Exercise Interventions For Adults Research Articles

The Best Exercise Modality and Dose for Reducing Pain in Adults With Low Back Pain: A Systematic Review With Model-Based Bayesian Network Meta-analysis.

OBJECTIVE: To quantify the dose-response relationship between overall and specific exercise modalities and pain, in patients with nonspecific chronic low back pain (LBP). DESIGN: Systematic review with Bayesian network meta-analysis. LITERATURE SEARCH: We searched the Medline, Embase, Web of Science, Cochrane Library, Scopus, and SPORTDiscus databases from inception to June 2023. STUDY SELECTION CRITERIA: We included randomized controlled trials of exercise interventions in adults with nonspecific chronic LBP and at least 1 pain outcome reported at the main trial end point. DATA SYNTHESIS: A random-effects network meta-analysis was conducted. We assessed risk of bias using the Cochrane Risk of Bias Tool 2.0, and used the GRADE approach to judge the certainty of evidence for each outcome. RESULTS: Eighty-two trials were included (n = 5033 participants). We found a nonlinear dose-response relationship between total exercise and pain in patients with nonspecific chronic LBP. The maximum significant response was observed at 920 MET minutes (standardized mean difference = -1.74; 95% credible intervals: -2.43, -1.04). The minimal clinically important difference for achieving meaningful pain improvement was 520 MET minutes per week. The dose to achieve minimal clinically important difference varied by type of exercise; Pilates was the most effective. The certainty of the evidence was very low to moderate for all outcomes. CONCLUSION: The dose-response relationship of different exercise modalities to improve pain in patients with nonspecific chronic LBP had a U-shaped trajectory and low- to moderate-certainty evidence. The clinical effect was most pronounced with Pilates exercise. J Orthop Sports Phys Ther 2024;54(5):1-13. Epub 8 March 2024. doi:10.2519/jospt.2024.12153.

Effects of a remotely supervised resistance training program on muscle strength and body composition in adults with cystic fibrosis: Randomized controlled trial

AbstractIntroductionAmong the limited studies on physical exercise interventions in adults with cystic fibrosis (CF), few have specifically addressed the improvement of peripheral muscle strength and body fat‐free mass. The aim of this study was to examine the impacts of a remotely supervised, individualized 8‐week resistance training program of moderate to high intensity on strength and body composition in these subjects.MethodsThis was a randomized controlled trial performed in adults with CF. The exercise group (EX) performed three 1‐h resistance training sessions per week over 8 weeks. The control group (CON) followed the physical activity recommendations of their physician. The main outcomes were muscle strength and body composition, with secondary measures including pulmonary function and quality of life. Two‐way repeated measures analysis was used.ResultsIn 23 participants (age 32.13 ± 7.72 years), the intervention showed a significant beneficial effect on leg press strength, with a large effect size, both in absolute (p = 0.011; = 0.281) and relative (p = 0.007; = 0.310) terms. Large intervention effects were observed on total fat mass (p < 0.001; = 0.415), body adiposity index (p < 0.001; = 0.436), and fat mass index (p < 0.001; = 0.445), all showing reduction in the EX group. In addition, significant large size effects were detected on total fat‐free mass (p = 0.046; = 0.177), trunk fat‐free mass (p = 0.039; = 0.188), and fat‐free mass index (p = 0.048; = 0.174), all favoring exercise. No significant effects were observed on pulmonary function and quality of life.ConclusionsAn 8‐week remotely supervised resistance training program, with moderate to high intensity, effectively improved lower limb muscle strength and body composition.

The role of exercise for pain management in adults living with and beyond cancer: a systematic review and meta-analysis.

Pain is a common side effect of cancer or cancer treatment that negatively impacts biopsychosocial wellbeing and quality of life. Exercise is a potential intervention to manage pain that is safe and has multiple benefits. The objective was to determine the role of exercise in cancer pain management. We completed a systematic review and meta-analysis of exercise interventions in adults with any type or stage of cancer by searching Ovid MEDLINE®, Embase, APA PsycInfo, the Cochrane Central Register of Controlled Trials, CINAHL, and SPORTDiscus. We included experimental and quasi-experimental designs where pain was measured as an outcome. Data synthesis included narrative and tabular summary. A meta-analysis was performed on studies powered to detect the effect of exercise on pain. Study quality was evaluated using the Cochrane risk of bias tool and certainty of evidence was evaluated using the GRADE tool. Seventy-six studies were included. Studies were predominantly conducted in breast cancer and exercise usually included a combination of aerobic and strength training. Ten studies were included in the meta-analysis demonstrating a significant effect for exercise in decreasing pain (estimated average standard mean difference (SMD) was g = - 0.73 (95% CI: - 1.16 to - 0.30)); however, the overall effect prediction interval was large. Overall risk of bias for most studies was rated as some concerns and the grading of evidence certainty was low. There are limitations in the evidence for exercise to manage cancer-related pain. Further research is needed to understand the role of exercise in a multimodal pain management strategy.

Exercise interventions for adults with cancer receiving radiation therapy alone.

Exercise interventions for adults with cancer receiving radiation therapy alone.

Effect of exercise interventions in adults with cancer receiving palliative care: a systematic review and meta-analysis.

Previous publications showed the effectiveness of exercise in adults with cancer receiving palliative care, but evidence for palliative care research on exercise is lacking. The purpose is to examine the effects of an exercise intervention on exercise capacity, physical function, and patient-reported outcome measures in adults with cancer receiving palliative care. We searched databases including EMBASE, PubMed, and Web of Science from inception until 2021. We used the Cochrane criteria to assess the risk of bias within studies. Using RevMan, mean difference (MD) and 95% confidence intervals or standardized mean difference (SMD) and 95% confidence intervals were calculated. A total of 14 studies and 1034 adults with cancer receiving palliative care are included in this systematic review and meta-analysis. Half of the studies were deemed to have high risk of bias. All of the interventions used aerobic and/or resistance exercises. The results indicated that exercise interventions significantly improved exercise capacity (mean difference: 46.89; 95% confidence interval: 4.51 to 89.26; Z = 2.17; P = 0.03), pain (standardized mean difference: - 0.29; 95% confidence interval: - 0.54 to - 0.03; Z = 2.18; P = 0.03), fatigue (standardized mean difference: - 0.48; 95% confidence interval: - 0.83 to - 0.12; Z = 2.66; P = 0.008), and quality of life (standardized mean difference: 0.23; 95% confidence interval: 0.02 to 0.43; Z = 2.12; P = 0.03). Exercise training, with aerobic exercise, resistance exercise, or combined aerobic and resistance exercise, helps to maintain or improve exercise capacity, pain, fatigue, and quality of life in adults with cancer receiving palliative care.

The Official Journal of ATTD Advanced Technologies & Treatments for Diabetes Conference 22‐25 February 2023 I Berlin & Online

The Official Journal of ATTD Advanced Technologies & Treatments for Diabetes Conference 22‐25 February 2023 I Berlin & Online

Attitudes and preferences toward exercise interventions in adults with attention deficit hyperactivity disorder: A survey study

Attention deficit hyperactivity disorder (ADHD) is characterized by inattention, impulsivity and hyperactivity, causing significant functional impairment. Current pharmacological treatments have significant side effects and concerns about abuse potential. Exercise interventions show promise, but adequately powered controlled studies are lacking, particularly in adults. Before embarking on large-scale trials, the willingness and feasibility of using exercise as a standalone or adjunct treatment in adults with ADHD must be determined. We used an online survey to assess the attitudes and preferences to exercise in 117 medicated and unmedicated UK-based adults with ADHD. Intervention preferences and characteristics, and exercise logs were also investigated. Analysis revealed that participants’ willingness to engage in exercise as a standalone treatment differed based on medication use. Despite this, exercise interventions were considered feasible, with most willing to dedicate considerable time to exercise. In terms of support, the most popular approaches were in-person support from a personal trainer or healthcare professional or independent exercise following a personalized plan. The current study was dominated by young adult females and relied on self-report but remains the first study to assess preferences for exercise interventions in those with ADHD and holds important implications for future exercise interventions in adults with ADHD.

Rheumatology Practitioners' View of Exercise in Adults With Systemic Sclerosis or Systemic Lupus Erythematosus

ABSTRACT Background Exercise is part of the general recommendations for care of people with most arthropathies or connective tissue diseases, but it does not feature specifically in the clinical guidelines for management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) by rheumatology practitioners. In this study, we sought to explore rheumatologists' (RHs') and rheumatology nurses' (RNs') perspectives and use of exercise interventions for adults with SLE or SSc. Methods Semistructured interviews were conducted with Australian RHs and RNs online using Zoom (video conferencing software). Interviews were transcribed verbatim, then coded and analyzed using NVivo for content analysis of themes. Results Seventeen participants completed the interviews (RHs n = 12, RNs n = 5). Five themes were identified: rheumatology practitioners perceive that (1) exercise is beneficial for adults with SLE or SSc, especially in managing fatigue, pain, and wellbeing; (2) exercise presents some general, structural, and disease-related barriers for adults with SLE or SSc; (3) rheumatology practitioners are confident in providing general exercise advice but lack time and confidence in prescribing exercise; (4) rheumatology practitioners' concerns about exercise are limited to those with heart and lung disease, inflamed joints, ulcerated fingertips, and severe contractures; and (5) to facilitate safe and attainable exercise, rheumatology practitioners recommend long-term, supervised, gradual, and affordable exercise options. There were no clear differences identified between the views of RNs and RHs. Conclusion Rheumatology practitioners require information and options for long-term and affordable exercise for adults with SLE or SSc that are supervised, individualized, and focus on a gradual progressive approach.

1365Does pain self-efficacy influence initial bending following exercise in adults with chronic low back pain?

Abstract Background Differences in pain self-efficacy between individuals with chronic low back pain (CLBP) may partly explain why response to exercise varies. The aim of this study was to determine if pain self-efficacy influences initial forward bending following an exercise intervention in adults with CLBP. Methods A total of 69 adults (18-65 years old) with moderate-severe CLBP-related disability who presented to a primary care physiotherapy clinic in Melbourne, Australia underwent baseline assessment of pain self-efficacy, pain intensity and kinesiophobia, prior to participation in one of two 12-week exercise interventions. Two outcome measures (lumbar and hip flexion range of motion (ROM) over the first quarter of forward bending from stance), were assessed at baseline, 6 and 12-weeks. Multiple linear mixed-effects modelling was performed for each outcome measure. Results For every 10-point increase in baseline pain self-efficacy, lumbar flexion ROM during initial bending decreased by an estimated mean 0.51 (95% CI: -1.41, 0.39) and 0.94 (95% CI: -1.75, -0.13) degrees at 6 and 12-weeks, respectively. Similarly, hip flexion ROM during initial bending decreased by an estimated mean 1.64 (95% CI: -3.70, 0.41) and 1.43 (95% CI: -3.34, 0.48) degrees at 6 and 12-weeks, respectively, per 10-point increase in baseline pain self-efficacy. Conclusions Pain self-efficacy did not influence initial forward bending following a 12-week exercise intervention. As the exercises were not targeted to improve bending, further research is required to verify these findings. Key message Pain self-efficacy may not explain variations in initial forward bending following an exercise intervention in adults with CLBP.

Using Inclusive Design to Develop a Tele–Tai Chi Intervention for Older Adults With Long-Term Mobility Disability

Tele-technologies may be able to increase access to evidence-based exercise interventions for adults aging with long-term mobility disabilities. This population experiences substantial barriers in attending such programs in person, including lack of transportation to classes, inaccessible buildings where classes are held, and lack of appropriate modifications offered for this population of older adults. It is critical to overcome such barriers to ensure this population has an opportunity to receive the benefits of evidence-based programs. In this study we are translating an in-person evidence-based tai chi intervention, Tai Chi for Arthritis, to an online platform using videoconferencing software for those aging with long-term mobility disabilities. We will describe our approach of including users from the target population and industry representatives (videoconferencing software developer, Tai Chi for Arthritis program developer as well as local master trainer) in the adaptation of the intervention and present the key findings from doing so.

Exercise rehabilitation in cardiac resynchronization: systematic review and a meta-analysis.

The benefit of exercise training in cardiac resynchronization therapy (CRT) recipients is not well established. We conducted a systematic review and meta-analysis to determine the effect of exercise training on clinical outcomes in CRT recipients.A comprehensive search until 2019 was conducted of MEDLINE, Epub, Embase, CINAHL and Cochrane databases as well as a bibliographic hand search to identify additional studies. We included all studies that compared aerobic exercise interventions in adults treated with CRT devices with adults treated with usual CRT care. These studies evaluated patient clinical characteristics, exercise testing measures, hemodynamic measures, echocardiography parameters, biomarkers and adverse events. Independent reviewers evaluated study eligibility, abstracted data and assessed risk of bias in duplicate. We used random-effect meta-analysis methods to estimate mean differences and odds ratios. Grades of Recommendation, Assessment, Development and Evaluation system were used to quantify absolute effects and quality of evidence. I2 was used to evaluate heterogeneity.We identified seven studies, six randomized control trials and one observational study, totaling 332 CRT patients in the exercise intervention and 534 patients receiving usual care. Peak VO2 was 2.4ml/kg/min higher in the exercise group in comparison with the control group (pooled mean difference 2.26, 95% CI 1.38-3.13, I2=53%, high quality). AT-VO2 improved with exercise rehabilitation, and heterogeneity was considered low (pooled mean difference 3.96, 95% CI 2.68-5.24, I2=0.0%, moderate quality).Peak VO2 and AT-VO2 are increased with aerobic exercise in CRT recipients, demonstrating a significant improvement in functional capacity.

Physical performance outcome measures used in exercise interventions for adults with childhood-onset disabilities: A scoping review.

People with childhood-onset disabilities face unique physical and social challenges in adulthood. Exercise interventions may improve physical performance in children, but there is a lack of research on adults. To describe studies that investigate exercise interventions and to evaluate the quality of physical performance outcome measures for adults with childhood-onset disabilities. Eligible studies reported on exercise interventions for adults (ages 16+) with cerebral palsy, spina bifida, or acquired brain injuries. Only randomized controlled trials published in English from 2008 to 2019 were included. MEDLINE, CINAHL, PEDro, EMBASE, and Cochrane Central Register of Controlled Trials were searched. Two reviewers independently screened studies and abstracted data. This scoping review included 4 trials reporting on cerebral palsy only. Three strength training programs found significant improvements in gait, and one mixed training program found significant improvements in strength and fitness. Only two outcome measures used are valid/reliable for adults (6 Minute Walk Test and Borg-20 Grades). Certain interventions may improve physical performance, but there is a lack of research on appropriate exercise interventions and physical performance outcome measures for adults with childhood-onset disabilities. Different exercise interventions should be investigated using larger sample sizes and outcome measures should be standardized.

The Role Of Exercise In Preventing Weight Regain In Adults Post-weight Loss Surgery

The steady increase in the prevalence of obesity is reflected in the rising rate of weight loss surgeries, and repeat surgery for weight regain that occurs 1-2 yr post-weight loss surgery (PWLS). PURPOSE: We performed a systematic review of randomized control trials (RCTs) to determine if exercise was associated with attenuation of weight regain in adults PWLS. METHODS: We searched 5 databases with terms related to exercise, weight, weight regain, and weight loss surgery, and found no systematic reviews of exercise interventions ≥1yr PWLS among adults ≥18 yr, nor did we locate professional exercise guidelines for this population. We then performed a search in PubMed for randomized controlled trials (RCTs) involving exercise interventions in adults ≥18 yr PWLS. Other inclusion criteria were RCTs in peer-reviewed journals published in English, that included the frequency, intensity, type and time of the exercise intervention, and a control group receiving usual care consisting of diet and exercise advice. The standardized mean difference effect sizes (d+) were calculated following random-effects models for body weight lost, and back-converted to the original unit for clinical interpretation. We assessed inconsistencies in d+ with the I2 statistic transformed from the Q statistic. RESULTS: The second search yielded 442 reports, with only 3 RCTs qualifying. Participants (n=132) were mostly white women 46.8±3.9yr, and 13.1±6.7mo PWLS. Interventions were supervised; lasted 40-60min/session, 2-5d/wk for 12-26wk; and involved moderate-to-vigorous intensity, combined aerobic and resistance training, while 1 added flexibility exercises. Compared to usual care, exercise interventions elicited moderate reductions in body weight ≥1yr PWLS (d+=-0.46, 95%CIs: -1.12, 0.21; -4.1kg) that did not reach significance (p=0.069) with high levels of heterogeneity (I2 =62.9%, 95%CIs: 0.0, 89.4). CONCLUSIONS: In a very limited literature, exercise interventions elicited clinically important reductions in weight of ~4kg representing ~4% of baseline weight ≥1yr PWLS. There is an urgent need for professional exercise guidelines and RCTs examining the effects of exercise on weight regain PWLS with larger, more diverse samples. Supported by the University of Connecticut Center on Excellence in Teaching and Learning

Long-Term Physical Activity Levels After the End of a Structured Exercise Intervention in Adults With Type 2 Diabetes and Prediabetes: A Systematic Review

ObjectivesRandomized, controlled trials have shown that exercise interventions reduce the incidence of type 2 diabetes in people with impaired glucose tolerance, and improve glycemic control, body composition and cardiorespiratory fitness in people with type 2 diabetes. We undertook the present systematic review to determine the extent to which participants in structured exercise trials continue to be physically active after the end of the interventions. MethodsWe systematically searched MEDLINE, EMBASE, CINAHL, SPORTDiscus and Cochrane Central Register of Controlled Trials for randomized, controlled trials that reported objective or self-reported physical activity levels in people with type 2 diabetes or prediabetes a minimum of 3 months after the end of a structured exercise intervention. This systematic review was registered on PROSPERO (PROSPERO CRD42018089468). ResultsOf 14,649 articles retrieved, 5 randomized, controlled trials (including 549 participants) were included in this systematic review. One study revealed significant improvements in self-reported physical activity levels in the intervention group compared with the control group 1, 3 and 5 years after baseline assessments, and decreased waist circumference, weight and body mass index at 1 year, but not 3 or 5 years. The 4 remaining studies did not find between-group differences at follow-up timepoints between 6 months and 3 years. ConclusionsFuture research should report physical activity levels at follow up to determine whether participation in a structured exercise intervention results in sustained increased physical activity levels. In addition, interventions should be evaluated for their effectiveness in improving adherence to long-term physical activity.

Is Exercise a Useful Intervention in the Treatment of Alcohol Use Disorder? Systematic Review and Meta-Analysis.

This systematic review and meta-analysis examined the effects of exercise on individuals with alcohol use disorders (AUDs) across multiple health outcomes. PubMed, Medline, Web of Science, Scopus, Academic Search complete, Sport Discuss, and ERIC databases. Interventional studies published between 2000 and 2018 focused on evaluating the effectiveness of exercise interventions in adults with AUD. This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines. Physical activity levels/fitness [VO2 max (Oxygen Uptake) and HRmax (Maximum Heart Rate)], levels of depression, anxiety, self-efficacy, quality of life, and alcohol consumption (number of standard drinks consumed per day and per week). The findings indicated that exercise significantly improved physical fitness as assessed by VO2 max (standardized mean difference [SMD]: 0.487, P < .05) and HRmax (SMD: 0.717, P < .05). Similarly, exercise significantly improved mental health as assessed by quality of life (SMD: 0.425, P < .05), but levels of depression, anxiety, self-efficacy, and alcohol consumption did not change significantly. Aerobic exercise alleviated depression and anxiety symptoms more than that of yoga and mixed types. Duration of exercise also had a similar effect on anxiety and depression. Exercise can be an effective and persistent adjunctive treatment for individuals with AUDs.

Exercise interventions for adults with cancer receiving radiation therapy alone

Exercise interventions for adults with cancer receiving radiation therapy alone

Comparison of Body Composition Estimates among Norland Elite®, Lunar iDXA®, and the BodPod® in Overweight to Obese Adults

ABSTRACTAccurate body composition assessment, which includes fat mass (adipose tissue mass, FM), fat-free mass (FFM), and percent fat mass (%FM) is needed to evaluate health and treatment efficacy. The current study compared body composition estimates obtained from the Norland Elite® DXA, BodPod®, and iDXA® before and after a12-week exercise intervention in adults (n=30, BMI 25–35 kg/m2) . Bland-Altman methods determined mean bias and limits of agreement for FM, %FM, and FFM between methods. Compared to the iDXA® and BodPod®, Elite® overestimated BF% and FM (P < .01). FFM was similar between iDXA® and Elite® but lower in Elite® than BodPod® (P < .01). There were no differences between methods in changes in FM or FFM after the exercise intervention. Prior to this study, it was unknown how the Norland Elite®, a DXA model marketed to bariatric surgery patients, compared to other common body composition assessment methodologies..

53 - Long-Term Physical Activity Adherence After the End of an Exercise Intervention in Adults With Type 2 Diabetes and Prediabetes: A Systematic Review

Randomized, controlled trials have shown that supervised exercise interventions reduce the incidence of type 2 diabetes in people with impaired glucose tolerance, and improve glycemic control, body composition and cardiorespiratory fitness in individuals with type 2 diabetes. We undertook the present systematic review to determine the extent to which participants in supervised exercise trials continue to be physically active after the end of the structured interventions.

EXERCISE AS AN AUGMENTATION TO PHARMACOTHERAPY FOR DEPRESSION IN OLDER AND YOUNGER ADULTS: A FEASIBILITY TRIAL EXPLORING BIOLOGICAL MECHANISMS

Introduction Exercise interventions for depression that also examine biological mechanisms are rare and none have included both younger and older adults with Major Depression. Our pilot intervention study tested the feasibility of conducting a physical exercise intervention as augmentation to pharmacotherapy for depression in younger and older adults while also exploring possible neural mechanisms underlying the antidepressant effects of exercise. Methods Fifteen sedentary younger (20-39 years) and older adults (60-79 years) meeting criteria for a Major Depressive Episode were randomized to receive a 12-week medication regimen of venlafaxine XR or venlafaxine XR plus physical exercise. The exercise intervention involved supervised moderate-intensity aerobic exercise sessions three times per week for 12 weeks. The primary aim was to develop the infrastructure for conducting an exercise intervention in adults with Major Depression while also collecting brain imaging measures to better understand mechanisms. The Montgomery Asberg Depression Rating Scale (MADRS) was used to assess change in depressive symptoms, the VO2submaximal test was used to assess change in cardiorespiratory fitness, and 7T structural MR imaging was used to assess change in regional brain morphology (i.e., cortical thickness) relevant to depression. Data analysis was conducted using repeated measures ANOVA and paired-samples and independent samples t-tests. Results Our results demonstrated feasibility of conducting a physical exercise intervention combined with pharmacotherapy trial in depressed younger and older adults. Ten younger adults and five older adults were randomized to receive treatment and 11 participants completed the study. There was 0% attrition and a 91% attendance rate (i.e., 33/36 sessions) among participants engaged in the exercise intervention. Although efficacy of the intervention was unable to be tested, trends suggested that the addition of physical exercise to medication treatment for depression may lead to rapid and stable decline in depressive symptoms and exercise-related improvements in cardiorespiratory fitness may be linked to an increase in cortical thickness in regions sensitive to depression (i.e., orbitofrontal cortex, anterior cingulate cortex, parahippocampal gyrus). Further, sensitivity analyses suggested that treatment-related increases in cortical thickness in the right medial orbitofrontal cortex and right rostral anterior cingulate cortex were associated with improved performance on measures of verbal learning and memory (p Conclusions This pilot clinical trial involving physical exercise as an augmentation to antidepressant medication treatment enabled this interdisciplinary research team to develop the infrastructure for conducting an exercise intervention for depression in late-life and early adulthood while also examining biological mechanisms. Recruitment challenges were overcome, and intervention adherence was exceptional. Trending associations between exercise-related improvements in fitness and changes in cortical thickness are promising avenues for future large-scale studies to explore. This research was funded by This project was supported by the Advanced Center for Intervention and Services Research (ACISR). PDF: http://submissions.mirasmart.com/Verify/AAGP2019/Original/AAGP2019-000336/AAGP2019-000336_Fig1.pdf PDF: http://submissions.mirasmart.com/Verify/AAGP2019/Original/AAGP2019-000336/AAGP2019-000336_Fig2.pdf

Exercise interventions for adults after liver transplantation

Exercise interventions for adults after liver transplantation