Personal Exercise Research Articles

Addressing muscle–tendon imbalances in adult male athletes with personalized exercise prescription based on tendon strain

PurposeImbalances of muscle strength and tendon stiffness can increase the operating strain of tendons and risk of injury. Here, we used a new approach to identify muscle–tendon imbalances and personalize exercise prescription based on tendon strain during maximum voluntary contractions (εmax) to mitigate musculotendinous imbalances in male adult volleyball athletes.MethodsFour times over a season, we measured knee extensor strength and patellar tendon mechanical properties using dynamometry and ultrasonography. Tendon micromorphology was evaluated through an ultrasound peak spatial frequency (PSF) analysis. While a control group (n = 12) continued their regular training, an intervention group (n = 10) performed exercises (3 × /week) with personalized loads to elicit tendon strains that promote tendon adaptation (i.e., 4.5–6.5%).ResultsBased on a linear mixed model, εmax increased significantly in the control group over the 9 months of observation (pCon = 0.010), while there was no systematic change in the intervention group (pInt = 0.575). The model residuals of εmax, as a measure of imbalances in muscle–tendon adaptation, demonstrated a significant reduction over time exclusively in the intervention group (pInt = 0.007). While knee extensor muscle strength increased in both groups by ~ 8% (pCon < 0.001, pInt = 0.064), only the intervention group showed a trend toward increased normalized tendon stiffness (pCon = 0.824, pInt = 0.051). PSF values did not change significantly in either group (p > 0.05).ConclusionThese results suggest that personalized exercise prescription can reduce muscle–tendon imbalances in athletes and could provide new opportunities for tendon injury prevention.

The Exercise Right for Active Ageing Study: Participation in Community-Based Exercise Classes by Older Australians During the COVID-19 Pandemic.

The aim of this study was to determine factors associated with participation of community-dwelling older Australians (≥65years) in the Exercise Right for Active Ageing program, consisting of 12 low- to moderate-intensity group exercise classes, delivered weekly, in person or online, by accredited exercise scientists and physiologists across Australia. Out of 6,949 participants recruited, 6,626 (95%) attended one or more classes and were included in the primary analysis, and 49% of participants attended all 12 classes. Factors associated with higher class attendance included participation in yoga/flexibility/mobility classes, attendance at a free trial class (adjusted incidence rate ratio [95% confidence interval]: 1.05 [1.03, 1.08]), and attending online classes (1.19 [1.11, 1.26]). Factors associated with lower class attendance included state of residence, living in inner regional areas (0.95 [0.93, 0.98]), and having two or more comorbidities (0.97 [0.95, 0.99]). High class attendance suggests that the Exercise Right for Active Ageing program was well received by older Australians, particularly in states less impacted by COVID-19 lockdowns.

The use of Guthrie’s theory in a combination of stimulus and response

Eliminating punishment can lead to a lack of focus or the emergence of bad habits that can affect the teaching and learning process. Stimulus and response should be given continuously as Guthrie suggested. The Contiguous Conditioning Theory created by Edwin Ray Guthrie (1886-1959) says the punishment given during the learning process is needed to change a person's behavior, exercises and tests or tests need to be done to get used to the stimulus that is needed. The purpose of this research are 1) to find the effects of using punishment, reward, exercise, and test (fatigue method), 2) to find The Contiguous Conditioning Theory using fatigue method in one single trial learning can be a new technique in learning English. It is experimental research. The result shows the Guthrie theory of fatigue method in one single trial learning is considered appropriate. The use of punishment and rewards gives a better stimulus. The experiment group has a better average point.

EXERCISE PRESCRIPTION IN A MULTIDISCIPLINARY LONG COVID CLINIC: METHODOLOGY FROM AN AUSTRALIAN EXPERIENCE

INTRODUCTION &amp; AIMS The University of Canberra Hospital Post-COVID Recovery Clinic is one of Australia’s few multidisciplinary outpatient clinics. Our model includes personally-prescribed exercise of both inspiratory and peripheral muscles. We have treated &amp;gt; 200 people with Long COVID with no serious adverse events, and our model is highly acceptable to consumers. This paper offers a detailed description of our methodology capturing how we achieve safe, tailored personal exercise, and carefully manage post-exertional symptom exacerbation (PESE). METHODOLOGY Initial screening appointments last 2 hours, and clients are referred for medical review if they have signs or symptoms of an acute or life-threatening complication (e.g. unexplained chest pain). Individualised exercise programs are prescribed, progressed, and monitored by an Exercise Physiologist or Physiotherapist initially on an individual basis, then in a supervised group setting. The group program consists of twice weekly sessions of 60 minutes duration. Clients attending group therapies are provided with a home exercise program to enable self-management. Clients are screened at baseline assessment for PESE triggered by participation in activities of daily living. All clients receive education about activity modification and pacing strategies. For clients experiencing PESE, activity is not progressed until they can tolerate 2 weeks of activity without PESE. For peripheral muscles, progressive resistance exercises are prescribed at a submaximal intensity (RPE 4-6/10), with 4-6 exercises completed 3 days/week. Once able to tolerate ADLs, low intensity cardiovascular exercise is gradually introduced with increased monitoring from a clinician. For patients with dyspnoea, high-intensity inspiratory muscle training is prescribed as 5 sets of 6 breaths at least 50% of their maximal inspiratory pressure (30 breaths total) 5 days per week. CONCLUSION Our experience indicates that it is possible to safely prescribe exercise in people with Long COVID, incorporating both peripheral and inspiratory muscle training, while carefully monitoring and managing PESE.

CONSUMER EXPERIENCE OF AN AUSTRALIAN MULTIDISCIPLINARY LONG COVID CLINIC THAT INCORPORATES PERSONALISED EXERCISE PRESCRIPTION: A QUALITATIVE ANALYSIS

INTRODUCTION &amp; AIMS Little is known about the Australian experience of Long COVID recovery, particularly with respect to exercise prescription. The aim of this study was to understand the consumer experience and acceptability of a novel Australian Long COVID Recovery Clinic that incorporates personalised exercise prescription, including respiratory and peripheral strengthening and carefully monitored cardiovascular training. METHODS Qualitative study; semi-structured interviews with a convenience sample of participants who have completed a multidisciplinary, individually-tailored and supervised programme at our Long COVID Recovery Clinic. Interviews were conducted by a researcher external to the clinic delivery. Major themes were identified by inductive thematic analysis. RESULTS 15 participants were interviewed. 14/15 (93%) participants described the clinic model as acceptable or highly acceptable. Five core themes were identified, including (1) encouraging staff and light-filled facilities are key to support recovery; (2) individually tailored, supervised exercise and pacing helped to improve confidence in building exercise capacity; (3) peer support and group therapy augments recovery; (4) recovery from Long COVID is incomplete, and other services augment the Long COVID Recovery Clinic model; and (5) importance of GP involvement in connection with clinic participation. Suggestions for improvement included extending the duration of the clinic programme beyond 2 months, reducing wait times by increasing staffing levels and adjusting the clinic schedule to broaden access options. CONCLUSION The majority of participants found the Long COVID Recovery Clinic, which incorporates both supervised exercise and pacing, acceptable and would recommend it to others. From the consumer perspective, the Long COVID Recovery Clinic aids recovery alongside GP management through a combination of peer support and an individually tailored program.

FREQUENCY OF POST-EXERTIONAL MALAISE AMONG INDIVIDUALS WITH POST ACUTE SEQUELAE OF SARS-COV-2 INFECTION

INTRODUCTION AND AIM Post acute sequelae of SARS-CoV-2 infection (PASC) is a multifaceted disorder with varying symptoms. Fatigue is commonly reported; however, it is unclear if similarities exist between PASC and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We sought to determine the frequency of post-exertional malaise in individuals with PASC; a hallmark symptom of ME/CFS. METHODS 116 participants (Age: 53.4±8.4, 36% Male) were identified to have PASC through medical screening. The Duke Activity Status Index (DASI) subjectively evaluated functional capacity, and participants achieving &amp;lt;100% of age and sex defined norms were eligible for the study. Participants attended one of three sites across Victoria and Tasmania to complete Cardiopulmonary Exercise Testing (CPET). Two days post CPET they were asked to complete the DePaul Symptom Questionnaire (DSQ) post-exertional malaise (PEM). PEM was defined as a score ≥ 2 for frequency and severity on DSQ-PEM items 1-5. A personalised exercise rehabilitation program is currently underway for participants, with results on responses to training to be available at the time of the conference. RESULTS 106 (91%) of the participants who completed a CPET achieved less than 85% of predicted relative VO2peak (21.79±5.72ml.min-1.kg-1). The DSQ-PEM questionnaire was completed in 75% (n=79) of participants. Among these individuals 78% (n=62) met the threshold for PEM. The PEM group were older (53±8 vs 48±8 years, p=0.04), had higher BMI (30.5±7.6 vs 26.7±3.9kg.m2, p=0.02), lower VO2peak (21.6±5.7 vs 25.6±5.4ml.min-1.kg-1, p=0.01) and six-minute walk distance (491±131 vs 583±112m, p=0.02). There was a similar proportion of men and women between both groups. CONCLUSION Like with ME/CFS, PEM is a common symptom in PASC. Additionally, these individuals are more deconditioned than PASC sufferers without PEM. Thus, practitioners should carefully consider the impact of PEM and deconditioning when developing rehabilitation programs.

South African mental healthcare providers' views about exercise for people with mental illness.

People living with mental illness (PWMI) have significantly reduced life expectancy compared to the general population, yet mental healthcare providers (MHCPs) do not regularly prescribe exercise, despite its proven health benefits. This study aimed to evaluate South African MHCPs' views regarding exercise for PWMI. A cross-sectional descriptive study conducted across five public sector specialised psychiatric units in Gauteng. Mental healthcare providers were surveyed using the Exercise in Mental Illness Questionnaire - Health Professionals Version. Most participants were nurses (49.1%) and doctors (26.2%) and reported no prior formal training in exercise prescription (79.4%). The vast majority (up to 89.7%) agreed regarding the physical benefits of exercise, particularly cardiometabolic benefits. The most common barriers, as perceived by MHCPs, to exercise participation for PWMI were: stigma (56.5%) and medication side effects (56.5%). The majority (76.2%) reported prescribing exercise for PWMI at least 'occasionally'. The method most frequently used was personal discussion (77.3%) and aerobic exercise was most frequently recommended (81.0%). Specific instructions regarding physical activity recommendations however were often not provided. Regarding MHCPs personal exercise habits, only a third (34%) met physical activity guidelines. Most MHCPs (92.1%) indicated an interest in further training regarding exercise for PWMI. Mental healthcare providers were supportive of exercise for PWMI. Strategies to address the stigma around mental illness and medication side-effects, to improve training regarding exercise prescription, as well as the exercise habits of MHCPs themselves, and collaboration with exercise professionals and organisations are recommended. This study provides insight into the views of South African MHCPs regarding exercise for PWMI.

The Impact of Medical Physical Training and a Structured Personalized Exercise Training Program on Hemodynamic Parameters and Arterial Stiffness in Pregnant Women.

In developed countries, heart disease is the primary cause of maternal mortality during pregnancy. Arterial stiffness, an independent risk factor for atherosclerosis and a predictor of cardiovascular complications, can be assessed using the augmentation index (AIx) and pulse wave velocity (PWV). In this prospective study, we aimed to evaluate diverse hemodynamic parameters and arterial stiffness in pregnant women before and after participating in a structured, personalized exercise training program. Forty healthy pregnant women, non-smokers, who agreed to participate daily for 12 weeks in a physical exercise training program under the supervision of a team made up of an obstetrician, a cardiologist, and a physiotherapist were included. Anthropometric characteristics, arterial function, and physical activity data were collected from the participants at two different time points: at the beginning of the exercise training program (T0) and at the end, after 12 weeks (T1). Upon conducting a statistical analysis, it was discovered that there were noteworthy disparities (p = 0.05) in body mass index, brachial AIx, systolic blood pressure, and pulse pressure values between the two time points. The regression analysis for the AIx brachial values and the PWVao values from Trim II (T0) and Trim III (T1) showed major differences between these two time points; the association between the AIx brachial values in the second and third trimesters of pregnancy revealed a strong direct significant correlation (p < 0.001), and the correlation between the PWVao values in the second (T0) and third trimester (T1) of pregnancy was weak and insignificant (p = 0.12). The findings of our study indicate that a personalized exercise training program positively impacts the physical and psychological well-being of pregnant women, leading to a reduction in PWV.

Проблема розмежування трудового та цивільного договору в умовах гіг-економіки

The author draws attention to the fact that the development of digital technologies has expanded the horizon of opportunities for the subjects of legal relations in which a person exercises the right to work. The subjects of these legal relations, independently exercising their freedom of will and acting in their interests, enter either a civil or an employment contract. However, given that in such legal relations, a person exercising the right to work is usually in the legal status of a weak party, society has faced the problem of abuse by employers. Employers have started giving labor relations, in essence, civil law structures, depriving employees of fundamental social and labor rights and guarantees or severely limiting them. In this regard, science, legislation, and judicial practice faced the problem of finding new approaches to distinguishing between civil and employment contracts, as the concepts of an employment contract established in science no longer correspond to modern conditions. Thus, with the emergence of remote work and other non-traditional forms of labor, the features of a traditional employment contract, which allowed distinguishing it from a contractor agreement, ceased to perform the distinguishing function. The article aims to formulate a new approach to defining the distinguishing features of an employment contract and a civil contract in the digital economy. The author’s analysis of legislation, scientific literature, and case law has concluded that an employment contract in the digital economy has variable features. This means there is a need for legislative consolidation of variants of the features of an employment contract. If two or more of them are present, this will allow recognition of an agreement under which a person exercises the right to work as an employment contract. At the same time, the article draws attention to the fact that a decision in this category of cases should meet the following requirements: The focus when deciding on the legal nature of the contract concluded should be on establishing which contract the person exercising his/her right to work intended. The court should avoid formalism and base its decision on facts. The primary purpose of such a decision is to effectively protect the labor and social rights of a person exercising the right to work. Keywords: right to labour, labour relations, employment contract, employee, employer, employment, remote work, freedom of will of the parties to the employment contract, social function of labour law, guarantees, IT sector, contractual regulation, amendment of an employment contract.

P161 Self-reported barriers to exercise from a national United Kingdom systemic lupus erythematosus cohort

Abstract Background/Aims Patients with systemic lupus erythematosus (SLE) are more inactive than the general population. Regular physical activity (PA) positively impacts many health parameters, including cardiovascular health. To better understand patient barriers to leisure time PA we conducted a national survey of patients with SLE in the UK. Methods An online survey was disseminated via LUPUS UK social media platforms between 5/05/2023 and 28/10/2023. Participants self-reported demographic data including postcodes. Indices of Multiple Deprivation (IMD) were used to define socioeconomic deprivation and were split into quantiles, where quartile 5 represents participants living in 20% least deprived areas in England. Categorical and continuous data were analysed using Fisher’s exact test and Mann-Whitney U test respectively. Results There were 249 individual responses. Table 1 describes the cohort demographics alongside response data. On a 0-10 scale (very unsatisfied to very satisfied), 171/244 (70%) of participants rated their satisfaction with their amounts of leisure time PA as ≤ 4. The most commonly reported barriers to PA were fatigue (221/249, 88.8%), pain (155/249, 62.2%) and lupus-related symptoms/flares (145/249, 58.2%). Dislike of exercise was reported by &amp;lt; 10% of cohort (22/249, 8.8%). When asked to identify the primary barrier to PA, 119/244 (48.8%) reported fatigue. Lack of motivation (40/244, 16.4%) and knowledge about exercise (18/244, 7.4%) were other predominant barriers. Concern around injury differed between ethnic groups (p = 0.016). Other barriers did not differ by sex, ethnic group or socioeconomic deprivation. Participants reporting lack of time were younger with a median age of 45 (35-53) versus 54 (43-63) years, p = &amp;lt;0.001. Patients reporting fatigue, pain and self-consciousness had higher BMI in kg/m2 (27.7 [23.6-32.3] vs 23.4 [20.8-28.2]; 28.7 [23.8-33.1] vs 25.4 [22.6-28.8]; 31.4 [27.9-38.4] vs 25.8 [23.1-30.2]), p = &amp;lt;0.001. Lupus-related symptoms/flares and concern that PA may worsen lupus were reported by participants with a shorter disease duration in years (8 [3-17] vs 12 [4.5-24] p = 0.002, and 7 [2-15] vs 10 [4.5-23] p = &amp;lt;0.001 respectively). Conclusion 70% of patients were dissatisfied with their level of leisure time PA. Fatigue and pain were the most commonly reported barriers to PA. Reported barriers differ between patients highlighting the need for personalised exercise programmes for patients with SLE. Disclosure A. Baranskaya: None. A.J. Wadley: None. J. Reynolds: None.

Cancer survivorship: understanding the patients’ journey and perspectives on post-treatment needs

Background Cancer treatments have many adverse effects on patient’s health leading to poor cardiorespiratory capacity, muscular- degeneration, fatigue, loss of strength and physical function, altered body-composition, compromised immune-function, peripheral neuropathy, and reduced quality of life (QOL). Exercise programs can significantly increase functional capacity when tailored to individual needs, thus improving health. Exercise interventions in cancer rehabilitation, when supported by appropriate nutrition can be effective in attaining a healthy weight and body-composition. The successful rehabilitation program should also include psycho-social education aimed to reduce anxiety and improve motivation.Methods The current study aimed to collect information on the post-treatment needs of cancer patients including barriers and expectations facing them, their caregivers and their families through consultation in focus group interviews. Cancer survivors living in the Republic of Ireland were recruited from the University Hospital Galway, community-based cancer centres, cancer support groups and social media platforms to participate in the study and attend a focus group interview. The focus group discussions were designed to obtain information on the collective views of cancer survivors on relevant topics selected. The topics were developed in consultation with a patient and public involvement (PPI) group supporting the study. The topics list was circulated to all participants prior to the focus group. The interviews were audio recorded and transcribed verbatim. Focus group transcripts were analysed subjected to a thematic framework analysis using NVivo.ResultsThirty-six participants took part in 9 focus groups. Our analysis uncovered two main themes. The first theme ‘cast adrift with no direction’ was grouped into three sub-themes: everything revolves around treatment; panic and fear; and what exercise should I be doing? The second theme ‘everybody is different’ was clustered into two sub-themes: side effects get in the way; and personalised exercise program.ConclusionThe study highlighted the lack of information and support needed by patients living with and beyond cancer. The study also highlighted the need for a personalised exercise programme designed to target the individual patient symptoms that would be ideal for the mitigation of long term symptoms and in improving QOL.

Working from home is associated with changes in sleep hygiene practice.

Sleep hygiene habits and self-reported sleep quality of those who work from home have yet to be fully understood. As working from home was widely implemented during the COVID-19 pandemic, the period might be a convenient model for studying the measures, as mentioned earlier. This study aimed to assess sleep hygiene habits and self-reported sleep quality in people working from home in March 2020, when the COVID-19 pandemic began. This study was designed as a cross-sectional web-based survey. An anonymous questionnaire consisted of sociodemographic variables and questions about personal habits, e.g., exercise activities and caffeine consumption. The outcome measures to assess sleep hygiene and sleep quality were the Sleep Hygiene Index (SHI) before and after the home office (HO) and the Pittsburgh Sleep Quality Index (PSQI). A total of 204 responses were received. The prevalence of significant sleep disturbance (PSQI > 5) was 51 %. The mean PSQI and SHI scores were 6.15±3.385 and 17.67±7.836, respectively. PSQI and SHI showed a significant mutual positive correlation at the level of significance p < 0.001. The total score for SHI was similar before and after working from home (p = 0.982). However, differences were observed in its components. The total score on SHI did not change when compared before and during HO. However, working from home was associated with sleep hygiene malpractice in some individual components of SHI. On the other hand, some aspects of sleep hygiene behavior improved during HO.

Self-paced heart rate control during treadmill exercise for persons with gait impairment: a case study

Introduction:A self-paced (SP) heart rate (HR) control system proposed in a previous study was found to be feasible for healthy participants. The aims of this work were to investigate whether the SP HR control system is feasible to achieve accurate HR control in a participant with gait impairments, and to assess its interaction with an existing motor-driven body weight support (BWS) system.Methods:One participant with cerebral palsy was recruited in this case study. Three preliminary tests were completed to determine the appropriate mean value and amplitude of the target heart rate curve, and to identify a customised heart rate response model. Two series of formal self-paced heart rate control tests were then conducted to investigate the influence of different heart rate compensators and the presence of the BWS system.Results:The customised heart rate controller achieved improved accuracy in heart rate control and reduced oscillation in the treadmill target speed: the root-mean-square heart rate tracking error (RMSE) was 2.38 beats per minute (bpm) vs. 3.91 bpm (customised controller vs. nominal controller), and the average power of changes in the treadmill target speed was 0.4 × 10−4 m2/s2 vs. 8.4 × 10−4 m2/s2. The BWS system resulted in improved HR tracking accuracy: RMSE on heart rate tracking was 3.02 bpm vs. 3.50 bpm (with BWS vs. without BWS). The BWS system had no influence on the automatic position control accuracy: RMSE on distance tracking was 0.0159 m vs. 0.0164 m.Conclusion:After customising the heart rate compensator, the self-paced heart rate control system is feasible to achieve accurate heart rate control in an individual with gait impairments, and it can correctly interact with the BWS system.

Essential elements of physical fitness analysis in male adolescent athletes using machine learning.

Physical fitness (PF) includes various factors that significantly impacts athletic performance. Analyzing PF is critical in developing customized training methods for athletes based on the sports in which they compete. Previous approaches to analyzing PF have relied on statistical or machine learning algorithms that focus on predicting athlete injury or performance. In this study, six machine learning algorithms were used to analyze the PF of 1,489 male adolescent athletes across five sports, including track & field, football, baseball, swimming, and badminton. Furthermore, the machine learning models were utilized to analyze the essential elements of PF using feature importance of XGBoost, and SHAP values. As a result, XGBoost represents the highest performance, with an average accuracy of 90.14, an area under the curve of 0.86, and F1-score of 0.87, demonstrating the similarity between the sports. Feature importance of XGBoost, and SHAP value provided a quantitative assessment of the relative importance of PF in sports by comparing two sports within each of the five sports. This analysis is expected to be useful in analyzing the essential PF elements of athletes in various sports and recommending personalized exercise methods accordingly.

Recommendations for physical activity and exercise in persons living with Systemic Lupus Erythematosus (SLE): consensus by an international task force

ObjectiveThis international task force aimed to provide healthcare professionals and persons living with systemic lupus erythematosus (SLE) with consensus-based recommendations for physical activity and exercise in SLE.MethodsBased on evidence from...

Effects of Personalized Exercise Prescriptions on Sarcopenia in Patients Undergoing Hemodialysis

Sarcopenia is a major factor affecting the health and quality of life of the patients undergoing hemodialysis.Exercise can effectively ameliorate sarcopenia in these patients.However,the type,intensity,time,and frequency of exercise influence the effect of exercise.This review describes the effects of different exercise prescriptions on sarcopenia in the patients undergoing hemodialysis.It aims to assist medical staff in developing personalized exercise prescriptions,guiding patients to engage in exercise,and provide effective strategies for the prevention and treatment of sarcopenia in the patients undergoing hemodialysis.

Personalised Exercise-Rehabilitation FOR people with Multiple long-term conditions (PERFORM): protocol for a randomised feasibility trial

IntroductionPersonalised Exercise-Rehabilitation FOR people with Multiple long-term conditions (PERFORM) is a research programme that seeks to develop and evaluate a comprehensive exercise-based rehabilitation intervention designed for people with multimorbidity, the...

Towards Automating Personal Exercise Assessment and Guidance with Affordable Mobile Technology.

Physical activity (PA) offers many benefits for human health. However, beginners often feel discouraged when introduced to basic exercise routines. Due to lack of experience and personal guidance, they might abandon efforts or experience musculoskeletal injuries. Additionally, due to phenomena such as pandemics and limited access to supervised exercise spaces, especially for the elderly, the need to develop personalized systems has become apparent. In this work, we develop a monitored physical exercise system that offers real-time guidance and recommendations during exercise, designed to assist users in their home environment. For this purpose, we used posture estimation interfaces that recognize body movement using a computer or smartphone camera. The chosen pose estimation model was BlazePose. Machine learning and signal processing techniques were used to identify the exercise currently being performed. The performances of three machine learning classifiers were evaluated for the exercise recognition task, achieving test-set accuracy between 94.76% and 100%. The research methodology included kinematic analysis (KA) of five selected exercises and statistical studies on performance and range of motion (ROM), which enabled the identification of deviations from the expected exercise execution to support guidance. To this end, data was collected from 57 volunteers, contributing to a comprehensive understanding of exercise performance. By leveraging the capabilities of the BlazePose model, an interactive tool for patients is proposed that could support rehabilitation programs remotely.

Maximal Exercise Tolerance, Objective Trunk Strength, and Mobility Measurements in Axial Spondyloarthritis.

Although exercise therapy is safe, effective, and recommended as a nonpharmacological treatment for axial spondyloarthritis (axSpA), there is a lack of guidelines regarding type and dosage. Insufficient knowledge about physical and physiological variables makes designing effective exercise programs challenging. Therefore, the goal of this study was to simultaneously assess trunk strength, spinal mobility, and the cardiorespiratory fitness of patients with axSpA. In a cross-sectional study, 58 patients with axSpA (mean age 40.8 yrs, 50% male, mean symptom duration 10.3 yrs) performed maximal cervical and trunk mobility and isometric strength tests in all planes (using David Back Concept devices) and a maximal cardiopulmonary bicycle exercise test (n = 25). Mobility and strength data were compared to healthy reference data. Cut-off values for clinical cardiopulmonary exercise testing interpretation were used to judge normality. Patients were compared based on radiographic involvement and symptom duration. Both strength (P ≤ 0.02) and mobility (P ≤ 0.001) were significantly lower for the patients with axSpA compared to the reference. Strength deficits were comparable between the radiographic and nonradiographic groups (P > 0.05, except trunk extension [P = 0.03]), whereas mobility showed higher deficits in the radiographic group (cervical extension [P = 0.02] and rotation [P = 0.01], and trunk extension [P = 0.03] and rotation [P = 0.03]), regardless of symptom duration. Similarly, symptom duration positively affected oxygen pulse (P = 0.03), relative anaerobic threshold (P = 0.02), and aerobic capacity (P = 0.02). In patients with axSpA, strength is more affected than mobility when compared to healthy controls. Likewise, mainly the metabolic component of aerobic capacity is impaired, affecting cardiopulmonary fitness. These findings indicate that future personalized exercise programs in patients with axSpA should incorporate exercises for cardiopulmonary fitness next to strength and mobility training.

Losing Ground Following Community Exercise Program Closures: A Qualitative Descriptive Study of the Impact of COVID-19 Related Pandemic Restrictions on Exercise Participation, Physical Activity, and Health of Older Adults with Balance and Mobility Limitations

Purpose: To understand the impact of COVID-19-related closures of community-based exercise programs (CBEPs) on exercise participation, physical activity, and health of older adults with balance and mobility limitations; facilitators, and barriers to exercise and physical activity; and preferred support from recreation centres and healthcare providers. Method: This qualitative descriptive study involved semi-structured interviews with seven older adults (aged 50–76 years) with balance and mobility limitations, enrolled in CBEPs at a recreation centre in a suburban area in Canada prior to the COVID-19 pandemic. We conducted a thematic analysis. Results: One major theme, losing ground in the absence of structured exercise, was identified. Despite engaging in alternative at-home or outdoor activities, participants perceived a worsening of their balance and mobility, dissatisfaction with the extent of exercises and physical activity, and loss of social connectedness. Participants desired structured, individualized exercise resources, and frequent check-ins from exercise instructors to stay physically active during program suspension. Conclusions: Following CBEP closures, older adults with balance and mobility limitations from a single recreation centre perceived declines in physical and mental health, exercise participation and social interaction, and desired personalized exercises and communication from exercise instructors. The small sample size may have limited achievement of saturation.