12-week Aerobic Program Research Articles

Synergistic Effects of Aerobic Exercise and Moringa Oleifera Supplementation on Glycemic Control and Metabolic Health in Type 2 Diabetes Patients: A Randomized Controlled Trial

Background: The action of aerobic exercise and Moringa Oleifera supplementation on type 2 diabetes mellitus (T2DM) have been individually documented, but their combination remains unclear. This study evaluates the synergistic effects of a 12-week aerobic exercise program and Moringa supplementation on metabolic and inflammatory markers in T2DM patients. Methods: A total of 120 T2DM patients were randomly assigned to four groups: control, aerobic exercise, moringa supplementation (250mg/kg/day), and a combination. BMI, blood glucose, serum insulin, serum C-peptide, renal function tests, HbA1c, adiponectin, IL-6, and lipid profile, were assessed before and after the intervention. Blood glucose levels were monitored weekly. Results: All intervention groups showed significant improvements in HbA1c levels compared to the control group, with the combination group demonstrating the greatest reduction. Blood glucose levels decreased significantly in the exercise and combination groups, with the aerobic exercise group outperforming moringa alone. Serum insulin levels significantly decreased in the moringa and combination groups, while serum C-peptide levels decreased in all groups. Lipid profile improvements were noted in all intervention groups, with the combination treatment showing superior results in reducing total cholesterol and BMI. Both adiponectin levels increased and IL-6 levels decreased significantly in all intervention groups, particularly in the combination group. Renal function tests showed no adverse changes, with a significant reduction in BUN levels observed only in the combination group. Conclusion: The combination of aerobic exercise and moringa supplementation provides a synergistic therapeutic effect, significantly improving glycemic control, lipid profile, adiponectin levels in T2DM patients.

Cost-effectiveness of strength exercise or aerobic exercise compared with usual care for patients with knee osteoarthritis: secondary results from a multiarm randomised controlled trial in Norway

ObjectivesTo evaluate the 1-year cost-effectiveness of strength exercise or aerobic exercise compared with usual care for patients with symptomatic knee osteoarthritis (OA), from a societal and healthcare perspective.DesignCost-effectiveness analysis embedded...

Evaluating the Effectiveness of Adaptive Aerobic Exercise in Improving Quality of Life for Patients with Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) significantly impacts individuals’ quality of life (QoL), particularly in regions with high prevalence rates like China, where environmental and lifestyle factors contribute to disease severity. Traditional management focuses on pharmacological treatments, but the potential of adaptive aerobic exercise to enhance QoL and physical health in COPD patients remains underexplored. This study aimed to assess the effectiveness of an adaptive aerobic exercise program tailored to individual patient capabilities and limitations in improving QoL and physical health parameters among COPD patients in China. A quasi-experimental study design was implemented, involving COPD patients from multiple healthcare centers across China. Participants were divided into two groups: the intervention group, which participated in a 12-week adaptive aerobic exercise program, and the control group, which received standard care. Primary outcome measures included QoL changes, assessed by the COPD Assessment Test (CAT) and the St. George’s Respiratory Questionnaire (SGRQ), and physical health improvements, measured by the six-minute walk test (6MWT) and spirometry (FEV1 and FVC). Secondary outcomes focused on exercise adherence, self-reported symptom changes, and healthcare utilization. The intervention group showed significant improvements in QoL, evidenced by reduced CAT scores and improved SGRQ outcomes, particularly in the domains of symptoms and activity level. Physical health also significantly improved, with increased 6MWT distances and enhanced spirometric measures indicating better lung function. High adherence rates (over 80%) and reduced self-reported exacerbations, along with decreased healthcare service needs, were observed in the exercise group. Adaptive aerobic exercise significantly improves the quality of life and physical health of COPD patients in China, demonstrating the value of integrating tailored physical activity interventions into COPD management strategies. The program’s high adherence rates and the observed decrease in healthcare utilization underscore its potential to be a viable, cost-effective addition to standard COPD care.

Effect of aerobic exercise on anthropometric parameters among Indian primary school children.

Childhood obesity is a global public health concern with significant implications for long-term health. This study addresses the rising rates of obesity among school-age children (10-12 years) and investigates the effectiveness of aerobic exercise interventions in improving anthropometric parameters, specifically focusing on BMI and mid-arm circumference (MAC). The study emphasizes the role of schools in shaping children's behaviors and aims to contribute empirical evidence to inform health promotion strategies for this demographic. The research employs a quasi-experimental design, involving 60 school-age children in Visnagar, Gujarat, India. The 12-week aerobic exercise intervention, conducted three times a week, comprises activities like running, jumping jacks, and dance routines. Data collection includes sociodemographic information, BMI, and MAC measurements. The study design, participant criteria, and intervention details are carefully outlined. Socio-demographic variables such as age and monthly family income significantly influence BMI, highlighting the importance of considering these factors in interventions. Pretest results show 80% of children classified as overweight, reducing to 58.3% post-intervention. The mean BMI significantly decreases from 24.41 to 22.84 (p < 0.05), indicating the positive impact of aerobic exercise. The study also explores the association between BMI, MAC, and socio-demographic variables through chi-square tests. Data shows the prevalence of overweight and obesity among school-age children and demonstrates the effectiveness of a 12-week aerobic exercise program in improving BMI. Findings align with existing literature on the positive impact of physical activity on weight management in children.

Modifying modularity: aerobic exercise improves functional connectivity in breast cancer survivors

IntroductionAerobic exercise has been shown to improve cancer-associated cognitive decline (CACD) in breast cancer survivors (BCS), and recent findings suggest that one mechanism by which exercise may reduce cognitive decline is through alteration of the brain's functional organization. Many cognitive abilities and measures of functional brain organization change with age and disease, typically reflected in cognitive decline and reduced differentiation of brain networks, or “modularity.” Although previous research has identified associations between lifestyle interventions, such as exercise, and increased modularity, no studies have examined these relationships in cancer populations. The primary aim of this study was to investigate the preliminary effects of a 12-week aerobic exercise program on changes in brain network modularity in BCS. As a secondary aim, we explored correlations between changes in modularity with moderate-to-vigorous physical activity (MVPA) and cognitive function. Data were exploratory and used for hypothesis generation for a future, larger study.MethodsParticipants included a subsample of 10 BCS (M age = 65.9 ± 9.3 years) from a larger pilot study (N = 30 BCS) who were randomized to a 12-week aerobic exercise program (AE) or usual care (UC). The present study collected brain magnetic resonance imaging, Actigraph accelerometry, and cognitive task performance at baseline and 3-month follow-up (i.e., post-intervention; n = 4 AE, n = 6 UC). Intervention effects on modularity, MVPA, and cognition were quantified as magnitude of change between groups (Cohen's d). Changes in modularity were further explored via paired t-tests within groups. Associations between changes in modularity, MVPA, and cognitive performance were explored using Spearman's correlations.ResultsThe magnitude of changes in modularity between groups were small-to-moderate and favored the AE group (d = 0.23 to d = 0.67 across thresholds). Paired t-tests revealed a significant increase in modularity in the AE group from baseline to 3-month follow-up (t = 3.08, p = 0.03, d = 1.17), but not in the UC group. The correlation between changes in MVPA and changes in modularity were not statistically significant (r = 0.36, p = 0.39), and correlations between modularity and cognitive performance yielded mixed effects by cognitive domain.DiscussionFindings suggest that aerobic exercise may influence functional brain network organization and cognition in BCS. These data warrant further investigation in larger exercise trials.

Effects of 12-week aerobic exercise with different frequencies on executive function in preschool children: a cluster randomized controlled trial

Objective To explore the effects of a 12-week aerobic exercise program with different frequencies on executive functions (EFs) in preschool children. Method Four kindergartens, comprising 126 preschool children in Shanghai, were enrolled in this 12-week cluster randomized controlled trial with a 12-week follow-up period. Kindergartens were allocated to high-frequency (three times a week) or low-frequency (once a week) exercise groups using stratified block randomization. Three core sub-EFs, including inhibition, working memory, and cognitive flexibility, were assessed at baseline, post-intervention, and the 12-week follow-up. Results Compared to baseline, both groups showed significant improvements in inhibition and working memory after the intervention and at the 12-week follow-up. However, only the high-frequency exercise group demonstrated a significant improvement in cognitive flexibility after the follow-up period. Nonetheless, there were no significant differences in the core sub-functions of EFs between the two groups at the end of the intervention or the follow-up periods. Conclusion A 12-week aerobic exercise of three times a week was insufficient to significantly improve EFs in preschool children compared to once a week. Future studies are needed to examine the dose-response relationship of aerobic exercise on EFs and to verify the effects of different exercise modalities on EFs in preschool children.

Feasibility, acceptability, and preliminary effectiveness of implementing a 12-week home-based aerobic and resistance exercise program for breast cancer patients receiving endocrine treatment in Indonesia: A mixed methods study.

To assess the feasibility, acceptability, and preliminary effectiveness of implementing a home-based aerobic and resistance exercise for patients with breast cancer receiving endocrine treatment in Indonesia. This is a mixed methods study with concurrent design consisting of quantitative single-arm pre-post intervention and qualitative study. We recruited patients with breast cancer (N = 36) receiving endocrine treatment and assigned 12 weeks of home-based pedometer-driven walking and resistance exercises using therapeutic bands. Descriptive statistics were used to assess the feasibility (recruitment, retention, and adherence) and safety. The modified Bruce treadmill test was used to measure predicted aerobic capacity (V̇O2 peak). Quality of life and fatigue were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and fatigue severity scale. Measurements were performed at baseline and post-intervention and analyzed with the paired t-test or Wilcoxon test. Semi-structured interviews and thematic analysis were conducted post-intervention to explore patients' acceptability. The results showed a recruitment rate of 75%, retention rate of 89%, and adherence rates were 53% for aerobic and 78% for resistance exercise. No severe adverse events were reported. Post-intervention interviews identified positive attitudes toward the intervention, with low burden and high perceived benefit. Exercise duration and predicted V̇O2 peak increased significantly (+1.1 min, p = 0.001 and +2.3 ml/kg/min, p = 0.043), but no significant change was detected for Quality of Life (p > 0.050) or fatigue severity (p = 0.299). A home-based aerobic and resistance exercise was feasible when implemented in the context of routine care in our study population, improving predicted aerobic capacity. Further research is required to understand limited changes to Quality of Life and fatigue and adaptations to support implementation in additional sites in Indonesia.

Developing optimized physical activity interventions for drug-resistant epilepsy: Challenges and lessons learned from a remote exercise intervention pilot trial

People with epilepsy (PWE) stand to benefit significantly from increasing their physical activity, but promotion of physical activity is difficult in any population; a challenge compounded by the unique barriers encountered by PWE, especially those with drug-resistant epilepsy (DRE). This study explores the feasibility of a remotely delivered, 12-week aerobic exercise program based on social cognitive theory principles in adults with DRE. This line of research is nested within the Multiphase Optimization Strategy (MOST), a framework that emphasizes iterative early pilot work (preparation phase research), followed by iterative optimization phase research. Ten participants were recruited, and four out of ten completed the study, resulting in 3.8 % recruitment from those preliminarily eligible by chart review, and 40 % retention. While acceptability was high among those who completed the study, recruitment, retention, and uptake were low. Three key related lessons learned emerged: 1) low appeal of an exercise intervention in our population of DRE 2) barriers related to comorbid mental health struggles, and 3) fear of seizures. How to best approach physical activity promotion in PWE, particularly DRE, will require a somewhat novel approach involving iterative pilot work and optimization before large scale efficacy trials and implementation can be achieved.

The IBD-FITT study — moderate-intensity exercise for patients with inflammatory bowel disease with moderate disease activity: an open-label randomized controlled trial

BackgroundInflammatory bowel disease (IBD), Crohn’s disease, and ulcerative colitis are chronic autoimmune lifelong diseases with fluctuating activity over time. The treatment includes medical therapy and surgery, however, there is no definite cure. Therefore, the quest for new and supplementary treatment options is imperative to improve patients’ general health and quality of life.Physical activity and exercise have been suggested to be elements in both the prevention and supplementary treatment of IBD; however, this is based on limited underpowered trials. Thus, the role of exercise as a treatment option still has to be settled.We aim to investigate the effect of a 12-week exercise intervention in adult patients with moderately active IBD on three categories of outcomes (1) disease-specific health-related quality of life (IBDQ); (2) general health status of the patients, i.e., waist circumference, disease activity by clinical scorings systems (Harvey Bradshaw Index, Simple Clinical Colitis Activity Index), blood pressure, blood lipids, and non-disease specific quality of life (EQ5D) scores; and (3) explorative outcomes on biomarkers (C-reactive protein and fecal calprotectin) plus different biomarkers of immunology (cytokine panel).MethodsWe will apply a superiority design in this open-label randomized clinical trial including 150 patients equally allocated to intervention and usual care. The intervention will be based on a 12-week aerobic exercise program and will include two supervised exercise sessions of 60 min per week, combined with one weekly home training session. We have defined a moderate exercise level as 60–80% of patients’ maximum heart rate. The patients in the intervention group will also be offered an online video lesson of 15–25 min on lifestyle guidance, and the same online video lesson will be offered in the comparator group. Questionnaires on quality of life will be forwarded electronically both at inclusion and at the end of the study, and the patients will have blood samples, and fecal samples for calprotectin at baseline, weeks 4 and 8, as well as after 12 weeks (study end).DiscussionThis will be a clinical trial investigating the effect of exercise on patients with Crohn’s disease and ulcerative colitis. This trial will add to the evidence on the possible effect of exercise and might clarify whether exercise can benefit as a supplementary treatment addendum. Thus, the trial may provide a new patient-active disease management approach.Trial registrationClinicalTrials.gov NCT04816812. Date of first registration: March 23, 2021.

Lifestyle intervention based on exercise and behavioural counselling and its effect on physical and psychological health in outpatients with schizophrenia spectrum disorders. An exploratory, pragmatic randomized clinical trial.

Patients with Schizophrenia Spectrum Disorders (SSD) often lead unhealthy lifestyles. This pragmatic trial evaluated the effectiveness of a lifestyle intervention, consisting of a 12-week aerobic exercise program and behavioural counselling, in SSD outpatients with metabolic syndrome (MetS). It also aimed to assess persistence of potential effects in a 24-month long-term follow-up. Effectiveness was measured in terms of a wide range of outcomes involving physical and psychological health, quality of life, physical activity and changes in motivation to exercise within the context of the self-determination theory. Our primary outcome was waist circumference change. Thirty-three out of 48 participants completed the study. No differences between groups were found in terms of BMI change or other metabolic parameters. However, the active group (AG) showed improvement regarding waist circumference, negative symptomatology and identified motivation to exercise during the study and follow-up. The AG exhibited changes toward a more active pattern of activity after intervention. Moreover, belonging to the AG was a significant predictor for achieving any degree of clinical improvement after 24-month follow-up. Combined interventions of exercise and behavioural counselling in SSD patients with MetS should be considered as an essential part of the integral treatment in the context of mental health services.

'I saw it as a marriage-You can't have one without the other': A qualitative study of patient and physiotherapist experiences with a therapeutic combined strength and aerobic physical activity exercise programme for hip osteoarthritis.

To explore physiotherapist and patient experiences with, and acceptability of, a 12-week physiotherapist-guided combined strength and aerobic physical activity exercise programme for hip osteoarthritis (OA). A qualitative study using semi-structured interviews with 13 people with hip OA and four physiotherapists. Patients underwent a 12-week home exercise programme customised by weekly visits with one of the four physiotherapists. The programme aimed for patients to participate in 150min of moderate-intensity aerobic physical activity, and 20-30min of strengthening exercise 2-3 times per week in concordance with American College of Sports Medicine (ACSM) dosage guidelines. Following the programme, patients and physiotherapists participated in individual semi-structured interviews to explore the acceptability of the exercise programme and barriers and facilitators to participation. Data were audio-recorded, transcribed and analysed using a thematic approach. Five over-arching themes (supporting subthemes) were identified from both patient and physiotherapist interviews: (i) positive outcomes (functional improvements, pain relief, empowerment through experience, commitment to continue); (ii) combined benefits of aerobic and strength exercises (complimentary effects, strengthening exercises key); (iii) valuing support from the physiotherapist (personalised care, skill performance feedback, coach effect, accountability); (iv) motivation and opportunity for exercise (positive symptom loop, integration into daily routine, prior exercise experience, Fitbit motivation); and (v) time-consuming commitment (physiotherapy visit frequency, travel inconvenience, time for exercise). Experiences of participants in this study indicate that, although time-consuming, a combined aerobic physical activity and strengthening programme prescribed at ACSM dosage guidelines is acceptable and confers positive outcomes in individuals with hip OA.

The Impact of a Twelve-Week Moderate Aerobic Exercise Program on Gastrointestinal Symptom Profile and Psychological Well-Being of Irritable Bowel Syndrome Patients: Preliminary Data from a Southern Italy Cohort.

Walking is popular moderate-intensity aerobic exercise that improves mental and gastrointestinal (GI) health. It can relieve symptoms associated with irritable bowel syndrome (IBS), e.g., intestinal gas, abdominal distension, and bowel disturbances. This study examined the impact of a moderate-intensity aerobic exercise program on the clinical and psychological parameters of IBS patients. In total, 40 IBS patients (11 males and 29 females; mean age 51.9 ± 7.8 years) participated in a 12-week aerobic exercise program. Participants completed questionnaires assessing GI symptoms, psychological profiles, and quality of life (QoL) before and after the intervention. Field tests, anthropometric measurements, and bioimpedance assessments were also conducted. The present findings confirmed a significant improvement in IBS symptoms after the aerobic exercise program. Bloating was the most common symptom and, together with abdominal pain, was significantly reduced after treatment. Psychological and QoL questionnaires indicated decreased anxiety, depression, somatization, and stress levels. Correlations were found between anxiety/depression and the severity of abdominal pain as well as between stress and the severity of abdominal distension. Moderate-intensity aerobic exercise positively impacted GI symptoms and psychological well-being, complementing dietary and psychological support as a non-pharmacological therapy for the management of IBS. These findings emphasize the importance of alternative approaches for IBS treatment.

Adherence to a Web-based Exercise Programme: A Feasibility Study Among Patients with Hip or Knee Osteoarthritis.

To describe adherence to a 12-week web-based aerobic exercise programme, to compare characteristics between those who adhere or not, and to identify barriers for exercising in patients with hip or knee osteoarthritis. Single-arm feasibility study. Patients with hip or knee osteoarthritis in specialist healthcare, age 40-80 years, and not candidates for joint surgery. Adherence to a 12-week exercise programme was defined as having completed ≥ 2 exercise sessions a week for at least 8 weeks. Baseline differences between adherent and non-adherent groups in demographics, symptoms, disability, physical activity and fitness were assessed using Mann-Whitney U or χ2 tests. Reasons for not completing exercise sessions were reported in weekly diaries. Results: A total of 29 patients (median age 64 years, 72% female) were included. Median baseline pain (numerical rating scale 0-10) was 5. Fifteen patients adhered to the exercise programme, 14 did not. Non-adherent patients were less active (p = 0.032) and had lower cardiorespiratory fitness (p = 0.031). The most frequently reported barrier to exercising was sickness. Less than 10% reported pain as a barrier. Half of the patients with hip or knee osteoarthritis adhered to the digitally delivered exercise programme and the most frequently reported barrier for adherence was sickness, while less than 10% reported pain as a reason for not exercising. ClinicalTrials.gov, NCT04084834. The Regional Committee for Medical and Health Research Ethics South-East, 2018/2198.

Differential effects of a 12-week aerobic exercise program on health-related physical fitness, physiological and biochemical markers among obese adults: a randomized controlled trial.

Background: work out is an valuable approach for improving standard of living physiological, biochemical, and physical strength in obese patients; though, few researches have mainly focal point on early survival rates, minorities, in physically passive men, and overweight men, or examined individual &amp; combined workout plan and measured body composition markers.&#x0D; Objective: In this research we have describes the effect of a 12-week different aerobic exercise involvement on obese people's self-reported result, physical strength, physiological and biochemical markers in ethnically mixed, physically motionless, obese adults.&#x0D; Methods: Total (n = 60) male adults with obese (Mean ± SD; age: 18.92 ± 1.54 yrs.; height: 172.4 ± 5.4 cm.; weight: 84.4 ± 6.3 kg) were randomly allocated into three equal (n = 20) groups: Step Aerobic Exercise Training (SAET), Floor Aerobic Exercise Training (FAET) or a control group. The SAET &amp; FAET training protocol has been performed three days of a week during period of study (12 weeks). All the selected variables of physical fitness, physiological and biochemical markers have been examined at baseline and 12 weeks. Group under control have been found not performing workout.&#x0D; Results: The exercise program SAET &amp; FAET significantly improved in muscular strength, cardiovascular endurance, flexibility, muscular endurance, vital capacity, and breath holding time (p &lt; 0.05). The workout schedule reduced significantly % body fat, mean resting pulse rate, respiratory rate and arterial blood pressure, (p &lt; 0.05). Furthermore, the lipids levels of total triglycerides, cholesterol, and low density lipoprotein have been reduced significantly in SAET &amp; FAET, high density lipoprotein enhance significantly (p &lt; 0.05).&#x0D; Conclusion: Research’s finding advocate that 12-weeks regular SAET &amp; FAET protocols have greater effects than control group on physical fitness of health related, physiological and biochemical variables in obese male adult individuals.

Effects of an aerobic training program on liver functions in male athletes: a randomized controlled trial

The optimal functioning of the liver is essential for athletic performance. It is necessary to maintain the liver’s enzymes at an optimal level so that liver cells can be protected from inflammation or damage. This study investigated the effects of a 12-week aerobic exercise program on the liver function of adult athletes. A pretest–posttest experimental design was used. A total of thirty healthy male athletes (football players) aged 21 to 24 years were recruited for this study and randomly and equally divided into the experimental group (EG) and control group (CG). The CG did not participate in any special activities. The EG performed an aerobic training program consisting of several exercises for 12 weeks. Evaluation of all participants in both groups was carried out before and after the intervention by measuring the blood levels of Alkaline phosphate, AST/SGOT, ALT/SGPT, Bilirubin Total/indirect/direct, Albumin, Globulin, and Total protein using the standard methods by collecting blood samples. There was a significant decrease (p < 0.05) in Bilirubin and globulin levels in the EG after 12 weeks of aerobic training sessions. However, there was no significant difference in alkaline phosphate, AST/SGOT, ALT/SGPT Total protein, and Albumin (p > 0.05) between both groups post-treatment. The 12 weeks of aerobic training used in the study can potentially improve the liver function of adult athletes.

Effects of a Dedicated Cardiac Rehabilitation Program for Patients With Obesity on Body Weight, Physical Activity, Sedentary Behavior and Physical Fitness: the OPTICARE XL Randomized Controlled Trial.

Previously published results of the OPTICARE XL open label randomized controlled trial showed no added value of OPTICARE XL CR, a dedicated cardiac rehabilitation (CR) program for patients with obesity, with respect to health-related quality of life (primary outcome). This clinical trial studied the effects of OPTICARE XL CR on several secondary outcomes, which included body weight, physical activity, sedentary behavior, and physical fitness. Patients with coronary artery disease or atrial fibrillation and body mass index (BMI) ≥ 30 were randomized to OPTICARE XL CR (n = 102) or standard CR (n = 99). OPTICARE XL CR is a 1-year group intervention, specifically designed for patients with obesity, and included aerobic and strength exercise, behavioral coaching, and an aftercare program. Standard CR consisted of a 6- to 12-week group aerobic exercise program, supplemented with cardiovascular lifestyle education. Study end points included body weight, physical activity, sedentary behavior (accelerometer), and physical fitness (6-Minute Walk Test and handgrip strength), which were evaluated 6months after the end of CR (primary end point) and 3months after the start of CR. Six months after completion of either program, improvements in body weight, physical activity, sedentary behavior, and physical fitness were similar between groups. Three months after CR start, patients randomized to OPTICARE XL CR showed greater weight loss (mean change = -3.6 vs -1.8kg) and a larger improvement in physical activity (+880 vs +481 steps per day) than patients randomized to standard CR. Patients allocated to OPTICARE XL CR lost significantly more body weight and showed promising results with respect to physical activity 3months after the start of CR; however, these short-term results were not expanded or sustained in the longer term. Patients with obesity do not benefit from standard CR programs. The new OPTICARE XL CR program showed its effects in the short term on weight loss and physical activity, and, therefore, redesign of the aftercare phase is recommended.

Cost-Effectiveness of a Cardiac Rehabilitation Program Specifically Designed for Patients With Obesity Within the OPTICARE XL Randomized Controlled Trial

ObjectiveTo assess the cost-effectiveness of a cardiac rehabilitation (CR) program specifically designed for cardiac patients with obesity vs standard CR. DesignCost-effectiveness analysis based on observations in a randomized controlled trial. SettingThree regional CR centers in the Netherlands. ParticipantsCardiac patients (N=201) with obesity (BMI≥30 kg/m2) referred to CR. InterventionsParticipants were randomized to a CR program specifically designed for patients with obesity (OPTICARE XL; N=102) or standard CR. OPTICARE XL included aerobic and strength exercise and behavioral coaching on diet and physical activity during 12 weeks, followed by a 9-month after-care program with “booster” educational sessions. Standard CR consisted of a 6- to 12-week aerobic exercise program, supplemented with cardiovascular lifestyle education. Main Outcome MeasuresAn economic evaluation, with an 18-month time horizon, in terms of quality-adjusted life years (QALYs) and costs from the societal perspective was performed. Costs were reported in 2020 Euros, discounted at a 4% annual rate, and health effects were discounted at a 1.5% annual rate. ResultsOPTICARE XL CR and standard CR resulted in comparable health gain per patient (0.958 vs 0.965 QALYs, respectively; P=.96). Overall, OPTICARE XL CR saved costs (-€4542) compared with the standard CR group. The direct costs for OPTICARE XL CR were higher than for standard CR (€10,712 vs €9951), whereas indirect costs were lower (€51,789 vs €57,092), but these differences were not significant. ConclusionsThis economic evaluation showed no differences between OPTICARE XL CR and standard CR in health effects and costs in cardiac patients with obesity.

Aerobic exercise improves central blood pressure and blood pressure variability among patients with resistant hypertension: results of the EnRicH trial.

Central blood pressure (BP) and BP variability are associated with cardiovascular disease risk. However, the influence of exercise on these hemodynamic parameters is unknown among patients with resistant hypertension. The EnRicH (The Exercise Training in the Treatment of Resistant Hypertension) was a prospective, single-blinded randomized clinical trial (NCT03090529). Sixty patients were randomized to a 12-week aerobic exercise program or usual care. The outcome measures include central BP, BP variability, heart rate variability, carotid-femoral pulse wave velocity, and circulating cardiovascular disease risk biomarkers including high-sensitivity C-reactive protein, angiotensin II, superoxide dismutase, interferon gamma, nitric oxide, and endothelial progenitor cells. Central systolic BP decreased by 12.22 mm Hg (95% CI, -1.88 to -22.57, P = 0.022) as did BP variability by 2.85 mm Hg (95% CI, -4.91 to -0.78, P = 0.008), in the exercise (n = 26) compared to the control group (n = 27). Interferon gamma -4.3 pg/mL (95%CI, -7.1 to -1.5, P = 0.003), angiotensin II -157.0 pg/mL (95%CI, -288.1 to -25.9, P = 0.020), and superoxide dismutase 0.4 pg/mL (95%CI, 0.1-0.6, P = 0.009) improved in the exercise compared to the control group. Carotid-femoral pulse wave velocity, heart rate variability, high-sensitivity C-reactive protein, nitric oxide, and endothelial progenitor cells were not different between groups (P > 0.05). In conclusion, a 12-week exercise training program improved central BP and BP variability, and cardiovascular disease risk biomarkers in patients with resistant hypertension. These markers are clinically relevant as they are associated with target organ damage and increased cardiovascular disease risk and mortality.

Aerobic exercise for HIV-associated neurocognitive disorders in individuals on antiretroviral therapy: A randomised controlled trial

Introduction The increasing burden of self-limiting forms of HIV-associated neurocognitive disorder (HAND) in the antiretroviral therapy era calls for adjunctive interventions. The study aimed to determine the effects of a 12-week aerobic exercise programme on HAND. Methods This is a parallel-group, randomized controlled trial with concealed allocation and intention-to-treat analysis. This study was a clinic-based programme. Seventy-three patients with HAND were enrolled in the trial. The intervention comprised a moderate-intensity aerobic exercise, 20–60 min per session, three times per week, for twelve weeks. The control group received exercise education. Prevalence of HAND constituted the primary outcome. HAND was identified and classified following the Frascati criteria. We computed the odds ratio and number needed-to-treat to estimate the treatment effect. Results There were 73 patients (38 in exercise and 35 in control arm). Individuals in the exercise arm recorded a significantly higher reduction in working memory deficit (OR = 5.14; CI = 2.6–10.4; NNT = 6) but not in attention-deficit (OR = 0.31, CI = 0.2–0.5; NNT = −5) compared to the control group at twelve-week. Reductions in attention deficit (OR = 1.55, 95 CI = 1.0–2.4; NNT = 5) and HAND prevalence (OR = 1.8, 95 CI = 1.2–2.8); NNT = 8) were significantly higher in the exercise group compared the control group at three-month. No significant between-group difference in functional independence was observed immediately after exercise (p > 0.05). Discussion The neuroprotective effects of aerobic exercise appear selective and vary with cognitive abilities impaired and aerobic capacity, with a greater change occurring with improved aerobic capacity. Conclusion Individuals with working memory and attention deficits may benefit more from moderate-intensity aerobic exercise.

ACUTE AEROBIC EXERCISE-INDUCED DECREASE IN BLOOD PRESSURE IS ASSOCIATED WITH CHRONIC BLOOD PRESSURE CHANGES IN PATIENTS WITH RESISTANT HYPERTENSION

Objective: The acute blood pressure (BP) decrease after an exercise training session seems to correlate with the chronic BP reductions following exercise training programs in participants with pre-hypertension; yet, among patients with resistant hypertension (RH) it is unknown. This study aims to investigate the association between the magnitude of BP decrease after acute exercise and the change in 24-hr ambulatory blood pressure (ABP) after an aerobic exercise intervention in patients with RH. Design and method: EnRicH trial was a randomized clinical trial assessing the effects of a 12-week moderate-intensity aerobic exercise program in participants with RH. In the present study, twenty-six patients (mean age 59.3 ± 8.2 years, 58.3% male) with RH that participated in the intervention arm of the EnRicH trial were included. Office and ABP measurements were obtained before and after the 12-week aerobic exercise training program. To assess the acute effect, resting BP measures were assessed before and 10 minutes after each exercise session of the third week of the exercise program. Exercise sessions were supervised, occurred three times per week, and included 40 min of aerobic exercise at 50% to 70% of VO2max and a 10-minute cooldown. Results: Resting systolic (-9.4 ± 7.0, p &lt; 0.001) and diastolic BP (-1.9 ± 3.4, p = 0.10) were significantly reduced after acute exercise. 24hr systolic (-6.2 ± 12.1, p = 0.015) and diastolic BP (-4.42 ± 6.1, p = 0.001) an office systolic (-10.9 ± 15.2, p = 0.001) and diastolic BP (-5.9 ± 11.1, p = 0.013) were significantly decreased after the exercise program. The acute changes were correlated with the chronic decrease in 24hr ambulatory systolic (r = 0.556, p = 0.003) and diastolic (r = 0.484, p = 0.012) BP, and office systolic (r = 0.478, p = 0.014) and diastolic BP (r = 0.452, p = 0.020). Multiple regression analysis revealed that the acute effect of exercise was an independent predictor of the chronic effect on systolic BP (ß = 0.556, adjusted r2 = 0.280, p = 0.003) BP. Conclusions: The magnitude of the acute effect of exercise in BP correlates with the chronic decrease in both office and 24hr BP effects. These results suggest that it is possible to predict those patients that are less likely to improve BP with an exercise training program without the burden of a period of several months of intervention.