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Coombes BK, Sierra-Silvestre E, Bisset LM, Mielke GI, Ware RS, Coombes JS, Burton NW, Coppieters MW. Pain exacerbation following physical activity in adults with diabetic neuropathy: Ecological momentary assessment of foot symptoms. Aust J Gen Pract 2024; 53:93-98. [PMID: 38437648 DOI: 10.31128/ajgp-05-23-6821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND AND OBJECTIVES People with diabetic peripheral neuropathy (DPN) report fluctuating foot symptoms. This study used ecological momentary assessment to: (1) compare foot symptoms between days, time points and periods with/without preceding physical activity or pain medication; and (2) determine relationships between symptoms and endogenous pain modulation. METHOD Ten low-active Australian adults with probable DPN underwent temporal summation of pain (TSP) and conditioned pain modulation (CPM) then completed mobile phone surveys five times daily for seven days, where they recorded the intensity of six foot symptoms and whether they performed physical activity or consumed pain medication in the preceding three hours. RESULTS: All foot symptoms except numbness were greater in periods following physical activity, whereas periods following pain medication showed greater shooting pain. TSP showed very large correlations with sensitivity to touch, burning pain, shooting pain and prickling/tingling. DISCUSSION: General practitioners should be aware that physical activity might exacerbate symptoms of DPN when encouraging their patients to be active.
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Affiliation(s)
- Brooke K Coombes
- BPhty (Hons), MPhty (Musc), GCertHigherEd, PhD, Lecturer, School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, Qld; Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld
| | - Eva Sierra-Silvestre
- BSc Physiotherapy, MSc (MT), PhD, Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld
| | - Leanne M Bisset
- PhD, MPhty (ManipPhty), MPhty (Sports), BPhty, Associate Professor, School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, Qld; Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld
| | - Gregore Iven Mielke
- BPhysEd (Hons), MPhil, PhD, The University of Queensland, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, Brisbane, Qld
| | - Robert S Ware
- BSc (Hons1), PhD, Professor, School of Medicine and Dentistry, Griffith University, Brisbane, Qld; Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld
| | - Jeff S Coombes
- BAppSci, Bed (Hons), MEd, PhD, Professor, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Qld
| | - Nicola W Burton
- BSc (Hons), MPsych (Clinical), GCertHigherEd, PhD, Associate Professor, School of Applied Psychology, Griffith University, Brisbane, Qld; Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld; Research Fellow, Centre for Mental Health, Griffith University, Brisbane, Qld
| | - Michel W Coppieters
- BPT, PhD, Professor, School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, Qld; Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld; Professor, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
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Suebkinorn O, Ramos JS, Grace SL, Gebremichael LG, Bulamu N, Pinero de Plaza MA, Dafny HA, Pearson V, Hines S, Dalleck LC, Coombes JS, Hendriks JM, Clark RA, Beleigoli A. Effectiveness of alternative vs traditional exercises on cardiac rehabilitation program utilization in women with or at high risk of cardiovascular disease: a systematic review protocol. JBI Evid Synth 2024; 22:281-291. [PMID: 37435676 DOI: 10.11124/jbies-22-00394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
OBJECTIVE This review will evaluate the effectiveness of alternative vs traditional forms of exercise on cardiac rehabilitation program utilization and other outcomes in women with or at high risk of cardiovascular disease. INTRODUCTION Exercise-based cardiac rehabilitation programs improve health outcomes in women with or at high risk of cardiovascular disease. However, such programs are underutilized worldwide, particularly among women. Some women perceive traditional gym-based exercise in cardiac rehabilitation programs (eg, typically treadmills, cycle ergometers, traditional resistance training) to be excessively rigorous and unpleasant, resulting in diminished participation and completion. Alternative forms of exercise such as yoga, tai chi, qi gong, or Pilates may be more enjoyable and motivating exercise options for women, enhancing engagement in rehabilitation programs. However, the effectiveness of these alternative exercises in improving program utilization is still inconsistent and needs to be systematically evaluated and synthesized. INCLUSION CRITERIA This review will focus on randomized controlled trials of studies measuring the effectiveness of alternative vs traditional forms of exercise on cardiac rehabilitation program utilization as well as clinical, physiological, or patient-reported outcomes in women with or at high risk of cardiovascular disease. METHODS The review will follow the JBI methodology for systematic reviews of effectiveness. Databases including MEDLINE (Ovid), CINAHL (EBSCOhost), Cochrane CENTRAL, Embase (Ovid), Emcare (Ovid), Scopus, Web of Science, LILACS, and PsycINFO (Ovid) will be searched. Two independent reviewers will screen articles and then extract and synthesize data. Methodological quality will be assessed using JBI's standardized instruments. GRADE will be used to determine the certainty of evidence. REVIEW REGISTRATION PROSPERO CRD42022354996.
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Affiliation(s)
- Orathai Suebkinorn
- Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
| | - Joyce S Ramos
- Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
| | - Sherry L Grace
- Faculty of Health, York University, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute & Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Lemlem G Gebremichael
- Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
| | - Norma Bulamu
- Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
| | - Maria Alejandra Pinero de Plaza
- Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
- National Health and Medical Research Council, Transdisciplinary Centre of Research Excellence in Frailty and Healthy Ageing, Adelaide, SA, Australia
| | - Hila A Dafny
- Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
| | - Vincent Pearson
- Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Sonia Hines
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
- Flinders Rural and Remote Health NT, Alice Springs, NT, Australia
| | - Lance C Dalleck
- Recreation, Exercise, and Sport Science Department, Western Colorado University, Gunnison, CO, USA
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Jeroen M Hendriks
- Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
- Centre for Heart Rhythm Disorders, The University of Adelaide and the Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Robyn A Clark
- Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
| | - Alline Beleigoli
- Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Mparntwe Centre for Evidence in Health, Flinders University: A JBI Centre of Excellence, Alice Springs, NT, Australia
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Grainger SA, Henry JD, Alister M, Bourdaniotis XE, Mead J, Bailey TG, Coombes JS, Vear N. Cardiorespiratory Fitness and Muscular Strength Do Not Predict Social Cognitive Capacity in Older Age. J Gerontol B Psychol Sci Soc Sci 2023; 78:1824-1833. [PMID: 37480568 PMCID: PMC10645310 DOI: 10.1093/geronb/gbad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVES Social cognitive function often declines in older age but the mechanisms underlying these declines are not completely clear. Cardiorespiratory fitness (CRF) and muscular strength are positively associated with broader cognitive function in older adults, yet surprisingly, no study has examined whether a similar relationship exists between CRF or muscular strength and social cognition in older age. METHODS We assessed whether higher CRF and muscular strength were associated with enhanced social cognitive function in a sample of fifty older adults (Mage = 70.08, standard deviation = 3.93). Participants completed a gold-standard cardiopulmonary exercise test to assess CRF, an isometric handgrip strength test to index muscular strength, and validated measures of social cognition to index emotion perception and theory of mind (ToM). RESULTS The results showed that CRF and muscular strength did not explain any unique variance in older adults' social cognitive performance. Bayesian analyses confirmed that the evidence for the null hypothesis was moderate for all tested relationships, except for the relationship between CRF and cognitive ToM where the evidence for the null was anecdotal. DISCUSSION This study has provided the first evidence to suggest that CRF and muscular strength-two important modifiable lifestyle factors-are not associated with social cognition in healthy older adults. However, replication studies are now needed to cross-validate these findings and to clarify whether any moderating variables may be important for understanding the relationship between fitness and social cognition in older age.
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Affiliation(s)
- Sarah A Grainger
- School of Psychology, University of Queensland, St Lucia, Queensland, Australia
| | - Julie D Henry
- School of Psychology, University of Queensland, St Lucia, Queensland, Australia
| | - Manikya Alister
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Jessica Mead
- School of Psychology, University of Queensland, St Lucia, Queensland, Australia
| | - Tom G Bailey
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
- School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Natalie Vear
- School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia
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Davids CJ, Roberts LA, Bjørnsen T, Peake JM, Coombes JS, Raastad T. Where Does Blood Flow Restriction Fit in the Toolbox of Athletic Development? A Narrative Review of the Proposed Mechanisms and Potential Applications. Sports Med 2023; 53:2077-2093. [PMID: 37578669 PMCID: PMC10587223 DOI: 10.1007/s40279-023-01900-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/15/2023]
Abstract
Blood flow-restricted exercise is currently used as a low-intensity time-efficient approach to reap many of the benefits of typical high-intensity training. Evidence continues to lend support to the notion that even highly trained individuals, such as athletes, still benefit from this mode of training. Both resistance and endurance exercise may be combined with blood flow restriction to provide a spectrum of adaptations in skeletal muscle, spanning from myofibrillar to mitochondrial adjustments. Such diverse adaptations would benefit both muscular strength and endurance qualities concurrently, which are demanded in athletic performance, most notably in team sports. Moreover, recent work indicates that when traditional high-load resistance training is supplemented with low-load, blood flow-restricted exercise, either in the same session or as a separate training block in a periodised programme, a synergistic and complementary effect on training adaptations may occur. Transient reductions in mechanical loading of tissues afforded by low-load, blood flow-restricted exercise may also serve a purpose during de-loading, tapering or rehabilitation of musculoskeletal injury. This narrative review aims to expand on the current scientific and practical understanding of how blood flow restriction methods may be applied by coaches and practitioners to enhance current athletic development models.
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Affiliation(s)
- Charlie J Davids
- Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia.
| | - Llion A Roberts
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Thomas Bjørnsen
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
| | - Jonathan M Peake
- Sport Performance Innovation and Knowledge Excellence (SPIKE), Queensland Academy of Sport, Brisbane, QLD, Australia
- School of Biomedical Science, Queensland University of Technology, Brisbane, QLD, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Truls Raastad
- Norwegian Olympic and Paralympic Committee and Confederation of Sports, Oslo, Norway
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
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Coombes BK, Bisset LM, Sierra-Silvestre E, Ware RS, Coppieters MW, Coombes JS, Burton NW. Personal Activity Intelligence eHealth intervention in people with diabetic peripheral neuropathy: A feasibility study. Aust J Gen Pract 2023; 52:771-777. [PMID: 37935148 DOI: 10.31128/ajgp-04-23-6797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
BACKGROUND AND OBJECTIVES People with diabetic peripheral neuropathy (DPN) report difficulty exercising. This study tested an innovative intervention to promote physical activity self-management and its impact on foot symptoms. METHOD Ten adults with DPN not meeting exercise guidelines consented to four weekly sessions involving exercise tasters, behaviour change counselling and Physical Activity Intelligence (PAI) self-monitoring, with a goal to maintain daily PAI scores ≥100. Foot symptoms were assessed using repeated mobile phone surveys at 0 and 12 weeks. RESULTS Participants attended a mean 3.5 sessions and achieved 100 PAI on 53% and 15% of days during Weeks 2-4 and 5-12, respectively. No major adverse events and large reductions in aching (P=0.02) and burning pain (P=0.03) in the feet were recorded. DISCUSSION The PAI eHealth intervention was feasible and safe and might reduce foot symptoms. More work is needed to support self-directed exercise maintenance.
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Affiliation(s)
- Brooke K Coombes
- BPhty (Hons), MPhty (Musc), GCertHigherEd, PhD, Lecturer, School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, Qld; Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld
| | - Leanne M Bisset
- PhD, MPhty (ManipPhty), MPhty (Sports), BPhty, Associate Professor, School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, Qld; Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld
| | - Eva Sierra-Silvestre
- BSc Physiotherapy, MSc (MT), PhD, Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld
| | - Robert S Ware
- BSc (Hons1), PhD, Professor, School of Medicine and Dentistry, Griffith University, Brisbane, Qld; Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld
| | - Michel W Coppieters
- BPT, PhD, Professor, School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, Qld; Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld; Adjunct Professor, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam
| | - Jeff S Coombes
- BAppSci, Bed (Hons), MEd, PhD, Professor, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Qld
| | - Nicola W Burton
- BSc (Hons), MPsych (Clinical), GCertHigherEd, PhD, Associate Professor, School of Applied Psychology, Griffith University, Brisbane, Qld; Research Fellow, Menzies Health Institute Queensland, Brisbane and Gold Coast, Qld; Research Fellow, Centre for Mental Health, Griffith University, Brisbane, Qld
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Feter N, Schaun GZ, Smith EC, Cassuriaga J, Alt R, Redig L, Alberton CL, Coombes JS, Rombaldi AJ. High-velocity resistance training improves executive function in mobility-limited older adults. Arch Gerontol Geriatr 2023; 114:105081. [PMID: 37269697 DOI: 10.1016/j.archger.2023.105081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To examine the effect of high-velocity resistance training (HVRT) on the executive function of middle-aged and older adults with and without mobility limitations. METHODS Participants (n = 41, female: 48.9%) completed a supervised 12-week HVRT intervention (2 sessions/week; at 40-60% of one-repetition maximum). The sample included 17 middle-aged adults (40-55 years); 16 older adults (>60 years) and 8 mobility-limited older adults (LIM). Executive function was assessed before and after the intervention period and was reported as z-scores. Maximal dynamic strength, peak power, quadriceps muscle thickness, maximal isometric voluntary contraction (MVIC), and functional performance were also measured pre and post intervention. Training-related adaptations in cognitive measures were calculated using a Generalized Estimating Equation model. RESULTS HVRT improved executive function in LIM (adjusted marginal mean differences [AMMD]: 0.21; 95%CI: 0.04, 0.38; p = 0.040) although no effect on middle-aged (AMMD: 0.04; 95%CI: -0.09; 0.17; p = 0.533) and older (AMMD: -0.11; 95%CI: -0.25; 0.02; p = 0.107) participants was observed. Improvements in maximal dynamic strength, peak power, MVIC, quadriceps muscle thickness, and functional performance were all associated with changes in executive function, and changes in the first four also seem to mediate the association between changes in functional performance and executive function. CONCLUSIONS HVRT-induced improvement in executive function of mobility-limited older adults were mediated by changes in lower-body muscle strength, power, and muscle thickness. Our findings reinforce the relevance of muscle-strengthening exercises to preserve cognition and mobility in older adults.
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Affiliation(s)
- Natan Feter
- Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Gustavo Z Schaun
- Neuromuscular Assessment Laboratory, Federal University of Pelotas, Pelotas, Brazil; Centre for Sport Science and University Sports, University of Vienna, 1150 Vienna, Austria
| | - Emily C Smith
- Centre of Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, Australia
| | - Júlia Cassuriaga
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Ricardo Alt
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Larissa Redig
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Cristine Lima Alberton
- Neuromuscular Assessment Laboratory, Federal University of Pelotas, Pelotas, Brazil; Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Jeff S Coombes
- Centre of Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, Australia
| | - Airton J Rombaldi
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
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Keating SE, Croci I, Wallen MP, Cox ER, Coombes JS, Burton NW, Macdonald GA, Hickman IJ. High-intensity Interval Training for the Management of Nonalcoholic Steatohepatitis: Participant Experiences and Perspectives. J Clin Transl Hepatol 2023; 11:1050-1060. [PMID: 37577222 PMCID: PMC10412696 DOI: 10.14218/jcth.2022.00091s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/10/2023] [Accepted: 02/15/2023] [Indexed: 07/03/2023] Open
Abstract
Background and Aims High-intensity interval training (HIIT) is a therapeutic option for people with nonalcoholic steatohepatitis (NASH). However, the perspectives and experiences of HIIT for people with NASH are unknown, limiting translation of research. We explored the experiences and perspectives of both professionally supervised and self-directed HIIT in people with NASH and evaluated participant-reported knowledge, barriers, and enablers to commencing and sustaining HIIT. Methods Twelve participants with NASH underwent 12 weeks of supervised HIIT (3 days/week, 4×4 minutes at 85-95% maximal heart rate, interspersed with 3 minutes active recovery), followed by 12-weeks of self-directed (unsupervised) HIIT. One-on-one, semistructured participant interviews were conducted by exercise staff prior to HIIT and following both supervised and self-directed HIIT to explore prior knowledge, barriers, enablers, and outcomes at each stage. Interviews were audio-recorded, transcribed, coded, and thematically analyzed by two independent researchers. Results Four dominant themes were identified: (1) no awareness of/experience with HIIT and ambivalence about exercise capabilities; (2) multiple medical and social barriers to commencing and continuing HIIT; (3) exercise specialist support was a highly valued enabler, and (4) HIIT was enjoyed and provided holistic benefits. Conclusions People with NASH may lack knowledge of and confidence for HIIT, and experience multiple complex barriers to commencing and continuing HIIT. Exercise specialist support is a key enabler to sustained engagement. These factors need to be addressed in future clinical programs to augment the uptake and long-term sustainability of HIIT by people with NASH so they can experience the range of related benefits.
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Affiliation(s)
- Shelley E. Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Ilaria Croci
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- K.G. Jebsen Center of Exercise in Medicine Norwegian University of Science and Technology, Department of Circulation and Medical Imaging, Faculty of Medicine, Trondheim, Norway
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Matthew P. Wallen
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Institute of Health and Wellbeing, Federation University, Mount Helen, Australia
| | - Emily R. Cox
- School of Environmental and Life Sciences, University of Newcastle, Ourimbah, Australia
| | - Jeff S. Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Nicola W. Burton
- School of Applied Psychology, Griffith University, Mt Gravatt, Australia
- Menzies Health Institute, Griffith University, Gold Coast, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Graeme A. Macdonald
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Ingrid J. Hickman
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
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de Zoete RMJ, Nikles J, Coombes JS, Onghena P, Sterling M. The effectiveness of aerobic versus strengthening exercise therapy in individuals with chronic whiplash-associated disorder: a randomised single case experimental design study. Disabil Rehabil 2023; 45:3519-3528. [PMID: 36173391 DOI: 10.1080/09638288.2022.2127937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 09/18/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Recent RCTs and meta-analyses compare the effectiveness of different types of exercise for chronic whiplash associated disorder (WAD). This study aimed to verify whether the results of these studies translate to statistically significant and clinically meaningful effects in individual participants. MATERIALS AND METHODS A series of replicated randomised single case experimental design studies (SCEDs) with A-B design (A: baseline, B: intervention). Eight participants with chronic WAD (8 female, mean [SD] age 47 [10] years) were randomised into one of four baseline durations (5, 8, 11, and 14 days) and to one of two eight-week exercise interventions (aerobic or strengthening). Daily measures of pain intensity, bothersomeness, and interference were collected during the baseline phase and the intervention phase. RESULTS Visual analyses indicated that three participants in the aerobic exercise group meaningfully improved. No improvements were found in the strengthening group. Effect sizes favoured the aerobic exercise group, yet randomisation tests of pooled effects did not show a difference in between-intervention effectiveness. CONCLUSION Contrary to our expectations, three out of four participants were nearly pain-free at the end of the aerobic exercise intervention, whereas none of the participants in the strengthening group improved meaningfully. This suggests that aerobic exercise may be favourable for WAD.Implications for RehabilitationOur results suggest that aerobic exercises are favourable over strengthening exercises and may be the preferred option for patients with chronic WAD.We found substantial variability in self-reported outcomes within participants, clinicians should be aware of this in the judgement of treatment effectiveness.
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Affiliation(s)
- Rutger M J de Zoete
- Recover Injury Research Centre, NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, Australia
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, Australia
| | - Jane Nikles
- Recover Injury Research Centre, NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Patrick Onghena
- Research Unit on Methods, Individual and Cultural Differences, Affect and Social Behaviour, Faculty of Psychology and Educational Sciences, Leuven, Belgium
| | - Michele Sterling
- Recover Injury Research Centre, NHMRC Centre of Research Excellence: Better Health Outcomes for Compensable Injury, The University of Queensland, Herston, Australia
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Gilson ND, Mielke GI, Coombes JS, Duncan MJ, Brown WJ. The Efficacy and Feasibility of a High Intensity Interval Training Program to Improve Cardiorespiratory Fitness in Truck Drivers: The Fit 2 Drive Cluster Controlled Pilot Study. J Occup Environ Med 2023; 65:836-840. [PMID: 37367634 DOI: 10.1097/jom.0000000000002914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE This cluster-controlled pilot study assessed the efficacy and feasibility of "Fit 2 Drive," a depot-delivered, high-intensity interval training (HIIT) program to improve the cardiorespiratory fitness (CRF) of truck drivers. METHODS Companies of local delivery drivers (44 men; mean [SD] age = 50.5 [9.8] years; Brisbane, Australia) were assigned to "Fit 2 Drive" (4 clusters; 27 drivers; 1 × 4 minutes supervised to self-managed HIIT, 3 times a week, 12 weeks) or a control (5 clusters; 17 drivers). Analyses assessed between group changes in CRF (VO 2peak ), HIIT session attendance, and delivery costs. RESULTS Driver clusters allocated to "Fit 2 Drive" significantly improved CRF compared to a control (mean difference of 3.6 mL·kg -1 ·min -1 ; P < 0.019; 95% confidence interval = 0.7-6.5 mL·kg -1 ·min -1 ). Drivers who completed the program attended 70% of sessions (25/36) with delivery costs averaging $710 AUD per driver. CONCLUSIONS The findings support the efficacy and feasibility of Fit 2 Drive but also highlight challenges for in-person delivery at scale.
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Affiliation(s)
- Nicholas D Gilson
- From the University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia (N.D.G., G.I.M., W.J.B.); The University of Queensland, School of Public Health, Herston Campus, Brisbane, Australia (G.I.M.); School of Medicine and Public Health; Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia (M.J.D.); and Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, Australia (M.J.D.)
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10
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de Zoete RMJ, McMahon KL, Coombes JS, Sterling M. The effects of physical exercise on structural, functional, and biochemical brain characteristics in individuals with chronic whiplash-associated disorder: A pilot randomized clinical trial. Pain Pract 2023; 23:759-775. [PMID: 37157897 DOI: 10.1111/papr.13240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/01/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Exercise for people with whiplash associated disorder (WAD) induces hypoalgesic effects in some, but hyperalgesic effects in others. We investigated the exercise-induced neurobiological effects of aerobic and strengthening exercise in individuals with chronic WAD. METHODS Sixteen participants (8 WAD, 8 pain-free [CON]) were randomised to either aerobic or strengthening exercise. MRI for brain morphometry, functional MRI for brain connectivity, and magnetic resonance spectroscopy for brain biochemistry, were used at baseline and after the 8-week intervention. RESULTS There were no differences in brain changes between exercise groups in either the WAD or CON group, therefore aerobic and strengthening data were combined to optimise sample size. After the exercise intervention, the CON group demonstrated increased cortical thickness (left parahippocampus: mean difference = 0.04, 95% CI = 0.07-0.00, p = 0.032; and left lateral orbital frontal cortex: mean difference = 0.03, 95% CI = 0.00-0.06, p = 0.048). The WAD group demonstrated an increase in prefrontal cortex (right medial orbital frontal) volume (mean difference = 95.57, 95% CI = 2.30-192.84, p = 0.046). Functional changes from baseline to follow-up between the default mode network and the insula, cingulate cortex, temporal lobe, and somatosensory and motor cortices, were found in the CON group, but not in the WAD group. There were no changes post-exercise in brain biochemistry. CONCLUSION Aerobic and strengthening exercises did not exert differential effects on brain characteristics, however differences in structural and functional changes were found between WAD and CON groups. This suggests that an altered central pain modulatory response may be responsible for differential effects of exercise in individuals with chronic WAD.
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Affiliation(s)
- Rutger M J de Zoete
- Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Brisbane, Queensland, Australia
- School of Allied Health Science and Practice, The University of Adelaide, Adelaide, South Australia, Australia
| | - Katie L McMahon
- Herston Imaging Research Facility, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
- School of Clinical Sciences, Faculty of Health, Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Michele Sterling
- Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Brisbane, Queensland, Australia
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11
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Sabag A, Chang CR, Francois ME, Keating SE, Coombes JS, Johnson NA, Pastor-Valero M, Rey Lopez JP. The Effect of Exercise on Quality of Life in Type 2 Diabetes: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2023; 55:1353-1365. [PMID: 36924331 DOI: 10.1249/mss.0000000000003172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Exercise is a proven therapy for managing cardiometabolic risk factors in type 2 diabetes (T2D). However, its effects on patient-reported outcome measures such as quality of life (QoL) in people with T2D remain unclear. Consequently, the primary aim of this study was to determine the effect of regular exercise on QoL in adults with T2D. A secondary aim was to determine the effect of different exercise modalities on QoL. The third aim was to determine whether improvements in QoL were associated with improvements in gly'cated hemoglobin (A1C). METHODS Relevant databases were searched to May 2022. Eligible studies included randomized trials involving ≥2 wk of aerobic and/or resistance exercise and assessed QoL using a purpose-specific tool. Mean differences and 95% confidence intervals (CI) were calculated as standardized mean difference (SMD) or weighted mean difference. A regression analysis was undertaken to examine the interaction between change in QoL with change in A1C. RESULTS Of the 12,642 studies retrieved, 29 were included involving 2354 participants. Exercise improved QoL when compared with control (SMD, 0.384; 95% CI, 0.257 to 0.512; P < 0.001). Aerobic exercise, alone (SMD, 0.475; 95% CI, 0.295 to 0.655; P < 0.001) or in combination with resistance training (SMD, 0.363; 95% CI, 0.179 to 0.548; P < 0.001) improved QoL, whereas resistance training alone did not. Physical components of health-related QoL (HRQoL) improved with all exercise modalities, but mental components of HRQoL remained unchanged. Exercise improved A1C (mean difference, -0.509%; 95% CI, -0.806% to -0.212%; P = 0.001), and this change was associated with improvements in HRQoL ( β = -0.305, SE = 0.140, Z = -2.18, P = 0.030). CONCLUSIONS These results provide robust evidence that regular aerobic exercise alone or in combination with resistance training is effective for improving QoL in adults with T2D. Such improvements seem to be mediated by improvements in physical components of HRQoL and are associated with improved blood glucose control. Further studies should be undertaken to determine the relative importance of exercise duration, intensity, and frequency on patient-reported outcomes such as QoL.
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Affiliation(s)
| | - Courtney R Chang
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, AUSTRALIA
| | - Monique E Francois
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, AUSTRALIA
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, 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, Brisbane, Queensland, AUSTRALIA
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12
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D'Souza RF, Figueiredo VC, Markworth JF, Zeng N, Hedges CP, Roberts LA, Raastad T, Coombes JS, Peake JM, Mitchell CJ, Cameron‐Smith D. Cold water immersion in recovery following a single bout resistance exercise suppresses mechanisms of miRNA nuclear export and maturation. Physiol Rep 2023; 11:e15784. [PMID: 37549955 PMCID: PMC10406566 DOI: 10.14814/phy2.15784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/09/2023] Open
Abstract
Cold water immersion (CWI) following intense exercise is a common athletic recovery practice. However, CWI impacts muscle adaptations to exercise training, with attenuated muscle hypertrophy and increased angiogenesis. Tissue temperature modulates the abundance of specific miRNA species and thus CWI may affect muscle adaptations via modulating miRNA expression following a bout of exercise. The current study focused on the regulatory mechanisms involved in cleavage and nuclear export of mature miRNA, including DROSHA, EXPORTIN-5, and DICER. Muscle biopsies were obtained from the vastus lateralis of young males (n = 9) at rest and at 2, 4, and 48 h of recovery from an acute bout of resistance exercise, followed by either 10 min of active recovery (ACT) at ambient temperature or CWI at 10°C. The abundance of key miRNA species in the regulation of intracellular anabolic signaling (miR-1 and miR-133a) and angiogenesis (miR-15a and miR-126) were measured, along with several gene targets implicated in satellite cell dynamics (NCAM and PAX7) and angiogenesis (VEGF and SPRED-1). When compared to ACT, CWI suppressed mRNA expression of DROSHA (24 h p = 0.025 and 48 h p = 0.017), EXPORTIN-5 (24 h p = 0.008), and DICER (24 h p = 0.0034). Of the analyzed miRNA species, miR-133a (24 h p < 0.001 and 48 h p = 0.007) and miR-126 (24 h p < 0.001 and 48 h p < 0.001) remained elevated at 24 h post-exercise in the CWI trial only. Potential gene targets of these miRNA, however, did not differ between trials. CWI may therefore impact miRNA abundance in skeletal muscle, although the precise physiological relevance needs further investigation.
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Affiliation(s)
- Randall F. D'Souza
- Liggins InstituteThe University of AucklandAucklandNew Zealand
- Discipline of NutritionThe University of AucklandAucklandNew Zealand
- Maurice Wilkins Centre for Molecular BiodiscoveryThe University of AucklandAucklandNew Zealand
| | - Vandre C. Figueiredo
- Liggins InstituteThe University of AucklandAucklandNew Zealand
- Department of Biological SciencesOakland UniversityRochesterMichiganUSA
| | - James F. Markworth
- Liggins InstituteThe University of AucklandAucklandNew Zealand
- Department of Animal SciencePurdue UniversityWest LafayetteIndianaUSA
| | - Nina Zeng
- Liggins InstituteThe University of AucklandAucklandNew Zealand
- Department of PhysiologyThe University of AucklandAucklandNew Zealand
| | - Christopher P. Hedges
- Discipline of NutritionThe University of AucklandAucklandNew Zealand
- Maurice Wilkins Centre for Molecular BiodiscoveryThe University of AucklandAucklandNew Zealand
| | - Llion A. Roberts
- School of Human Movement and Nutrition SciencesUniversity of QueenslandBrisbaneQueenslandAustralia
- Sports Performance Innovation and Knowledge ExcellenceQueensland Academy of SportBrisbaneQueenslandAustralia
- School of Health Sciences and Social WorkGriffith UniversityGold CoastQueenslandAustralia
| | - Truls Raastad
- Department of Physical PerformanceNorwegian School of Sport SciencesOsloNorway
| | - Jeff S. Coombes
- School of Human Movement and Nutrition SciencesUniversity of QueenslandBrisbaneQueenslandAustralia
| | - Jonathan M. Peake
- Sports Performance Innovation and Knowledge ExcellenceQueensland Academy of SportBrisbaneQueenslandAustralia
- School of Biomedical SciencesQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Cameron J. Mitchell
- Liggins InstituteThe University of AucklandAucklandNew Zealand
- School of KinesiologyUniversity of British ColombiaVancouverBritish ColumbiaCanada
| | - David Cameron‐Smith
- Liggins InstituteThe University of AucklandAucklandNew Zealand
- College of Engineering, Science and EnvironmentUniversity of NewcastleCallaghanNew South WalesAustralia
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13
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Weston ME, Barker AR, Tomlinson OW, Coombes JS, Bailey TG, Bond B. Agreement between left and right middle cerebral artery blood velocity responses to incremental and constant work-rate exercise in healthy males and females. Physiol Meas 2023; 44:074001. [PMID: 37406643 DOI: 10.1088/1361-6579/ace49d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/05/2023] [Indexed: 07/07/2023]
Abstract
Objective.To quantify the agreement between left and right middle cerebral artery blood velocity (MCAv) responses to incremental and constant work-rate exercise in adults.ApproachSeventeen healthy adults (23.8 ± 2.4 years, 9 females) completed a ramp incremental test to exhaustion on a cycle ergometer, three 6-minute transitions at a moderate-intensity, and three at a heavy-intensity, all on separate days. Bilateral MCAv was measured throughout using transcranial Doppler ultrasonography, with left and right MCAv data analysed separately. Data were analysed at baseline, gas exchange threshold, respiratory compensation point and exhaustion during ramp incremental exercise. MCAv responses to constant work-rate exercise were analysed using a mono-exponential model, to determine time- and amplitude-based kinetic response parameters.Main ResultsLeft and right MCAv responses to incremental and constant work-rate exercise were significantly, strongly and positively correlated (r≥ 0.61,P< 0.01). Coefficient of variation (left versus right) ranged from 7.3%-20.7%, 6.4%-26.2% and 5.9%-22.5% for ramp, moderate and heavy-intensity exercise, respectively. The relative change in MCAv from baseline was higher in the right compared to left MCAv during ramp, moderate and heavy-intensity exercise (allP< 0.05), but the effect sizes were small (d≤ 0.4). Small mean left-right differences were present during ramp incremental exercise at all time-points (<6 cm s-1; <4%), and for all kinetic parameters during moderate and heavy-intensity exercise (<3 cm s-1, <3%, <4 s).SignificanceThese findings demonstrate similarities between left and right MCAv responses to incremental and constant-work rate exercise in adults on a group-level, but also highlight individual variation in the agreement between left and right MCAv exercise responses.
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Affiliation(s)
- Max E Weston
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Owen W Tomlinson
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- School of Nursing Midwifery and Social Work, The University of Queensland, Brisbane, Australia
| | - Bert Bond
- Children's Health and Exercise Research Centre, Public Health and Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
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14
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Coombes JS, Dias KA, Lal R, Fassett RG, Wallen MP, Ramos JS, Russell S, Vear NK, Gajanand T, Bailey TG, Green DJ, Coombes BK, Roberts LA. Efficacy of two doses of external counterpulsation (ECP) on glycemic control in people with type 2 diabetes mellitus: A randomized SHAM-controlled trial. Diabetes Res Clin Pract 2023; 200:110701. [PMID: 37172647 DOI: 10.1016/j.diabres.2023.110701] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/12/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023]
Abstract
AIMS To determine the efficacy of two doses of external counterpulsation (ECP) on glycemic control in people with type 2 diabetes mellitus (T2D), and any persistent benefits 7 weeks following treatment. METHODS 50 participants with T2D were randomly assigned to either 1) 20x45-minute ECP sessions over 7 weeks (ECP45), 2) 20x30-minute ECP sessions over 7 weeks (ECP30) or 3) SHAM control. Outcomes were assessed at baseline, after 7 weeks of the intervention and 7 weeks after the interventions finished. Efficacy was determined from changes in HbA1c. RESULTS After 7 weeks, there were significant between-group differences, with ECP45 lowering HbA1c compared to SHAM (mean [95% CI] -0.7 [-0.1 to -1.3] %; -7 [-1 to -15] mmol/mol). Within group changes were; ECP45 (mean±SD -0.8±0.8%; -8±8 mmol/mol), ECP30 (-0.2±0.5%; -2±6 mmol/mol) and SHAM (-0.1±0.9%; -1±10 mmol/mol). HbA1c in the ECP45 group remained lower 7 weeks after completing the intervention; ECP45 (7.0±1.1%; 53±26 mmol/mol), ECP30 (7.7±1.4%; 60±16 mmol/mol) and SHAM (7.7±1.0%; 60±10 mmol/mol). CONCLUSIONS In people with T2D, ECP45 for 7 weeks improved glycemic control when compared to ECP30 and a SHAM control group.
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Affiliation(s)
- Jeff S Coombes
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
| | - Katrin A Dias
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
| | - Ravin Lal
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
| | - Robert G Fassett
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
| | - Matthew P Wallen
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
| | - Joyce S Ramos
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
| | - Suzanna Russell
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
| | - Natalie K Vear
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
| | - Trishan Gajanand
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
| | - Tom G Bailey
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
| | - Daniel J Green
- Department of Exercise and Sport Science, School of Human Sciences, The University of Western Australia, Perth, Western Australia, Australia.
| | - Brooke K Coombes
- School of Health Sciences and Social Work, Griffith University, Brisbane, Australia.
| | - Llion A Roberts
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia.
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15
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Vear NK, Moon Y, Mielke GI, Skinner TL, Coombes JS, McCarthy AL, Abbott CR, Bailey TG. Efficacy of exercise training for improving vascular dysfunction in people with cancer: a systematic review with meta-analyses. J Cancer Surviv 2023:10.1007/s11764-023-01372-7. [PMID: 37079184 DOI: 10.1007/s11764-023-01372-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/23/2023] [Indexed: 04/21/2023]
Abstract
PURPOSE Cancer treatments exert vascular toxic effects that can lead to the development of cardiovascular disease. Exercise training has the potential to prevent or reduce cancer treatment-induced damage to vascular structure and function. This systematic review with meta-analyses aimed to determine the isolated effects of exercise training on vascular outcomes in people with cancer. METHODS Seven electronic databases were searched on 20 September 2021 to identify randomised controlled trials, quasi-randomised trials, pilot and cohort studies. Included studies implemented a structured exercise intervention and assessed vascular structure and/or function in people during or following cancer treatment. Meta-analyses examined the effects of exercise training on endothelial function (via brachial artery flow-mediated dilation) and arterial stiffness (via pulse wave velocity). Methodological quality was assessed using the Cochrane Quality Assessment tool and modified Newcastle-Ottawa Quality Appraisal tool. Grading of Recommendations, Assessment, Development and Evaluations framework was used to assess the certainty of evidence. RESULTS Ten studies (discussed across 11 articles) met the inclusion criteria. Methodological quality of the included studies was moderate (71% average). Exercise improved vascular function when compared to control (standardised mean difference = 0.34, 95% CI (0.01, 0.67); p = 0.044: studies = 5, participants = 171), but not pulse wave velocity (standardised mean difference = - 0.64, 95% CI (- 1.29, 0.02); p = 0.056: studies = 4, participants = 333). The certainty of evidence was moderate for flow-mediated dilation and low for pulse wave velocity. CONCLUSIONS Compared to usual care, exercise training significantly improves flow-mediated dilation (endothelial function) but not pulse wave analysis, in people treated for cancer. IMPLICATIONS FOR CANCER SURVIVORS Exercise may improve vascular health in individuals during and following cancer treatment.
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Affiliation(s)
- Natalie K Vear
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia.
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia.
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia.
| | - Yubin Moon
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Herston, Queensland, 4006, Australia
| | - Tina L Skinner
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
- Mater Research Institute, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, Queensland, 4101, Australia
| | - Claudia R Abbott
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
| | - Tom G Bailey
- School of Nursing, Midwifery and Social Work, The University of Queensland, Level 3, Chamberlain Building (35), St Lucia, Queensland, 4072, Australia
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Level 2, Connell Building (26), St Lucia, Queensland, 4072, Australia
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16
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Koep JL, Bond B, Barker AR, Ruediger SL, Pizzey FK, Coombes JS, Bailey TG. Sex modifies the relationship between age and neurovascular coupling in healthy adults. J Cereb Blood Flow Metab 2023:271678X231167753. [PMID: 37017422 PMCID: PMC10369153 DOI: 10.1177/0271678x231167753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Neurovascular coupling (NVC) is the matching between local neuronal activity and regional cerebral blood flow (CBF), but little is known about the effects of age and sex on NVC. This study aimed to investigate the relationships and interaction between age and sex on NVC. Sixty-four healthy adults (18-85 years, N = 34 female) completed a visual stimulus evoked NVC assessment to a flashing checkerboard. NVC responses were measured in the posterior cerebral artery (PCAv) using transcranial Doppler ultrasound. A hierarchical multiple regression was used to determine the relationships between age, sex, and the age by sex interaction on NVC. There was a significant age by sex interaction for baseline (P = 0.001) and peak PCAv (P = 0.01), with a negative relationship with age in females (P < 0.005), and no relationship in males (P ≥ 0.17). NVC responses as a percent increase from baseline showed a significant age by sex interaction (P = 0.014), with a positive relationship with age in females (P = 0.04) and no relationship in males (P = 0.17), even after adjusting for baseline PCAv. These data highlight important sex differences, with an association between age and NVC only apparent in females but not males, and thus a need to account for sex dependent effects of ageing when investigating cerebrovascular regulation.
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Affiliation(s)
- Jodie L Koep
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Stefanie L Ruediger
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Faith K Pizzey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia
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17
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Gilson ND, Andersson D, Papinczak ZE, Rutherford Z, John J, Coombes JS, Brown WJ. High intensity and sprint interval training, and work-related cognitive function in adults: A systematic review. Scand J Med Sci Sports 2023; 33:814-833. [PMID: 36916717 DOI: 10.1111/sms.14349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 09/06/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVES To assess evidence on the impact of acute and chronic high intensity interval training (HIIT) and sprint interval training (SIT) on work-related performance tests of cognitive function in adults. METHODS The databases PubMed, CINAHL, Scopus, PsycINFO, Embase and the Cochrane Library were searched for relevant articles up to August 2022. Eligible studies assessed the effects of HIIT (70-100% VO2max ) and/or SIT (≥100% VO2max ) on cognitive function test scores in cognitively healthy adults, relative to a control or comparative exercise group/condition. Data on participant characteristics, exercise protocol, key outcomes and intervention setting were extracted. Study quality was assessed using a 9 (single session HIIT/SIT) and 14 (multiple session HIIT/SIT) item checklist. RESULTS 36 studies (15 countries; n=11 to 945 participants) met inclusion criteria. Mean quality scores were 'fair-to-good' for acute (single session; mean=6.9 [SD 1.0]), and chronic (multiple session; mean=9.8 [SD 1.6]) training studies. Eighteen from 36 studies (12/20 [55%] acute and 6/16 [38%] chronic training studies) evidenced significant improvements in aspects of cognitive function related to work performance (i.e., attention, inhibition, memory, information processing speed, cognitive flexibility, intelligence, reaction time and learning). Only four studies tested the impact of HIIT/SIT on cognitive function in a work-based setting (e.g., the office or home). CONCLUSIONS While there is promising evidence, particularly from acute training studies, to indicate that high intensity, short duration exercise benefits cognitive function in adults, there is very limited evidence of application in workplace contexts. To better understand the potential benefits to employee performance and safety, HIIT/SIT and cognitive function research needs to transition from laboratory to 'in-situ' occupational settings.
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Affiliation(s)
- Nicholas D Gilson
- The University of Queensland, Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Dan Andersson
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Zoe E Papinczak
- The University of Queensland, Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Zoe Rutherford
- The University of Queensland, Queensland Centre for Menal Health Research, School of Public Health, Brisbane, Australia
| | - Julie John
- The University of Queensland, Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia.,The University of Queensland, Queensland Centre for Menal Health Research, School of Public Health, Brisbane, Australia
| | - Jeff S Coombes
- The University of Queensland, Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Wendy J Brown
- The University of Queensland, Centre for Research on Exercise, Physical Activity, and Health, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
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Ruediger SL, Pizzey FK, Koep JL, Coombes JS, Askew CD, Bailey TG. Comparison of peripheral and cerebral vascular function between premenopausal, early and late postmenopausal females. Exp Physiol 2023; 108:518-530. [PMID: 36621779 DOI: 10.1113/ep090813] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/06/2022] [Indexed: 01/10/2023]
Abstract
NEW FINDINGS What is the central question of this study? We sought to investigate whether peripheral and cerebrovascular function are impaired in early and late postmenopausal females compared with premenopausal females, while also accounting for nitric oxide and estradiol levels. What is the main finding and its importance? We observed no differences in peripheral vascular and cerebrovascular function between healthy and physically active premenopausal females and early and late postmenopausal females. Our findings contradict previous cross-sectional observations of vascular and cerebrovascular dysfunction across menopause. Longitudinal studies assessing vascular and cerebrovascular outcomes across the menopausal transition are warranted. ABSTRACT The risk of cardiovascular and cerebrovascular disease increases in ageing females, coinciding with the onset of menopause. Differences in peripheral and cerebrovascular function across menopausal stages, however, are poorly characterized. The aim of this study was to compare peripheral and cerebrovascular function between healthy premenopausal (PRE), early (1-6 years after final menstrual period; E-POST) and late (>6 years after final menstrual period; L-POST) postmenopausal females. We also explored the association between reproductive hormones, NO bioavailability and cerebrovascular function. In 39 females (40-65 years of age), we measured arterial stiffness, brachial artery flow-mediated dilatation, and cerebrovascular reactivity (CVR) to hypercapnia in the middle (MCAv) and internal (ICA) carotid arteries. Follicle-stimulating hormone, estradiol, progesterone and plasma nitrate and nitrite concentrations were also measured. Years since final menstrual period (PRE, 0 ± 0 years; E-POST, 3 ± 1 years; L-POST, 11 ± 4 years; P < 0.001) and estradiol levels (PRE, 145.5 ± 65.6 pg ml-1 ; E-POSTm 30.2 ± 81.2 pg ml-1 ; L-POST, 7.7 ± 11.3 pg ml-1 ; P < 0.001) were different between groups. All groups exceeded the guidelines for recommended physical activity. There were no group differences in blood pressure (P = 0.382), arterial stiffness (P = 0.129), flow-mediated dilatation (P = 0.696) or MCAv CVR (P = 0.442). The ICA CVR blood flow response was lower in PRE compared with L-POST (26.5 ± 19.2 vs. 47.8 ± 12.6%; P = 0.010), but after adjusting for age these differences were no longer present. Flow-mediated dilatation (r = 0.313, P = 0.105) and ICA CVR (r = -0.154, P = 0.495) were not associated with the estradiol concentration. There were no associations between the estradiol concentration and NO bioavailability. These results suggest that in healthy, physically active early and late postmenopausal females, vascular and cerebrovascular function is generally well preserved.
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Affiliation(s)
- Stefanie L Ruediger
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Faith K Pizzey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jodie L Koep
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Christopher D Askew
- VasoActive Research Group, School of Health, University of the Sunshine Coast, Sippy Downs, Queensland, Australia.,Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, Queensland, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
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Valenzuela T, Coombes JS, Liu-Ambrose T, Mavros Y, Kochan N, Sachdev PS, Hausdorff J, Smith EC, Hollings M, Hawkins TC, Ashley NJ, Feter N, Wilson GC, Shih IHE, Guerrero Y, Jiang J, Wen W, Bailey T, Stensvold D, Wisløff U, Falck RS, Fiatarone Singh M. Study protocol for the BRAIN Training Trial: a randomised controlled trial of Balance, Resistance, And INterval training on cognitive function in older adults with mild cognitive impairment. BMJ Open 2022; 12:e062059. [PMID: 36600421 PMCID: PMC9772642 DOI: 10.1136/bmjopen-2022-062059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Epidemiological evidence suggests that both poor cardiovascular fitness and low muscle mass or strength markedly increase the rate of cognitive decline and incident dementia in older adults. Results from exercise trials for the improvement of cognition in older adults with mild cognitive impairment (MCI) have reported mixed results. This is possibly due to insufficient exercise intensities. The aim of the Balance, Resistance, And INterval (BRAIN) Training Trial is to determine the effects of two forms of exercise, high-intensity aerobic interval training (HIIT) and high-intensity power training (POWER) each compared with a sham exercise control group on cognition in older adults with MCI. METHODS AND ANALYSIS One hundred and sixty community-dwelling older (≥ 60 years) people with MCI have been randomised into the trial. Interventions are delivered supervised 2-3 days per week for 12 months. The primary outcome measured at baseline, 6 and 12 months is performance on a cognitive composite score measuring the executive domain calculated from a combination of computerised (NeuroTrax) and paper-and-pencil tests. Analyses will be performed via repeated measures linear mixed models and generalised linear mixed models of baseline, 6-month and 12-month time points, adjusted for baseline values and covariates selected a priori. Mixed models will be constructed to determine the interaction of GROUP × TIME. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of Sydney (HREC Ref.2017/368), University of Queensland (HREC Ref. 2017/HE000853), University of British Columbia (H16-03309), and Vancouver Coastal Health Research Institute (V16-03309) Human Research Ethics. Dissemination will be via publications, conference presentations, newsletter articles, social media, talks to clinicians and consumers and meetings with health departments/managers.It is expected that communication of results will allow for the development of more effective evidence-based exercise prescription guidelines in this population while investigating the benefits of HIIT and POWER on subclinical markers of disease. TRIAL REGISTRATION NUMBER ACTRN12617001440314 Australian New Zealand Clinical Trials Registry.
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Affiliation(s)
- Trinidad Valenzuela
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Jeff S Coombes
- Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia
| | - Teresa Liu-Ambrose
- Aging, Mobility, and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
| | - Yorgi Mavros
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Jeffrey Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience and Department of Physical Therapy, Faculty of Medicine, Tel Aviv University Sackler, Tel Aviv, Israel
| | - Emily C Smith
- Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia
| | - Matthew Hollings
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Tess C Hawkins
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Nicholas J Ashley
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Natan Feter
- Postgraduate Program of Physical Education, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Guy C Wilson
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Isabel Hui En Shih
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Yareni Guerrero
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Tom Bailey
- Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia
- School of Nursing Midwifery and Social Work, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia
| | - Dorthe Stensvold
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ryan S Falck
- School of Biomedical Engineering, Faculty of Applied Science, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Maria Fiatarone Singh
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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20
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Anderson CAJ, Suna JM, Keating SE, Cordina R, Tran DL, Ayer J, Coombes JS. Safety and efficacy of exercise training in children and adolescents with congenital heart disease: A systematic review and descriptive analysis. Am Heart J 2022; 253:1-19. [PMID: 35768047 DOI: 10.1016/j.ahj.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/01/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND While exercise training is beneficial in the prevention and management of many chronic diseases, the role of exercise training in children and adolescents with congenital heart disease is less understood. We sought to determine the safety and efficacy of exercise training in children and adolescents with congenital heart disease. METHODS We conducted a systematic search of the following databases: PubMed, CINAHL, EMBASE, Web of Science and SportDiscus. We included randomised controlled trials that incorporated an exercise intervention compared with a non-exercising comparator group and examined safety and efficacy in children and adolescents with congenital heart disease. A descriptive analysis of the included trials was then conducted. RESULTS A total of 9 articles from 6 trials (642 participants with varying conditions and disease severity) were included. Significant variability of study participants and outcomes were observed across the trials. No adverse events linked to the exercise interventions were stated. The articles reported numerous positive changes to clinically relevant fitness measures. Exercise capacity improved with exercise training in 3 of 4 trials in which it was measured. Cardiorespiratory fitness showed improvements in 3 of 4 trials. Neuromuscular fitness increased in 1 of 2 trials. Physiological and metabolic parameters were improved, and negative changes were not observed to several clinically important measures (e.g. muscular oxygenation, cardiac measures) in 2 of 2 trials. Physical activity increased in 1 of 3 trials. No articles reported on changes in measures of body composition. Outcomes are varied with little consensus on measurements or assessment methods. CONCLUSIONS Exercise training appears to be safe and efficacious for improving physical fitness in children and adolescents with congenital heart disease who have been appropriately screened by their medical team. However, the certainty of the evidence for these findings is low to moderate.
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Affiliation(s)
- Christopher A J Anderson
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.
| | - Jessica M Suna
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia; Queensland Paediatric Cardiac Service, Queensland Children's Hospital, Brisbane, 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, Brisbane, Queensland, Australia
| | - Rachael Cordina
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia; Heart Research Institute, Sydney, New South Wales, Australia
| | - Derek L Tran
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia; Heart Research Institute, Sydney, New South Wales, Australia
| | - Julian Ayer
- Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia; The Heart Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
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21
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Koep JL, Bond B, Barker AR, Ruediger SL, Pizzey FK, Coombes JS, Bailey TG. The relationships between age, sex and cerebrovascular reactivity to hypercapnia using traditional and kinetic-based analyses in healthy adults. Am J Physiol Heart Circ Physiol 2022; 323:H782-H796. [PMID: 36053752 PMCID: PMC9550584 DOI: 10.1152/ajpheart.00300.2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The effect of age and sex on intracranial and extracranial cerebrovascular function is poorly understood. We investigated the relationships between age, sex, and cerebrovascular reactivity (CVR) to hypercapnia in 73 healthy adults (18–80 yr, n = 39 female). CVR to hypercapnia was assessed in the middle cerebral artery (MCA) using transcranial Doppler ultrasound and at the internal carotid artery (ICA) using duplex ultrasound. MCA CVR was characterized by peak MCA velocity (MCAv) response per mmHg increase in end-tidal CO2 and by using a monoexponential model to characterize the kinetics (time constant) of the MCAv response. ICA reactivity was assessed as the relative peak increase in artery diameter. Hierarchical multiple regression determined the relationships between age, sex, and the age-by-sex interaction on all baseline and CVR outcomes. There was no relationship between ICA reactivity (%) with age (P = 0.07), sex (P = 0.56), or a moderator effect of sex on the age effect (P = 0.24). MCAv CVR showed no relationship with age (P = 0.59), sex (P = 0.09), or an age-by-sex moderator effect (P = 0.90). We observed a positive relationship of MCAv CVR time constant with age (P = 0.013), such that the speed of the MCA response was slower with advancing age. The present study provides comprehensive data on age- and sex-specific relationships with intracranial and extracranial cerebrovascular responses to hypercapnia. Despite similar MCAv CVR and ICA reactivity between sexes, kinetic responses of the MCA revealed a slower rate of adjustment with advancing age. NEW & NOTEWORTHY We observed similar MCA CVR and ICA reactivity in males and females. However, kinetic responses of the MCA to hypercapnia suggest that advancing age slows down the rate at which MCA velocity increases in response to hypercapnia. These data indicate distinct regulatory differences, and an impaired vasomotor control of the cerebrovasculature with advancing age, not detected by traditional methods.
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Affiliation(s)
- Jodie L Koep
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom.,Exeter Head Impacts, Brain Injury and Trauma (ExHIBIT) research group, University of Exeter, United Kingdom
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Stefanie L Ruediger
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Faith K Pizzey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
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22
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Johnston HE, Takefala TG, Kelly JT, Keating SE, Coombes JS, Macdonald GA, Hickman IJ, Mayr HL. The Effect of Diet and Exercise Interventions on Body Composition in Liver Cirrhosis: A Systematic Review. Nutrients 2022; 14:nu14163365. [PMID: 36014871 PMCID: PMC9414099 DOI: 10.3390/nu14163365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 12/01/2022] Open
Abstract
Alterations in body composition, in particular sarcopenia and sarcopenic obesity, are complications of liver cirrhosis associated with adverse outcomes. This systematic review aimed to evaluate the effect of diet and/or exercise interventions on body composition (muscle or fat) in adults with cirrhosis. Five databases were searched from inception to November 2021. Controlled trials of diet and/or exercise reporting at least one body composition measure were included. Single-arm interventions were included if guideline-recommended measures were used (computed tomography/magnetic resonance imaging, dual-energy X-ray absorptiometry, bioelectrical impedance analysis, or ultrasound). A total of 22 controlled trials and 5 single-arm interventions were included. Study quality varied (moderate to high risk of bias), mainly due to lack of blinding. Generally, sample sizes were small (n = 6–120). Only one study targeted weight loss in an overweight population. When guideline-recommended measures of body composition were used, the largest improvements occurred with combined diet and exercise interventions. These mostly employed high protein diets with aerobic and or resistance exercises for at least 8 weeks. Benefits were also observed with supplementary branched-chain amino acids. While body composition in cirrhosis may improve with diet and exercise prescription, suitably powered RCTs of combined interventions, targeting overweight/obese populations, and using guideline-recommended body composition measures are needed to clarify if sarcopenia/sarcopenic obesity is modifiable in patients with cirrhosis.
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Affiliation(s)
- Heidi E. Johnston
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
- Correspondence: ; Tel.: +61-7-3176-7938
| | - Tahnie G. Takefala
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Jaimon T. Kelly
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Shelley E. Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Jeff S. Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Graeme A. Macdonald
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
| | - Ingrid J. Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Hannah L. Mayr
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, QLD 4102, Australia
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
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Brown RC, Coombes JS, Jungbluth Rodriguez K, Hickman IJ, Keating SE. Effectiveness of exercise via telehealth for chronic disease: a systematic review and meta-analysis of exercise interventions delivered via videoconferencing. Br J Sports Med 2022; 56:bjsports-2021-105118. [PMID: 35715175 DOI: 10.1136/bjsports-2021-105118] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the effectiveness of videoconferencing exercise interventions for people with chronic diseases. DESIGN Systematic review incorporating meta-analysis. DATA SOURCES PubMed, Cinahl, MEDLINE, Web of Science, Embase and Scopus. ELIGIBILITY CRITERIA The current literature was searched following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Trials analysing participants with chronic disease undergoing aerobic and/or resistance exercise training over videoconferencing, with exercise capacity and/or quality of life outcomes were included. Meta-analyses were conducted for between-group comparisons of exercise capacity and quality of life. Risk of bias was analysed using the Downs and Black quality checklist and the certainty of evidence with Grading of Recommendations, Assessment, Development and Evaluation (GRADE). RESULTS Thirty-two trials were included in this review, of which 12 were comparator trials. Small-moderate between-group (videoconferencing vs comparator) effects favouring videoconferencing were seen for studies using a non-exercising comparator for exercise capacity (standardised mean difference (SMD)=0.616, 95% CI 0.278 to 0.954; p=<0.001) and quality of life (SMD=0.400, 95% CI 0.099 to 0.701; p=0.009). Small effects favouring videoconferencing were observed for studies using an exercising comparator for quality of life (SMD=0.271, 95% CI 0.028 to 0.515; p=0.029) and exercise capacity (SMD=0.242, 95% CI 0.059 to 0.426; p=0.009). Moderate risk of bias was identified for included studies (16.3±3.6/28), with GRADE certainty ratings of 'low' (quality of life) and 'moderate' (exercise capacity). Session attendance was 70% and was reported in 23 trials. No serious adverse events relating to videoconferencing were found. Nine trials documented the total number of technical issues that occurred in 17% of the sessions. Positive satisfaction outcomes were associated with ease of access and usefulness of technology. CONCLUSION In patients with chronic disease, videoconferencing exercise interventions appear to be feasible and effective for improving exercise capacity and quality of life. More robust methodology is needed in future studies to improve the certainty of the evidence. PROSPERO REGISTRATION NUMBER CRD42020191243.
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Affiliation(s)
- Riley Cc Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, St Lucia, Queensland, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, St Lucia, Queensland, Australia
| | - Klaus Jungbluth Rodriguez
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, St Lucia, Queensland, Australia
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
- Mater Research Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, St Lucia, Queensland, Australia
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Weston ME, Barker AR, Tomlinson OW, Coombes JS, Bailey TG, Bond B. The effect of exercise intensity and cardiorespiratory fitness on the kinetic response of middle cerebral artery blood velocity during exercise in adults. J Appl Physiol (1985) 2022; 133:214-222. [PMID: 35708705 PMCID: PMC9291408 DOI: 10.1152/japplphysiol.00862.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to compare the kinetic response of middle cerebral artery blood velocity (MCAv) to moderate and heavy-intensity cycling in adults, and explore the relationship between maximal oxygen uptake (V̇O2max) and MCAv kinetics. Seventeen healthy adults (23.8±2.4 years, 9 females) completed a ramp incremental test to exhaustion on a cycle ergometer to determine V̇O2max and the gas exchange threshold (GET). Across six separate visits, participants completed three 6-minute transitions at a moderate-intensity (90% GET) and three at a heavy-intensity (40% of the difference between GET and V̇O2max). Bilateral MCAv was measured using transcranial Doppler ultrasonography and analysed using a mono-exponential model with a time delay. The time constant (τ) of the MCAv response was not different between moderate- and heavy-intensity cycling (25±10 vs. 26±8 s, P=0.82), as was the time delay (29±11 vs. 29±10 s, P=0.95). The amplitude of the exponential increase in MCAv from baseline was greater during heavy (23.9±10.0 cm.s-1, 34.1±14.4%) compared to moderate (12.7±4.4 cm.s-1, 18.7±7.5%) intensity cycling (P<0.01). Following the exponential increase, a greater fall in MCAv was observed during heavy compared to moderate-intensity exercise (9.5±6.9 vs 2.8±3.8 cm.s-1, P<0.01). MCAv after 6 minutes of exercise remained elevated during heavy compared to moderate-intensity exercise (85.2±9.6 vs. 79.3±7.7cm.s-1, P≤0.01). V̇O2max was not correlated with MCAv τ or amplitude (r=0.11-0.26, P>0.05). These data suggest that the intensity of constant-work rate exercise influences the amplitude, but not time-based, response parameters of MCAv in healthy adults, and found no relationship between cardiorespiratory fitness and MCAv kinetics.
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Affiliation(s)
- Max Edwin Weston
- Sport and Health Sciences, grid.8391.3University of Exeter, Exeter, Devon, United Kingdom
| | - Alan R Barker
- Children's Health and Exercise Research Centre, grid.8391.3University of Exeter, Exeter, Devon, United Kingdom
| | - Owen William Tomlinson
- College of Medicine and Health, grid.8391.3University of Exeter, Exeter, Devon, United Kingdom
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, grid.1003.2University of Queensland, Brisbane, Queensland, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, grid.1003.2University of Queensland, Brisbane, Queensland, Australia
| | - Bert Bond
- Children's Health and Exercise Research Centre, grid.8391.3University of Exeter, Exeter, Devon, United Kingdom
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Cox ER, Brown WJ, Gajanand T, Bailey TG, Gomersall SR, Chachay VS, Burton NW, Fassett RG, Cox SV, Coombes JS, Keating SE. Effects of fitness and fatness on age-related arterial stiffening in people with type 2 diabetes. Clin Obes 2022; 12:e12519. [PMID: 35293141 PMCID: PMC9285462 DOI: 10.1111/cob.12519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 11/29/2022]
Abstract
People with type 2 diabetes (T2D) are at a greater risk of cardiovascular disease than the general population. Both non-modifiable (age) and modifiable (low aerobic fitness, high body fatness) factors are separately predictive of cardiovascular risk, although they often occur concomitantly. This study aimed to examine the (1) association between age and arterial stiffness, a subclinical marker of cardiovascular risk; and (2) effects of body fatness and aerobic fitness on age-related increases in arterial stiffness in people with T2D. Data from 64 individuals with T2D (age 59.8 ± 8.7 years, 40% female, HbA1c 8.4 ± 1.6%) were included in this cross-sectional analysis. Carotid-femoral pulse wave velocity (cfPWV) was used to quantify arterial stiffness. Aerobic fitness (relative V̇O2peak ) was determined via indirect calorimetry during maximal exercise testing. Central body fatness was determined using waist circumference. Data were analysed using hierarchical multiple regressions. After adjustment for sex and duration of T2D, each one standard deviation (SD) increase in age (8.68 years) was associated with a 0.63 m·s-1 increase in cfPWV (β = 0.416, p = 0.001). Following adjustment for aerobic fitness and body fatness, the standardized β was unchanged (0.417). A one SD increase in waist circumference (13.9 cm) and relative V̇O2peak (5.3 ml·kg-1 ·min-1 ) were associated with a similar magnitude of difference in cfPWV (0.47 m·s-1 and -0.44 m·s-1 , respectively). Therefore, age is a significant correlate of increased arterial stiffness in T2D, with higher aerobic fitness attenuating, and higher body fatness exacerbating, this increase. Interventions aimed at improving cardiovascular outcomes in people with T2D should target both increased aerobic fitness and reduced body fatness.
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Affiliation(s)
- Emily R. Cox
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
- Physiology and Ultrasound Laboratory in Science and ExerciseSchool of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
- School of Environmental and Life Sciences, University of NewcastleOurimbahNew South WalesAustralia
| | - Wendy J. Brown
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
| | - Trishan Gajanand
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
- Physiology and Ultrasound Laboratory in Science and ExerciseSchool of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
| | - Tom G. Bailey
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
- Physiology and Ultrasound Laboratory in Science and ExerciseSchool of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
- School of Nursing, Midwifery and Social Work, The University of QueenslandBrisbaneQueenslandAustralia
| | - Sjaan R. Gomersall
- School of Health and Rehabilitation Sciences, The University of QueenslandBrisbaneQueenslandAustralia
- School of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
| | - Veronique S. Chachay
- School of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
| | - Nicola W. Burton
- School of Applied Psychology, Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland, Griffith UniversityGold CoastQueenslandAustralia
| | - Robert G. Fassett
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
| | - Stephen V. Cox
- GenesisCareThe Wesley HospitalBrisbaneQueenslandAustralia
| | - Jeff S. Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
- Physiology and Ultrasound Laboratory in Science and ExerciseSchool of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
| | - Shelley E. Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
- Physiology and Ultrasound Laboratory in Science and ExerciseSchool of Human Movement and Nutrition Sciences, The University of QueenslandBrisbaneQueenslandAustralia
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Pizzey FK, Ruediger SL, Koep JL, Askew CD, Coombes JS, Bailey TG. Comparing the Effects of 30‐ and 60‐min of Acute Whole‐Body Passive Heat Stress on Peripheral Vascular Function in Older Adults. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r4367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Faith K. Pizzey
- School of Human Movement and Nutrition SciencesThe University of QueenslandSt. Lucia
| | - Stefanie L. Ruediger
- School of Human Movement and Nutrition SciencesThe University of QueenslandSt. Lucia
| | - Jodie L. Koep
- School of Human Movement and Nutrition SciencesThe University of QueenslandSt. Lucia
| | - Christopher D. Askew
- School of Health and Behavioural SciencesUniversity of the Sunshine CoastSippy Downs
- Sunshine coast Hospital and Health ServiceUniversity of the Sunshine CoastSippy Downs
| | - Jeff S. Coombes
- School of Human Movement and Nutrition SciencesThe University of QueenslandSt. Lucia
| | - Tom G. Bailey
- School of Human Movement and Nutrition SciencesThe University of QueenslandSt. Lucia
- School of NursingMidwifery and Social WorkThe University of QueenslandSt. Lucia
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Koep JL, Coombes JS, Barker AR, Taylor CE, Pizzey FK, Ruediger SL, Bond B, Bailey TG. Intracranial Cerebrovascular Reactivity by Traditional and Novel Methods in Young, Middle, and Old Aged Healthy Males and Females. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r4378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jodie L. Koep
- Physiology and Ultrasound Laboratory in Science and ExerciseCentre for Research on ExercisePhysical Activity and Health, School of Human Movement and Nutrition SciencesUniversity of QueenslandBrisbane
- Children's Health and Exercise Research Centre, Sport and Health SciencesCollege of Life and Environmental SciencesUniversity of QueenslandBrisbane
| | - Jeff S. Coombes
- Physiology and Ultrasound Laboratory in Science and ExerciseCentre for Research on ExercisePhysical Activity and Health, School of Human Movement and Nutrition SciencesUniversity of QueenslandBrisbane
| | - Alan R. Barker
- Children's Health and Exercise Research Centre, Sport and Health SciencesCollege of Life and Environmental SciencesUniversity of ExeterExeter
| | | | - Faith K. Pizzey
- Physiology and Ultrasound Laboratory in Science and ExerciseCentre for Research on ExercisePhysical Activity and Health, School of Human Movement and Nutrition SciencesUniversity of QueenslandBrisbane
| | - Stefanie L. Ruediger
- Physiology and Ultrasound Laboratory in Science and ExerciseCentre for Research on ExercisePhysical Activity and Health, School of Human Movement and Nutrition SciencesUniversity of QueenslandBrisbane
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health SciencesCollege of Life and Environmental SciencesUniversity of ExeterExeter
| | - Tom G. Bailey
- Physiology and Ultrasound Laboratory in Science and ExerciseCentre for Research on ExercisePhysical Activity and Health, School of Human Movement and Nutrition SciencesUniversity of QueenslandBrisbane
- School of NursingMidwifery and Social WorkUniversity of QueenslandBrisbane
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Beetham KS, Coombes JS, Howden EJ. Authors' Reply: More Research is Still Needed to Support the Real-World Generalizability of the Benefits of Lifestyle Interventions for Chronic Kidney Disease. J Am Soc Nephrol 2022; 33:1045-1046. [PMID: 35354602 PMCID: PMC9063884 DOI: 10.1681/asn.2022030244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Kassia S Beetham
- School of Behavioural and Health Science, Australian Catholic University, Brisbane, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Erin J Howden
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- Human Integrative Physiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
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29
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Williams CJ, Torquati L, Li Z, Lea RA, Croci I, Keating E, Little JP, Eynon N, Coombes JS. Oligofructose-Enriched Inulin Intake, Gut Microbiome Characteristics, and the V̇O2 Peak Response to High-Intensity Interval Training in Healthy Inactive Adults. J Nutr 2022; 152:680-689. [PMID: 34910161 DOI: 10.1093/jn/nxab426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/19/2021] [Accepted: 12/09/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The gut microbiome has been associated with cardiorespiratory fitness. OBJECTIVES To assess the effects of oligofructose (FOS)-enriched inulin supplementation on the gut microbiome and the peak oxygen uptake (V̇O2peak) response to high-intensity interval training (HIIT). METHODS The study was a randomized controlled trial. Forty sedentary and apparently healthy adults [n = 31 women; aged 31.8 ± 9.8 y, BMI (in kg⋅m-2) 25.9 ± 4.3] were randomly allocated to 1) 6 wk of supervised HIIT (4 × 4-min bouts at 85-95% peak heart rate, interspersed with 3 min of active recovery, 3·wk-1) + 12 g·d-1 of FOS-enriched inulin (HIIT-I) or 2) 6 wk of supervised HIIT (3·wk-1, 4 × 4-min bouts) + 12 g·d-1 of maltodextrin/placebo (HIIT-P). Each participant completed an incremental treadmill test to assess V̇O2peak and ventilatory thresholds (VTs), provided a stool and blood sample, and completed a 24-h diet recall questionnaire and FFQ before and after the intervention. Gut microbiome analyses were performed using metagenomic sequencing. Fecal short-chain fatty acids were measured by mass spectrometry. RESULTS There were no differences in the mean change in V̇O2peak response between groups (P = 0.58). HIIT-I had a greater improvement in VTs than HIIT-P [VT1 (lactate accumulation): mean difference + 4.3% and VT2 (lactate threshold): +4.2%, P < 0.05]. HIIT-I had a greater increase in the abundance of Bifidobacterium taxa [false discovery rate (FDR) < 0.05] and several metabolic processes related to exercise capacity (FDR < 0.05). Exploratory analysis of merged data found participants with a greater response to HIIT (V̇O2peak ≥3.5 mL⋅kg-1⋅min-1) had a 2.2-fold greater mean abundance of gellan degradation pathways (FDR < 0.05) and a greater, but not significant, abundance of Bifidobacterium uniformis species (P < 0.00023, FDR = 0.08). CONCLUSIONS FOS-enriched inulin supplementation did not potentiate HIIT-induced improvements in V̇O2peak but led to gut microbiome changes possibly associated with greater ventilatory threshold improvements in healthy inactive adults. Gellan degradation pathways and B. uniformis spp. were associated with greater V̇O2peak responses to HIIT.
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Affiliation(s)
- Camilla J Williams
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia
| | - Luciana Torquati
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia
- Department of Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
| | - Zhixiu Li
- Queensland University of Technology (QUT), Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, QLD, Australia
- Queensland University of Technology (QUT), Faculty of Health, School of Biomedical Sciences, Brisbane, QLD, Australia
| | - Rodney A Lea
- Queensland University of Technology (QUT), Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, QLD, Australia
- Queensland University of Technology (QUT), Faculty of Health, School of Biomedical Sciences, Brisbane, QLD, Australia
| | - Ilaria Croci
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Sport, Movement and Health, University of Basel, Basel, Switzerland
| | - Eliza Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia
| | - Jonathan P Little
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, BC, Canada
| | - Nir Eynon
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia
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30
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Brown WJ, Hayman M, Haakstad LA, Lamerton T, Mena GP, Green A, Keating SE, Gomes GA, Coombes JS, Mielke GI. Australian Guidelines for Physical Activity in pregnancy and postpartum. J Sci Med Sport 2022; 25:511-519. [DOI: 10.1016/j.jsams.2022.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
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Schultz MG, Currie KD, Hedman K, Climie RE, Maiorana A, Coombes JS, Sharman JE. The Identification and Management of High Blood Pressure Using Exercise Blood Pressure: Current Evidence and Practical Guidance. Int J Environ Res Public Health 2022; 19:ijerph19052819. [PMID: 35270514 PMCID: PMC8910717 DOI: 10.3390/ijerph19052819] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/16/2022] [Accepted: 02/24/2022] [Indexed: 11/16/2022]
Abstract
High blood pressure (BP) is a leading risk factor for cardiovascular disease (CVD). The identification of high BP is conventionally based on in-clinic (resting) BP measures, performed within primary health care settings. However, many cases of high BP go unrecognised or remain inadequately controlled. Thus, there is a need for complementary settings and methods for BP assessment to identify and control high BP more effectively. Exaggerated exercise BP is associated with increased CVD risk and may be a medium to improve identification and control of high BP because it is suggestive of high BP gone undetected on the basis of standard in-clinic BP measures at rest. This paper provides the evidence to support a pathway to aid identification and control of high BP in clinical exercise settings via the measurement of exercise BP. It is recommended that exercise professionals conducting exercise testing should measure BP at a fixed submaximal exercise workload at moderate intensity (e.g., ~70% age-predicted heart rate maximum, stage 1-2 of a standard Bruce treadmill protocol). If exercise systolic BP is raised (≥170 mmHg), uncontrolled high BP should be assumed and should trigger correspondence with a primary care physician to encourage follow-up care to ascertain true BP control (i.e., home, or ambulatory BP) alongside a hypertension-guided exercise and lifestyle intervention to lower CVD risk related to high BP.
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Affiliation(s)
- Martin G. Schultz
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia; (R.E.C.); (J.E.S.)
- Correspondence: ; Tel.: +61-(0)-3-6226-4264; Fax: +61-(0)-3-6226-7704
| | - Katharine D. Currie
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA;
| | - Kristofer Hedman
- Department of Clinical Physiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, 58183 Linköping, Sweden;
| | - Rachel E. Climie
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia; (R.E.C.); (J.E.S.)
| | - Andrew Maiorana
- Faculty of Health Sciences, School of Physiotherapy and Exercise Science, Curtin University and Allied Health Department, Fiona Stanley Hospital, Perth, WA 6102, Australia;
| | - Jeff S. Coombes
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD 4072, Australia;
| | - James E. Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia; (R.E.C.); (J.E.S.)
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Brown RCC, Jegatheesan DK, Conley MM, Mayr HL, Kelly JT, Webb L, Barnett A, Staudacher HM, Burton NW, Isbel NM, Macdonald GA, Campbell KL, Coombes JS, Keating SE, Hickman IJ. U-DECIDE: Utilising technology for Diet & Exercise Change In complex chronic conditions across Diverse Environments: Protocol for a Randomised Controlled Trial (Preprint). JMIR Res Protoc 2022; 11:e37556. [PMID: 35900834 PMCID: PMC9377441 DOI: 10.2196/37556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Abstract
Background The metabolic syndrome is common across many complex chronic disease groups. Advances in health technology have provided opportunities to support lifestyle interventions. Objective The purpose of this study is to test the feasibility of a health technology-assisted lifestyle intervention in a patient-led model of care. Methods The study is a single-center, 26-week, randomized controlled trial. The setting is specialist kidney and liver disease clinics at a large Australian tertiary hospital. The participants will be adults with a complex chronic condition who are referred for dietetic assessment and display at least one feature of the metabolic syndrome. All participants will receive an individualized assessment and advice on diet quality from a dietitian, a wearable activity monitor, and standard care. Participants randomized to the intervention group will receive access to a suite of health technologies from which to choose, including common base components (text messages) and optional components (online and mobile app–based nutrition information, an online home exercise program, and group-based videoconferencing). Exposure to the optional aspects of the intervention will be patient-led, with participants choosing their preferred level of engagement. The primary outcome will be the feasibility of delivering the program, determined by safety, recruitment rate, retention, exposure uptake, and telehealth adherence. Secondary outcomes will be clinical effectiveness, patient-led goal attainment, treatment fidelity, exposure demand, and participant perceptions. Primary outcome data will be assessed descriptively and secondary outcomes will be assessed using an analysis of covariance. This study will provide evidence on the feasibility of the intervention in a tertiary setting for patients with complex chronic disease exhibiting features of the metabolic syndrome. Results The study was funded in 2019. Enrollment has commenced and is expected to be completed by June 2022. Data collection and follow up are expected to be completed by December 2022. Results from the analyses based on primary outcomes are expected to be submitted for publication by June 2023. Conclusions The study will test the implementation of a health technology–assisted lifestyle intervention in a tertiary outpatient setting for a diverse group of patients with complex chronic conditions. It is novel in that it embeds patient choice into intervention exposure and will inform health service decision-makers in regards to the feasibility of scale and spread of technology-assisted access to care for a broader reach of specialist services. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12620001282976; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378337 International Registered Report Identifier (IRRID) DERR1-10.2196/37556
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Affiliation(s)
- Riley C C Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Dev K Jegatheesan
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Marguerite M Conley
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
| | - Hannah L Mayr
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
- Nutrition and Dietetics Research Group, Bond University, Robina, Australia
| | - Jaimon T Kelly
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Lindsey Webb
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
| | - Amandine Barnett
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Heidi M Staudacher
- Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation, Deakin University, Melbourne, Australia
| | - Nicola W Burton
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Nicole M Isbel
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Graeme A Macdonald
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Katrina L Campbell
- Healthcare Excellence and Innovation, Metro North Health, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Ingrid J Hickman
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
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Torquati L, Gajanand T, Cox ER, Willis C, Zaugg J, Keating SE, Coombes JS. Effects of exercise intensity on gut microbiome composition and function in people with type 2 diabetes. Eur J Sport Sci 2022; 23:530-541. [PMID: 35107058 DOI: 10.1080/17461391.2022.2035436] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise is positively associated with higher microbial diversity, but there is limited information on exercise intensity's effect on gut microbiome composition and function in clinical populations. This study examines whether different intensities of exercise exert differential effects on gut microbiome composition and function in low active people with type 2 diabetes.This is a sub-study of the Exercise for Type 2 Diabetes Study, a single centre, prospective, randomised controlled trial. Participants (n=12) completed 8-weeks of combined aerobic and resistance moderate intensity continuous training (C-MICT) or combined aerobic and resistance high-intensity interval training (C-HIIT). Faecal samples were collected before and after intervention to measure gut microbiome composition and metabolic pathways (metagenome shotgun sequencing) and short-chain fatty acids.Post-exercise α-diversity was different between groups as was the relative abundance of specific taxa was (p<0.05). Post-exercise relative abundance of Bifidobacterium, A. municiphila, and butyrate-producers Lachnospira eligens, Enterococcus spp., and Clostridium Cluster IV were higher at lower exercise intensity. Other butyrate-producers (from Eryspelothrichales and Oscillospirales), and methane producer Methanobrevibacter smithii were higher at higher exercise intensity. Pyruvate metabolism (ko00620),COG 'Cell wall membrane envelope biogenesis' and 'Unknown function' pathways were significantly different between groups and higher in C-MICT post-exercise. Differential abundance analysis on KO showed higher expression of Two-component system in C-HIIT. Transcription factors and 'unknown metabolism' related pathways decreased in both groups. There were no significant between group changes in faecal short chain fatty acids.Exercise intensity had a distinct effect on gut microbiome abundance and metabolic function, without impacting short-chain fatty acid outputTrial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12615000475549..
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Affiliation(s)
- L Torquati
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter EX1 2LU, United Kingdom
| | - T Gajanand
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, St Lucia campus 4072, Australia
| | - E R Cox
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, St Lucia campus 4072, Australia
| | - Crg Willis
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter EX1 2LU, United Kingdom
| | - J Zaugg
- Australian Centre for Ecogenomics, The University of Queensland, Brisbane, St Lucia campus 4072, Australia
| | - S E Keating
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, St Lucia campus 4072, Australia
| | - J S Coombes
- Centre for Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, St Lucia campus 4072, Australia
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Beetham KS, Krishnasamy R, Stanton T, Sacre JW, Douglas B, Isbel NM, Coombes JS, Howden EJ. Effect of a 3-Year Lifestyle Intervention in Patients with Chronic Kidney Disease: A Randomized Clinical Trial. J Am Soc Nephrol 2022; 33:431-441. [PMID: 34893535 PMCID: PMC8819984 DOI: 10.1681/asn.2021050668] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/19/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Supervised lifestyle interventions have the potential to significantly improve physical activity and fitness in patients with CKD. METHODS To assess the efficacy of a lifestyle intervention in patients with CKD to improve cardiorespiratory fitness and exercise capacity over 36 months, we conducted a randomized clinical trial, enrolling 160 patients with stage 3-4 CKD, with 81 randomized to usual care and 79 to a 3-year lifestyle intervention. The lifestyle intervention comprised care from a multidisciplinary team, including a nephrologist, nurse practitioner, exercise physiologist, dietitian, diabetes educator, psychologist, and social worker. The exercise training component consisted of an 8-week individualized and supervised gym-based exercise intervention followed by 34 months of a predominantly home-based program. Self-reported physical activity (metabolic equivalent of tasks [METs] minutes per week), cardiorespiratory fitness (peak O2 consumption [VO2peak]), exercise capacity (maximum METs and 6-minute walk distance) and neuromuscular fitness (grip strength and get-up-and-go test time) were evaluated at 12, 24, and 36 months. RESULTS The intervention increased the percentage of patients meeting physical activity guideline targets of 500 MET min/wk from 29% at baseline to 63% at 3 years. At 12 months, both VO2peak and METs increased significantly in the lifestyle intervention group by 9.7% and 30%, respectively, without change in the usual care group. Thereafter, VO2peak declined to near baseline levels, whereas METs remained elevated in the lifestyle intervention group at 24 and 36 months. After 3 years, the intervention had increased the 6-minute walk distance and blunted declines in the get-up-and-go test time. CONCLUSIONS A 3-year lifestyle intervention doubled the percentage of CKD patients meeting physical activity guidelines, improved exercise capacity, and ameliorated losses in neuromuscular and cardiorespiratory fitness.
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Affiliation(s)
- Kassia S. Beetham
- School of Behavioural and Health Science, Australian Catholic University, Brisbane, Queensland, Australia,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Rathika Krishnasamy
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia,Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia
| | - Tony Stanton
- Sunshine Coast University Hospital, Sunshine Coast, Queensland, Australia,School of Health and Sport Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia,School of Medicine, Griffith University, Sunshine Coast, Queensland, Australia
| | - Julian W. Sacre
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Bettina Douglas
- School of Nursing and Midwifery, The University of Queensland, Brisbane, Queensland, Australia
| | - Nicole M. Isbel
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Jeff S. Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Erin J. Howden
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia,Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
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Bray NA, Koloski NA, Jones MP, Do A, Pang S, Coombes JS, McAllister S, Campos J, Arthur L, Stanley P, DeMaria K, Chao CY, Catague R, Whaley A, Talley NJ, Holtmann GJ. Evaluation of a Multidisciplinary Integrated Treatment Approach Versus Standard Model of Care for Functional Gastrointestinal Disorders (FGIDS): A Matched Cohort Study. Dig Dis Sci 2022; 67:5593-5601. [PMID: 35362835 PMCID: PMC9652261 DOI: 10.1007/s10620-022-07464-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 02/14/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Functional gastrointestinal disorders (FGID) are linked to a variety of potential causes, and treatments include reassurance, life-style (including diet), psychological, or pharmacologic interventions. AIMS To assess whether a multidisciplinary integrated treatment approach delivered in a dedicated integrated care clinic (ICC) was superior to the standard model of care in relation to the gastrointestinal symptom burden. METHODS A matched cohort of 52 consecutive patients with severe manifestation of FGID were matched with 104 control patients based upon diagnosis, gender, age, and symptom severity. Patients in the ICC received structured assessment and 12-weeks integrated treatment sessions provided as required by gastroenterologist and allied health team. Control patients received standard medical care at the same tertiary center with access to allied health services as required but no standardized interprofessional team approach. Primary outcome was reduction in gastrointestinal symptom burden as measured by the Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS). Secondary outcome was reduction in anxiety and depressive symptoms as measured by the Hospital Anxiety and Depression Scale (HADS). RESULTS Mixed models estimated the within ICC change in SAGIS total as -9.7 (95% CI -13.6, -5.8; p < 0.0001), compared with -1.7 (95% CI -4.0, 0.6; p = 0.15) for controls. The difference between groups reached statistical significance, -7.6 (95% CI -11.4, -3.8; p < 0.0001). Total HADS scores in ICC patients were 3.4 points lower post-intervention and reached statistical significance (p = 0.001). CONCLUSION This matched cohort study demonstrates superior short-term outcomes of FGID patients in a structured multidisciplinary care setting as compared to standard care.
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Affiliation(s)
- Nicola A. Bray
- grid.1003.20000 0000 9320 7537Faculties of Medicine and Health and Behavioural Sciences, University of Queensland/TRI, Brisbane, QLD Australia
| | - Natasha A. Koloski
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia ,College of Health Medicine and Wellbeing, University of Newcastle/AGIRA, Callaghan, NSW Australia
| | - Michael P. Jones
- grid.1004.50000 0001 2158 5405School of Psychological Sciences, Macquarie University, Ryde, NSW Australia
| | - Anh Do
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Siong Pang
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Jeff S. Coombes
- grid.1003.20000 0000 9320 7537Faculties of Medicine and Health and Behavioural Sciences, University of Queensland/TRI, Brisbane, QLD Australia
| | - Sarah McAllister
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Jane Campos
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Leela Arthur
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Paul Stanley
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Katherine DeMaria
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Che-yung Chao
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Rachel Catague
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Amanda Whaley
- grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
| | - Nicholas J. Talley
- College of Health Medicine and Wellbeing, University of Newcastle/AGIRA, Callaghan, NSW Australia
| | - Gerald J. Holtmann
- grid.1003.20000 0000 9320 7537Faculties of Medicine and Health and Behavioural Sciences, University of Queensland/TRI, Brisbane, QLD Australia ,grid.412744.00000 0004 0380 2017Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD Australia
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Brown RCC, Coombes JS, Snoswell CL, Kelly JT, Keating SE. Medicare reimbursed telehealth exercise physiology services were underutilised through the coronavirus (COVID-19) pandemic: an ecological study. AUST HEALTH REV 2022; 47:175-181. [PMID: 36417781 DOI: 10.1071/ah22220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/04/2022] [Indexed: 11/24/2022]
Abstract
Objectives To describe the quantity and cost of in-person and telehealth exercise physiology (EP) reimbursed under the Medicare Benefits Schedule (MBS) in Australia before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods This study uses publicly available MBS data to describe EP services (in-person and telehealth) reimbursed by Medicare between January 2020 and December 2021. Data were extracted at state and national levels. Results Despite a reduction in quantity and cost in quartile (Q) 2 2020 (41% reduction), MBS-reimbursed EP services have remained relatively constant at a national level through the 2-year observation period. Service claims averaged 88 555 per quarter in 2020 and 95 015 in 2021. The proportion of telehealth consultations relative to total quarterly claims for EP was <1% in Q1 2020, 6.0% in Q2 2020, 2.4% in Q3 2020 and 1.7% in Q4 2020. This dropped to an average of 1.4% across 2021 (Q1-Q4). States undergoing lockdown periods reported decreased service rates relative to February 2020 (i.e. pre-lockdown). EP services were associated with a Medicare expenditure of AUD17.9M in 2020 (telehealth = 2.4% of total) and AUD19.7M (telehealth = 1.5% of total) in 2021. Conclusions Quantity and cost of MBS-reimbursed EP services remained relatively constant throughout the height of service disruption due to COVID-19 (2020/21). Telehealth uptake during this time has been minimal for EP.
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Affiliation(s)
- Riley C C Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Qld 4072, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Qld 4072, Australia
| | - Centaine L Snoswell
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Jaimon T Kelly
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Qld 4072, Australia
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Coombes JS, Keating SE, Mielke GI, Fassett RG, Coombes BK, O'Leary KP, Cox ER, Burton NW. Personal Activity Intelligence e-Health Program in People with Type 2 Diabetes: A Pilot Randomized Controlled Trial. Med Sci Sports Exerc 2022; 54:18-27. [PMID: 34334715 DOI: 10.1249/mss.0000000000002768] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Innovative strategies are needed to enable people with type 2 diabetes (T2D) to self-manage physical activity (PA). Personal Activity Intelligence (PAI) is a new metric that uses the heart rate response to PA to inform the user as to whether they are doing enough PA to reduce the risk of premature mortality. The PAI score reflects PA over the previous 7 d with the goal to maintain a score ≥100. The aim of this study was to investigate the feasibility, acceptability, and efficacy of the PAI e-Health Program in people with T2D. METHODS Thirty participants with T2D who were not meeting PA guidelines were randomly assigned to 12 wk of either 1) PAI e-Health Program or 2) PA attention control. The PAI e-Health Program consisted of receiving a wrist-worn heart rate monitor and an app with the PAI metric, and attending 4 × 2 h·wk-1 sessions of exercise and counseling. Feasibility and acceptability of the program were evaluated by achievement of a PAI score ≥100 and participant feedback. Efficacy was determined from changes in glycemic control, cardiorespiratory fitness, exercise capacity (time-on-test), body composition, sleep time, and health-related quality of life. RESULTS Program participants in the PAI e-Health Program had a mean ± SD PAI score of 119.7 ± 60.6 and achieved ≥100 PAI on 56.4% of the days. The majority of participants (80%) intended to continue to use PAI monitoring. Compared with control, the PAI group significantly improved their exercise capacity (mean difference, 95% confidence interval) (63 s, 17.9-108.0 s), sleep time (67.2 min, 7.2-127.1 min), total percent body fat (-1.3%, -2.6% to -0.1%), and gynoid fat percent (-1.5%, -2.6 to -0.5). CONCLUSIONS The PAI e-Health Program is feasible, acceptable, and efficacious in people with T2D.
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Affiliation(s)
- Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, AUSTRALIA
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, AUSTRALIA
| | - Gregore I Mielke
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, AUSTRALIA
| | - Robert G Fassett
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, AUSTRALIA
| | - Brooke K Coombes
- School of Allied Health Sciences, Griffith University, Queensland, AUSTRALIA
| | - Kaitlyn P O'Leary
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, AUSTRALIA
| | - Emily R Cox
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, AUSTRALIA
| | - Nicola W Burton
- School of Applied Psychology, Griffith University, Brisbane, AUSTRALIA
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Feter N, Caputo EL, Leite JS, Smith EC, Doring IR, Cassuriaga J, Delpino FM, Huckembeck CM, Alt R, Reichert FF, da Silva MC, Coombes JS, Rombaldi AJ. Depression and anxiety symptoms remained elevated after 10 months of the COVID-19 pandemic in southern Brazil: findings from the PAMPA cohort. Public Health 2021; 204:14-20. [PMID: 35121569 PMCID: PMC8716150 DOI: 10.1016/j.puhe.2021.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/22/2022]
Abstract
Objectives This study aimed to examine the changes in depression and anxiety symptoms among Brazilian adults over 10 months of the COVID-19 pandemic. Study design/Methods The present study used data from wave 1 (June/July 2020) and wave 2 (December 2020/January 2021) of the Prospective Study About Mental and Physical Health (PAMPA) Cohort, a state-level, ambispective longitudinal study with adults from southern Brazil. The frequency of anxiety and depressive symptoms was assessed using the Hospital Anxiety and Depression Scale. Anxiety and depressive symptoms before social distancing were retrospectively assessed during wave 1. Results Most of the 674 participants were classified as non-symptomatic for depressive (85.0%) and anxiety symptoms (73.2%) before the COVID-19 pandemic. At wave 1, there were increases in symptoms of depression (7.6% [95% confidence interval [CI]: 7.2%, 8.1%]) and anxiety (9.1% [95% CI: 8.6%, 9.5%]). These decreased at wave 2 (depression: 6.9% [95% CI: 6.5%, 7.2%]; anxiety: 7.4% [95% CI: 7.1%, 7.8%]) although they were still elevated compared with pre-COVID (depression: 4.5% [95% CI: 4.2%, 4.8%]; anxiety: 5.8% [95% CI: 5.5%, 6.1%]). Adults living alone (b = 0.44 [95% CI: 0.07, 0.82]) had a faster trajectory in anxiety symptoms than their counterparts. Cohort members who were living alone (b = 0.24 [95% CI: 0.06, 0.42]) and with diagnosed chronic disease (0.32 [95% CI: 0.18, 0.46]) had a faster increase in depressive symptoms than their respective counterparts. Participants aged ≥60 years showed a slower trajectory of depressive (b = −0.46 [95% CI: −0.73, −0.18]) and anxiety (b = −0.61 [95% CI: −1.20, −0.02) symptoms. Conclusions During 10 months of COVID-19, anxiety and depression symptoms improved but were still higher than before COVID-19.
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Affiliation(s)
- N Feter
- Postgraduate Program of Physical Education, Federal University of Pelotas, Pelotas, Brazil; Study Group of Physical Activity Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - E L Caputo
- Postgraduate Program of Physical Education, Federal University of Pelotas, Pelotas, Brazil; Study Group of Physical Activity Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - J S Leite
- Postgraduate Program of Health Sciences, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - E C Smith
- School of Human Movement and Nutritional Sciences, The University of Queensland, Brisbane, Australia
| | - I R Doring
- Study Group of Physical Activity Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - J Cassuriaga
- Postgraduate Program of Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - F M Delpino
- Postgraduate Program of Nursing, Federal University of Pelotas, Pelotas, Brazil
| | - C M Huckembeck
- Postgraduate Program of Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - R Alt
- Postgraduate Program of Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - F F Reichert
- Postgraduate Program of Physical Education, Federal University of Pelotas, Pelotas, Brazil; Study Group of Physical Activity Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - M C da Silva
- Postgraduate Program of Physical Education, Federal University of Pelotas, Pelotas, Brazil; Study Group of Physical Activity Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - J S Coombes
- School of Human Movement and Nutritional Sciences, The University of Queensland, Brisbane, Australia
| | - A J Rombaldi
- Postgraduate Program of Physical Education, Federal University of Pelotas, Pelotas, Brazil; Study Group of Physical Activity Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Ramos JS, Dalleck LC, Fennell M, Martini A, Welmans T, Stennett R, Keating SE, Fassett RG, Coombes JS. Exercise Training Intensity and the Fitness-Fatness Index in Adults with Metabolic Syndrome: A Randomized Trial. Sports Med - Open 2021; 7:100. [PMID: 34951682 PMCID: PMC8709799 DOI: 10.1186/s40798-021-00395-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Cardiorespiratory fitness and fatness (notably central obesity) are mediating factors of the metabolic syndrome (MetS) and consequent cardiovascular disease (CVD)/mortality risk. The fitness-fatness index (FFI) combines these factors and has been reported to be a better indicator of CVD and all-cause mortality risk, beyond the capacity of either fitness or fatness alone.
Objective
This study sought to investigate the effects of different exercise intensities on FFI in adults with MetS.
Methods
This was a sub-study of the ‘Exercise in the prevention of Metabolic Syndrome’ (EX-MET) multicentre trial. Ninety-nine adults diagnosed with MetS according to the International Diabetes Federation criteria were randomized to one of the following 16-week exercise interventions: i) moderate-intensity continuous training (MICT) at 60–70% HRpeak for 30 min/session (n = 34, 150 min/week); ii) 4 × 4 min bouts of high-intensity interval training at 85–95% HRpeak, interspersed with 3-min active recovery at 50–70% HRpeak (n = 34, 38 min/session, 114 min/week); and iii) 1 × 4 min bout of HIIT at 85–95% HRpeak (n = 31, 17 min/session, 51 min/week). Cardiorespiratory fitness (peak oxygen uptake, V̇O2peak) was determined via indirect calorimetry during maximal exercise testing and fatness was the ratio of waist circumference-to-height (WtHR). FFI was calculated as V̇O2peak in metabolic equivalents (METs) divided by WtHR. A clinically meaningful response to the exercise intervention was taken as a 1 FFI unit increase.
Results
Seventy-seven participants completed pre and post testing to determine FFI. While there was no significant between group difference (p = 0.30), there was a small group x time interaction effect on FFI [F(2, 73) = 1.226; η2 = 0.01], with numerically greater improvements following HIIT (4HIIT, + 16%; 1HIIT, + 11%) relative to MICT (+ 7%). There was a greater proportion of participants who had a clinically meaningful change in FFI following high-volume HIIT (60%, 15/25) and low-volume HIIT (65%, 17/26) compared to MICT (38%, 10/26), but with no significant between-group difference (p = 0.12). A similar trend was found when a sub-analysis comparing the FFI between those with type 2 diabetes (MICT, 33%, 3/9; high-volume HIIT, 64%, 7/11; and low-volume HIIT, 58%, 7/12) and without type 2 diabetes (MICT, 41%, 7/17; high-volume HIIT, 57%, 8/14; low-volume HIIT, 71%, 10/14).
Conclusion
Although there were no statistically significant differences detected between groups, this study suggests that the response to changes in FFI in adults with MetS may be affected by exercise intensity, when numerical differences between exercise groups are considered. Further research is warranted.
Trial registration number and date of registration: ClinicalTrials.gov NCT01676870; 31/08/2012.
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Koep JL, Taylor CE, Coombes JS, Bond B, Ainslie PN, Bailey TG. Autonomic control of cerebral blood flow: fundamental comparisons between peripheral and cerebrovascular circulations in humans. J Physiol 2021; 600:15-39. [PMID: 34842285 DOI: 10.1113/jp281058] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/25/2021] [Indexed: 01/12/2023] Open
Abstract
Understanding the contribution of the autonomic nervous system to cerebral blood flow (CBF) control is challenging, and interpretations are unclear. The identification of calcium channels and adrenoreceptors within cerebral vessels has led to common misconceptions that the function of these receptors and actions mirror those of the peripheral vasculature. This review outlines the fundamental differences and complex actions of cerebral autonomic activation compared with the peripheral circulation. Anatomical differences, including the closed nature of the cerebrovasculature, and differential adrenoreceptor subtypes, density, distribution and sensitivity, provide evidence that measures on peripheral sympathetic nerve activity cannot be extrapolated to the cerebrovasculature. Cerebral sympathetic nerve activity seems to act opposingly to the peripheral circulation, mediated at least in part by changes in intracranial pressure and cerebral blood volume. Additionally, heterogeneity in cerebral adrenoreceptor distribution highlights region-specific autonomic regulation of CBF. Compensatory chemo- and autoregulatory responses throughout the cerebral circulation, and interactions with parasympathetic nerve activity are unique features to the cerebral circulation. This crosstalk between sympathetic and parasympathetic reflexes acts to ensure adequate perfusion of CBF to rising and falling perfusion pressures, optimizing delivery of oxygen and nutrients to the brain, while attempting to maintain blood volume and intracranial pressure. Herein, we highlight the distinct similarities and differences between autonomic control of cerebral and peripheral blood flow, and the regional specificity of sympathetic and parasympathetic regulation within the cerebrovasculature. Future research directions are outlined with the goal to further our understanding of autonomic control of CBF in humans.
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Affiliation(s)
- Jodie L Koep
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Chloe E Taylor
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, British Columbia, Canada
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.,School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia
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Taylor JL, Keating SE, Holland DJ, Green DJ, Coombes JS, Bailey TG. Comparison of high intensity interval training with standard cardiac rehabilitation on vascular function. Scand J Med Sci Sports 2021; 32:512-520. [PMID: 34825728 DOI: 10.1111/sms.14106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 11/12/2021] [Accepted: 11/23/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To compare the short- and long-term effects of high-intensity interval training (HIIT) with usual care moderate intensity continuous training (MICT) on systemic vascular function and stiffness in patients with coronary artery disease undergoing a cardiac rehabilitation program. DESIGN Randomized controlled trial. METHODS Fifty-four patients (age = 63 ± 8 years, 93% male) were randomized to complete 3 sessions/week (2 supervised, 1 home-based) of either (1) 4 × 4-min HIIT or (2) 40-min MICT, for 4 weeks. Patients then continued 3 unsupervised home-based sessions/week of their allocated training for 11 months. Brachial artery flow-mediated dilation, pulse wave velocity, and blood pressure were measured at baseline, 4 weeks, 3 months, 6 months, and 12 months. Data were analyzed using linear mixed modeling and are presented as mean change from baseline (95% CI). RESULTS HIIT showed a greater improvement in flow-mediated dilation compared to MICT after 4 weeks [1.5% (0.9, 2.1) vs 0.1% (-0.5, 0.8); p = 0.004) but not 12 months [1.2% (-0.2, 2.5) vs 0.4% (-0.8, 1.7); p = 0.153). There were no short- or long-term group differences for changes in pulse wave velocity, peripheral or central blood pressure between HIIT and MICT after 4 weeks, or over 12 months. CONCLUSIONS A 4-week HIIT program was superior to MICT for improving vascular function, but not arterial stiffness or blood pressure. Over 12 months, changes in vascular function, blood pressure, and arterial stiffness were similar for HIIT and MICT.
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Affiliation(s)
- Jenna L Taylor
- Centre for Research on Exercise, Physical Activity, and Health (CREXPAH), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Cardiac Rehabilitation Department, The Wesley Hospital, Brisbane, Australia
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity, and Health (CREXPAH), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - David J Holland
- Centre for Research on Exercise, Physical Activity, and Health (CREXPAH), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Department of Cardiology, Sunshine Coast University Hospital, Birtinya, Australia.,School of Medicine, Griffith University, Sunshine Coast, Australia
| | - Daniel J Green
- School of Human Sciences (Exercise and Sport Sciences), University of Western Australia, Perth, WA, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity, and Health (CREXPAH), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Tom G Bailey
- Centre for Research on Exercise, Physical Activity, and Health (CREXPAH), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Physiology and Ultrasound Laboratory in Science and Exercise (PULSE), School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Qld, Australia
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42
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Koep JL, Weston ME, Barker AR, Bailey TG, Coombes JS, Lester A, Bond B. The within- and between-day reliability of cerebrovascular reactivity using traditional and novel analytical approaches. Exp Physiol 2021; 107:29-41. [PMID: 34806238 DOI: 10.1113/ep090031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/15/2021] [Indexed: 12/14/2022]
Abstract
NEW FINDINGS What is the central question of the study? What is the reliability of middle cerebral artery velocity cerebrovascular reactivity (CVR) when using traditional and novel outcomes, as measured by transcranial Doppler? What is the main finding and its importance? Traditional CVR approaches presented acceptable reproducibility but should be expressed as an absolute CVR. Large within- and between-individual differences in the middle cerebral artery velocity response profile support using a dynamic peak, rather than a set time point, for the most reliable interpretation. The study highlights the utility of novel kinetic CVR outcomes, but due to increased variability in time-based metrics, this analysis requires larger sample sizes than traditional methods. ABSTRACT Cerebrovascular reactivity (CVR) of middle cerebral artery velocity (MCAv) to CO2 is a common method to assess cerebrovascular function. Yet, the approaches used to calculate CVR outcomes vary. The aim of this study was to explore the within- and between-day reliability of traditional CVR outcomes. The second aim was to explore the reliability of novel kinetic-based analyses. Healthy adults (n = 10, 22.3 ± 3.4 years) completed assessments of CVR over 4 min using a fixed fraction of inspired CO2 (6%). This was repeated across four separate visits (between-day), and on one visit measures were repeated 2.5 h later (within-day). No mean biases were present between assessments for traditional CVR metrics, expressed as absolute (cm/s/mmHg) or relative (%/mmHg) outcomes (minute 3, minute 4, peak 1 s, peak 30 s) (between-day: P > 0.14, ηp 2 < 0.20; within-day: P > 0.22, d > 0.27). Absolute, rather than relative, CVR yielded the most reproducible parameters (coefficient of variation: 8.1-13.2% vs. 14-83%, respectively). There were significant differences between CVR outcomes (P < 0.001, ηp 2 > 0.89) dependent on the time point used to determine CVR, as a steady state MCAv response was rarely observed. Furthermore, the MCAv response was not reproducible within an individual (κ = 0.15, P = 0.09). No mean differences were present for novel kinetic outcomes (amplitude, time-delay, time constant) (between-day: P > 0.05, d < 0.33; within-day: P > 0.38, d < 0.25). The results support the need for standardisation and indicate CVR should be defined as a dynamic peak, rather than a set time point for increased reliability. For novel kinetic outcomes variability was greater (CV: 8.7-120.9%) due to the nature of time-based metrics.
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Affiliation(s)
- Jodie L Koep
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.,Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Max E Weston
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.,Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.,School of Nursing Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Alice Lester
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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Letnes JM, Berglund I, Johnson KE, Dalen H, Nes BM, Lydersen S, Viken H, Hassel E, Steinshamn S, Vesterbekkmo EK, Støylen A, Reitlo LS, Zisko N, Bækkerud FH, Tari AR, Ingebrigtsen JE, Sandbakk SB, Carlsen T, Anderssen SA, Singh MAF, Coombes JS, Helbostad JL, Rognmo Ø, Wisløff U, Stensvold D. Effect of 5 years of exercise training on the cardiovascular risk profile of older adults: the Generation 100 randomized trial. Eur Heart J 2021; 43:2065-2075. [PMID: 34746955 PMCID: PMC9156390 DOI: 10.1093/eurheartj/ehab721] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/09/2021] [Accepted: 10/01/2021] [Indexed: 11/12/2022] Open
Abstract
AIMS The aim of this study was to compare the effects of 5 years of supervised exercise training (ExComb), and the differential effects of subgroups of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT), with control on the cardiovascular risk profile in older adults. METHODS AND RESULTS Older adults aged 70-77 years from Trondheim, Norway (n = 1567, 50% women), able to safely perform exercise training were randomized to 5 years of two weekly sessions of HIIT [∼90% of peak heart rate (HR), n = 400] or MICT (∼70% of peak HR, n = 387), together forming ExComb (n = 787), or control (instructed to follow physical activity recommendations, n = 780). The main outcome was a continuous cardiovascular risk score (CCR), individual cardiovascular risk factors, and peak oxygen uptake (VO2peak). CCR was not significantly lower [-0.19, 99% confidence interval (CI) -0.46 to 0.07] and VO2peak was not significantly higher (0.39 mL/kg/min, 99% CI -0.22 to 1.00) for ExComb vs. control. HIIT showed higher VO2peak (0.76 mL/kg/min, 99% CI 0.02-1.51), but not lower CCR (-0.32, 99% CI -0.64 to 0.01) vs. control. MICT did not show significant differences compared to control or HIIT. Individual risk factors mostly did not show significant between-group differences, with some exceptions for HIIT being better than control. There was no significant effect modification by sex. The number of cardiovascular events was similar across groups. The healthy and fit study sample, and contamination and cross-over between intervention groups, challenged the possibility of detecting between-group differences. CONCLUSIONS Five years of supervised exercise training in older adults had little effect on cardiovascular risk profile and did not reduce cardiovascular events. REGISTRATION ClinicalTrials.gov: NCT01666340.
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Affiliation(s)
- Jon Magne Letnes
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway.,Levanger Hospital, Nord-Trøndelag Health Trust, Kirkegata 2, Levanger 7600, Norway
| | - Ida Berglund
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Kristin E Johnson
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Håvard Dalen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway.,Levanger Hospital, Nord-Trøndelag Health Trust, Kirkegata 2, Levanger 7600, Norway
| | - Bjarne M Nes
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Hallgeir Viken
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Erlend Hassel
- Norwegian Armed Forces Occupational Health Service, Post Box 800, Lillehammer 2617, Norway.,Department of Thoracic Medicine, Clinic of Thoracic and Occupational Medicine, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Sigurd Steinshamn
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Thoracic Medicine, Clinic of Thoracic and Occupational Medicine, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Elisabeth Kleivhaug Vesterbekkmo
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Asbjørn Støylen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Line S Reitlo
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Nina Zisko
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Fredrik H Bækkerud
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Atefe R Tari
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Jan Erik Ingebrigtsen
- Department of Sociology and Political Science, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Silvana B Sandbakk
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Teacher Education, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Trude Carlsen
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Sigmund A Anderssen
- Department of Sports Medicine, The Norwegian School of Sport Sciences, Sognsveien 220, Oslo 0863, Norway
| | - Maria A Fiatarone Singh
- Sydney School of Health Sciences and Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia.,Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, 1200 Centre St, Boston, MA 02131, USA
| | - Jeff S Coombes
- School of Human Movement and Nutrition Science, University of Queensland, Human Movement Studies Building, St Lucia QLD, Queensland 4067, Australia
| | - Jorunn L Helbostad
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway
| | - Øivind Rognmo
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,School of Human Movement and Nutrition Science, University of Queensland, Human Movement Studies Building, St Lucia QLD, Queensland 4067, Australia
| | - Dorthe Stensvold
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Post Box 8905, Trondheim 7491, Norway.,Department of Cardiology, St Olavs University Hospital, Prinsesse Kristinas gate 3, Trondheim 7030, Norway
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Doola R, Deane AM, Barrett HL, Okano S, Tolcher DM, Gregory K, Coombes JS, Schalkwijk C, Todd AS, Forbes JM, Sturgess DJ. The impact of a modified carbohydrate formula, and its constituents, on glycaemic control and inflammatory markers: A nested mechanistic sub-study. J Hum Nutr Diet 2021; 35:455-465. [PMID: 34743379 DOI: 10.1111/jhn.12959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/11/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Hyperglycaemia occurs frequently in the critically ill. Dietary intake of advanced glycation end-products (AGEs), specifically Nε-(carboxymethyl)lysine (CML), may exacerbate hyperglycaemia through perturbation of insulin sensitivity. The present study aimed to determine whether the use of nutritional formulae, with varying AGE loads, affects the amount of insulin administered and inflammation. METHODS Exclusively tube fed patients (n = 35) were randomised to receive Nutrison Protein Plus Multifibre®, Diason® or Glucerna Select®. Insulin administration was standardised according to protocol based on blood glucose (<10 mmol L-1 ). Samples were obtained at randomisation and 48 h later. AGEs in nutritional formula, plasma and urine were measured using mass spectrometry. Plasma inflammatory markers were measured using an enzyme-linked immunosorbent assay and multiplex bead-based assays. RESULTS AGE concentrations of CML in nutritional formulae were greatest with delivery of Nutrison Protein Plus® (mean [SD]; 6335 pmol mol-1 [2436]) compared to Diason® (4836 pmol mol-1 [1849]) and Glucerna Select® (4493 pmol mol-1 [1829 pmol mol-1 ]) despite patients receiving similar amounts of energy (median [interquartile range]; 12 MJ [8.2-13.7 MJ], 11.5 MJ [8.3-14.5 MJ], 11.5 MJ [8.3-14.5 MJ]). More insulin was administered with Nutrison Protein Plus® (2.47 units h-1 [95% confidence interval (CI) = 1.57-3.37 units h-1 ]) compared to Diason® (1.06 units h-1 [95% CI = 0.24-1.89 units h-1 ]) or Glucerna Select® (1.11 units h-1 [95% CI = 0.25-1.97 units h-1 ]; p = 0.04). Blood glucose concentrations were similar. There were associations between greater insulin administration and reductions in circulating interleukin-6 (r = -0.46, p < 0.01), tumour necrosis factor-α (r = -0.44, p < 0.05), high sensitivity C-reactive protein (r = -0.42, p < 0.05) and soluble receptor for advanced glycation end-products (r = -0.45, p < 0.01) concentrations. CONCLUSIONS The administration of greater AGE load in nutritional formula potentially increases the amount of insulin required to maintain blood glucose within a normal range during critical illness. There was an inverse relationship between exogenous insulin and plasma inflammatory markers.
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Affiliation(s)
- Ra'eesa Doola
- Princess Alexandra Hospital, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Adam M Deane
- The Royal Melbourne Hospital, The University of Melbourne and Mater Research Institute - The University of Queensland, Brisbane, QLD, Australia
| | - Helen L Barrett
- Mater Health Services, Mater Research Institute - The University of Queensland, Brisbane, QLD, Australia
| | - Satomi Okano
- Mater Research Institute - Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Debbie M Tolcher
- System Planning Branch, Strategy Policy and Planning Division, Brisbane, QLD, Australia
| | - Kye Gregory
- SHECC IMT, Queensland Health, Brisbane, QLD, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Casper Schalkwijk
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht, Maastricht University Medical Centre, Netherlands, The Netherlands
| | - Alwyn S Todd
- Mater Research Institute - The University of Queensland and Menzies Health Institute Brisbane, Griffith University, Brisbane, QLD, Australia
| | - Josephine M Forbes
- Mater Research Institute - The University of Queensland, Brisbane, QLD, Australia
| | - David J Sturgess
- Mater Research Institute - The University of Queensland, Brisbane, QLD, Australia
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45
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Hannan AL, Hing W, Coombes JS, Gough S, Climstein M, Adsett G, Jayasinghe R, Furness J. Effect of personal activity intelligence (PAI) monitoring in the maintenance phase of cardiac rehabilitation: a mixed methods evaluation. BMC Sports Sci Med Rehabil 2021; 13:124. [PMID: 34629086 PMCID: PMC8503999 DOI: 10.1186/s13102-021-00350-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/27/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Personal activity intelligence (PAI) is a single physical activity metric based upon heart rate responses to physical activity. Maintaining 100 PAI/week is associated with a 25% risk reduction in cardiovascular disease mortality and 50 PAI/week provides 60% of the benefits. The effect of utilising this metric within a cardiac population has not been previously investigated. The aim of this study was to determine the effect of PAI monitoring on the amount and/or intensity of physical activity for people in the maintenance phase of cardiac rehabilitation and to explore participants' perceptions of this approach. METHODS A concurrent mixed methods approach was undertaken. Participants in the maintenance phase of cardiac rehabilitation monitored PAI for six weeks via a wearable physical activity monitoring device (WPAM). In the first three weeks participants were blinded to their PAI score. A quality-of-life questionnaire (EQ-5D-5L) was completed, and semi-structured interviews conducted to investigate attitudes to PAI monitoring. Daily PAI data was collected throughout the 6-week period. RESULTS Twenty participants completed the trial. PAI earned/day was increased after participants could view their data (mean difference: 2.1 PAI/day (95% CI 0.3, 4.0), p = 0.027). The median change in percentage of days participants achieved a Total PAI score of 25 (p = 0.023) and 50 (p = 0.015) were also increased. The mean change in total scores for the EQ-5D-5L and EQVAS were improved after 6 weeks (0.6 ± 1.05; 95% CI (0.11-1.09); p = 0.019); (5.8/100; 95% CI (2.4-9.2); p = 0.002 respectively). Thematic framework analysis identified three global themes (perceptions on the WPAM, PAI and factors affecting exercise). Most participants stated motivation to exercise increased after they could view their PAI data. Many of the participants believed they would continue to use PAI long-term. Others were undecided; the latter primarily due to technical issues and/or preferring devices with greater functionality and attractiveness. All participants would recommend PAI. CONCLUSION This exploratory study showed monitoring PAI via a WPAM increased the amount and/or intensity of physical activity within the cardiac population. Participants found PAI interesting, beneficial, and motivating. If technical issues, aesthetics, and functionality of the WPAM were improved, participants may continue to use the approach long-term. PAI may be a viable strategy to assist people with cardiac disease maintain physical activity adherence.
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Affiliation(s)
- Amanda L Hannan
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia. .,Bond Institute of Health and Sport, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Wayne Hing
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia.,Water Based Research Unit, Bond University, Gold Coast, Australia
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Suzanne Gough
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Mike Climstein
- Clinical Exercise Physiology, School of Health and Human Sciences, Southern Cross University, Bilinga, QLD, Australia.,Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, University of Sydney, Sydney, NSW, Australia.,Water Based Research Unit, Bond University, Gold Coast, Australia
| | | | - Rohan Jayasinghe
- Cardiology Department, Gold Coast University Hospital, Queensland, Griffith University, Brisbane, QLD, Australia.,Macquarie University, Sydney, NSW, Australia
| | - James Furness
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia.,Water Based Research Unit, Bond University, Gold Coast, Australia
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46
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Weston ME, Barker AR, Tomlinson OW, Coombes JS, Bailey TG, Bond B. Differences in cerebrovascular regulation and ventilatory responses during ramp incremental cycling in children, adolescents, and adults. J Appl Physiol (1985) 2021; 131:1200-1210. [PMID: 34435503 DOI: 10.1152/japplphysiol.00182.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Regulation of cerebral blood flow during exercise in youth is poorly understood. This study investigated the cerebrovascular and ventilatory responses to a ramp incremental cycle test to exhaustion in 14 children (means ± SD age: 9.4 ± 0.9 yr), 14 adolescents (12.4 ± 0.4 yr), and 19 adults (23.4 ± 2.5 yr). Middle cerebral artery blood velocity (MCAv), partial pressure of end-tidal CO2 ([Formula: see text]), and ventilatory parameters were analyzed at baseline, gas exchange threshold (GET), respiratory compensation point (RCP), and exhaustion. The increase in minute ventilation relative to CO2 production during exercise was also calculated (V̇e/V̇co2 slope). Relative change from baseline (Δ%) in MCAv was lower in children, compared with adolescents and adults at GET [15 ± 10% vs. 26 ± 14%, and 24 ± 10%, respectively, P ≤ 0.03, effect size (d) = 0.9] and RCP (13 ± 11% vs. 24 ± 16% and 27 ± 15%, respectively, P ≤ 0.05, d ≥ 0.8). Δ%MCAv was similar in adults and adolescents at all intensities and similar in all groups at exhaustion. The magnitude of the V̇E/V̇co2 slope was negatively associated with Δ%MCAv at GET and RCP across all participants (P ≤ 0.01, r = -0.37 to -0.48). Δ%[Formula: see text] was smaller in children and adolescents compared with adults at GET and RCP (P ≤ 0.05, d ≥ 0.6). In children, Δ%[Formula: see text] and Δ%MCAv were not associated from baseline-GET (r¯ = 0.14) and were moderately associated from RCP-exhaustion (r¯ = 0.49). These relationships strengthened with increasing age and were stronger in adolescents (baseline-GET: r¯ = 0.47, RCP-exhaustion: r¯ = 0.62) and adults (baseline-GET: r¯ = 0.66, RCP-exhaustion: r¯ = 0.78). These findings provide the first evidence on the development of the regulatory role of [Formula: see text] on MCAv during exercise in children, adolescents, and adults.NEW & NOTEWORTHY This is the first study to observe similar increases in cerebral blood flow during incremental exercise in adolescents and adults. Increases in cerebral blood flow during exercise were smaller in children compared with adolescents and adults and were associated with a greater V̇E/V̇co2 slope. This study also provides the first evidence on the progressive development of the regulatory role of end-tidal CO2 on cerebral blood flow during exercise during the transition from childhood to adulthood.
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Affiliation(s)
- Max E Weston
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom.,Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Owen W Tomlinson
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
| | - Jeff S Coombes
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Tom G Bailey
- Physiology and Ultrasound Laboratory in Science and Exercise, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
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Davids CJ, Næss TC, Moen M, Cumming KT, Horwath O, Psilander N, Ekblom B, Coombes JS, Peake JM, Raastad T, Roberts LA. Acute cellular and molecular responses and chronic adaptations to low-load blood flow restriction and high-load resistance exercise in trained individuals. J Appl Physiol (1985) 2021; 131:1731-1749. [PMID: 34554017 DOI: 10.1152/japplphysiol.00464.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Blood flow restriction (BFR) with low-load resistance exercise (RE) is often used as a surrogate to traditional high-load RE to stimulate muscular adaptations, such as hypertrophy and strength. However, it is not clear whether such adaptations are achieved through similar cellular and molecular processes. We compared changes in muscle function, morphology and signaling pathways between these differing training protocols. Twenty-one males and females (mean ± SD: 24.3 ± 3.1 years) experienced with resistance training (4.9 ± 2.6 years) performed nine weeks of resistance training (three times per week) with either high-loads (75-80% 1RM; HL-RT), or low-loads with BFR (30-40% 1RM; LL-BFR). Before and after the training intervention, resting muscle biopsies were collected, and quadricep cross-sectional area (CSA), muscular strength and power were measured. Approximately 5 days following the intervention, the same individuals performed an additional 'acute' exercise session under the same conditions, and serial muscle biopsies were collected to assess hypertrophic- and ribosomal-based signaling stimuli. Quadricep CSA increased with both LL-BFR (7.4±4.3%) and HL-RT (4.6±2.9%), with no significant differences between training groups (p=0.37). Muscular strength also increased in both training groups, but with superior gains in squat 1RM occurring with HL-RT (p<0.01). Acute phosphorylation of several key proteins involved in hypertrophy signaling pathways, and expression of ribosomal RNA transcription factors occurred to a similar degree with LL-BFR and HL-RT (all p>0.05 for between-group comparisons). Together, these findings validate low-load resistance training with continuous BFR as an effective alternative to traditional high-load resistance training for increasing muscle hypertrophy in trained individuals.
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Affiliation(s)
- Charlie J Davids
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia
| | - Tore C Næss
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
| | - Maria Moen
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
| | | | - Oscar Horwath
- Åstrand Laboratory, Department of Physiology, Nutrition and Biomechanics, Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Niklas Psilander
- Åstrand Laboratory, Department of Physiology, Nutrition and Biomechanics, Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Björn Ekblom
- Åstrand Laboratory, Department of Physiology, Nutrition and Biomechanics, Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Jonathan M Peake
- Queensland Academy of Sport, Nathan, Australia.,Queensland University of Technology, School of Biomedical Science, Brisbane, Australia
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway
| | - Llion Arwyn Roberts
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia.,Griffith Sports Science, School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
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48
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Feter N, Dumith SC, Smith EC, da Cunha LL, Cassuriaga J, Leite JS, Alt R, Coombes JS, Rombaldi AJ. Physical activity attenuates the risk for dementia associated with aging in older adults with mild cognitive impairment. Findings from a population-based cohort study. J Psychiatr Res 2021; 141:1-8. [PMID: 34171758 DOI: 10.1016/j.jpsychires.2021.06.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
From 2016 to 2040 the number of people with dementia in the United Kingdom is expected to increase by 57%, while 70% percent of it is due to a higher life expectancy. Thus, we analyzed the overall and age-stratified effect of physical activity on risk of dementia in participants with mild cognitive impairment (MCI) of the English Longitudinal Study of Ageing (ELSA). Participants of the ELSA, aged over 50 with MCI, were followed-up nine times between 2002 and 2019. Physical activity was assessed using a self-reported, validated questionnaire and participants were classified as inactive, low, or moderate-to-high active. Medical diagnosis of dementia was self-reported or determined using the Informant Questionnaire on Cognitive Decline in the Elderly. Data from 521 participants with MCI were analyzed (56% women; mean [SD] age, 68.7 [10.6]). Over 17-year follow-up, 20.5 (95%CI: 17.3 to 24.2)% were diagnosed with dementia. The risk of incident dementia was reduced in participants engaging in low (HR: 0.34; 95%CI: 0.22 to 0.54) or moderate-to-high (HR: 0.16; 95%CI: 0.08 to 0.33) levels of physical activity. Risk of dementia in adults aged 80 or more engaging in low or moderate-to-high levels of physical activity was not different from inactive adults aged between 50 and 69 years. Results were sustained after competing risk regression model and sensitivity analyses to reduce the impact of reverse causality. Physical activity appears to minimize the risk associated with aging in older adults with MCI.
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Affiliation(s)
- Natan Feter
- Neuroscience and Physical Activity Research Group, Superior School of Physical Education, Federal University of Pelotas, Pelotas, Brazil; Centre of Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
| | - Samuel C Dumith
- Postgraduate Program in Health Sciences, Federal University of Rio Grande, Rio Grande, Brazil
| | - Emily C Smith
- Centre of Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Larissa L da Cunha
- Neuroscience and Physical Activity Research Group, Superior School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Júlia Cassuriaga
- Neuroscience and Physical Activity Research Group, Superior School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Jayne S Leite
- Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Ricardo Alt
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Jeff S Coombes
- Centre of Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Airton J Rombaldi
- Neuroscience and Physical Activity Research Group, Superior School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
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Feter N, Häfele CA, Cassuriaga J, Smith EC, Häfele V, Rosseto L, Coombes JS, Rombaldi AJ, da Silva MC. Two-minute exercise testing is sufficient to estimate maximal cardiorespiratory fitness in people with epilepsy. Epilepsy Behav 2021; 121:108086. [PMID: 34111765 DOI: 10.1016/j.yebeh.2021.108086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/12/2021] [Accepted: 05/19/2021] [Indexed: 11/18/2022]
Abstract
We aimed to examine the agreement between submaximal cardiopulmonary exercise testing (CPET) measures and peak oxygen consumption (VO2peak) in adults with epilepsy. Data from a randomized controlled trial with adults with epilepsy (N = 21) were analyzed. VO2peak was assessed using indirect calorimetry during a treadmill graded maximal CPET. Oxygen uptake efficiency slope (OUES) was calculated from the relationship between oxygen uptake and minute ventilation during the entire test (OUESpeak) and the first 2 (OUES2min), 3 (OUES3min), and 4 (OUES4min) minutes of the CPET. The strength of the association between measures was tested by Pearson correlation. Linear regression models were used to predict VO2peak based on OUES from the different testing durations. Agreement between measured and predicted maximal values was tested using intraclass correlation coefficient (ICC) and Bland-Altman plots. OUES2min, OUES3min, and OUES4min were highly associated with absolute (r = 0.84, r = 0.76, r = 0.75, respectively) and relative (r = 0.84, r = 0.78, r = 0.78, respectively) VO2peak. Agreement (ICC = 0.83) between CPET-measured and OUES-predicted VO2peak values was stronger with OUES2min than the other time-based OUES markers. Bland-Altman plot showed satisfactory agreement between predicted and measured CPET measures with the narrowest limits of agreement observed with the OUES2min. No potential bias was identified between these two measurements (p = 0.33). Changes in absolute (r = 0.77) and relative (r = 0.88) VO2peak were highly associated with the change in OUES2min. OUES2min can be used as a surrogate for maximal cardiorespiratory fitness in adults with epilepsy. Studies with larger samples size are encouraged to confirm our findings in a more heterogeneous population.
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Affiliation(s)
- Natan Feter
- School of Physical Education, Federal University of Pelotas, Pelotas, Brazil; Centre for Research on Exercise, Physical Activity and Health - Researchers, The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia.
| | - César A Häfele
- School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Júlia Cassuriaga
- School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Emily C Smith
- Centre for Research on Exercise, Physical Activity and Health - Researchers, The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Vítor Häfele
- School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Lucas Rosseto
- School of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health - Researchers, The University of Queensland, School of Human Movement and Nutrition Sciences, St Lucia Campus, Brisbane, Australia
| | - Airton J Rombaldi
- School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Marcelo C da Silva
- School of Physical Education, Federal University of Pelotas, Pelotas, Brazil
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Davids CJ, Raastad T, James LP, Gajanand T, Smith E, Connick M, McGorm H, Keating S, Coombes JS, Peake JM, Roberts LA. Similar Morphological and Functional Training Adaptations Occur Between Continuous and Intermittent Blood Flow Restriction. J Strength Cond Res 2021; 35:1784-1793. [PMID: 34027913 DOI: 10.1519/jsc.0000000000004034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Davids, CJ, Raastad, T, James, L, Gajanand, T, Smith, E, Connick, M, McGorm, H, Keating, S, Coombes, JS, Peake, JM, and Roberts, LA. Similar morphological and functional training adaptations occur between continuous and intermittent blood flow restriction. J Strength Cond Res 35(7): 1784-1793, 2021-The aim of the study was to compare skeletal muscle morphological and functional outcomes after low-load resistance training using 2 differing blood flow restriction (BFR) protocols. Recreationally active men and women (n = 42 [f = 21], 24.4 ± 4.4 years) completed 21 sessions over 7 weeks of load-matched and volume-matched low-load resistance training (30% 1 repetition maximum [1RM]) with either (a) no BFR (CON), (b) continuous BFR (BFR-C, 60% arterial occlusion pressure [AOP]), or (c) intermittent BFR (BFR-I, 60% AOP). Muscle mass was assessed using peripheral quantitative computed tomography before and after training. Muscular strength, endurance, and power were determined before and after training by assessing isokinetic dynamometry, 1RM, and jump performance. Ratings of pain and effort were taken in the first and final training session. An alpha level of p < 0.05 was used to determine significance. There were no between-group differences for any of the morphological or functional variables. The muscle cross sectional area (CSA) increased pre-post training (p = 0.009; CON: 1.6%, BFR-C: 1.1%, BFR-I: 2.2%). Maximal isometric strength increased pre-post training (p < 0.001; CON: 9.6%, BFR-C: 14.3%, BFR-I: 19.3%). Total work performed during an isokinetic endurance task increased pre-post training (p < 0.001, CON: 3.6%, BFR-C: 9.6%, BFR-I: 11.3%). Perceptions of pain (p = 0.026) and effort (p = 0.033) during exercise were higher with BFR-C; however, these reduced with training (p = 0.005-0.034). Overall, these data suggest that when 30% 1RM loads are used with a frequency of 3 times per week, the addition of BFR does not confer superior morphological or functional adaptations in recreationally active individuals. Furthermore, the additional metabolic stress that is proposed to occur with a continuous BFR protocol does not seem to translate into proportionally greater training adaptations. The current findings promote the use of both intermittent BFR and low-load resistance training without BFR as suitable alternative training methods to continuous BFR. These approaches may be practically applicable for those less tolerable to pain and discomfort associated with ischemia during exercise.
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Affiliation(s)
- Charlie J Davids
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Truls Raastad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Lachlan P James
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Trishan Gajanand
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Emily Smith
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Mark Connick
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Hamish McGorm
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia
| | - Shelley Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Jonathan M Peake
- Queensland Academy of Sport, Nathan, Australia.,School of Biomedical Sciences and Institute of Health and Biomedical Sciences, Queensland University of Technology, Brisbane, Australia; and
| | - Llion A Roberts
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.,Queensland Academy of Sport, Nathan, Australia.,School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
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