1
|
Lopes Soares L, Portes AMO, Costa SFF, Leite LB, Natali AJ. Autonomic Dysregulation in Pulmonary Hypertension: Role of Physical Exercise. Hypertension 2024; 81:2228-2236. [PMID: 39234679 DOI: 10.1161/hypertensionaha.124.23573] [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: 09/06/2024]
Abstract
Pulmonary hypertension (PH) is a rare and severe condition characterized by increased pressure in the pulmonary circulation, often resulting in right ventricular failure and death. The autonomic nervous system (ANS) plays a crucial role in the cardiovascular and pulmonary controls. Dysfunction of ANS has been implicated in the pathogenesis of cardiopulmonary diseases. Conversely, dysfunctions in ANS can arise from these diseases, impacting cardiac and pulmonary autonomic functions and contributing to disease progression. The complex interaction between ANS dysfunction and PH plays a crucial role in the disease progression, making it essential to explore interventions that modulate ANS, such as physical exercise, to improve the treatment and prognosis of patients with PH. This review addresses autonomic dysfunctions found in PH and their implications for the cardiopulmonary system. Furthermore, we discuss how physical exercise, a significant modulator of ANS, may contribute to the prognosis of PH. Drawing from evidence of aerobic and resistance exercise training in patients and experimental models of PH, potential cardiovascular benefits of exercise are presented. Finally, we highlight emerging therapeutic targets and perspectives to better cope with the complex condition. A comprehensive understanding of the interaction between ANS and PH, coupled with targeted physical exercise interventions, may pave the way for innovative therapeutic strategies and significantly improve the treatment and prognosis of vulnerable patients.
Collapse
Affiliation(s)
- Leôncio Lopes Soares
- Department of Physical Education, Federal University of Viçosa, Minas Gerais, Brazil (L.L.S., S.F.F.C., L.B.L., A.J.N.)
| | | | | | - Luciano Bernardes Leite
- Department of Physical Education, Federal University of Viçosa, Minas Gerais, Brazil (L.L.S., S.F.F.C., L.B.L., A.J.N.)
| | - Antônio José Natali
- Department of Physical Education, Federal University of Viçosa, Minas Gerais, Brazil (L.L.S., S.F.F.C., L.B.L., A.J.N.)
| |
Collapse
|
2
|
Usui N, Nakata J, Uehata A, Kojima S, Hisadome H, Ando S, Saitoh M, Inatsu A, Tsuchiya T, Mawatari T, Suzuki Y. Association of Postexercise Vagal Dysfunction With Protein-Energy Wasting and Noncardiovascular Outcomes in Patients Receiving Hemodialysis: A Retrospective Cohort Study. J Ren Nutr 2024; 34:321-329. [PMID: 38000522 DOI: 10.1053/j.jrn.2023.11.005] [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: 06/07/2023] [Revised: 10/19/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE Postexercise vagal dysfunction is linked to noncardiovascular mortality in hemodialysis patients, but the mechanism is unknown. This study aimed to determine the association of cardiovagal neuropathy with systemic inflammation, protein-energy wasting, and noncardiovascular hospitalization. METHODS This 2-center retrospective cohort study analyzed data from 280 hemodialysis patients who underwent exercise test. Patients were assessed for heart rate (HR) recovery (bpm) for 1 minute after exercise, a marker of vagal function, and were divided into 3 categories (Low: ≤ 6, Mid: 7-11, High: ≥ 12 bpm). We followed 1-year changes in the systemic inflammation-based prognostic score (Glasgow Prognostic Score [GPS]), body weight, and creatinine generation rate (CGR), an indicator of muscle mass, as well as 2-year hospitalization. RESULTS The HR recovery category was associated with serum C-reactive protein and albumin levels and GPS. After 1 year, the low HR recovery category was associated with worsening in GPS (low, 0 [0-0.5]; mid, 0 [0-1]; high, 0 [0-0]), weight (low, 100.0 [96.1-102.5]; mid, 101.3 [98.9-105.0]; high, 100.5 [98.2-102.9]%), and CGR (low, 97.0 [88.5-111.4]; mid, 110.2 [90.9-124.8]; high, 106.2 [95.5-115.5]%), and the correlations with GPS and CGR remained consistent after adjusting for confounders such as exercise capacity and hospitalization during the follow-up period. There were 117 patients hospitalized. Compared to the high HR recovery category, the mid (hazard ratio: 1.8, 95% confidence interval [CI]: 1.1-3.1, P = .02) and low (hazard ratio: 2.4, 95% CI: 1.5-4.0, P = .001) categories were independently associated with an increased risk of all-cause hospitalization. For noncardiovascular disease hospitalization, the low HR recovery category was independently associated with increased risk of hospitalization (hazard ratio: 2.1, 95% CI: 1.2-3.7, P = .007). CONCLUSIONS Vagal neuropathy in this population can contribute to adverse outcomes associated with systemic inflammation and protein-energy wasting.
Collapse
Affiliation(s)
- Naoto Usui
- Department of Rehabilitation, Kisen Hospital, Tokyo, Japan; Department of Nephrology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
| | - Junichiro Nakata
- Department of Nephrology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
| | - Akimi Uehata
- Division of Cardiology, Kisen Hospital, Tokyo, Japan
| | - Sho Kojima
- Department of Rehabilitation, Kisen Hospital, Tokyo, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | | | - Shuji Ando
- Department of Information Sciences, Tokyo University of Science, Chiba, Japan
| | - Masakazu Saitoh
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan
| | | | | | | | - Yusuke Suzuki
- Department of Nephrology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| |
Collapse
|
3
|
Amekran Y, El Hangouche AJ. Effects of Exercise Training on Heart Rate Variability in Healthy Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Cureus 2024; 16:e62465. [PMID: 39015867 PMCID: PMC11250637 DOI: 10.7759/cureus.62465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2024] [Indexed: 07/18/2024] Open
Abstract
This meta-analysis was conducted to investigate the effects of exercise training on heart rate variability (HRV) parameters associated with the autonomic nervous system (ANS) activity. Randomized controlled trials (RCTs) involving healthy adults (aged ≥ 18 years) were included. We searched PubMed, Scopus, Web of Science, and EBSCO databases to identify relevant studies. A random-effects meta-analysis was performed using the standardized mean difference (SMD) and 95% confidence interval (CI). Sixteen RCTs with a total of 623 participants were selected for the final analysis. The analysis showed that exercise training improved the standard deviation of normal-to-normal intervals (SDNN) (SMD: 0.58 (0.16, 1.00); p = 0.007), the root mean square of successive differences in heart period series (RMSSD) (SMD: 0.84 (0.36, 1.31); p = 0.0005), and the absolute power of high-frequency band (HF) (SMD: 0.89 (0.27, 1.51); p = 0.005) parameters compared to the control group. Analysis of the moderator variables showed that the effect of exercise on HRV indices may be influenced by sex, age, and type of exercise used, specifically in HF band, absolute power of low-frequency band (LF), and LF/HF ratio parameters. Despite the limited number of existing RCTs related to the subject, the results suggest that exercise training enhances HRV parameters associated with vagal-related activity (RMSSD and HF) and both sympathetic and parasympathetic activities (SDNN). This study overcomes the lack of meta-analyses on the effects of exercise training on autonomic modulation among healthy adults and may bridge the gap in understanding the potential physiological underpinnings of the acknowledged positive health benefits of exercise.
Collapse
Affiliation(s)
- Youssra Amekran
- Department of Physiology, Faculty of Medicine and Pharmacy, Abdelmalek Essaadi University, Tangier, MAR
| | | |
Collapse
|
4
|
Hammoud RA, Liu Q, Dixon SB, Onerup A, Mulrooney DA, Huang IC, Jefferies JL, Rhea IB, Ness KK, Ehrhardt MJ, Hudson MM, Ky B, Bhakta N, Sapkota Y, Yasui Y, Armstrong GT. The burden of cardiovascular disease and risk for subsequent major adverse cardiovascular events in survivors of childhood cancer: a prospective, longitudinal analysis from the St Jude Lifetime Cohort Study. Lancet Oncol 2024; 25:811-822. [PMID: 38821086 PMCID: PMC11447951 DOI: 10.1016/s1470-2045(24)00157-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND The effect of the increasing lifetime burden of non-major cardiovascular conditions on risk for a subsequent major adverse cardiovascular event among survivors of childhood cancer has not been assessed. We aimed to characterise the prevalence of major adverse cardiovascular events and their association with the cumulative burden of non-major adverse cardiovascular events in childhood cancer survivors. METHODS This is a longitudinal cohort study with participant data obtained from an ongoing cohort study at St Jude Children's Research Hospital: the St Jude Lifetime Cohort Study (SJLIFE). Prospective clinical follow-up was of 5-year survivors of childhood cancer who were diagnosed when aged younger than 25 years from 1962 to 2012. Age-frequency, sex-frequency, and race-frequency matched community-control participants completed a similar one-time clinical assessment. 22 cardiovascular events were graded using a St Jude Children's Research Hospital-modified version of the National Cancer Institute Common Terminology Criteria for Adverse Events (version 4.03). Cumulative incidence and burden of the primary outcome of major adverse cardiovascular events (cardiomyopathy, myocardial infarction, stroke, and other cardiovascular-related mortality) were estimated. Rate ratios (RR) of the association of major adverse cardiovascular events with 22 non-major adverse cardiovascular events were estimated using multivariable piecewise-exponential regression adjusting for attained age, age at diagnosis, sex, race and ethnicity, treatment era, diagnosis of diabetes, and exposure to cardiotoxic cancer therapies. The St Jude Lifetime Cohort study is registered with ClinicalTrials.gov, NCT00760656, and is ongoing. FINDINGS 9602 5-year survivors of childhood cancer, and 737 community controls were included in the longitudinal follow-up (from Sept 13, 2007, to Dec 17, 2021). The median follow-up was 20·3 years (IQR 12·0-31·4) from the date of primary cancer diagnosis (4311 [44.9%] were females). By the age of 50 years (analysis stopped at age 50 years due to the low number of participants older than that age), the cumulative incidence of major adverse cardiovascular events among survivors was 17·7% (95% CI 15·9-19·5) compared with 0·9% (0·0-2·1) in the community controls. The cumulative burden of major adverse cardiovascular events in survivors was 0·26 (95% CI 0·23-0·29) events per survivor compared with 0·009 (0·000-0·021) events per community control participant. Increasing cumulative burden of grade 1-4 non-major adverse cardiovascular events was associated with an increased future risk of major adverse cardiovascular events (one condition: RR 4·3, 95% CI 3·1-6·0; p<0·0001; two conditions: 6·6, 4·6-9·5; p<0·0001; and three conditions: 7·7, 5·1-11·4; p<0·0001). Increased risk for major adverse cardiovascular events was observed with specific subclinical conditions (eg, grade 1 arrhythmias [RR 1·5, 95% CI 1·2-2·0; p=0·0017]), grade 2 left ventricular systolic dysfunction (2·2, 1·6-3·1; p<0·0001), grade 2 valvular disorders (2·2, 1·2-4·0; p=0·013), but not grade 1 hypercholesterolaemia, grade 1-2 hypertriglyceridaemia, or grade 1-2 vascular stenosis. INTERPRETATION Among an ageing cohort of survivors of childhood cancer, the accumulation of non-major adverse cardiovascular events, including subclinical conditions, increased the risk of major adverse cardiovascular events and should be the focus of interventions for early detection and prevention of major adverse cardiovascular events. FUNDING The US National Cancer Institute and the American Lebanese Syrian Associated Charities.
Collapse
Affiliation(s)
- Rawan A Hammoud
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA.
| | - Qi Liu
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Stephanie B Dixon
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA; Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Aron Onerup
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA; Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Daniel A Mulrooney
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA; Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - I-Chan Huang
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - John L Jefferies
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Isaac B Rhea
- Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Matthew J Ehrhardt
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA; Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA; Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Bonnie Ky
- Department of Cardiovascular Medicine and Abramson Cancer Center, Thalheimer Center for Cardio-Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Nickhill Bhakta
- Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Yadav Sapkota
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA; School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
| |
Collapse
|
5
|
Miao J, Yang H, Shi R, Wang C. The effect of cardiac rehabilitation on cardiopulmonary function after coronary artery bypass grafting: A systematic review and meta-analysis. iScience 2023; 26:107861. [PMID: 38058302 PMCID: PMC10696125 DOI: 10.1016/j.isci.2023.107861] [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: 06/07/2023] [Revised: 07/15/2023] [Accepted: 09/06/2023] [Indexed: 12/08/2023] Open
Abstract
We carried out a meta-analysis on the effect of cardiac rehabilitation (CR) on cardiopulmonary function after coronary artery bypass grafting (CABG). Four databases were searched for studies comparing CR with control. A random-effects model was used to pool mean difference (MD). The meta-analysis showed an increase in peak oxygen consumption (peak VO2) (MD = 1.93 mL/kg/min, p = 0.0006), and 6-min walk distance (6MWD) (MD = 59.21 m, p < 0.00001), and a decrease in resting heart rate (resting HR) (MD = 5.68 bpm, p < 0.0001) in the CR group. The subgroup analysis revealed aerobic exercise could further improve resting HR and peak HR, and physical/combination with aerobic exercise could further increase 6MWD. The improvement of peak VO2, workload, resting HR, peak HR, and 6MWD regarding CR performed within one week after CABG is greater than that one week after CABG. CR after CABG can improve the cardiopulmonary function, which is reflected by the improvement of peak VO2, 6MWD, and resting HR.
Collapse
Affiliation(s)
- Jiapeng Miao
- Department of Cardiovascular Medicine, Zhuzhou Central Hospital, Xiangya hospital Zhuzhou, Central South University, 116 Changjiang South Road, Zhuzhou 412000, China
| | - Huayun Yang
- Department of Cardiovascular Medicine, Guilin People’s Hospital, 12 Wenming Road, Guilin 541002, China
| | - Ruizheng Shi
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, China
| | - Chengming Wang
- Department of Cardiovascular Medicine, Zhuzhou Central Hospital, Xiangya hospital Zhuzhou, Central South University, 116 Changjiang South Road, Zhuzhou 412000, China
| |
Collapse
|
6
|
Lang M, Mendt S, Paéz V, Gunga HC, Bilo G, Merati G, Parati G, Maggioni MA. Cardiac Autonomic Modulation and Response to Sub-Maximal Exercise in Chilean Hypertensive Miners. Front Physiol 2022; 13:846891. [PMID: 35492599 PMCID: PMC9043845 DOI: 10.3389/fphys.2022.846891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/11/2022] [Indexed: 11/15/2022] Open
Abstract
Cardiac autonomic modulation in workers exposed to chronic intermittent hypoxia (CIH) has been poorly studied, especially considering hypertensive ones. Heart rate variability (HRV) has been proven as valuable tool to assess cardiac autonomic modulation under different conditions. The aim of this study is to investigate the cardiac autonomic response related to submaximal exercise (i.e., six-minute walk test, 6MWT) in hypertensive (HT, n = 9) and non-hypertensive (NT, n = 10) workers exposed for > 2 years to CIH. Participants worked on 7-on 7-off days shift between high altitude (HA: > 4.200 m asl) and sea level (SL: < 500 m asl). Data were recorded with electrocardiography (ECG) at morning upon awakening (10 min supine, baseline), then at rest before and after (5 min sitting, pre and post) the 6MWT, performed respectively on the first day of their work shift at HA, and after the second day of SL sojourn. Heart rate was higher at HA in both groups for each measurement (p < 0.01). Parasympathetic indices of HRV were lower in both groups at HA, either in time domain (RMSSD, p < 0.01) and in frequency domain (log HF, p < 0.01), independently from measurement's time. HRV indices in non-linear domain supported the decrease of vagal tone at HA and showed a reduced signal's complexity. ECG derived respiration frequency (EDR) was higher at HA in both groups (p < 0.01) with interaction group x altitude (p = 0.012), i.e., higher EDR in HT with respect to NT. No significant difference was found in 6MWT distance regarding altitude for both groups, whereas HT covered a shorter 6MWT distance compared to NT (p < 0.05), both at HA and SL. Besides, conventional arm-cuff blood pressure and oxygen blood saturation values (recorded before, at the end and after 5-min recovery from 6MWT), reported differences related to HA only. HA is the main factor affecting cardiac autonomic modulation, independently from hypertension. However, presence of hypertension was associated with a reduced physical performance independently from altitude, and with higher respiratory frequency at HA.
Collapse
Affiliation(s)
- Morin Lang
- Department of Rehabilitation Sciences and Human Movement, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
- Network for Extreme Environment Research (NEXER), University of Antofagasta, Antofagasta, Chile
| | - Stefan Mendt
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Valeria Paéz
- Department of Rehabilitation Sciences and Human Movement, Faculty of Health Sciences, University of Antofagasta, Antofagasta, Chile
| | - Hanns-Christian, Gunga
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
| | - Grzegorz Bilo
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Department of Cardiology, Istituto Auxologico Italiano, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Giampiero Merati
- Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy
- IRCCS Don C. Gnocchi Foundation, Milan, Italy
| | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Department of Cardiology, Istituto Auxologico Italiano, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - Martina Anna Maggioni
- Charité—Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin, Berlin, Germany
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| |
Collapse
|
7
|
Saeidi M, Ravanbod R. Effects of resistance added on aerobic training on autonomic function in cardiac patients. Anatol J Cardiol 2022; 26:80-89. [PMID: 35190355 PMCID: PMC8878916 DOI: 10.5152/anatoljcardiol.2021.215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 08/16/2023] Open
Abstract
OBJECTIVE Autonomic imbalance in patients with chronic heart failure (CHF) and cardiovascular diseases (CVD) is characterized by reduced parasympathetic and enhanced sympathetic activity. Aerobic exercise improves autonomic function in patients with CHF and CVD. However, little is known about the effects of resistance training (RT) on cardiac autonomic function. Therefore, we aimed to investigate the effects of RT added on aerobic training on autonomic function in patients with CHF and CVD. DATA SOURCES The relevant clinical trials were searched in PubMed, Physiotherapy evidence Database (PEDro, Science Direct and Google Scholar databases using the following keywords, "resistance or strength training", "chronic heart failure", "coronary artery disease", "myocardial infarction", "hypertension", "cardiovascular disease", "heart rate variability (HRV)", "heart rate recovery (HRR)", "muscle sympathetic nerve activity (MSNA)", and "autonomic function". DATA SYNTHESIS Twelve articles with 323 subjects were eligible to be evaluated. The outcome measures included HRV, HRR, and MSNA. There were seven studies on CHF, two on CAD, and three studies on hypertension. Meta-analysis of all the studies showed that combined RT and aerobic training decreased MSNA significantly in patients with CHF and CAD (mean difference: -3.796; CI: -6.779 to 0.813; p=0.013; I2 =93.5%). No study evaluated the effects of RT or combined training on HRR. CONCLUSION We could not find sufficient data about the effects of RT alone on HRV and HRR, but the results showed that combined RT and aerobic training improved MSNA in patients with CHF and CAD, significantly. Further studies with similar methodological principles on the same patient population are needed.
Collapse
Affiliation(s)
- Marzieh Saeidi
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University; Tehran-Iran
| | - Roya Ravanbod
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University; Tehran-Iran
| |
Collapse
|
8
|
Andrade DC, Díaz-Jara E, Toledo C, Schwarz KG, Pereyra KV, Díaz HS, Marcus NJ, Ortiz FC, Ríos-Gallardo AP, Ortolani D, Del Rio R. Exercise intolerance in volume overload heart failure is associated with low carotid body mediated chemoreflex drive. Sci Rep 2021; 11:14458. [PMID: 34262072 PMCID: PMC8280104 DOI: 10.1038/s41598-021-93791-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/28/2021] [Indexed: 11/10/2022] Open
Abstract
Mounting an appropriate ventilatory response to exercise is crucial to meeting metabolic demands, and abnormal ventilatory responses may contribute to exercise-intolerance (EX-inT) in heart failure (HF) patients. We sought to determine if abnormal ventilatory chemoreflex control contributes to EX-inT in volume-overload HF rats. Cardiac function, hypercapnic (HCVR) and hypoxic (HVR) ventilatory responses, and exercise tolerance were assessed at the end of a 6 week exercise training program. At the conclusion of the training program, exercise tolerant HF rats (HF + EX-T) exhibited improvements in cardiac systolic function and reductions in HCVR, sympathetic tone, and arrhythmias. In contrast, HF rats that were exercise intolerant (HF + EX-inT) exhibited worse diastolic dysfunction, and showed no improvements in cardiac systolic function, HCVR, sympathetic tone, or arrhythmias at the conclusion of the training program. In addition, HF + EX-inT rats had impaired HVR which was associated with increased arrhythmia susceptibility and mortality during hypoxic challenges (~ 60% survival). Finally, we observed that exercise tolerance in HF rats was related to carotid body (CB) function as CB ablation resulted in impaired exercise capacity in HF + EX-T rats. Our results indicate that: (i) exercise may have detrimental effects on cardiac function in HF-EX-inT, and (ii) loss of CB chemoreflex sensitivity contributes to EX-inT in HF.
Collapse
Affiliation(s)
- David C Andrade
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Fisiología y Medicina de Altura, Facultad de Ciencias de la Salud, Universidad de Antofagasta, Antofagasta, Chile
| | - Esteban Díaz-Jara
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camilo Toledo
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes, Punta Arenas, Chile
| | - Karla G Schwarz
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Katherin V Pereyra
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Hugo S Díaz
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Noah J Marcus
- Dept. of Physiology and Pharmacology, Des Moines University, Des Moines, IA, USA
| | - Fernando C Ortiz
- Mechanism of Myelin Formation and Repair Laboratory, Instituto de Ciencias Biomédicas, Facultad de Ciencias de Salud, Universidad Autónoma de Chile, Santiago, Chile
| | - Angélica P Ríos-Gallardo
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes, Punta Arenas, Chile
| | - Domiziana Ortolani
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Del Rio
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Centro de Envejecimiento y Regeneración (CARE), Pontificia Universidad Católica de Chile, Santiago, Chile.
- Centro de Excelencia en Biomedicina de Magallanes (CEBIMA), Universidad de Magallanes, Punta Arenas, Chile.
| |
Collapse
|
9
|
Schwaab B, Bjarnason-Wehrens B, Meng K, Albus C, Salzwedel A, Schmid JP, Benzer W, Metz M, Jensen K, Rauch B, Bönner G, Brzoska P, Buhr-Schinner H, Charrier A, Cordes C, Dörr G, Eichler S, Exner AK, Fromm B, Gielen S, Glatz J, Gohlke H, Grilli M, Gysan D, Härtel U, Hahmann H, Herrmann-Lingen C, Karger G, Karoff M, Kiwus U, Knoglinger E, Krusch CW, Langheim E, Mann J, Max R, Metzendorf MI, Nebel R, Niebauer J, Predel HG, Preßler A, Razum O, Reiss N, Saure D, von Schacky C, Schütt M, Schultz K, Skoda EM, Steube D, Streibelt M, Stüttgen M, Stüttgen M, Teufel M, Tschanz H, Völler H, Vogel H, Westphal R. Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 2. J Clin Med 2021; 10:jcm10143071. [PMID: 34300237 PMCID: PMC8306118 DOI: 10.3390/jcm10143071] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 02/08/2023] Open
Abstract
Background: Scientific guidelines have been developed to update and harmonize exercise based cardiac rehabilitation (ebCR) in German speaking countries. Key recommendations for ebCR indications have recently been published in part 1 of this journal. The present part 2 updates the evidence with respect to contents and delivery of ebCR in clinical practice, focusing on exercise training (ET), psychological interventions (PI), patient education (PE). In addition, special patients’ groups and new developments, such as telemedical (Tele) or home-based ebCR, are discussed as well. Methods: Generation of evidence and search of literature have been described in part 1. Results: Well documented evidence confirms the prognostic significance of ET in patients with coronary artery disease. Positive clinical effects of ET are described in patients with congestive heart failure, heart valve surgery or intervention, adults with congenital heart disease, and peripheral arterial disease. Specific recommendations for risk stratification and adequate exercise prescription for continuous-, interval-, and strength training are given in detail. PI when added to ebCR did not show significant positive effects in general. There was a positive trend towards reduction in depressive symptoms for “distress management” and “lifestyle changes”. PE is able to increase patients’ knowledge and motivation, as well as behavior changes, regarding physical activity, dietary habits, and smoking cessation. The evidence for distinct ebCR programs in special patients’ groups is less clear. Studies on Tele-CR predominantly included low-risk patients. Hence, it is questionable, whether clinical results derived from studies in conventional ebCR may be transferred to Tele-CR. Conclusions: ET is the cornerstone of ebCR. Additional PI should be included, adjusted to the needs of the individual patient. PE is able to promote patients self-management, empowerment, and motivation. Diversity-sensitive structures should be established to interact with the needs of special patient groups and gender issues. Tele-CR should be further investigated as a valuable tool to implement ebCR more widely and effectively.
Collapse
Affiliation(s)
- Bernhard Schwaab
- Curschmann Klinik, D-23669 Timmendorfer Strand, Germany
- Medizinische Fakultät, Universität zu Lübeck, D-23562 Lübeck, Germany
- Correspondence:
| | - Birna Bjarnason-Wehrens
- Institute for Cardiology and Sports Medicine, Department of Preventive and Rehabilitative Sport- and Exercise Medicine, German Sportuniversity Cologne, D-50933 Köln, Germany; (B.B.-W.); (H.-G.P.)
| | - Karin Meng
- Institute for Clinical Epidemiology and Biometry (ICE-B), University of Würzburg, D-97080 Würzburg, Germany;
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital, D-50937 Köln, Germany;
| | - Annett Salzwedel
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, D-14469 Potsdam, Germany; (A.S.); (S.E.); or (H.V.)
| | | | | | - Matthes Metz
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, D-69120 Heidelberg, Germany; (M.M.); (K.J.); (D.S.)
| | - Katrin Jensen
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, D-69120 Heidelberg, Germany; (M.M.); (K.J.); (D.S.)
| | - Bernhard Rauch
- Institut für Herzinfarktforschung Ludwigshafen, IHF, D-67063 Ludwigshafen am Rhein, Germany;
- Zentrum für ambulante Rehabilitation, ZAR Trier GmbH, D-54292 Trier, Germany
| | - Gerd Bönner
- Medizinische Fakultät, Albert-Ludwigs-Universität zu Freiburg, D-79104 Freiburg, Germany;
| | - Patrick Brzoska
- Fakultät für Gesundheit, Universität Witten/Herdecke, Lehrstuhl für Versorgungsforschung, D-58448 Witten, Germany;
| | | | | | - Carsten Cordes
- Gollwitzer-Meier-Klinik, D-32545 Bad Oeynhausen, Germany;
| | - Gesine Dörr
- Alexianer St. Josefs-Krankenhaus Potsdam, D-14472 Potsdam, Germany;
| | - Sarah Eichler
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, D-14469 Potsdam, Germany; (A.S.); (S.E.); or (H.V.)
| | - Anne-Kathrin Exner
- Klinikum Lippe GmbH, Standort Detmold, D-32756 Detmold, Germany; (A.-K.E.); (S.G.)
| | - Bernd Fromm
- REHA-Klinik Sigmund Weil, D-76669 Bad Schönborn, Germany;
| | - Stephan Gielen
- Klinikum Lippe GmbH, Standort Detmold, D-32756 Detmold, Germany; (A.-K.E.); (S.G.)
| | - Johannes Glatz
- Reha-Zentrum Seehof der Deutschen Rentenversicherung Bund, D-14513 Teltow, Germany; (J.G.); (E.L.)
| | - Helmut Gohlke
- Private Practice, D-79282 Ballrechten-Dottingen, Germany;
| | - Maurizio Grilli
- Library Department, University Medical Centre Mannheim, D-68167 Mannheim, Germany;
| | - Detlef Gysan
- Department für Humanmedizin, Private Universität Witten/Herdecke GmbH, D-58455 Witten, Germany;
| | - Ursula Härtel
- LMU München, Institut für Medizinische Psychologie, D-80336 München, Germany;
| | | | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center and German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, D-37075 Göttingen, Germany;
| | | | | | | | | | | | - Eike Langheim
- Reha-Zentrum Seehof der Deutschen Rentenversicherung Bund, D-14513 Teltow, Germany; (J.G.); (E.L.)
| | | | - Regina Max
- Zentrum für Rheumatologie, Drs. Dornacher/Schmitt/Max/Lutz, D-69115 Heidelberg, Germany;
| | - Maria-Inti Metzendorf
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice, Medical Faculty of the Heinrich-Heine University, D-40225 Düsseldorf, Germany;
| | - Roland Nebel
- Hermann-Albrecht-Klinik METTNAU, Reha-Einrichtungen der Stadt Radolfzell, D-7385 Radolfzell, Germany;
| | - Josef Niebauer
- Universitätsinstitut für Präventive und Rehabilitative Sportmedizin, Uniklinikum Salzburg, Paracelsus Medizinische Privatuniversität, A-5020 Salzburg, Austria;
| | - Hans-Georg Predel
- Institute for Cardiology and Sports Medicine, Department of Preventive and Rehabilitative Sport- and Exercise Medicine, German Sportuniversity Cologne, D-50933 Köln, Germany; (B.B.-W.); (H.-G.P.)
| | - Axel Preßler
- Privatpraxis für Kardiologie, Sportmedizin, Prävention, Rehabilitation, D-81675 München, Germany;
| | - Oliver Razum
- Epidemiologie und International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, D-33615 Bielefeld, Germany;
| | - Nils Reiss
- Schüchtermann-Schiller’sche Kliniken, D-49214 Bad Rothenfelde, Germany;
| | - Daniel Saure
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, D-69120 Heidelberg, Germany; (M.M.); (K.J.); (D.S.)
| | | | - Morten Schütt
- Diabetologische Schwerpunktpraxis, D-23552 Lübeck, Germany;
| | - Konrad Schultz
- Klinik Bad Reichenhall, Zentrum für Rehabilitation, Pneumologie und Orthopädie, D-83435 Bad Reichenhall, Germany;
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University Hospital, University of Duisburg-Essen, D-45147 Essen, Germany; (E.-M.S.); (M.T.)
| | | | - Marco Streibelt
- Department for Rehabilitation Research, German Federal Pension Insurance, D-10704 Berlin, Germany;
| | | | | | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR University Hospital, University of Duisburg-Essen, D-45147 Essen, Germany; (E.-M.S.); (M.T.)
| | | | - Heinz Völler
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, D-14469 Potsdam, Germany; (A.S.); (S.E.); or (H.V.)
- Klinik am See, D-15562 Rüdersdorf, Germany
| | - Heiner Vogel
- Abteilung für Medizinische Psychologie und Psychotherapie, Medizinische Soziologie und Rehabilitationswissenschaften, Universität Würzburg, D-97070 Würzburg, Germany;
| | - Ronja Westphal
- Herzzentrum Segeberger Kliniken, D-23795 Bad Segeberg, Germany;
| |
Collapse
|
10
|
Laurino MJL, da Silva AKF, Santos LA, Ribeiro F, Vanzella LM, Corazza DAG, Vanderlei LCM. Vagal reactivation after a cardiac rehabilitation session associated with hydration in coronary artery disease patients: crossover clinical trial. Sci Rep 2021; 11:10482. [PMID: 34006912 PMCID: PMC8131702 DOI: 10.1038/s41598-021-89840-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 04/30/2021] [Indexed: 02/03/2023] Open
Abstract
This study aimed to investigate the hydration influence on the autonomic responses of coronary artery disease subjects in the immediate recovery period after a cardiovascular rehabilitation session, in view of the risks of a delayed autonomic recovery for this population. 28 males with coronary artery disease were submitted to: (I) Maximum effort test; (II) Control protocol (CP), composed by initial rest, warm-up, exercise and passive recovery; (III) Hydration protocol (HP) similar to CP, but with rehydration during exercise. The recovery was evaluated through the heart rate (HR) variability, HR recovery and by the rate of perceived exertion and recovery. The main results revealed that the vagal reactivation occurred at the first 30 s of recovery in HP and after the first minute in CP. A better behavior of the HR at the first minute of recovery was observed in HP. The rate of perceived exertion had a significant decrease in the first minute of recovery in HP, while in CP this occurred after the third minute. In conclusion, despite an anticipated vagal reactivation found at HP, these results should be analyzed with caution as there were no significant differences between protocols for all variables and the effect sizes were small.
Collapse
Affiliation(s)
- Maria Júlia Lopez Laurino
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil.
| | - Anne Kastelianne França da Silva
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Lorena Altafin Santos
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Felipe Ribeiro
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Laís Manata Vanzella
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Dayane Andrade Genoni Corazza
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| | - Luiz Carlos Marques Vanderlei
- Physical Therapy Post-graduation Program, Faculty of Science and Technology, São Paulo State University (UNESP), Rua Roberto Simonsen, 305, Presidente Prudente, São Paulo, 19060-900, Brazil
| |
Collapse
|
11
|
Zekios KC, Mouchtouri ET, Lekkas P, Nikas DN, Kolettis TM. Sympathetic Activation and Arrhythmogenesis after Myocardial Infarction: Where Do We Stand? J Cardiovasc Dev Dis 2021; 8:jcdd8050057. [PMID: 34063477 PMCID: PMC8156099 DOI: 10.3390/jcdd8050057] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/30/2021] [Accepted: 05/12/2021] [Indexed: 12/11/2022] Open
Abstract
Myocardial infarction often leads to progressive structural and electrophysiologic remodeling of the left ventricle. Despite the widespread use of β-adrenergic blockade and implantable defibrillators, morbidity and mortality from chronic-phase ventricular tachyarrhythmias remains high, calling for further investigation on the underlying pathophysiology. Histological and functional studies have demonstrated extensive alterations of sympathetic nerve endings at the peri-infarct area and flow-innervation mismatches that create a highly arrhythmogenic milieu. Such accumulated evidence, along with the previously well-documented autonomic dysfunction as an important contributing factor, has stirred intense research interest for pharmacologic and non-pharmacologic neuromodulation in post-infarction heart failure. In this regard, aldosterone inhibitors, sacubitril/valsartan and sodium-glucose cotransporter type 2 inhibitors have shown antiarrhythmic effects. Non-pharmacologic modalities, currently tested in pre-clinical and clinical trials, include transcutaneous vagal stimulation, stellate ganglion modulation and renal sympathetic denervation. In this review, we provide insights on the pathophysiology of ventricular arrhythmogenesis post-myocardial infarction, focusing on sympathetic activation.
Collapse
Affiliation(s)
- Konstantinos C. Zekios
- 1st Department of Cardiology, University Hospital of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece; (K.C.Z.); (D.N.N.)
- Department of Cardiology, University of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece;
| | - Eleni-Taxiarchia Mouchtouri
- Department of Cardiology, University of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece;
- Cardiovascular Research Institute, 1 St. Niarxou Avenue, 45500 Ioannina, Greece;
| | - Panagiotis Lekkas
- Cardiovascular Research Institute, 1 St. Niarxou Avenue, 45500 Ioannina, Greece;
| | - Dimitrios N. Nikas
- 1st Department of Cardiology, University Hospital of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece; (K.C.Z.); (D.N.N.)
| | - Theofilos M. Kolettis
- 1st Department of Cardiology, University Hospital of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece; (K.C.Z.); (D.N.N.)
- Department of Cardiology, University of Ioannina, 1 St. Niarxou Avenue, 45500 Ioannina, Greece;
- Cardiovascular Research Institute, 1 St. Niarxou Avenue, 45500 Ioannina, Greece;
- Correspondence:
| |
Collapse
|
12
|
Lin FL, Yeh ML. Walking and mindfulness improve the exercise capacity of patients with chronic obstructive pulmonary disease: A randomised controlled trial. Clin Rehabil 2021; 35:1117-1125. [PMID: 33706570 DOI: 10.1177/0269215521992917] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the effects of mindful walking practice on the exercise capacity of patients with chronic obstructive pulmonary disease (COPD). DESIGN A randomised controlled trial with four repeated measurements. SETTING Outpatient departments of a medical centre in northern Taiwan. PARTICIPANTS Patients with mild to severe COPD. INTERVENTION The control group received usual care, whereas the mindful walking group received usual care plus undertook a mindful walking practice. OUTCOME MEASURES The main outcome was the six-minute walk distance. And the Global Initiative for Chronic Obstructive Lung Disease classification, dyspnoea, heart rate variability and interoceptive awareness were control factors. RESULTS Compared with the control group (n = 40), the mindful walking group (n = 38) achieved a significantly longer six-minute walk distance (longer by 45.57 m; P = 0.04). The interaction effect of the six-minute walk distance significantly increased on Week 4 (P = 0.01), Week 8 (P = 0.002) and Week 12 (P = 0.02). Participants in Global Initiative for Chronic Obstructive Lung Disease class A exhibited significantly improved six-minute walk distance compared with those in class D (P = 0.001). Moreover, scores on the emotional awareness scale of interoceptive awareness were significantly associated with the six-minute walk distance (P = 0.02). CONCLUSION The eight-week mindful walking practice improved the exercise capacity of patients with COPD, and its effect was sustained for at least four weeks after the end of the practice. This study suggest that this practice improved COPD symptoms, reduced COPD risk and increased the interoceptive awareness of this population.
Collapse
Affiliation(s)
- Feng-Lien Lin
- Department of Nursing, National Taiwan University Hospital, Taipei City
| | - Mei-Ling Yeh
- Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing, National Taipei University of Nursing and Health Sciences, Taipei City
| |
Collapse
|
13
|
Park IK, Lee JY, Suk MH, Yoo S, Seo YG, Oh JK, Kwon JY. Effect of Equine-Assisted Activities on Cardiac Autonomic Function in Children with Cerebral Palsy: A Pilot Randomized-Controlled Trial. J Altern Complement Med 2020; 27:96-102. [PMID: 33252241 DOI: 10.1089/acm.2020.0346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objective: Children with cerebral palsy (CP) have an impaired cardiac autonomic function. Attenuated heart rate recovery (HRR), which is a valuable prognostic parameter for autonomic nervous system, is known to be associated with an increased risk of cardiovascular events and all-cause mortality. However, only few studies have observed the effects of exercise on the cardiac autonomic function in children with CP. The purpose of this pilot study was to examine the effects of equine-assisted activity (EAA) program on cardiac autonomic function in children with CP. Design: A single-blinded, parallel, two-arm pilot trial with 1:1 randomization to the EAA or control group. Setting: A tertiary university hospital and a local arena. Subjects: Twenty-six children with CP (Gross Motor Function Classification System Levels I-II). Intervention: Each lesson of the EAA program for the EAA group was conducted for 40 min twice a week, and the whole program duration was 16 weeks (a total of 32 sessions). Outcome measures: A graded exercise test was performed to measure the resting heart rate (RHR), HRR, and peak oxygen uptake (VO2peak) on both groups before and after the 16-week period. Results: The autonomic nervous function measured by the response of HRR improved at 1 min (p < 0.009), 3 min (p < 0.001), and 5 min (p < 0.004) only in the EAA group. RHR significantly improved in the EAA group (p < 0.013), whereas the VO2peak did not significantly differ between the two groups. Conclusion: The HRR and RHR of the children with CP improved after completing the 16-week EAA program. The results demonstrated that the program had a positive effect on the improvement of cardiac autonomic function in these patients. Clinical Trial Registration Number: NCT03870893.
Collapse
Affiliation(s)
- In-Kyeong Park
- Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Ji Young Lee
- Samsung Equestrian Team, Gunpo, Republic of Korea
| | - Min-Hwa Suk
- Department of Sport Science, College of Sport and Art, Hanyang University, Seoul, Republic of Korea
| | - Soojin Yoo
- Department of Health and Human Performance, University of Texas, Rio Grande Valley, Edinburg, TX, USA
| | - Yong-Gon Seo
- Division of Sports Medicine, Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Republic of Korea
| | - Jea-Keun Oh
- Department of Health Care and Sports Science, Korea National Sport University, Seoul, Republic of Korea
| | - Jeong-Yi Kwon
- Department of Physical & Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| |
Collapse
|
14
|
Christoffersen L, Gibson TM, Pui CH, Joshi V, Partin RE, Green DM, Lanctot JQ, Howell CR, Mulrooney DA, Armstrong GT, Robison LL, Hudson MM, Ness KK. Cardiac autonomic dysfunction in survivors of childhood acute lymphoblastic leukemia: The St. Jude Lifetime Cohort Study. Pediatr Blood Cancer 2020; 67:e28388. [PMID: 32383821 PMCID: PMC7302420 DOI: 10.1002/pbc.28388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/15/2020] [Accepted: 04/19/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cardiac autonomic dysfunction (CAD) is possible following treatment for childhood cancer. The aims of our analyses were to compare the prevalence of CAD between adult survivors of childhood acute lymphoblastic leukemia and controls, compare exercise response among survivors with and without CAD, and identify treatment-related risk factors for CAD. PROCEDURE Participants were treated for childhood acute lymphoblastic leukemia at St. Jude Children's Research Hospital between 1980 and 2003 (N = 338). A comparison group matched for race/ethnicity, age, and sex was also recruited (N = 325). Resting heart rate (HR) was assessed via electrocardiogram, and heart rate recovery (HRR) and exercise capacity were evaluated with submaximal cardiopulmonary exercise testing. RESULTS CAD was present in 33.7% of survivors and 27.6% of controls (P = 0.09). Although mean resting HR did not differ between survivors and controls (74 ± 12 vs 72 ± 12 beats per minute (bpm), P = 0.07), survivors had lower mean HRR than controls (22 ± 9 vs 25 ± 10 bpm; P < 0.001). Survivors with CAD had lower peak exercise tolerance (25.7 ± 6.5 vs 21.2 ± 4.9 mL/kg/min, P < 0.001) than those without. Survivors treated with cyclophosphamide in combination with vincristine ≥38 mg/m2 and/or glucocorticoids ≥10 000 mg/m2 were 1.56 (95% CI 1.09-2.24) times more likely to have CAD than those without this treatment. Obese survivors were 1.78 (95% CI: 1.31-2.40) times more likely to have CAD than nonobese survivors (P < 0.001). CONCLUSION CAD was present in over one third of survivors and was associated with lower exercise capacity. Obese survivors and those exposed to cyclophosphamide with high doses of vincristine and/or corticosteroids were at greatest risk.
Collapse
Affiliation(s)
- Lindsey Christoffersen
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN,Department of Rehabilitation Services, St. Jude Children’s Research Hospital, Memphis, TN
| | - Todd M. Gibson
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD
| | - Ching-Hon Pui
- Oncology Department, St. Jude Children’s Research Hospital, Memphis, TN
| | - Vijaya Joshi
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN,College of Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Robyn E. Partin
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Daniel M. Green
- Oncology Department, St. Jude Children’s Research Hospital, Memphis, TN
| | - Jennifer Q. Lanctot
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Carrie R. Howell
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Daniel A. Mulrooney
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN,Oncology Department, St. Jude Children’s Research Hospital, Memphis, TN
| | - Gregory T. Armstrong
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN,College of Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Leslie L. Robison
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| | - Melissa M. Hudson
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN,Oncology Department, St. Jude Children’s Research Hospital, Memphis, TN,College of Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Kirsten K. Ness
- Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN
| |
Collapse
|
15
|
Caru M, Curnier D. Sex and Gender Considerations After Surviving Acute Lymphoblastic Leukemia: An Exercise Oncology Context. J Adolesc Young Adult Oncol 2020; 9:441-444. [DOI: 10.1089/jayao.2019.0137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Maxime Caru
- Laboratory of Pathophysiology of Exercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada
- Sainte-Justine University Health Center, Research Center, Montreal, Canada
- Laboratoire EA 4430–Clinique Psychanalyse Developpement (CliPsyD), University of Paris Nanterre, Nanterre, France
| | - Daniel Curnier
- Laboratory of Pathophysiology of Exercise (LPEX), School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, University of Montreal, Montreal, Canada
- Sainte-Justine University Health Center, Research Center, Montreal, Canada
| |
Collapse
|
16
|
Tofas T, Draganidis D, Deli CK, Georgakouli K, Fatouros IG, Jamurtas AZ. Exercise-Induced Regulation of Redox Status in Cardiovascular Diseases: The Role of Exercise Training and Detraining. Antioxidants (Basel) 2019; 9:antiox9010013. [PMID: 31877965 PMCID: PMC7023632 DOI: 10.3390/antiox9010013] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 02/07/2023] Open
Abstract
Although low levels of reactive oxygen species (ROS) are beneficial for the organism ensuring normal cell and vascular function, the overproduction of ROS and increased oxidative stress levels play a significant role in the onset and progression of cardiovascular diseases (CVDs). This paper aims at providing a thorough review of the available literature investigating the effects of acute and chronic exercise training and detraining on redox regulation, in the context of CVDs. An acute bout of either cardiovascular or resistance exercise training induces a transient oxidative stress and inflammatory response accompanied by reduced antioxidant capacity and enhanced oxidative damage. There is evidence showing that these responses to exercise are proportional to exercise intensity and inversely related to an individual’s physical conditioning status. However, when chronically performed, both types of exercise amplify the antioxidant defense mechanism, reduce oxidative stress and preserve redox status. On the other hand, detraining results in maladaptations within a time-frame that depends on the exercise training intensity and mode, as high-intensity training is superior to low-intensity and resistance training is superior to cardiovascular training in preserving exercise-induced adaptations during detraining periods. Collectively, these findings suggest that exercise training, either cardiovascular or resistance or even a combination of them, is a promising, safe and efficient tool in the prevention and treatment of CVDs.
Collapse
|
17
|
Machado A, Quadflieg K, Oliveira A, Keytsman C, Marques A, Hansen D, Burtin C. Exercise Training in Patients with Chronic Respiratory Diseases: Are Cardiovascular Comorbidities and Outcomes Taken into Account?-A Systematic Review. J Clin Med 2019; 8:E1458. [PMID: 31540240 PMCID: PMC6780679 DOI: 10.3390/jcm8091458] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/06/2019] [Accepted: 09/10/2019] [Indexed: 12/16/2022] Open
Abstract
Patients with chronic obstructive pulmonary disease (COPD), asthma and interstitial lung diseases (ILD) frequently suffer from cardiovascular comorbidities (CVC). Exercise training is a cornerstone intervention for the management of these conditions, however recommendations on tailoring programmes to patients suffering from respiratory diseases and CVC are scarce. This systematic review aimed to identify the eligibility criteria used to select patients with COPD, asthma or ILD and CVC to exercise programmes; assess the impact of exercise on cardiovascular outcomes; and identify how exercise programmes were tailored to CVC. PubMed, Scopus, Web of Science and Cochrane were searched. Three reviewers extracted the data and two reviewers independently assessed the quality of studies with the Quality Assessment Tool for Quantitative Studies. MetaXL 5.3 was used to calculate the individual and pooled effect sizes (ES). Most studies (58.9%) excluded patients with both stable and unstable CVC. In total, 26/42 studies reported cardiovascular outcomes. Resting heart rate was the most reported outcome measure (n = 13) and a small statistically significant effect (ES = -0.23) of exercise training on resting heart rate of patients with COPD was found. No specific adjustments to exercise prescription were described. Few studies have included patients with CVC. There was a lack of tailoring of exercise programmes and limited effects were found. Future studies should explore the effect of tailored exercise programmes on relevant outcome measures in respiratory patients with CVC.
Collapse
Affiliation(s)
- Ana Machado
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, 3810 Aveiro, Portugal
| | - Kirsten Quadflieg
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Ana Oliveira
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, 3810 Aveiro, Portugal
- Respiratory Medicine, West Park Healthcare Centre, Toronto, ON M6M 2J5, Canada
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Charly Keytsman
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium
| | - Alda Marques
- Respiratory Research and Rehabilitation Laboratory (Lab3R), School of Health Sciences (ESSUA), University of Aveiro, 3810 Aveiro, Portugal
- Institute of Biomedicine (iBiMED), University of Aveiro, 3810 Aveiro, Portugal
| | - Dominique Hansen
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium
- Jessa hospital, Heart Centre Hasselt, 3500 Hasselt, Belgium
| | - Chris Burtin
- REVAL-Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium.
- BIOMED-Biomedical Research Institute, Hasselt University, 3590 Diepenbeek, Belgium.
| |
Collapse
|
18
|
Abstract
PURPOSE OF REVIEW Exercise and movement are increasingly used in pain management and in palliative care, outside the traditional context of physical medicine and rehabilitation. This critical review aims to provide specialists in pain and palliative medicine with recent insights into the use of exercise and movement in the approach to musculoskeletal disorders when pain and disability are the major complaints. RECENT FINDINGS If there is a common sense linking pain and movement in both directions, that is pain influencing movement - as a withdrawal movement or a reduction of mobility as a defense reaction - or movement evoking pain, not so clear and recognized is the link between exercise and movement in controlling pain. SUMMARY Conflicting results emerge between absolutely convincing basic science research confirming important effects induced by movement and exercise on pain and substantial poor low evidence level from clinical research as stated by almost all systematic reviews. The need of rigorous clinical trials is mandatory to ascertain a real clinical benefit for the use of movement and exercise for pain control.
Collapse
|
19
|
Influence of smoking on physical function, physical activity, and cardiovascular health parameters in patients with symptomatic peripheral arterial disease: A cross-sectional study. JOURNAL OF VASCULAR NURSING 2019; 37:106-112. [PMID: 31155156 DOI: 10.1016/j.jvn.2019.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 01/25/2019] [Accepted: 01/28/2019] [Indexed: 12/24/2022]
Abstract
The aim of this study was to analyze the impact of smoking on physical activity, walking capacity, and cardiovascular health in patients with symptomatic peripheral arterial disease (PAD). This cross-sectional study included 180 patients with symptomatic PAD. Patients were classified into 3 groups according to smoking history: smoker (n = 39), ex-smoker (n = 113), and never smoker (n = 28). Physical activity levels, physical function, walking capacity, and cardiovascular health parameters (clinical blood pressure, arterial stiffness, and heart rate variability) were assessed. Smoker patients presented higher sympathetic modulation to the heart (low frequency of heart rate variability: smokers, 71 ± 17 nu; ex-smokers, 53 ± 32 nu; never smokers, 49 ± 21 nu, P < .05) and sympathovagal balance (smokers: 2.44 ± 2.76, ex-smokers: 1.14 ± 1.74, never smokers: 1.04 ± 0.99, P < .05) and lower parasympathetic modulation to the heart (high frequency of heart rate variability: smokers, 29 ± 27 nu; ex-smokers, 47 ± 32 nu; never smokers, 51 ± 21 nu, P < .05) than other patients. In conclusion, nonsignificant differences were observed on physical activity levels, physical function, blood pressure, and arterial stiffness (P > .05). Smoking impairs cardiac autonomic modulation in patients with symptomatic PAD.
Collapse
|
20
|
Caru M, Corbin D, Périé D, Lemay V, Delfrate J, Drouin S, Bertout L, Krajinovic M, Laverdière C, Andelfinger G, Sinnett D, Curnier D. Doxorubicin treatments induce significant changes on the cardiac autonomic nervous system in childhood acute lymphoblastic leukemia long-term survivors. Clin Res Cardiol 2019; 108:1000-1008. [DOI: 10.1007/s00392-019-01427-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/29/2019] [Indexed: 12/12/2022]
|
21
|
The Effects of Passive Simulated Jogging on Short-Term Heart Rate Variability in a Heterogeneous Group of Human Subjects. JOURNAL OF SPORTS MEDICINE 2018; 2018:4340925. [PMID: 30402499 PMCID: PMC6191954 DOI: 10.1155/2018/4340925] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/12/2018] [Indexed: 12/12/2022]
Abstract
Background Heart rate variability (HRV) reflects neural balance between sympathetic and parasympathetic autonomic nervous systems (ANS). Reduced HRV occurs in several chronic diseases and physical inactivity. External addition of pulses to the circulation restores HRV. A new method to add pulses to the circulation can be accomplished with a passive simulated jogging device (JD). We hypothesized that application of JD might increase HRV in seated and supine postures in a heterogeneous group of volunteer subjects. Methods Twenty ambulatory persons (age range 31-88) were recruited. The physical activity intervention (JD) moved the feet in a repetitive and alternating manner; upward movement of the pedal is followed by a downward movement of the forefoot tapping against a semirigid bumper to simulate tapping of feet against the ground during jogging. Each subject underwent four, 30 min sessions in seated and supine postures with the active JD and same with Sham. HRV was assessed at baseline (BL), and Recovery (REC) from analysis of an electrocardiogram. Time domain variables were computed, namely, standard deviation of all normal RR intervals (SDNN) and square root of the mean of the sum of the squares of differences between adjacent RR intervals (RMSSD). Frequency domain measures were determined using a standard Fast Fourier spectral analysis, as well as parameters of Poincaré plots. Results Thirty minutes of JD significantly increased time domain measures and Poincaré parameters of HRV in both seated and supine postures. Frequency domain parameters showed no change. The effects of JD on HRV measures were not affected by age, gender, or posture. Conclusion The passive simulated jogging device increased HRV in both seated and supine postures. This intervention that provided effortless physical activity is a novel method to harness the beneficial effects of increasing HRV.
Collapse
|
22
|
Fenley A, Floriano RS, Chaves TDO, Nasser I, Reis MS. Análise comparativa de fórmulas preditivas de avaliação da capacidade funcional com o teste cardiopulmonar de jogadoras de futebol profissional. FISIOTERAPIA E PESQUISA 2018. [DOI: 10.1590/1809-2950/17005725032018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Comparar a validade de duas fórmulas de predição do consumo de oxigênio (VO2) com os valores obtidos no teste cardiopulmonar (TCP) em esteira ergométrica de jogadoras de futebol profissional. Dezoito jogadoras de futebol profissional foram submetidas ao TCP em esteira em um protocolo de carga incremental. Na sequência, foi determinado o VO2 da potência do limiar anaeróbio ventilatório (LAV) e no pico do exercício físico. Posteriormente, as fórmulas de predição de VO2 - i) VO2 = (0,2 x velocidade) + (0,9 x velocidade x inclinação) + 3,5 - velocidade em mph e inclinação %); e ii) MET (equivalente metabólica) = 6xHRI-5, onde HRI = frequência cardíaca máxima/frequência cardíaca de repouso - foram aplicadas nas mesmas potências para comparação. Para a primeira fórmula foi observado que tanto no LAV como no pico do TCP, os dados obtidos ficaram abaixo do previsto, sugerindo que a fórmula superestima o VO2 e, consequentemente, a capacidade e a potência aeróbicas. Na segunda fórmula foi observado que os valores ficaram abaixo do obtido, sugerindo que a fórmula subestimou o VO2 e, consequentemente a potência aeróbica, e mais uma vez a capacidade funcional. Diante disso, as fórmulas de predição não mostraram similaridade na determinação da capacidade funcional (CF) de jogadoras de futebol profissional, sugerindo não serem recomendadas para essa população.
Collapse
Affiliation(s)
- Alexandre Fenley
- Universidade Federal do Rio de Janeiro, Brazil; Universidade Federal do Rio de Janeiro, Brazil
| | | | | | - Igor Nasser
- Universidade Federal do Rio de Janeiro, Brazil; Universidade Federal do Rio de Janeiro, Brazil
| | - Michel Silva Reis
- Universidade Federal do Rio de Janeiro, Brazil; Universidade Federal do Rio de Janeiro, Brazil; Universidade Federal do Rio de Janeiro, Brazil
| |
Collapse
|
23
|
Bhati P, Moiz JA, Menon GR, Hussain ME. Does resistance training modulate cardiac autonomic control? A systematic review and meta-analysis. Clin Auton Res 2018; 29:75-103. [PMID: 30141031 DOI: 10.1007/s10286-018-0558-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Accepted: 08/13/2018] [Indexed: 02/01/2023]
Abstract
PURPOSE To systematically evaluate the literature on the effects of resistance training (RT) on cardiac autonomic control in healthy and diseased individuals. METHODS Electronic databases Pubmed, PEDro, and Scopus were systematically searched from their inception up to June 2018. Randomized controlled trials, quasi-experimental trials, and cross-over controlled trials investigating the effect of RT (of at least 4 weeks duration) on cardiac autonomic control assessed either by linear or non-linear measures of heart rate variability (HRV), baroreflex sensitivity, or post-exercise heart rate recovery were included. Of the studies retrieved, 28 were included in the systematic review. Meta-analysis was performed on 21 studies of the total 28 studies. RESULTS Quality and characteristic assessment revealed fair quality evidence. The majority of literature on healthy humans suggested no change in cardiac autonomic control following RT. Standardized mean differences (SMD) showed a significant effect of RT on root mean square of successive differences between adjacent inter-beat (R-R) intervals (RMSSD) [SMD 0.96, 95% confidence interval (CI) 0.20-1.73; p = 0.01], ratio of low- to high-frequency power of HRV (LF/HF ratio; SMD -0.72, 95% CI -1.03 to -0.42; p < 0.00001), standard deviation of the instantaneous beat-to-beat variability (SD1; SMD 1.78, 95% CI 1.07-2.49, p < 0.00001), and sample entropy (SMD 1.17, 95% CI 0.36-1.97, p = 0.005) in diseased individuals. CONCLUSION This rigorous systematic analysis revealed that RT has no or minimal effects on cardiac autonomic control of healthy individuals, but RT leads to improvement in cardiac autonomic control of diseased individuals.
Collapse
Affiliation(s)
- Pooja Bhati
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Jamal Ali Moiz
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India
| | - Geetha R Menon
- National Institute of Medical Statistics, Indian Council of Medical Research, New Delhi, 110029, India
| | - M Ejaz Hussain
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia (A Central University), New Delhi, 110025, India.
| |
Collapse
|
24
|
|
25
|
Mohammed J, Derom E, Van Oosterwijck J, Da Silva H, Calders P. Evidence for aerobic exercise training on the autonomic function in patients with chronic obstructive pulmonary disease (COPD): a systematic review. Physiotherapy 2018; 104:36-45. [DOI: 10.1016/j.physio.2017.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/12/2017] [Indexed: 02/04/2023]
|
26
|
Exercise therapy and autonomic function in heart failure patients: a systematic review and meta-analysis. Heart Fail Rev 2017; 23:91-108. [DOI: 10.1007/s10741-017-9662-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
27
|
Andrade DC, Arce-Alvarez A, Toledo C, Díaz HS, Lucero C, Quintanilla RA, Schultz HD, Marcus NJ, Amann M, Del Rio R. Revisiting the physiological effects of exercise training on autonomic regulation and chemoreflex control in heart failure: does ejection fraction matter? Am J Physiol Heart Circ Physiol 2017; 314:H464-H474. [PMID: 29167119 DOI: 10.1152/ajpheart.00407.2017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Heart failure (HF) is a global public health problem that, independent of its etiology [reduced (HFrEF) or preserved ejection fraction (HFpEF)], is characterized by functional impairments of cardiac function, chemoreflex hypersensitivity, baroreflex sensitivity (BRS) impairment, and abnormal autonomic regulation, all of which contribute to increased morbidity and mortality. Exercise training (ExT) has been identified as a nonpharmacological therapy capable of restoring normal autonomic function and improving survival in patients with HFrEF. Improvements in autonomic function after ExT are correlated with restoration of normal peripheral chemoreflex sensitivity and BRS in HFrEF. To date, few studies have addressed the effects of ExT on chemoreflex control, BRS, and cardiac autonomic control in HFpEF; however, there are some studies that have suggested that ExT has a beneficial effect on cardiac autonomic control. The beneficial effects of ExT on cardiac function and autonomic control in HF may have important implications for functional capacity in addition to their obvious importance to survival. Recent studies have suggested that the peripheral chemoreflex may also play an important role in attenuating exercise intolerance in HFrEF patients. The role of the central/peripheral chemoreflex, if any, in mediating exercise intolerance in HFpEF has not been investigated. The present review focuses on recent studies that address primary pathophysiological mechanisms of HF (HFrEF and HFpEF) and the potential avenues by which ExT exerts its beneficial effects.
Collapse
Affiliation(s)
- David C Andrade
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile , Santiago , Chile.,Centro de Investigación en Fisiología del Ejercicio, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
| | - Alexis Arce-Alvarez
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile , Santiago , Chile.,Centro de Investigación Biomédica, Universidad Autónoma de Chile , Santiago , Chile
| | - Camilo Toledo
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile , Santiago , Chile.,Centro de Investigación Biomédica, Universidad Autónoma de Chile , Santiago , Chile
| | - Hugo S Díaz
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile , Santiago , Chile.,Centro de Investigación Biomédica, Universidad Autónoma de Chile , Santiago , Chile
| | - Claudia Lucero
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile , Santiago , Chile.,Centro de Investigación Biomédica, Universidad Autónoma de Chile , Santiago , Chile
| | | | - Harold D Schultz
- Department of Cellular and Integrative Physiology, University of Nebraska Medical Center , Omaha, Nebraska
| | - Noah J Marcus
- Department of Physiology and Pharmacology, Des Moines University , Des Moines, Iowa
| | - Markus Amann
- Department of Internal Medicine, University of Utah , Salt Lake City, Utah
| | - Rodrigo Del Rio
- Laboratory of Cardiorespiratory Control, Department of Physiology, Pontificia Universidad Católica de Chile , Santiago , Chile.,Centro de Excelencia en Biomedicina de Magallanes, Universidad de Magallanes , Punta Arenas , Chile.,Centro de Envejecimiento y Regeneracion, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
28
|
Coats AJS, Forman DE, Haykowsky M, Kitzman DW, McNeil A, Campbell TS, Arena R. Physical function and exercise training in older patients with heart failure. Nat Rev Cardiol 2017; 14:550-559. [PMID: 28518178 PMCID: PMC7245611 DOI: 10.1038/nrcardio.2017.70] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Heart failure (HF) is a common end point for numerous cardiovascular conditions, including coronary artery disease, valvular disease, and hypertension. HF predominantly affects older individuals (aged ≥70 years), particularly those living in developed countries. The pathophysiological sequelae of HF progression have a substantial negative effect on physical function. Diminished physical function in older patients with HF, which is the result of combined disease-related and age-related effects, has important implications on health. A large body of research spanning several decades has demonstrated the safety and efficacy of regular physical activity in improving outcomes among the HF population, regardless of age, sex, or ethnicity. However, patients with HF, especially those who are older, are less likely to engage in regular exercise training compared with the general population. To improve initiation of regular exercise training and subsequent long-term compliance, there is a need to rethink the dialogue between clinicians and patients. This Review discusses the need to improve physical function and exercise habits in patients with HF, focusing on the older population.
Collapse
Affiliation(s)
- Andrew J Stewart Coats
- Monash University, Clayton Campus, Melbourne, Victoria 3800, Australia
- University of Warwick, Kirby Corner Road, Coventry CV4 8UW, UK
| | - Daniel E Forman
- Section of Geriatric Cardiology, University of Pittsburgh Medical Center, VA Pittsburgh Healthcare System, 259 Mt Nebo Pointe Drive, Pittsburgh, Pennsylvania 15213, USA
| | - Mark Haykowsky
- College of Nursing and Health Innovation, University of Texas at Arlington, 411 South Nedderman Drive, Arlington, Texas 76019, USA
| | - Dalane W Kitzman
- Cardiovascular Medicine Section, Department of Internal Medicine, Wake Forest School of Medicine, 1 Medical Center Boulevard, Winston-Salem, North Carolina 27157, USA
| | - Amy McNeil
- Department of Physical Therapy, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, Illinois 60612, USA
| | - Tavis S Campbell
- Department of Psychology, University of Calgary, 2500 University Drive North West, Calgary, Alberta T2N 1N4, Canada
| | - Ross Arena
- Department of Physical Therapy, Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, Illinois 60612, USA
| |
Collapse
|
29
|
Ramos JS, Dalleck LC, Borrani F, Beetham KS, Mielke GI, Dias KA, Wallen MP, Keating SE, Fassett RG, Coombes JS. High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: A randomised trial. Int J Cardiol 2017; 245:245-252. [PMID: 28747269 DOI: 10.1016/j.ijcard.2017.07.063] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 06/24/2017] [Accepted: 07/18/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Insulin resistance has been postulated to play a central role in the co-appearance of various cardiovascular disease risk factors constituting the metabolic syndrome (MetS). There is evidence that altered cardiac autonomic function (CAF) may precede the onset of insulin resistance. Exercise training has been shown to improve CAF in different populations, yet little is known regarding the exercise dose response for CAF. The aim of this study was to investigate the impact of different volumes of high-intensity interval training (HIIT) and traditional moderate-intensity continuous training (MICT) on CAF in participants with MetS. METHODS Individuals with MetS (n=56) were randomised into the following 16-week training interventions: i) MICT (n=16, 30min at 60-70%HRpeak, 5×/week); ii) 4HIIT (n=19, 4×4min bouts at 85-95%HRpeak, interspersed with 3min of active recovery at 50-70%HRpeak, 3×/week); or iii) 1HIIT (n=21, 1×4min bout at 85-95%HRpeak, 3×/week). R-R interval recorded for 5min in a supine position at pre- and post-intervention was used to derive linear (SDNN, RMSSD, pNN50, LF, HF, LF/HF) and non-linear (SD1, SD2, Alpha1, Alpha2, SampEn) heart rate variability (HRV) indices as measures of CAF. Group×time interaction effects were examined (ANCOVA) and Eta squared (η2) interaction effect sizes calculated. RESULTS While there were no significant between-group differences in CAF indices, there were small-to-medium group×time interaction effects on SDNN [F(2,52)=0.70, p=0.50, η2=0.02], RMSSD [F(2,52)=1.35, p=0.27, η2=0.03], HF power [F(2,52)=1.27, p=0.29, η2=0.03], SD1 [F(2,52)=0.47, p=0.63, η2=0.01], and SD2 [F(2,52)=0.41, p=0.67, η2=0.01]. The following represent the relative percentage increases across these variables for 4HIIT, MICT, and 1HIIT respectively (SDNN, +30%, +17%, 9%; RMSSD, +30%, +22%, -2%; HF power, +69%, +18%, +7%; SD1, +30%, +22%,-2%; SD2, +22%, +14%, 4%). CONCLUSIONS There were no significant between-group differences for the effects of exercise dose on CAF indices, however; high-volume HIIT demonstrated the greatest magnitude of effect for improving CAF in individuals with MetS.
Collapse
Affiliation(s)
- Joyce S Ramos
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia; Health and Exercise Science, Flinders University, South Australia, Australia
| | - Lance C Dalleck
- Recreation, Exercise, and Sport Science Department, Western State Colorado University, Gunnison, CO, United States
| | - Fabio Borrani
- Institut des Sciences du Sport de l'Universite de Lausanne (ISSUL), Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Kassia S Beetham
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Gregore Iven Mielke
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Katrin A Dias
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Matthew P Wallen
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Robert G Fassett
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Australia.
| |
Collapse
|
30
|
Valandro M, Pascon J, Pereira D, Mistieri M. Exercise training of dogs with myxomatous valve disease. ARQ BRAS MED VET ZOO 2017. [DOI: 10.1590/1678-4162-9230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The present study has the objective of evaluating the effects of exercise training, using moderate intensity walking (60 to 80% of maximum heart rate), from 30 to 50 minutes, three times a week, in alternate days, during eight weeks, on heart rate variability in dogs with myxomatous valve disease (MVD). For that, 20 dogs in stages B1 (1), B2 (14) and C2 (5) of MVD (ACVIM classification) were divided into untrained control group (CG, n=9) and training group (TG, n=11), and assessed at baseline (T0), after four (T1) and eight weeks (T2). Only one B1 and five B2 dogs completed the training program. In the time domain, the rMSSD was greater in TG in T1 (155,5+42,07) and T2 (199,8+83,54) than CG (T1:91,17+35,79 and T2:88,17+57,51). In the frequency domain, the variable High Frequency (HF) increased in TG in T1 (30950+25810) and T2 (40300+33870) when compared to the CG (T1:19090+23210 and T2:18810+22200) and within the group TG in T2 in relation to T0 (29340+20950). The proposed walking protocol is concluded to have increased the rMSSD and HF variables in TG, representing an increase of the parasympathetic tonus, justifying the indication of this therapy in B1 and B2 stages of MVD.
Collapse
|
31
|
Stubbs B, Vancampfort D, Rosenbaum S, Firth J, Cosco T, Veronese N, Salum GA, Schuch FB. An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry Res 2017; 249:102-108. [PMID: 28088704 DOI: 10.1016/j.psychres.2016.12.020] [Citation(s) in RCA: 304] [Impact Index Per Article: 43.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 11/12/2016] [Accepted: 12/17/2016] [Indexed: 12/31/2022]
Abstract
The literature regarding exercise for people with established anxiety disorders is equivocal. To address this issue, we conducted a systematic review and meta-analysis investigating the benefits of exercise compared to usual treatment or control conditions in people with an anxiety and/or stress-related disorders. Major electronic databases were searched from inception until December/2015 and a random effect meta-analysis conducted. Altogether, six randomized control trials (RCTs) including 262 adults (exercise n=132, 34.74 [9.6] years; control n=130, 37.34 [10.0] years) were included. Exercise significantly decreased anxiety symptoms more than control conditions, with a moderate effect size (Standardized Mean Difference=-0.582, 95%CI -1.0 to -0.76, p=0.02). Our data suggest that exercise is effective in improving anxiety symptoms in people with a current diagnosis of anxiety and/ or stress-related disorders. Taken together with the wider benefits of exercise on wellbeing and cardiovascular health, these findings reinforce exercise as an important treatment option in people with anxiety/stress disorders.
Collapse
Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Davy Vancampfort
- Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom; KU Leuven - University of Leuven Department of Rehabilitation Sciences, Leuven, Belgium
| | - Simon Rosenbaum
- KU Leuven - University of Leuven, Z.org Leuven, campus Kortenberg, Kortenberg, Belgium
| | - Joseph Firth
- Department of Exercise Physiology, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Theodore Cosco
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Nicola Veronese
- MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London WC1B 5JU, United Kingdom
| | - Giovanni A Salum
- Department of Medicine, Geriatrics Section, University of Padova, Italy; Programa de Pós Graduação em Ciências Médicas: Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe B Schuch
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Centro Universitário La Salle, Canoas, Brazil.
| |
Collapse
|
32
|
[The exercise training restores the heart rate variability in heart failure patients. A systematic review]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2017; 87:326-335. [PMID: 28065709 DOI: 10.1016/j.acmx.2016.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 11/21/2022] Open
Abstract
Cardiovascular diseases are a significant cause of morbidity and mortality in the general population. In this sense, the autonomic imbalance is the cornerstone of the pathophysiology underlying the development of these diseases. The aim of this study was to determine the efficacy of exercise training on heart rate variability (HRV) in adult patients with chronic heart failure. METHODOLOGY A systematic literature review was conducted in electronic databases. The considered studies were randomised clinical trials, quasi-experimental studies with non-randomised control group, quasi-experimental studies with analysis of pre- and post- intervention, and crossover studies with randomly assigned training and non-training periods. The standardised mean differences were calculated between pre- and post-intervention in both the control and experimental group. RESULTS Within-subject analysis of the control group showed no statistical significance in the standardised mean differences of HRV. In the experimental group, the standardised mean differences were positive for the root mean square of successive difference (+0.468±0.215; P=.032), high frequency band (HF) (0.934±0.256; P < .001) and low frequency band (LF) (< 0.415±0.096; P=.001). Moreover, the standardised mean difference was negative for LF/HF (-0.747±0.369, P=<.044). On the other hand, only 3 studies entered the comparative meta-analysis. The effect of exercise training was favourable for the experimental group in LF/HF (-2.21±95% CI: -3.83 to -0.60), HF, and LF. CONCLUSION The exercise training was effective in increasing HRV and restoring the autonomic balance in patients with heart failure.
Collapse
|
33
|
Sampaio LMM, Subramaniam S, Arena R, Bhatt T. Does Virtual Reality-based Kinect Dance Training Paradigm Improve Autonomic Nervous System Modulation in Individuals with Chronic Stroke? JOURNAL OF VASCULAR AND INTERVENTIONAL NEUROLOGY 2016; 9:21-29. [PMID: 27829967 PMCID: PMC5094257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Physical inactivity and low resting heart rate variability (HRV) are associated with an increased cardiovascular deconditioning, risk of secondary stroke and mortality. Aerobic dance is a multidimensional physical activity and recent research supports its application as a valid alternative cardiovascular training. Furthermore, technological advances have facilitated the emergence of new approaches for exercise training holding promise, especially those methods that integrate rehabilitation with virtual gaming. OBJECTIVE The purpose of this study was to evaluate cardiac autonomic modulation in individuals with chronic stroke post-training using a virtual reality - based aerobic dance training paradigm. METHODS Eleven community-dwelling individuals with hemiparetic stroke [61.7( ± 4.3) years] received a virtual reality-based dance paradigm for 6 weeks using the commercially available Kinect dance video game "Just Dance 3." The training was delivered in a high-intensity tapering method with the first two weeks consisting of 5 sessions/week, next two weeks of 3 sessions/week and last two weeks of 2 sessions/week, with a total of 20 sessions. Data obtained for HRV analysis pre- and post-intervention consists of HRV for ten minutes in (1) supine resting position; (2) quiet standing. High-frequency (HF) power measures as indicators of cardiac parasympathetic activity, low-frequency (LF) power of parasympathetic-sympathetic balance and LF/HF of sympatho-vagal balance were calculated. YMCA submaximal cycle Ergometer test was used to acquire VO2 max pre- and post-intervention. Changes in physical activity during dance training were assessed using Omran HJ-321 Tri-Axis Pedometer. RESULTS After training, participants demonstrated a significant improvement in autonomic modulation in the supine position, indicating an improvement in LF=48.4 ( ± 20.1) to 40.3 ( ± 8.0), p=0.03; HF=51.5 ( ± 19) to 59.7 ( ± 8), p= 0.02 and LF/HF=1.6 ( ± 1.9) to 0.8 ( ± 0.26), p=0.05]. Post-training the participants had significantly higher VO2max. Number of steps during dance intervention significantly increased from the 1st to the 20th session (p<0.05). CONCLUSION The current study is the first to assess the effect of a virtual reality-based aerobic dance training paradigm on HRV among individuals with chronic stroke. Given that the paradigm used in this study improves cardiac autonomic control, future studies should incorporate dance as an adjuvant therapy into clinical treatment program and assess its long-term efficacy.
Collapse
|
34
|
Hemodynamic, Autonomic, Ventilatory, and Metabolic Alterations After Resistance Training in Patients With Coronary Artery Disease: A Randomized Controlled Trial. Am J Phys Med Rehabil 2016; 96:226-235. [PMID: 27386813 DOI: 10.1097/phm.0000000000000568] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of this work was to evaluate the hemodynamic, autonomic, and metabolic responses during resistance and dynamic exercise before and after an 8-week resistance training program using a low-intensity (30% of 1 repetitium maximum), high-repetition (3 sets of 20 repetitions) model, added to an aerobic training program, in a coronary artery disease cohort. DESIGN Twenty male subjects with coronary artery disease (61.1 ± 4.7 years) were randomly assigned to a combined training group (resistance + aerobic) or aerobic training group (AG). Heart rate, stroke volume, cardiac output, minute ventilation, blood lactate, and parasympathetic modulation indices of heart rate (square root of the mean squared differences of successive RR intervals [RMSSD] and dispersion of points perpendicular to the line of identity that provides information about the instantaneous beat-to-beat variability [SD1]) were obtained before and after an 8-week RT program while performing exercise on a cycle ergometer and a 45-degree leg press. RESULTS Resistance training resulted in an increase in maximal and submaximal load tolerance (P < 0.01), a decreased hemodynamic response (P < 0.01), and a reduction in blood lactate in the combined training group compared to the aerobic training group during the 45-degree leg press. During exercise on a cycle ergometer, there was a decreased hemodynamic response and increased minute ventilation (P < 0.01). The 8-week RT program resulted in greater parasympathetic tone (RMSSD and SD1) and an increase in the SDNN index during exercise on a cycle ergometer and 45-degree leg press (P < 0.05). CONCLUSIONS An 8-week resistance training program associated with aerobic training may attenuate hemodynamic stress, and modify metabolic and autonomic responses during resistance exercise. The training program also appeared to elicit beneficial cardiovascular and autonomic effects during exercise.
Collapse
|