Cycle Ergometer Training Research Articles

Comprehensive assessment of the results of zorba dance-based rehabilitation in patients after myocardial infarction

Abstract Introduction Dance movement engages global muscle sequences of the human body, improves physical performance, and helps reduce stress and excessive muscle tension. Dance exercises allow you to better control your movement and muscles. Zorba Greek dancing as a form of physical activity brings benefits in the form of improved mental health, well-being and quality of life. Rehabilitation may contribute to improving cardiorespiratory fitness and mental condition in the group of patients after myocardial infarction. Aim of the study The aim of the study was to evaluate a rehabilitation program based on Zorba dance on selected clinical parameters in patients after myocardial infarction. Materials and methods The study included 99 patients after myocardial infarction who were rehabilitated for 5 weeks. Patients were enrolled into two groups. Group I (50 patients) performed cycle ergometer training and the Greek dance Zorba. Group II (49 patients) performed cycle ergometer training and rehabilitation exercises. At the beginning and after rehabilitation, patients' BMI, balance (scales: Tinetti, Berg, 30CST), gait (6MWT), psychophysical status (SF-36, WHO-5, FCIS), and breathlessness (mMRC scale) were assessed. Results After undergoing rehabilitation, there was a reduction in BMI (I vs. II p<0.01), improvement in balance on the Tinetti (I vs. II p<0.01) and Berg scale (I vs. II p<0.01), improvement in the 30CS test score (I vs. II p= 0.018), improvement in WHO-5 (I vs. II p< 0.01), and reduction in dyspnea (mMRC) (I vs. II p< 0.01) in the Zorba group. Conclusions Both methods of rehabilitation improve functional efficiency; However, rehabilitation with the use of Zorba dance additionally improves balance in patients after myocardial infarction.

Effect of Bicycle Ergometer Training and Nordic Walking Training on Improving Functional Exercise Capacity in Asthma Patients.

Introduction Asthma is a chronic respiratory condition characterized by inflammation of the airway leading to breathlessness. Exercise training has been recognized as a valuable component in the management of asthma, enhancing lung function and overall well-being. Bicycle ergometer training and Nordic walking are two distinct forms of exercise that have been shown to improve cardiovascular fitness and respiratory function. Despite the potential benefits of these exercises, limited research directly compares their efficacy in improving functional capacity specifically in asthma patients. The study thus aims to address this gap by providing personalized, tailored exercise programs for asthma patients. Methods A single-blinded experimental study using a simple random sampling method was conducted. A sample of 40 subjects was recruited for the study based on inclusion and exclusion criteria and were assigned into two groups. Group A subjects were trained with a bicycle ergometer and Group B subjects were trained with Nordic walking. The intervention was given to both groups for 12 weeks. The outcome measures used were the six-minute walk test, Modified Borg Scale, and Mini Asthma Quality of Life Questionnaire. Results A baseline analysis of outcome measures was done, which was followed up by a post-test analysis after 12 weeks. Pre-test and post-test data were compared using a paired t-test.Intergroup analysis was done by an independent t-test. Both groups showed significant improvement in post-test results. On comparing the two groups, Group A showed significant improvement as compared to Group B. Conclusion The study concludes that bicycle ergometer training is effective in improving functional capacity and enhancing the quality of life in asthma patients.

Effects of Different Protocols of Moderate-Intensity Intermittent Hypoxic Training on Mental Health and Quality of Life in Brazilian Adults Recovered from COVID-19: The AEROBICOVID Double-Blind Randomized Controlled Study

The aim of this study was to investigate the effects of different protocols of moderate-intensity intermittent hypoxic training in patients who had recovered from COVID-19 on quality of life (QoL) and mental health. The sample of this clinical trial-controlled double-blind study consisted of 67 participants aged 30–69 years, who were organized randomly according to Normoxia, Hypoxia, Hypoxia Recovery or Control Group. Eight weeks of cycle ergometer training were performed with a frequency of three training sessions per week in normoxic or hypoxic conditions (with or without hypoxic recovery). Health-related QoL and Mental Health Status were evaluated by 12-Item Short Form Survey and Depression Anxiety and Stress Scale instruments, respectively. All training groups improved the QoL’s physical dimensions (Baseline–Post: Normoxia Group 42.1 (11.0)–48.7 (7.0), Hypoxia Group 46.9 (11.8)–53.5 (6.6) and Hypoxia Recovery Group 45.8 (9.2)–51.1 (5.3)) and mental dimensions (Baseline–Post: Normoxia Group 48.8 (7.9)–54.6 (4.6), Hypoxia Group 45.2 (7.7)–53.2 (3.8) and Hypoxia Recovery Group 46.5 (9.7)–52.0 (9.9)). Regarding mental health outcomes, all training groups decreased depressive symptoms (66.7% Normoxia, 31.2% Hypoxia Recovery and 31% Hypoxia groups), anxiety symptoms (46.5% Normoxia, 45.9% Hypoxia Recovery and 39.5% in the Hypoxia groups) and stress symptoms (40.6% Normoxia, 36.3% Hypoxia Recovery and 22.1% Hypoxia groups). Significant statistical difference was not found between groups. Normoxic and hypoxic training showed a similar effect on QoL and the mental health of Brazilian adults who had recovered from COVID-19.

Medical Rehabilitation of Patients with Post-COVID-19 Syndrome-A Comparison of Aerobic Interval and Continuous Training.

Post-COVID-19 syndrome (PCS) is a multisystemic disorder marked by impaired physical performance as one lead symptom. Since it has been suggested that endurance training as part of medical rehabilitation may be effective in improving physical performance capacity in PCS, this study aimed to compare different modes of aerobic endurance training. A total of 110 PCS patients (49.3 ± 11.8 years; 38% women; time after infection = 260.2 ± 127.5 days) underwent detailed clinical screening including symptom-limited cardiopulmonary exercise testing at admission and after 4-6 weeks of inpatient medical rehabilitation. Questionnaires were used to assess disease perception. Patients performed controlled isocaloric cycle ergometer training (3-5 sessions/week; 18 min) as either continuous training (CT) at 50% of maximal workload or as interval training (IT; load = 60%, relief = 30%). Outcomes of PCS patients were compared to coronary artery disease patients (CAD; n = 96) to evaluate overall training effectiveness. Training participation was comparable between the groups, with no indication of training-specific exercise-induced fatigue. Overall, PCS patients improved significantly by a mean of 6.8 ± 12.1% for W at VT1; 3.1 ± 10.0% for VO2 at VT1; 5.5 ± 14.7% for O2 pulse at VT1; 7.5 ± 15.0% for W at VO2peak; 2.7 ± 11.0% for VO2peak and 4.6 ± 12.4% for O2 pulse at VO2peak (all p < 0.05) with no significant differences between groups (p > 0.05). Both groups showed reduced levels of fatigue, anxiety, and depression as well as improved quality of life and wellbeing (all p < 0.05). Compared to guideline-based cardiac rehabilitation, PCS patients showed a similar improvement in workload and oxygen uptake compared to CAD patients. PCS patients benefit from aerobic endurance training performed as moderate continuous or interval training as part of a medical rehabilitation program in terms of improved physical exercise capacity and disease perception. The results for PCS patients are comparable to the guideline-based rehabilitation of CAD patients.

Effects of Cycle Ergometer Training on Heart Rate Recovery and Mind Fullness in NYHA class I, II Heart Failure Patients

Aim: To determine effect of Cycle ergometer on heart rate recovery and mindfulness in NYHA Class I and II heart failure pts. Study design: The study was a randomized controlled trial. Place and duration: Total study duration was 6 months, carried out at Rawal general and dental hospital Islamabad. Methodology: 38 patients were divided into the Control and experimental group. The control group received only conventional Therapy at home and the hospital on the third and 6th weeks for a supervised conventional therapy session. The experimental group received conventional therapy and cycle ergometer training thrice weekly for six weeks. Baseline demographic data, Vitals, HRR1, HRR2, and MAAS scores were gathered from both groups and compared after six weeks. Results: The mean age of the control group was (46.37±4.43) and of the experimental group (was 50.47±9.22). The MAAS score was significant with a p-value (&lt; 0.05). HRR1 and HRR2 were also significant, with a p-value (&lt;0.05). Conclusion: This study showed that cycle ergometer exercise training significantly improved heart rate recovery in NYHA Class I and II heart failure patients and improved mindfulness. Keywords: Heart failure, Heart Rate Recovery 1(HRR1), Heart Rate Recovery 2 (HRR2), Mindful Attention Aware Scale

Effects of different exercise patterns on drug craving in female methamphetamine-dependent patients: Evidence from behavior and fNIRS

ObjectiveTo explore the effects of short-term moderate-intensity cycle ergometer and aerobic calisthenics training on drug craving and brain activity. MethodsForty female methamphetamine (MA)-dependent patients were randomly assigned to receive 30 min of either moderate-intensity cycle ergometer or aerobic calisthenics training. Before and after exercise, drug-cue exposure task was used to assess changes in subjective drug craving, and functional near-infrared spectroscopy (fNIRS) was used to assess activation of prefrontal cortex. ResultsAfter the intervention, drug craving was significantly decreased in both groups, and activation of frontal polar area (FPA) was significantly decreased in the cycle ergometer group. Functional connectivity between right dorsolateral prefrontal cortex (DLPFC) and FPA in the aerobic calisthenics group was significantly reduced. Pre-exercise levels of drug craving correlated positively with FPA activation. ConclusionBoth short-term moderate-intensity cycle ergometer and aerobic calisthenics training effectively reduced subjective drug craving in female MA-dependent patients. Cycle ergometer training mainly decreased neural activity in FPA, and likely suppressed drug craving by reducing the episodic memory and pleasure experience of drug-related cues. Aerobic calisthenics training reduced functional connectivity between FPA and right DLPFC, and likely helped subjects reduce the motivation for drug-related behavior and inhibit drug craving.

Evaluation of Complex Rehabilitation in Post-COVID-19 Patients a Preliminary Report

Introduction: COVID-19 results in numerous complications, mainly cardiac and pulmonary ones. Post-treatment physiotherapy is crucial in patients with its moderate and critical infection course.Study aim: Assessment of the results regarding complex rehabilitation in post-COVD patients.Material and methods: The study group constituted 15 participants (9 males and 6 females) who recovered from COVID-19. Their mean age was 52.75 years 8.13 years. All participants attended complex rehabilitation programmes, including: cycle ergometer training, respiratory and coughing exercises 3 times per week. The 6-Minute Walk Test was used to assess the pre- and post-treatment status of participants. The Modified Medical Research Council dyspnoea scale was applied to determine the dyspnoea-mediated disability before and after the treatment.Results: The 6-minute walking distance did not rise significantly in males or females. No significant changes were noted for blood pressure, heart rate or saturation between measurements. Dyspnoea-mediated disability level decreased in males (1.66 1.12 points vs. 0.11 0.33 points; p = 0.001).Conclusions: Complex physiotherapy in post-COVID-19 males improves dyspnoea-mediated disability. In males and females who recovered from COVID-19, complex physiotherapy leads to an increase in physical capacity as well normalisation of blood pressure, heart rate and oxygen saturation.

Additional effects of exercise to hypocaloric diet on body weight, body composition, glycaemic control and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes: A systematic review and meta-analysis.

This systematic review and meta-analysis evaluates the additional effect of exercise to hypocaloric diet on body weight, body composition, glycaemic control and cardio-respiratory fitness in adults with overweight or obesity and type 2 diabetes. Embase, Medline, Web of Science and Cochrane Central databases were evaluated, and 11 studies were included. Random-effects meta-analysis was performed on body weight and measures of body composition and glycaemic control, to compare the effect of hypocaloric diet plus exercise with hypocaloric diet alone. Exercise interventions consisted of walking or jogging, cycle ergometer training, football training or resistance training and duration varied from 2 to 52 weeks. Body weight and measures of body composition and glycaemic control decreased during both the combined intervention and hypocaloric diet alone. Mean difference in change of body weight (-0.77 kg [95% CI: -2.03; 0.50]), BMI (-0.34 kg/m2 [95% CI: -0.73; 0.05]), waist circumference (-1.42 cm [95% CI: -3.84; 1.00]), fat-free mass (-0.18 kg [95% CI: -0.52; 0.17]), fat mass (-1.61 kg [95% CI: -4.42; 1.19]), fasting glucose (+0.14 mmol/L [95% CI: -0.02; 0.30]), HbA1c (-1 mmol/mol [95% CI: -3; 1], -0.1% [95% CI: -0.2; 0.1]) and HOMA-IR (+0.01 [95% CI: -0.40; 0.42]) was not statistically different between the combined intervention and hypocaloric diet alone. Two studies reported VO2max and showed significant increases upon the addition of exercise to hypocaloric diet. Based on limited data, we did not find additional effects of exercise to hypocaloric diet in adults with overweight or obesity and type 2 diabetes on body weight, body composition or glycaemic control, while cardio-respiratory fitness improved.

Implementation of a rehabilitation program in a virtual reality for post-Covid-19 patients - preliminary results

This study aims to present the preliminary results of a novel rehabilitation program for post-COVID-19 patients that incorporates virtual reality (VR). The study included 20 patients who had previously been affected by SARS-CoV-2 and participated in inpatient pulmonary rehabilitation. These patients were randomly divided into either a VR group or a control group. The both the VR group and the control group participated in the same rehabilitation program, which consisted of exercise capacity training on a cycle ergometer, breathing exercises, resistance and general fitness training, and relaxation. Each training component was performed once a day. The groups that participated differed based on the training settings they received on the cycle ergometer and relaxation training. The study assessed exercise tolerance (6MWT), lung function (FEV1, FVC, TLC, FEV1%VC), stress levels (PSS-10), quality of life (WHOQOL-BREF), likewise anxiety and depression symptoms (HADS). The results showed that the VR group had a statistically significant improvement in all of the functional capacity tests compared to the control group. The VR group also had a statistically significant improvement in quality of life compared to the control group. These results suggest that the inclusion of VR in rehabilitation programs may be beneficial for post-COVID-19 patients.

A Systematic Review and Meta-Analysis of the Effectiveness of High-Intensity Interval Training in People with Cardiovascular Disease at Improving Depression and Anxiety.

Background To assess the effects of high-intensity interval training (HIIT) on depression and anxiety symptom in people with cardiovascular diseases (CVDs) compared with usual care (UC) and traditional aerobic continuous training (CT). Methods Randomized controlled trials (RCTs) that investigated the effectiveness of HIIT on depression and/or anxiety outcomes before and after treatment in people with CVDs were included. A systematic search of database containing PubMed, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, SPORTSDiscus, and CINAHL (EBSCOhost) was performed up to December 2021. The analyses of study characteristics, heterogeneity, and forest plot in analyses analogous were conducted via the pooled standardized mean difference (SMD) in random- or fixed-effect models as the measure of effectiveness. Results Twelve independent studies (515 participants) were included. One study was rated as low quality, and four studies were evaluated as high quality. The other studies were rated as moderate quality. Visual interpretation of funnel plots and Egger test indicated no evidence of publication bias. There was a statistically significant reduction in the severity of depression (12 studies, SMD = −0.42 [Random], 95% CI, −0.69 to −0.16, p=0.002, I2 = 52%) rather than that of anxiety symptoms (8 studies, SMD = −0.14 [Fixed], 95% CI, −0.35 to 0.06, p=0.18, I2 = 0%) following HIIT compared with UC and CT control groups. Subgroup analysis revealed that high-intensity treadmill training significantly improved (p=0.01) the depression symptom instead of training with a cycle ergometer (p=0.07) and strength training (p=0.40). Conclusions High-intensity interval treadmill training can significantly improve symptoms of depression rather than anxiety in cardiovascular patients compared to usual care and conventional aerobic continuous training.

Effect of cycle ergometer training using different intensities in increasing catecholamine hormone of overweight females

The main purpose of this study was to compare cycle ergometer training using low intensity and moderate intensity in increasing the catecholamine hormone of overweight females. This study was conducted on 50 overweight females with mean age of 22.44±2.97 years old and body mass index between 25 kg.m.2 to 30 kg.m.2. Treatment was given 4 times per week during 5 weeks periods in Group 1 with low intensity cycle ergometer continuous training (60%-70% HRmax), and Group 2 with moderate intensity cycle ergometer continuous training (70%-80% HRmax). Heart rate was monitored using polar heart rate monitor H10. Pre-test was taken before giving treatment and post-test after giving a treatment by taking blood a day after doing exercise and fasting at night and the blood samples obtained are taken to the laboratory for serum sample analysis. Data were analyzed using paired t-test. The result found that there was an increase in catecholamine hormone in both groups with a p-value of &lt;0.05. It can be concluded that cycle ergometer training using low and moderate-intensity improved catecholamine hormone for overweight females.

Feasibility and effectiveness of home-based phase III exercise program for frail patients after heart surgery: results of a pilot study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Research Council of Lithuania Introduction The number of elderly frail patients after cardiac surgery is increasing. Frailty has become an important burden to be treated in cardiac rehabilitation (CR). Purpose To evaluate feasibility and effectiveness of home-based exercise program including endurance, flexibility, sensomotoric and resistance training specially tailored for elderly frail patients after open heart surgery. Methods A pilot study of a prospective, single-center, randomized controlled trial. Inclusion criteria: CR after open heart surgery, age ≥ 65 years, Edmonton frailty scale (EFS) score ≥ 4, patient’s agreement to participate in the study. A sample of 30 Patients (73.1±4.16 years, 73% male, EFS-score 5.68±0.28) were randomly assigned to intervention group (IG n=17) or control group (CG n=13). All patients completed comprehensive 20-days inpatient CR program, including aerobic cycle ergometer training (30 min, 6 sessions/week), sensomotoric and flexibility training (15 min. 3d/w for each), resistance training (25 min, 3 d/w) and respiratory exercises (15 min, 5 days/week). After completion of inpatient-CR, the intervention group (IG) participated in a 12-week home-based exercise program including 30 to 45 minutes exercise sessions on 5 days/week, with endurance, flexibility, balance, and resistance training of low to moderate intensity. IG-participants received baseline instructions and the participation was monitored by telephone calls every second week. The CG received usual care. The 6-minutes-walking-test (6MWT) was used to assess functional capacity, the EFS to assess frailty level. Examination times were baseline, after 20-days CR and 12 weeks after completion of CR. Repeated measures ANOVA was used for statistical analysis. Results Baseline evaluation revealed good comparability of the groups showing significant difference only in the gender distribution (age IG 73.2±0.97 years vs. CG 73.5±1.59 years), p=0.722), frailty level (EFS score CG 6.3±0.4 vs. 5.58±0.35, p=0.56), functional capacity (6MWD IG 285.94±19.92 m. vs. CG 309.62±21.55 m, p=0.430, gender distribution IG were 9 (53%) males vs. CG 13 (100%), p=0.04). Main results are summarized in Table 1. The results show significant improvements in EFS-score and 6MWD over the observation time with no differences between the groups. The home-based program was feasible and safe for the IG, and no adverse effects or events occurred that led to premature discontinuation of study participation. Conclusions The specially tailored home-based-program for elderly frail patients after open heart surgery was well accepted and tolerated by the patients. The results are promising, but probably because of the small sample size, no significant differences were found between the groups in the degree of frailty or functional capacity.

Effect of neuromuscular electrical stimulation on exercise capacity in patients with severe chronic obstructive pulmonary disease: A randomised controlled trial

Objective To compare strengthening by neuromuscular electrical stimulation versus cycle ergometer training during a pulmonary rehabilitation program, in patients with severe to very severe chronic obstructive pulmonary disease. Design A prospective randomized controlled study. Setting Two inpatient pulmonary rehabilitation centers. Subjects Patients with severe to very severe chronic obstructive pulmonary disease and multidimensional index to predict risk of death ≥5, were randomly assigned to receive neuromuscular electrical stimulation or cycle ergometer training during pulmonary rehabilitation. Main measures The primary endpoint was the change in exercise capacity using 1-min sit-to-stand test Secondary endpoints were the changes in exercise capacity using 6-min walk test, quadriceps strength, quality of life and dyspnea. Results 102 patients were included. After 3 weeks, 47 patients in the neuromuscular electrical stimulation group, and 45 in the cycle ergometer training group were able to be analyzed. No significant difference was seen in the evolution of exercise capacity using 1-min sit-to-stand test (3.3 ± 3.8 and 2.6 ± 4.1) and 6-min walk test (37.8 ± 58.4 and 33.1 ± 46.7), in the evolution of quadriceps strength and endurance (9.2 ± 12.9 and 6.6 ± 16.1; 9.0 ± 13.2 and 6.2 ± 17.0), in the evolution of quality of life (St George's Respiratory Questionnaire: −11.3 ± 11.7 and −8.1 ± 11.6; COPD Assessment Test: −5.7 ± 7.1 and −4.7 ± 7.0), or in the evolution of dyspnea using Dyspnea 12 (−5.5 ± 10.2 and −5.9 ± 8.5) except using modified medical research council scale (95% confidence interval: 0.48 [0.05; 0.91], p = 0.027). Conclusion We found no significant difference between the two programs on exercise capacity, quadriceps strength and quality of life.

Cycle ergometer training and resistance training similarly increase muscle strength in trained men

ABSTRACT The aim of this study was to compare two different maximal intensity exercise modality training protocols of similar durations on muscle strength, cardiorespiratory fitness, and lower limb composition in recreationally trained men. Twenty-five trained men (28.9 ± 5.6 years) were randomly divided into Cycle ergometer (4 sets of 30 seconds sprints) and Leg press (4 sets of 10–12 repetitions to momentary failure). Both groups trained three times a week for 5 weeks. Before and after the training period, the participants performed a 10-repetition maximum (10RM) test for knee extension, an incremental exercise test on a treadmill for time to exhaustion (TTE) and peak oxygen consumption ( 2peak) and underwent dual energy X-ray absorptiometry to assess lower limb composition. Knee extension 10RM and TTE increased in both groups with no statistically significant between group (p = 0.614 and p = 0.210). Only cycle ergometer group increased 2peak (p = 0,012). For all lower limb composition outcomes, changes were minimal. The results suggest that 5 weeks of effort and duration matched exercise protocols using cycle ergometer training or leg press may produce similar strength adaptations.

Closure of outpatient cardiac rehabilitation during the first COVID-19 lockdown in Austria in spring 2020 resulted in deteriorating physical exercise capacity: a mixed-methods study

BackgroundGroup-based cardiac rehabilitation (CR) has inevitably been disrupted by COVID-19-related public health measures, increasing the risk of deterioration in modifiable risk factors for patients with cardiovascular disease (CVD).PurposeTo examine the impact of CR closure during the first COVID-19-related national lockdown in Austria in spring 2020 on patients' maintenance of physical activity, physical fitness levels, and cardiovascular risk profile; and to describe the patient experience of lack of group-based CR training due to COVID-19.MethodsThis mixed-methods study recruited patients from an outpatient CR centre in Austria during summer 2020. Eligibility criteria were regular attendance at weekly group-based exercise training at the centre until the COVID-19-related lockdown in March 2020; pre-lockdown completion of a maximal cycle ergometer test; no contraindications for maximal exercise testing; and no new complaints limiting exercise performance. Participants underwent post-lockdown quantitative assessment of physical fitness (maximal cycle ergometer testing, submaximal cycle ergometer training session at individual pre-lockdown settings) and cardiovascular risk status. These were compared with pre-lockdown data from medical records. Participants gave qualitative interviews about their experience of maintaining exercise during lockdown. Interviews were audio-recorded, transcribed, coded, and interpreted using framework analysis.ResultsTwenty-eight (57%) of 49 eligible patients were recruited, 1 withdrew, and 27 completed all study procedures. Two participants were excluded from analysis of physical fitness data, due to subsequent diagnosis of new complaints limiting exercise performance. Mean (SD) age was 69 (7.4) years. Six (22%) were female. Median (IQR) time since first CVD event was 8 (5.5, 9) years. In maximal ergometer testing, 14 (56%) had deteriorated, 10 (40%) were unchanged, and 1 (4%) had improved post-lockdown. At group level, power was significantly reduced (maximal ergometer testing, submaximal ergometer training), whereas CVD risk factors remained unchanged from pre- to post-lockdown (table 1). Qualitative analysis corroborated the negative impact of the closure of CR classes (table 2).ConclusionsThis patient cohort was heterogeneous with respect to physical activity levels and exercise capacity, yet overall motivated and experienced in exercise training, having regularly attended training sessions at the centre before the lockdown. Despite individually seeking out alternative exercise options during lockdown, group average exercise capacity deteriorated even in this motivated and exercise-conscious group. This highlights the importance of providing group-based opportunities for supervised high intensity training for patients who engage well in such a setting, and the detrimental impact of disruption to this type of CR service.Funding AcknowledgementType of funding sources: Public grant(s) – National budget only. Main funding source(s): Ludwig Boltzmann Gesellschaft COVID-19 Support Measure: Open Innovation in Science (OIS) Research Enrichment Fund

Immunological Effects of an Add-On Physical Exercise Therapy in Depressed Adolescents and Its Interplay with Depression Severity.

Background: Pro-inflammatory cytokines (PICs) have gained attention in the pathophysiology and treatment of depressive disorders. At the same time, the therapeutic effect of physical activity seems to work via immunomodulatory pathways. The interventional study “Mood Vibes” analyzed the influence of exercise on depression severity (primary endpoint) in depressive adolescents; the influence of PICs on the clinical outcome was analyzed as a secondary endpoint. Methods: Clinically diagnosed depressed adolescents (N = 64; 28.1% male; mean age = 15.9; mean BMI = 24.6) were included and participated either in Whole Body Vibration (WBV) (n = 21) or bicycle ergometer training (n = 20) in addition to treatment-as-usual (TAU). Patients in the control treatment group received TAU only (n = 23). The PICs (interleukin-6—IL-6 and tumor necrosis factor-α—TNF-α) were analyzed before intervention, after 6 weeks of training (t1), and 8 weeks post-intervention (t2). The effects of the treatment on depression severity were rated by self-rating “Depression Inventory for Children and Adolescents” (DIKJ). Results: Basal IL-6 decreased in all groups from t0 to t1, but it increased again in WBV and controls at t2. TNF-α diminished in ergometer and controls from baseline to t1. PIC levels showed no correlation with depression severity at baseline. The influence on DIKJ scores over time was significant for IL-6 in the WBV group (p = 0.008). Sex had an impact on TNF-α (p < 0.001), with higher concentrations in male patients. Higher body mass index was associated with higher IL-6 concentrations over all measurement points (p < 0.001). Conclusions: The positive effects of an intensive add-on exercise therapy on adolescent depression seem to be partly influenced by immunomodulation. A small sample size and non-randomized controls are limitations of this study.

Endurance-oriented training program with children and adolescents on maintenance hemodialysis to enhance dialysis efficacy\u2014DiaSport

ObjectivePediatric patients spend significant time on maintenance hemodialysis (HD) and traveling. They are often not capable of participating in sports activities. To assess the effects of exercise training during HD on dialysis efficacy in children and adolescents, we set up a multi-center randomized controlled trial (RCT).MethodsPatients on HD, age 6 to 18 years, were randomized either to 3× weekly bicycle ergometer training or to no training during HD for 12 weeks. Change in single-pool Kt/V (spKt/V) was the primary outcome parameter.ResultsWe randomized 54 patients of whom 45 qualified (23 in the intervention and 22 in the waiting control group, 14.5 ± 3.01 years, 32 male and 13 female) for the intention-to-treat (ITT) population. Only 26 patients finished study per-protocol (PP). Training was performed for an average of 11.96 weeks (0.14–13.14) at 2.08 ± 0.76 times per week and for a weekly mean of 55.52 ± 27.26 min. Single-pool Kt/V was similar in the intervention compared to the control group (1.70 [0.33] vs. 1.79 [0.55]) at V0 and (1.70 [0.36] vs. 1.71 [0.51]) at V1; secondary endpoints also showed no difference in both ITT and PP analysis. No significant adverse events were reported. No bleeding or needle dislocation occurred in 1670 training sessions.ConclusionsIntradialytic bicycle training is safe, but does not improve dialysis efficacy and physical fitness. However, the study can be considered underpowered, particularly because of high dropout rates. Future studies need better strategies to increase motivation and compliance and other more effective/intensive exercise measures should be evaluated.Trial registrationThe trial was registered in ClinicalTrials.Gov (Clinicaltrials.gov identifier: NCT01561118) on March 22, 2012.

High-Intensity Interval Cycle Ergometer Training in Parkinson's Disease: Protocol for Identifying Individual Response Patterns Using a Single-Subject Research Design.

Background: People with Parkinson's disease (PD) experience not only motor problems but also non-motor problems that seriously impede their daily functioning and quality of life. The current pharmacologic treatment of PD is symptomatic, and alternative rehabilitation treatments, which preferably also have a disease-modifying effect and promote neuroplasticity, are needed. Recent studies suggest that high-intensity interval training (HIIT) is promising for promoting neuroplasticity in human PD, with short training time and reduced burden. Biomarkers for neuroplasticity such as brain-derived neurotrophic factor (BDNF) and neurodegeneration (including neurofilament NfL and α-synuclein) may play a role, but their response to HIIT is not well-investigated.Objectives: The aims of this study were (1) to study the effects of 4 weeks of HIIT compared with 4 weeks of continuous aerobic exercise on motor and non-motor outcomes of PD and (2) to investigate the association between HIIT, motor/non-motor performances changes, and blood biomarker levels for neuroplasticity and neurodegeneration.Study Design: Single-subject research design with alternating treatment setup (ABACA) and frequent repeated measurements was used. Each participant received different intervention conditions (B/C) interspersed with baseline periods (A, i.e., ABACA or ACABA), and frequent repeated assessment of outcome measures is done to quantify within-subject, individual response patterns with sufficient power for data analysis. Blood samples were collected once a week in the baseline and training phases (A1 and B/C) and once every 2 weeks in the washout phases (A2 and A3).Intervention: Four subjects with PD on stable dopaminergic medication, two in Hoehn–Yahr stage 1–2, and two in Hoehn–Yahr stage 2.5–3 followed an ABACA or ACABA schedule, consisting of blocks with 30-min sessions of “B” (HIIT) or 50-min sessions of “C” [continuous aerobic exercise (CAE)] 3×/week for 4 weeks, separated by baseline “A” periods of 8 weeks for a total duration of 28 weeks.Outcome Measures: Outcome measures include disease status [Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS)], blood biomarkers (BDNF, Nfl, and α-synuclein), measures for functional mobility (including an activity tracker), and activities of daily living, as well as cognition, mood, biorhythm (sleeping problems), and quality of life.Data Analysis: Visual analysis of trends in level, slope, and variability in response patterns was carried out, confirmed by longitudinal regression analysis with phase (ABACA) as the independent variable.

Eight-week Aerobic Exercise Training Using Swiss-ball Improves Postural Stability Compared With Bicycle Ergometer Training.

PURPOSE: To compare the effect of aerobic training using Swiss-ball (SB) and aerobic training using bicycle on postural stability. METHODS: Sixteen healthy adults allocated into two group randomly: SB training group performed two-month aerobic training using SB and bicycle training group (Bike group) performed two-month aerobic training using bicycle ergometer. Subjects were asked to do the training for 30minute in a day and three days in a week. In each group, baseline and post intervention postural stability and peak oxygen consumption were measured. Postural stability was measured using stabilometric platform. During the assessment of stability, subjects were asked to close eyes and stay as still as possible for 30 seconds. Fundamental parameters obtained are: position of the body center of gravity, area and shape of sway density curve and velocity variables. RESULTS: All results show mean (SD). There was no main effect on peak oxygen consumption and no difference between training group (SB group: 33.1(5.0) ml/kg/min to 32.9(5.4)) ml/kg/min, Bike Group: 32.2(7.6) ml/kg/min to 35.5(8.0) ml/kg/min). On the other hand, significantly interaction was found on some postural stability measurement: area in which the center of gravity ((SB group: 2.3(0.4) cm2 to 3.0(1.3)) cm2, Bike Group: 1.9(1.0) cm2 to 2.4(1.4) cm2: no significantly interaction), total length of center of gravity displacement ((SB group: 55.3(9.9) cm to 46.4(8.4)) cm, Bike Group: 39.9(11.6) cm to 43.3(13.1) cm: interaction p<0.05), velocity of center of pressure ((SB group: 1.8(0.3) cm/sec to 1.6(0.3) cm/sec, Bike Group: 1.3(0.4) cm/sec to 1.4(0.4) cm/sec: interaction p<0.05). CONCLUSIONS: SB training shows no significantly effect on peak oxygen consumption. On the other hand, SB training improved postural stability compared with bicycle ergometer training.

Early time course of change in angiogenic proteins in human skeletal muscle and vascular cells with endurance training.

Angiogenic, mitochondrial, and related transcriptional proteins were assessed in human skeletal muscle and isolated vascular cells during the early phase of endurance training. Thigh muscle biopsies were obtained in healthy young subjects, after one acute bout (n=9) and after 3, 5, 7, and 14days (n=9) of cycle ergometer training. Whole muscle homogenates were analyzed for angiogenic, mitochondrial, and regulatory mRNA and protein levels. Angiogenic proteins were determined in muscle-derived endothelial cells and pericytes sorted by fluorescence-activated cell sorting. Acute exercise induced an increase in whole muscle mRNA of peroxisome proliferator-activated receptor gamma coactivator 1α (4.5-fold; P=.002) and vascular endothelial growth factor (VEGF) (2.4-fold; P=.001) at 2hours post. After 14days of training, there was an increase in CD31 protein (63%; P=.010) in whole muscle indicating capillary growth. There was also an increase in muscle VEGF receptor 2 (VEGFR2) (1.5-fold; P=.013), in OXPHOS proteins (complex I, II, IV, V; 1.4- to 1.9-fold; P<.05) after 14days of training and an increase in estrogen-related receptorα protein (1.5-fold; P=.039) at 14days compared to 5days of training. Both endothelial cells and pericytes expressed VEGF and other angiogenic factors at the protein level but with a distinctively lower expression of VEGFR2 and thrombospondin-1 (TSP-1) in pericytes. The findings illustrate that initiation of capillary and mitochondrial adaptations occurs within 14days of training and suggest that sustained changes in angiogenic proteins including VEGF and TSP-1 are moderate in whole muscle and vascular cells.