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Gollie JM, Ryan AS, Sen S, Patel SS, Kokkinos PF, Harris-Love MO, Scholten JD, Blackman MR. Exercise for patients with chronic kidney disease: from cells to systems to function. Am J Physiol Renal Physiol 2024; 326:F420-F437. [PMID: 38205546 DOI: 10.1152/ajprenal.00302.2023] [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: 09/25/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Chronic kidney disease (CKD) is among the leading causes of death and disability, affecting an estimated 800 million adults globally. The underlying pathophysiology of CKD is complex creating challenges to its management. Primary risk factors for the development and progression of CKD include diabetes mellitus, hypertension, age, obesity, diet, inflammation, and physical inactivity. The high prevalence of diabetes and hypertension in patients with CKD increases the risk for secondary consequences such as cardiovascular disease and peripheral neuropathy. Moreover, the increased prevalence of obesity and chronic levels of systemic inflammation in CKD have downstream effects on critical cellular functions regulating homeostasis. The combination of these factors results in the deterioration of health and functional capacity in those living with CKD. Exercise offers protective benefits for the maintenance of health and function with age, even in the presence of CKD. Despite accumulating data supporting the implementation of exercise for the promotion of health and function in patients with CKD, a thorough description of the responses and adaptations to exercise at the cellular, system, and whole body levels is currently lacking. Therefore, the purpose of this review is to provide an up-to-date comprehensive review of the effects of exercise training on vascular endothelial progenitor cells at the cellular level; cardiovascular, musculoskeletal, and neural factors at the system level; and physical function, frailty, and fatigability at the whole body level in patients with CKD.
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Affiliation(s)
- Jared M Gollie
- Research and Development Service, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia, United States
- Department of Health, Human Function, and Rehabilitation Sciences, The George Washington University, Washington, District of Columbia, United States
| | - Alice S Ryan
- Department of Medicine, University of Maryland, Baltimore, Maryland, United States
- Division of Geriatrics and Palliative Medicine, Baltimore Veterans Affairs Medical Center, Baltimore, Maryland, United States
| | - Sabyasachi Sen
- Department of Medicine, Washington DC Veterans Affairs, Medical Center, Washington, District of Columbia, United States
- Department of Medicine, The George Washington University, Washington, District of Columbia, United States
| | - Samir S Patel
- Research and Development Service, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia, United States
- Department of Medicine, Washington DC Veterans Affairs, Medical Center, Washington, District of Columbia, United States
- Department of Medicine, The George Washington University, Washington, District of Columbia, United States
| | - Peter F Kokkinos
- Division of Cardiology, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia, United States
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, United States
| | - Michael O Harris-Love
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Geriatric Research Education and Clinical Center, Eastern Colorado Veterans Affairs Health Care System, Denver, Colorado, United States
| | - Joel D Scholten
- Physical Medicine and Rehabilitation Service, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia, United States
| | - Marc R Blackman
- Research and Development Service, Washington DC Veterans Affairs Medical Center, Washington, District of Columbia, United States
- Department of Medicine, Washington DC Veterans Affairs, Medical Center, Washington, District of Columbia, United States
- Department of Medicine, The George Washington University, Washington, District of Columbia, United States
- Department of Medicine, Georgetown University, Washington, District of Columbia, United States
- Department of Rehabilitation Medicine, Georgetown University, Washington, District of Columbia, United States
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Sen S, Khosla S, Awan O, Cohen S, Gollie JM. Endothelial dysfunction in autoimmune, pulmonary, and kidney systems, and exercise tolerance following SARS-CoV-2 infection. Front Med (Lausanne) 2023; 10:1197061. [PMID: 37575987 PMCID: PMC10413142 DOI: 10.3389/fmed.2023.1197061] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Long COVID is characterized by persistent symptoms beyond 3-months of severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) infection that last for at least 2 months and cannot be explained by an alternative diagnosis. Autonomic, immunologic, endothelial, and hypercoagulation are implicated as possible mechanisms of long COVID symptoms. Despite recognition of the public health challenges posed by long COVID, the current understanding of the pathophysiological underpinnings is still evolving. In this narrative review, we explore the long-term effects of SARS-CoV-2 infection on T cell activation such as autoimmune disorders and endothelial cell dysfunction involving vascular impairments within pulmonary and renal architecture. We have described how endothelial dysfunction and vascular abnormalities may underscore findings of exercise intolerance by way of impaired peripheral oxygen extraction in individuals with long COVID.
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Affiliation(s)
- Sabyasachi Sen
- Division of Endocrinology, Department of Medicine, Veterans Affairs Medical Center, Washington, DC, United States
- Division of Endocrinology, Department of Medicine, George Washington University, Washington, DC, United States
| | - Shikha Khosla
- Division of Endocrinology, Department of Medicine, Veterans Affairs Medical Center, Washington, DC, United States
- Division of Endocrinology, Department of Medicine, George Washington University, Washington, DC, United States
| | - Omar Awan
- Division of Pulmonary Medicine, Department of Medicine, Veterans Affairs Medical Center, Washington, DC, United States
- Division of Pulmonary, Critical Care, and Sleep Disorders Medicine, The George Washington University, Washington, DC, United States
| | - Scott Cohen
- Division of Nephrology, Department of Medicine, Veterans Affairs Medical Center, Washington, DC, United States
| | - Jared M. Gollie
- Research and Development Service, Veterans Affairs Medical Center, Washington, DC, United States
- Department of Health, Human Function, and Rehabilitation Sciences, The George Washington University, Washington, DC, United States
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Pechstein AE, Gollie JM, Keyser RE, Guccione AA. Walking Endurance and Oxygen Uptake On-Kinetics in Individuals With Parkinson Disease Following Overground Locomotor Training. J Neurol Phys Ther 2023; 47:99-111. [PMID: 36538418 DOI: 10.1097/npt.0000000000000423] [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: 12/24/2022]
Abstract
BACKGROUND AND PURPOSE Poor walking endurance in Parkinson disease (PD) may be attributable to both bioenergetic and biomechanical factors, but locomotor training methods addressing both these factors simultaneously are understudied. Our objective was to examine the effects of overground locomotor training (OLT) on walking endurance in individuals with mild-to-moderate PD, and to further explore potential cardiorespiratory contributions. METHODS A single-arm, longitudinal design was used to examine the effects of 24 biweekly sessions of OLT in people with mild-to-moderate PD (n = 12). Walking endurance was measured as total distance walked during a 10-minute walk test (10minWT). Oxygen uptake (V˙ o2 ) on-kinetic profiles were determined using a monoexponential function. Perceived fatigability was assessed following the 10minWT using a self-report scale. Magnitude of change in primary outcomes was assessed using Cohen's d and adjusted for sample size (Cohen's d(unbiased) ). RESULTS Participants executed 3036 (297) steps and maintained 65.5% (8%) age-predicted heart rate maximum in a typical session lasting 56.9 (2.5) minutes. Medium effects in total distance walked-885.9 (157.2) versus 969.5 (140.9); Cohen's d(unbiased) = 0.54-and phase II time constant of the V˙ o2 on-kinetic profile-33.7 (12.3) versus 25.9 (15.3); Cohen's d(unbiased) = 0.54-were observed alongside trivial effects for perceived fatigability-4.7 (1.4) versus 4.8 (1.5); Cohen's d(unbiased) = 0.11-following OLT. DISCUSSION AND CONCLUSIONS These preliminary findings may demonstrate the potential for moderate-intensity OLT to improve walking endurance and enhance cardiorespiratory adjustments to walking activity in adults with mild-to-moderate PD.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A407 ).
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Affiliation(s)
- Andrew E Pechstein
- Department of Rehabilitation Science, George Mason University, Fairfax, Virginia (A.E.P., J.M.G., R.E.K., A.A.G.); Department of Physical Therapy, University of Delaware, Newark (A.E.P.); and Research Service, Veterans Affairs Medical Center, Washington, District of Columbia (J.M.G.)
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Gollie JM, Sen S. Circulating Endothelial Progenitor and Mesenchymal Stromal Cells as Biomarkers for Monitoring Disease Status and Responses to Exercise. Rev Cardiovasc Med 2022; 23:396. [PMID: 37680455 PMCID: PMC10483375 DOI: 10.31083/j.rcm2312396] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
Noncommunicable chronic diseases, such as obesity, cardiovascular disease (CVD), and type 2 diabetes (T2D), pose significant health challenges globally. Important advances have been made in the understanding of the pathophysiologal mechanisms and treatment of noncommunicable diseases in recent years. Lack of physical activity is a primary contributor to many noncommunicable diseases including metabolic syndrome, T2D, CVD, and obesity. Certain diabetes medications and non-pharmaceutical interventions, such as physical activity and exercise, are shown to be effective in decreasing the CVD risks associated with heart disease, stroke, obesity, prediabetes, and T2D. The ability to measure and analyze circulating adult stem cells (ASCs) has gained particular interest due to their potential to identify at-risk individuals and implications in various therapeutics. Therefore, the purpose of this narrative review is to (1) provide an overview of ASCs; specifically endothelial progenitor cells (EPCs) and mesenchymal stromal cells (MSCs), (2) describe the responses of these cells to acute and chronic exercise, and (3) highlight the potential effect of exercise on EPCs and MSCs in aging and disease. EPCs are circulating cells, abundantly available in peripheral blood, bone marrow, and umbilical cord, and are defined by cell surface markers such as CD34+. EPCs are expected to play an important role in angiogenesis and neovascularization and have been implicated in the treatment of CVD. MSCs are essential for maintaining tissue and organ homeostasis. MSCs are defined as multipotent heterogeneous cells that can proliferate in vitro as plastic-adherent cells, have fibroblast-like morphology, form colonies in vitro, and can differentiate into ostyeoblasts, adipocytes, chondroblasts, and myoblasts. In the presence of aging and disease, EPCs and MSCs decrease in quantity and functional capacity. Importantly, exercise facilitates EPC differentiation and production from bone marrow and also helps to promote migration and homing to the hypoxic and damaged tissue which in turn improve angiogenesis and vasculogenesis. Similarly, exercise stimulates increases in proliferation and migratory activity of MSCs. Despite the reported benefits of exercise on EPC and MSC number and function, little is known regarding the optimal exercise prescription for aging and clinical populations. Moreover, the interactions between medications and exercise on EPCs and MSCs is currently unclear. Use of ASCs as a biomarker have the potential to revolutionize the management of patients with a variety of metabolic and obesity related disorders and also pro-inflammatory diseases. Further investigation of clinical entities are urgently needed to understand the implications of interventions such as exercise, diet, and various medications on EPC and MSC quantity and function in aging and clinical populations.
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Affiliation(s)
- Jared M. Gollie
- Research & Development, VA Medical Center, Washington, DC 20422, USA
- Department of Health, Human Function, and Rehabilitation Sciences, The George Washington University, Washington, DC 20037, USA
| | - Sabyasachi Sen
- Department of Medicine, VA Medical Center, Washington, DC 20422, USA
- Department of Medicine, The George Washington University, Washington, DC 20037, USA
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Gollie JM, Dennis EA, Khan AF, Knight WJ, Ogbuawa O, Millstein ML, Thomas LN. Lower Extremity Strength Is A Predictor Of Function Prior To Total Joint Arthroplasty In Veterans. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000882076.72236.e0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gollie JM, Cohen SD, Patel SS. Physical Activity and Exercise for Cardiorespiratory Health and Fitness in Chronic Kidney Disease. Rev Cardiovasc Med 2022; 23:273. [PMID: 36945353 PMCID: PMC10026709 DOI: 10.31083/j.rcm2308273] [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: 11/06/2022] Open
Abstract
Chronic kidney disease (CKD) is associated with an increased risk for cardiovascular disease (CVD), major adverse CVD events, and cardiovascular mortality. Low levels of physical activity and reduced cardiorespiratory fitness further compound the health consequences in this patient population. Aerobic exercise alone and the combination of aerobic and resistance exercise have beneficial effects for improving aerobic capacity while resistance exercise alone improves strength and skeletal muscle health. Given the prevalence of CVD in CKD patients and limited treatment options targeting traditional and non-traditional CVD risk factors in this population, the incoroporation of physical activity and exercise into the care of CKD seems critical for improving patient outcomes. Therefore, the purpose of this narrative review is to discuss the evidence of physical activity and exercise in CKD patients and the effects on cardiovascular outcomes and fitness.
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Affiliation(s)
- Jared M. Gollie
- Research & Development Service, VA Medical Center, Washington DC 20422, USA
- Department of Health, Human Fuction, and Rehabilitation Sciences, The George Washington University, Washington DC 20037, USA
- Correspondence: (Jared M. Gollie)
| | - Scott D. Cohen
- Renal Service, VA Medical Center, Washington DC 20422, USA
- Department of Medicine, The George Washington University, Washington DC 20037, USA
| | - Samir S. Patel
- Research & Development Service, VA Medical Center, Washington DC 20422, USA
- Renal Service, VA Medical Center, Washington DC 20422, USA
- Department of Medicine, The George Washington University, Washington DC 20037, USA
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Gollie JM, Guccione AA, Keyser RE, Chin LMK, Panza GS, Herrick JE. Walking endurance, muscle oxygen extraction, and perceived fatigability after overground locomotor training in incomplete spinal cord injury: A pilot study. J Spinal Cord Med 2022; 45:381-389. [PMID: 32795157 PMCID: PMC9135420 DOI: 10.1080/10790268.2020.1798137] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective: The purpose of this study was to examine the effects of overground locomotor training (OLT) on walking endurance and gastrocnemius oxygen extraction in people with chronic cervical motor-incomplete spinal cord injury (SCI).Design: Prospective single-arm pre-post pilot study.Setting: Human Performance Research Laboratory.Participants: Adult men with traumatic chronic cervical SCI (n = 6; age = 30.8 ± 12.5).Intervention: Twenty-four sessions of structured OLT.Outcome measures: Walking endurance was determined during a constant work-rate time-to-exhaustion treadmill test. Normalized perceived fatigability was calculated by dividing subjective ratings of tiredness by walking time. Cardiorespiratory outcomes and muscle oxygen extraction were analyzed using breath-by-breath gas-exchange and near-infrared spectroscopy.Results: OLT resulted in large effects on walking endurance (1232 ± 446 s vs 1645 ± 255 s; d = 1.1; P = 0.045) and normalized perceived fatigability (5.3 ± 1.5 a.u. vs 3.6 ± 0.9 a.u.; d = 1.3; P = 0.033). Small-to-medium effects on absolute (2.8 ± 2.5 a.u. vs 4.2 ± 3.5 a.u.; d = 0.42; P = 0.035) and isotime (2.8 ± 2.5 a.u. vs 3.8 ± 3.0 a.u.; d = 0.33; P = 0.023) muscle oxygen extraction were also observed after OLT.Conclusion: These findings provide preliminary data supporting the potential for improved walking endurance, enhanced muscle O2 extraction, and reduced perceived fatigability in people with chronic cervical motor-incomplete SCI following the OLT program described in this study.
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Affiliation(s)
- Jared M. Gollie
- Research Services, Veterans Affairs Medical Center, Washington, District of Columbi, USA
- Department of Health, Human Function, and Rehabilitation Sciences, The George Washington University, Washington, District of Columbi, USA
- Rehabilitation Science Department, George Mason University, Fairfax, Virginia, USA
| | - Andrew A. Guccione
- Rehabilitation Science Department, George Mason University, Fairfax, Virginia, USA
| | - Randall E. Keyser
- Rehabilitation Science Department, George Mason University, Fairfax, Virginia, USA
- Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Lisa M. K. Chin
- Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Gino S. Panza
- Department of Physiology, Wayne State University, Detroit, Michigan, USA
- Research Services, John D. Dingell Veterans Affairs Medical Center, Detroit, Michigan, USA
| | - Jeffrey E. Herrick
- Department of Exercise Physiology, University of Lynchburg, Lynchburg, Virginia, USA
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Gollie JM, Patel SS, Harris-Love MO, Cohen SD, Blackman MR. Fatigability and the Role of Neuromuscular Impairments in Chronic Kidney Disease. Am J Nephrol 2022; 53:253-263. [PMID: 35344954 PMCID: PMC9871956 DOI: 10.1159/000523714] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/16/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND The combination of neuromuscular impairments plus psychosocial aspects of chronic kidney disease (CKD) may predispose these patients to greater risk for experiencing increased levels of fatigability. There has been extensive clinical and scientific interest in the problem of fatigue in CKD and end-stage kidney disease (ESKD) patients, whereas less attention has been directed to understanding fatigability. Accordingly, the primary purposes of this review are to (1) discuss fatigue and fatigability and their potential interactions in patients with CKD and ESKD, (2) provide evidence for increased fatigability in CKD and ESKD patients, (3) examine how commonly experienced neuromuscular impairments in CKD and ESKD patients may contribute to the severity of performance fatigability, and (4) highlight preliminary evidence on the effects of exercise as a potential clinical treatment for targeting fatigability in this population. SUMMARY Fatigue is broadly defined as a multidimensional construct encompassing a subjective lack of physical and/or mental energy that is perceived by the individual to interfere with usual or desired activities. In contrast, fatigability is conceptualized within the context of physical activity and is quantified as the interactions between reductions in objective measures of performance (i.e., performance fatigability) and perceptual adjustments regulating activity performance (i.e., perceived fatigability). We propose herein a conceptual model to extend current understandings of fatigability by considering the interactions among fatigue, perceived fatigability, and performance fatigability. Neuromuscular impairments reported in patients with CKD and ESKD, including reductions in force capacity, skeletal muscle atrophy, mitochondrial dysfunction, abnormal skeletal muscle excitability, and neurological complications, may each contribute to the greater performance fatigability observed in these patients. KEY MESSAGES Considering the interactions among fatigue, perceived fatigability, and performance fatigability provides a novel conceptual framework to advance the understanding of fatigability in CKD and ESKD patients. Measures of fatigability may provide valuable clinical insights into the overall health status of CKD and ESKD patients. Existing data suggest that CKD and ESKD patients are at greater risk of experiencing increased fatigability, partly due to neuromuscular impairments associated with reduced kidney function. Further investigations are warranted to determine the potential clinical role fatigability measures can play in monitoring the health of CKD and ESKD patients, and in identifying potential treatments targeting fatigability in this patient population.
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Affiliation(s)
- Jared M. Gollie
- Research Service, Washington DC VA Medical Center, Washington, DC, USA;,Department of Health, Human Function and Rehabilitation Sciences, George Washington University, Washington, DC, USA
| | - Samir S. Patel
- Renal Service, Washington DC VA Medical Center, Washington, DC, USA;,Department of Medicine, George Washington University, Washington, DC, USA
| | - Michael O. Harris-Love
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA;,Geriatric Research Education and Clinical Center, VA Eastern Colorado Health Care System, Aurora, CO, USA
| | - Scott D. Cohen
- Renal Service, Washington DC VA Medical Center, Washington, DC, USA;,Department of Medicine, George Washington University, Washington, DC, USA
| | - Marc R. Blackman
- Research Service, Washington DC VA Medical Center, Washington, DC, USA;,Department of Medicine, George Washington University, Washington, DC, USA;,Departments of Medicine and Rehabilitation Medicine, Georgetown University, Washington, DC, USA
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Harris-Love MO, Gollie JM, Keogh JWL. Eccentric Exercise: Adaptations and Applications for Health and Performance. J Funct Morphol Kinesiol 2021; 6:96. [PMID: 34842737 PMCID: PMC8628948 DOI: 10.3390/jfmk6040096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 12/12/2022] Open
Abstract
The goals of this narrative review are to provide a brief overview of the muscle and tendon adaptations to eccentric resistance exercise and address the applications of this form of training to aid rehabilitative interventions and enhance sports performance. This work is centered on the author contributions to the Special Issue entitled "Eccentric Exercise: Adaptations and Applications for Health and Performance". The major themes from the contributing authors include the need to place greater attention on eccentric exercise mode selection based on training goals and individual fitness level, optimal approaches to implementing eccentric resistance exercise for therapeutic purposes, factors that affect the use of eccentric exercise across the lifespan, and general recommendations to integrate eccentric exercise in athletic training regimens. The authors propose that movement velocity and the absorption or recovery of kinetic energy are critical components of eccentric exercise programming. Regarding the therapeutic use of eccentric resistance training, patient-level factors regarding condition severity, fitness level, and stage of rehabilitation should govern the plan of care. In athletic populations, use of eccentric exercise may improve movement competency and promote improved safety and performance of sport-specific tasks. Eccentric resistance training is a viable option for youth, young adults, and older adults when the exercise prescription appropriately addresses program goals, exercise tolerability, and compliance. Despite the benefits of eccentric exercise, several key questions remain unanswered regarding its application underscoring the need for further investigation.
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Affiliation(s)
- Michael O. Harris-Love
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Aurora, CO 80045, USA
- Muscle Morphology, Mechanics, and Performance Laboratory, Geriatrics Service, Veterans Affairs Medical Center, Washington, DC 20422, USA;
| | - Jared M. Gollie
- Muscle Morphology, Mechanics, and Performance Laboratory, Geriatrics Service, Veterans Affairs Medical Center, Washington, DC 20422, USA;
- Department of Health, Human Function, and Rehabilitation Sciences, School of Medicine & Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Justin W. L. Keogh
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia;
- Sports Performance Research Centre New Zealand, Auckland University of Technology, Auckland 1010, New Zealand
- Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
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Gollie JM, Harris-Love MO, Patel SS, Shara NM, Blackman MR. Rate of Force Development Is Related to Maximal Force and Sit-to-Stand Performance in Men With Stages 3b and 4 Chronic Kidney Disease. Front Rehabilit Sci 2021; 2. [PMID: 34708217 PMCID: PMC8547335 DOI: 10.3389/fresc.2021.734705] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: The primary aims of the present study were to assess the relationships of early (0–50 ms) and late (100–200 ms) knee extensor rate of force development (RFD) with maximal voluntary force (MVF) and sit-to-stand (STS) performance in participants with chronic kidney disease (CKD) not requiring dialysis. Methods: Thirteen men with CKD (eGFR = 35.17 ±.5 ml/min per 1.73 m2, age = 70.56 ±.4 years) and 12 non-CKD men (REF) (eGFR = 80.31 ± 4.8 ml/min per 1.73 m2, age = 70.22 ±.9 years) performed maximal voluntary isometric contractions to determine MVF and RFD of the knee extensors. RFD was measured at time intervals 0–50 ms (RFD0−50) and 100–200 ms (RFD100−200). STS was measured as the time to complete five repetitions. Measures of rectus femoris grayscale (RF GSL) and muscle thickness (RF MT) were obtained via ultrasonography in the CKD group only. Standardized mean differences (SMD) were used to examine differences between groups. Bivariate relationships were assessed by Pearson's product moment correlation. Results: Knee extensor MVF adjusted for body weight (CKD=17.14 ±.1 N·kg0.67, REF=21.55 ±.3 N·kg0.67, SMD = 0.79) and STS time (CKD = 15.93 ±.4 s, REF = 12.23 ±.7 s, SMD = 1.03) were lower in the CKD group than the REF group. Absolute RFD100−200 was significantly directly related to adjusted MVF in CKD (r = 0.56, p = 0.049) and REF (r = 0.70, p = 0.012), respectively. STS time was significantly inversely related to absolute (r = −0.75, p = 0.008) and relative RFD0−50 (r = −0.65, p = 0.030) in CKD but not REF (r = 0.08, p = 0.797; r = 0.004, p = 0.991). Significant inverse relationships between RF GSL adjusted for adipose tissue thickness and absolute RFD100−200 (r =−0.59, p = 0.042) in CKD were observed. Conclusion: The results of the current study highlight the declines in strength and physical function that occur in older men with CKD stages 3b and 4 not requiring dialysis. Moreover, early RFD was associated with STS time in CKD while late RFD was associated MVF in both CKD and REF. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT03160326 and NCT02277236.
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Affiliation(s)
- Jared M Gollie
- Skeletal Muscle Laboratory, Research Service, Washington, DC, United States.,George Washington University, Health, Human Function, and Rehabilitation Sciences, Washington, DC, United States.,George Mason University, Rehabilitation Science, Fairfax, VA, United States
| | - Michael O Harris-Love
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.,Muscle Morphology, Mechanics and Performance Laboratory, Eastern Colorado VA Geriatric Research Education and Clinical Center, Aurora, CO, United States
| | - Samir S Patel
- Renal Service, Washington DC VAMC, Washington, DC, United States.,Department of Medicine, George Washington University, Washington, DC, United States
| | - Nawar M Shara
- Department of Biostatistics and Biomedical Informatics, MedStar Health Research Institute, Washington, DC, United States
| | - Marc R Blackman
- Department of Medicine, George Washington University, Washington, DC, United States.,Research Service, Washington DC VAMC, Washington, DC, United States.,Departments of Medicine and Rehabilitation Medicine, Georgetown University, Washington, DC, United States
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Gollie JM, Patel SS, Scholten JD, Harris-Love MO. Preliminary Study of the Effects of Eccentric-Overload Resistance Exercise on Physical Function and Torque Capacity in Chronic Kidney Disease. J Funct Morphol Kinesiol 2020; 5:E97. [PMID: 33467312 PMCID: PMC7804887 DOI: 10.3390/jfmk5040097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022] Open
Abstract
The purpose of this preliminary study was to describe changes in physical function and torque capacity in adults with chronic kidney disease (CKD) in response to a novel progressive eccentric-overload resistance exercise (ERE) regime. Participants included men (n = 4) diagnosed with CKD according to estimated glomerular filtration rate (eGFR) between 59 and 15 mL/kg/1.73 m2 and not requiring dialysis. Physical function was determined by the Short Physical Performance Battery (SPPB), five repetitions of a sit-to-stand (STS) task, and timed-up and go (TUG). Knee extensor strength was assessed using both isometric and isokinetic contractions and performance fatigability indexes were calculated during a 30-s maximal isometric test and a 30-contraction isokinetic test at 180°/second. None of the patients exhibited significant worsening in their health status after training. Participants demonstrated improvements in several measures of physical function and torque capacity following 24 sessions of ERE. Following training, performance fatigability remained relatively stable despite the increases in torque capacity, indicating the potential for greater fatigue resistance. These findings provide initial evidence for ERE as a potential treatment option to combat declines in physical function and neuromuscular impairments in people with CKD. Future research is required to determine optimal progression strategies for maximizing specific neuromuscular and functional outcomes when using ERE in this patient population.
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Affiliation(s)
- Jared M. Gollie
- Physical Medicine and Rehabilitation and Research Services, Veterans Affairs Medical Center, Washington, DC 20422, USA;
- Department of Rehabilitation Science, George Mason University, Fairfax, VA 22030, USA
- Department of Health, Human Function, and Rehabilitation Sciences, The George Washington University, Washington, DC 20006, USA
| | - Samir S. Patel
- Renal Service, Veterans Affairs Medical Center, Washington, DC 20422, USA;
- Department of Medicine, The George Washington University, Washington, DC 20006, USA
| | - Joel D. Scholten
- Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center, Washington, DC 20422, USA;
| | - Michael O. Harris-Love
- Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO 80045, USA
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Aurora, CO 80045, USA
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Pechstein AE, Gollie JM, Guccione AA. Fatigability and Cardiorespiratory Impairments in Parkinson's Disease: Potential Non-Motor Barriers to Activity Performance. J Funct Morphol Kinesiol 2020; 5:E78. [PMID: 33467293 PMCID: PMC7739335 DOI: 10.3390/jfmk5040078] [Citation(s) in RCA: 9] [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: 09/28/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 01/18/2023] Open
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative condition after Alzheimer's disease, affecting an estimated 160 per 100,000 people 65 years of age or older. Fatigue is a debilitating non-motor symptom frequently reported in PD, often manifesting prior to disease diagnosis, persisting over time, and negatively affecting quality of life. Fatigability, on the other hand, is distinct from fatigue and describes the magnitude or rate of change over time in the performance of activity (i.e., performance fatigability) and sensations regulating the integrity of the performer (i.e., perceived fatigability). While fatigability has been relatively understudied in PD as compared to fatigue, it has been hypothesized that the presence of elevated levels of fatigability in PD results from the interactions of homeostatic, psychological, and central factors. Evidence from exercise studies supports the premise that greater disturbances in metabolic homeostasis may underly elevated levels of fatigability in people with PD when engaging in physical activity. Cardiorespiratory impairments constraining oxygen delivery and utilization may contribute to the metabolic alterations and excessive fatigability experienced in individuals with PD. Cardiorespiratory fitness is often reduced in people with PD, likely due to the combined effects of biological aging and impairments specific to the disease. Decreases in oxygen delivery (e.g., reduced cardiac output and impaired blood pressure responses) and oxygen utilization (e.g., reduced skeletal muscle oxidative capacity) compromise skeletal muscle respiration, forcing increased reliance on anaerobic metabolism. Thus, the assessment of fatigability in people with PD may provide valuable information regarding the functional status of people with PD not obtained with measures of fatigue. Moreover, interventions that target cardiorespiratory fitness may improve fatigability, movement performance, and health outcomes in this patient population.
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Affiliation(s)
- Andrew E. Pechstein
- Department of Rehabilitation Science, George Mason University, Fairfax, VA 22030, USA; (A.E.P.); (A.A.G.)
| | - Jared M. Gollie
- Department of Rehabilitation Science, George Mason University, Fairfax, VA 22030, USA; (A.E.P.); (A.A.G.)
- Research Services, Veterans Affairs Medical Center, Washington, DC 20422, USA
- Department of Health, Human Function, and Rehabilitation Sciences, The George Washington University, Washington, DC 20006, USA
| | - Andrew A. Guccione
- Department of Rehabilitation Science, George Mason University, Fairfax, VA 22030, USA; (A.E.P.); (A.A.G.)
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Abstract
Physical activity and exercise play a significant role in the management and prevention of chronic disease. Therefore, patient-center approaches offered within medical settings are essential for the promotion of health and well-being. The Whole Health model of care incorporates all aspects of care, including prevention, treatment, conventional, and complementary approaches resulting in care for the whole person. Integrative health coaching is a tool for clinicians seeking to achieve behavior changes for improved health, particularly in the areas of physical activity and exercise. The Whole Health model of care complements the rehabilitative process, using a combination of complementary and integrative medicine for health promotion. In addition to incorporating Whole Health tools into clinical care, rehabilitative specialists may partner with integrative health coaches to achieve challenging behavior changes in the areas of physical activity, exercise, and other areas of self-care.
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Affiliation(s)
- Heather L Malecki
- Washington DC VA Medical Center, Integrative Health & Wellness (117), 50 Irving Street NW, Washington, DC 20422, USA.
| | - Jared M Gollie
- Washington DC Veterans Affairs Medical Center, Research Service (151), Building 14, Room 1044, 50 Irving Street NW, Washington, DC 20422, USA; Department of Health, Human Function, and Rehabilitation Sciences, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA; Department of Rehabilitation Science, School of Health and Human Services, George Mason University, Fairfax, VA, USA
| | - Joel Scholten
- Department of Veterans Affairs, 810 Vermont Ave NW, Office 975 BB, Washington DC 20420, USA
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Panza GS, Herrick JE, Chin LM, Gollie JM, Collins JP, O’Connell DG, Guccione AA. Effect of overground locomotor training on ventilatory kinetics and rate of perceived exertion in persons with cervical motor-incomplete spinal cord injury. Spinal Cord Ser Cases 2019; 5:80. [PMID: 31632738 PMCID: PMC6786384 DOI: 10.1038/s41394-019-0223-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/29/2019] [Accepted: 09/08/2019] [Indexed: 11/09/2022] Open
Abstract
Study design Pre-post, pilot study. Objectives To characterize ventilatory (VE) responses to exercise following warm-up walking in individuals with chronic incomplete spinal cord injury (iSCI) during constant work rate (CWR) exercise. Secondarily, to investigate VE and tidal volume (VT) variability, and ratings of perceived exertion (RPE) before and after overground locomotor training (OLT). Setting Research laboratory. Methods A 6-min CWR walking bout at preferred pace was used as a warm-up followed by 6 min of rest and a second 6-min CWR bout at above preferred walking pace. The second CWR bout was analyzed. Breath-by-breath ventilatory data were examined using a curvilinear least squares fitting procedure with a mono-exponential model. VE and VT variability was calculated as the difference between the observed and predicted values and RPE was taken every 2 min. Results Participants (n = 3, C4-C5) achieved a hyperpneic response to exercise in VE and VT. OLT resulted in faster ventilatory kinetics and reductions of 24 and 29% for VE and VT variability, respectively. A 30% reduction in RPE was concurrent with the reductions in ventilatory variability. Conclusions OLT may improve ventilatory control during CWR in patients with cervical motor-iSCI. These data suggest that in some participants with iSCI, ventilation may influence RPE during walking. Future research should investigate mechanisms of ventilatory variability and its implications in walking performance in patients with iSCI.
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Affiliation(s)
- Gino S. Panza
- John D. Dingell Veterans Affairs Medical Center, Detroit, MI USA
- Department of Physiology, Wayne State University School of Medicine, Detroit, MI USA
| | - Jeffrey E. Herrick
- Department of Exercise Physiology, University of Lynchburg, Lynchburg, VA USA
| | - Lisa M. Chin
- Rehabilitation Medicine Department, National Institutes of Health, Clinical Center, Bethesda, MD USA
| | | | | | | | - Andrew A. Guccione
- Department of Rehabilitation Science, George Mason University, Fairfax, VA USA
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Gollie JM, Harris-Love MO, Patel SS, Blackman MR. Inertial Flywheel Resistance Exercise in Veterans with Chronic Kidney Disease Predialysis: A Case Series. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000560701.19204.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gollie JM, Harris-Love MO, Patel SS, Argani S. Chronic kidney disease: considerations for monitoring skeletal muscle health and prescribing resistance exercise. Clin Kidney J 2018; 11:822-831. [PMID: 30524717 PMCID: PMC6275456 DOI: 10.1093/ckj/sfy054] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 05/26/2018] [Indexed: 12/24/2022] Open
Abstract
Skeletal muscle wasting has gained interest as a primary consequence of chronic kidney disease (CKD) due to the relationship between skeletal muscle mass, mortality and major adverse cardiovascular events in this population. The combination of reductions in physical function, skeletal muscle performance and skeletal muscle mass places individuals with CKD at greater risk of sarcopenia. Therefore the monitoring of skeletal muscle composition and function may provide clinical insight into disease progression. Dual-energy X-ray absorptiometry and bioelectrical impedance analysis are frequently used to estimate body composition in people with CKD within clinical research environments, however, their translation into clinical practice has been limited. Proxy measures of skeletal muscle quality can be obtained using diagnostic ultrasound, providing a cost-effective and accessible imaging modality to aid further clinical research regarding changes in muscle composition. Clinicians and practitioners should evaluate the strengths and limitations of the available technology to determine which devices are most appropriate given their respective circumstances. Progressive resistance exercise has been shown to improve skeletal muscle hypertrophy of the lower extremities, muscular strength and health-related quality of life in end-stage renal disease, with limited evidence available in CKD predialysis. Fundamental principles (i.e. specificity, overload, variation, reversibility, individuality) can be used in the development of more advanced programs focused on improving specific neuromuscular and functional outcomes. Future research is needed to determine the applicability of skeletal muscle monitoring in clinical settings and the feasibility and efficacy of more advanced resistance exercise approaches in those with CKD predialysis.
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Affiliation(s)
- Jared M Gollie
- Muscle Morphology, Mechanics and Performance Laboratory, Human Performance Research Unit, Clinical Research Center, Veterans Affairs Medical Center, Washington, DC, USA
- Department of Health, Human Function, and Rehabilitation Sciences, School of Medicine & Health Sciences, George Washington University, Washington, DC, USA
- Correspondence and offprint requests to: Jared M. Gollie; E-mail: ; Twitter handle: @golliejm
| | - Michael O Harris-Love
- Muscle Morphology, Mechanics and Performance Laboratory, Human Performance Research Unit, Clinical Research Center, Veterans Affairs Medical Center, Washington, DC, USA
- Department of Exercise and Nutritional Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- Geriatrics and Extended Care Service/Research Service, Veterans Affairs Medical Center, Washington, DC, USA
| | - Samir S Patel
- Renal Service, Veterans Affairs Medical Center, Washington, DC, USA
- Department of Medicine, School of Medicine & Health Sciences, George Washington University, Washington, DC, USA
| | - Sholey Argani
- Renal Service, Veterans Affairs Medical Center, Washington, DC, USA
- Department of Medicine, School of Medicine & Health Sciences, George Washington University, Washington, DC, USA
- Department of Medicine, School of Medicine, Uniform Services University of the Health Sciences, Bethesda, MD, USA
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Gollie JM. Fatigability during volitional walking in incomplete spinal cord injury: cardiorespiratory and motor performance considerations. Neural Regen Res 2018; 13:786-790. [PMID: 29862998 PMCID: PMC5998625 DOI: 10.4103/1673-5374.232461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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] [Accepted: 02/10/2018] [Indexed: 02/06/2023] Open
Abstract
Fatigability describes the decline in force production (i.e., performance fatigability) and/or changes in sensations regulating performance (i.e., perceived fatigability) during whole-body activity and poses a major challenge to those living with spinal cord injuries (SCI). After SCI, the inability to overcome disruptions to metabolic homeostasis due to cardiorespiratory limitations and physical deconditioning may contribute to increased fatigability severity. The increased susceptibility to fatigability may have implications for motor control strategies and motor learning. Locomotor training approaches designed to reduce fatigability and enhance aerobic capacity in combination with motor learning may be advantageous for promoting functional recovery after SCI. Future research is required to advance the understanding of the relationship between fatigability, cardiorespiratory function and motor performance following SCI.
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Affiliation(s)
- Jared M. Gollie
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center-Human Performance Research Unit, Veteran Affairs Medical Center Washington, DC, USA
- Department of Health, Human Function, and Rehabilitation Sciences, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
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Gollie JM, Herrick JE, Keyser RE, Chin LMK, Collins JP, Shields RK, Panza GS, Guccione AA. Fatigability, oxygen uptake kinetics and muscle deoxygenation in incomplete spinal cord injury during treadmill walking. Eur J Appl Physiol 2017; 117:1989-2000. [PMID: 28744558 DOI: 10.1007/s00421-017-3685-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 03/13/2017] [Accepted: 07/20/2017] [Indexed: 01/17/2023]
Abstract
PURPOSE The purpose of the present study was to characterize hypothesized relationships among fatigability and cardiorespiratory fitness in individuals with chronic motor-incomplete SCI (iSCI) during treadmill walking. The theoretical framework was that exacerbated fatigability would occur concomitantly with diminished cardiorespiratory fitness in people with iSCI. METHODS Subjects with iSCI (n = 8) and an able-bodied reference group (REF) (n = 8) completed a 6-min walking bout followed by a walking bout of 30-min or until volitional exhaustion, both at a self-selected walking speed. Fatigability was assessed using both perceived fatigability and performance fatigability measures. Pulmonary oxygen uptake kinetics (VO2 on-kinetics) was measured breath-by-breath and changes in deoxygenated hemoglobin/myoglobin concentration (∆[HHb]) of the lateral gastrocnemius was measured by near-infrared spectroscopy. Adjustment of VO2 and ∆[HHb] on-kinetics were modeled using a mono-exponential equation. RESULTS Perceived fatigability and performance fatigability were 52% and 44% greater in the iSCI group compared to the REF group (p = 0.003 and p = 0.004). Phase II time constant (τp) of VO2 on-kinetics and ∆[HHb] ½ time during resting arterial occlusion were 55.4% and 16.3% slower in iSCI vs REF (p < 0.01 and p = 0.047, respectively). CONCLUSIONS The results of the present study may suggest that compromised O2 delivery and/or utilization may have contributed to the severity of fatigability in these individuals with iSCI. The understanding of the extent to which fatigability and VO2 and Δ[HHb] on-kinetics impacts locomotion after iSCI will assist in the future development of targeted interventions to enhance function.
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Affiliation(s)
- Jared M Gollie
- Department of Rehabilitation Science, George Mason University, 4400 University Drive MS2G7, Fairfax, VA, 22030, USA.
| | - Jeffrey E Herrick
- Department of Rehabilitation Science, George Mason University, 4400 University Drive MS2G7, Fairfax, VA, 22030, USA
| | - Randall E Keyser
- Department of Rehabilitation Science, George Mason University, 4400 University Drive MS2G7, Fairfax, VA, 22030, USA
| | - Lisa M K Chin
- Department of Rehabilitation Science, George Mason University, 4400 University Drive MS2G7, Fairfax, VA, 22030, USA
| | - John P Collins
- Department of Rehabilitation Science, George Mason University, 4400 University Drive MS2G7, Fairfax, VA, 22030, USA
| | - Richard K Shields
- Department of Physical Therapy and Rehabilitation Sciences, University of Iowa, Iowa, USA
| | - Gino S Panza
- Department of Rehabilitation Science, George Mason University, 4400 University Drive MS2G7, Fairfax, VA, 22030, USA
| | - Andrew A Guccione
- Department of Rehabilitation Science, George Mason University, 4400 University Drive MS2G7, Fairfax, VA, 22030, USA
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Gollie JM, Herrick JE, Keyser RE, Collins JP, Shields RK, Chin LMK, Guccione AA. Fatigability And Vo2 On-kinetics In Adults With Incomplete Spinal Cord Injury. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000518689.83230.d0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Background: Locomotor training (LT) is the most commonly used treatment to improve walking performance following spinal cord injury (SCI). The advancement of LT treatments requires the addition of integrative models accounting for the numerous systems responsible for the recovery of walking function following SCI. Objective: This perspective monograph aims to (a) describe a performance-based framework for overground LT (OLT), (b) describe principles of adaptation and motor learning used to inform OLT program design, and (c) present an example OLT program based on the proposed framework. Methods: Individuals with chronic motor-incomplete SCI (7 male, 1 female) classified according to the American Spinal Injury Association Impairment Scale (AIS) as C and D were included. OLT included two 90-minute sessions performed over 12 weeks for a total of 24 sessions. Outcomes measures included overground walking speed, walking economy, pulmonary oxygen uptake, and muscle oxygen extraction measured via near-infrared spectroscopy. Results: Preliminary findings demonstrate the potential of OLT, as describe here, to increase overground walking speed, improve walking economy, accelerate processes associated with oxygen delivery and utilization at the rest-to-work transition, and lower oxygen extraction requirements of skeletal muscle during walking in individuals with chronic motor-incomplete SCI. Conclusion: The proposed framework offers a valuable template for LT program design in both clinical and research settings. Further research is necessary to better understand the effects of OLT and how principles of specificity, progressive overload, and variation within the performance-based framework can be manipulated to maximize function, health, and quality of life in SCI.
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Affiliation(s)
- Jared M. Gollie
- Department of Rehabilitation Science, George Mason University College of Health and Human Services, Fairfax, Virginia
| | - Andrew A. Guccione
- Department of Rehabilitation Science, George Mason University College of Health and Human Services, Fairfax, Virginia
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Gollie JM, Herrick JE, Panza GS, Chin LM, Guccione AA. Effects Of Locomotor Training On Vo2 On-kinetics In Persons With Incomplete Spinal Cord Injury. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000485046.14668.78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jo PY, Rounds AK, Lichy AM, Gollie JM, Panza GS, Guccione AA. Gait Adaptation Following Task-specific Locomotor Training In An Individual With Incomplete Spinal Cord Injury. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000486211.16357.6b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Panza GS, Herrick JE, Gollie JM, Murray D, Collins J, Guccione AA. Task Specific Locomotor Training Effects On Ventilatory Drive In Men With Incomplete Spinal Cord Injury. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000486365.77806.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Herrick JE, Panza GS, Gollie JM. Leptin, Leptin Soluble Receptor, and the Free Leptin Index following a Diet and Physical Activity Lifestyle Intervention in Obese Males and Females. J Obes 2016; 2016:8375828. [PMID: 28050279 PMCID: PMC5168550 DOI: 10.1155/2016/8375828] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/17/2016] [Accepted: 10/20/2016] [Indexed: 11/17/2022] Open
Abstract
Leptin (LEP) is associated with appetite regulation and metabolism. Concentration is linear with adiposity, suggesting LEP resistance. LEP circulates freely and bound with its soluble receptor (sOB-r); the ratio is the free leptin index (FLI), an index of leptin resistance; lower FLI suggests reduced biological action. Purpose. The aim was to determine the effect of changes in adipose tissue distribution on LEP, sOB-r, and FLI following 6 months (6 M) of a diet/exercise weight loss program (WLP). In addition, we aim to identify predictors of the FLI. Methods. 6 M WLP consisted of diet/lifestyle interventions following ADA guidelines. Body composition was assessed by DXA. LEP and sOB-r analysis were done via ELISA. Results. 10 adults completed the WLP. Significant reductions were seen in total fat percentage (% fat), nontrunk fat, (NTF), and trunk fat (TF) from base to 3 m and 6 M (p ≤ 0.05). The FLI were reduced at 3 M and 6 M for males and 6 M for females. Total body fat and body weight predicted the FLI in both sexes. Conclusions. LEP and FLI reductions following 6 M of WLP were achieved independent of sOB-r changes. We also demonstrate that the FLI can be predicted noninvasively through total fat mass and body weight in kilograms.
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Affiliation(s)
- Jeffrey E. Herrick
- Department of Rehabilitation Science, George Mason University, 4400 University Drive, MS 2G7, Fairfax, VA 22030, USA
- *Jeffrey E. Herrick:
| | - Gino S. Panza
- Department of Rehabilitation Science, George Mason University, 4400 University Drive, MS 2G7, Fairfax, VA 22030, USA
| | - Jared M. Gollie
- Department of Rehabilitation Science, George Mason University, 4400 University Drive, MS 2G7, Fairfax, VA 22030, USA
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Panza GS, Kirk EP, Collins JP, Gollie JM, Herrick JE. The Effects of Gender, Fat Mass Distribution, and Weight Loss on Free Leptin Index. Med Sci Sports Exerc 2015. [DOI: 10.1249/01.mss.0000477074.81875.c4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gollie JM, Popkess AK, Panza GS, Wooten JS, Herrick JE. Calorie Matching Prior To Resistance Training Prevents Post-exercise Decrease In Glucagon-like Peptide-1 In Females. Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000495359.19507.c2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
To investigate the effects of different loads on system and lower-body kinetics during jump squats, 12 resistance-trained men performed jumps under different loading conditions: 0%, 12%, 27%, 42%, 56%, 71%, and 85% of 1-repetition maximum (1-RM). System power output was calculated as the product of the vertical component of the ground reaction force and the vertical velocity of the bar during its ascent. Joint power output was calculated during bar ascent for the hip, knee, and ankle joints, and was also summed across the joints. System power output and joint power at knee and ankle joints were maximized at 0% 1-RM (p < 0.001) and followed the linear trends (p < 0.001) caused by power output decreasing as the load increased. Power output at the hip was maximized at 42% 1-RM (p = 0.016) and followed a quadratic trend (p = 0.030). Summed joint power could be predicted from system power (p < 0.05), while system power could predict power at the knee and ankle joints under some of the loading conditions. Power at the hip could not be predicted from system power. System power during loaded jumps reflects the power at the knee and ankle, while power at the hip does not correspond to system power.
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Affiliation(s)
- Gavin L Moir
- Exercise Science Department, East Stroudsburg University, East Stroudsburg, PA 18301-2999, USA.
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