Exercise Intervention Studies Research Articles

The work Lifestyle-integrated Functional Exercise program for preventing functional decline in employees aged 55 years and older: development and initial evaluation

BackgroundDespite the global increase in older employees, workplace physical activity interventions (WPAIs) for this target group have not yet been sufficiently developed. The major drawback of existing WPAIs is low adherence due to lack of time or limited motivation. A novel approach could be to integrate tailored neuromotor and strength exercises into everyday working tasks to prevent the functional decline of older employees at the workplace without needing much additional time for training. This approach was tested in the present study by evaluating the proof-of-concept of a novel WPAI based on the Lifestyle-integrated Functional Exercise (LiFE) program integrated into a working environment (wLiFE55 +).MethodsThe proof-of-concept of wLiFE55 + was quantified within a 4-week pre-post exercise intervention study by measuring (1) feasibility including adherence, activity frequency, adverse events and acceptance (integrability of wLiFE55 + activities, perceived improvement and safety, satisfaction, physical demand, personal trainer session, intervention content) and (2) pre-to-post changes in neuromotor function (12-Level Balance Scale, 12-LBS; Community Balance and Mobility Scale, CBM), strength (60sec Chair Stand Test), and PA (1-week activity monitoring). For statistical analysis, the median and interquartile range (IQR) were computed. For pre-to-post changes, Wilcoxon signed-rank tests with effect size (r) were also performed.ResultsSeventeen older employees (mean age 59 years, 8 female) were included of which fifteen completed the study. The intervention adherence was 100%, and the activity adherence was 58% (9 out of 12 maximum possible wLiFE55 + activities implemented). Depending on the specific activity, the frequency of practice ranged between 25–75% of the days of the intervention period, and single wLiFE55 + activities were practiced between one and three times per day. No adverse events occurred, and acceptance was high. Pre-to-post increases with medium effect sizes were found for neuromotor function (CBM, 12-LBS) and specific PA variables (total sedentary time, sedentary bouts > 30 min).ConclusionThe results of the study highlight the feasibility of wLiFE55 + in a work setting with older employees. The pre-to-post increases observed in neuromotor measures and reductions in sedentary time suggest that wLiFE55 + may counteract the age-related functional decline in older employees and justifies future studies in this field. The next steps are program adjustments to boost exercise frequency and evaluating wLiFE55 + in a randomized controlled trial.

#2320 The impact of interventions for people with chronic kidney disease on health-related quality of life: a systematic review

Abstract Background and Aims Health-related quality of life (HRQoL) is poorer for those with chronic kidney disease (CKD) than the general population and worsens as CKD progresses. Evidence is mixed as to which interventions improve HRQoL for those with CKD, and HRQoL is often under-reported in randomised controlled trials where it is most commonly a secondary outcome. Reviews including HRQoL as an outcome have thus far focused on the impact per intervention, therefore we aimed to ascertain which interventions, of any type, have an impact on HRQoL outcomes for those with non-dialysis dependent CKD (NDD-CKD). Method The protocol was prospectively registered on PROSPERO (CRD42022364474) and PRISMA guidelines were followed. Inclusion criteria were randomised controlled trials in an NDD-CKD population (excluding transplant recipients), any intervention type, usual care/placebo comparators, using validated and reported HRQoL outcomes measures. Databases searched were Embase, Medline, PsychINFO, CINAHL plus, Web of Science, PubMed, and Google Scholar, with reference searching of included studies. Reports were independently screened by two researchers who also performed data extraction and quality assessment (using the Cochrane Risk of Bias 2.0 tool). Synthesis was undertaken using Synthesis without Meta-analysis (SWiM) methods. Conversion to one-sided p-values, synthesising outcomes in albatross plots and combining p-values via Fisher's method was performed using the metap package in R. HRQoL measures were broken down into physical, mental, kidney disease symptoms, adverse effects of kidney disease, burden of kidney disease, overall kidney disease, and overall HRQoL domains for analysis. Results Searches yielded 8983 records, and 39 studies met inclusion criteria, with a total of 11,940 participants. Nine groups were formed based on type of intervention, with data synthesis possible in the eight groups with more than one study (Fig. 1). 26 (66%) studies were rated as having high risk of bias, largely due to frequent lack of blinding and HRQoL being a patient reported outcome. 37 studies had sufficient data for presentation in albatross plots (Fig. 2). Using combined p-values for all HRQoL outcomes in each group of studies, benefit to HRQoL in at least one study was shown for education interventions (p < 0.001, seven studies, none with low risk of bias), exercise interventions (p < 0.001, eight studies, all with high risk of bias), medications to treat CKD-related anaemia (p < 0.001, eight studies, four with low risk of bias), nutritional interventions (p < 0.001, four studies, all with high risk of bias) and weight loss interventions (p < 0.001, two studies, one with low risk of bias). No benefit to HRQoL was shown for medications aimed at slowing CKD progression (p = 0.492, five studies), medications for depression (p = 0.266, two studies) and medications to treat acidosis (p = 0.99, two studies). Conclusion This review identified several interventions with evidence of benefit to HRQoL for people with NDD-CKD, including medications to treat anaemia and weight loss interventions. Studies of education, exercise and nutritional interventions showed potential benefit, but with high risk of bias. Further high-quality randomised controlled trials of interventions for people with NDD-CKD should include and report HRQoL outcomes, in addition to targeting potentially modifiable determinants of HRQoL in these groups.

Beyond muscles: Investigating immunoregulatory myokines in acute resistance exercise - A systematic review and meta-analysis.

Myokines, released from the muscle, enable communication between the working muscles and other tissues. Their release during physical exercise is assumed to depend on immune-hormonal-metabolic interactions concerning mode (endurance or resistance exercise), duration, and intensity. This meta-analysis aims to examine the acute changes of circulating myokines inducing immunoregulatory effects caused by a bout of resistance exercise and to consider potential moderators of the results. Based on this selection strategy, a systematic literature search was conducted for resistance exercise intervention studies measuring interleukin (IL-) 6, IL-10, IL-1ra, tumor necrosis factor (TNF-) α, IL-15, IL-7, transforming growth factor (TGF-) β1, and fractalkines (FKN) before and immediately after resistance exercise in healthy individuals. Random-effects meta-analysis was performed for each myokine. We identified a moderate positive effect of resistance exercise for IL-6 and IL-1ra. Regarding IL-15 and TNF-α, small to moderate effects were found. For IL-10, no significant effect was observed. Due to no data, meta-analyses for IL-7, TGF-β1, and FKN could not be performed. No moderators (training status, type of exercise, risk of bias, age, sex, time of day, exercise volume, exercise intensity, exercise dose) of the results were detected for all tested myokines. Taken together, this systematic review and meta-analysis showed immediate positive effects of an acute resistance exercise session on IL-6, IL-1ra, TNF-α, and IL-15 levels.

Effects of Exercise on Gut Microbiota of Adults: A Systematic Review and Meta-Analysis.

The equilibrium between gut microbiota (GM) and the host plays a pivotal role in maintaining overall health, influencing various physiological and metabolic functions. Emerging research suggests that exercise modulates the abundance and functionality of gut bacteria, yet the comprehensive effects on GM diversity remain to be synthesized. The study aims to quantitatively examine the effect of exercise on the diversity of gut microbiota of adults using a systemic review and meta-analysis approach. PubMed, Ebsco, Embase, Web of Science, Cochrane Central Register of Controlled Trials, the China National Knowledge Infrastructure, and Wanfang Data were searched from their inception to September 2023. Exercise intervention studies with a control group that describe and compare the composition of GM in adults, using 16S rRNA gene sequencing, were included in this meta-analysis. A total of 25 studies were included in this meta-analysis with a total of 1044 participants. Based on a fixed-effects model [Chi2 = 29.40, df = 20 (p = 0.08); I2 = 32%], the pooled analysis showed that compared with the control group, exercise intervention can significantly increase the alpha diversity of adult GM, using the Shannon index as an example [WMD = 0.05, 95% CI (0.00, 0.09); Z = 1.99 (p = 0.05)]. In addition, exercise interventions were found to significantly alter GM, notably decreasing Bacteroidetes and increasing Firmicutes, indicating a shift in the Firmicutes/Bacteroidetes ratio. The subgroup analysis indicates that females and older adults appear to exhibit more significant changes in the Shannon Index and observed OTUs. Exercise may be a promising way to improve GM in adults. In particular, the Shannon index was significantly increased after exercise. Distinct responses in GM diversity to exercise interventions based on gender and age implicated that more research was needed.

Feasibility of a physical exercise intervention for patients on a palliative care unit: a critical analysis

BackgroundRecent exercise intervention studies have shown promising results in improving quality of life (QoL) and physical function (PF) in diverse chronic disease and advanced cancer patients. However, the effects of structured exercise in palliative care patients, having different therapeutic needs, lower life expectancies and PFs remain unknown. This study primarily aimed to assess the feasibility of an exercise intervention with follow-up by analysing recruitment numbers, screening procedures, acceptability, preferences, and safety of the exercise intervention as well as retention in follow-up. Our secondary aims related to changes in QoL and PF.MethodsThis study comprised of a one-arm design without a control group. Over 6 months, every in-hospital palliative care unit (PCU) patient was screened for eligibility. Eligible patients were asked to participate in a 2-week exercise intervention consisting of resistance training and/or endurance training with moderate or high intensity based on personal preferences and a 4-week follow-up. Before and after the exercise intervention, QoL and PF were assessed and a qualitative interview after the intervention addressed expectations and experiences of the exercise intervention. For follow-up, patients were provided with information on independent training and after 1 and 4 weeks a QoL assessment and qualitative interview were conducted.ResultsOf 124 patients screened, 10 completed the intervention with an adherence rate of (80 ± 25%), of which 6 patients completed follow-up. Endurance training was the most performed training type and only a few minor adverse events occurred in certain or likely connection to the exercise intervention. While physical QoL and PF measured by arm curl strength and time up and go performance improved, mental QoL and the other PF tests remained unchanged.ConclusionDespite the challenges that were faced in our screening and testing process, that are specific to the palliative patient population with their unique therapeutic requirements and varying mental-/ physical capabilities, we discovered the 2-week exercise intervention to be feasible, safe, and well tolerated by palliative care patients. Moreover, it seems that short-term improvements in QoL and PF are possible. Further full scale studies are required to confirm our findings.Trial registrationThe study was retrospectively registered on 25.01.2022 in the German Clinical Trials Register (DRKS00027861)

Effects of Group Exercise Intervention on Quality of Life and Physical Parameters in Patients with Childhood Cancer: A Systematic Review.

Although the survival rates of childhood cancer are increasing, children diagnosed as having cancer experience psychological and physical problems and a declining quality of life (QOL). A systematic review of PubMed databases was conducted up to September 2023 to identify studies reporting the effects of group exercise intervention in children with cancer. The inclusion criteria were pre-specified, including children aged ≤19 years old who received group exercise intervention and interventional studies written in English. Studies involving non-exercise intervention or non-group intervention were excluded. Five studies were included in the present review. In three studies, QOL and physical parameters were improved after group exercise intervention, and in two studies, only physical parameters were improved. Improvements in QOL were achieved through psychosocial variables, improved scores of subscales of pain and hurt, nausea, and procedure-related anxiety, and reduced cancer-related fatigue. All studies had high numbers of participants who completed the intervention. However, all studies showed a high risk of bias regarding the selection of the reported results, and most studies showed a high risk of bias regarding deviations from the intended intervention and outcome measurement. The reviewed studies showed that group exercise intervention for children with cancer could improve their QOL and/or physical parameters.

Does Physical Exercise Modify the Pathophysiology of Alzheimer's Disease in Older Persons?

Physical exercise is well known for its benefits on brain health. However, the mechanisms through which these benefits occur remain discussed, especially in the context of cognitive conditions such as Alzheimer's disease. The present short review summarizes the findings of interventional studies that examined the effects of exercise training on the specific and non-specific biomarkers of Alzheimer's disease. Controlled exercise intervention studies published in the English language were selected if they assessed the effects of a physical exercise intervention of at least 2 weeks in middle-aged or older adults on one of the following biomarkers measured either in the brain, the cerebrospinal fluid or the blood: beta-amyloid, tau, neurofilament light chain, and glial fibrillary acidic protein. Overall, there was no strong evidence of significant effects of exercise interventions on any of the selected biomarkers. However, in specific populations, such as women with obesity, pre-diabetes, or depression, favorable changes in blood beta-amyloid concentrations were reported. Further benefits on cerebrospinal fluid beta-amyloid were also demonstrated in APOE-ε4 allele carriers with Alzheimer's disease. In conclusion, the current evidence suggests that physical exercise does not modulate the pathophysiology of Alzheimer's disease in the overall population of middle-aged and older adults. Nonetheless, some specific populations, such as women with metabolic disorders and Alzheimer's disease patients with APOE-ε4 genotype, seem to be favorably affected. Further studies, including long follow-ups, large sample sizes, and concomitantly assessing the effects of other factors such as sedentary behavior and diet, are required to bring further evidence to the field.

A109: A Study of the Relationship Between Exercise Adherence and Depression

Purpose: As the social economy rapidly advances, and competition intensifies, university students are confronted with both increased opportunities and significant psychological pressures. Notably, the incidence of depression is on the rise, with approximately 20.3% of university students in China experiencing certain psychological issues. Against this backdrop, this study seeks to explore the interplay between exercise motivation, exercise adherence, and depression among university students. Methods: A cohort of 25 subclinical individuals experiencing psychological issues related to depression was chosen to partake in a 2-month exercise intervention study. The intervention involved Salsa dance, with a frequency of approximately 2 hours twice a week. Prior to the initiation and subsequent to the conclusion of the intervention, participants' exercise motivation and depression scores were assessed using the Motivation to Exercise Scale and the Flow Centre Depression Scale, respectively. A repeated measures ANOVA was used to examine the effect of exercise intervention, exercise motivation on depression. Results: The ANOVA results showed a significant main effect of the exercise intervention [F(1,23)=153.59, p < 0.001]. The main effect of motor motivation was significant [F(1,23)=66.80, p < 0.001]. There was a significant interaction between exercise intervention and motivation to exercise on depression scores [F(1,23)=45.84, p < 0.001], suggesting that the effect of the exercise intervention on depression changed with changes in motivation to exercise. For the change in mean brain alpha wave frequency after the exercise intervention between subjects with different exercise motivation, the repeated ANOVA showed a significant main effect of the exercise intervention [F(1,8)=106.91, p < 0.001]. Significant main effects of the exercise intervention [F(1,8)=106.91, p < 0.001] and motor motivation [F(1, 8) = 17.13, p < 0.001] were found. Significant interaction between exercise intervention and exercise motivation on alpha wave mean frequency [F(1,8)=8.73, p=0.027] were also found. It was suggested that the effect of exercise intervention on the mean frequency of alpha waves varied with exercise motivation. Conclusion: The results indicated a connection between exercise adherence and depression. Physical activity, serving as a non-impairing behavioral strategy, can offer an alternative or complementary intervention for the treatment of depression. This positions exercise intervention therapy as a promising approach for effectively addressing depression with minimal risk. The findings in this paper are valuable in guiding new directions for the treatment of depression.

Scoping Review of Swimming and Aquatic Exercise Intervention Studies for Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder

Scoping Review of Swimming and Aquatic Exercise Intervention Studies for Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder

Regular protein supplement consumption proves feasible in advanced tumor patients participating in a multimodal nutrition and exercise intervention study

Regular protein supplement consumption proves feasible in advanced tumor patients participating in a multimodal nutrition and exercise intervention study

Multiple sclerosis and exercise-A disease-modifying intervention of mice or men?

Research suggests that physical exercise can promote an anti-inflammatory and neuroprotective state. If so, increasing or optimizing exercise could be considered a 'disease-modifying intervention' in neuroinflammatory diseases, such as multiple sclerosis (MS). Exercise intervention studies conducted in animal models of MS are promising. Various aerobic and strength training regimes have been shown to delay disease onset and to reduce both the clinical and pathological disease severity in mice. However, fundamental differences between the physiology of animals and humans, the disease states studied, and the timing of exercise intervention are significant. In animal models of MS, most exercise interventions begin before disease initiation and before any clinical sign of disease. In contrast, studies in humans recruit participants on average nearly a decade after diagnosis and often once disability is established. If, as is thought to be the case for disease-modifying treatments, the immunomodulatory effect of exercise decreases with advancing disease duration, current studies may therefore fail to detect the true disease-modifying potential. Clinical studies in early disease cohorts are needed to determine the role of exercise as a disease-modifying intervention for people with MS.

Chemotherapy-related symptoms and exercise adherence in older patients with myeloid neoplasms.

Exercise may ameliorate treatment-related symptoms, but older adults have lower exercise adherence compared to their younger counterparts due to treatment-related symptoms. We recruited older patients with myeloid neoplasms receiving chemotherapy to a pilot study of a mobile health exercise intervention. Participants entered their steps and resistance data into the app daily, and symptom data twice a week, over an 8-12week period. In this proof-of-concept analysis, we used a linear mixed-effects model to assess the association of symptoms from the previous week with exercise adherence in the current week among older adults with myeloid neoplasms. Mean age was 74.3 (SD = 5.0) years (N = 7). At baseline, patients on average walked 2564 daily steps (SD = 1816), which increased to 2967 (SD = 3448) post-intervention. Patients on average performed 3.5 (SD = 2.6) days of resistance training weekly, with mean duration of 21.5min (SD = 11.6) and rated perceived exertion of 3.68 (SD = 1.78) on a 0-10 scale. Lower average steps in the current week was associated with greater interference with daily activities from pain (β = - 203.13, p = 0.05), memory (β = - 492.29, p = 0.09), numbness (β = - 353.57, p = 0.07), and sadness (β = - 403.03, p = 0.09) in the previous week. Similarly, lower average resistance minutes in the current week were associated with greater pain, sadness, and anxiety in the previous week. We found that greater pain, sadness, and anxiety were associated with lower exercise adherence. Symptom monitoring and management in older adults with myeloid neoplasms receiving chemotherapy can promote exercise adherence and in turn improve symptoms. ClinicalTrials.gov Identifier: NCT04035499. Registered 7/29/2019.

P09.05.A IMPACT OF A 16-WEEK SUPERVISED EXERCISE INTERVENTION ON CANCER-RELATED FATIGUE IN PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA UNDERGOING ADJUVANT CHEMOTHERAPY

Abstract BACKGROUND Cancer-related fatigue (CRF) is considered one of the most prevalent symptoms in brain tumor patients undergoing concurrent chemoradiation (approx. 80 % of those affected). Several studies have identified beneficial effects of physical activity on reducing CRF. However, few studies have examined the reduction of CRF by exercise in glioma patients. Here we present prospective data showing the effect of an intensive 16-week supervised exercise intervention on CRF in neuro-oncological patients. MATERIAL AND METHODS Between July 2020 and April 2023, patients with newly diagnosed glioblastoma and after surgery and concomitant radiochemotherapy have been recruited for this single-arm trial in progress. Participants have received a 16-week supervised training intervention on a 1:1-basis consisting of two intensive 50-minute sessions per week (bicycle ergometry at an average of 75 % of maximum heart rate and progressive whole-body resistance training). CRF has been assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C30). We calculated change scores (scores: 0-100; 100=max. fatigue) from baseline, after 8 weeks, and post-intervention (week 16). RESULTS So far, 26 glioblastoma patients (13 women) aged 35-84 years (mean 59 years) participated in the exercise intervention. All patients received adjuvant chemotherapy (50 % Stupp, 42 % CeTeG, 8 % other). Paired t-test indicated a statistically significant reduction in CRF from baseline to post-intervention (p=.030; 95 % CI: -0.5 - 24.2). Mean scores reduced from 40.4 to 36.2 (week 8) to 26.9 (week 16). However, the decrease between week 0 and week 8 was not yet significant (p=.281; 95 % CI: -7.6 - 13.6). CONCLUSION The present trial shows that a 16-week supervised exercise program can reduce CRF in glioblastoma patients despite adjuvant chemotherapy. Thus, and consistent with studies of exercise interventions in patients of other tumor types, glioblastoma patients have the opportunity to actively contribute to the reduction of tumor- and therapy-induced side effects through intensive physical training.

Resistance Training in Post-COVID Recovery: Rationale and Current Evidence.

During hospitalisation with COVID-19, individuals may experience prolonged periods of immobilisation. Combined with the inflammatory effects of the virus, this may lead to a significant reduction in both muscle mass and strength. Data from several long-term studies suggest that these symptoms may not fully resolve within one year. Owing to its effectiveness at inducing muscle fibre hypertrophy and improving neuromuscular efficiency, resistance training is of great interest in the rehabilitation of this population. This narrative review aims to identify the rationale and potential efficacy of resistance training for restoring physical function following infection with SARS-CoV-2, as well as evidence of its use in clinical practice. The studies included in this narrative review consisted mostly of multi-component rehabilitation trials. Of these, widespread improvements in muscle strength were reported using intensities of up to 80% of participants' 1-repetition-maximum. Evidence thus far indicates that resistance training may be safe and effective in patients following COVID-19, although its individual contribution is difficult to discern. Future exercise intervention studies investigating the efficacy of resistance training as a sole modality are needed.

Risk factors for non-communicable diseases among overweight and obese women of Somali background in Oslo, Norway

BackgroundNon-communicable diseases (NCDs) are the most common causes of morbidity and mortality globally. Somalis are a relatively new immigrant group in Norway and knowledge about their health status and risk factors for NCDs is limited. This study aimed to determine the prevalence of selected risk factors for NCDs among overweight and obese women of Somali background in Oslo, Norway. MethodsBaseline data of an exercise intervention study among women of Somali background (n = 168, recruited between September 2020 and September 2022). Body mass index (BMI) (kg/m2), waist-hip-ratio (WHR), blood pressure, glycated hemoglobin (HbA1c), non-fasting glucose, and blood lipids were measured. ResultsMean (SD) age was 46.8 years (10.4) and BMI was 33.9 kg/m2 (5.1). Mean total cholesterol (TC), low-density lipoprotein (LDL), HbA1c, non-fasting glucose, and blood pressure were within the normal range on average. Per one unit increase in BMI systolic blood pressure (SBP) increased by 0.89 mm/Hg (95%CI: 0.35−1.44, P = 0.002) and diastolic blood pressure (DBP) increased by 0.46 mm/Hg (95%CI: 0.17−0.75 P = 0.002). No relation between BMI and HbA1c, blood lipids, age, education level, number of children in the household, or length of residence in Norway was found. ConclusionDespite the high BMI, most of the selected risk factors for NCDs had mean values within the normal range. The participants had a low prevalence of diabetes type 2 and hyperlipidemia, although there was a moderate association between BMI and blood pressure. This indicates that it is possible to be obese and be of relatively good health in this population. Trial registrationThe study was registered at clinicaltrials.gov NCT04578067.

Plasma Proteomic Kinetics in Response to Acute Exercise

Regular exercise has many favorable effects on human health, which may be mediated in part by the release of circulating bioactive factors during each bout of exercise. Limited data exist regarding the kinetic responses of plasma proteins during and after acute exercise. Proteomic profiling of 4163 proteins was performed using a large-scale, affinity-based platform in 75 middle-aged adults who were referred for treadmill exercise stress testing. Plasma proteins were quantified at baseline, peak exercise, and 1-h postexercise, and those with significant changes at both exercise timepoints were further examined for their associations with cardiometabolic traits and change with aerobic exercise training in the Health, Risk Factors, Exercise Training and Genetics Family Study, a 20-week exercise intervention study. A total of 765 proteins changed (false discovery rate < 0.05) at peak exercise compared to baseline, and 128 proteins changed (false discovery rate < 0.05) at 1-h postexercise. The 56 proteins that changed at both timepoints included midkine, brain-derived neurotrophic factor, metalloproteinase inhibitor 4, and coiled-coil domain-containing protein 126 and were enriched for secreted proteins. The majority hadconcordant direction of change at both timepoints. Across all proteins assayed, gene set enrichment analysis showed increased abundance of coagulation-related proteins at 1-h postexercise. Forty-five proteins were associated with at least one measure of adiposity, lipids, glucose homeostasis, or cardiorespiratory fitness in Health, Risk Factors, Exercise Training and Genetics Family Study, and 20 proteins changed with aerobic exercise training. We identified hundreds of novel proteins that change during acute exercise, most of which resolved by 1 h into recovery. Proteins with sustained changes during exercise and recovery may be of particular interest as circulating biomarkers and pathways for further investigation in cardiometabolic diseases. These data will contribute to a biochemical roadmap of acute exercise that will be publicly available for the entire scientific community.

Complexity and pitfalls in maximal exercise testing for persons with multiple sclerosis.

Valid measurements of cardiorespiratory fitness in persons with multiple sclerosis (pwMS) are essential during inpatient rehabilitation for a precise evaluation of the current health status, for defining appropriate exercise intensities, and for evaluation of exercise intervention studies. We aim (i) to examine the proportion of pwMS that attain the American College of Sports Medicine (ACSM) criteria for maximal effort during graded cardiopulmonary exercise testing (CPET), and (ii) to provide insight into participant characteristics that limit maximal exercise performance. This cross-sectional study comprises a retrospective examination of ACSM criteria for maximal effort during graded CPET of n=380 inpatient pwMS (mean age: 48±11 years; 66% female). Chi-square or Fisher's exact tests were conducted to compare differences in the distribution of criteria achieved. Participants' characteristics were examined as potential predictors using binary logistic regression. Only 60% of the overall sample attained a respiratory exchange ratio ≥1.10. With regard to the definition applied, only 24% or 40% of the participants achieved an oxygen consumption plateau, and 17% or 50% attained the heart rate criterion. Forty-six per cent met at least two out of three criteria. The disability status, gender, disease course and body mass index were associated with the attainment of maximal effort. Our findings suggest that a relevant proportion of inpatient pwMS do not attain common criteria utilized to verify maximal oxygen consumption. Identified predictors for criteria attainment can be used to create models to predict cardiorespiratory fitness and to optimise CPET protocols in restrictive groups of pwMS.

The effects of cognitive and physical exercise interventions on cognition in Huntington’s disease: A systematic review

AbstractBackgroundCognitive and physical exercise interventions demonstrate efficacy in improving cognition in several populations but have not been reviewed in Huntington’s disease (HD). This systematic review aims to examine the effects of cognitive and physical interventions in HD.MethodElectronic databases (MEDLINE, EMBASE, PsycINFO, CENTRAL) were searched from inception through till 10 May 2021 for interventional studies of cognitive or physical exercise interventions in HD, with any control or no control. Clinical trial registries, theses databases and organisational websites were additionally searched. The primary outcome was change on objective measures of cognition. Additional outcomes included change in psychosocial, functional and neuroimaging outcomes. Risk of bias for each outcome domain was assessed independently by two reviewers using the Cochrane RoB 2 and ROBINS‐I tools. As studies reported multiple eligible outcomes in cognitive and psychosocial domains, composite effect sizes were calculated as standardized mean differences (Hedges’ g) with 95% CI.ResultFifteen studies (three cognitive, five physical, seven multidomain interventions) were included. There were five randomized controlled trials, two non‐randomized controlled trials and eight single arm studies. Most studies were therefore considered at serious risk of bias due to confounding. Interventions that included cognitive training (alone or combined with exercise) tended to report larger cognitive effect sizes, whereas studies of physical exercise (alone or combined with cognitive rehabilitation or stimulation) reported negligible benefits. Studies of multidomain interventions had larger effects on psychosocial functioning. Functional outcomes were only available from studies of multidomain interventions, which had negligible benefits. Across interventions, structural brain changes were reported in cortical and subcortical regions, but regions of interest and analyses were heterogeneous. No studies reported functional brain changes.ConclusionOur review indicates that cognitive training may benefit cognition in HD, while multidomain interventions may improve psychosocial function. Cognitive and physical interventions may promote structural brain changes, but functional brain changes are unclear. Larger randomised controlled trials are required to confirm the effects of cognitive or physical interventions in HD.

Wireless physical activity monitor use among adults living with HIV in a community-based exercise intervention study: a quantitative, longitudinal, observational study

ObjectivesOur aim was to examine wireless physical activity monitor (WPAM) use and its associations with contextual factors (age, highest education level, social support and mental health) among adults living with...

Development and utilization of a smartphone app for data collection and monitoring in the context of a home-based multimodal nutrition and physical exercise intervention study with advanced tumour patients

Development and utilization of a smartphone app for data collection and monitoring in the context of a home-based multimodal nutrition and physical exercise intervention study with advanced tumour patients