observed. CONCLUSION A short-term preoperative home-based exercise intervention is feasible before lung cancer resection and may enhance accessibility to prehabilitation. Clinical effectiveness should be investigated in future studies.
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Affiliation(s)
- Pedro Machado
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal
- Univ Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal
- Physioclem, Physical Therapy Clinics, 2460-042 Alcobaça, Portugal
| | - Sara Pimenta
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal
| | - Ana Luís Garcia
- Thoracic Surgery Unit, Portuguese Oncology Institute of Coimbra, 3000-075 Coimbra, Portugal
| | - Tiago Nogueira
- Thoracic Surgery Unit, Portuguese Oncology Institute of Coimbra, 3000-075 Coimbra, Portugal
| | - Sónia Silva
- Pulmonology Department, Leiria Hospital Center, 2410-197 Leiria, Portugal
| | - Bárbara Oliveiros
- Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Raul A Martins
- Univ Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID/PTD/04213/2019), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal
| | - Joana Cruz
- Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal
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17
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Smith RW, Housh TJ, Arnett JE, Anders JPV, Neltner TJ, Ortega DG, Schmidt RJ, Johnson GO. Utilizing the RPE-Clamp model to examine interactions among factors associated with perceived fatigability and performance fatigability in women and men. Eur J Appl Physiol 2023; 123:1397-1409. [PMID: 36856798 DOI: 10.1007/s00421-023-05163-x] [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: 11/02/2022] [Accepted: 02/17/2023] [Indexed: 03/02/2023]
Abstract
PURPOSE The purpose of the present study was to examine the interactions between perceived fatigability and performance fatigability in women and men by utilizing the RPE-Clamp model to assess the fatigue-induced effects of a sustained, isometric forearm flexion task anchored to RPE = 8 on time to task failure (TTF), torque, and neuromuscular responses. METHODS Twenty adults (10 men and 10 women) performed two, 3 s forearm flexion maximal voluntary isometric contractions (MVICs) followed by a sustained, isometric forearm flexion task anchored to RPE = 8 using the OMNI-RES (0-10) scale at an elbow joint angle of 100°. Electromyographic amplitude (EMG AMP) was recorded from the biceps brachii. Torque and EMG AMP values resulting from the sustained task were normalized to the pretest MVIC. Neuromuscular efficiency was defined as NME = normalized torque/normalized EMG AMP. Mixed factorial ANOVAs and Bonferroni corrected dependent t tests and independent t tests were used to examine differences across time and between sex for torque and neuromuscular parameters. RESULTS There were no differences between the women and men for the fatigue-induced decreases in torque, EMG AMP, or NME, and the mean decreases (collapsed across sex) were 50.3 ± 8.6 to 2.8 ± 2.9% MVIC, 54.7 ± 12.0 to 19.6 ± 5.3% MVIC, and 0.94 ± 0.19 to 0.34 ± 0.16, respectively. Furthermore, there were no differences between the women and men for TTF (251.8 ± 74.1 vs. 258.7 ± 77.9 s). CONCLUSION The results suggested that the voluntary reductions in torque to maintain RPE and the decreases in NME were likely due to group III/IV afferent feedback from peripheral fatigue that resulted in excitation-contraction coupling failure.
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Affiliation(s)
- Robert W Smith
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA.
- , 840 N 14th Street, Lincoln, NE, 68508, USA.
| | - Terry J Housh
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
| | - Jocelyn E Arnett
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
| | - John Paul V Anders
- The Exercise Science Program, Department of Human Sciences, The Ohio State University, Columbus, OH, 43017, USA
| | - Tyler J Neltner
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
| | - Dolores G Ortega
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
| | - Richard J Schmidt
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
| | - Glen O Johnson
- Exercise Physiology Laboratory, Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68510, USA
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Marzouk M, McKeown DJ, Borg DN, Headrick J, Kavanagh JJ. Perceptions of fatigue and neuromuscular measures of performance fatigability during prolonged low-intensity elbow flexions. Exp Physiol 2023; 108:465-479. [PMID: 36763088 PMCID: PMC10103868 DOI: 10.1113/ep090981] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/24/2023] [Indexed: 02/11/2023]
Abstract
NEW FINDINGS What is the central question of this study? What is the predictive relationship between self-reported scales to quantify perceptions of fatigue during exercise and gold standard measures used to quantify the development of neuromuscular fatigue? What is the main finding and its importance? No scale was determined to be substantively more effective than another. However, the number of ongoing contractions performed was shown to be a better predictor of fatigue in the motor system than any of the subjective scales. ABSTRACT The purpose of this study was to determine the relationship between transcranial magnetic stimulation (TMS) measures of performance fatigability and commonly used scales that quantify perceptions of fatigue during exercise. Twenty healthy participants (age 23 ± 3 years, 10 female) performed 10 submaximal isometric elbow flexions at 20% maximal voluntary contraction (MVC) for 2 min, separated by 45 s of rest. Biceps brachii muscle electromyography and elbow flexion torque responses to single-pulse TMS were obtained at the end of each contraction to assess central factors of performance fatigability. A rating of perceived exertion (RPE) scale, Omnibus Resistance scale, Likert scale, Rating of Fatigue scale and a visual analogue scale (VAS) were used to assess perceptions of fatigue at the end of each contraction. The RPE (root mean square error (RMSE) = 0.144) and Rating of Fatigue (RMSE = 0.145) scales were the best predictors of decline in MVC torque, whereas the Likert (RMSE= 0.266) and RPE (RMSE= 0.268) scales were the best predictors of electromyographic amplitude. Although the Likert (RMSE = 7.6) and Rating of Fatigue (RMSE = 7.6) scales were the best predictors of voluntary muscle activation of any scale, the number of contractions performed during the protocol was a better predictor (RMSE = 7.3). The ability of the scales to predict TMS measures of performance fatigability were in general similar. Interestingly, the number of contractions performed was a better predictor of TMS measures than the scales themselves.
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Affiliation(s)
- Monica Marzouk
- Neural Control of Movement LaboratoryMenzies Health Institute QueenslandGriffith UniversityGold CoastQueenslandAustralia
| | - Daniel J. McKeown
- Neural Control of Movement LaboratoryMenzies Health Institute QueenslandGriffith UniversityGold CoastQueenslandAustralia
| | - David N. Borg
- The Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social WorkQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Jonathon Headrick
- Neural Control of Movement LaboratoryMenzies Health Institute QueenslandGriffith UniversityGold CoastQueenslandAustralia
| | - Justin J. Kavanagh
- Neural Control of Movement LaboratoryMenzies Health Institute QueenslandGriffith UniversityGold CoastQueenslandAustralia
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Heleno E, Andias R, Neto M, Silva AG. A Feasibility Study of Pain Neuroscience Education and Exercise for Community-Dwelling Older Adults With Chronic Pain. J Geriatr Phys Ther 2023; 46:26-35. [PMID: 34417415 DOI: 10.1519/jpt.0000000000000327] [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: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Pain prevalence in older adults is high and greatly impacts their functioning. The primary aim of this study was to determine the feasibility of an intervention consisting of pain neuroscience education (PNE) plus exercise for community-dwelling older adults attending primary care, by assessing recruitment rates (inclusion, refusal, and exclusion rates), adverse events, and acceptability of the intervention. Secondary aims were to establish suitable procedures for delivering the intervention and assess the feasibility of data collection for psychosocial and physical functioning. METHODS A mixed-methods feasibility study with 2 groups was conducted. One group received 8 weekly 75-minute sessions of PNE plus exercise (PNE+E) and the other received usual care (UC), which consisted of appointments with the general practitioner. Inclusion, refusal, exclusion, and retention rates, dropouts, and adverse events were assessed. The Brief Pain Inventory, the Pain Catastrophizing Scale, the Tampa Scale, the Geriatric Depression Scale, the World Health Organization Disability Assessment Schedule, the 4-meter walk gait speed test and the 5 times sit-to-stand tests were used for assessment. A focus group interview was conducted with participants from the PNE+E group. Descriptive statistics were used for quantitative data and thematic analysis for qualitative data. RESULTS AND DISCUSSION Of 61 participants recruited, 33 (PNE+E = 22; UC = 11) entered the study, and 24 completed the intervention (PNE+E = 15; UC = 9). The inclusion rate was 54%, the refusal rate was 21%, the exclusion rate was 35%, the dropout rate was 32% in the PNE+E and 18% in the UC, and the retention rate was 68% in the PNE+E group and 82% in the UC group. No adverse events were reported and the intervention was well accepted by participants. Data collection for the clinical outcomes was feasible and results suggested higher improvements in the PNE+E group than in the UC group. CONCLUSION PNE+E is possible to implement, safe, and well accepted by community-dwelling older adults independent of their education level. This study informs future studies on practical and methodological strategies that should be considered when designing a PNE+E intervention for older adults, such as adapting the language of the PNE to participants, using relatable metaphors, and encouraging written and exercise homework.
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Affiliation(s)
- Emanuel Heleno
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Rosa Andias
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Aveiro, Portugal
| | | | - Anabela G Silva
- School of Health Sciences, University of Aveiro, Aveiro, Portugal
- Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Aveiro, Portugal
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20
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Cheng KYK, Bao Z, Long Y, Liu C, Huang T, Cui C, Chow SKH, Wong RMY, Cheung WH. Sarcopenia and Ageing. Subcell Biochem 2023; 103:95-120. [PMID: 37120466 DOI: 10.1007/978-3-031-26576-1_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] [Indexed: 05/01/2023]
Abstract
Musculoskeletal ageing is a major health challenge as muscles and bones constitute around 55-60% of body weight. Ageing muscles will result in sarcopenia that is characterized by progressive and generalized loss of skeletal muscle mass and strength with a risk of adverse outcomes. In recent years, a few consensus panels provide new definitions for sarcopenia. It was officially recognized as a disease in 2016 with an ICD-10-CM disease code, M62.84, in the International Classification of Diseases (ICD). With the new definitions, there are many studies emerging to investigate the pathogenesis of sarcopenia, exploring new interventions to treat sarcopenia and evaluating the efficacy of combination treatments for sarcopenia. The scope of this chapter is to summarize and appraise the evidence in terms of (1) clinical signs, symptoms, screening, and diagnosis, (2) pathogenesis of sarcopenia with emphasis on mitochondrial dysfunction, intramuscular fat infiltration and neuromuscular junction deterioration, and (3) current treatments with regard to physical exercises and nutritional supplement.
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Affiliation(s)
- Keith Yu-Kin Cheng
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhengyuan Bao
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
- Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yufeng Long
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Chaoran Liu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Tao Huang
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Can Cui
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Simon Kwoon-Ho Chow
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Ronald Man Yeung Wong
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing-Hoi Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China.
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Maximos M, Stratford P, Tang A, Dal Bello-Haas V. Description and Functional Benefits of Meeting Frequency, Intensity, and Time of Resistance and Cardiovascular Exercises: A Study of Older Adults in a Community-Based, Slow-Stream Rehabilitation, Hospital-to-Home Transition Program. Gerontol Geriatr Med 2022; 8:23337214221096303. [PMID: 35615344 PMCID: PMC9125058 DOI: 10.1177/23337214221096303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 11/18/2022] Open
Abstract
This prospective cohort study described cardiovascular and resistance exercises completed by older adults in a community-based, slow-stream rehabilitation, hospital-to-home transition program; compared exercises completed to the American College of Sports Medicine (ACSM) exercise guidelines; and, assessed differences in Late Life Function and Disability Index (LLFDI)-Function Component (FC) between older adults who met and did not meet the ACSM guidelines. Descriptive statistics and Factorial ANCOVA were conducted. For cardiovascular exercise 59.3% of participants met frequency, 73.4% met intensity, and 35.9% met time. For resistance exercise, 67.2% of participants met frequency, 42.2% met intensity, and 76.6% number of repetitions. Participants who met both frequency and time for cardiovascular exercise had higher LLFDI-FC scores, as did those who met intensity and/or number of repetitions for resistance exercise. The findings provide support that older adults engaged in a slow-stream rehabilitation program can meet the ACSM exercise guidelines for community-dwelling older adults, and that meeting the guidelines improves function.
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Affiliation(s)
- Melody Maximos
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, USA
| | - Paul Stratford
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, USA
| | - Ada Tang
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, USA
| | - Vanina Dal Bello-Haas
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, USA
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22
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Boxman-Zeevi Y, Schwartz H, Har-Nir I, Bordo N, Halperin I. Prescribing Intensity in Resistance Training Using Rating of Perceived Effort: A Randomized Controlled Trial. Front Physiol 2022; 13:891385. [PMID: 35574454 PMCID: PMC9099373 DOI: 10.3389/fphys.2022.891385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 04/07/2022] [Indexed: 12/01/2022] Open
Abstract
Introduction: Rating of perceived effort (RPE) scales are used to prescribe intensity in resistance training (RT) in several ways. For instance, trainees can reach a specific RPE value by modifying the number of repetitions, lifted loads, or other training variables. Given the multiple approaches of prescribing intensity using RPE and its growing popularity, we compared the effects of two RPE prescription approaches on adherence rates, body composition, performance and psychological outcomes, in an online RT intervention. Methods: We randomly assigned 57 healthy participants without RT experience (60% females, age range: 18-45) to one of two groups that received two weekly RT sessions using a resistance-band for 8 weeks. In the fixed-repetition group, participants adjusted the band resistance with the goal of completing 10 repetitions and reaching a 7-RPE on a 0-10 scale by the 10th repetition. In the open-repetition group, participants selected their preferred band resistance and completed repetitions until reaching a 7-RPE by the final repetition. We measured body composition, performance, and program satisfaction rates. Results: We assessed 46 participants at post-test, 24 from the fixed-repetition group and 22 from the open-repetition group. We observed non-significant and trivial differences between groups in all outcomes (p > 0.05). We then combined the pre-post change scores of the two groups. We found that adherence rates began at 89% and gradually decreased to 42%. On average, participants increased their fat-free mass [0.3 kg (95% CI: 0.1-0.6)], isometric mid-thigh pull [5.5 kg (95% CI: 0.8-10.4)], isometric knee-extension [2.2 kg (95% CI: 0.8-3.7)], and push-ups [6.3 repetitions (95% CI: 4.5-8.2)]. We observed non-significant and trivial changes in bodyweight, grip-force, and countermovement jump. Participants reported high satisfaction rates with all components of the program. Conclusion: Participants in both groups improved their body composition and physical capacity to a similar extent, and reported comparable satisfaction rates with the programs they followed. Accordingly, either prescription approach can be used to deliver online RT sessions based on personal preferences and logistical constraints. However, since adherences rates declined over the course of the study, future research should test additional strategies aiming to maintain adherence rates.
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Affiliation(s)
- Yael Boxman-Zeevi
- Department of Health Promotion, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sylvan Adams Sports Institute, Tel Aviv University, Tel-Aviv, Israel
| | - Hadar Schwartz
- Department of Health Promotion, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sylvan Adams Sports Institute, Tel Aviv University, Tel-Aviv, Israel
| | - Itai Har-Nir
- Department of Health Promotion, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sylvan Adams Sports Institute, Tel Aviv University, Tel-Aviv, Israel
| | - Nadia Bordo
- Faculty of Industrial Engineering and Management, Technion—Israel Institute of Technology, Haifa, Israel
| | - Israel Halperin
- Department of Health Promotion, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sylvan Adams Sports Institute, Tel Aviv University, Tel-Aviv, Israel
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23
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Williamson E, Boniface G, Marian IR, Dutton SJ, Garrett A, Morris A, Hansen Z, Ward L, Nicolson PJA, Rogers D, Barker KL, Fairbank J, Fitch J, French DP, Comer C, Mallen CD, Lamb SE. The clinical effectiveness of a physiotherapy delivered physical and psychological group intervention for older adults with neurogenic claudication: the BOOST randomised controlled trial. J Gerontol A Biol Sci Med Sci 2022; 77:1654-1664. [PMID: 35279025 PMCID: PMC9373932 DOI: 10.1093/gerona/glac063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Indexed: 11/30/2022] Open
Abstract
Background Neurogenic claudication (NC) is a debilitating spinal condition affecting older adults’ mobility and quality of life. Methods A randomized controlled trial of 438 participants evaluated the effectiveness of a physical and psychological group intervention (BOOST program) compared to physiotherapy assessment and tailored advice (best practice advice [BPA]) for older adults with NC. Participants were identified from spinal clinics (community and secondary care) and general practice records and randomized 2:1 to the BOOST program or BPA. The primary outcome was the Oswestry Disability Index (ODI) at 12 months. Data were also collected at 6 months. Other outcomes included ODI walking item, 6-minute walk test (6MWT), and falls. The primary analysis was intention-to-treat. Results The average age of participants was 74.9 years (standard deviation [SD] 6.0) and 57% (246/435) were female. There was no significant difference in ODI scores between treatment groups at 12 months (adjusted mean difference [MD]: −1.4 [95% confidence intervals (CI) −4.03, 1.17]), but, at 6 months, ODI scores favored the BOOST program (adjusted MD: −3.7 [95% CI −6.27, −1.06]). At 12 months, the BOOST program resulted in greater improvements in walking capacity (6MWT MD: 21.7m [95% CI 5.96, 37.38]) and ODI walking item (MD: −0.2 [95% CI −0.45, −0.01]) and reduced falls risk (odds ratio: 0.6 [95% CI 0.40, 0.98]) compared to BPA. No serious adverse events were related to either treatment. Conclusions The BOOST program substantially improved mobility for older adults with NC. Future iterations of the program will consider ways to improve long-term pain-related disability. Clinical Trials Registration Number: ISRCTN12698674
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Affiliation(s)
- Esther Williamson
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, University of Oxford, UK.,College of Medicine and Health, University of Exeter
| | - Graham Boniface
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, University of Oxford, UK
| | - Ioana R Marian
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Susan J Dutton
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK
| | - Angela Garrett
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, University of Oxford, UK
| | - Alana Morris
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, University of Oxford, UK
| | - Zara Hansen
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, University of Oxford, UK
| | - Lesley Ward
- Department of Sport, Exercise and Rehabilitation, Northumbria University, UK
| | - Philippa J A Nicolson
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, University of Oxford, UK
| | - David Rogers
- Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK
| | - Karen L Barker
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, University of Oxford, UK.,Oxford University Hospitals NHS Trust, Oxford, UK
| | - Jeremy Fairbank
- Nuffield Department of Rheumatology, Orthopaedics and Musculoskeletal Sciences, University of Oxford, UK
| | | | - David P French
- Manchester Centre for Health Psychology, University of Manchester, UK
| | - Christine Comer
- University of Leeds, Leeds, UK.,Leeds Community Healthcare NHS Trust, Otley, UK
| | - Christian D Mallen
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Sarah E Lamb
- College of Medicine and Health, University of Exeter
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24
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Hurst C, Robinson SM, Witham MD, Dodds RM, Granic A, Buckland C, De Biase S, Finnegan S, Rochester L, Skelton DA, Sayer AA. Resistance exercise as a treatment for sarcopenia: prescription and delivery. Age Ageing 2022; 51:6527381. [PMID: 35150587 PMCID: PMC8840798 DOI: 10.1093/ageing/afac003] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Indexed: 12/27/2022] Open
Abstract
Sarcopenia is a generalised skeletal muscle disorder characterised by reduced muscle strength and mass and associated with a range of negative health outcomes. Currently, resistance exercise (RE) is recommended as the first-line treatment for counteracting the deleterious consequences of sarcopenia in older adults. However, whilst there is considerable evidence demonstrating that RE is an effective intervention for improving muscle strength and function in healthy older adults, much less is known about its benefits in older people living with sarcopenia. Furthermore, evidence for its optimal prescription and delivery is very limited and any potential benefits of RE are unlikely to be realised in the absence of an appropriate exercise dose. We provide a summary of the underlying principles of effective RE prescription (specificity, overload and progression) and discuss the main variables (training frequency, exercise selection, exercise intensity, exercise volume and rest periods) that can be manipulated when designing RE programmes. Following this, we propose that an RE programme that consists of two exercise sessions per week and involves a combination of upper- and lower-body exercises performed with a relatively high degree of effort for 1–3 sets of 6–12 repetitions is appropriate as a treatment for sarcopenia. The principles of RE prescription outlined here and the proposed RE programme presented in this paper provide a useful resource for clinicians and exercise practitioners treating older adults with sarcopenia and will also be of value to researchers for standardising approaches to RE interventions in future sarcopenia studies.
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Affiliation(s)
- Christopher Hurst
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sian M Robinson
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Miles D Witham
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Richard M Dodds
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Antoneta Granic
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Charlotte Buckland
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- AGILE, Chartered Society of Physiotherapy, London, UK
| | | | - Susanne Finnegan
- AGILE, Chartered Society of Physiotherapy, London, UK
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Lynn Rochester
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Avan A Sayer
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
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Totally Excited about Moving Mobility and Exercise (TEAM Me): A Successful Multidisciplinary Exercise Quality Improvement Initiative for Pediatric and Young Adult Oncology and Stem Cell Transplant Inpatients. CHILDREN 2022; 9:children9020186. [PMID: 35204907 PMCID: PMC8870635 DOI: 10.3390/children9020186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/27/2022] [Accepted: 01/31/2022] [Indexed: 01/31/2023]
Abstract
Background: Pediatric, adolescent and young adult (PAYA) patients are less active than their healthy counterparts, particularly during inpatient stays. Methods: We conducted a quality improvement initiative to increase activity levels in patients admitted to our pediatric oncology and cellular therapy unit using a Plan-Do-Study-Act (PDSA) model. An interdisciplinary team was assembled to develop an incentive-based inpatient exercise and activity program titled Totally Excited About Moving Mobility and Exercise (TEAM Me). As part of the program, patients were encouraged by their care team to remain active during their inpatient stay. As an additional incentive, patients earned stickers to display on TEAM Me door boards along with tickets that could be exchanged for prizes. Activity was assessed by documentation of physical therapy participation, tests of physical function, and surveys of staff perceptions of patient activity levels, motivations, and barriers. Results: Compared to baseline, patient refusals to participate in physical therapy decreased significantly (24% vs. 2%) (p < 0.02), and staff perceptions of patient motivation to stay active increased from 40% to 70% in the post implementation period. There were no changes in physical function tests. Conclusions: An incentive-based exercise program for young oncology inpatients greatly improved patient activity levels, participation in physical therapy and influenced professional caregivers’ beliefs.
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Bruce J, Mazuquin B, Mistry P, Rees S, Canaway A, Hossain A, Williamson E, Padfield EJ, Lall R, Richmond H, Chowdhury L, Lait C, Petrou S, Booth K, Lamb SE, Vidya R, Thompson AM. Exercise to prevent shoulder problems after breast cancer surgery: the PROSPER RCT. Health Technol Assess 2022; 26:1-124. [PMID: 35220995 DOI: 10.3310/jknz2003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Upper limb problems are common after breast cancer treatment. OBJECTIVES To investigate the clinical effectiveness and cost-effectiveness of a structured exercise programme compared with usual care on upper limb function, health-related outcomes and costs in women undergoing breast cancer surgery. DESIGN This was a two-arm, pragmatic, randomised controlled trial with embedded qualitative research, process evaluation and parallel economic analysis; the unit of randomisation was the individual (allocated ratio 1 : 1). SETTING Breast cancer centres, secondary care. PARTICIPANTS Women aged ≥ 18 years who had been diagnosed with breast cancer and were at higher risk of developing shoulder problems. Women were screened to identify their risk status. INTERVENTIONS All participants received usual-care information leaflets. Those randomised to exercise were referred to physiotherapy for an early, structured exercise programme (three to six face-to-face appointments that included strengthening, physical activity and behavioural change strategies). MAIN OUTCOME MEASURES The primary outcome was upper limb function at 12 months as assessed using the Disabilities of Arm, Hand and Shoulder questionnaire. Secondary outcomes were function (Disabilities of Arm, Hand and Shoulder questionnaire subscales), pain, complications (e.g. wound-related complications, lymphoedema), health-related quality of life (e.g. EuroQol-5 Dimensions, five-level version; Short Form questionnaire-12 items), physical activity and health service resource use. The economic evaluation was expressed in terms of incremental cost per quality-adjusted life-year and incremental net monetary benefit gained from an NHS and Personal Social Services perspective. Participants and physiotherapists were not blinded to group assignment, but data collectors were blinded. RESULTS Between 2016 and 2017, we randomised 392 participants from 17 breast cancer centres across England: 196 (50%) to the usual-care group and 196 (50%) to the exercise group. Ten participants (10/392; 3%) were withdrawn at randomisation and 32 (8%) did not provide complete baseline data. A total of 175 participants (89%) from each treatment group provided baseline data. Participants' mean age was 58.1 years (standard deviation 12.1 years; range 28-88 years). Most participants had undergone axillary node clearance surgery (327/392; 83%) and 317 (81%) had received radiotherapy. Uptake of the exercise treatment was high, with 181 out of 196 (92%) participants attending at least one physiotherapy appointment. Compliance with exercise was good: 143 out of 196 (73%) participants completed three or more physiotherapy sessions. At 12 months, 274 out of 392 (70%) participants returned questionnaires. Improvement in arm function was greater in the exercise group [mean Disabilities of Arm, Hand and Shoulder questionnaire score of 16.3 (standard deviation 17.6)] than in the usual-care group [mean Disabilities of Arm, Hand and Shoulder questionnaire score of 23.7 (standard deviation 22.9)] at 12 months for intention-to-treat (adjusted mean difference Disabilities of Arm, Hand and Shoulder questionnaire score of -7.81, 95% confidence interval -12.44 to -3.17; p = 0.001) and complier-average causal effect analyses (adjusted mean difference -8.74, 95% confidence interval -13.71 to -3.77; p ≤ 0.001). At 12 months, pain scores were lower and physical health-related quality of life was higher in the exercise group than in the usual-care group (Short Form questionnaire-12 items, mean difference 4.39, 95% confidence interval 1.74 to 7.04; p = 0.001). We found no differences in the rate of adverse events or lymphoedema over 12 months. The qualitative findings suggested that women found the exercise programme beneficial and enjoyable. Exercise accrued lower costs (-£387, 95% CI -£2491 to £1718) and generated more quality-adjusted life years (0.029, 95% CI 0.001 to 0.056) than usual care over 12 months. The cost-effectiveness analysis indicated that exercise was more cost-effective and that the results were robust to sensitivity analyses. Exercise was relatively cheap to implement (£129 per participant) and associated with lower health-care costs than usual care and improved health-related quality of life. Benefits may accrue beyond the end of the trial. LIMITATIONS Postal follow-up was lower than estimated; however, the study was adequately powered. No serious adverse events directly related to the intervention were reported. CONCLUSIONS This trial provided robust evidence that referral for early, supported exercise after breast cancer surgery improved shoulder function in those at risk of shoulder problems and was associated with lower health-care costs than usual care and improved health-related quality of life. FUTURE WORK Future work should focus on the implementation of exercise programmes in clinical practice for those at highest risk of shoulder problems. TRIAL REGISTRATION This trial is registered as ISRCTN35358984. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Julie Bruce
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Bruno Mazuquin
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Pankaj Mistry
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Sophie Rees
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Alastair Canaway
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Anower Hossain
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, Bangladesh
| | - Esther Williamson
- Centre for Rehabilitation Research, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Emma J Padfield
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Ranjit Lall
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Helen Richmond
- Primary Healthcare Research Unit, Faculty of Medicine, Memorial University of Newfoundland, St John's, NL, Canada
| | - Loraine Chowdhury
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Clare Lait
- Gloucestershire Care Services NHS Trust, Gloucester, UK
| | - Stavros Petrou
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Katie Booth
- Warwick Clinical Trials Unit, Division of Health Sciences, University of Warwick, Coventry, UK
| | - Sarah E Lamb
- College of Medicine and Health, University of Exeter, Exeter, UK
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Lea JWD, O'Driscoll JM, Hulbert S, Scales J, Wiles JD. Convergent Validity of Ratings of Perceived Exertion During Resistance Exercise in Healthy Participants: A Systematic Review and Meta-Analysis. SPORTS MEDICINE - OPEN 2022; 8:2. [PMID: 35000021 PMCID: PMC8742800 DOI: 10.1186/s40798-021-00386-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 11/21/2021] [Indexed: 11/18/2022]
Abstract
Background The validity of ratings of perceived exertion (RPE) during aerobic training is well established; however, its validity during resistance exercise is less clear. This meta-analysis used the known relationships between RPE and exercise intensity (EI), heart rate (HR), blood lactate (BLa), blood pressure (BP) and electromyography (EMG) to determine the convergent validity of RPE as a measure of resistance exercise intensity and physiological exertion, during different forms of resistance exercise. Additionally, this study aims to assess the effect of several moderator variables on the strength of the validity coefficients, so that clearer guidance can be given on the use of RPE during resistance exercise. Methods An online search of 4 databases and websites (PubMed, Web of Science SPORTDiscus and ResearchGate) was conducted up to 28 February 2020. Additionally, the reference lists of the included articles were inspected manually for further unidentified studies. The inclusion criteria were healthy participants of any age, a rating scale used to measure RPE, resistance exercise of any type, one cohort receiving no other intervention, and must present data from one of the following outcome measures: EI, HR, BP, EMG or BLa. Weighted mean effect sizes (r) were calculated using a random-effects model. Heterogeneity was assessed using the τ2 and I2 statistics. Moderator analysis was conducted using random-effects meta-regression. Results One-hundred and eighteen studies were included in the qualitative synthesis, with 75 studies (99 unique cohorts) included in the meta-analysis. The overall weighted mean validity coefficient was large (0.88; 95% CI 0.84–0.91) and between studies heterogeneity was very large (τ2 = 0.526, I2 = 96.1%). Studies using greater workload ranges, isometric muscle actions, and those that manipulated workload or repetition time, showed the highest validity coefficients. Conversely, sex, age, training status, RPE scale used, and outcome measure no significant effect. Conclusions RPE provides a valid measure of exercise intensity and physiological exertion during resistance exercise, with effect sizes comparable to or greater than those shown during aerobic exercise. Therefore, RPE may provide an easily accessible means of prescribing and monitoring resistance exercise training. Trial Registration The systematic review protocol was registered on the PROSPERO database (CRD42018102640). Supplementary Information The online version contains supplementary material available at 10.1186/s40798-021-00386-8.
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Affiliation(s)
- John W D Lea
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK.
| | - Jamie M O'Driscoll
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - Sabina Hulbert
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
| | - James Scales
- Institute of Population and Health Sciences, Queen Mary University of London, London, E1 4NS, UK
| | - Jonathan D Wiles
- School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK
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Effect of fatigue strength exercise on anterior thigh skin temperature rewarming after cold stress test. J Therm Biol 2021; 101:103098. [PMID: 34879916 DOI: 10.1016/j.jtherbio.2021.103098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/20/2021] [Accepted: 09/14/2021] [Indexed: 11/21/2022]
Abstract
Although dynamic thermography skin temperature assessment has been used in medical field, scientific evidence in sports is scarce. The aim of the study was to assess changes in anterior thigh skin temperature in response to a cold stress test after a strength exercise fatiguing protocol. Ten physically active adults performed a familiarization session and two strength exercise sessions, one with dominant and the other with non-dominant lower limb. Participants performed bouts of 10 concentric and eccentric contractions of leg extensions in an isokinetic device until reaching around 30% of force loss. Infrared thermographic images were taken at baseline conditions and after the fatigue level from both thighs after being cooled using a cryotherapy system. ROIs included vastus medialis, rectus femoris, adductor and vastus lateralis. Skin temperature rewarming was assessed during 180s after the cooling process obtaining the coefficients of the following equation: ΔSkin temperature = β0 + β1 * ln(T), being β0 and β1 the constant and slope coefficients, respectively, T the time elapsed following the cold stress in seconds, and ΔSkin temperature the difference between the skin temperature at T respect and the pre-cooling moment. Lower β0 and higher β1 were found for vastus lateralis and rectus femoris in the intervention lower limb compared with baseline conditions (p < 0.05 and ES > 0.6). Adductor only showed differences in β0 (p = 0.01 and ES = 0.92). The regressions models obtained showed that β0 and β1 had a direct relationship with age and muscle mass, but an inverse relationship with the number of series performed until 30% of fatigue (R2 = 0.8). In conclusion, fatigue strength exercise results in a lower skin temperature and a faster thermal increase after a cold stress test.
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Forde C, Haddad M, Hirani SP, Keene DJ. Is an individually tailored programme of intense leg resistance and dynamic exercise acceptable to adults with an acute lateral patellar dislocation? A feasibility study. Pilot Feasibility Stud 2021; 7:197. [PMID: 34749823 PMCID: PMC8573884 DOI: 10.1186/s40814-021-00932-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/22/2021] [Indexed: 11/29/2022] Open
Abstract
Background Lateral patellar dislocations mainly affect active teenagers and young adults. To help people recover, non-surgical exercise-based treatment is often recommended but the optimal exercise-based treatment is unknown. Currently, treatment outcomes after this injury are variable. Common problems include recurrent dislocation, reduced activity levels, and later surgery. A programme of intense leg resistance exercises, and dynamic exercises related to participants’ activity-related goals, has rationale, but has not been previously reported. In line with the Medical Research Council guidance, this study aimed to assess the acceptability of a novel evidence-based exercise programme for adults after acute lateral patellar dislocation and the feasibility of future research evaluating this treatment. Methods A single-group prospective study was conducted at the John Radcliffe Hospital, Oxford, UK. Participants were 16 years or older with an acute first-time or recurrent lateral patellar dislocation. Participants received up to six face-to-face, one-to-one, physiotherapy sessions, over a maximum of 3 months, and performed intensive home exercises independently at least three times per week. Strategies to increase exercise adherence were used. Primary objectives were to determine the number of eligible patients, the recruitment rate (proportion of eligible patients that provided written informed consent), participant adherence to scheduled physiotherapy sessions and self-reported adherence to prescribed exercise, and intervention acceptability to participants measured by attrition and a study-specific questionnaire. Data were analysed using descriptive statistics. Results Fifteen of 22 (68%) patients with a lateral patellar dislocation were eligible. All eligible (100%) were recruited. Two of 15 (13%) participants provided no outcome data, 2/15 (13%) provided partial outcome data, and 11/15 (73%) provided all outcome data. Questionnaire responses demonstrated high intervention acceptability to participants. Participants attended 56/66 (85%) physiotherapy sessions and 10/11 (91%) participants reported they ‘always’ or ‘often’ completed the prescribed exercise. One participant redislocated their patella; another experienced knee pain or swelling lasting more than one week after home exercise on three occasions. Conclusion The intervention appeared acceptable to adults after acute lateral patellar dislocation, and a future randomised pilot trial is feasible. This future pilot trial should estimate attrition with increased precision over a longer duration and assess participants’ willingness to be randomised to different treatments across multiple centres. Trial registration ClinicalTrials.govNCT03798483, registered on January 10, 2019 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00932-x.
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Affiliation(s)
- Colin Forde
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kadoorie Research Centre, University of Oxford, Kadoorie Centre for Critical Care Research and Education, Level 3, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK.
| | - Mark Haddad
- School of Health Sciences, City, University of London, London, UK
| | | | - David J Keene
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Kadoorie Research Centre, University of Oxford, Kadoorie Centre for Critical Care Research and Education, Level 3, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK
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30
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The effect of muscle fatigue on wrist joint position sense in healthy adults. J Hand Ther 2021; 33:329-338. [PMID: 30962121 DOI: 10.1016/j.jht.2019.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 03/04/2019] [Accepted: 03/04/2019] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Pretest and posttest experimental study. INTRODUCTION The effect of muscle fatigue on wrist joint position sense (JPS) has yet to be determined. PURPOSE OF THE STUDY The primary aim was to determine whether muscle fatigue affects wrist JPS in healthy adults. The secondary aims were to compare the effect of muscle fatigue on younger and older adults JPS and determine the association between JPS rate of change and total muscle fatigue (TMF) rates postexercise. METHODS Forty male and female healthy adults were assigned into younger (18-40 years) and older (41-65 years) groups. Preexercise and postexercise testing consisted of active wrist JPS, handgrip, and wrist extensor strength assessments. Muscle fatigue was induced via a calibrated gripper and wrist extension dumbbell exercises. Dependent variables were the JPS rate of change (ie, preexercise and postexercise), TMF rate (ie, grip and wrist extension average strength decline), and Borg Rating of Perceived Exertion scale scores. RESULTS Postexercise wrist JPS test scores were significantly higher than preexercise. Exercises induced statistically significant TMF rates and Borg Rating of Perceived Exertion scores among all participants. No statistically significant age-group differences on JPS rate of change, and TMF rate was found. A statistically significant mild correlation (r = 0.425) existed between JPS rate of change and TMF rates. DISCUSSION Postexercise fatigue significantly impairs wrist JPS in both younger and older adults. On average, an 18% muscle strength decline led to 215% wrist JPS deficit. CONCLUSIONS Significant wrist proprioception deficits persist for ≤5 min following exertional exercises, regardless of age level.
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van Dijk M, Allegaert P, Locus M, Deschodt M, Verheyden G, Tournoy J, Flamaing J. Geriatric Activation Program Pellenberg, a novel physiotherapy program for hospitalized patients on a geriatric rehabilitation ward. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2021; 26:e1905. [PMID: 33783923 DOI: 10.1002/pri.1905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 01/07/2021] [Accepted: 03/11/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND PURPOSE Regaining functional independence and independent living is challenging in hospitalized geriatric patients. Different from community dwelling and institutionalized older people, geriatric patients on rehabilitation wards generally receive more frequent and structured physiotherapy with the primary aim to discharge them to their home or place of residence. There is a paucity of evidence concerning the structure and components of physiotherapy programs to improve functional performance in this particular group. In this paper, we describe how we developed the Geriatric Activation Program Pellenberg (GAPP) based on patients' needs and available literature. METHODS We searched the literature on physiotherapy interventions focusing on the core components for improvement of functional performance: strength, balance, function, (gait)speed, coordination, and endurance training. Based on physiotherapist staffing and physiotherapy time allocated to each patient, we organized the practical, daily delivery of the program. RESULTS GAPP is a 5-day program, repeated weekly, delivered by physiotherapists and physiotherapy students. Each day, one or a combination of two to three different core components of functional performance is trained intensively in 45-min sessions. A set of standard exercises is constantly adjusted to each patients' capacity. On day 5, there is a mix of these core elements in a group session (e.g., chair-dance, table tennis, karate) and the Berg Balance Scale is completed to evaluate progress. CONCLUSION GAPP is a multicomponent physiotherapy program for hospitalized patients on a geriatric rehabilitation ward, aimed at improving functional performance.
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Affiliation(s)
- Margaretha van Dijk
- Department of Physical Medicine and Rehabilitation, UZ Leuven-University Hospitals Leuven, Campus Pellenberg, Pellenberg, Belgium
| | - Patsy Allegaert
- Department of Physical Medicine and Rehabilitation, UZ Leuven-University Hospitals Leuven, Campus Pellenberg, Pellenberg, Belgium
| | - Marlies Locus
- Department of Physical Medicine and Rehabilitation, UZ Leuven-University Hospitals Leuven, Campus Pellenberg, Pellenberg, Belgium
| | - Mieke Deschodt
- Geriatrics and Gerontology, Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium.,Nursing Science (INS), Department of Public Health, University of Basel, Basel, Switzerland
| | - Geert Verheyden
- Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium
| | - Jos Tournoy
- Geriatrics and Gerontology, Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium.,Department Geriatric Medicine, UZ Leuven-University Hospitals Leuven, Leuven, Belgium
| | - Johan Flamaing
- Geriatrics and Gerontology, Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium.,Department Geriatric Medicine, UZ Leuven-University Hospitals Leuven, Leuven, Belgium
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Lea JWD, O'Driscoll JM, Coleman DA, Wiles JD. Validity and reliability of the 'Isometric Exercise Scale' (IES) for measuring ratings of perceived exertion during continuous isometric exercise. Sci Rep 2021; 11:5334. [PMID: 33674722 PMCID: PMC7970867 DOI: 10.1038/s41598-021-84803-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 01/25/2021] [Indexed: 11/08/2022] Open
Abstract
Isometric exercise (IE) interventions are an effective non-medical method of reducing arterial blood pressure (BP). Current methods of prescribing and controlling isometric exercise intensity often require the use of expensive equipment and specialist knowledge. However, ratings of perceived exertion (RPE) may provide a more accessible means of monitoring exercise intensity. Therefore, the aim of this study was to assess the validity of a specific Isometric Exercise Scale (IES) during a continuous incremental IE test. Twenty-nine male participants completed four incremental isometric wall squat tests. Each test consisted of five 2-min stages of progressively increasing workload. Workload was determined by knee joint angle from 135° to 95°. The tests were continuous with no rest periods between the stages. Throughout the exercise protocol, RPE (IES and Borg's CR-10), heart rate and blood pressure were recorded. A strong positive linear relationship was found between the IES and the CR-10 (r = 0.967). Likewise, strong positive relationships between the IES and wall squat duration (r = 0.849), HR (r = 0.819) and BP (r = 0.841) were seen. Intra-class correlation coefficients and coefficients of variations for the IES ranged from r = 0.81 to 0.91 and 4.5-54%, respectively, with greater reliability seen at the higher workloads. The IES provides valid and reliable measurements of RPE, exercise intensity, and the changes in physiological measures of exertion during continuous incremental IE; as such, the IES can be used as an accessible measure of exercise intensity during IE interventions.
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Affiliation(s)
- John W D Lea
- School of Human and Life Sciences, Canterbury Christ Church University, Kent, UK
| | - Jamie M O'Driscoll
- School of Human and Life Sciences, Canterbury Christ Church University, Kent, UK
| | - Damian A Coleman
- School of Human and Life Sciences, Canterbury Christ Church University, Kent, UK
| | - Jonathan D Wiles
- School of Human and Life Sciences, Canterbury Christ Church University, Kent, UK.
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Smeuninx B, Elhassan YS, Manolopoulos KN, Sapey E, Rushton AB, Edwards SJ, Morgan PT, Philp A, Brook MS, Gharahdaghi N, Smith K, Atherton PJ, Breen L. The effect of short-term exercise prehabilitation on skeletal muscle protein synthesis and atrophy during bed rest in older men. J Cachexia Sarcopenia Muscle 2021; 12:52-69. [PMID: 33347733 PMCID: PMC7890266 DOI: 10.1002/jcsm.12661] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/19/2020] [Accepted: 11/24/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Poor recovery from periods of disuse accelerates age-related muscle loss, predisposing individuals to the development of secondary adverse health outcomes. Exercise prior to disuse (prehabilitation) may prevent muscle deterioration during subsequent unloading. The present study aimed to investigate the effect of short-term resistance exercise training (RET) prehabilitation on muscle morphology and regulatory mechanisms during 5 days of bed rest in older men. METHODS Ten healthy older men aged 65-80 years underwent four bouts of high-volume unilateral leg RET over 7 days prior to 5 days of inpatient bed rest. Physical activity and step-count were monitored over the course of RET prehabilitation and bed rest, whilst dietary intake was recorded throughout. Prior to and following bed rest, quadriceps cross-sectional area (CSA), and hormone/lipid profiles were determined. Serial muscle biopsies and dual-stable isotope tracers were used to determine integrated myofibrillar protein synthesis (iMyoPS) over RET prehabilitation and bed rest phases, and acute postabsorptive and postprandial myofibrillar protein synthesis (aMyoPS) rates at the end of bed rest. RESULTS During bed rest, daily step-count and light and moderate physical activity time decreased, whilst sedentary time increased when compared with habitual levels (P < 0.001 for all). Dietary protein and fibre intake during bed rest were lower than habitual values (P < 0.01 for both). iMyoPS rates were significantly greater in the exercised leg (EX) compared with the non-exercised control leg (CTL) over prehabilitation (1.76 ± 0.37%/day vs. 1.36 ± 0.18%/day, respectively; P = 0.007). iMyoPS rates decreased similarly in EX and CTL during bed rest (CTL, 1.07 ± 0.22%/day; EX, 1.30 ± 0.38%/day; P = 0.037 and 0.002, respectively). Postprandial aMyoPS rates increased above postabsorptive values in EX only (P = 0.018), with no difference in delta postprandial aMyoPS stimulation between legs. Quadriceps CSA at 40%, 60%, and 80% of muscle length decreased significantly in EX and CTL over bed rest (0.69%, 3.5%, and 2.8%, respectively; P < 0.01 for all), with no differences between legs. No differences in fibre-type CSA were observed between legs or with bed rest. Plasma insulin and serum lipids did not change with bed rest. CONCLUSIONS Short-term resistance exercise prehabilitation augmented iMyoPS rates in older men but did not offset the relative decline in iMyoPS and muscle mass during bed rest.
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Affiliation(s)
- Benoit Smeuninx
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Yasir S. Elhassan
- Institute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
- Centre for Endocrinology, Diabetes and MetabolismBirmingham Health PartnersBirminghamUK
| | - Konstantinos N. Manolopoulos
- Institute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
- Centre for Endocrinology, Diabetes and MetabolismBirmingham Health PartnersBirminghamUK
| | - Elizabeth Sapey
- NIHR Clinical Research Facility, University Hospitals Birmingham NHS Foundation Trust and Institute of Inflammation and AgeingUniversity of BirminghamBirminghamUK
| | - Alison B. Rushton
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Sophie J. Edwards
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Paul T. Morgan
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
| | - Andrew Philp
- Garvan Institute of Medical ResearchSydneyNSWAustralia
- St Vincents Medical School, UNSW MedicineUNSW SydneySydneyNSWAustralia
| | - Matthew S. Brook
- MRC‐ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular PhysiologyUniversity of NottinghamDerbyUK
| | - Nima Gharahdaghi
- MRC‐ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular PhysiologyUniversity of NottinghamDerbyUK
| | - Kenneth Smith
- MRC‐ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular PhysiologyUniversity of NottinghamDerbyUK
| | - Philip J. Atherton
- MRC‐ARUK Centre of Excellence for Musculoskeletal Ageing Research, Clinical, Metabolic and Molecular PhysiologyUniversity of NottinghamDerbyUK
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamBirminghamUK
- MRC‐Arthritis Research UK Centre for Musculoskeletal Ageing ResearchUniversity of BirminghamUK
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Hirsch SM, Chapman CJ, Frost DM, Beach TAC. Mechanical Energy Expenditure at Lumbar Spine and Lower Extremity Joints During the Single-Leg Squat Is Affected by the Nonstance Foot Position. J Strength Cond Res 2020; 36:2417-2426. [PMID: 33273304 DOI: 10.1519/jsc.0000000000003854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hirsch, SM, Chapman, CJ, Frost, DM, and Beach, TAC. Mechanical energy expenditure at lumbar spine and lower extremity joints during the single-leg squat is affected by the nonstance foot position. J Strength Cond Res XX(X): 000-000, 2020-Previous research has shown that discrete kinematic and kinetic quantities during bodyweight single-leg squat (SLS) movements are affected by elevated foot positioning and sex of the performer, but generalizations are limited by the high-dimensional data structure reported. Using a 3D inverse dynamical linked-segment model, we quantified mechanical energy expenditure (MEE) at each joint in the kinetic chain, the total MEE (sum of MEE across aforesaid joints), and the relative contribution of each joint to total MEE during SLSs performed with elevated foot positioned beside stance leg (SLS-Side), and in-front of (SLS-Front) and behind (SLS-Back) the body. Total MEE differed between SLS variations (p = 0.002), with the least amount observed in the SLS-Back (effect size [ES] = 0.066-0.069). Approximately 50% of total MEE was contributed by the knee joint in each SLS variation, whereas MEE at the ankle, hip, and lumbar spine (in absolute and relative terms) varied complexly as a function of the elevated foot position. Total MEE (p = 0.0192, ES = 0.852) and the absolute MEE at the knee and spine was greater in men across the SLS variations performed (p = 0.025-0.036, ES = 0.715-0.766), but only the lumbar spine contribution to total MEE was larger in men across all SLS variations (p = 0.045, ES = 0.607). Otherwise, there were no other sex-specific responses observed. Biomechanically, SLS movements are generally "knee-dominant," but changing elevated foot position effectively redistributes MEE among other joints in the linkage. Consistent with the previous conclusions reached based on discrete kinematic and kinetic data, not all SLSs are equal.
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Affiliation(s)
- Steven M Hirsch
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario
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Gokalp O, Kirmizigil B. Effects of Thrower's Ten exercises on upper extremity performance: A randomized controlled study. Medicine (Baltimore) 2020; 99:e22837. [PMID: 33080765 PMCID: PMC7571874 DOI: 10.1097/md.0000000000022837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/24/2020] [Accepted: 09/19/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The Thrower's Ten Exercise program is an exercise program especially designed to improve the strength, power and endurance of the shoulder complex. The aim of this study was to investigate the effects of the Thrower's Ten exercises on the upper extremity performance in healthy sedentary individuals. METHODS 36 healthy sedentary individuals completed this study conducted with a randomized controlled design. The subjects were divided into 2 groups: exercise and control. The exercise group received a training of the Thrower's Ten exercises of 50-minute sessions 3 times a week for a duration of 8 weeks. Before and after the study, the subjects were tested for dynamic balance on the upper extremity with the Upper Limp Y balance test and for explosive power with the medicine ball throw test. Moreover, the strength of the shoulder internal and external rotator muscles was measured with an isokinetic dynamometer at a speed of 60°/second. The study was registered on the Clinical Trials website by the number NCT04162886. RESULTS A comparison between the groups showed significant differences in terms of dynamic balance and explosive power (P < .05), but not in terms of isokinetic muscle strength and body composition (P > .05). On the other hand, comparisons of the dynamic equilibrium, explosive power and isokinetic muscle strength parameters within the exercise group returned statistically different results (P < .05). CONCLUSIONS The Thrower's Ten exercises represent an effective method to improve the balance on the upper extremity, explosive power and isokinetic strength in healthy sedentary individuals.
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Bass A, Aubertin-Leheudre M, Vincent C, Karelis AD, Morin SN, McKerral M, Duclos C, Gagnon DH. Effects of an Overground Walking Program With a Robotic Exoskeleton on Long-Term Manual Wheelchair Users With a Chronic Spinal Cord Injury: Protocol for a Self-Controlled Interventional Study. JMIR Res Protoc 2020; 9:e19251. [PMID: 32663160 PMCID: PMC7545333 DOI: 10.2196/19251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/30/2020] [Accepted: 07/07/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND In wheelchair users with a chronic spinal cord injury (WUSCI), prolonged nonactive sitting time and reduced physical activity-typically linked to this mode of mobility-contribute to the development or exacerbation of cardiorespiratory, musculoskeletal, and endocrine-metabolic health complications that are often linked to increased risks of chronic pain or psychological morbidity. Limited evidence suggests that engaging in a walking program with a wearable robotic exoskeleton may be a promising physical activity intervention to counter these detrimental health effects. OBJECTIVE This study's overall goals are as follows: (1) to determine the effects of a 16-week wearable robotic exoskeleton-assisted walking program on organic systems, functional capacities, and multifaceted psychosocial factors and (2) to determine self-reported satisfaction and perspectives with regard to the intervention and the device. METHODS A total of 20 WUSCI, who have had their injuries for more than 18 months, will complete an overground wearable robotic exoskeleton-assisted walking program (34 sessions; 60 min/session) supervised by a physiotherapist over a 16-week period (one to three sessions/week). Data will be collected 1 month prior to the program, at the beginning, and at the end as well as 2 months after completing the program. Assessments will characterize sociodemographic characteristics; anthropometric parameters; sensorimotor impairments; pain; lower extremity range of motion and spasticity; wheelchair abilities; cardiorespiratory fitness; upper extremity strength; bone architecture and mineral density at the femur, tibia, and radius; total and regional body composition; health-related quality of life; and psychological health. Interviews and an online questionnaire will be conducted to measure users' satisfaction levels and perspectives at the end of the program. Differences across measurement times will be verified using appropriate parametric or nonparametric analyses of variance for repeated measures. RESULTS This study is currently underway with active recruitment in Montréal, Québec, Canada. Results are expected in the spring of 2021. CONCLUSIONS The results from this study will be essential to guide the development, implementation, and evaluation of future evidence-based wearable robotic exoskeleton-assisted walking programs offered in the community, and to initiate a reflection regarding the use of wearable robotic exoskeletons during initial rehabilitation following a spinal cord injury. TRIAL REGISTRATION ClinicalTrials.gov NCT03989752; https://clinicaltrials.gov/ct2/show/NCT03989752. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19251.
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Affiliation(s)
- Alec Bass
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | | | - Claude Vincent
- Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Québec, QC, Canada
| | - Antony D Karelis
- Department of Exercise Science, Université du Québec à Montréal, Montréal, QC, Canada
| | - Suzanne N Morin
- Department of Medicine, McGill University, Montréal, QC, Canada
| | - Michelle McKerral
- Departement of Psychology, Faculty of Arts and Sciences, Université de Montréal, Montréal, QC, Canada
| | - Cyril Duclos
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Dany H Gagnon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
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Emanuel A, Rozen Smukas II, Halperin I. An analysis of the perceived causes leading to task-failure in resistance-exercises. PeerJ 2020; 8:e9611. [PMID: 33194334 PMCID: PMC7391967 DOI: 10.7717/peerj.9611] [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: 04/30/2020] [Accepted: 07/05/2020] [Indexed: 11/20/2022] Open
Abstract
Background While reaching task-failure in resistance-exercises is a topic that attracts scientific and applied interest, the underlying perceived reasons leading to task-failure remain underexplored. Here, we examined the reasons subjects attribute to task-failure as they performed resistance-exercises using different loads. Methods Twenty-two resistance-trained subjects (11-females) completed one Repetition-Maximum (RM) tests in the barbell squat and bench-press. Then, in the next two counterbalanced sessions, subjects performed two sets to task-failure in both exercises, using either 70% or 83% of 1RM. Approximately 30 seconds after set-completion, subjects verbally reported the reasons they perceived to have caused them to reach task-failure. Their answers were recorded, transcribed, and thematically analyzed. The differences between the frequencies of the identified categories were then tested using a mixed logistic regression model. Results The most commonly reported reason was muscle fatigue (54%, p < 0.001), mostly of the target muscles involved in each exercise. However, remote muscles involved to a lesser extent in each exercise were also reported. Approximately half of the remaining reasons included general fatigue (26%), pain (12%), cardiovascular strain (11%), and negative affect (10%), with the latter three reported more often in the squat (p = 0.022). Conclusions In contrast to our expectations, task-failure was perceived to be caused by a range of limiting factors other than fatigue of the target muscles. It now remains to be established whether different perceived limiting factors of resistance-exercises lead to different adaptations, such as muscular strength and hypertrophy.
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Affiliation(s)
- Aviv Emanuel
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.,School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv, Israel
| | - Isaac Isur Rozen Smukas
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv, Israel
| | - Israel Halperin
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv, Israel
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The anti-inflammatory effect of resistance training in hypertensive women: the role of purinergic signaling. J Hypertens 2020; 38:2490-2500. [DOI: 10.1097/hjh.0000000000002578] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Marshall RN, Morgan PT, Martinez-Valdes E, Breen L. Quadriceps muscle electromyography activity during physical activities and resistance exercise modes in younger and older adults. Exp Gerontol 2020; 136:110965. [PMID: 32360986 PMCID: PMC7264709 DOI: 10.1016/j.exger.2020.110965] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/17/2020] [Accepted: 04/23/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Understanding the root cause of the age-related impairment in muscle adaptive remodelling with resistance exercise training (RET) and developing pragmatic and accessible resistance exercise for older adults, are essential research directives. METHODS We sought to determine whether indices of quadriceps muscle EMG activity in response to different modes of RET and activities of daily living (ADL), differed between 15 healthy younger (25 ± 3 years) and 15 older (70 ± 5 years) adults. On four separate days, participants completed a maximal voluntary contraction (MVC) of the knee extensors, followed by a 15 m walking task, stair climbing task (i.e. ADL) and lower-limb RET through body-weight squats (BW-RET) and seated knee extensions on a machine (MN-RET) or via elastic bands (EB-RET). Surface quadriceps electromyography (EMG) was measured throughout all tasks to provide indirect estimates of changes in muscle activity. RESULTS MVC was significantly greater in young vs. older adults (Young: 256 ± 72 vs. Old: 137 ± 48 N·m, P < 0.001). EMG activity during all exercise tasks was significantly higher in older vs. younger adults when expressed relative to maximal EMG achieved during MVC (P < 0.01, for all). In addition, relative quadriceps muscle EMG activity was significantly greater in EB-RET (Young: 20.3 ± 8.7 vs. Old: 37.0 ± 10.7%) and MN-RET (Young: 22.9 ± 10.3, vs. Old: 37.8 ± 10.8%) compared with BW-RET (Young: 8.6 ± 2.9 vs. Old: 27.0 ± 9.3%), in young and older adults (P < 0.001). However, there was no significant difference in quadriceps EMG between EB-RET and MN-RET (P > 0.05). CONCLUSIONS In conclusion, relative quadriceps muscle EMG activity was higher across a range of activities/exercise modes in older vs. younger adults. The similar quadriceps muscle EMG activity between EB-RET and MN-RET provides a platform for detailed investigation of the neuromuscular and muscle metabolic responses to such pragmatic forms of RET to strengthen the evidence-base for this mode of RET as a potential countermeasure to sarcopenia.
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Affiliation(s)
- Ryan N Marshall
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom; MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, United Kingdom
| | - Paul T Morgan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom; MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, United Kingdom
| | - Eduardo Martinez-Valdes
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom; Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, United Kingdom
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom; MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, United Kingdom; NIHR, Birmingham Biomedical Research Centre, Birmingham, United Kingdom.
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Electromyography Evaluation of Bodyweight Exercise Progression in a Validated Anterior Cruciate Ligament Injury Rehabilitation Program: A Cross-Sectional Study. Am J Phys Med Rehabil 2020; 98:998-1004. [PMID: 31626021 PMCID: PMC6824507 DOI: 10.1097/phm.0000000000001232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Supplemental digital content is available in the text. Regaining muscle strength is essential for successful outcome after anterior cruciate ligament injury, why progression of exercise intensity in anterior cruciate ligament injury rehabilitation is important. Thus, this study evaluated hamstring and quadriceps muscle activity progression during bodyweight exercises used in a validated anterior cruciate ligament injury rehabilitation program.
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Hutchinson JC, Zenko Z, Santich S, Dalton PC. Increasing the Pleasure and Enjoyment of Exercise: A Novel Resistance-Training Protocol. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2020; 42:143-152. [PMID: 32150721 DOI: 10.1123/jsep.2019-0089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 11/13/2019] [Accepted: 12/16/2019] [Indexed: 06/10/2023]
Abstract
This study was designed to test the effect of an increasing- (UP) or decreasing-intensity (DOWN) resistance-training (RT) protocol on the pleasure and enjoyment of RT. The participants (N = 40; mean age = 35.0 ± 9.2 years) completed two RT sessions comprising 3 × 10 repetitions of six exercises. In the UP condition, load progressively increased from 55% to 75% of 1-repetition maximum, while in the DOWN condition, this pattern was reversed (i.e., 75-55% 1-repetition maximum). The DOWN condition resulted in more overall pleasure compared with UP and a slope of increasing pleasure, while the UP condition resulted in decreasing pleasure. Enjoyment of RT, postexercise pleasure, and remembered pleasure were all significantly greater for DOWN compared with UP (all ps > .01). These findings suggest that decreasing RT intensity throughout an exercise bout can elicit a positive slope of pleasure and enhance affective evaluations of exercise.
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Calatayud J, Pérez-Alenda S, Carrasco JJ, Escriche-Escuder A, Cruz-Montecinos C, Andersen LL, Bonanad S, Querol F, Casaña J. Electromyographic and Safety Comparisons of Common Lower Limb Rehabilitation Exercises for People With Hemophilia. Phys Ther 2020; 100:116-126. [PMID: 31584672 DOI: 10.1093/ptj/pzz146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 04/19/2019] [Indexed: 11/14/2022]
Abstract
BACKGROUND Ankles and knees are commonly affected in people with hemophilia and thus are targets for prevention or rehabilitation. However, to our knowledge, no studies have evaluated muscle activity and safety during exercises targeting the lower limbs in people with hemophilia; this lack of information hinders clinical decision-making. OBJECTIVE The aim of this study was to compare the tolerability of, safety of, and muscle activity levels obtained with external resistance (elastic or machine)-based and non-external resistance-based lower limb exercises in people with hemophilia. DESIGN This was a cross-sectional study. METHODS Eleven people who had severe hemophilia and were undergoing prophylactic treatment participated. In a single experimental session, participants performed knee extension and ankle plantar flexion during 3 exercise conditions in random order: elastic band-based resistance (elastic resistance), machine-based resistance (machine resistance), and no external resistance. Exercise intensities for the 2 external resistance-based conditions were matched for perceived exertion. Muscle activity was determined using surface electromyography (EMG) for the rectus femoris, biceps femoris, gastrocnemius lateralis, and tibialis anterior muscles. Participants were asked to rate exercise tolerability according to a scale ranging from "very well tolerated" to "not tolerated" and to report possible adverse effects 24 and 48 hours after the session. RESULTS No adverse effects were reported, and exercise tolerability was generally high. In the knee extension exercise, the rectus femoris normalized EMG values during the elastic resistance and machine resistance conditions were similar; 29% to 30% higher activity was obtained during these conditions than during the non-external resistance condition. In the ankle plantar flexion exercise, the gastrocnemius lateralis normalized EMG value was 34% higher during the machine resistance condition than without external resistance, and the normalized EMG values during the elastic resistance and other conditions were similar. LIMITATIONS The small sample size and single training session were the primary limitations of this study. CONCLUSIONS Exercises performed both with elastic bands and with machines at moderate intensity are safe, feasible, and efficient in people with severe hemophilia, providing comparable activity levels in the agonist muscles.
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Affiliation(s)
- Joaquín Calatayud
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia, Valencia, Spain; and National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Sofía Pérez-Alenda
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe, Valencia, Spain; and Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia, c/Gascó Oliag 5, CP 46010, Valencia, Spain
| | - Juan J Carrasco
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia; and Intelligent Data Analysis Laboratory, University of Valencia
| | | | - Carlos Cruz-Montecinos
- Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia; Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; and Laboratory of Biomechanics and Kinesiology, San José Hospital, Santiago, Chile
| | - Lars L Andersen
- National Research Centre for the Working Environment; and Sport Sciences, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Santiago Bonanad
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe
| | - Felipe Querol
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe; and Department of Physiotherapy, Physiotherapy in Motion Multispeciality Research Group (PTinMOTION), University of Valencia
| | - José Casaña
- Department of Physiotherapy, Exercise Intervention for Health Research Group (EXINH-RG), University of Valencia
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Cavarretta DJ, Hall EE, Bixby WR. The Effects of Increasing Training Load on Affect and Perceived Exertion. J Strength Cond Res 2019; 36:16-21. [PMID: 31868816 DOI: 10.1519/jsc.0000000000003393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cavarretta, DJ, Hall, EE, and Bixby, WR. The effects of increasing training load on affect and perceived exertion. J Strength Cond Res XX(X): 000-000, 2019-This study was designed to investigate how affect and ratings of perceived exertion based on repetitions in reserve (RPE/RIR) change as a function of increasing load during a 10 repetition maximum (RM) test. Twenty-nine novice lifters completed a 10RM test for 2 different conditions presented in a randomized, counterbalanced fashion. RPE/RIR and affect were assessed immediately after each successful 10RM attempt. RPE/RIR was significantly different at all loads from 50 to 100% 10RM (p < 0.001) with no differences between exercise and exercise load (p = 0.059). RPE/RIR was higher for all lower body exercises compared with upper-body exercises (p < 0.001) but was not different between machine and free-weight exercises (p > 0.344). Affect became less positive only at 100% 10RM compared with all other loads (p < 0.05). Finally, affect was more positive for upper-body exercises compared to lower-body exercises (p = 0.025) and more positive for machines compared to free-weights (p = 0.015). The results of this study suggest that among novice lifters, RPE/RIR increases as load increases during a 10RM and affective valence remains relatively constant but becomes less positive when exercising at maximal intensities (100% 10RM). Further research is needed to replicate these findings and elucidate the effects of different muscles used (e.g., upper vs. lower body) and modality of exercise (e.g., machine vs. free-weight) on RPE/RIR and affect among both novice and experienced lifters.
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Affiliation(s)
| | - Eric E Hall
- Department of Exercise Science, Elon University, Elon, North Carolina
| | - Walter R Bixby
- Department of Health, Fitness, and Exercise Studies, Anne Arundel Community College, Arnold, Maryland
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Thamm A, Freitag N, Figueiredo P, Doma K, Rottensteiner C, Bloch W, Schumann M. Can Heart Rate Variability Determine Recovery Following Distinct Strength Loadings? A Randomized Cross-Over Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224353. [PMID: 31703468 PMCID: PMC6888606 DOI: 10.3390/ijerph16224353] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/03/2019] [Accepted: 11/06/2019] [Indexed: 11/16/2022]
Abstract
This study aimed to compare the acute effects of hypertrophic (HYP) and maximum strength (MAX) loadings on heart rate variability (HRV) and to compare possible loading-specific alterations with other markers of recovery. Ten young men with strength training experience performed two leg press loadings (HYP: five times 10 repetitions at 70% of one repetition maximum (1RM) with 2 minutes inter-set rest; MAX: 15 times one repetition at 100% of 1RM with 3 minutes inter-set rest) in a randomized order. The root mean square of successive differences statistically decreased after both protocols (HYP: 65.7 ± 26.6 ms to 23.9 ± 18.7 ms, p = 0.026; MAX: 77.7 ± 37.0 ms to 55.3 ± 22.3 ms, p = 0.049), while the frequency domains of HRV remained statistically unaltered. The low frequency (LF) band statistically increased at 48h post-MAX only (p = 0.033). Maximal isometric voluntary contraction (MVC) statistically decreased after HYP (p = 0.026) and returned to baseline after 24h of recovery. Creatine kinase (CK) statistically increased above baseline at 1h post-loadings (HYP p = 0.028; MAX p = 0.020), returning to baseline at 24h post. Our findings indicate no distinct associations between changes in HRV and MVC or CK.
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Affiliation(s)
- Antonia Thamm
- Department of Molecular and Cellular Sports Medicine, German Sport University, 50933 Cologne, Germany; (A.T.); (N.F.); (W.B.)
| | - Nils Freitag
- Department of Molecular and Cellular Sports Medicine, German Sport University, 50933 Cologne, Germany; (A.T.); (N.F.); (W.B.)
| | - Pedro Figueiredo
- Portugal Football School, Portuguese Football Federation, 1495-433 Oeiras, Portugal;
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, 4475-690 Maia, Portugal
| | - Kenji Doma
- College of Healthcare Sciences, James Cook University, Townsville 4811, Australia;
| | | | - Wilhelm Bloch
- Department of Molecular and Cellular Sports Medicine, German Sport University, 50933 Cologne, Germany; (A.T.); (N.F.); (W.B.)
| | - Moritz Schumann
- Department of Molecular and Cellular Sports Medicine, German Sport University, 50933 Cologne, Germany; (A.T.); (N.F.); (W.B.)
- Correspondence: ; Tel.: +49-221-4982-4821
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McKendry J, Shad BJ, Smeuninx B, Oikawa SY, Wallis G, Greig C, Phillips SM, Breen L. Comparable Rates of Integrated Myofibrillar Protein Synthesis Between Endurance-Trained Master Athletes and Untrained Older Individuals. Front Physiol 2019; 10:1084. [PMID: 31543824 PMCID: PMC6728413 DOI: 10.3389/fphys.2019.01084] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/07/2019] [Indexed: 12/21/2022] Open
Abstract
Background An impaired muscle anabolic response to exercise and protein nutrition is thought to underpin age-related muscle loss, which may be exacerbated by aspects of biological aging that may not be present in older individuals who have undertaken long-term high-level exercise training, or master athletes (MA). The aim of this study was to compare rested-state and exercise-induced rates of integrated myofibrillar protein synthesis (iMyoPS) and intracellular signaling in endurance trained MA and healthy age-matched untrained individuals (Older Controls). Methods In a parallel study design, iMyoPS rates were determined over 48 h in the rested-state and following a bout of unaccustomed resistance exercise (RE) in OC (n = 8 males; 73.5 ± 3.3 years) and endurance-trained MA (n = 7 males; 68.9 ± 5.7 years). Intramuscular anabolic signaling was also determined. During the iMyoPS measurement period, physical activity was monitored via accelerometry and dietary intake was controlled. Results Anthropometrics, habitual activity, and dietary intake were similar between groups. There was no difference in rested-state rates of iMyoPS between OC (1.47 ± 0.06%⋅day–1) and MA (1.46 ± 0.08%⋅day–1). RE significantly increased iMyoPS above rest in both OC (1.60 ± 0.08%⋅day–1, P < 0.01) and MA (1.61 ± 0.08%⋅day–1, P < 0.01), with no difference between groups. AktThr308 phosphorylation increased at 1 h post-RE in OC (P < 0.05), but not MA. No other between-group differences in intramuscular signaling were apparent at any time-point. Conclusion While our sample size is limited, these data suggest that rested-state and RE-induced iMyoPS are indistinguishable between MA and OC. Importantly, the OC retain a capacity for RE-induced stimulation of skeletal muscle remodeling.
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Affiliation(s)
- James McKendry
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Brandon J Shad
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Benoit Smeuninx
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Sara Y Oikawa
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Gareth Wallis
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Carolyn Greig
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.,NIHR Birmingham Biomedical Research Centre, Birmingham, United Kingdom.,MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, United Kingdom
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.,NIHR Birmingham Biomedical Research Centre, Birmingham, United Kingdom.,MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, United Kingdom
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Mikami T, Tano K, Lee H, Lee H, Park J, Ohta F, LeBaron TW, Ohta S. Drinking hydrogen water enhances endurance and relieves psychometric fatigue: a randomized, double-blind, placebo-controlled study 1. Can J Physiol Pharmacol 2019; 97:857-862. [PMID: 31251888 DOI: 10.1139/cjpp-2019-0059] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Acute physical exercise increases reactive oxygen species in skeletal muscle, leading to tissue damage and fatigue. Molecular hydrogen (H2) acts as a therapeutic antioxidant directly or indirectly by inducing antioxidative enzymes. Here, we examined the effects of drinking H2 water (H2-infused water) on psychometric fatigue and endurance capacity in a randomized, double-blind, placebo-controlled fashion. In Experiment 1, all participants drank only placebo water in the first cycle ergometer exercise session, and for comparison they drank either H2 water or placebo water 30 min before exercise in the second examination. In these healthy non-trained participants (n = 99), psychometric fatigue judged by visual analogue scales was significantly decreased in the H2 group after mild exercise. When each group was divided into 2 subgroups, the subgroup with higher visual analogue scale values was more sensitive to the effect of H2. In Experiment 2, trained participants (n = 60) were subjected to moderate exercise by cycle ergometer in a similar way as in Experiment 1, but exercise was performed 10 min after drinking H2 water. Endurance and fatigue were significantly improved in the H2 group as judged by maximal oxygen consumption and Borg's scale, respectively. Taken together, drinking H2 water just before exercise exhibited anti-fatigue and endurance effects.
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Affiliation(s)
- Toshio Mikami
- Department of Health and Sports Science, Nippon Medical School, Musashino, Tokyo 180-0023, Japan
| | - Kohei Tano
- Fitness Club, Asahi Big S Mukogaoka, Kawasaki-city, Kanagawa pref. 214-0014, Japan
| | - Hosung Lee
- Department of Health and Sports Science, Nippon Medical School, Musashino, Tokyo 180-0023, Japan
| | - Hyowon Lee
- Department of Health and Sports Science, Nippon Medical School, Musashino, Tokyo 180-0023, Japan
| | - Jonghyuk Park
- Department of Health and Sports Science, Nippon Medical School, Musashino, Tokyo 180-0023, Japan
| | - Fumiaki Ohta
- Hydrogen Health Medical Laboratory, Co., Ltd., Arakawa-ku, Tokyo 116-0001, Japan
| | - Tyler W LeBaron
- Slovak Academy of Sciences, Centre of Experimental Medicine, Institute for Heart Research, Bratislava 84005, Slovak Republic.,Molecular Hydrogen Institute, Enoch, UT 84721, USA
| | - Shigeo Ohta
- Department of Neurology Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo 113-8421, Japan
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Smeuninx B, Nishimura Y, McKendry J, Limb M, Smith K, Atherton PJ, Breen L. The effect of acute oral phosphatidic acid ingestion on myofibrillar protein synthesis and intracellular signaling in older males. Clin Nutr 2019; 38:1423-1432. [PMID: 29970319 DOI: 10.1016/j.clnu.2018.06.963] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/30/2018] [Accepted: 06/10/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Age-related muscle loss (sarcopenia) may be driven by a diminished myofibrillar protein synthesis (MyoPS) response to anabolic stimuli (i.e. exercise and nutrition). Oral phosphatidic acid (PA) ingestion has been reported to stimulate resting muscle protein synthesis in rodents, and enhance resistance training-induced muscle remodelling in young humans. PURPOSE This study examined the effects of acute oral PA ingestion on resting and exercise-induced MyoPS rates in older individuals. METHODS Sixteen older males performed a bout of unilateral leg resistance exercise followed by oral ingestion of 750 mg of soy-derived PA or a rice-flour placebo (PL) over 60 min post-exercise. A primed-continuous infusion of l-[ring-13C6]-phenylalanine with serial muscle biopsies was used to determine MyoPS at rest and between 0-150 and 150-300 min post-exercise. RESULTS Plasma [PA] concentrations were elevated above basal values from 180 to 300 min post-exercise in PA only (P = 0.02). Exercise increased MyoPS rates above basal values between 150 and 300 min post-exercise in PL (P = 0.001), but not PA (P = 0.83). Phosphorylation of p70S6K, rpS6, 4E-BP1 and Akt was elevated above basal levels in the exercised leg over 150-300 min post-exercise for PL only (P = 0.018, 0.007, 0.011 and 0.002, respectively), and were significantly greater than PA (P < 0.01 for all proteins). The effects of oral PA ingestion on proteolytic signaling markers were equivocal. CONCLUSIONS Acute oral phosphatidic acid ingestion appears to interfere with resistance exercise-induced intramuscular anabolic signaling and MyoPS in older males and, therefore, may not be a viable treatment to counteract sarcopenia. Clinicaltials.gov registration no: NCT03446924.
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Affiliation(s)
- Benoit Smeuninx
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, West Midlands B15 2TT, UK; MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston, West Midlands B15 2TT, UK
| | - Yusuke Nishimura
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, West Midlands B15 2TT, UK
| | - James McKendry
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, West Midlands B15 2TT, UK
| | - Marie Limb
- Clinical, Metabolic and Molecular Physiology Group, University of Nottingham, Royal Derby Hospital, Nottingham DE22 3DT, UK
| | - Ken Smith
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston, West Midlands B15 2TT, UK; Clinical, Metabolic and Molecular Physiology Group, University of Nottingham, Royal Derby Hospital, Nottingham DE22 3DT, UK
| | - Philip J Atherton
- MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston, West Midlands B15 2TT, UK; Clinical, Metabolic and Molecular Physiology Group, University of Nottingham, Royal Derby Hospital, Nottingham DE22 3DT, UK
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, West Midlands B15 2TT, UK; MRC-ARUK Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston, West Midlands B15 2TT, UK.
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Calatayud J, Pérez-Alenda S, Carrasco JJ, Escriche A, Cruz-Montecinos C, Andersen LL, Bonanad S, Querol F, Casaña J. Upper-Body Exercises With External Resistance Are Well Tolerated and Enhance Muscle Activity in People With Hemophilia. Phys Ther 2019; 99:411-419. [PMID: 30690577 DOI: 10.1093/ptj/pzy136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 09/18/2018] [Indexed: 02/09/2023]
Abstract
BACKGROUND Conventional nonresisted therapeutic exercises for people with hemophilia involve a careful, low-intensity approach to avoid injuries. Externally resisted exercise is highly efficient for increasing muscle strength in healthy adults but its feasibility for people with hemophilia remains unknown. OBJECTIVE The purpose of this study was to evaluate muscle activity during upper-body rehabilitation exercises with 2 types of external resistance and without external resistance (conventional) and to examine tolerability, kinesiophobia, and possible adverse effects derived from the session. DESIGN This was a cross-sectional study. METHODS Twelve people with hemophilia A/B (11 with severe hemophilia undergoing prophylactic treatment, 1 with mild hemophilia) participated. During the experimental session, participants completed the Tampa Scale of Kinesiophobia and performed 2 exercises-elbow flexion and shoulder abduction-with 3 conditions for each exercise: elastic resistance (externally resisted), free weights (externally resisted), and conventional nonresisted. Surface electromyography signals were recorded for the biceps brachii, triceps brachii, upper trapezius, and middle deltoid muscles. After the session, exercise tolerability and kinesiophobia were assessed. Adverse effects were evaluated 24 and 48 hours after the session. RESULTS Externally resisted exercises provided greater muscle activity than conventional nonresisted therapeutic exercises. The exercises were generally well tolerated and there was no change in kinesiophobia following the session. No adverse effects were observed in the following days. LIMITATIONS Small sample size was the main limitation. CONCLUSIONS In people with severe hemophilia undergoing prophylactic treatment, elbow flexion and shoulder abduction exercises with external resistance at moderate intensities are feasible and provide greater muscle activity than nonresisted conventional exercises.
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Affiliation(s)
- Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain; and National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Sofía Pérez-Alenda
- Department of Physiotherapy, University of Valencia, C/Gascó Oliag, 5 Valencia 46010, Valencia, Spain; and Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Juan J Carrasco
- Department of Physiotherapy and Intelligent Data Analysis Laboratory, University of Valencia
| | - Adrián Escriche
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia
| | - Carlos Cruz-Montecinos
- Department of Physiotherapy, University of Valencia; and Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Lars L Andersen
- National Research Centre for the Working Environment; and Sport Sciences, Department of Health Science and Technology, Aalborg University, Denmark
| | - Santiago Bonanad
- Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe
| | - Felipe Querol
- Department of Physiotherapy, University of Valencia; and Haemostasis and Thrombosis Unit, University and Polytechnic Hospital La Fe
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia
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Combined exercise training improves blood pressure and antioxidant capacity in elderly individuals with hypertension. J Exerc Sci Fit 2019; 17:67-76. [PMID: 30949214 PMCID: PMC6430041 DOI: 10.1016/j.jesf.2019.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 03/02/2019] [Accepted: 03/11/2019] [Indexed: 12/21/2022] Open
Abstract
Background/objective Although regular exercise plays a role in achieving healthy aging, a specific mode of exercise may be required for elderly individuals with hypertension (HT). Therefore, this study aimed to assess the effects of combined endurance and strength training (CBT) on blood pressure (BP) and antioxidant capacity in elderly individuals with HT. Methods In a single-blinded, randomized controlled trial, 54 older men and women aged 67 ± 5.8 years completed endurance training (ET, n = 13), strength training (ST, n = 13), combined endurance and strength training (CBT, n = 16) or served as controls (CON, n = 12). The intervention was a supervised exercise training (1-h sessions, three per week for 12 weeks), followed by a self-supervised exercise training for 12 weeks. Measurements of BP, glutathione peroxidase (GPx), total nitrite/nitrate (NOx-), malondialdehyde (MDA), and high-sensitive C-reactive protein (hs-CRP) were obtained before and after the supervised and the self-supervised periods. Results After the supervised period, systolic BP (SBP) decreased by 7.9% in the ET (p < 0.05) and 8.2% in the CBT (p < 0.01); GPx activity increased by 41.3% in the ET (p < 0.01), 19.1% in the ST (p < 0.05), and 49.2% in the CBT (p < 0.01); NOx-concentrations increased by 66.2% in the ET and 71.9% in the CBT (both p < 0.01), MDA concentrations decreased by 65.1% in the ST (p < 0.05) and 61% in the CBT (p < 0.01); hs-CRP concentrations decreased by 49.2% in only the CBT (p < 0.05). After the self-supervised period, SBP decreases by 7.5% in only the CBT (p < 0.01); NOx-concentrations increased by 68.5% in the ET and 92.4% in the CBT (both p < 0.01). However, there was no significant difference in SBP, GPx activity, NOx-, MDA and hs-CRP concentrations between the training groups. Conclusion The hypotensive and antioxidant effects of the CBT seem to be similar to the ET after the supervised training period. However, after the self-supervised training period, the CBT program might affect better due to greater exercise adherence and attendance in elderly individuals with HT.
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Iona T, Scarfone R, Palumbo A, Iocco M, Ammendolia A. Is cardio-fitness multi-planar exercise really useful to train? GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03822-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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