Aerobic Training Program Research Articles

Efficacy and Safety of a Combined Aerobic, Strength and Flexibility Exercise Training Program in Patients with Implantable Cardiac Devices.

Purpose: The “FIDE Project” (Fitness Implantable DEvice) was organized by the Institute of Sports Medicine and Science and the World Society of Arrhythmias with the aim of demonstrating the usefulness of exercise training in improving functional capacity in patients with implantable cardiac devices. Materials and Methods: Thirty sedentary patients were selected for the project (25 males and 5 females), with a mean age of 73 ± 5 years (range 44–94 years). Twenty-five were implanted with a Pacemaker (PM) and five with an Implantable Cardioverter Defibrillator (ICD). Atrial fibrillation/atrial flutter was present in ten (34%) patients, post-ischemic dilated cardiomyopathy in five (17.2%), sick sinus syndrome in six (20,7%), complete atrium-ventricular block in six (20.7%), hypertrophic cardiomyopathy in one (3.4%) and recurrent syncope in one (3.4%). The baseline assessment comprised cardiovascular examination, resting and stress ECG, cardiopulmonary exercise testing (V ˙O2peak), strength assessment of different muscle groups, and a flexibility test. The same measurements were repeated after 15–20 consecutive training sessions, over a 2-month period. The exercise prescription was set to 70–80% of HRR (Heart rate reserve) and to 50–70% of 1RM (1-repetition maximum, muscular force). The training protocol consisted of two training sessions per week performed in our institute, 90 min for each (warm-up, aerobic phase, strength phase and stretching) and one or more at home autonomously. Results: The cardiopulmonary testing after the training period documents a significant improvement in V ˙O2peak (15 ± 4 mL/kg/min vs. 17 ± 4; p = 0.001) and in work load (87 ± 30 watts vs. 108 ± 37; p = 0.001). Additionally, strength capacity significantly increased after the cardiac rehabilitation program, (quadriceps: 21 ± 18 kg vs. 29 ± 16 kg, p = 0.00003). Flexibility tests show a positive trend, but without statistical significance (sit-and-reach test: −19 ± 11 cm vs. −15 ± 11.7 cm; back-scratch test: −19 ± 11.6 cm vs. −15 ± 10 cm; lateral flexibility right −44 ± 1.4 cm vs. −43 ± 9.5 cm; left −43 ± 5 vs. −45 ± 8.7 cm). Conclusion: A brief period of combined aerobic, strength and flexibility exercise training (FIDE project) proved to be effective and safe in improving functional capacity in patients with cardiac implantable devices.

RESISTANT HYPERTENSION PATIENTS’ PERSPECTIVES ABOUT AN AEROBIC EXERCISE PROGRAM: INSIGHTS FROM THE ENRICH TRIAL

Objective: Aerobic exercise training programs decrease blood pressure in patients with resistant hypertension. However, patients’ experiences regarding exercise training participation are often undervalued. The aim of this study is to explore the lived experiences of patients with resistant hypertension who participated in a 12-week moderate intensity aerobic exercise training program. Design and method: An exploratory qualitative study was conducted with twenty patients (11 males and 9 females) with resistant hypertension, after the exercise program. Participants’ mean age was 58.9 ± 8.9 years and were taking an average of 4.7 ± 0.9 antihypertensive medications. Focus group interviews were performed to explore participants’ perspectives. The interviews were video-recorded, transcribed verbatim, and submitted to thematic analysis. Results: Five main themes have emerged from interviews’ analyses: 1) impacts of participating in the exercise program; 2) facilitators of adherence to exercise; 3) perceived barriers; 4) perception of the program structure; and 5) global satisfaction with the exercise training program. Overall positive benefits were reported regarding emotional and physical well-being, associated with a decrease in daily life stress and irritability alongside a decrease in blood pressure. Adherence to the physical activity program was facilitated by the commitment to attend the training sessions, different schedule options and the professional and individualized supervision. Participants referred to lack of motivation, absence of company, physical health limitations and difficulty in conciliating schedules as barriers to the maintenance of exercise training. Conclusions: The perceived benefits by the participants are important indicators of adherence and maintenance of exercise training, despite the perceived barriers. This study has an innovative approach by focusing on the participants’ perception analysis, going beyond quantitative clinical data, and providing important insights to increase future participants’ adherence to exercise training programs.

ACUTE AEROBIC EXERCISE-INDUCED DECREASE IN BLOOD PRESSURE IS ASSOCIATED WITH CHRONIC BLOOD PRESSURE CHANGES IN PATIENTS WITH RESISTANT HYPERTENSION

Objective: The acute blood pressure (BP) decrease after an exercise training session seems to correlate with the chronic BP reductions following exercise training programs in participants with pre-hypertension; yet, among patients with resistant hypertension (RH) it is unknown. This study aims to investigate the association between the magnitude of BP decrease after acute exercise and the change in 24-hr ambulatory blood pressure (ABP) after an aerobic exercise intervention in patients with RH. Design and method: EnRicH trial was a randomized clinical trial assessing the effects of a 12-week moderate-intensity aerobic exercise program in participants with RH. In the present study, twenty-six patients (mean age 59.3 ± 8.2 years, 58.3% male) with RH that participated in the intervention arm of the EnRicH trial were included. Office and ABP measurements were obtained before and after the 12-week aerobic exercise training program. To assess the acute effect, resting BP measures were assessed before and 10 minutes after each exercise session of the third week of the exercise program. Exercise sessions were supervised, occurred three times per week, and included 40 min of aerobic exercise at 50% to 70% of VO2max and a 10-minute cooldown. Results: Resting systolic (-9.4 ± 7.0, p < 0.001) and diastolic BP (-1.9 ± 3.4, p = 0.10) were significantly reduced after acute exercise. 24hr systolic (-6.2 ± 12.1, p = 0.015) and diastolic BP (-4.42 ± 6.1, p = 0.001) an office systolic (-10.9 ± 15.2, p = 0.001) and diastolic BP (-5.9 ± 11.1, p = 0.013) were significantly decreased after the exercise program. The acute changes were correlated with the chronic decrease in 24hr ambulatory systolic (r = 0.556, p = 0.003) and diastolic (r = 0.484, p = 0.012) BP, and office systolic (r = 0.478, p = 0.014) and diastolic BP (r = 0.452, p = 0.020). Multiple regression analysis revealed that the acute effect of exercise was an independent predictor of the chronic effect on systolic BP (ß = 0.556, adjusted r2 = 0.280, p = 0.003) BP. Conclusions: The magnitude of the acute effect of exercise in BP correlates with the chronic decrease in both office and 24hr BP effects. These results suggest that it is possible to predict those patients that are less likely to improve BP with an exercise training program without the burden of a period of several months of intervention.

The Effects of Exercise Training on Cardiopulmonary Exercise Testing and Cardiac Biomarkers in Adult Patients with Hypoplastic Left Heart Syndrome and Fontan Circulation.

Background: Several studies have shown that adult patients with Hypoplastic Left Heart Syndrome (HLHS) and Fontan circulation have a reduced exercise tolerance that affects daily life. Recent studies have investigated the effects of aerobic exercise training in patients with univentricular heart; however, this research topic is still poorly studied. The aim of this study was to evaluate the effects of an aerobic exercise training program on cardiopulmonary exercise testing parameters and cardiac biomarkers in patients with HLHS. Methods: We enrolled 12 patients with a mean age of 24 ± 2.5 years (range 22–27 years), 50% male, with HLHS at Bambino Gesù Children’s Hospital IRCCS. All patients underwent a cardiopulmonary test and blood sampling before (T0) and after (T1) a 4-week aerobic exercise program. Cardiac biomarkers hs-cTnT, NT-proBNP, ST2, GDF-15 were studied. Results: Data analysis demonstrated an increase in cardiorespiratory performance after 4 weeks of aerobic exercise training activity. In particular, the data showed a significant improvement in test duration (p < 0.05), heart rate at rest (p < 0.05), heart rate recovery 1 min (p < 0.05), VO2 max (p < 0.01) and oxygen uptake efficiency slope (p < 0.05). At the same time, the data showed a significant reduction in NT-proBNP and ST2 values (p < 0.01 and p < 0.05, respectively) and a significant increase in GDF-15 (p < 0.01). No significant changes were found between the hs-cTnT values. Conclusions: Our study demonstrated the 4-week efficacy of an aerobic training program in improving cardiorespiratory performance and cardiac biomarker values in adult patients with HLHS and Fontan circulation. More studies with larger numbers of patients will be needed to confirm these data.

Effects of different exercise training programs on the functional performance in fibrosing interstitial lung diseases: A randomized trial.

We aimed to compare the effects of different aerobic exercise training (ET) programs on respiratory performance, exercise capacity, and quality of life in fibrosing interstitial lung diseases (f-ILD). A case-control study where 31 patients with f-ILD diagnosis based on chest high-resolution computed tomography were recruited from Main Alexandria University hospital-Egypt. Ten patients were randomly assigned for only lower limbs (LL) endurance training program, and 10 patients for upper limbs, lower limbs, and breathing exercises (ULB) program for consecutive 18 sessions (3 sessions/week for 6 consecutive weeks). Eleven patients who refused to participate in the ET program were considered as control. All patients were subjected for St George's respiratory questionnaire (SGRQ), 6-minute walk test (6-MWT), forced spirometry and cardiopulmonary exercise testing (CPET) before and after ET programs. Fibrosing non-specific interstitial pneumonia (NSIP) and collagenic associated-ILD were the commonest pathologies among the ET groups (30% each) with mean age of 44.4±12.25 and 41.90±7.58 years for LL and ULB groups respectively and moderate-to-severe lung restriction. 6-MWT and SGRQ significantly improved after both ET programs (p<0.001). Peak oxygen consumption (VO2) improved significantly after both LL training (median of 22 (interquartile range (IQR) = 17.0-24.0) vs. 17.5 (IQR = 13.0-23.0) ml/kg/min, p = 0.032) and ULB training (median of 13.5 (IQR = 11.0-21.0) vs. 10.5 (IQR = 5.0-16.0) ml/kg/min, p = 0.018). Further, maximal work load and minute ventilation (VE) significantly improved after both types of ET training (p<0.05); however, neither ventilation equivalent (VE/VCO2) nor FVC% improved after ET (p = 0.052 and 0.259 respectively). There were no statistically significant important differences between LL and ULB training programs regarding 6-MWT, SGRQ or CPET parameters (p>0.05). ET was associated with improvements in exercise capacity and quality of life in f-ILD patients irrespective of the type of ET program provided.

The effect of a 6-month intradialytic exercise program on hemodialysis adequacy and body composition: a randomized controlled trial.

End-stage kidney disease (ESKD) is strongly associated with factors that aggravate the physical activity level and body composition status of hemodialysis patients (HD). Even though exercise in HD patients have shown remarkable benefits on hemodialysis adequacy, it is yet inconclusive if exercise can positively affect body composition parameters or if dialysis adequacy may affect body composition status. This study aimed to investigate the effect of a 6-month intradialytic exercise training program on dialysis adequacy indices and body composition parameters in HD patients. A total of 24 HD patients were randomly assigned into two equally sized groups. The exercise group (EX group) participated in a 6-month intradialytic moderate-intensity aerobic exercise training program at the beginning of the HD sessions, three times a week for 60min, and maintained a Borg's Rating of Perceived Exertion score between 13 and 14. The Control group (C group) remained untrained. At baseline, during, and at the end of the 6-month study, we assessed single-pool Kt/V, urea reduction ratio (URR), and body composition parameters, such as extracellular water (ECW)/ intracellular water (ICW) ratio, body mass index (BMI) and lean tissue mass (LTM). In all patients, the 6-min-walking test (6MWT) was performed as a marker of physical performance. A significant increase of both Kt/V (increase by 19%, p = 0.01), and URR (increase by 7%, p = 0.03) values has been observed in the EX group after the 6-month training program. Similarly, a statistically significant increase in 6MWT distance (from 442 ± 67m to 481 ± 68m, p = 0.02) in the EX group has also been found, compared to the C group (from 393 ± 59m to 427 ± 81m, p = 0.06). Neither EX nor C group has shown significant changes in body composition parameters. After training, linear regression analysis revealed a strong positive correlation between Kt/V and 6MWT changes (r = 0.74, p = 0.04) in the EX group. Six months of intradialytic aerobic exercise might increase dialysis adequacy, by increasing Kt/V and URR, and physical performance, regardless of changes in body composition indices.

Aerobic Exercise Training Effects on Omentin-1, Insulin Resistance, and Lipid Profile Among Male Smokers

ABSTRACT Background: Omentin-1 is a circulating adipokine that can serve as a biomarker for assessment of metabolic risk factors. We investigated the effect of eight weeks of aerobic exercise training on serum omentin-1, insulin resistance and lipid profile in nonsmokers and smokers. Methods: Nineteen male nonsmokers (aged 27.88 ± 2.47 years, and with BMI of 22.69 ± 1.77 kg.m−2) and twenty male smokers (aged 30.11 ± 1.96 years, and with BMI of 23.12 ± 1.91 kg.m−2) were randomly assigned into nonsmokers control group (C), nonsmokers exercise group (E), control smoker group (CS), and exercise smoker group (ES). Exercise groups participated in an eight-week aerobic exercise training program (three times a week, 20–35 min per session at 55%-70% of maximum heart rate). Serum omentin-1 and insulin values were determined by ELISA. The Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), glucose level and lipid profile were measured before and after the intervention. Pearson correlation test, Eta test, paired samples t-test, one and two-way analysis of variance (ANOVA) and post-hoc Tukey test were applied for data analysis (p < .05). Results: Aerobic exercise improved both serum omentin-1 and high lipoprotein cholesterol (HDL-C) in the exercise groups (P < .05). Also, exercise training reduced insulin, glucose, HOMA-IR, triglyceride (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels (p < .05). Omentin-1 was significantly correlated with glucose, insulin, HOMA-IR, TG, TC, LDL-C and HDL-C in both nonsmokers and smokers. Conclusions: The findings suggest that aerobic exercise-induced changes in omentin-1 in the exercise-trained groups may be associated with the beneficial effects of exercise on reduced insulin resistance and lipid profile.

MO603: Effects of Intradialytic Bicycle Ergometer Exercise on Inflammation Transcription Factors in Patients with Chronic Kidney Disease

Abstract BACKGROUND AND AIMS Oxidative stress and inflammation are involved in the pathophysiological mechanisms in patients with chronic kidney disease (CKD) on hemodialysis (HD). In this context, the therapeutic potential of targeting the gene transcription factors associated with these mechanisms has been studied; for instance, nuclear factor erythroid 2-related factor 2 (Nrf2), the master regulator of antioxidant responses and, nuclear factor κappa B (NF-κB) that promotes the inflammatory response. However, the effects of physical exercise on the modulation of these factors are under investigation in CKD patients. Therefore, the aim of the present study was to evaluate the effects of an intradialytic aerobic exercise training program on the expression of transcription factors (Nrf2 and NF-κB) in patients with CKD on HD. METHODS This is a longitudinal, randomized clinical trial with a washout period and crossover performed with 18 patients randomized into two groups: Exercise (individualized intradialytic aerobic exercise on an adapted stationary exercise bike) three times per week for 3 months and control (without exercise). After the washout period (1 month), the exercise group became the control, and the other group performed the exercises for another 3 months. Peripheral blood mononuclear cells (PBMCs) were isolated, and quantitative real-time PCR analysis was performed to evaluate Nrf2, NF-kB and NAD(P)H: quinone oxidoreductase-1 (NQO1) mRNA expression. The plasma levels of inflammatory cytokines, tumour necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6) were evaluated by ELISA. RESULTS Eighteen patients [11 men, 44.1 ± 8.4 years, 17.3 (6.6–124) months on HD] completed all the study. The obtained data revealed that the intervention did not affect the mRNA expression of Nrf2, NQO1 and NF-κB (Table 1). Also, TNF-α levels were not changed. However, IL-6 showed a tendency to decrease after the exercise intervention (P = 0.054). CONCLUSION Three months of intradialytic aerobic exercise were insufficient for modulating the transcription factors associated with antioxidant activity (Nrf2 and NQO1) and inflammation (NF-κB) in patients with CKD.

Fitness Changes in Adolescent Girls Following In-School Combined Aerobic and Resistance Exercise: Interaction With Birthweight.

To assess the efficacy of a supervised in-school combined resistance and aerobic training program in adolescent girls and investigate whether responses differ according to birthweight. Participants (girls aged 13-17y) were randomized either to an intervention replacing physical education (PE) classes with 2 × 60-minute training sessions per week (n = 58) or to a control group that continued to attend 2 × 60minutes per week of curriculum PE (n = 41). We measured muscular fitness (handgrip, standing long jump, and sit-ups), cardiorespiratory fitness (20-m shuttle run), skinfolds, and lean body mass preintervention and postintervention and determined effect size (Hedge's g) differences between changes in these measures. We also compared changes within lower (<3000g) and normal birthweight intervention and PE control subgroups. The intervention group showed greater improvements in all the fitness measures and lean body mass (g = 0.22-0.48) and lower skinfold increases (g = 0.41) than PE controls. Within the intervention group, improvements in all fitness measures were largerin lower birthweight (g = 0.53-0.94) than in normal birthweight girls (g = 0.02-0.39). Replacing curriculum PE with supervised training improved muscular and cardiorespiratory fitness and body composition outcomes in adolescent females. Our findings suggest an enhanced adaptive response to training in participants with lower birthweight which warrants further investigation.

Change of Fibroblast Growth Factor 21 Level Correlates with the Severity of Diabetic Sensory Polyneuropathy after Six-Week Physical Activity.

Diabetic neuropathy (DN) is a very frequent microvascular complication of type 2 diabetes mellitus (T2DM). Obesity and physical inactivity are well-known risk factors for T2DM. Fibroblast growth factor 21 (FGF21) is a liver-secreted hormone with several beneficial effects on obesity-related metabolic disorders. We aimed to investigate the effect of short-term physical activity on the levels of FGF21, and its correlation with the severity of peripheral sensory polyneuropathy in T2DM patients. Thirty patients with DN were enrolled in the study, compared to age- and gender-matched controls. We conducted a six-week aerobic training program, which meant treadmill and cycle ergometers three times a week. Anthropometric and laboratory parameters were measured for each patient before and after intervention. Serum levels of FGF21, TNF-alpha, irisin, leptin and adiponectin were measured by ELISA. The sensory perception threshold (CPT) was quantitatively measured using Neurometer®. We found significant decreases in BMI, waist circumference, HbA1c and TNF-alpha levels. From baseline to six-week follow-up, FGF21 levels were significantly increased in DN patients. Significant negative correlations were shown between the changes in FGF21 levels and BMI, between changes in FGF21 and the improvement of CPT values, and between the changes in FGF21 and TNF-alpha levels. There was no difference in irisin, adiponectin and leptin levels in DN patients after aerobic training program. The physical activity may increase the level of FGF21 in T2DM patients with neuropathy. Our results highlight the importance of regular physical activity in the treatment of diabetic neuropathy.

Changes in health-related quality of life, motivation for physical activity, and the levels of anxiety and depression after individualized aerobic training in subjects with metabolic syndrome

ObjectiveNumerous studies associate metabolic syndrome (MetS) with poor life quality, depression, and anxiety. Aerobic exercise training has proven its value in promoting health among subjects with MetS. We aimed to evaluate the changes in health-related quality of life (HRQOL), motivation for physical activity, and the levels of anxiety and depression in subjects with MetS after individualized aerobic training. MethodsA total of 140 subjects with MetS (53.2 ± 6.8 years, 55% female) were analyzed after the random assignment to the intervention (n = 84) or the control group (n = 56). Only the intervention group participated in the 8-week HR targeted aerobic training program, which consisted of exercises on a cycle ergometer for 30‑40 min/day, 5 days/week. In all study participants HRQOL, motivation for physical activity, anxiety and depression levels were evaluated by the Medical Outcomes Study 36-Item Short-Form Health Survey, the Exercise Motivations Inventory-2, and the Hospital Anxiety and Depression scale before and after 8 weeks. ResultsAfter 8 weeks, self-reported physical functioning significantly increased only in the intervention group (p = 0.01). The scores of mental health-summary and role limitations due to emotional problems also improved in subjects with MetS, who participated in the aerobic training program (p < 0.001, p = 0.009, respectively). The scores for social engagement motive, enjoyment and revitalization motive, and fitness motive to exercise increased (p = 0.003, p < 0.001, p = 0.023, respectively), whereas the level of depression reduced only in the intervention group (p = 0.021). ConclusionsThe 8-week individualized aerobic training had a positive effect on HRQOL, motivation for physical activity, and the level of depression in subjects with MetS.

The effects of aerobic exercsie program on the bilateral coordination of preschool children

The aim of this study was to determine the effects of aerobic exercise program on the bilateral coordination of preschool children. The boys and girls (n = 60), aged five to six, were randomly assigned to the experimental group (n = 30) or the control group (n = 30). The children in the experimental group were involved in aerobic training program over a 12-week period. Three training sessions were performed per week, lasting 30 minutes each. For the evaluation of children’s coordination, the Bilateral Coordination subtest from the BOT-2 (Bruininks- Oseretsky Test of Motor Proficiency) battery of tests was used. The children completed seven different tasks, both at the initial and the final measurement, which were further used to calculate the total score. To determine the changes in bilateral coordination, the two-factor (group × time) univariate analysis of variance (ANOVA) was used, while the effect size, presented by the partial Eta squared, was calculated for each task and the total score. A nonsignificant effect (p = .280) was observed for the task “Touching Nose with Index Fingers - Closed Eyes”, whereas a significant improvements in all the other tasks and the total score were found in the intervention group (p &lt; .05). The magnitude of effect size ranged from medium to large. The findings indicate that the aerobic exercise program contributes to the development of bilateral coordination in preschool children.

Hematological responses of HIV-seropositive patients to aerobic and resistance exercise training programs

This study investigated the alterations of haematologic parameters of HIV-positive patients due to a 10-week aerobic and resistance exercise training. The study examined the influence of aerobic and resistance exercises on White Blood Cells (WBC), Red Blood Cells (RBC), Haematocrit (HCT), and Platelets (PLT). The pretest-posttest control-group experimental design was employed in this study. Eighty-eight HIV-seropositive patients in the first two stages of HIV and attending the outpatient clinic at the University of Benin Teaching Hospital participated in the study. Randomization was done into control (30) and two experimental groups, aerobic exercise (28) and resistance exercise (30). The experimental groups exercised for 45 minutes, thrice a week for 10 weeks and the non-experimental group received usual anti-retroviral drugs and counseling. The initial intensity of the exercise was 60% HRmax and 1-RM and progression was by 10% every 3 weeks. Haematologic parameters were recorded initially and on termination of 10 weeks for all three groups. Frequency, mean, standard deviation, and analysis of co-variates (ANCOVA) were used for data analysis. The Bonferroni pairwise comparison was used as a Post-hoc test to identify the source of differences. The outcome of this research showed that exercise resulted in significant alterations in haematologic parameters of WBC, RBC, HCT, and PLT. Recommendations were made based on the outcome of this research that health personnel should prescribe exercise for HIV-infected persons due to the enhancement of haematologic parameters which in turn improves health.

The effects of early rehabilitation on functional exercise tolerance in decompensated heart failure patients: Results of a multicenter randomized controlled trial (ERIC-HF study)

Objective To analyze (1) the effect of an aerobic training program on functional exercise tolerance in decompensated heart failure (DHF) patients; (2) to assess the effects of an aerobic training program on functional independence; and (3) dyspnea during activities of daily living. Design A randomized controlled clinical trial with follow-up at discharge. Settings Eight hospitals. Recruitment took place between 9/ 2017 and 3/2019. Group Assignments Patients with DHF who were admitted to the hospital, were randomly assigned to usual rehabilitation care guideline recommended (control group) or aerobic training program (exercise group). Main outcome Functional exercise tolerance was measured with a 6-min walking test at discharge. Results In total 257 patients with DHF were included, with a mean age of 67 ± 11 years, 84% (n = 205) had a reduced ejection fraction and the hospital stay was 16 ± 10 days. At discharge, patients in the intervention group walked further compared to the control group (278 ± 117m vs 219 ± 115m, p < 0.01) and this difference stayed significant after correcting for confounders (p < 0.01). A significant difference was found favoring the exercise group in functional independence (96 ± 7 vs 93 ± 12, p = 0.02) and dyspnea associated to ADL (13 ± 5 vs 17 ± 7, p < 0.01) and these differences persisted after correcting for baseline values and confounders (functional independence p < 0.01; dyspnea associated with ADL p = 0.02). Conclusion The ERIC-HF program is safe, feasible, and effective in increasing functional exercise tolerance and functional independence in hospitalized patients admitted due to DHF.

Impact of 12-Week Moderate-Intensity Aerobic Training on Inflammasome Complex Activation in Elderly Women.

Aging often associates with a chronic low-grade inflammatory status that can be consequent to the activation of Toll-like receptors (TLRs) and the downstream NLR family pyrin domain containing 3 (NLRP3) inflammasome and causes a chronic secretion of pro-inflammatory cytokines. Since exercise has known anti-inflammatory effects, we investigated the effect of Nordic walking training on inflammasome activation and downstream effectors in elderly women. A population of elderly women was divided into EXP (n = 29) that completed 12 weeks of the moderate-intensity aerobic training program and CTRL (n = 29), performing no activity. Blood samples were taken before and after the first (T1-pre and T1-post, respectively) and last (T2-pre and T2-post, respectively) exercise unit. Inflammasome activation status was assessed by whole blood NLRP3 and TLR4 expression by RT-qPCR. Serum levels of IL-1β, IL-6, TNFα, and IL-18 cytokines were assayed by multiplex fluorescent beads-based immunoassays or ELISA. NLRP3 and TLR4 levels were reduced 2 folds between T1-pre and T2-pre and induced at T2-post, compared to T2-pre, by 2.6- and 2.9-fold, respectively. A single exercise bout elicited a 1. 38-, 1. 5-, and 1.36-fold rise of IL-1β, TNFα, and IL-6 concentration, respectively, although not significant, at the beginning of the training (T1-pre vs. T1-post), a 1.4-fold decrease for IL-1β and TNFα at the end of the training (T1-pre vs. T2-pre), and a 2-, 1.8- and 1.26-fold increase after the last exercise session (T2-pre vs. T2-post) for the three cytokines. When stratifying the population based on BMI in normal weight (NW) and overweight (OW), NLRP3 and TLR4 expression was affected only in NW. As for inflammatory cytokines, IL-1β was modulated in NW at the beginning of the training, whereas in OW at the end of the training; for TNFα, this time-dependent modulation was significant only in OW. Applied aerobic training affected the resting expression of inflammasome constituents (NLRP3 and TLR4) and levels of downstream effectors (IL-1β, TNFα, and IL-6). However, at the end of the program, participants acquire an acute inflammatory response to exercise that was absent at baseline. Future studies would have to define the molecular mechanisms associated with, and how to potentiate, the exercise-associated inflammatory response.

Abstract OT2-13-01: Supervised training exercise program during chemotherapy for breast cancer (STRENGTH) trial

Abstract Background: Chemotherapy for breast cancer can have a detrimental effect on cardiorespiratory fitness. VO2max (maximal oxygen consumption measured during exercise) is a key predictor of cardiovascular risk and has been found to be lower in women with a history of breast cancer compared with healthy women. Chemotherapy is associated with a decrease in VO2max but these decreases may be attenuated with exercise training, such as resistance, aerobic and high-intensity interval training programs. Physical activity may reduce the risk of mortality for breast cancer patients, improve quality of life (QoL) and reduce weight. All gyms and fitness studios had to close due to the COVID-19 pandemic, and while some have re-opened, many patients are not comfortable returning to an exercise facility now and are incorporating virtual exercise into their routine. Prior studies have demonstrated the safety, feasibility and potential benefits of home-based exercise programs for breast cancer patients receiving chemotherapy. However, many of these programs are self-reported, which can create bias and to our knowledge, there is no existing data on the effect of home-based exercise programs for breast cancer patients receiving neoadjuvant chemotherapy. The goal of the STRENGTH Trial is to evaluate the effect of a 12-week virtual supervised exercise program in breast cancer patients receiving chemotherapy on cardiorespiratory fitness. Study Description: This is a single-center, prospective, single-arm study designed to evaluate the effect of a virtual supervised exercise training program in breast cancer patients receiving chemotherapy on cardiorespiratory fitness. All participants are assigned to a 12-week virtual supervised exercise program and asked to complete a total of 150 minutes of moderate intensity physical activity per week, as a combination of a weekly virtual personal training session and workout classes streamed from the Peloton®Digital platform (i.e. walking, running, cardio, yoga, strength training, and cycling classes). Due to the ongoing COVID-19 pandemic, cardiorespiratory fitness cannot be assessed using a cardiopulmonary exercise test. As such, the co-primary endpoints are resting blood pressure and heart rate and distance walked during a Six-Minute Walk Test (6MWT), which is measured at the start and completion of the 12-week supervised exercise program. Secondary endpoints are QoL as assessed by the Functional Assessment of Cancer Therapy - General (FACT-G) and symptom management assessment by the MD Anderson Symptom Inventory (MDASI). Several exploratory clinical endpoints will be collected including adherence to the program, type of fitness classes completed, and treatment toxicities. Eligibility Criteria: Patients aged ≥18 years with stage I to IV breast cancer who are planned to receive at least 12 weeks of chemotherapy of investigator’s choice are eligible for inclusion. Patients who have an ejection fraction on echocardiogram &amp;lt;40%, symptomatic heart failure, myocarditis, myocardial infarction, cerebrovascular accident, pulmonary embolism or COVID-19 infection within past 3 months, severe, uncorrected valvular disease, uncontrolled hypertension and/or uncontrolled arrhythmias are excluded. Statistical Methods: Continuous and categorical variables measured in this study will be summarized. The distributions of the data collected in the study participants from the 6MWT, FACT-G and MDASI will be evaluated. Based upon the findings, either paired t-tests or nonparametric Wilcoxon signed-rank tests will be performed to analyze the differences observed between the pre-exercise intervention data and the post-exercise intervention data. P values &amp;lt;= 0.05 will be considered statistically significant. . Accrual: At this time, 20 patients have enrolled out of a planned 30 participants. Citation Format: Eleonora Teplinsky, Amanda Podolski, Benita Burke, Kasey Bessada, Laura Klein, Moira Christoudias, Kariann Abbate. Supervised training exercise program during chemotherapy for breast cancer (STRENGTH) trial [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr OT2-13-01.

Effects of twelve-week aerobic exercise on selected health-related physical fitness variables on Gonji preparatory school male students

The purpose of the present study was to investigate the effect of twelve-week aerobic exercise on health-related physical fitness components of grade eleven Gonjy preparatory school male students. The study employed an experimental research design. A simple random sampling method was used to select 30 sample students from the 242 total populations and classify them randomly into two equal experimental and control groups (n = 15). The Control group had participated in regular physical education one class of 40-minute per week in the school, but the experimental group participated additional three sessions per week for 60 minutes aerobic exercise training program, which comprised walking, jogging, running, rope skipping, and aerobic dance. Experimental and control groups had taken pre and post-test cardiorespiratory fitness, body composition, muscular endurance, muscular strength, and flexibility measured using cooper test, three-minute step test, using body mass index formula, siting tuck, chin up and sit &amp; reach test respectively. The data collected from the study groups were analyzed by using Statistical Package for Social Science version 23 software and computed independent t-test and paired t-test and the level of significance was set at 0.05 levels. The results revealed in independent and paired t-test analysis of 12-week aerobic exercise training has significantly changed on cardiorespiratory fitness (p=0.001), muscular endurance (p=0.001) flexibility (independent p=0.04 paired p=0.02), and body mass index (p=0.001). But no significant change was observed on muscular strength in experimental and control groups of independent t-test (p=0.534 and p=0.41) and paired t-test (p=0.43 and p=0.33). Based on the finding, it was concluded that the 12 weeks aerobic exercise training program for three days per week schedule has been advantageous for the improvement of students’ health-related physical fitness variables. &#x0D; &#x0D; &#x0D; &#x0D;

Differential Expression of Genes Associated with Chromatin Modifications in Skeletal Muscle during Aerobic Training Program

Introduction: Skeletal muscle plasticity in exercise can be modulated by epigenomic events such as gene silencing, histone modifications and DNA methylation. In this context, our objective was to analyze the expression of genes associated with chromatin modifications in human muscle biopsies of vastus lateralis after a 20 week training program. Methods: Using data from DNA microarray experiments registered in the NCBI GEO DataSet database GSE117070, we calculated the Z ratio values as the criterion to evaluate the differential expression of genes associated with chromatin modification during aerobic training in skeletal muscle. Using the web interface GENEMANIA, we built a co-expression interaction network with the overexpressed genes. We compared Z-score values obtained from pre-trained and post-trained samples through nonparametric tests. Results: We found 10 overexpressed genes after the 20 week training program, namely, EZH1, KMT2A, KMT2D, KDM4C, KDM6A, CREBBP, HDAC10, HDAC4, DNMT3L, and H2AX. The most relevant biological processes obtained from the network included chromatin organization (FDR 9.04 × 10−9) and histone modification (FDR 9.04 × 10−9). Conclusions: In skeletal muscle, after aerobic training, there is overexpression of genes associated with the modification of the chromatin through alterations in histones and DNA, resulting in epigenetic transcriptional changes.

Quality of life responses after combined and aerobic water-based training programs in older women: a randomized clinical trial (ACTIVE Study).

Quality of life (QoL) is an important health index for older adults. The aim of this study was to compare the effects of 16weeks of aerobic training to 8weeks of aerobic followed by 8weeks of combined (i.e., resistance and aerobic exercises) training, as well as to a control group on the QoL of older women exercising in the aquatic environment. 52 older women were first randomized to either aerobic training (n = 35) or a control group (n = 17). After 8weeks of intervention, participants initially assigned to the aerobic training group were again randomized to either 8 additional weeks of aerobic (n = 17) or combined training (n = 18). Aerobic training was performed at the heart rate percentage associated with the anaerobic threshold, while resistance training sets were performed at maximal effort. The control group performed low-intensity water-based therapeutic exercises. QoL was assessed before (week 0) and after the intervention (week 17) using the WHOQOL-BREEF and WHOQOL-OLD questionnaires. Generalized Estimating Equations (GEE) and Bonferroni post hoc tests (α = 0.05) were used to compare time points and groups. QoL improved significantly only in the training groups after the 16-week training intervention, whereas it remained unchanged in the control group. In addition, autonomy, environment, and present, past and future activities domains were more impacted after combined training. QoL improved only in the water-based training groups, and the addition of resistance exercises to the training program resulted in additional benefits to autonomy, environment, and past, present, and future activities domains. Clinical Trials NCT03892278.

Exercise Intolerance, Benefits, and Prescription for People Living With a Fontan Circulation: The Fontan Fitness Intervention Trial (F-FIT)-Rationale and Design.

Background: Despite developments in surgical techniques and medical care, people with a Fontan circulation still experience long-term complications; non-invasive therapies to optimize the circulation have not been established. Exercise intolerance affects the majority of the population and is associated with worse prognosis. Historically, people living with a Fontan circulation were advised to avoid physical activity, but a small number of heterogenous, predominantly uncontrolled studies have shown that exercise training is safe—and for unique reasons, may even be of heightened importance in the setting of Fontan physiology. The mechanisms underlying improvements in aerobic exercise capacity and the effects of exercise training on circulatory and end-organ function remain incompletely understood. Furthermore, the optimal methods of exercise prescription are poorly characterized. This highlights the need for large, well-designed, multi-center, randomized, controlled trials.Aims and Methods: The Fontan Fitness Intervention Trial (F-FIT)—a phase III clinical trial—aims to optimize exercise prescription and delivery in people with a Fontan circulation. In this multi-center, randomized, controlled study, eligible Fontan participants will be randomized to either a 4-month supervised aerobic and resistance exercise training program of moderate-to-vigorous intensity followed by an 8-month maintenance phase; or usual care (control group). Adolescent and adult (≥16 years) Fontan participants will be randomized to either traditional face-to-face exercise training, telehealth exercise training, or usual care in a three-arm trial with an allocation of 2:2:1 (traditional:telehealth:control). Children (<16 years) will be randomized to either a physical activity and exercise program of moderate-to-vigorous intensity or usual care in a two-arm trial with a 1:1 allocation. The primary outcome is a change in aerobic exercise capacity (peak oxygen uptake) at 4-months. Secondary outcomes include safety, and changes in cardiopulmonary exercise testing measures, peripheral venous pressure, respiratory muscle and lung function, body composition, liver stiffness, neuropsychological and neurocognitive function, physical activity levels, dietary and nutritional status, vascular function, neurohormonal activation, metabolites, cardiac function, quality of life, musculoskeletal fitness, and health care utilization. Outcome measures will be assessed at baseline, 4-months, and 12-months. This manuscript will describe the pathophysiology of exercise intolerance in the Fontan circulation and the rationale and protocol for the F-FIT.