Aerobic Exercise Prescription Research Articles

Exercise interventions for the effect of endothelial function in hypertensive patients: A systematic review and meta-analysis.

Endothelial dysfunction is crucial factor to the hypertension occurrence, and controversy remains regarding the effect of exercise on improving endothelial function in hypertensive patients. The authors used meta-analysis to evaluate the intervention effect of exercise on endothelial function in hypertensive patients and to investigate exercise protocols that may have a greater intervention effect. A total of 37 studies and a total of 2801 participants were included. The results were as follows: endogenous nitric oxide (NO)[SMD=.89, 95% CI (.48, 1.30), p<.0001], endothelin-1 (ET-1): [SMD=-.94, 95% CI (-1.15, -.73), p<.0001], flow-mediated dilation (FMD) [SMD=-.57, 95% CI (.36,.79), p<.000001]. In subgroup analysis, high-intensity aerobic exercise, with a single exercise duration of 35-50min, 3-4 times/week for a total of 10-12weeks, had the largest amount of intervention effect on NO, and moderate-intensity resistance exercise, with a single exercise duration of ≥60min, 6 times/week for a total of 15-18weeks, had the largest amount of intervention effect on ET-1. In conclusion, exercise can improve NO levels, FDM levels, and reduce ET-1 secretion of hypertension patients, thereby improve their endothelial function. The ideal intervention effect of improving NO level was more likely to be obtained by taking the exercise prescription of high-intensity aerobic exercise with a single exercise duration of 35-50min, 3-4 times/week for 10-12weeks; the ideal intervention effect of improving ET-1 was more likely to be obtained by taking the exercise prescription of oderate -intensity resistance exercise with a single exercise duration of ≥60min, 6 times/week for 15-18weeks.

Neuromuscular contributions to disability in children with cerebral palsy and the impact of dynamic stretching orthoses and therapeutic exercise interventions: a narrative review.

Cerebral palsy (CP) is the most common motor disability in children. The initial lesion to the developing brain may result in a myriad of neuromuscular comorbidities, including mobility deficiencies. The neuromuscular contributions to disability and rehabilitative frameworks specific to children with CP have been investigated separately. However, few reviews have examined the relationship between neuromuscular pathophysiology and rehabilitative frameworks among children with CP. Therefore, the purpose of this review was to investigate the impact of dynamic stretching orthoses and therapeutic exercise on range of motion (ROM), aerobic capacity, and mobility in relation to the neuromuscular contributions to disability in children with CP. Reviews of PubMed, Google Scholar, and Web of Science were conducted to identify literature focusing on the neuromuscular pathophysiology contributing to disability in children with CP and rehabilitative frameworks associated with this population. The search used a combination of keywords and subject headings to include 'cerebral palsy', 'musculoskeletal', 'neuromuscular', 'spasticity', 'rehabilitation', 'exercise', 'aerobic', and 'orthosis'. Selected manuscripts featured original cross-sectional and longitudinal research and meta-analyses. A total of 303 manuscripts were initially identified through search terms, with 182 articles excluded based on title and abstract evaluation, leaving 121 manuscripts for full-text analysis. Seven studies meeting the narrative review criteria were included. Evidence supporting the efficacy of dynamic stretching orthoses for improving lower extremity ROM is inconclusive. Aerobic and progressive resistive training may be beneficial for improving aerobic capacity and muscle strength in children with CP, which may result in enhanced mobility. Depending on the individual's clinical presentation, ROM and therapeutic exercise may be implemented to optimize function. Incorporating progressive resistive and aerobic exercises into a rehabilitation plan may improve mobility and aerobic capacity. As such, clinicians should consider resistance and aerobic exercise prescription as part of a long-term treatment plan for children with CP.

PRESCRIBING BLOOD FLOW-RESTRICTED CYCLING USING RPE BALANCES THE PHYSIOLOGICAL AND PERCEPTUAL DEMANDS IN HEALTHY ADULTS

INTRODUCTION Aerobic exercise is commonly prescribed using fixed heart rates or power/speed. These methods may not be suitable when incorporating blood flow restriction (BFR), as this technique can influence these measurements. Prescribing exercise via perception of exertion (RPE), which reflects overall psychophysiological stress, may present an alternative to overcome these issues. Aim: Describe physiological and perceptual responses during fixed-power and fixed-RPE cycling performed with blood flow restriction (BFR_{PWR} and BFR_{RPE}) and without (CON_{PWR} and CON_{RPE}). METHODS Following baseline testing, twelve active males cycled for ten minutes under four conditions. CON_{PWR} was performed first, then the remaining conditions in a randomised and counterbalanced order. BFR_{PWR} and CON_{PWR} were performed at the power equivalent to the first ventilatory threshold (161±38W). CON_{RPE} and BFR_{RPE} were prescribed at the RPE reported during CON_{PWR}. Continuous ventilatory and heart rate measurements were recorded as two-minute averages. Subjective RPE, effort, muscular discomfort, and cuff pain were recorded every two minutes. Blood lactate was measured pre-exercise, post-exercise, and two-minutes post-exercise. RESULTS BFR_{PWR} resulted in the greatest physiological and perceptual responses among all conditions. Power output was lower during BFR_{RPE} (119±48W) than CON_{RPE} (139±47W). Oxygen consumption during BFR_{RPE} (20.8±5.1mL·kg-1·min-1) was lower than CON_{PWR} (25.3±6.0mL·kg-1·min-1, p&amp;lt;0.001) and CON_{RPE} (22.3±5.9mL·kg-1·min-1, p=0.007). Heart rate during CON_{PWR} (143±22beats·min-1) was greater than BFR_{RPE} (133±26beats·min-1, p&amp;lt;0.001) and CON_{RPE} (131±25beats·min-1, p&amp;lt;0.001). Muscular discomfort was not different between BFR_{RPE} (2.5±1.3au) and CON_{PWR}(2.3±1.5au), yet both were greater than CON_{RPE} (p&amp;lt;0.001, 1.8±1.5au). Cuff pain was greater during BFR_{PWR} (3.3±1.7au) than BFR_{RPE} (2.2±1.1au, p&amp;lt;0001). Blood lactate was greater during fixed-power (4.9±3.5mmol·L-1) compared to fixed-RPE trials (3.6±2.7mmol·L-1, p&amp;lt;0.001). CONCLUSIONS BFR_{RPE} caused less discomfort and pain than BFR_{PWR} without compromising physiological stress compared to CON_{RPE}. BFR_{RPE} should be considered when high mechanical loads are contraindicated, or discomfort/pain is undesirable. These findings improve our understanding of aerobic BFR exercise prescription to healthy adults.

Dynamics of the course of Duchenne muscular dystrophy in patients taking ataluren and concomitant drug and non-drug therapy

Background. Duchenne muscular dystrophy is a hereditary, X-linked, progressive, disabling disease. One of the possible pathogenetic methods for treating this disease is the drug ataluren, which acts at the stage of protein translation in the ribosome and makes it possible to read information from mRNA, despite the presence of a premature stop codon in it, and, as a result, synthesize the dystrophin protein.Aim. To evaluate the dynamics of the course of Duchenne muscular dystrophy in patients receiving appropriate drug and non-drug therapy and patients receiving pathogenetic therapy with ataluren.Materials and methods. We examined 38 patients with genetically confirmed Duchenne muscular dystrophy. Of these, 11 patients with a genetically confirmed nonsense mutation receiving pathogenetic therapy with ataluren and 27 patients in the comparison group with other mutations in the dystrophin gene. 6‑minute walk test and timed function tests was done at baseline and during follow-up. Ataluren side effects were assessed.Results. Statistically significant positive dynamics were revealed during follow-up at 12 month when assessing the distance of a 6‑minute walk test and tests for getting up from the floor and running 10 meters in groups taking ataluren and receiving standard drug therapy with the initial initiation of a course of regular physical exercise. The control group was characterized by negative dynamics in speed tests.Conclusion. Thus, when taking ataluren in the standard recommended dosage, patients with Duchenne muscular dystrophy with a nonsense mutation shows a decrease in the rate of disease progression and an improvement in speed and endurance. The initial prescription of regular non-weightbearing aerobic exercise on the early ambulatory stage is also characterized by an increase in motor skills.

A Comparison of Critical Speed and Critical Power in Runners Using Stryd Running Power.

Although running traditionally relies on critical speed (CS) as an indicator of critical intensity, portable inertial measurement units offer a potential solution for estimating running mechanical power to assess critical power (CP) in runners. The purpose of this study was to determine whether CS and CP differ when assessed using the Stryd device, a portable inertial measurement unit, and if 2 running bouts are sufficient to determine CS and CP. On an outdoor running track, 10 trained runners (V˙O2max, 59.0 [4.2]mL·kg-1·min-1) performed 3 running time trials (TT) between 1200 and 4400m on separate days. CS and CP were derived from 2-parameter hyperbolic speed-time and power-time models, respectively, using 2 (CS2TT and CP2TT) and 3 (CS3TT and CP3TT) TTs. Subsequently, runners performed constant-intensity running for 800m at their calculated CS3TT and CP3TT. Running at the calculated CS3TT speed (3.88 [0.44]m·s-1) elicited an average Stryd running power (271 [28]W) not different from the calculated CP3TT (270 [28]; P = .940; d = 0.02), with excellent agreement between the 2 values (intraclass correlation coefficient = .980). The CS2TT (3.97 [0.42]m·s-1) was not higher than CS3TT (3.89 [0.44]m·s-1; P = .178; d = 0.46); however, CP2TT (278 [29] W) was greater than CP3TT (P = .041; d = 0.75). The running intensities at CS and CP were similar, supporting the use of running power (Stryd) as a metric of aerobic fitness and exercise prescription, and 2 trials provided a reasonable, albeit higher, estimate of CS and CP.

Evaluation of the "Step-Ramp-Step" Protocol: Accurate Aerobic Exercise Prescription with Different Steps and Ramp Slopes.

To assess whether: i) a lower amplitude constant-load MOD is appropriate to determine the mean response time (MRT); ii) the method accurately corrects the dissociation in the V̇O 2 -PO relationship during ramp compared with constant-load exercise when using different ramp slopes. Eighteen participants (7 females) performed three SRS tests including: i) step-transitions into MOD from 20 to 50 W (MOD 50 ) and 80 W (MOD 80 ); and ii) slopes of 15, 30, and 45 W·min -1 . The V̇O 2 and PO at the gas exchange threshold (GET) and the corrected respiratory compensation point (RCP CORR ) were determined. Two to three 30-min constant-load trials evaluated the V̇O 2 and PO at the maximal metabolic steady state (MMSS). There were no differences in V̇O 2 at GET (1.97 ± 0.36, 1.99 ± 0.36, 1.95 ± 0.30 L·min -1 ), and RCP (2.81 ± 0.57, 2.86 ± 0.59, 2.84 ± 0.59) between 15, 30, and 45 W·min -1 ramps, respectively ( P > 0.05). The MRT in seconds was not affected by the amplitude of the MOD or the slope of the ramp (range 19 ± 10 s to 23 ± 20 s; P > 0.05). The mean PO at GET was not significantly affected by the amplitude of the MOD or the slope of the ramp (range 130 ± 30 W to 137 ± 30 W; P > 0.05). The PO at RCP CORR was similar for all conditions ((range 186 ± 43 W to 193 ± 47 W; P > 0.05). The SRS protocol accounts for the V̇O 2 MRT when using smaller amplitude steps, and for the V̇O 2 slow component when using different ramp slopes, allowing for accurate partitioning of the exercise intensity domains in a single test.

Impact of atrial fibrillation type on outcomes following aerobic exercise training: analysis from the ACTIVE-AF Trial

Abstract Background The ACTIVE-AF study demonstrated that aerobic exercise prescription promotes the maintenance of sinus rhythm in patients with atrial fibrillation (AF). However, it is unclear whether these benefits are observed in patients with both paroxysmal and persistent AF. Purpose Compare efficacy of exercise intervention on arrhythmia recurrence between paroxysmal (ParAF) and persistent (PerAF) patients. Methods This study was a prospective, randomized, controlled trial of patients with symptomatic paroxysmal or persistent AF, referred for consideration of AF ablation. Randomization was 1:1 to either aerobic exercise intervention or usual medical care for a period of 6 months with a further 6 months follow-up. The exercise intervention was delivered in a hybrid format of weekly supervised exercise sessions coupled with prescribed home exercise, up to a total of 210 minutes per week. The intervention was led by a clinical exercise physiologist. Management of arrhythmia was at the discretion of a cardiologist blinded to patient randomisation. The primary endpoint reported here is recurrent AF without rhythm control strategies. Results Of the 120 patients enrolled in the study, 74 (62%) had a history of ParAF. Patients with PerAF typically had higher body mass index (32.0±6.6 versus 29.5±5.2 Kg/m2, p=0.02) and left atrial volume (38.0±9.4 versus 28.1±6.5 mL/m2, p&amp;lt;0.001) but similar prevalence of hypertension, diabetes mellitus, coronary artery disease and obstructive sleep apnea. Baseline peak oxygen consumption (VO2peak) was similar between ParAF and PerAF groups (20.0±6.0 versus 19.6±5.4mL/kg/min). Over the 12-month follow-up, AF recurrence in the ParAF patients was lower in the exercise group compared to control group (Hazard Ratio 0.42, 95% CI: 0.23-0.77, p=0.005). However, we did not find evidence of any between-group difference amongst patients with PerAF (HR 0.65, 95% CI: 0.34-1.23). Conclusions In this post-hoc analysis of a randomised controlled trial comparing the efficacy of exercise intervention versus standard medical care amongst patients with symptomatic AF, we observed a reduction in AF recurrence for patients with ParAF, but not amongst those with PerAF. These findings support the need for early lifestyle modification amongst patients with AF, before progression to PerAF occurs. Future studies should explore whether the exercise prescription can be modified to improve outcomes for patients with more advanced AF.

Do Clinical Exercise Tests Permit Exercise Threshold Identification in Patients Referred to Cardiac Rehabilitation?

To evaluate the feasibility of "threshold-based" aerobic exercise prescription in cardiovascular disease, we aimed to quantify the proportion of patients whose clinical cardiopulmonary exercise test (CPET) permit identification of estimated lactate threshold (θLT) and respiratory compensation point (RCP) and to characterize the variability at which these thresholds occur. Breath-by-breath CPET data of 1102 patients (65 ± 12 years) referred to cardiac rehabilitation were analyzed to identify peak O2 uptake (V˙O2peak; mL·min-1 and mL·kg-1·min-1) and θLT and RCP (reported as V˙O2, %V˙O2peak, and %peak heart rate [%HRpeak]). Patients were grouped by the presence or absence of thresholds: group 0: neither θLT nor RCP; group 1: θLT only; and group 2: both θLT and RCP. Mean V˙O2peak was 1523 ± 627 mL·min-1 (range: 315-3789 mL·min-1) or 18.0 ± 6.5 mL·kg-1·min-1 (5.2-46.5 mL·kg-1·min-1) and HRpeak was 123 ± 24 beats per minute (bpm) (52 bpm-207 bpm). There were 556 patients (50%) in group 0, 196 (18%) in group 1, and 350 (32%) in group 2. In group 1, mean θLT was 1240 ± 410 mL·min-1 (580-2560 mL·min-1), 75% ± 8%V˙O2peak (52%-92%V˙O2peak), or 84%± 6%HRpeak (64%-96%HRpeak). In group 2, θLT was 1390 ± 360 mL·min-1 (640-2430 mL·min-1), 70% ± 8%V˙O2peak (41%-88%V˙O2peak), or 78% ± 7%HRpeak (52%-96%HRpeak), and RCP was 1680 ± 440 mL·min-1 (730-3090 mL·min-1), 84% ± 7%V˙O2peak (54%-99%V˙O2peak), or 87% ± 6%HRpeak (59%-99%HRpeak). Compared with group 1, θLT in group 2 occurred at a higher V˙O2 but lower %V˙O2peak and %HRpeak (P < 0.05). Only 32% of CPETs exhibited both θLT and RCP despite flexibility in protocol options. Commonly used step-based protocols are suboptimal for "threshold-based" exercise prescription.

Aerobic Exercise Prescription in Cardiac Rehabilitation Based on Heart Rate from Talk Test Stages and 6-Minute Walk Test.

Although the Talk Test (TT) is a reliable and low-cost test, its use for aerobic exercise prescription is still limited. To analyze the heart rate (HR) in the stages of the TT and at the peak of the 6-minute walk test (6MWT) as a parameter to prescribe aerobic exercise compared with HR at the first and second ventilatory thresholds (VT1 and VT2) of cardiopulmonary exercise test (CPET). Individuals with cardiovascular disease attended three assessment days: 1) anamnesis and CPET; 2) 6MWT; and 3) TT. One-way repeated measures ANOVA or Friedman's test were used to compare HR at VT1 and VT2 with HR at TT stages: last positive (TT+), first equivocal (TT±), and negative (TT-), and at the peak of the 6MWT. Pearson's or Spearman's test assessed correlations between HR at VTs, TT stages, and 6MWT. Statistical significance was set at 5%. The study included 22 cardiac patients (13 men, 61 ± 8 years). HR at VT1 was similar to HR at TT+ (p = 0.987) and TT± (p = 0.154), and moderately correlated with TT+ (r = 0.479, p = 0.024). HR at VT2 was similar to TT- (p = 0.383), with a strong correlation (r = 0.757, p < 0.001). HR at the peak of the 6MWT was significantly different from HR at TT+, TT±, and VT1 (p = 0.001, p = 0.005, and p < 0.001, respectively) but similar to TT- (p = 0.68). HR at TT+ and TT- reflect HR at VT1 and VT2, respectively, differently from 6MWT, which was similar only to VT2. TT may be an objective test to assist aerobic exercise prescription in cardiac rehabilitation.

A Clinical Guide for Assessment and Prescription of Exercise and Physical Activity in Cardiac Rehabilitation. ACSANZ Position Statement.

Patients with cardiovascular disease benefit from cardiac rehabilitation, which includes structured exercise and physical activity as core components. This position statement provides pragmatic, evidence-based guidance for the assessment and prescription of exercise and physical activity for cardiac rehabilitation clinicians, recognising the latest international guidelines, scientific evidence and the increasing use of technology and virtual delivery methods. The patient-centred assessment and prescription of aerobic exercise, resistance exercise and physical activity have been addressed, including progression and safety considerations.

In Cardiac Patients Beta-Blockers Attenuate the Decrease in Work Rate during Exercise at a Constant Submaximal Heart Rate.

Exercise prescription based on fixed heart rate (HR) values is not associated with a specific work rate (WR) during prolonged exercise. This phenomenon has never been evaluated in cardiac patients, and might be associated with a slow component of HR kinetics and -adrenergic activity. The aim was to quantify, in cardiac patients, the work rate decrease at a fixed HR, and to test if it would be attenuated by β-blockers. 17 patients with coronary artery disease in stable conditions (69 ± 9 yr) were divided into two groups according to the presence (BB) or absence (no-BB) of a therapy with β-blockers, and performed on a cycle ergometer: an incremental exercise (INCR); a 15-min "HRCLAMPED" exercise, in which WR was continuously adjusted to maintain a constant HR, corresponding to the gas exchange threshold (GET) +15%. HR was determined by the ECG signal, and pulmonary gas exchange was assessed breath-by-breath. During INCR HRpeak was lower in BB vs. no-BB (p < 0.05), whereas no differences were observed for other variables. During HRCLAMPED the decrease in WR needed to maintain HR constant was less pronounced in BB vs. no-BB (-16 ± 10% vs. -27 ± 10, p = 0.04), and was accompanied by a decreased O2 only in no-BB (-13 ± 6%, p < 0.001). The decrease in WR during 15-min exercise at a fixed HR (slightly higher than that at GET) was attenuated in BB, suggesting a potential role by β-adrenergic stimulation. The phenomenon may represent, also in this population, a sign of impaired exercise tolerance, and interferes with aerobic exercise prescription.

Ventilatory Threshold Related to V̇O2reserve, Heart Rate Reserve and Rating of Perceived Exertion in a Large Varied Sample.

ACSM guidelines state that aerobic exercise intensity should be 30/40-89% V̇O2reserve (V̇O2R) or heart rate reserve (HRR). Determining the proper intensity within this range is the "art" of exercise prescription, often relying on rating of perceived exertion (RPE) as the adjunctive intensity modulator. Current guidelines do not consider the use of ventilatory threshold (VT) due to the need for specialized equipment and methodological issues. The purpose of this investigation was to evaluate VT related to V̇O2peak, V̇O2R, HRR and RPE across the full spectrum of very low to very high V̇O2peak values. 863 records of exercise tests were retrospectively examined. Data were stratified for V̇O2peak, activity level, age, test modality and sex. When stratified for V̇O2peak, V̇O2 at VT (V̇O2vt) had a lower mean value of ~14 ml•kg-1•min-1 in the lowest fit, rose gradually until median V̇O2peak, and rose steeply thereafter. When graphed relative to V̇O2peak; V̇O2 at VT as a % of V̇O2R (VT%V̇O2R) resembled a U-shaped curve, with a nadir ~43% V̇O2R, at V̇O2peak ~ 40 ml•kg-1•min-1. Average VT%V̇O2R increased to ~75% in groups with the lowest or highest V̇O2peak. There was a large variance in the value of VT at all V̇O2peak levels. Mean RPE at VT was 12.5 ± 0.93, regardless of V̇O2peak. Given the relationship of VT as the transition from moderate- to higher-intensity exercise, these data may help the undertanding of aerobic exercise prescription in persons across the spectrum of V̇O2peak values.

AP-453071-3 IMPACT OF SEX ON OUTCOMES FOLLOWING AEROBIC EXERCISE TRAINING IN PATIENTS WITH SYMPTOMATIC ATRIAL FIBRILLATION

Aerobic exercise prescription promotes the maintenance of sinus rhythm in patients with atrial fibrillation (AF). There is little data exists on whether this may be modified by patient sex. Compare outcoes between male and female patents amongst a randomized controlled trial of aerobic exercise prescription for patients with symptomatic AF. This study was a prospective, randomized, controlled trial of patients with symptomatic paroxysmal or persistent AF, referred for consideration of AF ablation. Randomization was 1:1 to either aerobic exercise intervention or usual medical care for a period of 6 months with a further 6 months follow-up. The exercise intervention was delivered in a hybrid format of weekly supervised exercise sessions coupled with prescribed home exercise, up to a total of 210 minutes per week. The intervention was led by a clinical exercise physiologist. Management of arrhythmia was at the discretion of a cardiologist blinded to patient randomization. The primary endpoint reported here is recurrent AF without rhythm control strategies. Of the 120 patients enrolled in the study (65±10 years, BMI 30±6, 38% Persistent AF), 51 were female (42.5%). Female patients were less likely to have persistent AF at baseline (19.6%) compared to males (47.8%), had comparable BMI (30.8 v 30.2 kg/m2), were older (68±7 v 63±11 years) and had lower baseline peak oxygen uptake (16±4 v 23±5mL/kg/min, p<0.001). After 12-mnths of follow-up, both male (HR 0.52, 95% CI: 0.29-0.91) and female patients (HR 0.47, 95% CI: 0.23-0.95) in the exercise group had reduced recurrence of AF without anti-arrhythmic medication or AF ablation. Although male and female patients exhibit baseline differences in risk factor profile, aerobic exercise training is equally effective in males and females for the reduction of recurrent arrhythmia amongst patients with symptomatic atrial fibrillation.

Adolescents With More Oculomotor and Vestibular Signs of Sport-Related Concussion Benefit from Aerobic Exercise: An Exploratory Analysis.

Abstract Early targeted heart rate (HR) aerobic exercise has been shown to reduce the duration of recovery from sport-related concussion (SRC) as well as the incidence of persistent post-concussive symptoms (PPCS). It is not known, however, if more severe oculomotor and vestibular presentations of SRC benefit from a prescription of aerobic exercise. The current study is an exploratory analysis of two published randomized controlled trials that compared aerobic exercise within 10 days of injury with a placebo-like stretching intervention. Combining the two studies yielded a larger sample size to stratify severity of concussion based on the number of abnormal physical examination signs present at the initial office evaluation, which were confirmed with self-reported symptoms and recovery outcomes. The most discriminant cut-off was between those who had ≤3 oculomotor and vestibular signs and those who had >3 signs. Aerobic exercise (hazard ratio = 0.621 [0.412, 0.936], p = 0.023) reduced recovery times even when controlling for site (hazard ratio = 0.461 [0.303, 0.701], p < 0.001), severity (hazard ratio = 0.528 [0.325, 0.858], p = 0.010) and the interaction term of intervention and severity (hazard ratio = 0.972 [0.495, 1.909], p = 0.935). Adolescents who presented with >3 signs and were assigned to the placebo-like stretching group had a PPCS incidence of 38%, which was the highest of all subgroups (aerobic exercise and ≤3 findings: 8%; stretching and ≤3 findings: 11%; aerobic exercise and >3 findings: 21%). This exploratory study provides pilot evidence that prescribed sub-symptom threshold aerobic exercise treatment early after SRC may be effective for adolescents with more oculomotor and vestibular physical examination signs and should be validated in future adequately powered trials.

National survey of Australian cardiac rehabilitation programmes: does current exercise programming adhere to evidence-based guidelines and best practice?

ObjectivesThe efficacy of exercise-based cardiac rehabilitation (CR) for patient outcomes is well established, with better outcomes when delivery meets recommended guidelines. The aim of this study was to assess how...

The effect of acute heat exposure on the determination of exercise thresholds from ramp and step incremental exercise.

The aim of this study was to examine how respiratory (RT) and lactate thresholds (LT) are affected by acute heat exposure in the two most commonly used incremental exercise test protocols (RAMP and STEP) for functional evaluation of aerobic fitness, exercise prescription and monitoring training intensities. Eleven physically active male participants performed four incremental exercise tests, two RAMP (30W·min-1) and two STEP (40W·3min-1), both in 18°C (TEMP) and 36°C (HOT) with 40% relative humidity to determine 2 RT and 16 LT, respectively. Distinction was made within LT, taking into account the individual lactate kinetics (LTIND) and fixed value lactate concentrations (LTFIX). A decrease in mean power output (PO) was observed in HOT at LT (-6.2 ± 1.9%), more specific LTIND (-5.4 ± 1.4%) and LTFIX (-7.5 ± 2.4%), compared to TEMP, however not at RT (-1.0 ± 2.7%). The individual PO difference in HOT compared to TEMP over all threshold methods ranged from -53W to +26W. Mean heart rate (HR) did not differ in LT, while it was increased at RT in HOT (+10 ± 8bpm). This study showed that exercise thresholds were affected when ambient air temperature was increased. However, a considerable degree of variability in the sensitivity of the different threshold concepts to acute heat exposure was found and a large individual variation was noticed. Test design and procedures should be taken into account when interpreting exercise test outcomes.

Acute responsiveness to single leg cycling in adults with obesity.

Obesity is associated with several skeletal muscle impairments which can be improved through an aerobic exercise prescription. The possibility that exercise responsiveness is diminished in people with obesity has been suggested but not well-studied. The purpose of this study was to investigate how obesity influences acute exercise responsiveness in skeletal muscle and circulating amino metabolites. Non-obese (NO; n= 19; 10F/9M; BMI=25.1± 2.8kg/m2 ) and Obese (O; n= 21; 14F/7M; BMI=37.3± 4.6kg/m2 ) adults performed 30 min of single-leg cycling at 70% of VO2 peak. 13 C6 -Phenylalanine was administered intravenously for muscle protein synthesis measurements. Serial muscle biopsies (vastus lateralis) were collected before exercise and 3.5- and 6.5-h post-exercise to measure protein synthesis and gene expression. Targeted plasma metabolomics was used to quantitate amino metabolites before and 30 and 90 min after exercise. The exercise-induced fold change in mixed muscle protein synthesis trended (p= 0.058) higher in NO (1.28 ± 0.54-fold) compared to O (0.95 ± 0.42-fold) and was inversely related to BMI (R2 = 0.140, p= 0.027). RNA sequencing revealed 331 and 280 genes that were differentially expressed after exercise in NO and O, respectively. Gene set enrichment analysis showed O had six blunted pathways related to metabolism, cell to cell communication, and protein turnover after exercise. The circulating amine response further highlighted dysregulations related to protein synthesis and metabolism in adults with obesity at the basal state and in response to the exercise bout. Collectively, these data highlight several unique pathways in individuals with obesity that resulted in a modestly blunted exercise response.

Abstract 15833: Impact of Sex on Outcomes Following Aerobic Exercise Training in Patients With Symptomatic Atrial Fibrillation

Introduction: Aerobic exercise prescription may promote maintenance of sinus rhythm in patients with atrial fibrillation (AF). Very little data exists on whether this may be modified by patient sex. Hypothesis: Male and female patients with AF would benefit from exercise prescription. Methods: This study was a prospective, randomized, controlled trial of patients with symptomatic paroxysmal or persistent AF, referred for consideration of AF ablation. Randomization was 1:1 to either aerobic exercise intervention or usual medical care for a period of 6 months with a further 6 months follow-up. The exercise intervention was delivered in a hybrid format of weekly supervised exercise sessions coupled with prescribed home exercise, up to a total of 210 minutes per week. The intervention was led by a clinical exercise physiologist. Management of arrhythmia was at the discretion of a cardiologist blinded to patient randomization. The primary endpoint reported here is recurrent AF without rhythm control strategies. Results: Of the 120 patients enrolled in the study (Aged 65±10, BMI 30±6, 38% Persistent AF), 51 were female (42.5%). Female patients were less likely to have persistent AF at baseline (19.6%) compared to males (47.8%), had comparable BMI (30.8 v 30.2 kg/m 2 ), were older (68±7 v 63±11 years) and had lower baseline peak oxygen uptake (16±4 v 23±5mL/kg/min, p&lt;0.001). After 12-mnths of follow-up, both male (HR 0.52, 95% CI: 0.29-0.91, p=0.02) and female patients (HR 0.47, 95% CI: 0.23-0.95) in the exercise group had reduced recurrence of AF without anti-arrhythmic medication or AF ablation. Conclusions: Despite baseline differences in risk factor profile, aerobic exercise training is equally effective in males and females for the reduction of recurrent arrhythmia amongst patients with symptomatic atrial fibrillation. Exercise-based intervention should be recommended to patients of both sex, to promote the maintenance of sinus rhythm.

Aerobic Training for Healthy Men and Women: Determining Intensities by Different Equations.

The aim of this study is to develop equations for aerobic exercise prescription for the intensities of 50, 60, 70 and 80% in healthy subjects of both sexes. Method. This is a cross-sectional study with convenience sampling drawn from a database of 228 healthy subjects who were randomized into the regression group (GR: 197 subjects (male = 143 and female = 54)) and cross-validation group (CVG: 31 individuals [men = 20 and women = 11]). Kohavi’s assumptions were followed in relation to cross-validation and bootstrap for precision estimation and model selection. The GR was used to build the estimation equations from the multiple linear regression. The CVG was determined to analyze the validity in the estimation equations. The equations to determine the intensities were constructed by means of multiple regression, the independent variables were determined by the stepwise method, observing the significance level of p < 0.05. Results. The reliability level of Cronbach’s alpha of the multiple linear regression equations was moderate for the intensity of 50% (0.51); for the intensities of 60, 70 and 80%, it corresponded to 0.50, 0.53 and 0.57, respectively. Conclusion. The results show that it is possible to apply the equations in the determination of aerobic exercise intensities for healthy individuals. However, the need for further studies in other populations to prove the reliability of the proposed equations is evident.

EFEITO DO EXERCÍCIO AERÓBICO SOBRE O METABOLISMO E A SAÚDE FÍSICA DAS ESTUDANTES UNIVERSITÁRIAS OBESAS

ABSTRACT Objective: To explore the effects of aerobic exercise on the metabolism and physical health of obese college students. Methods: 219 obese college students of different stages were selected by stratified group sampling according to colleges and grades. The effects on physical indices of obese female college students were analyzed by the two-factor variation method after 32 weeks of aerobic exercise training. Results: The experimental group and the control group were significantly improved, and long-term aerobic prescription training was more effective than special education in changing the physical health of obese female college students. After 32 weeks of extreme weight loss training, in the statistical process of 219 valid data, 188 people were found to have lost weight, with the most significant drop reaching 8 kg; BMI decreased in 193 people, and body fat content decreased in 172 people. After 12 weeks of aerobic exercise, the level of cardiopulmonary function of female college students increased. The aerobic exercise prescription designed by the experiment can improve upper and lower limb strength, body flexibility, abdominal muscle strength, and lung function of female college students, which cannot be achieved by diet control alone. Conclusion: Aerobic exercise prescription is an effective means to improve the effect of cardiopulmonary exercise on female college students, and can stimulate the students’ enthusiasm and initiative to exercise independently. Level of evidence II; Therapeutic studies - investigation of treatment results