Aerobic Exercise In Patients Research Articles

Effect of anti-tumor necrosis factor therapy on the efficacy of aerobic exercise in patients with ankylosing spondylitis

Background: This study aims to evaluate the effects of aerobic exercise on ankylosing spondylitis (AS) patients' clinical outcomes when combined with anti-tumor necrosis factor (TNF) treatments. Methods: Fifty patients diagnosed with AS participate in the study, with 25 on anti-TNF treatment and 25 off anti-TNF treatment. Patients' age, education, body mass index, smoking habits, symptom duration, date of diagnosis, medication use, comorbidities, and surgical history were assessed. Patients receive instructions to walk for 30 minutes, three times per week for twelve weeks and receive evaluation at weeks 0, 6, and 12. Disease activity is evaluated using Visual Analog Scale (VAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), while sleep quality is assessed by the Pittsburgh Sleep Quality Index (PSQI). The Ankylosing Spondylitis Life Quality (ASQoL) is used to measure the quality of life and physical activity is measured by the International Physical Activity Questionnaire (IPAQ). Results: During week 6, VAS, BASDAI, PSQI, and IPAQ scores were significantly lower in both groups, one taking anti-TNF and the other anti-TNF-free, in comparison to baseline and week 12 scores. After undergoing six weeks of aerobic exercise treatment, those taking anti-TNF displayed greater improvements in ASQoL scores in contrast to those who were not taking anti-TNF. Conclusion: Aerobic exercise is an effective intervention for enhancing disease activity, quality of life, sleep quality, and physical activity in patients with AS. Additionally, anti-TNF treatment appears to amplify the clinical benefits associated with exercise and facilitate patients' physical activity.

Effect of Tai Chi vs Aerobic Exercise on Blood Pressure in Patients With Prehypertension

Prehypertension increases the risk of developing hypertension and other cardiovascular diseases. Early and effective intervention for patients with prehypertension is highly important. To assess the efficacy of Tai Chi vs aerobic exercise in patients with prehypertension. This prospective, single-blinded randomized clinical trial was conducted between July 25, 2019, and January 24, 2022, at 2 tertiary public hospitals in China. Participants included 342 adults aged 18 to 65 years with prehypertension, defined as systolic blood pressure (SBP) of 120 to 139 mm Hg and/or diastolic BP (DBP) of 80 to 89 mm Hg. Participants were randomized in a 1:1 ratio to a Tai Chi group (n = 173) or an aerobic exercise group (n = 169). Both groups performed four 60-minute supervised sessions per week for 12 months. The primary outcome was SBP at 12 months obtained in the office setting. Secondary outcomes included SBP at 6 months and DBP at 6 and 12 months obtained in the office setting and 24-hour ambulatory BP at 12 months. Of the 1189 patients screened, 342 (mean [SD] age, 49.3 [11.9] years; 166 men [48.5%] and 176 women [51.5%]) were randomized to 1 of 2 intervention groups: 173 to Tai Chi and 169 to aerobic exercise. At 12 months, the change in office SBP was significantly different between groups by -2.40 (95% CI, -4.39 to -0.41) mm Hg (P = .02), with a mean (SD) change of -7.01 (10.12) mm Hg in the Tai Chi group vs -4.61 (8.47) mm Hg in the aerobic exercise group. The analysis of office SBP at 6 months yielded similar results (-2.31 [95% CI, -3.94 to -0.67] mm Hg; P = .006). Additionally, 24-hour ambulatory SBP (-2.16 [95% CI, -3.84 to -0.47] mm Hg; P = .01) and nighttime ambulatory SBP (-4.08 [95% CI, -6.59 to -1.57] mm Hg; P = .002) were significantly reduced in the Tai Chi group compared with the aerobic exercise group. In this study including patients with prehypertension, a 12-month Tai Chi intervention was more effective than aerobic exercise in reducing SBP. These findings suggest that Tai Chi may help promote the prevention of cardiovascular disease in populations with prehypertension. Chinese Clinical Trial Registry Identifier: ChiCTR1900024368.

DOP13 Effect of 8 weeks of combined aerobic and resistance exercise on quality of life, muscle strength, aerobic capacity, and disease activity in patients with Inflammatory Bowel Disease; a parallel group randomized clinical trial

Abstract Background Sarcopenia is prevalent in patients with IBD (inflammatory bowel disease). This study aimed to assess the effects of an 8-weeks combined aerobic and resistance training program on the quality of life, disease activity, muscle strength, and aerobic capacity in patients with IBD. (Registration ID: NCT05455762) Methods This study was a single-blind parallel-group randomized clinical trial. Inclusion criteria were patients 18 to 65 years old with a confirmed diagnosis of IBD. Exclusion criteria: active malignancy, consumption of systemic corticosteroids, and patients with moderate to severe physical activity more than 150 minutes/week. Patients were allocated to each group by block randomization with a 1:1 ratio. The intervention consisted of walking sessions on even days and six resistance exercises on odd days. The primary outcome was the patients' quality of life, measured by the Persian version of the ibdq-9 questionnaire. secondary outcomes included disease severity, muscle strength, 6-minute walk test, and 30-second sit-to-stand test. We measured muscle strength by a handheld dynamometer. Results Of 72 patients screened 64 were eligible for the study. During the follow-up period, 13 patients, 8 from the exercise group and 5 from the control group, were excluded from the study. 51 patients, 28 females and 23 males, with a mean age of 34.9 ± 10.57 were analyzed. Two groups were matched in demographic and IBD-related characteristics. Unlike the control group, the exercise group showed a significant increase in overall quality of life (40.29 to 47.75, p=0.005), particularly in intestinal and systemic symptoms domains (p=0.01 and p=0.004). the inter-group analysis found no significantly higher mean difference in QOL scores between the exercise and control groups (p=0.053). The Partial Mayo score in patients with ulcerative colitis (UC) significantly decreased in the intervention group but not in the control group. The Harvey-Bradshaw index in Crohn patients didn’t change in either group. There were no exercise-related serious complications. The 6-minute walk test distance significantly increased in the exercise group but not in the control group. The 30-second sit-to-stand test didn’t significantly change in either group. Of muscles examined (hand grip, shoulder abductor, hip flexor, knee extensor, and elbow flexor) only knee extension strength increased in both groups. Conclusion Combined resistance and aerobic exercise in patients with IBD is safe and can significantly improve the quality of life and aerobic capacity. This regimen also improved clinical severity in patients with UC but not in Crohn’s. Muscle strength did not significantly improve when comparing the two groups, possibly due to the short duration of the intervention.

Effectiveness of Maitland Manual Therapy Approach Mobilization with Aerobic Exercise in Patients with Chronic Low Back Pain

Background: Low back pain is the most common type of musculoskeletal pain and various treatments are given totreat it. Mobilization and aerobic exercise has very good effect in relieving pain and disability. This study focusesto evaluate the combined effect of mobilization and aerobic exercise program in patient with chronic LBP.Methods: The study designed used was a pretest and post test experimental study. Samples are taken withconvenient sample method. N=10 with a duration of 12 weeks. Posterioanterior mobilization and high intensityexercises where given and data’s were calculated and the results were obtained by two outcome tools –VAS andOSW questionnaire. the data colected from (12/01/2023 to 10/03/2023) with gardern city university physiotherapyout patient department.Results: The pre test mean value of VAS is 7.1 and the post test mean value is 5.8.The mean difference of pre testand post test value of VAS measurement is 1.9.The pre test mean value of OSW questionnaire is 41% and the posttest mean value is 21%. The mean difference of pre test and post test value of OSW questionnaire is 20%.Conclusion: Maitland mobilization with high intensity aerobic exercise was effective in reducing pain anddisability and also in the improvement of range of motion for low back pain. This study can be used as treatmentprotocol in the field of physiotherapy to treat the patient with chronic low back pain.

How do practitioners prescribe exercise to patients with breast cancer? Professional perspectives on the key considerations for aerobic exercise in patients with breast cancer undergoing chemotherapy

ObjectivesThis study aimed to understand the key factors experienced accredited exercise physiologists (AEPs) and medical professionals consider when prescribing/recommending aerobic exercise to patients with breast cancer undergoing chemotherapy. DesignModified Delphi Survey. MethodsA four-round, two-phase survey was conducted. Following a Delphi approach, four cancer-specific AEPs, four oncologists, and one breast cancer surgeon (median 13-yr breast-cancer-specific experience) completed phase one. Eighty-four AEPs (median 5-yr experience) completed phase two. Phase one participants answered open- and close-ended questions regarding key considerations for aerobic exercise in patients with breast cancer undergoing chemotherapy, and what information should be collected to guide exercise prescription. All questions and considerations agreed upon in phase one (>70 % rating 7–9 on a 0–9 Likert Scale) were rated by AEPs in phase two. ResultsKey considerations for exercise assessment and prescription aligned closely with exercise guidelines for cancer survivors. Common strategies for exercise individualisation were identified by AEPs, including separating aerobic exercise into 5‐to‐–9-minute bouts when required and avoiding exercising to complete exhaustion. Exercise intensity and duration should be adjusted throughout chemotherapy to improve tolerance and adherence. Novel considerations for subjective questioning and objective assessments to tailor exercise prescription were outlined. ConclusionsThis study identifies how professionals approach exercise assessment and prescription in patients with breast cancer undergoing chemotherapy. Findings can guide AEPs in practice when prescribing tailored exercise to breast cancer patients undergoing chemotherapy and inform future guidelines.

Acute Changes on Left Atrial Function during Incremental Exercise in Patients with Heart Failure with Mildly Reduced Ejection Fraction: A Case-Control Study.

the aim of this study was to assess acute changes in left atrial (LA) function during incremental aerobic exercise in patients with heart failure with mildly reduced ejection fraction (HFmrEF) in comparison to healthy subjects (HS). twenty patients with established HFmrEF were compared with 10 HS, age-matched controls. All subjects performed a stepwise exercise test on a cycle ergometer. Echocardiography was performed at baseline, during submaximal effort, at peak of exercise, and after 5 min of recovery. HS obtained a higher value of METs at peak exercise than HFmrEF (7.4 vs. 5.6; between group p = 0.002). Heart rate and systolic blood pressure presented a greater increase in the HS group than in HFmrEF (between groups p = 0.006 and 0.003, respectively). In the HFmrEF group, peak atrial longitudinal strain (PALS) and conduit strain were both increased at submaximal exercise (p < 0.05 for both versus baseline) and remained constant at peak exercise. Peak atrial contraction strain (PACS) did not show significant changes during the exercise. In the HS group, PALS and PACS increased significantly at submaximal level (p < 0.05 for both versus baseline), but PALS returned near baseline values at peak exercise; conduit strain decreased progressively during the exercise in HS. Stroke volume (SV) increased in both groups at submaximal exercise; at peak exercise, SV remained constant in the HFmrEF, while it decreased in controls (between groups p = 0.002). patients with HFmrEF show a proper increase in LA reservoir function during incremental aerobic exercise that contributes to maintain SV throughout the physical effort.

Physical capacity increase in patients with heart failure is associated with improvement in muscle sympathetic nerve activity

BackgroundExercise training improves physical capacity in patients with heart failure with reduced ejection fraction (HFrEF), but the mechanisms involved in this response is not fully understood. The aim of this study was to determine if physical capacity increase in patients HFrEF is associated with muscle sympathetic nerve activity (MSNA) reduction and muscle blood flow (MBF) increase. MethodsThe study included 124 patients from a 17-year database, divided according to exercise training status: 1) exercise-trained (ET, n = 83) and 2) untrained (UNT, n = 41). MSNA and MBF were obtained using microneurography and venous occlusion plethysmography, respectively. Physical capacity was evaluated by cardiopulmonary exercise test. Moderate aerobic exercise was performed 3 times/wk. for 4 months. ResultsExercise training increased peak oxygen consumption (V̇O2, 16.1 ± 0.4 vs 18.9 ± 0.5 mL·kg−1·min−1, P < 0.001), LVEF (28 ± 1 vs 30 ± 1%, P = 0.027), MBF (1.57 ± 0.06 vs 2.05 ± 0.09 mL.min−1.100 ml−1, P < 0.001) and muscle vascular conductance (MVC, 1.82 ± 0.07 vs 2.45 ± 0.11 units, P < 0.001). Exercise training significantly decreased MSNA (45 ± 1 vs 32 ± 1 bursts/min, P < 0.001). The logistic regression analyses showed that MSNA [(OR) 0.921, 95% CI 0.883–0.962, P < 0.001] was independently associated with peak V̇O2. ConclusionsThe increase in physical capacity provoked by aerobic exercise in patients with HFrEF is associated with the improvement in MSNA.

Real-time analysis of heart rate variability during aerobic exercise in patients with cardiovascular disease.

Exercise therapy for cardiovascular disease (CVD) is mainly evaluated based on the heart rate (HR) or Borg scale. However, these indices can be unreliable depending on the patient's medication or their subjective decisions; thus, alternative methods are required for easier and safer implementation of aerobic exercise. Here, we examined whether real-time analysis of HR variability (HRV) can help maintain exercise intensity at the ventilatory threshold (VT) during exercise. Twenty-eight patients with CVD treated at Keio University Hospital between August 2018 and March 2020 were enrolled. Initially, oxygen uptake (VO2) and HR at the VT were determined using the cardiopulmonary exercise test. Patients then performed aerobic exercise on a stationary bicycle for 30min while a parameter of HRV, the high-frequency (HF) component, was monitored in real time using an electrocardiograph. The work rate during exercise was adjusted every 2min to maintain the HF range between 5 and 10. The VO2 and HR values, recorded every 2min during exercise, were compared with those at VT. The Bland-Altman method was used to confirm similarity. VO2 and HR during exercise were closely correlated with those at VT (e.g., 19min after exercise initiation; VO2: r=0.647, HR: r=0.534). The Bland-Altman plot revealed no bias between the mean values (e.g., 19min; VO2: -0.22mL/kg/min; HR: -0.07/min). Real-time HRV analysis with electrocardiograph alone during exercise can provide continuous and non-invasive exercise intensity measurements at VT, promoting safer and effective exercise strategies.

Cardiac Rehabilitation and Cardiopulmonary Fitness in Children and Young Adults With Congenital Heart Diseases: A Critically Appraised Topic.

Public health guidelines and a myriad of studies have proven that exercise is beneficial in the alleviation of various cardio-metabolic diseases. Congenital heart disease (ConHD) is one of the most frequently occurring congenital structural malfunctions in the pediatric population, affecting nine of every 1,000 live births. Only a few studies have established the impact of a structured exercise program on cardiopulmonary fitness in diverse groups of patients with ConHD. It is also alarming to know that a substantial number of these patients and their caregivers often remain very wary of exercise. Anxiety about exercise may increase the risk of developing morbid obesity and other long-term health complications of ConHD. The present review of a critically appraised topicis undertaken to answer the question, "Does structured exercise intervention (cardiac rehabilitation) improve cardiorespiratory fitness in children and young adults with ConHD?" Exercise science and the medical literature were searched for studies that engaged the use of aerobic exercise in patients with different ConHD diagnoses. The search yielded four studies after screening with the inclusion and exclusion criteria, which were further narrowed to three studies after a full-text review. These studies yielded results showing significant increments in peak exercise workload, duration, power output, peak oxygen uptake, or improved tissue oxygenation and muscle strength after an exercise training intervention. It is noteworthy that a group identified as "cyanotic palliated" exhibited the most significant impairment both at baseline and after the exercise intervention. This review provides level 1b medical evidence that a structured exercise program may improve cardiopulmonary fitness in patients with ConHD, which is likely to be beneficial to their overall physical, motor, and psychosocial development. The results of this review may be useful for alleviating the anxiety of patients and their caregivers about participation in structured exercise programs. This review should also motivate future research investigations to develop clinical guidelines for the management of patients with ConHD by adding exercise prescriptions to their daily therapeutic regimens.

Effects on neuromodulation, acupuncture, and aerobic exercises on migraine and tension-type headache outcomes: A systematic review and meta-analysis.

Headache disorders are common diseases that cause a social burden. This systematic review and meta-analysis aimed to evaluate the effects of various non-pharmacological treatments to address or prevent acute headaches, including neuromodulation, acupuncture, and aerobic exercises in patients with episodic migraine and tension-type headache (TTH). We performed a systematic search of the electronic databases PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, WANFANG MEDICINE ONLINE, and Chinese Medical Journal database using Stata/SE 14.0 to obtain weighted mean differences (WMDs). The outcomes included monthly headache days, headache intensity, headache duration, days per month of acute medication use, and the Medical Outcomes Study 36-Item Short-Form Health Survey. Of 872 identified articles, 27 were included in the meta-analysis. Neuromodulation was associated with reduced headache days (WMD: -1.274, 95% CI [-1.914, -0.634], P < .001), duration (WMD: -2.2, 95% CI [-3.32, -0.107], P < .001) and medication consumption (WMD: -1.808, 95% CI [-2.546, -1.071], P < .001) in cases of migraine. Acupuncture was associated with the alleviation of headache days (WMD: -0.677, 95% CI [-0.932, -0.422], P < .001) and intensity (WMD: -0.893, 95% CI [-1.573, -0.212], P = .01) in cases of migraine and acute medication use (WMD: -3.29, 95% CI [-4.86, -1.72], P < .001) in cases of TTH. Aerobic exercise was associated with reduced headache duration (WMD: -5.1, 95% CI [-8.97, -1.22], P = .01) in cases of TTH. The risk of bias for included articles was moderate. There is low- and moderate-quality evidence that neuromodulation, acupuncture, and aerobic exercises are associated with attenuated headache symptoms in patients with episodic migraine or TTH. However, high-quality studies are needed to draw more detailed conclusions.

EXERCISE IN THE PHYSICAL REHABILITATION OF CIRROTICS: A RANDOMIZED PILOT STUDY.

Physical exercise delays the sarcopenic process and can reverse the loss of muscle strength, improve quality of life and prognosis in cirrhotic patients. The aim was to verify the effects of face-to-face versus home aerobic exercise on the variables fatigue, respiratory and peripheral muscle strength, functional capacity and quality of life in patients with compensated cirrhosis. Patients were selected by convenience, stratified and randomized into supervised face-to-face exercise (n=13) and home exercise without daily supervision (n=12). Patients were submitted to a program of aerobic physical exercises, with progressive duration of 30 to 50 minutes, twice a week for twelve weeks. Before starting the program and every four weeks, all patients in both groups were assessed for fatigue (fatigue severity scale), respiratory (Pimáx and Pemáx) and peripheral (concentric quadriceps peak torque) muscle strength, functional capacity (6-minute walking distance) and quality of life (Short Form-36 Health Survey questionnaire). The face-to-face group showed reduced fatigue (P<0.001), increased inspiratory (P<0.001), expiratory (P<0.001) and peripheral (P<0.001) muscle strength of the 6MWD (P<0.001) and improved quality of life. The home group showed no significant improvement in these variables. A face-to-face program of moderate aerobic exercise in patients with compensated cirrhosis reduces fatigue, improves functional capacity and quality of life and increases respiratory and peripheral muscle strength. Home physical exercises do not cause the same adaptive effects in this population.

Physical therapy in patients with Duchenne muscular dystrophy: dynamics of the course of the disease

BACKGROUND: Duchenne muscular dystrophy is the most severe and common form among childhood muscular dystrophies, characterized by a progressive course. One of the main measures to slow down the rate of progression of the disease is physiotherapy, but now there are no recommendations to identify the optimal motor regimen, which is effective and safe for patients with Duchenne muscular dystrophy.&#x0D; AIM: The aim of the study was to evaluate the effectiveness of regular dynamic aerobic exercise in patients with Duchenne muscular dystrophy who are capable of independent movement.&#x0D; MATERIALS AND METHODS: We examined 15 patients with genetically confirmed Duchenne muscular dystrophy aged 4,9 to 9,0 years (mean age 6,9 years) who did not participate in rehabilitation programs with exercise therapy for 6 months prior to inclusion in the study. All patients underwent a course of physical therapy, the duration of the course was 4 months, the course was divided into 2 stages: preparatory stage (individual cardiac functional reserve 5160% with the number of repetitions of each exercise 68 times) and training stage (individual cardiac functional reserve 6170% with the number of repetitions each exercise 1012 times) The duration of the training was 60 minutes. At the baseline and during dynamic observation after 2 and 4 months, the following were evaluated: 6-minute walk test, timed function test (time to stand from supine, running 10 m, time to climb and descent 4 stairs).&#x0D; RESULTS: Statistically significant positive dynamics was revealed: the average values of the distance of the 6-minute walk at the baseline were 478,2 10,1 m, then 489,5 11,4 m (p 0.05) after 2 months and 502,6 10,7 m (p 0.005) after 4 months. The average values of the time to stand from supine at the baseline was 3,7 0,2 sec., after 2 months 3,5 0,2 sec. (p 0.08), after 4 months 3,5 0,2 sec. (p 0.05). Mean values of time to run 10 m at baseline 4,3 0,1 sec., after 2 months 4,1 0,2 sec. (p 0,05), and after 4 months 4,1 0,1 sec. (p 0.005).&#x0D; CONCLUSIONS: Thus, the regular performance of aerobic physical therapy exercises without weights in combination with training on an exercise bike can increase endurance and speed in ambulant patients with Duchenne muscular dystrophy.

The effect of aerobic exercise on metabolic parameters of patients with non-alcoholic fatty liver disease: systematic review and meta-analysis.

The aim of this study was to determine and evaluate the effect of aerobic exercise on fasting blood glucose, Insulin, Insulin resistance, Glycosylated hemoglobin (Hemoglobin A1C), Lipid profile as important indicators of non-alcoholic fatty liver disease. This research is a systematic review and meta-analysis that was conducted in 2021. For the present study, databases, ScienceDirect, PubMed, Scopus, science of Web, SID, Magiran and Google Scholar from 2010 to 2021, were searched along with keywords. After the initial screening, the full text of the articles was evaluated and the articles that met the inclusion criteria were analyzed. A total of 120 articles were reviewed, of which 16 articles met the criteria for entering the systematic review and meta-analysis. Accordingly, 710 people with fatty liver disease were divided into two groups of control and experimental group of 307 and 403 people, respectively. The mean age of the subjects in the present study was 52±10 years. The intervention effects were evaluated using the mean difference (MD) and the random effects model. Data were analyzed using effect size tests, bias analysis and heterogeneity analysis and by STATA software. Meta-analysis results indicated that endurance training in general significantly reduced glucose levels (P=0.004, SDM=-0.26, SE=0.09), insulin (P=0.01, SDM=-0.29, SE=0.11), HOMA-IR (P=0.01, SDM=-0.28, SE=0.11), Hba1c (P=0.001, SDM=-0.33, SE=0.12), triglycerides (P=0.02, SDM=-0.31, SE=0.13) and LDL (P=0.03, SDM=-0.21, SE=0.1). The results of meta-analysis did not show a significant effect on HDL levels after aerobic exercise in patients with fatty liver (P=0.97, SDM=0, SE=0.09). Endurance training improves the levels of glucose, insulin, Hba1c, Homa-IR, triglyceride, and LDL; although, there was no significant change in HDL levels due to endurance training. However, there is still a need for further research in this area.

Abstract 5868: Factors associated with exercise participation in patients with breast cancer

Abstract BACKGROUND: The American Cancer Society recommends at least 150 minutes of moderate and/or strenuous exercise and muscle-strengthening activities each week for adults. Exercise has been associated with decreased breast cancer mortality and adverse symptoms. This study’s purpose is to understand prevalence and predictors of inadequate aerobic exercise in patients recently diagnosed with breast cancer to inform interventions to increase exercise participation. METHODS: Patients seen at least once at Mayo Clinic Rochester were prospectively enrolled within one year of an initial breast cancer diagnosis in the Mayo Clinic Breast Disease Registry after providing informed consent. This analysis includes those who completed a baseline survey with self-reported exercise data using the Godin Leisure-Time Exercise Questionnaire. This longitudinal cohort study was approved by the Mayo Clinic institutional review board. RESULTS: 1,738 participants reported their usual weekly quantity of moderate and strenuous exercise an average of 95 days (SD 71 days, range 0-365) after diagnosis. Table 1 displays participant characteristics overall and by whether participants reported at least 150 minutes of moderate and/or strenuous activity weekly (“met guidelines”) or not (“did not meet guidelines”). Overall, 39% of participants met guidelines, including 56% of those aged 18-39 years, 40% of those aged 40-69 years, and 27% of those aged 70+ years. CONCLUSION: Older age was associated with less likelihood of meeting exercise guidelines (all age groups vs 70+, p &amp;lt; 0.05). A more diverse cohort will be needed to evaluate differences by gender and race/ethnicity. There did not appear to be any obvious impact on exercise level by time since diagnosis (during the first year after diagnosis) or educational status, though substantial missing data limit conclusions related to the latter. Additional research is needed to assess exercise levels later in survivorship and the impact of various treatment modalities on exercise habits Table 1. Patient and tumor characteristics Citation Format: Paulina S. Marell, Janet E. Olson, Joerg Herrmann, Nicole L. Larson, Nathan K. LeBrasseur, Stacy D. D'Andre, Andrea L. Cheville, Toure Barksdale, Charles L. Loprinzi, Fergus J. Couch, Kathryn J. Ruddy. Factors associated with exercise participation in patients with breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5868.

Application Value of Health Education Combined with Aerobic Exercise in Nursing of Patients with Mastitis Found in Physical Examination.

Objective To explore the application value of health education combined with aerobic exercise in patients with mastitis found in physical examination. Methods The clinical data of 100 patients with mastitis who underwent physical examination in the physical examination center of our hospital from October 2020 to October 2021 were retrospectively analyzed. According to the order of physical examination, they were equally split into experimental group and control group. The control group received the routine clinical intervention, while the experimental group received health education combined with aerobic exercise to evaluate the clinical effects of different intervention modes on patients with mastitis. Results Compared with the control group, the experimental group after intervention achieved notably higher scores of CD-RISC, self-management ability, and mastitis-related knowledge (P < 0.001), lower scores of breast pain, skin color, and local mass diameter (P < 0.001), and a higher SF-36 score (P < 0.001). Conclusion The clinical intervention combining health education with aerobic exercise in patients with mastitis found in the physical examination is an effective method to improve their mood state and self-management ability, and further research will help provide a good solution for such patients.

Aerobic exercise in patients with haemophilia: A systematic review on safety, feasibility and health effects.

Haemophilia is a congenital bleeding disorder going along with disease-specific joint complications and general health implications attributed to the lack of daily movement. Recent guidelines recommend physical activity for people with haemophilia (PwH). Yet, aerobic exercise in PwH is little studied and seldomly prescribed by clinicans. The aim of this systematic review is to investigate the safety, feasibility and health-related efficiency of AE in PwH. A systematic literature search according to the PRISMA guidelines was conducted (PubMed, Web of Science). Inclusion criteria were defined using PICOS. Methodological quality was assessed via TESTEX. Out of 789 studies identified, seven studies (three randomized controlled, two controlled, two single-group prospective trails) were included. The TESTEX mean score was 8.1 (±3.8). AE was realized as aquatic exercise, nordic walking, treadmill running, bicycle riding and swimming. Neither bleeding rates nor the factor amount increased and AE led to diverse health-related improvements. Little research has been conducted evaluating AE in PwH. Yet, AE can be considered as safe and feasible when being supervised by experts. However, disease-specific recommendations for AE are difficult to provide. Therefore, experts can currently only back AE recommendations on experience and nonhaemophilia-specific general guidelines.

Real-Time Analysis of Heart Rate Variability During Aerobic Exercise in Patients with Cardiovascular Disease

Real-Time Analysis of Heart Rate Variability During Aerobic Exercise in Patients with Cardiovascular Disease

Lifestyle intervention improves Left atrial strain in type 2 diabetes: results from the DIASTOLIC randomised trial

Abstract Introduction Left atrial (LA) strain has been shown to be an independent predictor of cardiovascular events in many conditions and superior to conventional measures of LA function (LA volumes and emptying fraction). The effects of low-energy diet or exercise on cardiovascular function in younger adults with type 2 diabetes (DIASTOLIC) study has previously demonstrated an improvement in left ventricle peak early diastolic strain rate in response to aerobic exercise in patients with type-2 diabetes (T2D). However, the effect of lifestyle intervention on LA function, assessed by cardiac magnetic resonance (CMR) imaging, is unknown. Methods The DIASTOLIC study was a prospective, randomised, open-label, blind endpoint trial, that randomised 90 obese participants with T2D (aged 18–65 years) to a 12-week intervention of: (i) routine care, (ii) aerobic exercise training, or (iii) low energy (≈810kcal/day) meal replacement plan (MRP). CMR was performed at baseline and week-12. Images were analysed using Medis v3.1. LA strain (LAS) was assessed using Feature Tracking (QStrain v2.0), corresponding to LA reservoir (LAS-r), conduit (LAS-cd), and booster pump (LAS-bp) using 4- and 2-chamber standard steady-state free precession cine images, and average values calculated. LA emptying fraction (LAEF) was calculated using biplane area-length method (QMass v8.1) for total, passive and active EF. Results 73 participants with T2D completed the trial and had analysable LA images (28 routine care, 22 exercise and 23 MRP). There was no significant change in CMR measured standard LA volumetric function (LAV/LAEF) and echocardiogram measured LV filling pressures (E/e') in any groups. The routine care arm showed no significant change in body mass index (BMI) or LAS (see Table). In the MRP group, there were significant reductions in BMI (4.8 kg/m2), mean systolic blood pressure (SBP) (13mmHg), and a significant increase in LAS-r and LAS-bp (29.9±7.0 to 32.3±7.0,p=0.036 and 14.6±5.3 to 17.2±3.7,p=0.034). The exercise arm showed a small reduction in BMI (0.8kg/m2), with no significant change in BP or LAS. Conclusion There was significant improvement in LAS post-lifestyle intervention in young adults with T2D, despite no change in volumetric measurements. MRP led to weight loss and improved SBP, with associated improved LA filling and contraction. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute for Health Research (NIHR) a career development fellowship.

Presence and clinical significance of myocardial ischemia during aerobic exercise training in patients with ischemic burden

Abstract Funding Acknowledgements Type of funding sources: None. Background Cardiovascular rehabilitation is efficient and safe for patients with coronary artery disease (CAD). Exercises are usually prescribed below the clinic and electrocardiographic ischemic threshold. Training above this threshold remains controversial, given the potential risks compared to the additional benefits. However, clinic and electrocardiographic detection of ischemia has lower accuracy than myocardial perfusion scintigraphy (MPS). Therefore, MPS during physical training can better assess ischemia. Moreover, serial maximum MPS can document the benefits of exercise that can be correlated with ischemia during training. Purpose To investigate the presence and clinical significance of scintigraphic myocardial ischemia during aerobic exercise in patients with CAD and ischemic burden. Methods Thirty-three patients with stable CAD were evaluated at maximum effort (M1) and at rest (R1) using MPS. Twelve patients were excluded; 3 did not complete the intervention, and 9 did not exhibit ischemia. The remaining 21 patients with ischemic burden were included. The intervention consisted of a 12-week training program of moderate-intensity aerobic exercises, below the clinical and electrocardiographic ischemic threshold. During weeks 1 (T1) and 12 (T2), patients underwent MPS during the exercises. After 12 weeks, patients underwent another MPS at maximum effort (M2). All images were quantitatively analyzed, and the presence, extent, and intensity of ischemia were determined. The Wilcoxon test was used to compare 2 variables, and the Friedman test to compare 3 variables, followed by the post hoc Dunn’s test. Correlations were analyzed using Spearman’s test. The level of significance was set at 5% (p &amp;lt; 0.05). Results The prevalence of scintigraphic ischemia during exercise training was 81% at T1 and 71% at T2. The median number (and interquartile range) of ischemic segments at T1 was 3 (2–5), which was significantly different (p = 0.003) from that observed at M1 [5 (3–8)]. The median values of the myocardial uptake in the ischemic segments at R1, T1, and M1 were 59.1% (53.1–68.5), 51.5% (45.3–60.3), and 40.8% (37.3–53.3), respectively, with significant differences between T1 and R1 (p &amp;lt; 0.05) and between T1 and M1 (p &amp;lt; 0.01). After 12 weeks, the extent and intensity of ischemia at maximum effort decreased. The median number of ischemic segments significantly decreased from 5 (3–8) at M1 to 4 (2–6) at M2 (p = 0.005). This reduction in the extent of ischemia after training was significantly correlated with the number of ischemic segments at M1 (r = 0.60; p = 0.004) and at T1 (r = 0.64; p = 0.002), such that patients with more extensive ischemia experienced greater benefits from training. Conclusions Scintigraphic ischemia was highly prevalent during moderate-intensity aerobic training in patients with CAD and ischemic burden. There was a correlation between the ischemic stimulus during training and the documented benefits at maximum effort. Abstract Figure. Polar maps at rest, training and maximum

Efficacy of aerobic exercise on the cardiometabolic and renal outcomes in patients with chronic kidney disease: a systematic review of randomized controlled trials.

Severalrandomized controlled trials (RCTs) have demonstrated the cardiometabolic effects of aerobic exercise in the general population and in patients with cardiovascular diseases. However, the efficacy of aerobic exercise in patients with chronic kidney disease (CKD) remains to be elucidated. RCTs comparing aerobic exercise with no aerobic exercise in patients with CKD not requiring kidney replacement therapy were identified through PubMed using RobotAnalyst, a web-based software system that combines text-mining and machine learning algorithms for organizing references. Cardiometabolic and renal outcomes of interest included body mass index (BMI); systolic blood pressure (SBP); hemoglobin A1c (HbA1c), total cholesterol (TCHO), low- and high- density lipoprotein cholesterol (LDLC and HDLC, respectively), and urinary protein (UP) levels/concentration; peak oxygen uptake (Vo2peak); and glomerular filtration rate (GFR) at the end of the follow-up period. The standardized mean difference (SMD) of each outcome was estimated using the DerSimonian-Laird random-effect model with inverse-variance weighting. A total of 15 trials, including 622 patients, were included. Their follow-up periods were 3-4, 6-12, and > 12-months in 7 (46.7%), 7 (46.7%), and 1 (6.7%) trial(s), respectively. Meta-analyses showed that aerobic exercise significantly decreased BMI (SMD, -0.19 [95% confidence interval, -0.38, -0.00]) and SBP (-0.75 [-1.24, -0.26]) and increased Vo2peak (0.54 [0.29, 0.78]); however, no significant association was observed in HbA1c, TCHO, HDLC, LDLC, GFR, and UP. Meta-regression models suggested that aerobic exercise was more likely to improve Vo2peak in patients with younger age, no diabetes, and lower BMI. Aerobic exercise of 3-12months' duration improved obesity, high blood pressure, and low exercise capacity in overweight/obese patients with CKD, but it had no significant effect on GFR andproteinuria. Well-designed large RCTs with a longer follow-up periodare needed to evaluate the efficacy of aerobic exercise in patients with CKD.