Benefits Of Exercise For Adults Research Articles

Characteristics of the Differential Response to Exercise in Adults with Restless Legs Syndrome

Objective/Background: Restless legs syndrome (RLS) is a prevalent, sensorimotor sleep disorder characterized by the irresistible urge to move that is temporarily relieved by movement. Despite evidence for the benefits of exercise in RLS, inter-individual variation in the response to exercise exists, whereby some people experience symptom improvement while others report exacerbations. The present study examined factors that may account for differences in perceived responses to exercise in RLS. Patients/MethodsParticipants (N=527) completed a nationwide survey with items assessing RLS, physical activity, sedentary levels, and experiences with RLS responsiveness to exercise. Logistic regression analyses examined associations between individual characteristics (e.g., age, sex) and perceptions of improvement and exacerbation with exercise. Exploratory analyses examined characteristics associated with perceived positive responsiveness (i.e., exercise only improves RLS) or negative responsiveness (i.e., exercise only worsens RLS). ResultsOrdinal logistic regression identified lower RLS severity (OR=0.83,p=0.044), higher prevalence of a condition that could cause secondary RLS (OR=1.76,p=0.005), lower prevalence of periodic limb movements (OR=0.52,p=0.001), and higher physical activity levels (OR=1.47,p<0.001) as significant, independent predictors of exercise improving RLS symptoms. Individual feature ordinal logistic regression identified female sex as significantly associated with exercise exacerbating symptoms (OR=0.62,p=0.008). Exploratory logistic regression identified people with higher BMI (OR=0.69,p=0.019) and higher RLS severity (OR=0.70, p=0.026) had lower odds of being positive responders to exercise. ConclusionsThe present study presents factors that might account for individual differences in the response to exercise. Overall, our results suggest that milder cases of RLS (lower severity, absence of PLMs), people with secondary forms of RLS, and those with a lower BMI may perceive exercise as more beneficial for symptoms. These should be considered in exercise-based management aimed at managing symptoms as the collective body of research supports the benefits of exercise in adults with RLS.

Inflammation and metabolism gene sets in subcutaneous abdominal adipose tissue are altered 1 hour after exercise in adults with obesity.

Although the health benefits of exercise in adults with obesity are well described, the direct effects of exercise on adipose tissue that may lead to improved metabolic health are poorly understood. The primary aims of this study were to perform an unbiased analysis of the subcutaneous abdominal adipose tissue transcriptomic response to acute exercise in adults with obesity, and to compare the effects of moderate-intensity continuous exercise versus high-intensity interval exercise on this response. Twenty-nine adults with obesity performed a session of either high-intensity interval exercise (HI; 10 × 1 min at 90%HRpeak, 1 min recovery between intervals; n = 14) or moderate-intensity continuous exercise (MI; 45 min at 70%HRpeak; n = 15). Groups were well matched for BMI (HI 33 ± 3 vs. MI 33 ± 4 kg/m2), sex (HI: 9 women vs. MI: 10 women), and age (HI: 32 ± 6 vs. MI: 29 ± 5). Subcutaneous adipose tissue was collected before and 1 h after the session of HI or MI, and samples were processed for RNA sequencing. Gene set enrichment analysis revealed 7 of 21 gene sets enriched postexercise overlapped between HI and MI. Interestingly, both HI and MI upregulated gene sets involved in inflammation (IL6-JAK-STAT3 signaling, allograft rejection, TNFα signaling via NFκB, and inflammatory response; FDR q value < 0.25). Exercise also downregulated adipogenic and oxidative metabolism gene sets in both groups. Overall, these data suggest genes involved in subcutaneous adipose tissue metabolism and inflammation may be an important part of the initial response after a session of exercise.NEW & NOTEWORTHY This study compared the effects of a single session of high-intensity interval exercise versus moderate-intensity continuous exercise on transcriptional changes in subcutaneous abdominal adipose tissue collected from adults with obesity. Our novel findings indicate exercise upregulated inflammation-related gene sets, while it downregulated metabolism-related gene sets - after both high-intensity and moderate-intensity exercise. These data suggest exercise can alter the adipose tissue transcriptome 1 h after exercise in ways that may impact inflammation and metabolism.

Supervised Exercise Immediately After Bariatric Surgery: the Study Protocol of the EFIBAR Randomized Controlled Trial

BackgroundPrevious studies have investigated weight loss caused by exercise following bariatric surgery. However, in most cases, the training program is poorly reported; the exercise type, volume, and intensity are briefly mentioned; and the sample size, selection criteria, and follow-up time vary greatly across studies.PurposeThe EFIBAR study aims to investigate over 1 year the effects of a 16-week supervised exercise program, initiated immediately after bariatric surgery, on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, and quality of life in patients with severe/extreme obesity.Material and MethodsThe EFIBAR study is a parallel-group, superiority, randomized controlled trial (RCT), comprising 80 surgery patients. Half of the participants, randomly selected, perform a 16-week supervised exercise program, including both strength and aerobic training, starting immediately after the surgery (7–14 days). For each participant, all primary and secondary outcomes are measured at three different time points: (i) before the surgery, (ii) after the intervention (≈4 months), and (iii) 1 year after the surgery.ConclusionThe EFIBAR study will provide new insights into the multidimensional benefits of exercise in adults with severe/extreme obesity following bariatric surgery.Trial RegistrationEFIBAR randomized controlled trial was prospectively registered at Clinicaltrials.gov (NCT03497546) on April 13, 2018.Graphical abstract

Establishing physical activity in breast cancer: self-report versus activity tracker.

Establishing accurate estimates of physical activity at baseline is essential for interventions assessing the potential benefits of exercise in adults with cancer. This study compares self-reported physical activity with independent data from activity trackers in women with early breast cancer (BC) recruited into a "walking" intervention during chemotherapy. Baseline (pre-intervention) questions inquired about self-reported physical activity-number of walking days/week and minutes/day-in women who were initiating chemotherapy for Stage I-III BC. Activity trackers measured steps per day during the first full week of chemotherapy. Weighted Kappa statistic and Pearson correlation coefficients were used to evaluate agreement and association between self-reported and objectively tracked physical activity levels, respectively. Univariate analyses were conducted to identify variables that may influence congruence between the two measures. In a sample of 161 women, 77% were white, with mean age 56years. Agreement between self-reported and objectively tracked physical activity was "fair" (kappa coefficient = 0.31), with most patients (59%) over-reporting their physical activity levels. There was weak correlation between the two measures (r = 0.24); however, correlation was strong in participants who were not married (r = 0.53) and/or living alone (r = 0.69). Objective methods for assessing physical activity (activity trackers, accelerometers) should be used as a complement to self-reported measures to establish credible activity levels for intervention studies seeking to increase physical activity and/or measure the impact of increased physical activity in women with breast cancer.

Provider Perspectives on Exercise in Children with Type 1 Diabetes

Background: The benefits of exercise for adults with type 1 diabetes (T1D) are well known but literature in children is limited creating knowledge deficits for pediatric providers and patients. The objective of this study was to determine provider awareness of guidelines, current practices and barriers to counseling during visits. Methods: Members of the Pediatric Endocrine Society were asked to take an online survey including questions about provider demographics and perspectives on exercise counseling for children with T1D. Descriptive analyses were performed. Results: A total of 80 providers completed the survey. The majority practice in an urban setting (69%) at academic medical centers (82%). Of respondents, 54% reported they were unaware of exercise guidelines from the American Diabetes Association (ADA) that suggest 60 minutes of exercise daily. Of those who reported awareness, 16 of 37 identified them correctly but only 7 of the 16 reported recommending them clinically. Most providers (40%) reported recommending at least 30 minutes of exercise 5 days per week. The majority reported exercise counseling should be a priority at all visits (55% strongly agree, 30% agree) and cited barriers to counseling were: presence of more pressing issues (76%) and lack of time (61%). Respondents reported cardiovascular health (85%), improved insulin sensitivity (68%) and weight control (56%) as the most important exercise benefits. Conclusions: Pediatric endocrinologists report exercise counseling is important for patients with T1D but time barriers to counseling exist for the majority. Counseling tools that require less time during clinical visits may be beneficial to providers and patients. Also, even respondents who were aware of current guidelines reported recommending shorter periods of exercise. The reason for this discrepancy is unknown but it may reflect the desire to recommend more realistic goals. Further research about the benefits of shorter periods of exercise in this population is needed. Disclosure J. Ilkowitz: None. M. Gallagher: None.

The steps to health randomized trial for arthritis: a self-directed exercise versus nutrition control program.

Despite the established benefits of exercise for adults with arthritis, participation is low. Safe, evidence-based, self-directed programs, which have the potential for high reach at a low cost, are needed. To test a 12-week, self-directed, multicomponent exercise program for adults with arthritis. Randomized controlled trial. Data were collected from 2010 to 2012. Data were analyzed in 2013 and 2014. Adults with arthritis (N=401, aged 56.3 [10.7] years, 85.8% women, 63.8% white, 35.2% African American, BMI of 33.0 [8.2]) completed measures at a university research center and participated in a self-directed exercise intervention (First Step to Active Health(®)) or nutrition control program (Steps to Healthy Eating). Intervention participants received a self-directed multicomponent exercise program and returned self-monitoring logs for 12 weeks. Self-reported physical activity, functional performance measures, and disease-specific outcomes (arthritis symptoms and self-efficacy) assessed at baseline, 12 weeks, and 9 months. Participants in the exercise condition showed greater increases in physical activity than those in the nutrition control group (p=0.01). Significant improvements, irrespective of condition, were seen in lower body strength, functional exercise capacity, lower body flexibility, pain, fatigue, stiffness, and arthritis management self-efficacy (p values<0.0001). More adverse events occurred in the exercise than nutrition control condition, but only one was severe and most were expected with increased physical activity. The exercise program improves physical activity, and both programs improve functional and psychosocial outcomes. Potential reasons for improvements in the nutrition control condition are discussed. These interventions have the potential for large-scale dissemination. This study is registered at Clinicaltrials.gov NCT01172327.

Exercise to preserve beta cell function in recent-onset type 1 diabetes mellitus (EXTOD) - a study protocol for a pilot randomized controlled trial

BackgroundExercise has a beta cell preserving effect in patients with type 2 diabetes. This benefit of exercise has not been examined in type 1 diabetes. Significant beta cell function is present at the time of diagnosis of type 1 diabetes and therefore studies of beta cell preservation are ideally conducted immediately after diagnosis.Many of the variables required to design and power such a study are currently unknown. The aim of EXTOD is to obtain the information required to design a formal study of exercise and beta cell preservation in newly diagnosed patients with type 1 diabetes.MethodsBarriers to exercise will initially be assessed in a qualitative study of newly diagnosed patients. Then, sixty newly diagnosed adult type 1 diabetes patients will be randomized to either conventional treatment or exercise, stratified on beta cell function and fitness. The exercise group will be encouraged to increase their level of activity to a minimum of 150 minutes of moderate to vigorous intensity exercise per week, aiming for 240 minutes per week of exercise for 12 months. Beta cell function will be measured by meal-stimulated C peptide. Primary outcomes are recruitment, adherence to exercise, loss to follow-up, and exercise levels in the non-intervention arm (contamination). The secondary outcome of the study is rate of loss of beta cell function.DiscussionThe outcomes of the EXTOD study will help define the barriers, uptake and benefits of exercise in adults newly diagnosed with type 1 diabetes. This information will enable design of a formal study to assess the effect of exercise on beta cell preservation in newly diagnosed patients with type 1 diabetes.Trial registrationCurrent controlled trials ISRCTN91388505

Hiv-associated lipodystrophy and exercise

As individuals affected by HIV/AIDS live longer due to the availability of HAART, the challenge to health care professionals is to manage and alleviate abnormalities associated with HAART. HIVlipodystrophy- altered body fat redistribution- is the most common stigmatising physical abnormality related to the use of HAART, which maybe alleviated by exercise participation. Currently, there is no reliable management standard care for HIV-associated lipodystrophy. However, there is sufficient evidence to support the benefits of exercise in adults with HIV infection. As various types of ARTs become available in the most HIV/AIDS stricken developing countries, there are inadequate studies to evaluate and promote exercise in alleviating HIV lipodystrophy and other related complications. The current paper reviews HIV-related lipodystrophy, related metabolic dysfunction, and the role of exercise in its management. The paper highlights the need to evaluate the effectiveness of exercise on HIV lipodystrophy syndrome. An emphasis needs to be put on raising awareness among health care professionals in Sub-Saharan Africa where the prevalence of HIV/AIDS is the highest in the world.

EXERCISE AND PREGNANCY OUTCOME AMONG URBAN, LOW INCOME, BLACK WOMEN

Despite the benefits of exercise for adults, there remain concerns about safety of exercise during pregnancy. This research assessed associations between exercise prior to and during pregnancy with pregnancy outcomes and complications in a sample of 922 urban, low income, Black women. Women ages 18 years and older were enrolled in this study at 5 hospital-based or affiliated prenatal clinics located in Baltimore City. At their first prenatal visit, women completed a questionnaire about participation in strenuous (eg jogging) and non-strenuous (eg walking) exercise for fun and fitness both prior to and during pregnancy. Pregnancy outcome data (birthweight and length of gestation) and complications were obtained from clinical records. Overall, 12.2% of infants were born low birthweight (2500 grams or less). The percentages born low birthweight were not significantly different between those who did not exercise during pregnancy (11.2%), those who participated only in strenuous exercise (10.5%), those who participated only in non-strenuous exercise (12.2%) and those who participated in both strenuous and non-strenuous exercise (18.2%) (p = .53). For the full sample, 13.7% of the infants were born preterm (less than 37 weeks gestation). There were no significant differences in percent born preterm between those who did not exercise during pregnancy (14.2%), those who participated only in strenuous exercise (15.8%), those who participated only in non-strenuous exercise (13.4%), and those who participated in strenuous and non-strenuous activities (12.7%) (p = .97). There were also no statistically significant differences in spontaneous pregnancy loss according to exercise participation. Finally, the occurrence of complications of pregnancy such as bleeding, hospitalization, or abruptio placentae did not vary significantly by exercise participation prior to or during pregnancy. These results suggest that participation in physical activity did not increase risk of poor pregnancy outcomes or clinical complications in this sample.