Arm Exercise Research Articles

Wristband accelerometers to motivate arm exercise after stroke (WAVES): Activity data from a pilot randomised controlled trial

Encouraging impaired limb use during routine and rehabilitation activities after stroke is challenging. We evaluated changes in stroke arm activity related to vibration prompts delivered by a wrist-worn accelerometer (“CueS wristband”). A pilot randomised controlled trial was conducted with adults < 3 months after stroke causing any arm impairment. All received instruction for a self-directed four-week programme encouraging bimanual tasks, and wore a wristband on the impaired side 8am–8pm. Intervention wristbands were programmed to deliver vibration prompts if hourly activity targets were unmet. To allow for incremental recovery, patient preference and diurnal variability, the target was selected as 5%, 10% or 20% above median levels recorded hourly over the previous 3 days. Data were downloaded at twice weekly reviews. Activity counts per minute (CPM) were calculated from CueS mean signal vector magnitude (1 s epoch) at the first (baseline) and the last (endpoint) review. Standard accelerometers recorded natural arm activity over 72 h starting at 4 and 8 weeks post-baseline. Mann Whitney U test compared CPM between groups, and for 1 hour before/after prompts amongst intervention participants. Thirty-three participants (14 intervention; 19 control) enrolled over 16 months: mean age 71 years (SD11); 13 male; mean days post-stroke 30 (SD19); median baseline Action Research Arm Test 20/57 [IQR 3.5,41]. Median number of prompts delivered were 7 per participant/day [IQR: 6,8]. Median CPM during 1 hour before/after prompts was 651 versus 759 (+16.6%; P = 0.002). CPM increased immediately after prompting, suggesting a direct behavioural impact. Compared to control, the intervention group continued to increase CPM beyond wristband removal. Whilst these results are encouraging, this was a small study and data may not reflect only arm activity. Personalised prompts delivered by a wrist-worn accelerometer may enhance self-directed arm activity after stroke.

Aerobic exercise and DNA methylation in postmenopausal women: An ancillary analysis of the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial.

Physical activity is associated with a lower risk of breast, colon, and endometrial cancer. Epigenetic mechanisms such as changes in DNA methylation may help to explain these protective effects. We assessed the impact of a one year aerobic exercise intervention on DNA methylation biomarkers believed to play a role in carcinogenesis. The Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial was a two-armed randomized controlled trial in 320 healthy, inactive, postmenopausal women with no history of cancer. In an ancillary analysis, frozen blood samples (n = 256) were reassessed for levels of DNA methylation within LINE-1 and Alu repeats as well as within the promoter regions of APC, BRCA1, RASSF1, and hTERT genes. Differences between the exercise and control arm at 12-months, after adjusting for baseline values, were estimated within an intent-to-treat and per-protocol analysis using linear regression. No significant differences in DNA methylation between the exercise and control arms were observed. In an exploratory analysis, we found that the prospective change in estimated VO2max was negatively associated with RASSF1 methylation in a dose-response manner (p-trend = 0.04). A year-long aerobic exercise intervention does not affect LINE-1, Alu, APC, BRCA1, RASSF1, or hTERT methylation in healthy, inactive, postmenopausal women. Changes in DNA methylation within these genomic regions may not mediate the association between physical activity and cancer in healthy postmenopausal women. Additional research is needed to validate our findings with RASSF1 methylation.Trial Registration: ClinicalTrials.gov NCT00522262.

SINCROBOX® as a method to improve shoulder’s function in mastectomized women

Objectives: To asses the effect of a sports discipline called SINCROBOX® (consisting in stationary biking coordinated with different arm exercises, namely grip strength, light weightlifts, elastic band stretching, etc) in the functional capacity of mastectomized women’s shoulder. Methods: A randomized blinded cohort study was carried out, with 2 groups of mastectomized women (due to breast cancer). The first one (28 patients) was subjected to SINCROBOX® training for three months, while the second one (22 patients) served as control group. Every patient was subjected to physical exam (range of motion measurement of the affected shoulder) and to functional shoulder tests (DASH, Constant, STT and Oxford) before beginning the training and after 3 months of exercise. A Student’s T test was performed for statistical analysis in each group. Results: Every variable assessed showed statistically significant advantages in the training group: range of motion increased more than 10° in all directions; SST (+20.9; p&lt;0.001), DASH (-19.8; p&lt;0.001), Constant (+15; p=0.004) and Oxford (+8.6; p&lt; 0.001). There were no differences in the control group, before and after training. No complications were found in both groups. Conclusion: SINCROBOX® is a safe sports discipline that has the ability to improve mastectomized women’s shoulder’s functional capacity.

Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial

ObjectiveTo estimate the effect of a moderate to high intensity aerobic and strength exercise training programme on cognitive impairment and other outcomes in people with mild to moderate dementia.DesignMulticentre, pragmatic,...

Commentary: An interactive videogame for arm and hand exercise in people with Parkinson's disease: A randomized controlled trial.

Commentary: An interactive videogame for arm and hand exercise in people with Parkinson's disease: A randomized controlled trial.

Portable EMG Data Acquisition Module for Upper Limb Prosthesis Application

Electromyography (EMG) signals are gaining popularity to develop the prosthetics. In this paper, an efficient multi-channel EMG signal acquisition system has been proposed for upper limb prosthetic application. Various arm exercises have been performed to obtain EMG signals from five different arm muscles for the validation of developed hardware. The muscle’s position has been selected by palpation method. Furthermore, the classification algorithms have been examined for seven different activities. Total 29 subjects have been chosen (25 intact and four Amputees) to acquire the EMG data by these activities. To classify the recorded EMG data set, nine time domain and seven frequency domain features have been extracted. A comparative analysis of different classifiers is presented for different muscle position of electrodes. The signal processing and classification algorithms have been processed in MATLAB 2016a. The accuracy of classification ranges for different classification algorithms from 57.69% to 99.92% for all subjects.

Chronic iliofemoral vein obstruction – an under-recognized cause of exercise limitation

Local symptoms of chronic venous insufficiency after deep vein thrombosis (DVT) are well described, but little is known about the effect of residual venous obstruction on exercise capacity. We tested our hypothesis that chronic residual iliofemoral vein occlusion (IFVO) after DVT may impair exercise capacity. Nine post-DVT patients with residual IFVO and effort intolerance were studied; a comparison cohort consisted of 11 healthy volunteers. Exercise tolerance was assessed by bimodality incremental symptom-limited cardiopulmonary testing, using leg and arm ergometers. In healthy subjects, leg vein obstruction was modelled by application to the thighs of cuff tourniquets inflated to 30–40 mmHg. Leg exercise tolerance as measured by oxygen uptake at peak exercise (peak ⩒’O2) was reduced in patients (median 50% predicted (range 36–83%) vs. 88% predicted (67–129%) in normal subjects, p < 0.001). Arm exercise tolerance was also reduced in patients, but less severely than in the legs – the median arm: leg ratio of peak ⩒’O2 was 0.95 (0.77–1.43) in patients vs. a normal ratio of 0.73 (0.6–1.0) in healthy subjects (p < 0.003). In healthy subjects, bilateral leg vein obstruction by tourniquets reduced peak ⩒’O2 in leg exercise to 76% predicted (range 55–108%; p < 0.001 vs. standard test). In conclusion, the comparison of arm vs. leg exercise capacity in post-DVT patients with residual IFVO and the effect of experimental venous obstruction (thigh tourniquets) in healthy subjects suggest that reduced exercise capacity in patients was at least partially caused by reduced venous return. Chronic venous obstruction should be recognized as a cause of exercise limitation.

Upper limb muscle activation during sports video gaming of persons with spinal cord injury

Objective Video gaming as a therapeutic tool has largely been studied within the stroke population with some benefits reported in upper limb motor performance, balance, coordination, and cardiovascular status. To date, muscle activation of upper limb muscles in persons with spinal cord injuries (SCI) has not been studied during video game play. In this paper, we provide descriptive and comparative data for muscle activation and strength during gaming for players with tetraplegia and paraplegia, as well as, compare these results with data from traditional arm exercises (ie, biceps curl and shoulder press) with light weights which are commonly prescribed for a home program. Participants Fourteen individuals with chronic SCI (9 tetraplegia, 5 paraplegia). Design We measured upper limb muscle activation with surface electromyography (EMG) during Wii Sports video game play. Muscle activation was recorded from the playing arm during 4 selected games and normalized to a maximum voluntary contraction (MVC). Outcome measures Heart rate and upper limb motion were recorded simultaneously with EMG. Wilcoxon signed rank tests were used to analyze differences in muscle activation between participants with paraplegia versus tetraplegia and compare gaming with traditional arm exercises with light weights. A Friedman 2-way analysis of variance identified key muscle groups active during game play. Results Overall muscle activation across the games was not different between those with paraplegia and tetraplegia. Heart rate during video game play for tennis and boxing were on average 10 to 20 beats/minute above resting heart rate. The magnitude of EMG was relatively greater for traditional arm exercises with light weights compared with game play. Conclusion The selected Wii games were able to elicit upper extremity muscle activation and elevated heart rates for individuals with SCI that may be used to target therapeutic outcomes.

Slow loaded breathing training improves blood pressure, lung capacity and arm exercise endurance for older people with treated and stable isolated systolic hypertension.

Hypertension and reduced lung function are important features of aging. Slow loaded breathing training reduces resting blood pressure and the question is whether this can also improve lung function. Thirty-two people (67 ± 5 years, 16 male) with controlled isolated systolic hypertension undertook an eight weeks randomised controlled training trial with an inspiratory load of 25% maximum inspiratory pressure (MIP) at 6 breaths per minute (slow loaded breathing; SLB) or deep breathing control (CON). Outcome measures were resting blood pressure (BP) and heart rate; MIP; lung capacity; chest and abdominal expansion; arm cranking exercise endurance at 50% heart rate reserve. Home based measurement of resting systolic BP decreased by 20 mm Hg (15 to 25) (Mean and 95%CI) for SLB and by 5 mm Hg (1 to 7) for CON. Heart rate and diastolic BP also decreased significantly for SLB but not CON. MIP increased by 15.8 cm H2O (11.8 to 19.8) and slow vital capacity by 0.21 L (0.15 to 0.27) for SLB but not for CON. Chest and abdominal expansion increased by 2.3 cm (2.05 to 2.55) and 2.5 cm (2.15 to 2.85), respectively for SLB and by 0.5 cm (0.26 to 0.74) and 1.7 cm (1.32 to 2.08) for CON. Arm exercise time increased by 4.9 min (3.65 to 5.15) for SLB with no significant change for CON. Slow inspiratory muscle training is not only effective in reducing resting BP, even in older people with well controlled isolated systolic hypertension but also increases inspiratory muscle strength, lung capacity and arm exercise duration.

Effect of Cold-Water Immersion on Elbow Flexors Muscle Thickness After Resistance Training.

Matos, F, Neves, EB, Rosa, C, Reis, VM, Saavedra, F, Silva, S, Tavares, F, and Vilaça-Alves, J. Effect of cold-water immersion on elbow flexors muscle thickness after resistance training. J Strength Cond Res 32(3): 756-763, 2018-Cold-water immersion (CWI) is commonly applied to speed up the recovery process after exercise. Muscle damage may induce a performance reduction and consequence of the intramuscular pressure induced by the muscular swelling. The aim of the study was to verify the CWI effects on muscle thickness (MT) behavior of the elbow flexors after a strength training (ST) protocol. Eleven men were submitted to an ST, performed in 2 different weeks. In one of the weeks, subjects experienced a passive recovery. In the other, subjects were submitted to a CWI (20 minutes at 5-10° C). Ultrasound (US) images were taken before, after, as well as 24, 48, and 72 hours after exercise, to evaluate the MT. Muscle thickness in both exercise arm (EA) and control arm (CA) was significantly higher 48 and 72 hours after exercise when subjects were submitted to a passive recovery compared with the CWI (p = 0.029, p = 0.028, p = 0.009, and p = 0.001, 48 hours, 72 hours, EA, and CA, respectively). When each arm was analyzed with or without using CWI individually, significantly higher MT was observed in the EA with CWI: before exercise in relation to 72 hours after exercise (p = 0.042) and after exercise in relation to the other measurements (p = 0.003, p = 0.003, p = 0.038, and p < 0.0001, before exercise and 24, 48, 72 hours after exercise, respectively). The evaluation of MT by US provides evidence that CWI after ST (and 24 hours after exercise) may reduce muscle swelling in the postexercise days when compared with a passive recovery. Seems to be a paradox between the uses of CWI for an acute reduction of muscle swelling.

Effects of a 6-month moderate-intensity exercise program on metabolic parameters and bone mineral density in men on androgen deprivation therapy for prostate cancer.

237 Background: Androgen deprivation therapy (ADT) is commonly used to treat prostate cancer (PC) but is associated with significant side effects including metabolic abnormalities and bone loss. Although multiple trials have demonstrated that exercise is associated with improvements in multiple side effects of ADT, its effects on metabolic and skeletal outcomes is unclear. We conducted a phase II randomized controlled trial (RCT) comparing three different exercise delivery models. The present analysis examined prespecified endpoints of change in metabolic parameters and bone mineral density. Methods: Men with stage TxNxMx PC starting or continuing ADT for at least 6 months were enrolled and randomized equally to personal training (n = 18), supervised group training (n = 14), or home-based training (n = 16). Participants in all intervention arms underwent moderate to vigorous physical activity with a target of 150 minutes per week for 6 months. Fasting blood work and dual x-ray absorptiometry (DXA) were done at baseline and 6 months (blood work) and 12 months (DXA). Paired t-tests and ANCOVA were used to analyze findings. Results: 48 participants (mean age 69.9 years) were enrolled. The primary analysis demonstrated no significant difference between arms on most quality of life and fitness outcomes so groups were combined for the present analysis. Exercise was not associated with statistically significant changes in hemoglobin, total cholesterol, low density lipoprotein, high density lipoprotein, triglycerides, or fasting blood glucose (p = 0.075 to 0.87). Similarly, exercise was not associated with changes in bone mineral density at lumbar spine, total hip, or femoral neck sites on DXA (p = 0.44 to 0.71). Mean weight change was +0.8 kg. There was no difference between exercise arms on any outcome. Conclusions: Although our study is limited by a small sample size, our results suggest that 6 months of moderate intensity exercise is not associated with improvements in either metabolic or skeletal outcomes in men on ADT. More intensive behavioural interventions and/or pharmacological interventions will be required to reverse the deleterious effects of ADT. Clinical trial information: NCT02046837.

The Effects of Exercise on Physical and Psychological Outcomes in Cancer Caregivers: Results From the RECHARGE Randomized Controlled Trial.

Family caregivers to cancer patients are at risk for physical and psychological morbidity as a direct result of being in the caregiver role. Exercise as an intervention to support caregiver health and well-being has been tested in other caregiver populations; however, no randomized controlled trials testing the effects of an aerobic and resistance training program have been conducted where cancer caregivers only have participated. To examine the effects of a 12-week exercise program on quality of life (Short Form 36 v2), psychological outcomes, physical activity levels, and physical fitness in caregivers to cancer patients. Seventy-seven caregivers were randomized to either an exercise intervention or wait-list control. Two participants in the exercise arm dropped out immediately after their baseline assessment. Outcome data for n = 77 participants were analyzed using intention-to-treat analysis with linear mixed models. Significant group by time interaction effects were detected for exercise on the mental health component score of quality of life, self-reported weekly exercise levels, and the six-minute walk test. Small to medium effect sizes were detected on several outcomes including physical health component of quality of life (d = 0.36), mental health component of quality of life (d = 0.74), depression (d = 0.41), anxiety (d = 0.35), physical activity levels (d = 0.80), and the six-minute walk test (d = 0.21). The findings suggest that exercise may improve health and well-being and could be considered as an additional type of support offered to cancer caregivers. NCT02580461.

Performance comparison of the MOXY and PortaMon near-infrared spectroscopy muscle oximeters at rest and during exercise.

The purpose of the study was to compare muscle oxygenation as measured by two portable, wireless near-infrared spectroscopy (NIRS) devices under resting and dynamic conditions. A recently developed low-cost NIRS device (MOXY) was compared against an established PortaMon system that makes use of the spatially resolved spectroscopy algorithm. The influence of increasing external pressure on tissue oxygen saturation index (TSI) indicated that both devices are stable between 2 and 20mmHg. However, above this pressure, MOXY reports declining TSI values. Analysis of adipose tissue thickness (ATT) and TSI shows a significant, nonlinear difference between devices at rest. The devices report similar TSI (%) values at a low ATT (<7 mm) (PortaMon minus MOXY difference is +1.1±2.8%) with the major subsequent change between the devices occurring between 7 and 10mm; at ATT values >10 mm the difference remains constant (-14.7±2.8%). The most likely explanation for this difference is the small source-detector separation (2.5cm) in the MOXY resulting in lower tissue penetration into muscle in subjects with higher ATT. Interday test-retest reliability of resting TSI was evaluated on five separate occasions, with the PortaMon reporting a lower coefficient of variation (1.8% to 2.5% versus 5.7% to 6.2%). In studies on male subjects with low ATT, decreases in the TSI were strongly correlated during isometric exercise, arterial occlusion, and incremental arm crank exercise. However, the MOXY reports a greater dynamic range, particularly during ischemia induced by isometric contraction or occlusion (Δ74.3% versus Δ43.7%; hyperemia MAX-occlusion MIN). This study shows that in this subject group both MOXY and PortaMon produce physiologically credible TSI measures during rest and exercise. However, the absolute values obtained during exercise are generally not comparable between devices unless corrected by physiological calibration following an arterial occlusion.

Music ergogenic effect on strength performance: randomized clinical test

Background: Using preferred music during the exercise series was a differentiated way to increase muscle performance and fatigue slowdown, increasing the number of repetitions in these exercises. Despite of some studies present the effects of music, there is still a little music influence in strength training. Objectives: Verify the music effect on the strength performance in young adults, and the relation with the preferences of muscular grouping according to gender. Methods: a cross-sectional, controlled and crossover study was carried out with 20 physically active young adult participants (10 men). After previous laboratory evaluations, they underwent two exercise sessions, one experimental, where the participant performed 3 maximum series of exercises Barbell Curl and Leg Extensor seat listening to songs of their own choosing and another control session without music, adopting the series with greater repetition in each exercise for analysis. A minimum interval of 48 hours was adopted between each session. The protocol order (i.e. with music or without music) was made by the raffle. In the sessions, participants were asked to perform the maximum number of repetitions at 80% of the load determined in the laboratory. Results: The use of their preferred music significantly increased the number of repetitions in the two exercises, however, the preferences for muscular clusters characterized by the genders proved to be a determining variable. Conclusion: With the increasing of repetitions it was possible to observe an ergogenic resource to increase the performance in strength training, thus, a differentiated performance pattern was found between men and women in arm exercises when they use music.

Comparable neutrophil responses for arm and intensity-matched leg exercise

Comparable neutrophil responses for arm and intensity-matched leg exercise

Comparison of Cardio Respiratory Responses and Level of Exertion Following two Common tests for Arm Exercise Capacity in Patients with COPD

Comparison of Cardio Respiratory Responses and Level of Exertion Following two Common tests for Arm Exercise Capacity in Patients with COPD

Long-Term Effects of Weight Loss and Exercise on Biomarkers Associated with Angiogenesis.

Background: We tested the effect of weight loss on circulating levels of the angiogenic factors VEGF and pigment epithelium-derived factor (PEDF) in postmenopausal overweight/obese women, 18 months after completing a year-long 4-arm randomized controlled trial of behavioral weight loss and/or exercise versus control (i.e., 30 months postrandomization).Methods: The 439 overweight/obese, postmenopausal women, ages 50 to 75 years, were randomized to: diet (goal: 10% weight loss, N = 118), exercise (225 min/wk moderate-to-vigorous activity, N = 117), diet + exercise (N = 117), or control (N = 87). At 12 months, 399 women gave a blood sample; 156 returned at 30 months. Biomarkers were measured by immunoassay. Changes were compared using generalized estimating equations, adjusting for baseline BMI, age, and race/ethnicity.Results: Participants randomized to diet, exercise, and diet + exercise arms had greater reductions in VEGF at 30 months (-14.1% P = 0.02; -19.7% P = 0.003; -14.5% P = 0.002, respectively) versus controls (-4.5%). There were no statistically significant changes in PEDF in any intervention arm. Participants maintaining ≥10% of baseline weight loss at 30 months had greater reductions in VEGF versus those who gained weight/had no weight change (-22.3% vs. -10.2% respectively, P = 0.002). Participants maintaining any weight loss had significantly lower levels of PEDF at 30 months versus those who gained weight/no weight change.Conclusions: Sustained weight loss via diet and/or exercise results in reductions in angiogenic factors, and can be maintained up to 30-month follow-up. Limitations include relatively small numbers, and possible bias toward more successful weight loss among women who returned at 30 months.Impact: Maintaining weight loss can achieve long-term reductions in biomarkers of angiogenesis that can persist up to 18 months after completion of a weight loss intervention. Cancer Epidemiol Biomarkers Prev; 26(12); 1788-94. ©2017 AACR.

A Robust Dynamic Heart-Rate Detection Algorithm Framework During Intense Physical Activities Using Photoplethysmographic Signals.

Dynamic accurate heart-rate (HR) estimation using a photoplethysmogram (PPG) during intense physical activities is always challenging due to corruption by motion artifacts (MAs). It is difficult to reconstruct a clean signal and extract HR from contaminated PPG. This paper proposes a robust HR-estimation algorithm framework that uses one-channel PPG and tri-axis acceleration data to reconstruct the PPG and calculate the HR based on features of the PPG and spectral analysis. Firstly, the signal is judged by the presence of MAs. Then, the spectral peaks corresponding to acceleration data are filtered from the periodogram of the PPG when MAs exist. Different signal-processing methods are applied based on the amount of remaining PPG spectral peaks. The main MA-removal algorithm (NFEEMD) includes the repeated single-notch filter and ensemble empirical mode decomposition. Finally, HR calibration is designed to ensure the accuracy of HR tracking. The NFEEMD algorithm was performed on the 23 datasets from the 2015 IEEE Signal Processing Cup Database. The average estimation errors were 1.12 BPM (12 training datasets), 2.63 BPM (10 testing datasets) and 1.87 BPM (all 23 datasets), respectively. The Pearson correlation was 0.992. The experiment results illustrate that the proposed algorithm is not only suitable for HR estimation during continuous activities, like slow running (13 training datasets), but also for intense physical activities with acceleration, like arm exercise (10 testing datasets).

Exercise and type 1 diabetes: overcoming the barriers

Exercise and type 1 diabetes: overcoming the barriers

Randomized controlled trial of increasing physical activity on objectively measured and self-reported cognitive functioning among breast cancer survivors: The memory & motion study.

Increasing physical activity can improve cognition in healthy and cognitively impaired adults; however, the benefits for cancer survivors are unknown. The current study examined a 12-week physical activity intervention, compared with a control condition, on objective and self-reported cognition among breast cancer survivors. Sedentary breast cancer survivors were randomized to an exercise arm (n = 43) or a control arm (n = 44). At baseline and at 12 weeks, objective cognition was measured with the National Institutes of Health Cognitive Toolbox, and self-reported cognition using the Patient-Reported Outcomes Measurement Information System scales. Linear mixed-effects regression models tested intervention effects for changes in cognition scores. On average, participants (n = 87) were aged 57 years (standard deviation, 10.4 years) and were 2.5 years (standard deviation, 1.3 years) post surgery. Scores on the Oral Symbol Digit subscale (a measure of processing speed) evidenced differential improvement in the exercise arm versus the control arm (b = 2.01; P < .05). The between-group differences in improvement on self-reported cognition were not statistically significant but were suggestive of potential group differences. Time since surgery moderated the correlation, and participants who were ≤2 years post surgery had a significantly greater improvement in Oral Symbol Digit score (exercise vs control (b = 4.00; P < .01), but no significant improvement was observed in patients who were >2 years postsurgery (b = -1.19; P = .40). A significant dose response was observed with greater increased physical activity associated with objective and self-reported cognition in the exercise arm. The exercise intervention significantly improved processing speed, but only among those who had been diagnosed with breast cancer within the past 2 years. Slowed processing speed can have substantial implications for independent functioning, supporting the potential importance of early implementation of an exercise intervention among patients with breast cancer. Cancer 2018;124:192-202. © 2017 American Cancer Society.