Aerobic Exercise Prescription Research Articles

Feasibility of Measuring Ventilatory Threshold in Adults With Stroke-Induced Hemiparesis: Implications for Exercise Prescription

ObjectivesTo assess the feasibility of measuring ventilatory threshold (VT) in adults with walking impairments due to stroke. Secondary objectives are to assess reliability of VT over trials; assess whether participants could sustain treadmill walking at VT; and compare mean heart rate during sustained treadmill walking to estimated heart rate reserve (HRR). DesignCross-sectional, single-group design. SettingUniversity research laboratory. ParticipantsVolunteer sample of adults (N=8) with impaired walking resulting from chronic stroke. InterventionsThree submaximal treadmill walking tests on 3 separate days; a 30-minute treadmill walking session on a fourth day. Main Outcome MeasuresGas exchange variables were measured, and 2 independent observers identified VT. Mean heart rate response to treadmill walking at VT was measured and compared with estimated 40% of HRR. ResultsVT was measured successfully in 88% of all trials. There was no difference in VT among trials (P=.17). After multiple imputations to account for 3 missing data points, the intraclass correlation coefficient was .87 (95% confidence interval, .80–.95). All participants were able to walk for 20 minutes at VT. Mean ± SD heart rate during the session was 66.0%±8.0% of estimated maximal heart rate. There was no significant difference between mean heart rate and estimated HRR values (P=.70). ConclusionsIn adults with impaired walking resulting from stroke, VT can be safely measured during submaximal treadmill walking. Participants were able to sustain walking at VT, and this value may provide an appropriate stimulus for aerobic exercise prescription in this population.

Effects of Yoga in a Behavioral Weight Loss Program on Body Composition and Fitness

Yoga is currently a popular form of exercise; however, little is known as to its impact within the context of a weight loss intervention. PURPOSE: To compare a behavioral weight loss program with a prescription of aerobic exercise only (AR) or yoga plus aerobic exercise (YOGA) on changes in muscular endurance, flexibility, body composition, and cardiorespiratory fitness at 6 and 12 months. METHODS: Thirty-seven women (age=46.8±6.0 years; BMI=30.6±2.9 kg/m2) were randomized to AR (n=19) or YOGA (n=18). Both groups received a reduced calorie diet. AR was prescribed aerobic exercise that progressed to 40 min/day, 5 days/wk. YOGA was prescribed the same dose of aerobic exercise plus yoga for 3 days/wk. Participants attended weekly intervention meetings for 6 months and then received monthly telephone contact for 6 months. Muscular endurance (1 minute sit-up test), flexibility (sit and reach test), body composition (bioelectrical impedance), weight, and cardiorespiratory fitness (graded exercise test) were measured at baseline, 6, and 12 months. RESULTS: Chi-square analysis of retention rates revealed 94.7% YOGA vs. 72.2% AR (p=.063) at month 6 and 94.7% YOGA vs. 61.1% AR (p=.013) at month 12. Analyses were conducted with baseline values carried forward for missing data and results are presented below.Table: No title available.CONCLUSIONS: YOGA vs. AR resulted in a significant improvement in weight loss, percent body fat, and fitness at 6 and 12 months. There was an improvement in muscular endurance and flexibility for both groups at 6 and 12 months; however, this difference was not significant between the groups at either time point. Retention was significantly better for YOGA vs. AR. Thus, the addition of yoga to a behavioral weight loss program appears to be a promising option that warrants further investigation.

Effects of Aerobic Exercise Based upon Heart Rate at Aerobic Threshold in Obese Elderly Subjects with Type 2 Diabetes.

In obese diabetic subjects, a correct life style, including diet and physical activity, is part of a correct intervention protocol. Thus, the aim of this study was to evaluate the effects of aerobic training intervention, based on heart rate at aerobic gas exchange threshold (AerTge), on clinical and physiological parameters in obese elderly subjects with type 2 diabetes (OT2DM). Thirty OT2DM subjects were randomly assigned to an intervention (IG) or control group (CG). The IG performed a supervised aerobic exercise training based on heart rate at AerTge whereas CG maintained their usual lifestyle. Anthropometric measures, blood analysis, peak oxygen consumption (), metabolic equivalent (METpeak), work rate (WRpeak), and WRAerTge were assessed at baseline and after intervention. After training, patients enrolled in the IG had significantly higher (P < 0.001) , METpeak, WRpeak, and WRAerTge and significantly lower (P < 0.005) weight, BMI, %FM, and waist circumference than before intervention. Both IG and CG subjects had lower glycated haemoglobin levels after intervention period. No significant differences were found for all the other parameters between pre- and posttraining and between groups. Aerobic exercise prescription based upon HR at AerTge could be a valuable physical intervention tool to improve the fitness level and metabolic equilibrium in OT2DM patients.

Determining the I (Intensity) for a FITT-VP Aerobic Exercise Prescription

Determining the I (Intensity) for a FITT-VP Aerobic Exercise Prescription

Integrated Resistance and Aerobic Exercise Protects Fitness during Bed Rest

The current exercise countermeasures have not fully protected astronauts' preflight aerobic and muscular fitness levels during International Space Station (ISS) missions, prompting a need to optimize the exercise prescription to improve or maintain astronauts' ability to perform critical tasks and eventually extend the duration of missions. To test the hypothesis that an integrated resistance and aerobic exercise prescription performed with exercise equipment similar to that on the ISS can be tolerated and maintain cardiovascular and muscular fitness during 14 d of exposure to a model of microgravity. Subjects (n = 9) participated in 14-21 d of pre-bed rest training and familiarization, 14 d of bed rest + iRAT exercise, and 7 d of ambulatory recovery. Peak aerobic capacity (V˙O2peak), ventilatory threshold (VT), and isokinetic and leg press tests were performed before and after bed rest to evaluate cardiovascular and muscle functions. Muscle cross-sectional area (CSA) was determined before, during, and after bed rest using magnetic resonance imaging (MRI). Improvements from before to after bed rest were observed in V˙O2peak (2.8 ± 0.2 to 3.2 ± 0.2 L·min(-1)), VT (1.9 ± 0.2 to 2.1 ± 0.2 L·min(-1)), leg muscle power (1582 ± 317 to 1740 ± 359 W), and muscle CSA of the grouped vastus lateralis, vastus intermedius, and vastus medialis muscles (67.5 ± 8.4 to 68.9 ± 8.3 cm). Muscle strength and total CSA of the upper and lower legs were not different from before to after bed rest. This is the first report of exercise being completely effective for the prevention of cardiovascular and skeletal muscle deconditioning during strict bed rest using exercise equipment similar to that on the ISS. This was accomplished with high subject compliance.

Aerobic Exercise Prescription for Older Population: A Short Review

Aerobic exercise can lower the susceptibility to certain preventable chronic diseases, decrease mortality and improve health in the older adults. The health benefits of aerobic exercise include prevention of cardiovascular and coronary heart diseases; lowering blood pressure and blood lipids; lowering the risk of type 2 diabetes mellitus, back pain, osteoarthritis, osteoporosis, falls and, to some extent, sarcopenia; and improving quality of life and independent living in older adults. Aerobic training should be continued in order to be beneficial. If it is professionally prescribed by a physiotherapist or clinical exercise specialist using the most current research evidence, aerobic exercise can be enjoyable and safe. Professional and medical supervision during aerobic training may be needed for the older population and those who are at a higher risk for cardiovascular disease, stroke, hypertension or who have diabetes mellitus, obesity, osteoarthritis, and osteoporosis. More research is still needed to identify the physiological and cellular mechanisms that show exercise can slow the aging process. This review article presents aerobic exercise-induced cardiovascular benefits and optimal exercise prescription for promoting cardiovascular-pulmonary-muscular health and preventing age-related diseases and mortality

Exercício físico e síndrome metabólica

The metabolic syndrome (MS) is characterized by a cluster of risk factors for cardiovascular diseases and type 2 diabetes mellitus (T2DM) that occur together more often than alone by chance, commonly associated with obesity (particularly central obesity), elevated blood pressure and triglycerides, low levels of HDL cholesterol and disglycemia. In the last decades, the number of individuals affected by more than one of the risks factors for MS has increased severely, turning this syndrome into a public health problem worldwide. The treatment for MS should be performed by different therapies that involve medical resources and lifestyle interventions. In respect to lifestyle changes, physical exercise has been indicated as an important alternative that acts directly or indirectly on all risk factors comprising the MS. Thus, the present review explores the role of systematic physical exercise practice on different risk factors for MS. Initially we focus on the effect of physical exercise on obesity, especially on the abdominal one. Subsequently the effects of physical exercise on LDL- and HDL-cholesterols and triglycerides are shown. Additionally, we presented some considerations on the benefits of exercise on blood pressure, insulin resistance and T2DM. Finally, we stated the methodological guidelines for prescription of aerobic exercise, muscular strength and flexibility for individuals with MS.

Qual é a melhor estratégia de prescrição do exercício aeróbio para aumentar o dispêndio energético em pacientes sedentários?

Aerobic exercise is an important complementary strategy for weight control, but there are questions about the optimal dose of exercise with this purpose. This review describes the methodological bases of aerobic exercise prescription, with emphasis on the optimization of energy expenditure (EE) and weight reduction in sedentary subjects. In this context, the study focused mainly on the intensity of aerobic exercise prescription. The percentage of oxygen uptake reserve (%VO2R) – along with the American College of Sports Medicine to calculate training workloads –, have been used to define the exercise intensity and estimate EE, due to its hypothetical 1:1 relationship with the percentage of heart rate reserve (%HRR). However, there are limitations in the application of this method, since studies applying continuous bouts of exercise with different intensities have reported that such hypothetical 1:1 relationship between ‘%HRR-%VO2R’ may overestimate or underestimate EE. Another issue refers to the optimal training intensity. High-intensity short-term exercises have been recommended to promote greater benefits on cardiorespiratory fitness, body composition, and cardiovascular risk factors compared to long-term moderate exercise bouts. However, aspects related to adherence to exercise routines cast doubt over the effectiveness of this strategy, which should be considered when designing exercise programs in the context of weight reduction and health promotion.

Is high-intensity exercise better than moderate-intensity exercise for weight loss?

This viewpoint debates the state-of-the-art research focusing on the optimal intensity of the exercise programs for inducing a sustained weight or fat-mass loss in overweight/obese people. In our demanding society, the most attractive messages in the popular press are those promising the best results in a short time. This might explain the emphasis given by media to those scientific articles that report the efficacy on weight loss of exercise programs by their shorter duration and higher intensity.However, in the literature on overweight or obese people, there is little conclusive evidence for more favorable effects with high-intensity training than with continuous moderate-intensity exercise on body weight or fat mass loss. Since both exercise protocols have been demonstrated as useful to reduce body weight, the decision on the intensity of exercise prescription should be individualized and based on outcomes different from fat or weight loss. In this regard, there are pro and contra arguments for the prescription of high-intensity aerobic exercise in obese people. Among the pro arguments, is the demonstration that, in several studies, high-intensity training appears to induce superior improvements in aerobic fitness. Among the contra arguments to prescribe high-intensity exercise is the demonstration that prescribing a higher-intensity exercise decreases adherence and results in the completion of less exercise. Thus, a successful exercise program should be proposed at a moderate intensity and a low perceived effort because obese subjects who have low self-efficacy, poor mood status, and are not familiar with high-intensity workouts could easily drop out.

Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor.

Recovery of motor function after stroke involves relearning motor skills and is mediated by neuroplasticity. Recent research has focused on developing rehabilitation strategies that facilitate such neuroplasticity to maximize functional outcome poststroke. Although many molecular signaling pathways are involved, brain-derived neurotrophic factor (BDNF) has emerged as a key facilitator of neuroplasticity involved in motor learning and rehabilitation after stroke. Thus, rehabilitation strategies that optimize BDNF effects on neuroplasticity may be especially effective for improving motor function poststroke. Two potential poststroke rehabilitation strategies that consider the importance of BDNF are the use of aerobic exercise to enhance brain function and the incorporation of genetic information to individualize therapy. Converging evidence demonstrates that aerobic exercise increases BDNF production and consequently enhances learning and memory processes. Nevertheless, a common genetic variant reduces activity-dependent secretion of the BDNF protein. Thus, BDNF gene variation may affect response to motor rehabilitation training and potentially modulate the effects of aerobic exercise on neuroplasticity. This perspective article discusses evidence that aerobic exercise promotes neuroplasticity by increasing BDNF production and considers how aerobic exercise may facilitate the acquisition and retention of motor skills for poststroke rehabilitation. Next, the impact of the BDNF gene val66met polymorphism on motor learning and response to rehabilitation is explored. It is concluded that the effects of aerobic exercise on BDNF and motor learning may be better exploited if aerobic exercise is paired more closely in time with motor training. Additionally, information about BDNF genotype could provide insight into the type and magnitude of effects that aerobic exercise may have across individuals and potentially help guide an individualized prescription of aerobic exercise to enhance motor rehabilitation poststroke.

Point/Counterpoint

Point/Counterpoint

Aerobic Exercise Intensity Assessment and Prescription in Cardiac Rehabilitation

Aerobic exercise intensity prescription is a key issue in cardiac rehabilitation, being directly linked to both the amount of improvement in exercise capacity and the risk of adverse events during exercise. This joint position statement aims to provide professionals with up-to-date information regarding the identification of different exercise intensity domains, the methods of direct and indirect determination of exercise intensity for both continuous and interval aerobic training, the effects of the use of different exercise protocols on exercise intensity prescription and the indications for recommended exercise training prescription in specific cardiac patients' groups. The importance of functional evaluation through exercise testing prior to starting an aerobic training program is strongly emphasized, and ramp incremental cardiopulmonary exercise test, when available, is proposed as the gold standard for a physiologically comprehensive exercise intensity assessment and prescription. This may allow a shift from a 'range-based' to a 'threshold-based' aerobic exercise intensity prescription, which, combined with thorough clinical evaluation and exercise-related risk assessment, could maximize the benefits obtainable by the use of aerobic exercise training in cardiac rehabilitation.

Aerobic exercise intensity assessment and prescription in cardiac rehabilitation: a joint position statement of the European Association for Cardiovascular Prevention and Rehabilitation, the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation

Aerobic exercise intensity prescription is a key issue in cardiac rehabilitation, being directly linked to both the amount of improvement in exercise capacity and the risk of adverse events during exercise. This joint position statement aims to provide professionals with up-to-date information regarding the identification of different exercise intensity domains, the methods of direct and indirect determination of exercise intensity for both continuous and interval aerobic training, the effects of the use of different exercise protocols on exercise intensity prescription and the indications for recommended exercise training prescription in specific cardiac patients' groups. The importance of functional evaluation through exercise testing prior to starting an aerobic training program is strongly emphasized, and ramp incremental cardiopulmonary exercise test, when available, is proposed as the gold standard for a physiologically comprehensive exercise intensity assessment and prescription. This may allow a shift from a 'range-based' to a 'threshold-based' aerobic exercise intensity prescription, which, combined with thorough clinical evaluation and exercise-related risk assessment, could maximize the benefits obtainable by the use of aerobic exercise training in cardiac rehabilitation.

EFFECTS OF EXERCISE THERAPY AT THE INTENSITY OF ANAEROBIC THRESHOLD FOR CARDIOPULMONARY FUNCTION IN PATIENTS WITH AMI AFTER PERCUTANEOUS CORONARY INTERVENTION

ObjectivesThe purpose is to investigate the feasibility and safety of aerobic exercise prescription from the individually-based results of cardiopulmonary exercise test (CPET) and influence of aerobic exercise training for cardiopulmonary...

Aerobic exercise prescription in patients with chronic heart failure

Aerobic exercise training is a well-established nonpharmacological tool in patients with clinically stable chronic heart failure. In recent years, β-blocker therapy has become a primary pharmacologic intervention in patients with chronic heart failure. Despite the undeniable improvements in patients, the β-blocker era has aroused uncertainties about aerobic exercise intensity prescription. It is well known that aerobic exercise prescription is performed by a percentage of the patient's heart rate reserve and the use of β-blockers could interfere in this method. For this reason, the aim of this review is to provide an update about aerobic exercise prescription in patients with chronic heart failure who are using β-blockers.

The effects of aerobic exercise on exercise cardiac output and related parameters in patients with chronic heart failure

ObjectiveTo study the effects of aerobic exercise on exercise cardiac output and related parameters in patients with chronic heart failure (CHF).MethodsTotal of 50 CHF patients were enrolled in the study,...

The effects of aerobic exercise on exercise tolerance in patients with chronic heart failure

ObjectiveTo study the effects of aerobic exercise on exercise tolerance in patients with chronic heart failure (CHF).MethodsTotal of 50 CHF patients were enrolled in the study, left ventricular ejection fraction...

The effects of aerobic exercise on left atrial and ventricular remodelling in patients with chronic heart failure

ObjectiveTo study the effects of aerobic exercise on left atrial and ventricular remodelling in patients with chronic heart failure (CHF).MethodsTotal of 50 CHF patients were enrolled in the study, left...

Effects of a structured physical activity intervention on measures of physical performance in frail elderly patients after cardiac rehabilitation: a pilot study with 1-year follow-up

The objective of this prospective randomized controlled study was to compare the long-term effects of a structured physical activity intervention with those of aerobic exercises alone, in a cohort of elderly patients who had undergone elective cardiac surgery, and who were classified as frail at the end of rehabilitation based on their Short Physical Performance Battery (SPPB) score. At the end of rehabilitation, 140 frail elderly patients were randomly allocated either to the intervention group (IG) or to the control group (CG). CG participants received the usual aerobic exercise prescription, while IG participants were also taught additional exercises for strength, flexibility, balance and coordination. The improvement in SPPB score after 1year was the outcome of the study. IG showed a significant improvement in SPPB score (9.0±1.1 vs. 7.7±1.4, p<0.001), while no significant change was found in CG (7.7±1.6 vs. 7.6±1.5, p=0.252). IG also showed a significantly higher proportion of participants who improved their SPPB score of at least 1 point (70 vs. 37%, p<0.001). In conclusions, our structured physical activity intervention significantly improves the SPPB score in frail elderly patients who have undergone elective cardiac surgery. An intervention that improves the SPPB score might delay the occurrence of mobility disability.

Racial differences in the responses to shear stress in human umbilical vein endothelial cells

Background:African American ethnicity is an independent risk factor for exaggerated oxidative stress, which is related to inflammation, hypertension, and cardiovascular disease. Recently, we reported that in vitro oxidative stress and inflammation levels differ between African American and Caucasian human umbilical vein endothelial cells (HUVECs), African American HUVECs having higher levels of both. However, it remains to be shown whether the cells would respond differently to external stimuli.Methods:We used a cone and plate viscometer to apply laminar shear stress (LSS) as an aerobic exercise mimetic to compare the responses by race. HUVECs were exposed to static conditions (no LSS), low LSS (5 dyne/cm2), and moderate LSS (20 dyne/cm2).Results:It was found that African American HUVECs had higher levels of oxidative stress under static conditions, and when LSS was applied protein expression levels (NADPH oxidase NOX2, NOX4 and p47phox subunits, eNOS, SOD2, and catalase) and biomarkers (NO, SOD, and total antioxidant capacity) were modulated to similar levels between race.Conclusion:African American HUVECs may be more responsive to LSS stimulus indicating that aerobic exercise prescriptions may be valuable for this population since the potential exists for large in vivo improvements in oxidative stress levels along the endothelial layer in response to increased shear flow.