Effects Of Exercise In Patients Research Articles

Dose-response effects of graded therapeutic exercises in patients with long-standing subacromial pain

Dose-response effects of graded therapeutic exercises in patients with long-standing subacromial pain

Specific spinal stabilisation exercises in patients with low back pain – a systematic review

The aim of this review was to evaluate the effects of specific spinal stabilisation exercises in patients with low back pain (LBP). PubMed and PEDro databases were searched. Ten relevant randomised controlled trials (RCTs) with a study population of patients with acute, sub-acute or chronic LBP were reviewed and quality assessed. The intervention method should have included specific spinal stabilisation exercises including co-contraction of multifidus muscles and transversus abdominis muscles. Seven RCTs were high quality and three were low quality. The results indicate moderate evidence of improved disability and/or pain level, increased multifidi cross-sectional area, and limited evidence for improved quality of life after treatment. The outcome measures used showed extensive heterogeneity. Larger, randomised, controlled trials of high quality, in different subgroups of LBP patients, with long-term follow-up are warranted. A standardisation of outcome measures would be beneficial in order to facilitate comparability among studies.

Effects of Treadmill Exercise on Dopaminergic Transmission in the 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine-Lesioned Mouse Model of Basal Ganglia Injury

Studies have suggested that there are beneficial effects of exercise in patients with Parkinson's disease, but the underlying molecular mechanisms responsible for these effects are poorly understood. Studies in rodent models provide a means to examine the effects of exercise on dopaminergic neurotransmission. Using intensive treadmill exercise, we determined changes in striatal dopamine in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned mouse. C57BL/6J mice were divided into four groups: (1) saline, (2) saline plus exercise, (3) MPTP, and (4) MPTP plus exercise. Exercise was started 5 d after MPTP lesioning and continued for 28 d. Treadmill running improved motor velocity in both exercise groups. All exercised animals also showed increased latency to fall (improved balance) using the accelerating rotarod compared with nonexercised mice. Using HPLC, we found no difference in striatal dopamine tissue levels between MPTP plus exercise compared with MPTP mice. There was an increase detected in saline plus exercise mice. Analyses using fast-scan cyclic voltammetry showed increased stimulus-evoked release and a decrease in decay of dopamine in the dorsal striatum of MPTP plus exercise mice only. Immunohistochemical staining analysis of striatal tyrosine hydroxylase and dopamine transporter proteins showed decreased expression in MPTP plus exercise mice compared with MPTP mice. There were no differences in mRNA transcript expression in midbrain dopaminergic neurons between these two groups. However, there was diminished transcript expression in saline plus exercise compared with saline mice. Our findings suggest that the benefits of treadmill exercise on motor performance may be accompanied by changes in dopaminergic neurotransmission that are different in the injured (MPTP-lesioned) compared with the noninjured (saline) nigrostriatal system.

A randomised, controlled study on the effects of a short-term endurance training programme in patients with major depression

Objective: To evaluate the short-term effects of exercise in patients with major depression. Design: Prospective, randomised, controlled study. Setting: A university hospital. Patients: A consecutive series of 38 inpatients with...

Effects of a Multimodal Exercise Program for People With Ankylosing Spondylitis

Few randomized controlled studies have examined the effects of exercise in patients with ankylosing spondylitis (AS). This study investigated the effects of a 12-week, multimodal exercise program in patients with AS. A convenience sample of 30 patients with AS (18 male, 12 female), with a mean age of 34.9 years (SD=6.28), participated in the study. Twenty-six subjects were classified as having stage I AS and 4 subjects were classified as having stage II AS according to the modified New York Criteria. This study was a randomized controlled trial. Subjects were assigned to either a group that received an exercise program or to a control group. The exercise program consisted of 50 minutes of multimodal exercise, including aerobic, stretching, and pulmonary exercises, 3 times a week for 3 months. Subjects in both groups received medical treatment for AS, but the exercise group received the exercise program in addition to the medical treatment. All subjects received a physical examination at baseline and at 12 weeks. The examinations were conducted under the supervision of a physician who specialized in physical medicine and rehabilitation and included the assessment of spinal mobility using 2 methods: clinical measurements (chin-to-chest distance, Modified Schober Flexion Test, occiput-to-wall distance, finger-to-floor distance, and chest expansion) and inclinometer measurements (gross hip flexion, gross lumbar flexion, and gross thoracic flexion). In addition, vital capacity was measured by a physiologist, and physical work capacity was evaluated by a doctorally prepared exercise instructor. The measurements of the exercise group for chest expansion, chin-to-chest distance, Modified Schober Flexion Test, and occiput-to-wall distance were significantly better than those of the control group after the 3-month exercise period. The spinal movements of the exercise group improved significantly at the end of exercise program, but those of the control group showed no significant change. In addition, the results showed that the posttraining value of gross thoracic flexion of the exercise group was significantly higher than that of the control group. Physical work capacity and vital capacity values improved in the exercise group but decreased in the control group. In this study, a multimodal exercise program including aerobic, stretching, and pulmonary exercises provided in conjunction with routine medical management yielded greater improvements in spinal mobility, work capacity, and chest expansion.

A Randomized Controlled Trial on the Efficacy of Exercise for Patients With Chronic Neck Pain

A randomized controlled trial with single-blind outcome assessments. To evaluate the efficacy of a neck exercise program in patients with chronic neck pain. The effect of exercise for patients with chronic neck pain has been investigated in a number of studies. The efficacy is, however, questionable. A total of 145 patients were randomly allocated into an exercise (n = 67) and a nonexercise (control) group (n = 78). Patients in the control group were given infrared irradiation and neck care advice. In addition to infrared irradiation and advice, patients in the exercise group had undergone an exercise program with activation of the deep neck muscles and dynamic strengthening of the neck muscles for 6 weeks. Subjective pain and disability and isometric neck muscle strength were measured at baseline, 6 weeks, and 6 months. Analysis was by intention-to-treat. At week 6, the exercise group had a significantly better improvement in disability score (P = 0.03), subjective report of pain (P = 0.01), and in isometric neck muscle strength (P = 0.57-0.00) in most of the directions than the control group. However, significant differences between the two groups were found only in the subjective report of pain and patient satisfaction at the 6-month follow-up. At week 6, patients with chronic neck pain can benefit from the neck exercise program with significant improvement in disability, pain, and isometric neck muscle strength in different directions. However, the effect of exercise was less favorable at 6 months.

Feasibility of exercise during treatment for multiple myeloma.

Fatigue and insomnia are problems for patients with cancer. Research findings show that aerobic exercise decreases cancer-related fatigue. Because patients with cancer who have skeletal muscle wasting may not obtain maximum benefit from aerobic exercise training, exercise programs may need to include resistance training. Thus far, testing exercise as an intervention for fatigue has focused on patients with breast cancer and excluded patients with bone metastasis. There is a need to test the feasibility and effectiveness of exercise for patients with other types of cancer and with bone involvement. The effect of aerobic and strength resistance training on the sleep of patients with cancer has not been tested. A pilot/feasibility study with a randomized controlled design was conducted to investigate home-based exercise therapy for 24 patients receiving high-dose chemotherapy and autologous peripheral blood stem cell transplantation as treatment for multiple myeloma. None of the patients injured themselves. Because of the small sample size in the feasibility study, the effect of exercise on lean body weight was the only end point that obtained statistical significance. However, the results suggest that an individualized exercise program for patients receiving aggressive treatment for multiple myeloma is feasible and may be effective for decreasing fatigue and mood disturbance, and for improving sleep.

Acute Effects of Exercise in Patients With Previous Deep Venous Thrombosis: Impact of the Post-thrombotic Syndrome.

Kahn, S R; Azoulay, L; Hirsch, A; Haber, M; Strulovitch, C; Shrier, I Author Information

Beneficial effects of water-based exercise in patients with chronic kidney disease

Beneficial effects of water-based exercise in patients with chronic kidney disease

Acute Effects of Exercise in Patients With Previous Deep Venous Thrombosis : Impact of the Postthrombotic Syndrome

The postthrombotic syndrome (PTS) occurs frequently after deep venous thrombosis (DVT) and is believed to worsen with upright posture and physical activity. However, the effects of exercise in patients with previous DVT have not been studied.To determine whether previous DVT and PTS limit the ability to exercise, and whether exercise increases the severity of venous symptoms and signs.A repeated-measures cohort study that was conducted at a university-affiliated teaching hospital, 1999-2000.Subjects with a first episode of unilateral DVT at least 1 year earlier were recruited from the Thrombosis Clinic (total, 41 subjects; with PTS, 19 subjects).Treadmill exercise session.Venous symptoms, calf muscle fatigability, flexibility, and leg volume before and after treadmill exercise were measured and compared. Exercise did not worsen venous symptoms, despite a higher gain in affected leg volume in subjects with PTS vs subjects without PTS (mean difference: affected leg, 53 mL; unaffected leg, -15 mL; p = 0.018). Calf flexibility significantly improved after exercise in subjects with PTS (gastrocnemius: affected-unaffected, PTS vs no PTS + 4.5 degrees, p = 0.0029; soleus: affected-unaffected, PTS vs no PTS + 5.7 degrees, p = 0.0011).Exercise did not acutely exacerbate symptoms and, in subjects with PTS, resulted in improved flexibility in the affected leg. Our findings suggest that treadmill or similar exercise is unlikely to make symptoms of PTS worse, and may improve flexibility. Further study is indicated to determine whether a regular exercise-training program might have a role in the management of patients with PTS, since, to date, the treatment options for this condition are limited.

Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta‐analysis of controlled clinical trials

Context: Exercise is widely perceived to be beneficial for glycemic control and weight loss in patients with type 2 diabetes. However, clinical trials on the effects of exercise in patients with type 2 diabetes have had small sample sizes and conflicting results. Objective: To systematically review and quantify the effect of exercise on glycosylated hemoglobin (HbA(1c)) and body mass in patients with type 2 diabetes. Data sources: Database searches of MEDLINE, EMBASE, Sport Discuss, Health Star, Dissertation Abstracts and the Cochrane Controlled Trials Register for the period up to and including December 2000. Additional data sources included bibliographies of textbooks and articles identified by the database searches. Study selection: We selected studies that evaluated the effects of exercise interventions (duration ≥ = 8 weeks) in adults with type 2 diabetes. Fourteen (11 randomized and three non‐randomized) controlled trials were included. Studies that included drug cointerventions were excluded. Data extraction: Two reviewers independently extracted baseline and post‐intervention means and SDs for the intervention and control groups. The characteristics of the exercise interventions and the methodological quality of the trials were also extracted. Data synthesis: Twelve aerobic training studies [mean (SD), 3.4 (0.9) times/week for 18 (15) weeks] and two resistance training studies [mean (SD), 10 (0.7) exercises, 2.5 (0.7) sets, 13 (0.7) repetitions, 2.5 (0.4) times/week for 15 (10) weeks] were included in the analyses. The weighted mean post‐intervention HbA(1c) was lower in the exercise groups compared with the control groups (7.65% vs 8.31%; weighted mean difference, 0.66%; P < 0.001). The difference in post‐intervention body mass between exercise groups and control groups was not significant (83.02 kg vs 82.48 kg; weighted mean difference, 0.54; P= 0.76). Conclusion: Exercise training reduces HbA(1c) by an amount that should decrease the risk of diabetic complications, but no significantly greater change in body mass was found when exercise groups were compared with control groups.

Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials.

Exercise is widely perceived to be beneficial for glycemic control and weight loss in patients with type 2 diabetes. However, clinical trials on the effects of exercise in patients with type 2 diabetes have had small sample sizes and conflicting results. To systematically review and quantify the effect of exercise on glycosylated hemoglobin (HbA(1c)) and body mass in patients with type 2 diabetes. Database searches of MEDLINE, EMBASE, Sport Discuss, Health Star, Dissertation Abstracts, and the Cochrane Controlled Trials Register for the period up to and including December 2000. Additional data sources included bibliographies of textbooks and articles identified by the database searches. We selected studies that evaluated the effects of exercise interventions (duration >/=8 weeks) in adults with type 2 diabetes. Fourteen (11 randomized and 3 nonrandomized) controlled trials were included. Studies that included drug cointerventions were excluded. Two reviewers independently extracted baseline and postintervention means and SDs for the intervention and control groups. The characteristics of the exercise interventions and the methodological quality of the trials were also extracted. Twelve aerobic training studies (mean [SD], 3.4 [0.9] times/week for 18 [15] weeks) and 2 resistance training studies (mean [SD], 10 [0.7] exercises, 2.5 [0.7] sets, 13 [0.7] repetitions, 2.5 [0.4] times/week for 15 [10] weeks) were included in the analyses. The weighted mean postintervention HbA(1c) was lower in the exercise groups compared with the control groups (7.65% vs 8.31%; weighted mean difference, -0.66%; P<.001). The difference in postintervention body mass between exercise groups and control groups was not significant (83.02 kg vs 82.48 kg; weighted mean difference, 0.54; P =.76). Exercise training reduces HbA(1c) by an amount that should decrease the risk of diabetic complications, but no significantly greater change in body mass was found when exercise groups were compared with control groups.

Exercise inhibits epithelial sodium channels in patients with cystic fibrosis.

The aim of this study was to determine the effects of a single exercise bout on luminal Cl(-) and Na(+) conductance in the respiratory epithelium of patients with cystic fibrosis (CF). In nine patients with CF and nine healthy control subjects, the transepithelial electrical potential difference (PD) of the nasal respiratory epithelium was recorded, first at rest and then during moderate-intensity exercise. Under both conditions, PD was first measured while superfusing the epithelium with isotonic saline. Then, the effects of amiloride and amiloride plus low chloride plus isoproterenol were determined. Exercise resulted in a significant lower PD compared with rest in patients with CF (-6.6 +/- 16.6 mV versus -33.6 +/- 10.0 mV, p < 0.0001) and control subjects (0.1 +/- 8.7 mV versus -7.1 +/- 5.1 mV, p < 0.01). The effects of amiloride on PD were reduced during exercise compared with rest in patients with CF (+15.8 +/- 9.5 mV versus +26.1 +/- 11.0 mV, p < 0.01) and control subjects (+5.8 +/- 4.8 mV versus +10.0 +/- 3.1 mV, p < 0.01). There was no effect of exercise on chloride conductance in patients with CF and control subjects. We conclude that moderate-intensity exercise partially blocks the amiloride-sensitive sodium conductance in the respiratory epithelium. The inhibition of luminal sodium conductance could increase water content of the mucus in the CF lung during exercise and may, in part, explain the beneficial effects of exercise in patients with CF.

Effects of Clinical Pilates Exercises in Patients With Rheumatoid Arthritis

Effects of Clinical Pilates Exercises in Patients With Rheumatoid Arthritis

The Effect of Intensive Group Exercise in Patients with Chronic Low Back Pain

The purpose of the present study was to evaluate the effect of 15 weeks of intensive bi-weekly group exercise in sedentary subjects with long-lasting chronic low back pain (CLBP). Twenty-nine sedentary subjects with long-lasting CLBP were successively assigned to an exercise group (EG, n=16) or a control group (CG, n=13). Patients in the EG exercised for 75 min bi-weekly for 15 weeks. The CG followed traditional medical care. Cardiovascular fitness, back and abdominal muscle strength, and flexibility of hip muscles and the spine were measured before and after treatment. Outcome measures were low back pain (visual analogue scale, VAS), functional disability (the revised Oswestry LBP Disability Index), anxiety and depression (Hospital Anxiety and Depression Scale, HAD), and active and passive pain coping strategies (Vanderbilt Pain Management Inventory, VPMI). The results showed statistically significant differences between the groups in advantage of the EG in all physical capacity tests, except for cardiov...

Comparison of Aerobic Exercise, Clomipramine, and Placebo in the Treatment of Panic Disorder

The purpose of this study was to compare the therapeutic effect of exercise for patients with panic disorder to a drug treatment of proven efficacy and to placebo. Forty-six outpatients suffering from moderate to severe panic disorder with or without agoraphobia (DSM-III-R criteria) were randomly assigned to a 10-week treatment protocol of regular aerobic exercise (running), clomipramine (112.5 mg/day), or placebo pills. The dropout rate was 31% for the exercise group, 27% for the placebo group, and 0% for the clomipramine group. In comparison with placebo, both exercise and clomipramine led to a significant decrease in symptoms according to all main efficacy measures (analysis of variance, last-observation-carried-forward method and completer analysis). A direct comparison of exercise and clomipramine revealed that the drug treatment improved anxiety symptoms significantly earlier and more effectively. Depressive symptoms were also significantly improved by exercise and clomipramine treatment. These results suggest that regular aerobic exercise alone, in comparison with placebo, is associated with significant clinical improvement in patients suffering from panic disorder, but that it is less effective than treatment with clomipramine.

Valor del Doppler de esfuerzo para el diagnóstico de la estenosis mitral severa

Exercise in mitral stenosis produces an increase in cardiac output and heart rate which determines the increment in the transmitral gradient. However, it has not yet been established what level is reached by the gradients on exercise in severe mitral stenosis nor whether the rise in the gradient during such exercise is different to that occurring in non-severe stenosis. To evaluate the effect of exercise in patients with severe mitral stenosis on the mitral valve gradients in absolute values and on the increment with respect to base values. Forty-eight mitral stenosis patients (mean age: 48.8 +/- 11 years) underwent 50 exercise Doppler echocardiographic studies using supine bicycle ergometry in two stages with increases of 25 W every 3 minutes; from each of these we obtained the peak and mean mitral gradient using a non-imaging continuous-wave Doppler probe. We also conducted this procedure on 14 patients with a mean age of 50 +/- 6 who had Bjork mitral prostheses which were functioning normally. We defined a hemodynamic profile of severity based on the data from 18 patients whose basal mitral valve areas was < 1.2 cm2 (group I), and compared them with the data from the 32 studies of mitral stenosis patients with an area > 1.1 cm2 (group II) and with the patients with mitral prostheses (group III). The mean mitral gradient (mmHg) in group I was greater than in group II at rest (9.3 +/- 3.2 and 6.6 +/- 2.7; p < 0.001), at 25 W (20.6 +/- 4.8 and 14.1 +/- 5; p < 0.001) and at 50 W (25.9 +/- 5.4 and 17.3 +/- 5.8; p < 0.001). The increase in mean mitral gradient from the baseline to 50 watts was 16.7 +/- 4.5 mmHg in group I, which was greater than in group II and III (11.1 +/- 4.1 and 6.8 +/- 2.6 mmHg; p < 0.001). Exercise Doppler echocardiography enabled us to define a differential hemodynamic profile in patients with severe mitral stenosis which can be used in isolation as an indicator of severity in this condition.

Role of exercise in rehabilitation of coronary heart disease in cases combined with noninsulin‐dependent diabetes mellitus

It has been shown that exercise has a positive influence on the course of patients with coronary heart disease. However, the effect of exercise in patients with coronary heart disease and noninsulin‐dependent diabetes mellitus (NIDDM) is unknown. The study involved 30 men 47 to 66 years old with coronary heart disease and NIDDM; their tolerance for exercise increased, the number of angina episodes decreased during daily activity, and there was a reduction in resting glycemia. A schedule of an exercise session lasting 5 minutes six times a week, which was increased by 5 minutes after every 7 to 10 training sessions, is completely safe for use in outpatient rehabilitation of these patients.

Hemodynamic, Ventilatory and Metabolic Effects of Light Isometric Exercise in Patients With Chronic Heart Failure

Light isometric exercise, such as lifting or carrying loads that require 25% of a maximal voluntary contraction, is frequently reported to cause dyspnea in patients with heart failure. The pathophysiologic mechanisms responsible for the appearance of this symptom, however, are unknown. Accordingly, hemodynamic, metabolic and ventilatory responses to 6 min of light isometric forearm exercise were examined and compared in 20 patients with chronic heart failure and abnormal ejection fraction (24 +/- 9%) and 17 normal individuals. In contrast to findings in normal volunteers, exercise cardiac index did not increase whereas exercising forearm and mixed venous lactate concentrations increased (p less than 0.05) above levels at rest in patients with heart failure; at 90 s of recovery, blood lactate concentration remained elevated (p less than 0.05). The venous lactate concentration of the nonexercising arm, unlike that of the exercising forearm, was not altered. Oxygen uptake, carbon dioxide production and minute ventilation increased similarly in patients and normal subjects during exercise, but only in patients did each increase further (p less than 0.05) during recovery. Thus, in patients with heart failure, light isometric forearm exercise represents an anaerobic contraction with lactate production. The subsequent increase in carbon dioxide production leads to a disproportionate increase in minute ventilation and oxygen uptake during recovery that may be perceived as breathlessness.

Metabolic effects of exercise in patients with type IV hyperlipoproteinemia

Metabolic responses to 30 minutes of submaximal exercise were investigated in 11 healthy control subjects and 6 patients with type IV hyperlipoproteinemia (endogenous or essential hypertriglyceridemia). All subjects were male and ranged in age from 35 to 55 years. Before exercise they fasted overnight for at least 12 hours. The relative work performed, judged by the levels in heart rate and cardiac output on exercise, was comparable in the two groups, and the effects of exercise were qualitatively similar. Plasma glucose and triglyceride levels showed little change. Plasma concentration of cholesterol increased at the end of exercise by approximately 13 percent above control values compared to a concomitant increase in hematocrit of 3 percent. Plasma free fatty acid levels fell as exercise started and then returned to normal valves at the end of the 30 minutes of exercise; they then increased markedly after exercise but returned subsequently to control levels after 45 minutes. In response to muscular exercise, therefore, both control subjects and patients with type IV hyperlipoproteinemia significantly increase plasma cholesterol concentration. Subjects with hyperlipoproteinemia appear to mobilize free fatty acids in a normal manner for energy purposes, and the excess release of free fatty acids during exercise is apparently not derived from the abundantly circulating triglycerides; the latter were not altered by submaximal exercise.