Exercise Dose Research Articles

Physical Activity and Mortality in Patients with Coronary Artery Disease.

Coronary artery disease (CAD) accounts for half of heart-related mortalities. Secondary prevention measures are aimed at enhancing the probability of survival in acute and chronic heart diseases. Physical activity (PA) has been shown to effectively reduce all-cause and cardiovascular (CV) mortality rates. This article reviews the relationship between PA and mortality in patients with CAD. Additionally, we discuss the process of vascular changes that contributes to survival benefits in physically active CAD patients, along with exercise dosing and guideline recommendations. Recent studies have shown that physical inactivity poses a modifiable risk factor that impedes favorable vasculature remodeling, unlike active individuals. Recent meta-analyses provide strong evidence of the multifaceted advantages of PA in lowering mortality rates in patients with CAD, as opposed to physically inactive participants. In summary, substantial evidence indicates that PA is significantly associated with reduction in all-cause and CV mortality in CAD patients, with a dose-response relationship.

Trainability for cardiopulmonary fitness is low in patients with peripheral artery disease.

In patients with peripheral arterial disease (PAD), exercise therapy is recommended to relieve leg symptoms, as noted in the 2016 AHA/ACC and 2017 ESC/ESVS guidelines. We assessed the trainability for cardiopulmonary fitness (CPF) and quality of life (QOL); three distinct patient types, namely, PAD, heart failure (HF), and stroke, were compared. This is a multicentre, retrospective analysis of prospectively collected data from three clinical studies. Data collected from 123 patients who completed 36 sessions of supervised aerobic training of moderate intensity were analysed, with 28 PAD, 55 HF, and 40 stroke patients totalling 123. Before and after training, cardiopulmonary exercise testing with non-invasive cardiac output monitoring and QOL evaluation using a 36-Item Short Form Survey (SF-36) were performed. Non-response was defined as a negative change in the post-training value compared with that in the pre-training value. The result showed an improvement in CPF in all three groups. However, cardiorespiratory fitness (CRF) increased by a lesser extent in the PAD group than in the HF and stroke groups; the physical and mental component scores (MCS) of SF-36 exhibited a similar pattern. Non-response rates of peak V˙O2, oxygen uptake efficiency slope, and MCS were higher in the PAD group. In the PAD group, non-responders regarding peak V˙O2 had a higher pulse wave velocity than responders. In patients with PAD following exercise therapy, CRF and QOL improved to a lesser extent on average; their non-response rate was also higher compared with that of HF or stroke patients. Therefore, a higher dose of exercise might be needed to elicit adaptation in PAD patients, especially those with high pulse wave velocity.

Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis

ObjectiveTo investigate potential moderating effects of resistance exercise dose components including intensity, volume and frequency, for the management of common tendinopathies.DesignSystematic review with meta-analysis and meta-regressions.Data sourcesIncluding but not limited...

Effects of different doses of exercise and diet-induced weight loss on beta-cell function in type 2 diabetes (DOSE-EX): a randomized clinical trial

Diet-induced weight loss is associated with improved beta-cell function in people with type 2 diabetes (T2D) with remaining secretory capacity. It is unknown if adding exercise to diet-induced weight loss improves beta-cell function and if exercise volume is important for improving beta-cell function in this context. Here, we carried out a four-armed randomized trial with a total of 82 persons (35% females, mean age (s.d.) of 58.2 years (9.8)) with newly diagnosed T2D (<7 years). Participants were randomly allocated to standard care (n = 20), calorie restriction (25% energy reduction; n = 21), calorie restriction and exercise three times per week (n = 20), or calorie restriction and exercise six times per week (n = 21) for 16 weeks. The primary outcome was beta-cell function as indicated by the late-phase disposition index (insulin secretion multiplied by insulin sensitivity) at steady-state hyperglycemia during a hyperglycemic clamp. Secondary outcomes included glucose-stimulated insulin secretion and sensitivity as well as the disposition, insulin sensitivity, and secretion indices derived from a liquid mixed meal tolerance test. We show that the late-phase disposition index during the clamp increases more in all three intervention groups than in standard care (diet control group, 58%; 95% confidence interval (CI), 16 to 116; moderate exercise dose group, 105%; 95% CI, 49 to 182; high exercise dose group, 137%; 95% CI, 73 to 225) and follows a linear dose–response relationship (P > 0.001 for trend). We report three serious adverse events (two in the control group and one in the diet control group), as well as adverse events in two participants in the diet control group, and five participants each in the moderate and high exercise dose groups. Overall, adding an exercise intervention to diet-induced weight loss improves glucose-stimulated beta-cell function in people with newly diagnosed T2D in an exercise dose-dependent manner (NCT03769883).

Train Smart Study: protocol for a randomised trial investigating the role of exercise training dose on markers of brain health in sedentary middle-aged adults

IntroductionRegular aerobic exercise is associated with improved cognitive function, implicating it as a strategy to reduce dementia risk. This is reinforced by the association between greater cardiorespiratory fitness and larger...

Implementing digital devices to increase mobility training for people receiving inpatient rehabilitation: protocol for a feasibility hybrid type II randomized controlled trial

BackgroundPeople with mobility limitations can benefit from rehabilitation programs incorporating intensive, repetitive, and task-specific exercises using digital devices such as virtual reality gaming systems, tablet and smartphone applications, and wearable devices. The Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial (n = 300) showed improvements in mobility in people using these types of digital devices in addition to their usual rehabilitation care when the intervention was provided by an additional study-funded physiotherapist. However, it is not clear if this intervention can be implemented by hospital physiotherapists with a usual clinical load. The AMOUNT Implementation trial aims to explore the feasibility of conducting a large-scale implementation trial.MethodsA pragmatic, assessor blinded, feasibility hybrid type II randomized controlled trial will be undertaken at a public hospital in Australia. There will be two phases. Phase I (Implementation phase) will involve implementing the digital devices into physiotherapy practice. Physiotherapists from the rehabilitation ward will receive a multifaceted implementation strategy guided by the Capabilities, Opportunities, Motivation-Behaviour (COM-B) theoretical model. The implementation strategy includes identifying and training a clinical champion; providing digital devices and education and training; facilitating use of the devices through clinical reasoning sessions and journal clubs; and audit and feedback of exercise dosage documentation. Phase II (Trial phase) will involve randomising 30 eligible inpatients from the same ward into either usual care or usual care plus an additional 30 min or more of exercises using digital devices. This intervention will be provided by the physiotherapists who took part in the implementation phase. We will collect data on feasibility, implementation, and patient-level clinical outcomes. The three primary outcome measures are the extent to which physiotherapists document the dosage of exercises provided to participants (feasibility criteria: exercise practice sheets complete for ≥85% of all participants); ability to recruit participants; and fidelity to the protocol of using digital devices to prescribe exercises (feasibility criteria: average of ≥ 30mins per day for > 50% intervention participants).DiscussionThis feasibility study will provide important information to guide the planning and conduct of a future large-scale implementation trial.Trial registrationAustralian and New Zealand Clinical Trial Registry; ACTRN12621000938808; registered 19/07/2021. Trial sponsor: Prince of Wales Hospital. 320–346 Barker Street, Randwick, NSW, 2031, Australia. Protocol version: 6.2 7th April 2021.

Exercise during chemotherapy: Friend or foe?

A higher chemotherapy completion rate is associated with better outcomes including treatment efficacy and overall survival. Exercise may have the potential to improve relative dose intensity (RDI) by reducing the frequency and severity of chemotherapy-related toxicities. We examined the association between exercise adherence and RDI and possible clinical- and health-related fitness predictors of RDI. Chemotherapy records were extracted from the electronic medical record for patients enrolled in the ENACT trial (n = 105). Chemotherapy completion was assessed using average RDI. A threshold of 85% was established for "high" versus "low" RDI. Logistic regression analyses were used to estimate the associations between the clinical- and health-related fitness predictors of RDI. Patients with breast cancer (BC) had a significantly higher average RDI (89.8% ± 17.6%) compared with gastrointestinal cancer (GI) (76.8% ± 20.9%, p = 0.004) and pancreatic cancer (PC) (65.2% ± 20.1%, p < 0.001). Only 25% of BC patents required a dose reduction compared to 56.3% of GI and 86.4% of PC patients. Cancer site was significantly associated with RDI. Compared with BC, patients with GI (β = -0.12, p = 0.03) and PC (β = -0.22, p = 0.006) achieved significantly lower RDI. Every 2.72 unit increase in overall exercise adherence led to a significant 7% decrease in RDI (p = 0.001) in GI patients. Metastatic GI patients had a 15% RDI increase for every 2.72 unit increase in exercise adherence (p = 0.04). Exercise is a supportive therapy that has potential to enhance chemotherapy tolerance and completion. The relationship between exercise adherence and RDI is influenced by factor such as cancer site and treatment type. Special attention must be paid to how exercise is prescribed to ensure that exercise adherence does not negatively affect RDI. Cancer site, exercise dosage, and multimodal interventions to address toxicities are key areas identified for future research.

The AFLETES Study: Atrial Fibrillation in Veteran Athletes and the Risk of Stroke.

Endurance athletes are at an increased risk of atrial fibrillation (AF) when compared with the general population. However, the risk of stroke in athletes with AF is unknown. We aimed to assess this risk using an international online survey. Individuals that had competed in ≥1 competitive events and were ≥40 years old were included. Self-reported demographic, medical history, and training history data were collected, and a CHA2DS2-VASc was calculated. Binary logistic regression was used to assess variables associated with AF and stroke. There were 1002 responses from participants in 41 countries across Africa, Asia, Australasia, Europe, and North and South America, and 942 were included in the final analysis. The average age was 52.4 ± 8.5 years, and 84% were male. The most common sports were cycling (n = 677, 72%), running (n = 558, 59%), and triathlon (n = 245, 26%). There were 190 (20%) individuals who reported AF and 26 individuals (3%) who reported stroke; of which, 14 (54%) had AF. Lifetime exercise dose [odds ratio (OR), 1.02, 95% confidence interval (95% CI),1.00-1.03, P = 0.02] and swimming (OR, 1.56, 95% CI, 1.02-2.39, P = 0.04) were associated with AF in multivariable analysis, independent of other risk factors. Atrial fibrillation was associated with stroke (OR, 4.18, 95% CI, 1.80-9.72, P < 0.01), even in individuals with a low (0/1) CHA2DS2-VASc score (OR, 4.20, 95% CI, 1.83-9.66, P < 0.01). This survey provides early evidence that veteran endurance athletes who develop AF may be at an increased risk of developing stroke, even in those deemed to be at low risk by CHA2DS2-VASc score.

Do we need to rethink the determination of exercise-related energy expenditure in cardiac telerehabilitation interventions?

The American College of Sports Medicine determined the energy consumption of daily activities and sports. Cardiac telerehabilitation (CTR) requires knowing how much energy people consume in daily life outside of cardiac rehabilitation activities. Therefore, we have investigated if the estimated values are valid in CTR. Data from two studies were incorporated. The first study measured ventilatory threshold (VT)1, VT2, and peak exercise on cardiopulmonary exercise testing (CPET) collected from 272 cardiac (risk) patients and compared them to the estimated oxygen consumption (VO2) at low-to-moderate-intense exercise (3-6 metabolic equivalents [METs]). Next, a patient-tailored application was developed to support CTR using these estimated values, and the intervention (the second study) was conducted with 24 coronary artery disease patients using this application during a CTR intervention. In the first study, VO2 at VT1, VT2 and peak exercise corresponded to 3.2 [2.8, 3.8], 4.3 [3.8, 5.3], and 5.4 [4.5, 6.2] METs, which are significantly different from the estimated VO2 at low-to-moderate-intense exercise, especially lower in older, obese, female, and post-myocardial infarction/heart failure patients. These VO2 varied considerably between patients. The telerehabilitation study did not show significant progress in peak VO2, but using the application's estimated target, 97.2% of the patients achieved their weekly target, which is a significant overestimate. The estimated and observed exercise-related energy expenditures by CPET were significantly different, resulting in an overestimation of the exercise done by the patients at home. The results can have a significant impact on the quantification of exercise dose during (tele)rehabilitation programs.

Physical Therapist Management of a Person With Frailty Across the Continuum

Management of the older adult with frailty is challenging. Multiple morbidities and their interrelationships can make the management of frailty arduous to diagnose and effectively treat. However, explicitly assessing for frailty can help optimize the older adult's care and provide an appropriate focus for the interventions. Effective treatment interventions must be individualized to encourage active participation and engagement. Appropriate dosing of exercise is essential. Nonetheless, the key to reversing or preventing a downward trajectory is increasing physical activity, necessitating the individual's active participation and empowerment.

Stroke Rehabilitation and Motor Recovery

Up to 50% of the nearly 800,000 patients who experience a new or recurrent stroke each year in the United States fail to achieve full independence afterward. More effective approaches to enhance motor recovery following stroke are needed. This article reviews the rehabilitative principles and strategies that can be used to maximize post-stroke recovery. Evidence dictates that mobilization should not begin prior to 24 hours following stroke, but detailed guidelines beyond this are lacking. Specific classes of potentially detrimental medications should be avoided in the early days poststroke. Patients with stroke who are unable to return home should be referred for evaluation to an inpatient rehabilitation facility. Research suggests that a substantial increase in both the dose and intensity of upper and lower extremity exercise is beneficial. A clinical trial supports vagus nerve stimulation as an adjunct to occupational therapy for motor recovery in the upper extremity. The data remain somewhat mixed as to whether robotics, transcranial magnetic stimulation, functional electrical stimulation, and transcranial direct current stimulation are better than dose-matched traditional exercise. No current drug therapy has been proven to augment exercise poststroke to enhance motor recovery. Neurologists will collaborate with rehabilitation professionals for several months following a patient's stroke. Many questions still remain about the ideal exercise regimen to maximize motor recovery in patients poststroke. The next several years will likely bring a host of new research studies exploring the latest strategies to enhance motor recovery using poststroke exercise.

CORE-CERT Items as a Minimal Requirement for Replicability of Exercise Interventions: Results From Application to Exercise Studies for Breast Cancer Patients.

Hacke, C, Knuth, J, Bucher, M, Weisser, B, and Schmidt, T. CORE-CERT items as a minimal requirement for replicability of exercise interventions: results from application to exercise studies for breast cancer patients. J Strength Cond Res 37(5): e346-e360, 2023-Exercise interventions have been demonstrated to be useful in the prevention and therapy for multiple different diseases. The Consensus on Exercise Reporting Template (CERT) has been developed as the reporting guideline for exercise studies. The main goals of CERT are to ensure completeness of reporting, to enable interpretation of exercise programs, and to allow extraction of data for meta-analyses and the development of guidelines. However, for clinicians, the most important aspect of good reporting might be the replicability of protocols for their patients. This study was designed to determine the core components of exercise interventions for breast cancer, which are considered as minimal requirement for replicability in practice. The original items of CERT were specified, subdivided, or extended by additional key items to develop a "CORE-CERT checklist." The original CERT and our CORE-CERT were then applied to 29 exercise RCTs for breast cancer obtained from the most frequently cited and most recent meta-analyses in current guidelines. The reporting quality using both templates were examined. Mean original CERT score was 11 of 19 (59%) of completed items and 13 of 19 (68%) of reporting completeness for CORE-CERT. Reporting quality using CORE-CERT items was approximately 8% higher, indicating a more precise description of items in CORE-CERT. Differences concerned exercise dosage, nonexercise components, supervision, and description of each exercise. We propose a novel CORE-CERT guideline necessary for the replicability of exercise interventions in clinical practice. The application of CORE-CERT demonstrated a slightly better but still insufficient reporting quality of exercise interventions for breast cancer.

The Acute and Chronic Effects of Resistance and Aerobic Exercise in Hemostatic Balance: A Brief Review

Hemostatic balance refers to the dynamic balance between blood clot formation (coagulation), blood clot dissolution (fibrinolysis), anticoagulation, and innate immunity. Although regular habitual exercise may lower the incidence of cardiovascular diseases (CVD) by improving an individual's hemostatic profile at rest and during exertion, vigorous exercise may increase the risk of sudden cardiac death and venous thromboembolism (VTE). This literature review aims to investigate the hemostatic system's acute and chronic adaptive responses to different types of exercise in healthy and patient populations. Compared to athletes, sedentary healthy individuals demonstrate similar post-exercise responses in platelet function and coagulatory and fibrinolytic potential. However, hemostatic adaptations of patients with chronic diseases in regular training is a promising field. Despite the increased risk of thrombotic events during an acute bout of vigorous exercise, regular exposure to high-intensity exercise might desensitize exercise-induced platelet aggregation, moderate coagulatory parameters, and up-regulate fibrinolytic potential via increasing tissue plasminogen activator (tPA) and decreasing plasminogen activator inhibitor (PAI-1) response. Future research might focus on combining different types of exercise, manipulating each training characteristic (frequency, intensity, time, and volume), or investigating the minimal exercise dosage required to maintain hemostatic balance, especially in patients with various health conditions.

Level of pain catastrophising determines if patients with long-standing subacromial impingement benefit from more resistance exercise: predefined secondary analyses from a pragmatic randomised controlled trial (the SExSI Trial)

ObjectiveThe primary aim was to investigate the effectiveness of adding more resistance exercise to usual care on pain mechanisms (including temporal summation, conditioned pain modulation (CPM) and local pain sensitivity)...

Impact of Early COVID-19 Waves on Cardiac Rehabilitation Delivery in Australia: A National Survey.

The novel coronavirus disease of 2019 (COVID-19) pandemic significantly disrupted health care, especially outpatient services such as cardiac rehabilitation (CR). We investigated the impact of early COVID-19 waves on the delivery of Australian CR programs, comparing this time period with usual practice prior to the pandemic (2019) and current practice (2021) once the early waves had subsided. Specifically, we aimed to understand how the delivery of programs during COVID-19 compared to usual practice. An anonymous online cross-sectional survey of Australian CR program staff was conducted, comprising three sections: program and respondent characteristics, COVID-19 impact on program delivery, and barriers to, and enablers of, program delivery. Respondents were asked to consider three key timepoints: 1) Pre-COVID-19 (i.e. usual practice in 2019), 2) Early COVID-19 waves (March-December 2020), and 3) Currently, at time of survey completion post early COVID-19 waves (May-July 2021). Of the 314 Australian CR programs, 115 responses were received, of which 105 had complete data, representing a 33% response rate. All states and territories were represented. During early COVID-19 waves programs had periods of closure (40%) or reduced delivery (70%). The majority of programs reported decreased CR referrals (51.5%) and decreased participation (77.5%). The two core components of CR-exercise and education-were significantly impacted during early COVID-19 waves, affecting both the number and duration of sessions provided. Exercise session duration did not return to pre-pandemic levels (53.5 min compared to 57.7 min, p=0.02). The majority of respondents (77%) reported their CR program was inferior in quality to pre-pandemic and more organisational support was required across information technology, staffing, administration and staff emotional and social support. Australian CR programs underwent significant change during the early COVID-19 waves, consistent with international CR reports. Fewer patients were referred and attended CR and those who did attend received a lower dose of exercise and education. It will be important to continue to monitor the long-term impacts of the COVID-19 pandemic to ensure CR programs return to pre-pandemic functioning and continue to deliver services in line with best practice and evidence-based recommendations.

Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke.

Although aerobic training (AT) and resistance training (RT) are recommended after stroke, the optimal dosage of these interventions and their effectiveness on balance, walking capacity, and quality of life (QoL) remain conflicting. Our study aimed to quantify the effects of different modes, dosages and settings of exercise therapy on balance, walking capacity, and QoL in stroke survivors. PubMed, CINHAL, and Hinari databases were searched for randomised controlled trials (RCTs) evaluating the effects of AT and RT on balance, walking, and QoL in stroke survivors. The treatment effect was computed by the standard mean differences (SMDs). Twenty-eight trials (n = 1571 participants) were included. Aerobic training and RT interventions were ineffective on balance. Aerobic training interventions were the most effective in improving walking capacity (SMD = 0.37 [0.02, 0.71], p = 0.04). For walking, capacity, a higher dosage (duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve) of AT interventions demonstrated a significantly greater effect (SMD = 0.58 [0.12, 1.04], p = 0.01). Combined AT and RT improved QoL (SMD = 0.56 [0.12, 0.98], p = 0.01). Hospital located rehabilitation setting was effective for improving walking capacity (SMD = 0.57 [0.06, 1.09], p = 0.03) compared with home and/or community and laboratory settings. Our findings showed that neither AT nor RT have a significant effect on balance. However, AT executed in hospital-located settings with a higher dose is a more effective strategy to facilitate walking capacity in chronic stroke. In contrast, combined AT and RT is beneficial for improving QoL. A high dosage of aerobic exercise, duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve is beneficial for improving walking capacity.

A single dose of exercise stimulates skeletal muscle mitochondrial plasticity in myotonic dystrophy type 1.

Myotonic dystrophy type 1 (DM1) is the second most common muscular dystrophy after Duchenne and is the most prevalent muscular dystrophy in adults. DM1 patients that participate in aerobic exercise training experience several physiological benefits concomitant with improved muscle mitochondrial function without alterations in typical DM1-specific disease mechanisms, which suggests that correcting organelle health is key to ameliorate the DM1 pathology. However, our understanding of the molecular mechanisms of mitochondrial turnover and dynamics in DM1 skeletal muscle is lacking. Skeletal muscle tissue was sampled from healthy and DM1 mice under sedentary conditions and at several recovery time points following an exhaustive treadmill run. We demonstrate that DM1 patients exhibit an imbalance in the transcriptional apparatus for mitochondrial turnover and dynamics in skeletal muscle. Additionally, DM1 mice displayed elevated expression of autophagy and mitophagy regulators. A single dose of exercise successfully enhanced canonical exercise molecular pathways and skeletal muscle mitochondrial biogenesis despite failing to alter the cellular pathology in DM1 mice. However, treadmill running stimulated coordinated organelle fusion and fission signaling, as well as improved alternative splicing of Optic atrophy 1. Exercise also evoked autophagy and mitophagy pathways in DM1 skeletal muscle resulting in the normalized expression of autophagy- and lysosome-related machinery responsible for the clearance of dysfunctional organelles. Collectively, our data indicate that mitochondrial dynamics and turnover processes in DM1 skeletal muscle are initiated with a single dose of exercise, which may underlie the adaptive benefits previously documented in DM1 mice and patients.

Influence of functional asymmetry on performance of technical actions at freestyle wrestlers

Purpose: to reveal the influence of functional asymmetry on the performance of technical actions in freestyle wrestlers. Material and methods. Analysis of scientific and methodical literature and Internet sources; pedagogical testing; pedagogical experiment; methods of mathematical statistics. The profile of functional asymmetry of the brain in freestyle wrestlers was determined. We used the tapping test by E. Ilyin, tests to determine motor and visual asymmetry and dynamometry. According to the results of the tapping test, E. Ilyin, the coefficient of functional asymmetry was calculated based on the working capacity of the left and right hands. 24 freestyle wrestlers aged 18-21 took part in the study. Results: during the previous study it was found that wrestlers mainly perform technical actions in one direction. A sportsman at the initial stage of training must learn techniques in both directions. However, at the stage of maximum realization of individual capabilities this rule should not always be observed. Since the majority of respondents suggested that in order to improve sports results it is necessary to strengthen the asymmetry of the wrestler, a set of special exercises was applied in the experimental group. In the given complex the accentuated performance of basic technical actions in a convenient way, individual dosage of exercises on development of flexibility, force, and also static endurance on the leading side was provided. After conducting the pedagogical experiment, we again conducted educational and training matches and analyzed them according to the indicators that were interesting to us. Having processed the results obtained after conducting the pedagogical experiment, we reached the following conclusions. In the control group, the increase in results for all indicators was: «right-handed people to the right» - 4,4 %; «right-handed to the left» - 0,8 %; «left-handed to the right» - 3,9 %; «left-handed to the left» - 10,9 %. In the experimental group, according to the same indicators, we observed the following increase in results: «right-handed to the right» - 13,5 %; «right-handed to the left» - 0,4 %; «left-handed to the right» - 0,5 %; «left-handed to the left» - 18,7 %. The conducted statistical processing made it possible to establish that there was a reliable increase in technical actions in the convenient direction for both right-handed and left-handed players. Summarizing the results of the pedagogical experiment, we can come to the conclusion that the use of a set of exercises embedded in the accented execution of technical processes in the leading direction contributes to the increase in results and the increase in the efficiency of the execution of technical processes. Conclusions. The analysis of the distribution of the individual profile of functional asymmetry in freestyle wrestlers showed that among the 24 wrestlers we studied aged 18-21 years, the right-sided profile of functional asymmetry predominates – 66 % of wrestlers, the left-sided profile of functional asymmetry has 20 % of wrestlers, the rest 14 % are ambidexters. The presence of a connection between the performance of a technical action and the profile of functional asymmetry in wrestlers was revealed: athletes perform technical actions in the leading direction more often and more efficiently. The use of a complex of exercises aimed at increasing asymmetry contributes to the growth of technical processes, and more pronounced in the leading direction. Thus, the increase in the control group «right-handed to the right» was 4,4 %, «left-handed to the left» - 10,9 %, in the experimental group – 13,5 % and 18,7 %, respectively.

A feasibility, safety, and efficacy evaluation of supervised aerobic and resistance exercise for patients with glioblastoma undertaking adjuvant chemoradiotherapy.

While therapeutically effective, chemoradiotherapy treatment for high-grade glioma (glioblastoma) is often accompanied by side effects. Exercise has been demonstrated to alleviate the adverse effects of such treatments in other cancers. We aimed to evaluate the feasibility and preliminary efficacy of supervised exercise incorporating autoregulation. Thirty glioblastoma patients were recruited, five declined exercise and 25 were provided with a multimodal exercise intervention for the duration of their chemoradiotherapy treatment. Patient recruitment, retention, adherence to training sessions and safety were evaluated throughout the study. Physical function, body composition, fatigue, sleep quality, and quality of life were evaluated before and after the exercise intervention. Eight of the 25 participants commencing exercise withdrew prior to completion of the study (32%). Seventeen patients (68%) demonstrated low to high adherence (33%-100%) and exercise dosage compliance (24%-83%). There were no reported adverse events. Significant improvements were observed for all trained exercises and lower limb muscle strength and function with no significant changes observed for any other physical function, body composition, fatigue, sleep, or quality of life outcomes. Only half of glioblastoma patients recruited were willing or able to commence, complete or meet minimum dose compliance for the exercise intervention during chemoradiotherapy indicating the intervention evaluated may not be feasible for part of this patient cohort. For those who were able to complete the exercise program, supervised, autoregulated, multimodal exercise was safe and significantly improved strength and function and may have prevented deterioration in body composition and quality of life.

Enthusiastic Students of Poltekkes Semarang Participated in Self-Body Weight Training in the Covid-19 Era: A Survey Study

Abstract: Sports in the era of covid-19 have become a powerful weapon to maintain psychic and physical health for the public. But the question arises, what kind of exercise is good to do in the era of covid-19? Good exercise certainly exercises improves cardiorespiratory and muscle fitness. But sometimes the understanding of physical activity and exercise is still wrong. Physical activity is synonymous with daily activity while exercise is systemized and structured. In addition, regulating the exercise dose including intensity and volume is one of the problems. The purpose of this study is to provide an understanding of the preparation of exercise programs and analyze the enthusiasm of students to take part in self-body weight training. The research method is a survey, the instrument is a questionnaire, and the participants are 34 students of the Semarang Poltekkes male and female genders. The results that student enthusiasm was 60% very high, 38% high, 32% moderate, 21% low, and 1% very low. In conclusion, most students have a high enthusiasm for participating in training, then students state that they understand the content of the material and can compile an exercise program simply by paying attention to the principles of FITT (frequency, intensity, time, and type).