Exercise Intervention Program Research Articles

The Impact of Auricular Vagus Nerve Stimulation on Pain and Life Quality in Patients with Fibromyalgia Syndrome.

The purpose of this study is to evaluate the impact of auricular vagus nerve stimulation, applied in conjunction with an exercise treatment program, on pain and life quality in patients with fibromyalgia syndrome (FMS). To achieve the study objectives, 60 female patients between the ages 18 and 50, with diagnosed FMS according to the American College of Rheumatology (ACR) 2010 diagnostic criteria, were randomly divided into 2 groups of 30. The first group was assigned 20 sessions of a home-based exercise program, while the second group was assigned 20 sessions of auricular vagus nerve stimulation and 20 sessions of a home-based exercise program. Patients were assessed before and after the treatments using the Visual Analog Scale (VAS) for pain, Beck Depression Scale for depression, Beck Anxiety Scale for anxiety, Fibromyalgia Impact Questionnaire (FIQ) for functional evaluation, and Short Form-36 (SF-36) for life quality. In this randomized controlled trial, comparisons within the groups revealed that both groups had statistically significant improvements in pain, depression, anxiety, functionality, and life quality scores (p < 0.05), while comparisons across the groups revealed that the group experiencing the vagus nerve stimulation had no statistically significant differences between the baseline scores, except for those of SF-36's subparameters of physical function, social functionality, and pain. In fact, comparisons across the groups after the interventions revealed that the group experiencing the vagus nerve stimulation had better scores but not statistically significant. From analysis of this data, we observed that vagus nerve stimulation in FMS treatment did not give additional benefit together with exercise, except for three subparameters of SF-36. It was identified that further studies which separately investigate the effects of vagus nerve stimulation and exercise on FMS with longer follow-up periods and an increased number of patients are needed.

Physiotherapists deliver management broadly consistent with recommended practice in rotator cuff tendinopathy: An observational study

BackgroundRotator cuff tendinopathy is a common and disabling cause of shoulder pain. While conservative treatment is recommended as initial management, recent findings suggest that general practitioners and rheumatologists do not consistently align with recommended care. This study aimed to survey Australian physiotherapists to explore the extent to which recommended management is being applied. MethodsA cross-sectional online survey. ResultsFive hundred and two Australian physiotherapists completed the survey. Results demonstrated the majority of physiotherapists provide conservative management consistent with guideline recommendations, through delivery of exercise and education, comparable to management by physiotherapists in the United Kingdom, Belgium and the Netherlands. Parameters and construction of exercise treatment programs were highly variable within the cohort, qualitative analysis highlighting varied reasoning underpinning these management decisions. ConclusionsAustralian physiotherapists are broadly consistent with providing recommended management, however heterogeneity exists in the methods and parameters of treatment delivery.

Effect of Calanus Oil Supplementation and 16 Week Exercise Program on Selected Fitness Parameters in Older Women

We investigated changes in functional fitness after an exercise program in combination with Calanus oil supplementation, a novel source of bioactive lipids rich in wax esters with omega-3 polyunsaturated fatty acid (n-3 PUFA). Fifty-five healthy sedentary women aged 65–80 (mean age 70.9 ± 3.9 years, BMI 27.24 ± 3.9 kg m−2, VO2peak 19.46 ± 3.7 ml kg−1 min−1) were enrolled in the study. The participants were divided into two groups: exercise training plus Calanus Oil supplementation (n = 28) or exercise plus placebo (sunflower oil) supplementation (n = 27). The exercise intervention program was completed by 53 participants and contained functional circuit training (twice a week, 45 min plus 15 min of stretching and balance training) and Nordic walking (once a week, 60 min) for 16 weeks. Senior fitness test, exercise stress test on bicycle ergometer, hand-grip, and body composition were evaluated before and after the program. Our results show that functional fitness and body composition improved following the interventional exercise program, but for most of the parameters there was no synergic effect of supplementing n-3 PUFA-rich Calanus oil. In comparison to the placebo group, the group with Calanus supplementation experienced significantly higher improvement of functional strength of lower body which was evaluated by the chair stand test. Supplementation with Calanus may have a synergic effect with exercise on functional strength of the lower body in the elderly.

Blood pressure control in hypertensive patients and its relation with exercise and exercise-related behaviors: A case-control study.

The effects of exercise interventions on blood pressure control in hypertensive patients have received extensive attention and recognition. However, the influence of exercise-related behaviors on the effects of blood pressure control and the management factors that affect exercise behaviors remain inconclusive. Therefore, this study aimed to explore the relationships between exercise and exercise-related behaviors and blood pressure control, expecting to provide a scientific basis for further improvement of exercise intervention programs for patients with hypertension.Long-term residents in a community in Fuzhou, Fujian Province, China who were diagnosed with hypertension at a medical facility were recruited for this study. Hypertensive patients with uncontrolled blood pressure were placed in the case group, and those with controlled blood pressure were placed in the control group. The count data were analyzed with the χ2 test based on α = 0.05. A univariate logistic regression analysis was performed to screen significant variables; independent variables were selected based on professional knowledge and were tested for co-linearity. These variables were incorporated into a non-conditional multivariate logistic regression analysis to analyze relevant factors for blood pressure control, while calculating odds ratio (ORs), 95% confidence intervals (CIs), and P values. Differences with a P < .05 were considered statistically significant.A total of 598 patients were included in the present study. Univariate and multivariate analyses showed that exercise (OR = 0.194; 95%CI: 0.133–0.283), frequency of self-monitoring of blood pressure (OR = 2.412; 95%CI: 1.137–5.117), and regular housework (OR = 0.397, 95%CI: 0.248–0.633) were statistically significant factors for blood pressure control. In addition, there was a relationship between exercise-related behaviors and blood pressure control: walking (OR = 0.189, 95% CI: 0.065–0.551), 60 to 120 min/day of exercise time (OR = 0.317, 95% CI: 0.118–0.856). Sex (OR = 2.248, 95% CI: 1.279–3.954), health belief (OR = 0.016, 95% CI: 0.004–0.059), and company of a family member during exercise (OR = 0.048, 95% CI: 0.025–0.094) were significant factors predictive of regular exercise in hypertensive patients.Improving exercise-related behaviors and their management can help improve the effects of exercise interventions on blood pressure control in middle-aged and elderly hypertensive patients.

Effects of aerobic fitness on cognitive motor interference during self-paced treadmill walking in older adults.

Older adults experience greater cognitive motor interference (CMI) due to declines in cognitive and physical function. Although aerobic fitness has beneficial effects on cognition, its association with CMI is not clear. This study aims to investigate the effects of aerobic fitness on CMI during self-paced treadmill walking in older adults. Thirty participants (67.6 ± 10.34years, 21 females) were included in a 2-day cross-sectional design study. Aerobic fitness was assessed with the Rockport 1-mile test. The dual-task paradigm consisted of walking only, and dual-task standing and dual-task walking (i.e., standing/walking while performing the Modified Stroop color word test) on a treadmill. To assess CMI, gait speed and accuracy rate were measured to later calculate the dual-task cost for each parameter. Individuals with low aerobic fitness exhibited significantly greater gait speed dual-task cost than individuals with high aerobic fitness (p < 0.05). There were no significant findings for accuracy rate dual-task cost. These study findings are the first to demonstrate increases in CMI in relation to low aerobic fitness. Results can be attributed to the relationship between aerobic fitness and cognition as well as theories related to attentional capacity. Older adults with low aerobic fitness possess greater CMI when compared to older adults with high aerobic fitness. This provides a foundation of knowledge on how aerobic fitness in older adults may affect CMI which can lead researchers to examine the causal relationships between an aerobic exercise intervention program and CMI in older adults.

Behavioral and neuronal interactions between exercise and alcohol: Sex and genetic differences.

Alcohol use disorders (AUDs) lead to early death and many devastating consequences for individuals, families and society. Currently, few effective treatments are available, but emerging research suggests exercise might be beneficial in some individuals. To develop the most effective exercise treatment program, more research on intensity, type, timing, stage of addiction, drug involved, sex of subject and subject population is needed. This review highlights the complexity of the interaction between alcohol behaviors and exercise, with a focus on the role of sex and genetics. Moreover, we describe a variety of rodent models used to investigate the neuronal physiology changes that underlie alcohol consumption and exercise. Specifically, current data indicate that moderate exercise may ameliorate neuronal damage caused by alcohol consumption. Additionally, we describe studies of rodent models in the context of hedonic substitution to draw broad conclusions about shared underlying neurobiological mechanisms. Until recently, most studies in rodents were performed only in males, and few studies have utilized different genetic strains of mice or rats. Comparing similar behavioral paradigms across sex and strain, it has become clear that major sex and genetic differences exist for each behavioral context alone (alcohol consumption and exercise) and combined. Therefore, future research in this area should be developed with careful study design and attention to address both of these factors.

Designing an intervention program over the effects of Pilates on pregnancy outcomes among the pregnant women: A protocol study

BackgroundPregnancy is a pleasure for most women, it is often considered as a stressful period with physiological, anatomical, biochemical, and psychological changes. Pilates exercise improved quality of life in women. Therefore, the present study targeted at designing an intervention program over the effects of Pilates on pregnancy outcomes among the pregnant women. MethodsIn this protocol, a clinical intervention will be designed in three phases. In the first phase of the study, a researcher-made checklist will be used to evaluate the pregnancy and neonatal outcomes based on the literature review. In the second phase, an intervention program of Pilates exercise will be conducted according to different studies and viewpoints of a panel of reproductive health and physical activity specialists. The exercises will include two sessions of 30 minutes per week for 12 weeks conducted under the supervision of a qualified trainer. The third phase of the intervention will include the pre-test and post-test using a standard questionnaire and a researcher-made checklist for the two intervention groups and one control group. DiscussionsThe present study provides useful data regarding the design of a Pilates exercise intervention program for pregnant women with the aim of influencing pregnancy and neonatal outcomes, reducing depression, low back pain and improving maternal mental health. It can also reduce their medical and treatment costs. The strategies of this program could be important and cost effective, and therefore we hope that the success of such a program is a step forward in improving reproductive health status.

Effects of Multicomponent Exercise on Cognitive Function in Elderly Korean Individuals.

Background and PurposeThe aim of this study was to investigate the effects of multicomponent exercise on cognitive function, depression, and quality of life in elderly individuals.MethodsThis study prospectively recruited 605 participants, and constructed an exercise pyramid comprising even distributions of daily physical activities, aerobic exercise, muscle-strengthening exercise, flexibility exercise, balance exercise, and activities that subjects could perform while sitting down. The exercise program was divided into six stages according to the participant's level of frailty. The 12-week exercise program intervention was conducted once yearly.ResultsThe exercise regimen was followed by 402 of the 605 enrolled participants, giving a dropout rate of 33.6%. The 27-month exercise program was completed by 60 participants. The scores for the Mini Mental State Examination for dementia screening (MMSE-DS), short form of the Geriatric Depression Scale, World Health Organization Quality of Life Assessment (WHOQOL-BREF), International Physical Activity Questionnaire (IPAQ), fear of falling, handgrip strength, and walking speed were improved after the exercise intervention. The analysis of frailty revealed that participants in the frail group showed greater improvements for the MMSE-DS, WHOQOL-BREF, IPAQ, fear of falling, handgrip strength, and walking speed.ConclusionsIndividually customized, multicomponent exercise programs lead to improved levels of cognitive function, depression, and quality of life, especially among those who are more frail.

The relationship between daily physical activity, subjective sleep quality, and mood in sedentary Hungarian adults: A longitudinal within-subjects study

Purpose This study investigated the day-to-day variability of daily physical activity and its effect on sleep and mood in a longitudinal within-subjects study for 7 days and 6 nights. Materials and methods Healthy office employees aged 25–35 years with a sedentary lifestyle participated in the study. Seven-day sleep diaries were used to evaluate sleep patterns. Ten-point scales were used to measure the level of happiness and stress. Daily physical activity was measured in steps/day using pedometers. Two hundred forty-five steps/day scores and changes induced in sleep and mood were analysed. Results There is a relationship between daily physical activity and sleep/mood. An inverted U-shaped relationship may be assumed between sleep duration, sleep quality, feelings after waking up, and the number of steps/day. Increasing the number of steps/day decreases the level of stress and daytime sleepiness and increases sleep efficiency. Sleep efficiency/daytime sleepiness and sleep duration did not show any association. Conclusions Based on the results, after a physically exhausting day, decreased stress and improved sleep efficiency may be experienced, while sleep duration may decrease, which may reduce the participants’ motivation to develop an active lifestyle. For further studies, it would be crucial to use individual exercise intervention programmes to reinforce the positive effects of exercise on sleep and/or mood.

The Impact of Mind-body Exercises on Motor Function, Depressive Symptoms, and Quality of Life in Parkinson's Disease: A Systematic Review and Meta-analysis.

Purpose: To systematically evaluate the effects of mind-body exercises (Tai Chi, Yoga, and Health Qigong) on motor function (UPDRS, Timed-Up-and-Go, Balance), depressive symptoms, and quality of life (QoL) of Parkinson’s patients (PD). Methods: Through computer system search and manual retrieval, PubMed, Web of Science, The Cochrane Library, CNKI, Wanfang Database, and CQVIP were used. Articles were retrieved up to the published date of June 30, 2019. Following the Cochrane Collaboration System Evaluation Manual (version 5.1.0), two researchers independently evaluated the quality and bias risk of each article, including 22 evaluated articles. The Pedro quality score of 6 points or more was found for 86% (19/22) of these studies, of which 21 were randomized controlled trials with a total of 1199 subjects; and the trial intervention time ranged from 4 to 24 weeks. Interventions in the control group included no-intervention controls, placebo, waiting-lists, routine care, and non-sports controls. Meta-analysis was performed on the literature using RevMan 5.3 statistical software, and heterogeneity analysis was performed using Stata 14.0 software. Results: (1) Mind-body exercises significantly improved motor function in PD patients, including UPDRS (SMD = −0.61, p < 0.001), TUG (SMD = −1.47, p < 0.001) and balance function (SMD = 0.79, p < 0.001). (2) Mind-body exercises also had significant effects on depression (SMD = −1.61, p = 0.002) and QoL (SMD = 0.66, p < 0.001). (3) Among the indicators, UPDRS (I2 = 81%) and depression (I2 = 91%) had higher heterogeneity; according to the results of the separate combined effect sizes of TUG (I2 = 29%), Balance (I2 = 16%) and QoL (I2 = 35%), it shows that the heterogeneity is small; (4) After meta-regression analysis of the age limit and other possible confounding factors, further subgroup analysis showed that the reason for the heterogeneity of UPDRS motor function may be related to the sex of PD patients and severity of the disease; the outcome of depression was heterogeneous. The reason for this may be the use of specific drugs in the experiment and the duration of intervention in the trial. Conclusion: (1) Mind-body exercises were found to have significant improvements in motor function, depressive symptoms, and quality of life in patients with Parkinson’s disease, and can be used as an effective method for clinical exercise intervention in PD patients. (2) Future clinical intervention programs for PD patients need to fully consider specific factors such as gender, severity of disease, specific drug use, and intervention cycle to effectively control heterogeneity factors, so that the clinical exercise intervention program for PD patients is objective, scientific, and effective.

Effects of Home Exercises on Shoulder Pain and Pathology in Chronic Spinal Cord Injury: A Randomized Controlled Trial.

The aims of this study were to replicate findings that a home exercise program intervention improved shoulder pain and function and to assess changes in supraspinatus tendon pathology associated with the home exercise program in persons with chronic spinal cord injury. The study is a single-blind randomized controlled trial. Individuals with spinal cord injury of at least 1 yr and chronic shoulder pain of moderate or greater average intensity were enrolled. Participants were randomized to a 12-wk home exercise program consisting of strengthening and stretching exercises or to an education-only control group, with immediate postintervention and 4-wk postintervention (16 wks) follow-ups. The main outcome measures were self-report measures of shoulder pain and impairment, the Physical Examination of the Shoulder Scale, quantitative ultrasound metrics of the supraspinatus tendon, and the Ultrasound Shoulder Pathology Rating Scale. Thirty-two participants were randomized to home exercise program or education-only control condition. The mean ± SD age was 44.8 ± 12.5; 81.3% were male; 65.6% had motor complete paraplegia. Using a per-protocol, within-group analysis method, significant differences were observed between baseline and postintervention for the home exercise program group for the least pain intensity (P = 0.02), number of days with shoulder pain (P = 0.042), Physical Examination of the Shoulder Scale scores (dominant side, P = 0.036; nondominant side, P = 0.008), the Disabilities of the Arm, Shoulder, and Hand (P = 0.028), and the Patient Global Impression of Change (P = 0.015). The education-only control condition group demonstrated significant changes in average unpleasantness of shoulder pain after the intervention period (P = 0.049). Comparisons in changes from baseline between groups showed that the home exercise program group had greater improvements in nondominant-side Physical Examination of the Shoulder Scale scores and global impression of change, whereas the education-only control condition group had greater improvements in depressive symptoms.For quantitative ultrasound measures, no significant changes were found with within-group analyses for the home exercise program group, although the education-only control condition group demonstrated a decrease in tendon width in the nondominant-side supraspinatus tendon (P = 0.036). Comparison of changes between groups suggests that the education-only control condition group had a greater increase in dominant shoulder supraspinatus tendon ultrasound contrast at the end of the study. Changes in several measures of shoulder pain and function occurred after the home exercise program intervention, although the magnitude of changes was only significantly greater than those of the education-only control condition group for two measures. Significant changes in supraspinatus pathology were not detected with quantitative ultrasound metrics.

Challenges Associated with the Implementation of an Exercise and Sport Intervention Program in a Greek Refugee Camp: A Report of Professional Practice.

Objective Refugees have a particularly high prevalence of psychopathological disorders. Despite this, little attention has been paid to the treatment of traumatized refugees, and research on the effects of exercise and sport among refugees is still in its infancy. Thus far, no randomized controlled trials have been carried out in a refugee camp setting, most likely because such trials are complicated by multiple organizational and methodological issues. We highlight some major challenges when carrying out experimental research in a refugee camp. Method This report of professional practice is based on systematic observations, individual and focus group interviews, and experiences made in a pre-experimental study, implemented in a refugee camp on the Greek mainland. Results The report provides background information about how refugees generally come to Greece, how transit camps are typically managed, which institutions are involved in the camp management, which rules need to be followed by people working in a camp, which countries refugees generally come from, and the conditions in which they live in the camp. We also identify general factors that complicate experimental research in such a setting, and highlight specific issues pertaining to sport and exercise-based intervention trials. Conclusions Currently, more people are fleeing their home regions than after the end of the Second World War. This situation calls for a change in the understanding of humanitarian aid. Pure material and technical support must be complemented by public health measures, including exercise and sport programs. Researchers who want to enter this field of research can learn important lessons from our observations.

The Short Physical Performance Battery (ASSESSMENT)

The Short Physical Performance Battery (ASSESSMENT)

P635The addition of yoga to aerobic exercise programs reduces global cardiovascular risk

Abstract Introduction Regular physical activity may modulate the inflammatory process and be cardio-protective. Yoga is a form of exercise that may have cardiovascular benefits. The effects of yoga on global cardiovascular risk have not been adequately described. The purpose of this study is to determine whether the addition of yoga to a regular exercise regimen reduces global cardiovascular risk. Methods Sixty consecutive individuals with essential hypertension were recruited in a lifestyle intervention program. All individuals with known hypertensive end organ damage, known cardiovascular diseases, as well as those taking medications/supplements that affected blood pressure, blood sugar, cholesterol or vascular inflammation were excluded. Participants were randomized to either a yoga group or similar duration stretching control group. Participants, over the 3-month intervention regimen, performed 15 minutes of either yoga or stretching in addition to 30 minutes of aerobic exercises thrice weekly. Blood pressure, cholesterol levels and hs-CRP were measured, and Reynold's Global Cardiovascular Risk Score was calculated at baseline and at the end of the 3-month intervention program. Results At screening, there were no statistically significant differences between the groups in any measured parameters or the 10-year risk of a cardiovascular event as measured by the Reynolds Risk Score. (8.2 vs. 9.0%; yoga vs. control group) After the 3-month intervention period, there was a statistically significantly greater decrease in the Reynold's Risk Score in the yoga vs. the control group. (7.0 vs. 8.4%, p=0.003, relative reduction 13.2 vs. 6.5%, p&lt;0.0001) Baseline and 3 Month Outcomes Conclusions In patients with essential hypertension on no medications and with no known end organ damage, the practice of yoga incorporated into a 3-month exercise intervention program was associated with significant greater improvement in the Reynold's Risk of a 10-year cardiovascular event, when compared to the control stretching group. If these results are validated in more diverse populations over a longer duration of follow up, yoga may represent an important addition to traditional cardiovascular disease prevention programs.

Bicycle exercise training improves ambulation in patients with peripheral artery disease

ObjectiveExercise training has multiple beneficial effects in patients with arteriosclerotic diseases; however, the exact underlying mechanisms of the effects are not completely understood. This study aimed to evaluate the effectiveness of a supervised exercise program in improving gait parameters, including the variability and walking performance of lower limb movements, in patients with peripheral artery disease (PAD) and intermittent claudication (IC). MethodsSixteen patients with a history of PAD and IC were recruited for this study, and they completed a 3-month supervised bicycle exercise program. The ankle-brachial index and responses to quality of life (QOL) questionnaires were evaluated. Near-infrared spectroscopy was also performed to determine the hemoglobin oxygen saturation in the calf. Patients' kinematics and dynamics, including joint range of motion and muscle tension, were evaluated using an optical motion capture system. Computed tomography images of each muscle were assessed by manual outlining. Data were collected before and after the supervised bicycle exercise program, and differences were analyzed. ResultsSignificant differences were not found in step length, ankle-brachial index, and hemoglobin oxygen saturation before and after the supervised bicycle exercise program; however, IC distance (P = .034), maximum walking distance (P = .006), and all QOL questionnaire scores (P < .001) showed significant improvement. Hip range of motion (P = .035), maximum hip joint torque (right, P = .031; left, P = .044), maximum tension of the gluteus maximus muscle (right, P = .044; left, P = .042), and maximum hip joint work (right, P = .048; left, P = .043) also significantly decreased bilaterally. Computed tomography images showed a significant increase in the cross-sectional area of the abdominal, trunk, and thigh muscles but not in that of the lower leg muscles after the supervised exercise program intervention. ConclusionsIn this study, bicycle exercise training improved the QOL and walking distance and decreased hip movement. The results showed that bicycling might be as useful as walking in patients with PAD.

Predicting Exercise Intentions and Behaviors of Taiwanese Children in a Longitudinal Sample

PurposeThe primary purpose of this study was to investigate changes in exercise intentions and behaviors among children across time. Then, we investigated how determinants in the Theory of Planned Behavior (TPB) predicted exercise intentions and behaviors, and explored if demographic predictors contributed to predicting behaviors. Design and methodsA three-wave, 12-month longitudinal study was conducted. A proportional stratified random sampling method was adopted, and 1997 children from 11 elementary schools in Taipei City were recruited. Numbers of participants were 1074, 1064, and 995 at times 1, 2, and 3, respectively. ResultsChildren's exercise intentions and behaviors significantly changed (both p < .05) during a 6-month interval. Attitudes, subjective norms, and perceived behavioral control (PBC) at time 1 could respectively explain 51.0% and 17.1% of the variance in time 1 and 2 intentions (F(3, 1068) = 372.20, F(3, 1059) = 73.92, both p < .001). PBC was the strongest predictor of the intention to exercise. Intentions were the immediate determinant of exercise behaviors. PBC not only indirectly affected exercise behaviors through intentions but also directly affected exercise behaviors. Gender and sports club participation directly affected children's exercise behaviors. ConclusionsThe findings support the TPB model being suitable for use in longitudinal studies; its core constructs significantly predicted children's exercise intentions and behaviors. Practice implicationsThis study highlights that clinical practitioners and school nurses working with children can help youth engage in regular exercise by enhancing their intentions and perceived behavioral control, and cultivating positive attitudes and subjective norms when planning exercise intervention programs.

DOES AQUATIC EXERCISE IMPROVE QUALITY OF LIFE IN OBESE LOW-BACK PAIN POPULATION?

Background: Low-back pain is one of the most common reasons for work stress, poor health, sickness, and reducing the quality of life. While obesity is a growing public health concern, it was proved that obesity is a risk factor for low back pain. Whereas obese low-back pain people cannot avoid weight load on the spine in any exercise, but they can easily carry out the exercise in water. This study aimed to know the effect of aquatic exercise on quality of life among obese low-back pain people.Methods: A total of 39 women with BMI≥27 kg.m-2 who had non-specific chronic low-back pain were purposively selected for this study. They randomly assigned in two groups; exercising (N=19, 37.85±5.83 years with 32.97±4.84kg.m-2) and control group (N=20, 40.8±5.25 years with 31.87±4.79 kg.m-2). The exercising group carried out the aquatic exercise, twice per week, 60 minutes per session, for 12 weeks. Quality of life was measured using the SF-36v2 questionnaire with eight domains; physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health.Results: The findings showed a significant (p≤0.001) improvement in the quality of life in the exercising group after 12 weeks. The significant improvement was found on seven domains of the SF-36v2 in the exercising group after the aquatic exercise intervention program while there was no significant effect on mental health (p=0.051). In the control group, a negative change in mean difference (-3.02) was observed in the mental health domain, while it was changed (15.32) for the exercising group. There was no significant change in BMI in both groups, also.Conclusion: In conclusion, a 12-week aquatic exercise is an appropriate intervention program to improve the overall quality of life among obese women who are suffering from non-significant chronic low- back pain.

Effects of Exercise Intervention Program on Bone Mineral Accretion in Children and Adolescents with Cystic Fibrosis: A Randomized Controlled Trial.

To evaluate effect of one year exercise intervention program on bone mineral accrual in children and adolescent with cystic fibrosis (CF). Fifty-two CF children (mean age 149.79 mo) were randomized into experimental (15 boys and 10 girls) and control groups (15 boys and 12 girls). Experimental group performed prescribed exercises three times/week, while control group continued with routine physical activities for one year. Following were assessed at baseline and at one year: Bone mineral density (BMD) of whole body and lumbar spine, pulmonary function, exercise capacity, quality of life and habitual activity. Change in whole body and lumbar spine BMD over 12 mo in experimental group was lower by 0.006g/cm2 (95% CI -0.02 to 0.02) and higher by 0.001g/cm2 (95% CI -0.04 to 0.03) than controls, respectively. However, difference between groups was non-significant for both parameters. Experimental group had a significant improvement in their exercise capacity (p = 0.006), quality of life, and serum vitamin D (p = 0.007) levels. Differences between groups for changes in pulmonary function and habitual activity were non-significant. Exercise regime was not associated withsignificant improvement in BMD of CF patients, but it had a positive impact on both physical and psychological health of these patients.

EFFECTS OF A PERSONALIZED PHYSICAL EXERCISE PROGRAM IN PERIPHERAL AND CENTRAL BLOOD PRESSURE IN OLDER ADULTS – THE AGA@4LIFE INTERVENTION MODEL

Objective: To test the effect of a tailored physical exercise intervention program on brachial and central blood pressure (bBP and cBP, respectively) in a Portuguese elderly cohort, included in the [email protected] project. Design and method: Thirty-three elderly participants (mean age:82 ± 9 years; 65–93 years) were divided into two groups (intervention group –IG – and control group – CG) according to their willingness to participate in the physical training program. The exercise program included aerobic and strength components, prescribed in a personalized approach according to the [email protected] model, and implemented under direct control of two experienced professionals. An oscillometric-based device was used to measure bBP and to derive cBP, both at baseline ant three-months after the intervention period. Results: The groups had similar clinical and demographic characteristics at baseline. No significant changes were observed in any of the considered endpoints in the CG. Conversely, a significant reduction was depicted in the IG, for both bBP and cBP. Peripheral systolic BP reduced from 150 ± 25 mmHg at baseline to 137 ± 23 mmHg after intervention (p = .008), and similar trend was depicted for diastolic BP (83 ± 17 mmHg at baseline, 78 ± 12 mmHg after intervention; p = .07). Central systolic BP reduced from 135 ± 21 mmHg to 125 ± 12 mmHg (p = .001) and central diastolic BP reduced from 84 ± 17 mmHg to 79 ± 11 (p = .06). A trend for a reduction in total vascular resistance was also observed in the IG (-.150; p = .06). Conclusions: Tailored physical exercise as foreseen in the [email protected] program is an effective non-pharmacological tool to reduce pBP and cBP in older adults. On behalf of the [email protected] Consortium. This work is co-financed by the European Regional Development Fund (ERDF), through the partnership agreement Portugal 2020 - Regional Operation Program CENTRO2020, under the project CENTRO-01-0145-FEDER-023369 [email protected]: AGA - Comprehensive Geriatric approach to promote an active and healthy aging - implementation of an integrated and multidisciplinary intervention program

Telerehabilitation is non-inferior to usual care following total hip replacement — a randomized controlled non-inferiority trial

ObjectivesDetermine if outpatient physiotherapy care via telerehabilitation is as effective as in-person physiotherapy care after total hip replacement. DesignRandomised, single-blind, controlled, non-inferiority clinical trial. SettingQEII Jubilee Hospital, Brisbane, Australia. ParticipantsSeventy patients receiving a total hip replacement entered the study, sixty-nine completed the study. InterventionsThe control group (n=35; x¯ age 67; female 60%) received in-person outpatient physiotherapy and a paper-based home exercise programme. The intervention group (n=35; x¯ age 62; female 66%) received remotely delivered telerehabilitation directly into their homes and a technology-based home exercise program using an iPad application. Main outcome measuresThe primary outcome was the quality of life subscale of the Hip disability and Osteoarthritis Outcome Score measured at six weeks post-operatively. Secondary outcomes included objective strength and balance outcomes, self-reported function and satisfaction outcomes, and home exercise program compliance. ResultsNo between group difference was detected in the Hip disability and Osteoarthritis Outcome Score quality of life subscale at the primary end point of six weeks (P=0.970). Strength, balance and self-reported function showed no between group differences. Overall satisfaction was high across both groups, with the intervention group scoring higher for ease of attending appointments (intervention 95 (10), control 86 (18), mean difference 9 (95% CI 2 to 16), P=0.017. The intervention group were more compliant with their home exercise programme (intervention 86% (20%), control 74% (26%), mean difference 12% (95% CI 1% to 23%), P=0.048). ConclusionsTelerehabilitation programmes can be delivered to total hip replacement patients in their own homes, using readily available technology while maintaining high levels of satisfaction. More importantly, telerehabilitation patients appear to achieve non-inferior physical and functional outcomes as those receiving in-person rehabilitation programmes. Trial Registration: ACTRN12615000824561. (Australian New Zealand Clinical Trials Registry).