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Stavrou VT, Vavougios GD, Astara K, Mysiris DS, Tsirimona G, Papayianni E, Boutlas S, Daniil Z, Hadjigeorgiou G, Bargiotas P, Gourgoulianis KI. The Impact of Different Exercise Modes in Fitness and Cognitive Indicators: Hybrid versus Tele-Exercise in Patients with Long Post-COVID-19 Syndrome. Brain Sci 2024; 14:693. [PMID: 39061433 PMCID: PMC11275076 DOI: 10.3390/brainsci14070693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/26/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
The purpose of our study was to obtain evidence that an unsupervised tele-exercise program (TEgroup) via an online platform is a feasible alternative to a hybrid mode of supervised and unsupervised exercise (HEgroup) sessions for improving fitness indexes, respiratory and cognitive functions, and biomarkers of oxidative stress in patients recovering from COVID-19. Forty-nine patients with long post-COVID-19 were randomly divided into two groups (HEgroup: n = 24, age 60.0 ± 9.5 years versus TEgroup: n = 25, age 58.7 ± 9.5 years). For each patient, we collected data from body composition, oxidative stress, pulmonary function, physical fitness, and cognitive function before and after the 12-week exercise rehabilitation program (ERP). Our data showed differences in both groups before and after 12-week ERP on fitness indicators, body composition, and pulmonary function indicators. Our findings demonstrated differences between groups after 12-week ERP on adjustment in the domains of cognitive function (HEgroup increased the "visuospatial" domain: 3.2 ± 1.1 versus 3.5 ± 0.8 score, p = 0.008 and TEgroup increased the "memory" domain: 3.3 ± 1.0 versus 3.8 ± 0.5 score, p = 0.003; after 12-week ERP showed differences between groups in domain "attention" TEgroup: 4.8 ± 1.5 versus HEgroup: 3.6 ± 1.8 score, p = 0.014) and the diffusing capacity for carbon monoxide (HEgroup increased the percent of predicted values at 0.5 ± 32.3% and TEgroup at 26.0 ± 33.1%, p < 0.001). These findings may be attributed to the different ways of learning exercise programs, resulting in the recruitment of different neural circuits.
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Affiliation(s)
- Vasileios T. Stavrou
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece; (G.D.V.); (Z.D.); (K.I.G.)
- RespiHub, ONISLOS-MSCA COFUND, Department of Neurology, Medical School, University of Cyprus, 2029 Nicosia, Cyprus;
| | - George D. Vavougios
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece; (G.D.V.); (Z.D.); (K.I.G.)
- Department of Neurology, Medical School, University of Cyprus, 2029 Nicosia, Cyprus;
| | - Kyriaki Astara
- Department of Neurology, 417 Army Equity Fund Hospital (NIMTS), 11521 Athens, Greece;
| | - Dimitrios S. Mysiris
- Department of Neurology, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece;
| | - Glykeria Tsirimona
- Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece; (G.T.); (E.P.); (S.B.)
| | - Eirini Papayianni
- Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece; (G.T.); (E.P.); (S.B.)
| | - Stylianos Boutlas
- Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece; (G.T.); (E.P.); (S.B.)
| | - Zoe Daniil
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece; (G.D.V.); (Z.D.); (K.I.G.)
- Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece; (G.T.); (E.P.); (S.B.)
| | | | - Panagiotis Bargiotas
- RespiHub, ONISLOS-MSCA COFUND, Department of Neurology, Medical School, University of Cyprus, 2029 Nicosia, Cyprus;
- Department of Neurology, Medical School, University of Cyprus, 2029 Nicosia, Cyprus;
| | - Konstantinos I. Gourgoulianis
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece; (G.D.V.); (Z.D.); (K.I.G.)
- Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41100 Larissa, Greece; (G.T.); (E.P.); (S.B.)
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Cook JD, Charest J. Sleep and Performance in Professional Athletes. CURRENT SLEEP MEDICINE REPORTS 2023; 9:56-81. [PMID: 36683842 PMCID: PMC9843114 DOI: 10.1007/s40675-022-00243-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 01/19/2023]
Abstract
Purpose of Review Sleep is an essential human behavior that plays a key role in proper biopsychosocial development as well as short- and long-term biological, physical, psychological, and cognitive health. Sleep plays a key role in athletic performance, influencing an athlete's ability to train, recover, and perform, as well as their overall wellness. Over the recent decade, the awareness of sleep's import has penetrated just about every professional sport domain. The purpose of the review was to identify and synthesize the literature published within the past 5 years (2018-2022) that relates to sleep and performance in professional athletes. Literature related to nonprofessional, high-level athletes (e.g., collegiate; Olympic) was omitted as well as those associated with non-traditional professional sports (e.g., eSports). Recent Findings Results from 38 articles were incorporated into this review, which covered (1) the sleep's role in the training, physical injury prevention and recovery, competitive performance, and mental health of professional athletes, (2) common sleep problems and disorders in professional athletes, and (3) the impact of unique challenges from training, travel, competition, and other factors on sleep health. Additionally, we provide an orientation to utilized strategies and interventions to assist with sleep health in professional athletes, as well as conclude with a commentary on critical steps forward. Summary Sleep plays a critically important role in the training, recovery, performance, and overall wellness of professional athletes. Professional athletes are vulnerable to a variety of sleep-related problems and disorders, due to unique factors related to training, travel, and competition, among other factors. Improved, standardized research methodology and partnerships between professional athletes, coaches, teams, and organizations and researchers are necessary to advance the knowledge of sleep and performance in professional athletes, including identifying sport-specific differences and variation across individual characteristics, as well as developing individualizable, dynamic, and appropriate interventions for improving sleep health among professional athletes.
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Affiliation(s)
- Jesse D. Cook
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI USA
- Department of Psychology, University of Wisconsin-Madison, Madison, WI USA
| | - Jonathan Charest
- Faculty of Kinesiology, University of Calgary, Calgary, AB Canada
- Centre for Sleep & Human Performance, 106, 51 Sunpark Drive SE, Calgary, AB T2X 3V4 Canada
- École de Psychologie, Université Laval, Québec, QC Canada
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Athletes with mild post-COVID-19 symptoms experience increased respiratory and metabolic demands: Α cross-sectional study. SPORTS MEDICINE AND HEALTH SCIENCE 2022:S2666-3376(22)00063-4. [PMID: 36312217 PMCID: PMC9595388 DOI: 10.1016/j.smhs.2022.10.004] [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: 07/22/2022] [Revised: 10/09/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Coronavirus Disease 2019 (COVID-19) has significantly affected different physiological systems, with a potentially profound effect on athletic performance. However, to date, such an effect has been neither addressed nor investigated. Therefore, the aim of this study was to investigate fitness indicators, along with the respiratory and metabolic profile, in post-COVID-19 athletes. Forty male soccer players, were divided into two groups: non-hospitalized COVID-19 (n = 20, Age: 25.2 ± 4.1 years, Body Surface Area [BSA]: 1.9 ± 0.2 m2, body fat: 11.8% ± 3.4%) versus [vs] healthy (n = 20, Age: 25.1 ± 4.4 years, BSA: 2.0 ± 0.3 m2, body fat: 10.8% ± 4.5%). For each athlete, prior to cardiopulmonary exercise testing (CPET), body composition, spirometry, and lactate blood levels, were recorded. Differences between groups were assessed with the independent samples t-test (p < 0.05). Several differences were detected between the two groups: ventilation (V˙E: Resting: 14.7 ± 3.1 L·min−1 vs. 11.5 ± 2.6 L·min−1, p = 0.001; Maximal Effort: 137.1 ± 15.5 L·min−1 vs. 109.1 ± 18.4 L·min−1, p < 0.001), ratio VE/maximal voluntary ventilation (Resting: 7.9% ± 1.8% vs. 5.7% ± 1.7%, p < 0.001; Maximal Effort: 73.7% ± 10.8% vs. 63.1% ± 9.0%, p = 0.002), ratioVE/BSA (Resting: 7.9% ± 2.0% vs. 5.9% ± 1.4%, p = 0.001; Maximal Effort: 73.7% ± 11.1% vs. 66.2% ± 9.2%, p = 0.026), heart rate (Maximal Effort: 191.6 ± 7.8 bpm vs. 196.6 ± 8.6 bpm, p = 0.041), and lactate acid (Resting: 1.8 ± 0.8 mmol·L vs. 0.9 ± 0.1 mmol·L, p < 0.001; Maximal Effort: 11.0 ± 1.6 mmol·L vs. 9.8 ± 1.2 mmol·L, p = 0.009), during CPET. No significant differences were identified regarding maximal oxygen uptake (55.7 ± 4.4 ml·min−1·kg−1 vs. 55.4 ± 4.6 ml·min−1·kg−1, p = 0.831). Our findings demonstrate a pattern of compromised respiratory function in post-COVID-19 athletes characterized by increased respiratory work at both rest and maximum effort as well as hyperventilation during exercise, which may explain the reported increased metabolic needs.
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Stavrou VT, Astara K, Tourlakopoulos KN, Papayianni E, Boutlas S, Vavougios GD, Daniil Z, Gourgoulianis KI. Obstructive Sleep Apnea Syndrome: The Effect of Acute and Chronic Responses of Exercise. Front Med (Lausanne) 2022; 8:806924. [PMID: 35004785 PMCID: PMC8738168 DOI: 10.3389/fmed.2021.806924] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 12/07/2021] [Indexed: 11/22/2022] Open
Abstract
Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder with high prevalence in general population, but alarmingly low in clinicians' differential diagnosis. We reviewed the literature on PubMed and Scopus from June 1980–2021 in order to describe the altered systematic pathophysiologic mechanisms in OSAS patients as well as to propose an exercise program for these patients. Exercise prevents a dysregulation of both daytime and nighttime cardiovascular autonomic function, reduces body weight, halts the onset and progress of insulin resistance, while it ameliorates excessive daytime sleepiness, cognitive decline, and mood disturbances, contributing to an overall greater sleep quality and quality of life.
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Affiliation(s)
- Vasileios T Stavrou
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Kyriaki Astara
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Konstantinos N Tourlakopoulos
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Eirini Papayianni
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Stylianos Boutlas
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - George D Vavougios
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Zoe Daniil
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Konstantinos I Gourgoulianis
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
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Eight Weeks Unsupervised Pulmonary Rehabilitation in Previously Hospitalized of SARS-CoV-2 Infection. J Pers Med 2021; 11:jpm11080806. [PMID: 34442450 PMCID: PMC8399744 DOI: 10.3390/jpm11080806] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of our study was to determine the impact of unsupervised Pulmonary Rehabilitation (uns-PR) on patients recovering from COVID-19, and determine its anthropometric, biological, demographic and fitness correlates. All patients (n = 20, age: 64.1 ± 9.9 years, 75% male) participated in unsupervised Pulmonary Rehabilitation program for eight weeks. We recorded anthropometric characteristics, pulmonary function parameters, while we performed 6 min walk test (6 MWT) and blood sampling for oxidative stress measurement before and after uns-PR. We observed differences before and after uns-PR during 6 MWT in hemodynamic parameters [systolic blood pressure in resting (138.7 ± 16.3 vs. 128.8 ± 8.6 mmHg, p = 0.005) and end of test (159.8 ± 13.5 vs. 152.0 ± 12.2 mmHg, p = 0.025), heart rate (5th min: 111.6 ± 16.9 vs. 105.4 ± 15.9 bpm, p = 0.049 and 6th min: 112.5 ± 18.3 vs. 106.9 ± 17.9 bpm, p = 0.039)], in oxygen saturation (4th min: 94.6 ± 2.9 vs. 95.8 ± 3.2%, p = 0.013 and 1st min of recovery: 97.8 ± 0.9 vs. 97.3 ± 0.9%), in dyspnea at the end of 6 MWT (1.3 ± 1.5 vs. 0.6 ± 0.9 score, p = 0.005), in distance (433.8 ± 102.2 vs. 519.2 ± 95.4 m, p < 0.001), in estimated O2 uptake (14.9 ± 2.4 vs. 16.9 ± 2.2 mL/min/kg, p < 0.001) in 30 s sit to stand (11.4 ± 3.2 vs. 14.1 ± 2.7 repetitions, p < 0.001)] Moreover, in plasma antioxidant capacity (2528.3 ± 303.2 vs. 2864.7 ± 574.8 U.cor., p = 0.027), in body composition parameters [body fat (32.2 ± 9.4 vs. 29.5 ± 8.2%, p = 0.003), visceral fat (14.0 ± 4.4 vs. 13.3 ± 4.2 score, p = 0.021), neck circumference (39.9 ± 3.4 vs. 37.8 ± 4.2 cm, p = 0.006) and muscle mass (30.1 ± 4.6 vs. 34.6 ± 7.4 kg, p = 0.030)] and sleep quality (6.7 ± 3.9 vs. 5.6 ± 3.3 score, p = 0.036) we observed differences before and after uns-PR. Our findings support the implementation of unsupervised pulmonary rehabilitation programs in patients following COVID-19 recovery, targeting the improvement of many aspects of long COVID-19 syndrome.
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