Aerobic Activity Research Articles

The talk test as a useful tool to monitor aerobic exercise intensity in healthy population.

The talk test (TT) is subjective method to measure exercise intensity in costless and feasible manner, compared to sophisticated laboratory equipment. We attempted to investigate whether the TT was a valid method for evaluation of exercise intensity, by comparing with values derived from various physiologic markers during cardiopulmonary exercise testing on treadmill in healthy population. A total of 17 healthy subjects (12 males and 5 females) participated in this study. The TT was applied, which consisted of 3-stages difficulties demanding respiratory load while they performed the cardiopulmonary exercise testing on treadmill. In each of the TT stages, ergospirometric and psychophysiologic response marker were collected such as heart rate, oxygen consumption, respiratory exchange ratio, minute ventilation, carbon dioxide output, tidal volume, respiratory rate, and rating of perceived exertion of breathing. Statistical analyses revealed a significant difference of all dependent variables in each of three TT stages, comparing with the resting phase before the TT. The TT showed strong correlation coefficient with all variables except for rating of perceived exertion during the resting phase before the TT. According to increase of exercise intensity, all dependent variables showed a linear tendency with the stages of the TT. Our findings indicated that each of the TT stages was strongly correlated with ergospirometric variables as well as psychophysiologic response during cardiopulmonary exercise testing on treadmill. We suggested that the TT can be used to evaluate and prescribe exercise intensity of aerobic activity in cardiovascular and pulmonary rehabilitation settings.

Pilot Project: Heart Chargers-A Successful Model for a Home-Based Physical Activity Program Utilizing Telemedicine for Fontan Patients.

Fontan patients have decreased exercise capacity which further declines throughout adolescence. A positive exercise capacity trajectory in children predicts better adult Fontan outcomes. Hospital-based physical activity programs improve exercise capacity and attenuate the age-expected decline in Fontan patients. The purpose of this project was to investigate the feasibility and safety of a partially reimbursable 12-month, home-based, individualized physical activity program (Heart Chargers) for Fontan patients utilizing telemedicine. The Heart Chargers team included a cardiologist, nurse coordinator, and exercise physiologists. Eligible participants with a Fontan completed a baseline cardiopulmonary exercise test (CPET) and consented to participate in Heart Chargers, a 12-month home-based exercise prescription. The individualized exercise prescription focused on skeletal and respiratory muscle strength training and aerobic activities. Participants received a Garmin© device to monitor adherence. Telephone check-ins ranged from weekly to monthly as participants gained independence. Pre- and post-program CPET and informal surveys of physical activity self-efficacy were completed. Nine participants have completed the Heart Chargers program. There was no pre-postdifference in maximal or submaximal oxygen consumption (VO2), peak heart rate, or oxygen saturation. There was a significant pre-post increase in systolic blood pressure (p-value 0.004) and minute ventilation (p-value 0.012) at peak exercise. Per subjective report, exercise-related self-efficacy increased after program completion. There were no adverse events. At present, 7 participants remain actively enrolled in the program. Heart Chargers, a novel, home-based, partially reimbursable, 12-month individualized exercise program using telemedicine was successfully implemented in Fontan patients with no adverse events. The lack of decline in exercise capacity for participants is encouraging.

1616-P: Effects of Hazelnuts Consumption Combined with Physical Activity on Lipid Metabolism and Correlations with Marrow Adiposity Homeostasis

Consumption of hazelnuts has been associated with reduced cardiovascular risk and improved metabolic outcomes. Furthermore, the Bone Marrow Fat (BMF) might contribute to skeletal as well as systemic metabolism, modulating insulin sensitivity and, consequently, cardiovascular risk. Previously, we demonstrated a beneficial effect of hazelnuts and cocoa integration on vascular reactivity and metabolic profile in healthy individuals. Aim of this randomized controlled interventional study with 3 parallel groups was to investigate the effects of a daily supplementation with 30 g of hazelnuts, with or without aerobic physical activity (PA), throughout 8 weeks, on insulin sensitivity and resistance, lipid profile, and on BMF content (evaluated by proton magnetic resonance spectroscopy) in healthy individuals. Twenty-five adults (age 18-50 yrs; BMI 18-28 Kg/m2) were randomized in 3 groups: 9 subjects (5F/4M, age 25.6±8.8 yrs, BMI 23.3±2.5) received 30 g of hazelnuts associated with diet (Group 1); 9 subjects (6F/3M, age 26.3±6.3 yrs, BMI 22.0±2.1) received 30 g of hazelnuts associated with diet and aerobic PA (Group 2); 7 subjects (4 F/3 M, age 29.7±6.4 yrs, BMI 23.3±4.2) received only diet (Group 3). After the 8 weeks-intervention, an improvement in LDL-Cholesterol was found in Groups 1 and 2 [-9.3±11.5% (Group 1) vs -5.0±13.6% (Group 2) vs +21.9±35.7% (Group 3); p=0.02]. BMF content variation negatively correlated with LDL-Cholesterol change in Group 1 (r=-0.802, p=0.054); variations in BMF content and in HDL-Cholesterol positively correlated in Group 2 (r=+0.8687, p=0.011). This study confirms the beneficial effects of hazelnuts, in association with PA in improving lipid profile. The correlations between HDL- and LDL-cholesterol and BFM changes suggest an impact of bone homeostasis on whole-body lipid metabolism, through a rapid utilization of lipids, drawing them out of the circulation and decreasing their deposition in the organ tissues. Disclosure A.Ferrulli: None. S.Massarini: None. C.Macrì: None. P.Senesi: None. I.Terruzzi: None. G.Rosso: Employee; Soremartec Italia Srl, Ferrero Group. M.Charron: Employee; Soremartec Italia Srl, Ferrero Group. R.Menta: Employee; Soremartec Italia Srl, Ferrero Group. L.Luzi: Advisory Panel; Eli Lilly and Company, Medtronic, Research Support; Gelesis, Speaker's Bureau; A. Menarini Diagnostics, Amgen Inc., Boehringer Ingelheim and Eli Lilly Alliance, Eli Lilly and Company, Novo Nordisk, Novartis. Funding IRCCS MultiMedica (Ricerca Corrente)

Low CO2 partial pressure steers CHO cells into a defective metabolic state.

The accumulation of carbon dioxide during large-scale culture of animal cells brings adverse effects, appropriate aeration strategies alleviate CO2 accumulation while improper reactor operation may lead to the presence of low CO2 partial pressure (pCO2) condition as occurs in many industrial cases. Thus, this study aims to reveal the in-depth influence of low pCO2 on Chinese Hamster Ovary (CHO) cells for providing a reference for design space determination of CO2 control with regard to the Quality by Design (QbD) guidelines. The headspace air over purging caused the ultra-low pCO2 (ULC) where the monoclonal antibody production as well as the aerobic metabolic activity were reduced. Intracellular metabolomics analysis indicated a less efficient aerobic glucose metabolic state under ULC conditions. Based on the increase of intracellular pH and lactate dehydrogenase activity, the shortage of intracellular pyruvate could be the cause of the deficient aerobic metabolism, which could be partially mitigated by pyruvate addition under ULC conditions. Finally, a semi-empirical mathematical model was used to better understand, predict and control the occurrence of extreme pCO2 conditions during the cultures of CHO cells. Low pCO2 steers CHO cells into a defective metabolic state. A predictive relation among pCO2, lactate, and pH control was applied to get new insights into CHO cell culture for better and more robust metabolic behavior and process performance and the determination of QbD design space for CO2 control.

“It’s Absolutely Intense, and I Love It!” A Qualitative Investigation of “Pegging” as Leisure

In recent years, there has been growing interest among scholars in sexual practices as leisure behavior. The present study focused on “pegging,” which is a new term for the sexual practice of biological females (vagina) anally penetrating (i.e. with strap-on devices, sex toys) biological males (penis) among heterosexual couples. Drawing on our connections within alternative sexuality communities, we interviewed 17 individuals (10 peggers and 7 peggees) to investigate how their pegging practices may reflect specific leisure qualities. Findings suggest that pegging functions primarily as casual leisure largely in the forms of sensory stimulation, play, active entertainment, and pleasurable aerobic activity (for peggers using strap-ons). Pegging was associated with significant relationship benefits for participants, including thorough communication, trust, shared intimacy, and mutual pleasure.

Aerobic, muscle-strengthening, and flexibility physical activity and risks of all-cause and cause-specific mortality: a population-based prospective cohort of Korean adults

BackgroundStudies have shown that aerobic and muscle-strengthening physical activities reduce mortality risk. However, little is known about the joint associations of the two activity types and whether other type of physical activity, such as flexibility activity, can provide similar mortality risk reduction.ObjectivesWe examined the independent associations of aerobic, muscle-strengthening, and flexibility physical activities with all-cause and cause-specific mortality in a population-based prospective cohort of Korean men and women. We also examined the joint associations of aerobic and muscle-strengthening activities, the two physical activity types that are recommended by the current World Health Organization physical activity guidelines.DesignThis analysis included 34,379 Korea National Health and Nutrition Examination Survey 2007–2013 participants (aged 20–79 years) with mortality data linkage through December 31, 2019. Engagement in walking, aerobic, muscle-strengthening, and flexibility physical activities was self-reported at baseline. Cox proportional hazards model was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders.ResultsFlexibility physical activity (≥ 5 vs. 0 d/wk) was inversely associated with all-cause (HR [95% CI] = 0.80 [0.70–0.92]; P-trend < 0.001) and cardiovascular mortality (0.75 [0.55–1.03], P-trend = 0.02). Moderate- to vigorous-intensity aerobic physical activity (≥ 50.0 vs. 0 MET-h/wk) was also associated with lower all-cause (HR [95% CI] = 0.82 [0.70–0.95]; P-trend < 0.001) and cardiovascular mortality (0.55 [0.37–0.80]; P-trend < 0.001). Similar inverse associations were observed with total aerobic physical activity, including walking. Muscle-strengthening activity (≥ 5 vs. 0 d/wk) was inversely associated with all-cause mortality (HR [95% CI] = 0.83 [0.68–1.02]; P-trend = 0.01) but was not associated with cancer or cardiovascular mortality. Compared to participants meeting the highest guidelines for both moderate- to vigorous-intensity aerobic and muscle-strengthening physical activities, those not meeting in any guideline were associated with higher all-cause (1.34 [1.09–1.64]) and cardiovascular mortality (1.68 [1.00-2.82]).ConclusionsOur data suggest that aerobic, muscle-strengthening, and flexibility activities are associated with lower risk of mortality.

Endurance Training and Cardiovascular Health: Mechanism and Clinical Implications

Introduction and objective:&#x0D; Cardiovascular diseases are the leading cause of death worldwide, but regular physical activity can help reduce the risk of heart disease. Intensive endurance training brings many undeniable benefits but recently there have been scientific studies regarding potential complications that this type of physical activity may cause. This publication attempts to analyze whether the intensity of endurance training can reach a level at which it becomes harmful to the health of athletes.&#x0D; Materials and methods:&#x0D; This article reviews the literature on the impact of physical activity on cardiovascular health, with particular emphasis on endurance training. Articles were searched by key words, e.g. endurance training, cardiovascular health, marathon, running, cycling in various configurations, in Pubmed, Medline, Google Scholar databases.&#x0D; Actual state of knowledge:&#x0D; Regular physical activity is commonly regarded as the best preventive factor for cardiovascular diseases. Intensive endurance training significantly increases the efficiency of the cardiovascular system. Despite the significant benefits of regular endurance training, scientific reports suggest that athletes practicing this type of activity are more prone to developing certain cardiovascular disorders, such as coronary heart disease, atrial fibrillation, sinus bradycardia, and myocardial fibrosis.&#x0D; Colclusion:&#x0D; Regular and moderate aerobic physical activity is key to maintain optimal health. Endurance athletes develop a series of adaptations in the cardiovascular system, exhibit greater survival rates, and are less likely to experience sudden cardiac death compared to those who do not engage in regular physical activity. There is evidence suggesting a higher incidence of certain cardiovascular complications compared to healthy individuals who do not engage in sports. The reasons for these changes and their impact should be the subject of further research.

Habitual physical activity improves outcomes among patients with myocardial infarction.

This study evaluates the association between habitual physical activity (HPA) and the outcomes of patients with myocardial infarction (MI). Patients newly diagnosed with MI were divided into two groups based on whether they engaged in HPA, defined as an aerobic activity with a duration of no less than 150 min/week, before the index admission. The primary outcomes included major adverse cardiovascular events (MACEs), cardiovascular (CV) mortality, and cardiac readmission rate 1 year following the index date of admission. A binary logistic regression model was applied to analyze whether HPA was independently associated with 1-year MACEs, 1-year CV mortality, and 1-year cardiac readmission rate. Among the 1,266 patients (mean age 63.4 years, 72% male), 571 (45%) engaged in HPA, and 695 (55%) did not engage in HPA before MI. Patients who participated in HPA were independently associated with a lower Killip class upon admission (OR = 0.48: 95% CI, 0.32-0.71, p < 0.001) and a lower prevalence of 1-year MACEs (OR = 0.74: 95% CI, 0.56-0.98, p = 0.038) and 1-year CV mortality (OR = 0.50: 95% CI, 0.28-0.88, p = 0.017) than those who did not participate in HPA. HPA was not associated with cardiac-related readmission (OR = 0.87: 95% CI, 0.64-1.17, p = 0.35). HPA before MI was independently associated with a lower Killip class upon admission, 1-year MACEs, and 1-year CV mortality rate.

Barriers and facilitators to participation in exercise prehabilitation before cancer surgery for older adults with frailty: a qualitative study

BackgroundOlder adults with frailty are at an increased risk of adverse outcomes after surgery. Exercise before surgery (exercise prehabilitation) may reduce adverse events and improve recovery after surgery. However, adherence with exercise therapy is often low, especially in older populations. The purpose of this study was to qualitatively assess the barriers and facilitators to participating in exercise prehabilitation from the perspective of older people with frailty participating in the intervention arm of a randomized trial.MethodsThis was a research ethics approved, nested descriptive qualitative study within a randomized controlled trial of home-based exercise prehabilitation vs. standard care with older patients (≥ 60 years) having elective cancer surgery, and who were living with frailty (Clinical Frailty Scale ≥ 4). The intervention was a home-based prehabilitation program for at least 3 weeks before surgery that involved aerobic activity, strength and stretching, and nutritional advice. After completing the prehabilitation program, participants were asked to partake in a semi-structured interview informed by the Theoretical Domains Framework (TDF). Qualitative analysis was guided by the TDF.ResultsFifteen qualitative interviews were completed. Facilitators included: 1) the program being manageable and suitable to older adults with frailty, 2) adequate resources to support engagement, 3) support from others, 4) a sense of control, intrinsic value, noticing progress and improving health outcomes and 5) the program was enjoyable and facilitated by previous experience. Barriers included: 1) pre-existing conditions, fatigue and baseline fitness, 2) weather, and 3) guilt and frustration when unable to exercise. A need for individualization and variety was offered as a suggestion by participants and was therefore described as both a barrier and facilitator.ConclusionsHome-based exercise prehabilitation is feasible and acceptable to older people with frailty preparing for cancer surgery. Participants identified that a home-based program was manageable, easy to follow with helpful resources, included valuable support from the research team, and they reported self-perceived health benefits and a sense of control over their health. Future studies and implementation should consider increased personalization based on health and fitness, psychosocial support and modifications to aerobic exercises in response to adverse weather conditions.

National Trends in Physical Activity Among Adults in South Korea Before and During the COVID-19 Pandemic, 2009-2021

There is a lack of comprehensive data on the association of the COVID-19 pandemic with the prevalence of physical activity in large-scale data sets. To investigate long-term trends in physical activity using information from a nationally representative survey covering 2009 to 2021. This general population-based and repeated cross-sectional study was conducted from 2009 to 2021 using the Korea Community Health Survey, a nationally representative survey in South Korea. Data from 2009 to 2021 for 2 748 585 Korean adults were obtained through a nationwide, large-scale, serial study. Data were analyzed from December 2022 through January 2023. COVID-19 pandemic onset. The trend of sufficient aerobic physical activity was measured by prevalence and mean metabolic equivalent of task (MET) score based on World Health Organization physical activity guidelines and defined as 600 MET-min/wk or greater. The cross-sectional survey included age, sex, body mass index (BMI), region of residence, education level, income level, smoking status, alcohol consumption level, stress status, physical activity level, and history of diabetes, hypertension, and depression. Among 2 748 585 Korean adults (738 934 aged 50-64 years [29.1%] and 657 560 aged ≥65 years [25.9%]; 1 178 869 males [46.4%]), the prevalence of sufficient physical activity did not change significantly during the prepandemic period (β difference, 1.0; 95% CI, 0.6 to 1.4). During the pandemic, the prevalence of sufficient physical activity decreased significantly, from 36.0% (95% CI, 35.9% to 36.1%) in 2017 to 2019 to 30.0% (95% CI, 29.8% to 30.2%) in 2020 and 29.7% (95% CI, 29.5% to 29.9%) in 2021. Trends showed decreases in the prevalence of sufficient physical activity among older adults (ages ≥65 years; β difference, -16.4; 95% CI, -17.5 to -15.3) and younger adults (ages 19 to 29 years; β difference, -16.6; 95% CI, -18.1 to -15.0) during the pandemic. In particular, the trend of sufficient physical activity declined during the pandemic in females (β difference, -16.8; 95% CI, -17.6 to -16.0), individuals in urban residences (β difference, -21.2; 95% CI, -22.2 to -20.2), healthy participants (eg, those with normal BMI, 18.5 to 22.9: β difference,-12.5; 95% CI, -13.4 to -11.7), and individuals at increased risk of stress (eg, history of a depressive episode; β difference, -13.7; 95% CI, -19.1 to -8.4). Prevalence trends in mean MET score were similar to those in the main results; total mean MET score decreased from the 2017 to 2019 period (1579.1 MET-min/wk; 95% CI, 1567.5 to 1590.7 MET-min/wk) to the 2020 to 2021 period (1191.9 MET-min/wk; 95% CI, 1182.4 to 1201.4 MET-min/wk. This cross-sectional study found that the national prevalence of physical activity was stable or consistent before the pandemic period, with a marked decrease during the pandemic, particularly among healthy individuals and subgroups at increased risk of negative outcomes, including older adults, females, urban residents, and those with depressive episodes. Future studies may be needed to evaluate the association between the COVID-19 pandemic and changes in physical activity.

WARBURG EFFECT CHARACTERIZES THE SKELETAL MUSCLE IN FABRY DISEASE: EXPERIMENTAL EVIDENCE AND CLINICAL IMPLICATIONS

Objective: Skeletal muscle (SM) pain and fatigue are common in Fabry disease (FD), and strongly impact the patient's quality of life. Still, the SM in FD is poorly investigated. Although energetic alterations are reported in cells from FD patients, they have never been related to fatigue and pain. Given the pivotal relevance of energetics for SM health, we undertook the investigation of the SM. Design and method: We consistently observed a reduced tolerance to aerobic activity and lactate accumulation in FD-humanized mouse model and patients. Accordingly, in sedentary mouse FD SM we detected an increase in fast/glycolytic-fibers, mirrored by an upregulation of glycolytic enzymes and glucose-transporters Results: In fibroblasts derived from FD patients, we confirmed a high glycolytic-rate and accordingly, metabolomic/lipidomic-analysis revealed that lipids are underutilized as energetic fuel in FD-patients. In the quest for a tentative mechanism, we explored analogies with genetic myopathies, that show altered expression of energetic metabolism. Specifically, we explored HIF-1 upregulation and found it increased in FD mice and patients. Consistent with our previous screening of miRNAs associated with metabolic stress in FD, we observed a significant upregulation of miR-17 in FD patients and mice. Of note, miR-17 has been associated with cellular metabolic remodeling and HIF-1 up-regulation in different contexts. In our experimental setting, a specific antagomir targeting miR-17 was able to inhibit HIF-1 accumulation and revert metabolic-remodeling in FD-cells. Conclusions: Our findings unveil an anaerobic glycolytic-switch under normoxia, known as Warburg Effect, which is induced by miR-17-mediated-upregulation of HIF-1. The miR-17/HIF-1 pathway can be a new therapeutic target in FD, and Exercise-testing and blood lactate may become a new diagnostic and monitoring-tool in FD.

In a marine teleost, the significance of oxygen supply for acute thermal tolerance depends upon the context and the endpoint used.

Eight juvenile European seabass were exposed to two thermal ramping protocols with different levels of aerobic activity and tolerance endpoint: the critical thermal maximum for swimming (CTSmax) while exercising aerobically until fatigue and the critical thermal maximum (CTmax) under static conditions until loss of equilibrium (LOE). In the CTSmax protocol, warming caused a profound increase in the rate of oxygen uptake (ṀO2), culminating in a gait transition from steady aerobic towards unsteady anaerobic swimming, then fatigue at 30.3±0.4°C (mean±s.e.m.). Gait transition and fatigue presumably indicate an oxygen limitation, which reflects the inability to meet the combined demands of swimming plus warming. The CTmax protocol also elicited an increase in ṀO2, culminating in LOE at 34.0±0.4°C, which is significantly warmer than fatigue at CTSmax. The maximum ṀO2achieved in the CTmax protocol was, however, less than 30% of that achieved in the CTSmax protocol. Therefore, the static CTmax did not exploit full cardiorespiratory capacity for oxygen supply, indicating that LOE was not caused by systemic oxygen limitation. Consequently, systemic oxygen supply can be significant for tolerance of acute warming in seabass but this depends upon the physiological context and the endpoint used.

PERBANDINGAN AKTIVITAS FISIK JENIS AEROBIK DAN ANAEROBIK TERHADAP KADAR HIGH DENSITY LIPOPROTEIN (HDL)

PERBANDINGAN AKTIVITAS FISIK JENIS AEROBIK DAN ANAEROBIK TERHADAP KADAR HIGH DENSITY LIPOPROTEIN (HDL)

Anxiolytic effects of aqueous extract of Hiptis spicigera Lam (Lamiaceae) in mice on chronic immobilisation and physical activity test

The Anxiety disorders are considering as serious problems in our society life like family environment, school and work functioning. They increase the risk of other psychiatric disorders pathologies, including depression, drug and alcohol abuse and the incidence of suicide. For ameliorate this situation, anxiolytic and hypnotic substances like benzodiazepines, barbiturates and their relatives compounds are very regularly prescribed. However, the frequent use of tranquillizers and psychotropic compounds involve the variety in autonomic, endocrine, allergic, and neurological side effects. So, anxiety disorders are reveled as the world health problem. This study aims at assessing the combined of anxiolytic effect of the decoction of dried Hypstis spicigera leaves and aerobic physical activity in white mice. For this purpose, the Elevated Plus Maze test (EPM) and the Open Field (OF) test were used. Thirty male and female mice of approximately eight weeks of age and 23 g body weight were used. They were divided into seven groups of five animals each. The first one normal group received distilled water (per os), a negative control group received distilled water by oral way and underwent anxiety induction and a positive control group received diazepam intraperitoneally and underwent anxiety induction and physical activity. Then, four groups received different concentration of decoction of Hypstis spicigera by oral way, followed by chronic immobilisation stress and physical activity. Thus, the results of the EPM showed that chronic stress caused a significant decrease (p&lt;0.001 ) of the percentage of time spent in the open arms from 42.93% in the normal control mice to 14.79% in the negative control group. Similarly, Hyptis spicigera lam decoction and physical activity induced a significant (p&lt;0.001) increase of this percentage from 14.79% in the negative control group to 82.52% of the 225 mg/kg dose group. The diazepam also induced a significant (p&lt;0.001) increase of this percentage. Those from the open field showed that chronic stress caused a significant (p&lt;0.001) decrease in the amount of time spent in the centre from 4.8±0.83 s in the normal control mice to 1.2±0.44 s in the negative control group. Similarly, Hyptis spicigera Lam decoction and physical activity induced a significant (p&lt;0.001) increase of time spent from 1.2±0.44 s in the 225 mg/kg dose group in the negative control group to 15±1s in the 225mg/kg dose group. Diazepam also induced a significant (p&lt;0.001) increase of this time. Hyptis spicigera Lam decoction and physical activity have anxiolytic activity. Reason is why this plant is used more in traditional medicine.

The efficacy of high- and low-load resistance training in patients with coronary artery disease: a follow-up of a randomised controlled trial

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Slovenian Research Agency. Background Perseverance of beneficial effects of exercise training in cardiac rehabilitation remains understudied. Maximal aerobic capacity (VO2 max) and quality life were mostly maintained at 1 year follow-up after aerobic training (AT) or after a combination of AT and mostly low-load (LL) resistance training (RT), while the effects of high-load (HL) RT remain unknown in patients with coronary artery disease (CAD). Purpose This study investigated the effects of combination of AT with HL-RT or LL-RT in comparison to AT alone on maximal aerobic capacity, physical activity, and quality of life in patients with CAD at 1-year follow-up after cardiac rehabilitation. Methods We initially enrolled 79 patients with CAD to combined AT and HL-RT, combined AT and LL-RT or AT alone, and 59 patients completed the study. The assessments at 1-year follow-up were completed by 53 patients, with [mean (SD) or median (interquartile range)] age = 61 (8) years, height = 172.1 (8.4) cm, weight = 83.93 (14.03) kg and left ventricular ejection fraction = 50 (45,60) %. During the study, all patients performed the same interval aerobic cycling (40 min/session, intervals of 3-5 min of work-load cycling separated by 2 min of unloaded cycling, intensity progressed from 50% to 80% of maximal workload achieved at baseline cardiopulmonary exercise test). In HL-RT-group, the training load progressively increased from 70% of 1-RM (6–11 reps/set) to 80% of 1-RM (6–8 reps/set), while in LL-RT group the training load progressively increased from 35% of 1-RM (12–22 reps/set) to 40% of 1-RM (12–16 reps/set) in the first seven weeks of the intervention. Similar progression of RT was used after 1-RM re-evaluation following 7 weeks of training. After cardiac rehabilitation, patients were given written brochure with included advice on home-based physical activity with emphasis on aerobic and resistance exercises. Maximal aerobic performance, objectively measured physical activity and quality of life were measured after 1-year. Results At 1-year follow-up majority of the patients increased VO2max (62%). Patients increased VO2max (+0.08 l/min, p = 0.022) and had higher respiratory exchange ratio (+0.06, p &amp;lt; 0.001), regardless of the randomisation. There was no significant effect of time x group interaction on the outcomes. VO2max was increased in AT (+0.13 l/min, p = 0.026) and LL-RT (+0.12 l/min, p = 0.031) groups, while respiratory exchange ratio was greater in LL-RT (+0.6, p = 0.004) and HL-RT (+0.7, p = 0.003) groups at follow-up. Post-training physical activity and quality of life were high but remained unchanged after 1 year. Conclusions The combination of AT and HL-RT or LL-RT was not superior to AT alone in changes of maximal aerobic performance, physical activity and quality of life in patients with coronary artery disease at 1-year follow-up.

The WALK HOP program: a French innovative multicentric home-based cardiac rehabilitation initiative

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Fonds pour l'innovation du système de santé (FISS) - France. Background Cardiac rehabilitation (CR) has demonstrated scientific benefits in terms of morbidity and mortality. In France, 2019 national data indicates that only 22,3% of coronary patients benefit from CR. The development of alternative programs to center-based cardiac rehabilitation (CBCR) must be considered as a public health priority and requires a reorganization of ambulatory care pathways. Purpose The objective of the "Walk Hop" program is to demonstrate that home-based cardiac tele-rehabilitation (HBCT) is a complementary and safe approach to CBCR, able to increase the proportion of patients benefiting from a rehabilitation program. Methods This feasibility study started begin of 2022. 3,200 coronary patients will be recruited in 8 participating cardiac rehabilitation centers (CRC). Total duration of the experiment is 42 months. The program is financially supported by the French authorities. The HBCT solution developed for the study is proposed to patients by the CRC cardiologist. A multidisciplinary platform consisting of a secure portal and an application allows bidirectional communication. Patients are equiped with a cycle ergometer and a validated heart rate monitor. The application presents aerobic and muscle strenghtening activities and therapeutic education and collects data from the sessions carried out, adherence to the program, symptoms and quality of life. Results By october 2022, 157 active patients have been included in the program with a large majority of men (86%). Mean age is 53,9 ± 9,0. Hypercholesterolemia is noted in 36,9% of the included patients, smoking in 31%, arterial hypertension in 30,6% and diabetes in 11,1%. Obesity/overweight affects 60% of the population. Mean time from angioplasty to initiation of the rehabilitation is 81 ± 90 days. Mean number of home rehabilitation sessions is 21 and a total of 3342 home sessions have been realized. No cardiovascular event or rehospitalization have been registered since the beginnng. Mean adherence to the prescribed sessions is 80 ± 20% and the mean power gain at the end of the program is 14,6 ± 9,9 %. 94% of the patients expressed satisfaction or high satisfaction at the end of the program. Conclusion(s) The Walk Hop program is evaluating the feasibility and acceptability of HBCT with remote monitoring and digital assistance by smartphone. The preliminary data are encouraging in view of the final expected impact: greater cost-effective access to rehabilitation programs by removing obstacles like distance or resumption of work. It is also expected that HBCT will provide an improvement in the long-term maintenance benefits.

Prolonged Normothermic Machine Perfusion: Buying More Time for Liver Graft Assessment and Repair.

Prolonged Normothermic Machine Perfusion: Buying More Time for Liver Graft Assessment and Repair.

Possiamo ottenere un cambiamento dello stile di vita significativo e stabile nel tempo?

Lifestyle is universally considered a fundamental issue in the preven¬tion and therapy of both type 2 diabetes and metabolic syndrome. However, implementation at a general population level of recom¬mendations resulting from available evidence is largely insufficient. In particular, only a limited fraction of the general population meets the recommended levels of aerobic physical activity, and individuals meeting the recommended levels of resistance physical activity are even less. Interestingly, there is further reduction in these proportions in subjects with prediabetes and especially in those with type 2 diabe¬tes. It is noteworthy that people with or at risk for diabetes represent a significant proportion of the general population, show objective evi¬dence of impaired exercise capacity, for different mechanisms, and fre¬quently have long-standing sedentary habits, difficult to be changed. All these aspects should be taken into account, when designing in-tervention programs aimed at improving the current situation. As re¬gards the possibility of a stable increase in physical exercise levels and reduction in sedentary habits of individuals with diabetes, available data are limited. However, they indicate that it is possible to improve these aspects in a significant proportion of subjects. Behavioral chan¬ges reported in studies are generally smaller than the prefixed impro¬vements, but sufficient to obtain favorable and clinically significant effects. Interventions applied in these programs show several shortco¬mings, indicating the need for a continuous revision of strategies.

Physical activity, obesity, and bladder cancer incidence.

Cigarette smoking is an established risk factor for bladder cancer (BC), but evidence for physical inactivity and obesity is limited. This analysis included 146,027 participants from the Cancer Prevention Study-II (CPS-II) Nutrition Cohort, a large prospective cohort of cancer incidence established in 1992. Multivariable-adjusted Cox proportional hazards models were used to examine associations between body mass index (BMI), moderate-to-vigorous intensity aerobic physical activity (MVPA), leisure-time spent sitting, and BC risk. Effect modification by stage, smoking status, and sex was examined. Only participants accumulating 15.0- < 30.0 MET-hrs/wk of MVPA had a lower risk of BC overall (RR 0.88, 95% CI 0.78, 0.99, compared to > 0-7.5 MET-hrs/wk) in the fully adjusted models. When stratifying on BC stage, MVPA (15- < 30 MET-hrs/wk vs. > 0- < 7.5 MET-hrs/wk, RR 0.83, 95% CI 0.70-0.99) and excess sitting time (≥ 6h/day vs. 0- < 3h/day RR 1.22, 95% CI 1.02, 1.47) were associated with risk of invasive BC only. There was no consistent evidence for effect modification by smoking status or sex. This study supports that MVPA and sitting time may play a role in BC incidence, but associations likely differ by stage at diagnosis. While additional studies are needed to confirm associations by stage, this study adds to the evidence of the importance of being physically active for cancer prevention.

Leisure-time physical activity and mortality from influenza and pneumonia: a cohort study of 577 909 US adults

ObjectiveTo examine the association of leisure-time physical activity with mortality from influenza and pneumonia.MethodsA nationally representative sample of US adults (aged ≥18 years) who participated in the National Health Interview...