8-week Program Research Articles

Mechanisms of change in compassion-based programs for medical students

Medical practice exposes physicians to numerous stressors, leading to high rates of psychological distress and burnout, a problem that begins during medical school. Scientific evidence suggests that promoting compassion among physicians could improve their well-being and promote patient-centered care. However, the mechanisms underlying these benefits remain unclear. This study aimed to examine the mediators and moderators of changes in psychological distress and well-being following Compassion Cultivation Training (CCT) among medical students. A randomized controlled trial with 40 medical students assigned to an 8-week CCT program or a waitlist control group was conducted. Participants were assessed at pre-intervention, post-intervention, and a 2-month follow-up on measures of psychological distress, well-being, mindfulness, compassion, emotion regulation, and burnout. Results indicated that CCT led to significant reductions in stress and anxiety immediately after the program, mediated by improvements in emotion regulation and mindfulness skills. Gender moderated changes in stress, anxiety, depression, and well-being at post-intervention, with women benefiting more than men, though these differences were not sustained at follow-up. In conclusion, this study contributes to the growing body of literature on the benefits of compassion training in healthcare and provides insights into the mechanisms through which compassion could support physicians and medical students.

Assessment of atrial strain variations in amateur runners: A 10-week unsupervised training program and half-Marathon impact study using 2D and speckle-tracking echocardiography

BackgroundCompetitive running leads to cardiac remodeling and functional changes in cardiovascular haemodynamics in professional runners. Data on atrial changes in amateur runners completing a half-marathon are limited. The study sought to analyze the impact of training and a 21.0975-km run on echocardiographic parameters of left (LA) and right (RA) atrial anatomy and function in recreational runners. MethodsThe study group comprised 52 amateur runners [mean age 32.96 (5.12) years], including 32 men. Echocardiographic evaluations were performed at three stages: prior to the ten-week unsupervised training, and then before and after the run. Morphological and functional parameters were assessed using two-dimensional imaging, Doppler, and speckle-tracking technique. ResultsDuring the training period, both LA dimension [31.87 mm vs. 33.96 mm; p < 0.001] and LA volume [59.00 ml vs. 68.00 ml; p < 0.001] increased and no changes were found for RA morphological parameters. Ten weeks of preparatory training resulted in an increase in LA contractile strain (LASct) [10.50 % vs. 11.00 %; p = 0.030], without affecting the RA function. Change of LASct was particularly pronounced in young women (<32 years; p = 0.029). Half-marathon performance decreased the LA volume. ConclusionsAmateur training for 21.0975-km run remodels LA and enhances LA active contractile function (especially in young women) without influencing RA. The half-marathon decreases LA volume and does not affect RA morphology and function in recreational runners.

Efficacy of an Online Self-Management Program for Chronic Burn Pain: A Randomized Controlled Trial of the Take Charge of Burn Pain Program

This randomized controlled trial investigated the effectiveness of an online self-management program, "Take Charge of Burn Pain (TCBP)," for 96 individuals living with chronic burn pain. Participants were randomly assigned to either the 7-week TCBP program integrating cognitive-behavioral therapy techniques, pain education, and self-management strategies or an attention control group focused on general burn recovery information. Assessments conducted at baseline, post-treatment, and 2 and 5-month follow-ups included measures of pain severity, pain interference, pain self-efficacy, posttraumatic stress disorder symptoms, and depression. Compared to the control group, participants in the TCBP program demonstrated greater reductions in pain severity (mean difference: -1.24, 95% CI: -1.93 to -0.55, p = 0.0007) and pain catastrophizing (mean difference: -5.41, 95% CI: -10.33 to -0.49, p = 0.0318) post-treatment when adjusting for key variables. At the two-month follow-up, the TCBP group showed significant improvements in pain interference (P = 0.0123), self-efficacy (P = 0.0269), functional abilities (P = 0.0014), and social role participation (P = 0.0498) compared to the control group. Treatment effects were not sustained at five-month follow-up. Participants in both groups reported high levels of satisfaction with the online intervention, with the majority finding the program helpful, easy to use, and willing to recommend it to others with pain. Findings suggest preliminary support for short-term benefits of TCBP for managing certain facets of chronic burn pain. This underscores the need to refine digital approaches to maintain and promote long-term improvements. The potential of self-guided online psychological interventions to enhance pain coping strategies for burn survivors persists.

Sustained Effect Of Neurocreative Music Therapy On Upper Limb Abilities, Spasticity, Selective Control And Quality Of Life In Cerebral Palsy: A Case Report

Abstract This case report, presents the sustained effect of Neurocreative Music Therapy (NCMT) which a uniqe music therapy approach on the upper limb in an individual with cerebral palsy (CP). Our case is a 19-year-old individual with hemiparetic CP and she was included in the 8-week NCMT application program. Before the application, a phenomenological interview was conducted in accordance with the principle of the NCMT approach, which prioritizes the needs and pleasures of the individual. Before and immediately after the 8-week NCMT application, the patient's spasticity was assessed with the Modified Ashwort Scale, selective motor control with the Selective Control of the Upper Extremity Scale, upper limb abilities in daily activities with the ABILHAND-Kids, and quality of life with the Pediatric Quality of Life Inventory CP Module 3.0. As a result of the assessments, an individual-specific music therapy program was planned and implemented. The outcome measurements made immediately after the NCMT application were repeated in the 4th and 8th weeks following the end of the application. According to the results of the scales, it was observed that spasticity decreased, selective motor control increased, upper limb abilities improved, and quality of life increased. The obtained improvements were generally maintained in the 4th week following the end of the therapy. It was observed that there was a decrease in the sustainability of the effect in the 8th week following the end of the therapy in other measurement parameters other than quality of life. As a result, we concluded that NCMT is an effective approach in the rehabilitation of individuals with CP and that its effects may be transferred to the post-rehabilitation period.

Chronic effects of a static stretching intervention program on range of motion and tissue hardness in older adults

IntroductionClinically, knowing whether a static stretching (SS) intervention program conducted for several weeks can reduce passive muscle stiffness is important. Still, only a few previous studies have evaluated the chronic effects of an SS intervention program in older adults, and the potential relationship between ROM changes and muscle stiffness changes is still unclear. This study aimed to investigate the effects of a 10- week SS intervention partially supervised program on joint range of motion (ROM) and tissue hardness in older adults.MethodsThe SS intervention program was conducted at least three times a week for 10 weeks in the ankle plantar flexor muscles of 24 community-dwelling older adults (73.8 ± 5.1 years; height: 156.0 ± 6.8 cm; body mass: 52.7 ± 8.0 kg). The SS intervention program consisted of 4 × 30-s repetitions. Ankle joint dorsiflexion (DF) ROM and tissue hardness of the medial gastrocnemius were measured before and after the 10-week SS intervention program.Results and discussionThe results showed that the 10-week SS intervention program significantly increased DF ROM (+9°, p &amp;lt; 0.01, Cohen’s d = 1.37) and decreased tissue hardness (−0.9, p = 0.04, Cohen’s d = −0.27). However, there was no significant correlation between these changes (r = 0.086, p = 0.561). The results of this study suggest that a 10-week SS intervention program can effectively increase DF ROM and decrease tissue hardness but that the increase in DF ROM is related to stretch tolerance rather than changes in tissue hardness.

Effects of electrical muscle stimulation exercise on lower limb muscles and lumbar movement in older adults with disabilities: A pre- and post-test controlled experimental study

In older adults with disabilities, muscle weakness reduces mobility and causes postural issues. Electrical muscle stimulation (EMS) training is effective for increasing strength by inducing involuntary skeletal muscle contractions. Thus, this study aimed to examine changes in lumbar movement, muscle activity during walking, and maximum muscle strength of lower-limb joints based on an 8-week EMS exercise program for older adults with physical disabilities. Sixteen older adults (aged 56–78 years) with physical disabilities were selected and randomly assigned to either the exercise group (EG, n = 8) or the control group (CG, n = 8). EG participants were instructed to wear EMS suits and participate in an elastic band and bare-body exercise program, whereas CG participants performed the exercise program without the EMS suits. Lumbar range of motion (ROM), body circumference, partial volume, maximum muscle strength, and muscle activity were measured. Statistical analysis was performed using SPSS 28.0 for Windows, with the critical value of α = 0.05. Compared to CG participants, EG participants had a superior ROM, body volume, partial volume, maximum muscle strength (knee joints), and muscle activity while walking. These positive outcomes highlight the efficacy of combining EMS with an exercise program for strength and rehabilitation training in older adults with physical disabilities.

Trajectories and predictors of adolescent purpose development in self-driven learning.

Purpose offers several important benefits to youth. Thus, it is necessary to understand how a sense of purpose develops in supportive contexts and what psychological resources can help. From 2021 to 2022, this study investigated purpose change among 321 youth (Mage = 16.4 years; 71% female; 25.9% Black, 33.3% Asian, 15.6% Hispanic/Latinx, 13.4% White, 9.7% multiracial) participating in GripTape, a ~10-week self-driven learning program. Many youth started with high initial purpose that increased throughout enrollment (Strengthening), whereas others began with slightly lower purpose that remained stable (Maintaining). For each unit increase in baseline agency, youth were 1.6x more likely to be classified as Strengthening. As such, agency may be a resource that helps youth capitalize on certain types of environments.

Metabolic signatures of combined exercise and fasting: an expanded perspective on previous telomere length findings.

Aging is a complex process marked by a gradual decline in physiological function and increased susceptibility to diseases. Telomere length is frequently regarded as one of the primary biomarkers of aging. Metabolic profiles are key features in longevity and have been associated with both age and age-related diseases. We previously reported an increase in the telomere length in healthy female subjects when Ramadan fasting was combined with physical training. This study aims to characterize the metabolic signature differentiating the combined effects of exercise and fasting from exercise alone and explore the correlations with the previously reported telomere length changes. Twenty-nine young, non-obese, and healthy female subjects were previously randomized into two groups: one group followed a 4-week exercise program, while the other group followed the same 4-week exercise program but also fasted during Ramadan. Metabolic profiles were assessed pre- and post-intervention using untargeted metabolomics. Our results showed a significant decrease in many lipid metabolites in the exercise-while-fasting group, particularly ceramides. Our study sheds light on the dynamic changes in lipid metabolism and its potential role in inflammation and age-related diseases, and contributes to the broader understanding of how lifestyle factors can influence cellular aging and metabolic health.

“It Took Away the Trauma of Failing”: A Mixed Methods Feasibility Trial of an Open Goals Physical Activity Program

ABSTRACT Open goals (e.g. to “see how many steps you can reach today”) may be a promising strategy for promoting physical activity. The findings from initial studies, typically based on single sessions of exercise, showed that open goals can produce at least as much activity as specific goals (e.g. to reach 10,000 steps a day), while promoting more positive experiences and higher intentions to repeat the activity, especially among less active individuals. However, the feasibility of using open goals over a longer duration remains unclear. Therefore, in this study, we examined the feasibility of using open goals in a 10-week step-based physical activity program. A single-arm mixed methods design was used, involving 15 healthy adults (13 female; Mage = 42.53) with low to moderate physical activity levels. Participants were provided with a pedometer, diary, and open goals for each week, alongside brief support sessions. The feasibility domains assessed included recruitment, acceptability, adherence, and retention. Quantitative methods assessed physical activity, enjoyment, and self-efficacy, while supplementary qualitative methods explored participants’ perceptions of open goals. The study showed high recruitment and retention rates, increased physical activity, and positive psychological experiences, indicating the feasibility of the 10-week open-goal program. Secondary outcomes suggest that open goals may function by increasing enjoyment and self-efficacy while decreasing negative outcomes such as pressure, guilt, and failure. The findings indicate that using open goals in longer-term physical activity programs is feasible, expanding on the limitations of previous single-session designs, and offering recommendations for future trials.

The Effects of an 8-Week Cognitive-Motor Training Program on Proprioception and Postural Control Under Single and Dual Task in Older Adults: A Randomized Clinical Trial.

The aim of this study was to assess the effects of an 8-week cognitive-motor training program on postural control and knee proprioception under single and dual task conditions. Design: Randomized clinical trial. Methods: The present study was registered with the ID number NCT04786132. A total of 20 healthy and physically active older adults (73.25 ± 5.98 years) volunteered to participate and were randomly assigned into an experimental and a control group (EG and CG). Postural control was measured with the Romberg test, with open (RBOE) and closed eyes (RBCE) and under unipodal dominant side (RUDL) conditions. Proprioception was assessed by measuring participants' ability to reposition their dominant knee at 45°. Finally, performance of the cognitive task was measured through a subscale of the Barcelona Test called "categorical evocation in associations". The EG and the CG completed 8-week training programs with two sessions, 30 min per week, of postural control and proprioception exercises. The EG additionally included music in each session. Results: The analysis using a mixed ANOVA model revealed no significant group × time interaction effects (p < 0.05) for any of the assessments. However, a significant main effect for the time factor was observed, with both the control and experimental groups showing improved outcomes in the post-intervention measurements. Specifically, significant results were found for RBOE (F (4,15) = 11.87, p < 0.001, η2p = 0.76), RBCE (F (4,15) = 11.62, p < 0.001, η2p = 0.75), and proprioception (F (1,18) = 11.53, p < 0.003, η2p = 0.39). Conclusions: The 8-week training program had a positive impact on the post-intervention results for motor control and proprioception, but not on the results of the cognitive task. There were no significant differences between the groups that carried out sessions with or without music.

High-intensity interval training is an effective exercise mode to maintain normal blood pressure during pregnancy: a randomized control trial

Pregnant women are more susceptible to high blood pressure (BP) than the general adult population; therefore, all means of preventing this condition should be considered. High-intensity interval training (HIIT) is effective in this regard in the general population, but there is a lack of evidence of its effectiveness during pregnancy. This study aimed to compare an 8-week HIIT program to self-performed moderate-to-vigorous physical activity among pregnant women by evaluating changes in BP after a maximal progressive cardiorespiratory exercise test (CPET) performed at pre-intervention and post-intervention time points. A total of 54 Caucasian women in uncomplicated, singleton pregnancies (age 32 ± 4 years, 22 ± 4 weeks of gestation; M ± SD) with normal BP values completed the interventions. The experimental (HIIT) group (n = 34) completed an online supervised HIIT program consisting of three sessions per week and supplemented by an educational class once per week. Participants in the education (EDU) group (n = 20) attended an educational class once per week and were encouraged to perform moderate-to-vigorous physical activity (PA) on their own. Pre- and post-intervention, all women underwent a CPET on a cycle ergometer with a respiratory gas analyzer. On the day of the CPET, maternal systolic and diastolic BP (mmHg) was measured at rest (before the CPET) and approximately 60 min after the CPET using an electronic BP monitor. Identical CPET and BP measurement protocols were employed for both the HIIT and EDU groups at the pre- and post-intervention time points. Pre-intervention, the HIIT and EDU groups both showed a decrease in systolic and diastolic BP after the CPET, though only the change in systolic BP was statistically significant (HIIT group: p = 0.01; EDU group: p = 0.001). Post-intervention, there were no significant differences in either group between resting and post-CPET BP. There were significant post-intervention differences in VO2peak (p < 0.001) and HRmax (p = 0.002) between the HIIT and EDU groups. From pre- to post-intervention, the EDU and HIIT groups both showed decreases in resting systolic or diastolic BP; there was a significant difference in systolic BP in the EDU group (p = 0.005) and a significant difference in diastolic BP in the HIIT group (p = 0.03). Both groups maintained normal BP values throughout the experiment. However, HIIT, in addition to maintaining normotension, improved cardiorespiratory fitness in pregnant women. It seems that both supervised HIIT and self-performed moderate-to-vigorous PA can be recommended as strategies to prevent BP disorders during pregnancy. More studies are needed to confirm our findings.Trial registration The full study protocol was registered in ClinicalTrials.gov (NCT05009433).

Effects of horizontally versus vertically loaded resistance exercises on performance and muscle architecture.

The aim of this study was to compare a training program based on horizontally (HT) versus vertically (VT) loaded exercises on performance and muscle architecture of the lower body muscles. Nineteen resistance trained individuals were randomly assigned to HT (N.=10; age: 25.9±4.2 y; body mass: 72.7±11.4 kg; height: 174.0±6.0 cm) or VT group (N.=9; age: 26.9±4.4 y; body mass: 76.2±10.8 kg; height: 174.2.0±5.8 cm). Both 6-week training programs included 4 training sessions per week and were equated for the total number of repetitions. One repetition maximum (1RM) was assessed for squat and hip thrust, together with vertical and horizontal jumps and sprint. Muscle thickness (MT) and echo intensity (EI) of vastus lateralis, vastus medialis and gluteus were also evaluated pre- and post-training period. A significantly greater increase in 1RM hip thrust was detected in HT (+17.9%; P=0.004) while greater increases in 1RM squat were found in VT (+10.5%; P=0.007). A greater increase (P=0.009) in vastus medialis MT was detected in VT (4.1%) compared to HT (-7.9%). Similar increases in MT of gluteus were registered in both groups (P<0.05). A greater improvement in standing long jump (P=0.004) was detected in HT (+7.6%) compared to VT (+1.6%), while both groups significantly improved vertical jump performance. Combining both groups, strong correlations were detected between gluteus EI and 20-m sprint (r=0.79; P<0.001). Results indicate that HT was more effective than VT for horizontal jumps while both HT and VT were equally effective on vertical jumps. Both HT and VT promoted similar changes in muscle architecture of the gluteus, but not of the vastus medialis.

Participants' perspectives on a multimodal stress management and comprehensive lifestyle modification program for patients with Crohn's disease-A qualitative interview study.

Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) that is prevalent worldwide and associated with reduced quality of life for patients. Multimodal therapy approaches, which emphasize lifestyle modifications such as mindfulness and stress reduction, can be promising in enhancing health-related quality of life for IBD patients. However, research on multimodal therapy approaches for CD remains insufficient. This qualitative interview study is part of a mixed-methods approach that is embedded in a randomized controlled trial. It investigates the impact of a comprehensive 10-week day clinic lifestyle modification program on the health condition and quality of life of CD patients. Telephone interviews (n = 19) were conducted three months after the program to examine individuals' viewpoints on the intervention, including perceived changes and transfer of elements into daily life. Reflexive thematic analysis was performed using MAXQDA software. The results indicate that CD can have very individual and comprehensive impacts (psychological, physical, social), leading to reduced perceived quality of life and well-being. By participating in the program, patients wanted to find self-help options to complement conventional pharmacotherapy and actively manage their disease. Patients expressed high satisfaction with the program, feeling it provided valuable support for daily disease management. They were able to integrate adequate therapy elements into their routines to complement their care. Patients recognized significant improvements in various domains, mainly in the psychological domain, e.g., improved self-efficacy, symptom management, and, also partly physical/symptomatic and social improvements. A multimodal stress reduction and lifestyle modification day clinic appears to be beneficial as a complementary therapy for CD patients. It offers additional options and helps patients to address individual symptoms and needs, improve their understanding of the disease and their quality of life. Although promising, further research is needed to assess its long-term effects. ClinicalTrials.gov, identifier: NCT05182645.

Greater improvement in aerobic capacity after a polarized training program including cycling interval training at low cadence (50-70 RPM) than freely chosen cadence (above 80 RPM).

This study compared the impact of two polarized training programs (POL) on aerobic capacity in well-trained (based on maximal oxygen uptake and training experience) female cyclists. Each 8-week POL program consisted of sprint interval training (SIT) consisting of 8-12 repetitions, each lasting 30 seconds at maximal intensity, high-intensity interval training (HIIT) consisting of 4-6 repetitions, each lasting 4 minutes at an intensity of 90-100% maximal aerobic power, and low-intensity endurance training (LIT) lasting 150-180 minutes with intensity at the first ventilatory threshold. Training sessions were organized into 4-day microcycles (1st day-SIT, 2nd day-HIIT, 3rd day-LIT, and 4th day-active rest), that were repeated throughout the experiment. In the first POL program, exercise repetitions during SIT and HIIT training were performed with freely chosen cadence above 80 RPM (POLFC group, n = 12), while in the second POL program with low cadence 50-70 RPM (POLLC group, n = 12). Immediately before and after the 8-week POL intervention, participants performed an incremental test to measure maximal aerobic power (Pmax), power achieved at the second ventilatory threshold (VT2), maximal oxygen uptake (VO2max), maximal pulmonary ventilation (VEmax), and gross efficiency (GE). Moreover, participants performed VO2max verification test. Analysis of variance showed a repeated measures effect for Pmax (F = 21.62; η2 = 0.5; p = 0.00), VO2max (F = 39.39; η2 = 0.64; p = 0.00) and VEmax (F = 5.99; η2 = 0.21; p = 0.02). A repeated measures x group mixed effect was demonstrated for Pmax (F = 4.99; η2 = 0.18; p = 0.03) and VO2max (F = 6.67; η2 = 0.23; p = 0.02). Post-hoc Scheffe analysis showed that increase in Pmax were statistically significant only in POLLC group. The Friedman test showed that VT2 differed between repeated measures only in the POLLC group (χ2 = 11; p = 0.001; W = 0.917). In conclusion, it was found that POL program where SIT and HIIT were performed at low cadence was more effective in improving aerobic capacity in well-trained female cyclists, than POL with SIT and HIIT performed at freely chosen cadence. This finding is a practical application for athletes and coaches in cycling, to consider not only the intensity and duration but also the cadence used during various interval training sessions.

Factors Influencing the Attrition Rate of a 10-Week Multimodal Rehabilitation Program in Patients After Lung Transplant: A Neural Network Analysis.

Despite the effectiveness of exercise and nutritional interventions to improve aerobic capacity and quality of life in lung transplant (LT) recipients, their compliance is low. Strategies to reduce the high attrition rate (participants lost over time) is a major challenge. Artificial neural networks (ANN) may assist in the early identification of patients with high risk of attrition. The main objective of this study is to evaluate the usefulness of ANNs to identify prognostic factors for high attrition rate of a 10-week rehabilitation program after a LT. This prospective observational study included first-time LT recipients over 18 years of age. The main outcome for each patient was the attrition rate, which was estimated by the amount of missing data accumulated during the study. Clinical variables including malnutrition, sarcopenia, and their individual components were assessed at baseline. An ANN and regression analysis were used to identify the factors determining a high attrition rate. Of the 41 participants, 17 (41.4%) had a high rate of attrition in the rehabilitation program. Only 23 baseline variables had no missing data and were included in the analysis, from which a low age-dependent body mass index (BMI) was the most important conditioning factor for a high attrition rate (p = 7.08 × 10-5), followed by end-stage respiratory disease requiring PT (p = 0.000111), low health-related quality-of-life (HRQoL) (p = 0.0009078), and low handgrip strength (p = 0.023). The prevalence of high attrition rate in LT recipients is high. The profile of patients with a high probability of attrition includes those with chronic obstructive pulmonary disease, low BMI and handgrip strength, and reduced HRQoL.

Training Effects of Traditional versus Cluster Set Configuration with and without Blood Flow Restriction.

Purpose: This study compared the effects of four different resistance training (RT) programs that differed in the set configuration (cluster vs. traditional) and the blood flow condition [free-flow (FF) vs. blood flow restriction (BFR)] on strength, neuromuscular and hypertrophic adaptations.Methods: Forty-two resistance-trained males were randomly assigned into four protocols that differed in the set configuration (TRA: without rest between repetitions vs. CLU: 30 s rest every 2 repetitions) and in the blood flow condition [FF vs. BFR (50% of arterial occlusion pressure)]. Subjects followed an 8-week RT program, twice per week, with similar intensity (55%-65% 1RM), sets (3), repetitions per set (10-6), and resting time (2 minutes) in the full-squat (SQ) exercise. Before and after the RT program, they were evaluated for: 1) muscle size of the vastus lateralis; 2) vertical jump; 3) maximal isometric contraction; 4) progressive loading test; and 5) fatigue test.Results: BFR-TRA and FF-CLU induced greater increases in 1RM, and velocity against submaximal loads than FF-TRA and BFR-CLU (BFR × time and CLU × time interactions, p = 0.02). The TRA protocols showed greater increases in maximal isometric force than CLU (CLU × time interaction, p = 0.03). BFR did not enhance jump performance unlike the FF protocols (p < 0.01). The TRA protocols induced greater hypertrophy in the distal region of the vastus lateralis than CLU protocols (CLU × time interaction, p = 0.04), with BFR-TRA producing the greatest gains in all vastus lateralis sections.Conclusions: The different combinations of set configurations and blood flow conditions resulted in highly specific adaptations that illustrate the potential of adaptation for each protocol. The divergent underlying mechanisms of CLU and BFR methodologies may offset each other when combined.

The optimal treatment duration for inspiratory muscle strengthening exercises in stroke patients: a double-blinded randomized controlled trial

ABSTRACT Background Little is known about the ideal duration of inspiratory muscle training in stroke patients. Objective The aim of this study was to assess the effects of short-term and long-term inspiratory muscle strengthening exercises in stroke patients. Methods This study was a prospective, double-blind, randomized controlled trial involving 50 stroke patients. Based on baseline maximum inspiratory pressure (MIP) values, participants were divided into two strata: those with severely weak inspiratory muscle (stratum A) and those with moderately weak inspiratory muscle (stratum B). Within each stratum, individuals were randomly assigned to either the 4-week exercise group, the 8-week exercise group, or the sham group. The exercise groups underwent inspiratory muscle strengthening exercises. The MIP, 6-minute walk test (6MWT), and the Nottingham Extended Activities of Daily Living (NEADL) Index were assessed at baseline, 8, 12, and 24 weeks. Results Subjects in Stratum A exhibited notably greater improvement after 8 weeks of training compared to those in Stratum B. Furthermore, both Stratums displayed significantly greater improvement following 8 weeks of training compared to sham training. In Stratum B cases, a significantly higher level of improvement was noted with the 4-week training in comparison to the sham training. A significant increase in NEADL index and 6MWT score was observed during the 24-week follow-up period. Conclusion For individuals with moderately weak inspiratory muscle strength, a 4-week exercise program proves sufficient in enhancing inspiratory muscle strength, walking capacity, and daily life activities. However, individuals with severely weak inspiratory muscle strength benefit more from an 8-week treatment.

MHealth-Based Self-Management Program for Patients With Rheumatoid Arthritis: A Pilot Randomized Controlled Study.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that gradually limits physical function and decreases quality of life (QOL). We evaluated an mHealth-based self-management program to help patients with RA improve their physical and psychological health, self-efficacy, physical activity, and QOL. The sample included 73 experimental and 69 control participants. A pilot randomized controlled design was employed to identify the effectiveness of an 8-week mHealth-based self-management program, which comprised educational modules regarding disease management and exercise, cognitive training, and motivational support through mobile messages and periodic phone calls. Knowledge of the health effects of RA, disease activity, perceived health, depression, self-efficacy for controlling symptoms, physical activity, and QOL were evaluated pre- and postintervention and after the 4-week follow-up period. This pilot study indicates that the mHealth-based program for people with RA is feasible. The mHealth self-management program improved patients' knowledge of RA, depression, self-efficacy for controlling symptoms, physical activity, and perceived health; however, disease activity and QOL did not significantly change. This pilot study demonstrates the potential of mHealth intervention as an effective program for strengthening self-management capacities in patients with RA. Trial Registration: KCT0007523.

Limiting Access to Resistance Training Equipment During the Off-Season: The Impact on Collegiate Pitching Metrics.

Gdovin, JR, Hogan, B, and Williams, CC. Limiting access to resistance training equipment during the off-season: the impact on collegiate pitching metrics. J Strength Cond Res XX(X): 000-000, 2024-Resistance training has been shown to improve overhead throwing velocity, but it is unknown as to how limiting access to a strength and conditioning facility affects a baseball pitcher's readiness for the spring season. Therefore, the purpose of this study was to examine the influence of an individualized pitching program on pitching metrics during an 8-week fall season in collegiate baseball pitchers without a simultaneous structured strength training program. Twelve National Collegiate Athletic Association Division-I baseball pitchers completed the study and wore a PULSE Throw Workload Monitor to track peak arm slot angle, peak arm velocity, and peak elbow varus torque, while a radar gun measured ball velocity. An 8-week pitching program had subjects throw 30 and 50 maximum effort pitches in the first and eighth week, respectively, while workload increased by 5 maximum effort pitches every 2 weeks. Paired samples t-tests were conducted to compare variables of interest before and after an 8-week fall season with an alpha level set at 0.05. There was no significant difference in peak arm slot angle, peak arm velocity, and peak elbow varus torque (p > 0.05); however, there was a significant decrease in ball velocity (p < 0.001). These data indicate that 8-week pitching programs, not coupled with a resistance training regimen, negatively affect a pitcher's ball velocity. Sport coaches and practitioners should thus make accommodations to access the necessary equipment for a pitching and strength training program to be implemented simultaneously to ensure that pitchers are prepared to perform at an optimal level during the spring season.

Comparison of high-intensity interval training and moderate-intensity continuous training on cardiopulmonary function, cardiac autonomic function and vascular function in adolescent boys with obesity: A randomized controlled trial.

Adolescent obesity can impair cardiopulmonary function, vascular elasticity, endothelial function, and vago-sympathetic balance. While moderate-intensity continuous training (MICT) benefits cardiovascular health in obese adolescents, the effects of high-intensity interval training (HIIT) are less understood. We hypothesize that HIIT may be more effective than MICT in improving VO2peak, vascular elasticity, endothelial function, and vago-sympathetic balance in obese adolescent boys. Forty four participants were randomly assigned to the HIIT (10×1-min at 85%-95% peak HR, intersperse with 2-min active recovery at 60%-70% peak HR) or MICT (35min at 65%-75% peak HR) for an 8-week program. The primary outcome measured was the change in VO2peak with secondary outcomes including brachial-ankle pulse wave velocity (baPWV), flow-mediated dilation (FMD), and heart rate variability (HRV). Forty four adolescent boys with obesity (age, 14±1years old, body mass index, 31.6±1.3kg/m2) were enrolled and 43 (97.73%) completed the 8-week exercise. No significant difference of VO2peak was found between the HIIT and MICT group (p=0.243). There was no significant difference of baPWV between the groups (p=0.789). Change in FMD% was significantly higher in the HIIT group compared to the MICT group (p<0.001). The Change in HRV-high frequency (HRV-HF; p=0.009) and HRV-low frequency/high frequency (HRV-LF/HF; p=0.035) was significantly higher in the HIIT group compared to the MICT group. Among adolescent boys with obesity, 8-week HIIT and MICT had similar effects on improving VO2peak. HIIT may be superior to MICT to improve endothelial function and vago-sympathetic balance.