Exercise Interventions In Patients Research Articles

Efficacy and feasibility of aerobic exercise interventions as an adjunctive treatment for patients with schizophrenia: a meta-Analysis

Schizophrenia is a chronic mental disorder primarily treated with antipsychotics, which have limited efficacy for negative symptoms. This study aims to evaluate the effectiveness and feasibility of exercise interventions as adjuncts to pharmacotherapy through a meta-analysis, providing valuable insights for rational intervention design. Four databases were searched, and randomized controlled trials with no language restrictions published up to March 27, 2023, were included. The primary outcome indicator was the Positive and Negative Symptom Scale (PANSS) total score along with its three sub-scales. Secondary outcomes included the Scale for Assessment of Negative Symptoms (SANS) and Body Mass Index (BMI), which were used to assess the efficacy of aerobic exercise interventions in patients with schizophrenia. Subgroup analyses were conducted to explore the impact of intervention duration and total weekly exercise time, while treatment feasibility was assessed through adherence rates. A total of 17 publications involving 973 patients with schizophrenia were deemed eligible and included in the analysis. Compared to other forms of adjunctive interventions, the network meta-analysis of 12 PANSS-based studies revealed that adjunctive aerobic exercise interventions were the most effective in reducing overall PANSS scores in patients with schizophrenia, with statistically significant pooled results (MD = −4.84, 95% CI: −5.72, −3.96). Both the PANSS negative symptom subscale (MD = −2.11, 95% CI: −3.26, −0.95) and SANS (MD = −9.11, 95% CI: −11.94, −6.27) indicated that adjunctive aerobic exercise interventions effectively alleviate negative symptoms. Subgroup meta-analysis indicated that 2-3 month interventions involving 100–220 min of exercise per week were the most effective. Additionally, adherence to the adjunctive aerobic exercise regimen was found to be comparable to that of conventional treatment alone. Aerobic exercise interventions, as adjunctive therapy, are an effective measure for reducing PANSS scores in patients with schizophrenia, contributing to the alleviation of both the positive and negative symptoms, and patients demonstrated strong adherence to aerobic exercise.

Exercise recommendations for patients with myositis: a narrative review of safety and efficacy.

Idiopathic inflammatory myopathies (IIM) are marked by progressive muscle weakness and lasting disability. Therapies targeting patient well-being include the use of prescription drugs as well as exercise. Maintaining or increasing muscular strength and endurance as well as cardiorespiratory fitness (CRF) improves quality of life (QoL) as well as functional status in IIM patients. This narrative review highlights exercise interventions in patients of different IIM subtypes with the intent to provide a summary table with exercise recommendations that will safely and effectively improve QoL in myositis patients.

Aerobic exercise interventions to address impaired quality of life in patients with pituitary tumors

Patients with pituitary tumors may experience persistent fatigue and reduced physical activity, based on subjective measures after treatment. These symptoms may persist despite gross total resection of their tumors and biochemical normalization of pituitary function. While reduced quality of life has been commonly acknowledged in pituitary tumor patients, there is a lack of studies on what interventions may be best implemented to ameliorate these issues, particularly when hormonal levels have otherwise normalized. Aerobic exercise programs have been previously described to ameliorate symptoms of chronic fatigue and reduced physical capacity across a variety of pathologies in the literature. As such, a prescribed aerobic exercise program may be an underrecognized but potentially impactful intervention to address quality of life in pituitary tumor patients. This review seeks to summarize the existing literature on aerobic exercise interventions in patients with pituitary tumors. In addition, future areas of study are discussed, including tailoring exercise programs to the hormonal status of the patient and incorporating more objective measures in monitoring response to interventions.

Exercise intervention for patients with chronic low back pain: a systematic review and network meta-analysis.

Chronic low back pain (CLBP) is an aging and public health issue that is a leading cause of disability worldwide and has a significant economic impact on a global scale. Treatments for CLBP are varied, and there is currently no study with high-quality evidence to show which treatment works best. Exercise therapy has the characteristics of minor harm, low cost, and convenient implementation. It has become a mainstream treatment method in clinics for chronic low back pain. However, there is insufficient evidence on which specific exercise regimen is more effective for chronic non-specific low back pain. This network meta-analysis aimed to evaluate the effects of different exercise therapies on chronic low back pain and provide a reference for exercise regimens in CLBP patients. We searched PubMed, EMBASE, Cochrane Library, and Web of Science from inception to 10 May 2022. Inclusion and exclusion criteria were used for selection. We collected information from studies to compare the effects of 20 exercise interventions on patients with chronic low back pain. This study included 75 randomized controlled trials (RCTs) with 5,254 participants. Network meta-analysis results showed that tai chi [standardized mean difference (SMD), -2.11; 95% CI, -3.62 to -0.61], yoga (SMD, -1.76; 95% CI -2.72 to -0.81), Pilates exercise (SMD, -1.52; 95% CI, -2.68, to -0.36), and sling exercise (SMD, -1.19; 95% CI, -2.07 to -0.30) showed a better pain improvement than conventional rehabilitation. Tai chi (SMD, -2.42; 95% CI, -3.81 to -1.03) and yoga (SMD, -2.07; 95% CI, -2.80 to -1.34) showed a better pain improvement than no intervention provided. Yoga (SMD, -1.72; 95% CI, -2.91 to -0.53) and core or stabilization exercises (SMD, -1.04; 95% CI, -1.80 to -0.28) showed a better physical function improvement than conventional rehabilitation. Yoga (SMD, -1.81; 95% CI, -2.78 to -0.83) and core or stabilization exercises (SMD, -1.13; 95% CI, -1.66 to -0.59) showed a better physical function improvement than no intervention provided. Compared with conventional rehabilitation and no intervention provided, tai chi, toga, Pilates exercise, sling exercise, motor control exercise, and core or stabilization exercises significantly improved CLBP in patients. Compared with conventional rehabilitation and no intervention provided, yoga and core or stabilization exercises were statistically significant in improving physical function in patients with CLBP. Due to the limitations of the quality and quantity of the included studies, it is difficult to make a definitive recommendation before more large-scale and high-quality RCTs are conducted.

Effect of Early Rehabilitation Nursing on Patients with Myocardial Infarction: A Meta-analysis

Objectives: In this study, we systematically evaluated the effectiveness and safety of rehabilitation nursing in the treatment of patients with acute myocardial infarction (AMI), and its effect on improving the cardiac function and exercise tolerance of AMI patients. Methods: All relevant published articles were searched through a computer-based retrieval of PubMed, Embase, Biosis Previews, Cochrane Library, Web of Science, China National Knowledge Internet, China Biomedical Literature Service System, Weipu Information Chinese Periodical Service Platform and Wanfang databases since their establishment. Randomized controlled trials on rehabilitation nursing and exercise intervention for patients with AMI were included, and the Cochrane risk-of-bias tool was used for quality evaluation. After quality evaluation and data extraction, we conducted statistical analysis using RevMan 5.3. Results: A total of 15 English articles were included. The meta-analysis showed that the left ventricular ejection fraction (mean difference [MD] = 5.76, 95% confidence interval [CI]: 4.55-6.97, p < .00001), left ventricular end-diastolic diameter (MD = 6.81, 95% CI: 8.17-5.45, p < .00001) and 6-minute walking distance (MD = 2.41, 95% CI: 3.42-1.40, p < .00001) showed statistically significant differences between the rehabilitation nursing group and the control group (p < .0001). However, no statistically significant difference was found in systolic blood pressure (MD = 2.29, 95% CI: 2.53-7.12, p = 0.35). Conclusion: Early rehabilitation nursing can effectively improve cardiac function and exercise tolerance in patients with AMI. It has a degree of guiding significance for improving the quality of life of patients with MI and reducing complications.

Home- versus clinic-based exercise intervention in patients with heart failure (EXIT-HF trial): a pragmatic randomized controlled trial

Abstract Background The limited accessibility partially explains the low uptake of cardiac rehabilitation (ExCR) for heart failure (HF). Home-based programs might address those obstacles but few data from randomized trials are available. Purpose To compare the effectiveness of a home-based versus clinic-based ExCR intervention in HF patients. Methods Single-center, single-blind, parallel groups, non-inferiority pragmatic randomized control trial (1:1 and after COVID-19 2:1 home- vs clinic-based). Adult HF patients referred to our cardiac rehabilitation (CR) unit were randomized to either a clinic-based (24 supervised sessions at a CR unit of a tertiary hospital over 12 weeks) or home-based (4 supervised ExT sessions to familiarize with the training protocol and the remaining sessions continued at home) over 12 weeks. Exercise training protocol consisted of a combination of endurance (at 60%-80% of peak oxygen uptake [VO2peak] and resistance training (elastic bands). The primary endpoint was the change in VO2peak at the end of the 12-week program. Secondary outcomes included adherence (>80% of sessions attendance) and change of Minnesota Living with HF Questionnaire (MLHFQ) scores. Results 120 patients (mean age 64±11 years; 64% men) were randomized: 44 to clinic- and to 76 home-based intervention. 41% had an ischemic cardiomyopathy, 27% had an ICD/CRT, the mean LVEF was 36±11% (62% had LVEF <40%), 73% were on NYHA class II, and the median NT-proBNP was 361 [IQR 170-1008] ng/mL. Intervention groups were well balanced, including basal VO2peak that was similar between groups (17.8±4.8 vs 18.1±5.2 mL/min/Kg; p=0.75). Adherence was similar between groups (87.5% vs 82.5%; p=0.50). At week 12, on average, patients increased VO2 peak by 0.9±2.5 mL/min/Kg compared to baseline (p<0.001). No significant differences were found between clinic- and home-based interventions (p=0.25). Consistently, the MLHFQ total score decreased significantly overall (-10.3±1.7 points; p<0.001), with no significant differences between groups (p=0.91). The drop-out rate was 14% and 17% in clinic- and home-based groups, respectively. Conclusions The clinical impact of home-based CR program on peakVO2 and health-related quality of life of HF patients was similar to a standard supervised clinic-based one. Our data support the home-based program as an effective alternative way of delivering CR in HF.

Effects of physical exercise interventions on cognitive function in Parkinson's disease: An updated systematic review and meta-analysis of randomized controlled trials

ObjectiveTo determine whether physical exercise interventions can improve cognitive function, including overall performance and specific domains, in patients with Parkinson's disease (PD) and to provide potential evidence on how cognitive benefits can be optimized by exercise prescriptions. MethodsUsing PubMed, Web of Science, and Cochrane Library (from inception to August 2022), four independent reviewers screened the search results and extracted data from randomized controlled trials of physical exercise interventions in patients with PD with an outcome measure of cognitive function. Random-effects meta-analysis models were used to report standardized mean differences (SMDs) with 95 % confidence intervals (CIs). ResultsTwenty-one randomized controlled trials including 761 patients with PD were eligible for inclusion. Physical exercise interventions led to significant improvements in global cognitive function (SMD = 0.69; 95 % CI = 0.31 to 1.06; P < 0.001). With respect to cognitive domains, the significant effect of exercise was found on executive function (SMD = 0.94; 95 % CI = 0.05 to 1.83; P = 0.039), but not on attention/working memory, language, memory, and visuospatial function. In moderator variable analyses, the effect on global cognition was observed in combined exercise programs (SMD = 0.79; 95 % CI = 0.46 to 1.12; P < 0.001), whereas there were no significant positive effects in aerobic exercise programs, strength exercise programs, and flexibility exercise programs. In addition, exercise interventions of light-to-moderate intensity with at least 60 min in duration, and of any frequency or period, were beneficial to the global cognitive function. ConclusionThis updated systematic review and meta-analysis suggests that physical exercise interventions are effective in improving global cognitive function and, to a lesser extent, executive function in patients with PD. At least 60 min a day of combined exercise programs on as many days of the week as feasible may be recommended as the non-pharmacological therapeutic option to improve cognitive function.

Impact of walk advice alone or in combination with supervised or home-based structured exercise on patient-reported physical function and generic and disease-specific health related quality of life in patients with intermittent claudication, a secondary analysis in a randomized clinical trial

BackgroundSupervised exercise is an integral part of the recommended first-line treatment for patients with intermittent claudication (IC). By reflecting the patients’ perspectives, patient-reported outcome measurements provide additional knowledge to the biomedical endpoints and are important outcomes to include when evaluating exercise interventions in patients with IC. We aimed to evaluate the one-year impact of three strategies: unsupervised Nordic pole walk advice (WA), WA + six months of home-based structured exercise (HSEP) or WA + six months of hospital-based supervised exercise (SEP) on health-related quality of life and patient-reported physical function in patients with IC.MethodsThis secondary exploratory analysis of a multi-center, randomized clinical trial compared three exercise strategies. The primary outcome of the secondary analysis was the one-year change in the 36-Item Short-Form (SF-36). Secondary outcomes were three- and six-months SF-36 changes alongside three, six- and 12-months changes in the disease-specific Vascular Quality of Life instrument (VascuQoL) and the Patient-Specific Functional Scale (PSFS). The Kruskal–Wallis test with Bonferroni-adjusted post-hoc tests were used for between-group comparisons. Effect size calculations were used to describe the size of observed treatment effects, and the clinical meaningfulness of observed changes in the VascuQoL summary score at one year was studied using established minimally important difference (MID) thresholds.ResultsA total of 166 patients with IC, mean age: 72.1 (SD 7.4) years, 41% women, were randomized. No significant between-group differences were observed over time for the SF-36 or the PSFS scores whereas some significant between-group differences were observed in the VascuQoL domain and summary scores over time, favoring SEP and/or HSEP over WA. The observed SF-36 and VascuQoL domain and summary score effect sizes were small to moderate, and many domain score effect sizes also remained unchanged over time. A significantly higher proportion of the patients in the SEP group reached the VascuQoL summary score MID of improvement in one year.ConclusionClinically important improvements were observed in SEP using the VascuQoL, while we did not observe any significant between-group differences using the SF-36. Whereas effect sizes for the observed changes over time were generally small, a significantly higher proportion of patients in SEP reached the VascuQoL MID of improvement.Trial registrationNCT02341716, January 19, 2015 (retrospectively registered).

Evaluation of a 12-week app-guided exercise intervention in patients with knee osteoarthritis (re.flex): a study protocol for a randomized controlled trial

BackgroundCurrent health care demonstrates an insufficient provision and utilization of physical exercises despite their recommendation as a first-line treatment in clinical guidelines for patients with knee osteoarthritis (OA). Mobile health (m-health) technologies offer new opportunities to guide and monitor home-based exercise programs by using mobile devices and inertial sensors in combination with a digital application (app). This study will evaluate patient benefits resulting from the use of the specific digital health application re.flex for patients with knee OA.MethodsThis monocentric, two-arm, randomized controlled parallel-group trial will evaluate the effectiveness of the app- and sensor-guided exercise program re.flex for patients with moderate-to-severe knee OA. We aim to recruit 200 participants via newspapers, newsletters and information events. Participants will be randomly allocated to the intervention group and the control group in a 1:1 ratio. Participants in the control group will not receive any study intervention or instruction for any change to their previous health care utilization. Despite this, they are allowed to make use of usual care provided by their treating physician. The intervention group comprises a 12-week home training program with three sessions per week in addition to usual care. Exercises will be guided and monitored by use of the training app (re.flex) and two accelerometers that are attached proximally and distally to the affected knee joint. Pre- and postmeasurements will take place at baseline (t0) and after 12 weeks (t1). Primary outcomes will be osteoarthritis-specific pain and physical function measured with the Knee Osteoarthritis Outcome Score (KOOS) subscales Pain and Function in daily living (ADL). Second, further self-reported health outcomes, a performance measurement, app logfiles and safety will be assessed. Intervention effects will be calculated by baseline-adjusted analysis of covariance (ANCOVA) using an intention-to-treat approach. Multiple imputation will be applied.DiscussionRe.flex can bridge part of the gap between recommendations for strengthening exercises in patients with knee OA and the insufficient actual care situation. This randomized controlled trial is designed to provide conclusions on the effectiveness of the health application re.flex for the population under study and will provide further insight into adherence rates and the safety of its use.Trial registrationThe trial was registered on 20/01/2023 at www.drks.de (ID: DRKS00030932).

Home- versus centre-based EXercise InTervention in patients with Heart Failure (EXIT-HF trial): A pragmatic randomized controlled trial

IntroductionThe limited accessibility and the lack of adherence explain, in part, the low proportion of heart failure (HF) patients undergoing exercise-based cardiac rehabilitation (CR) programs. Home-based programs showed to be as effective and less costly than centre-based ones and might address those obstacles. Whether the evidence from international studies can be applied to our population is still unclear. ObjectivesTo compare the clinical and economic impact of a home-based versus centre-based CR intervention in HF patients. MethodsThis is a single-center, single-blind, parallel groups, non-inferiority pragmatic randomized control trial. Adult HF patients (n=120) will be randomized to either a centre-based or home-based CR program. In both groups’ patients will participate in a 12-week combined CR program with 2 sessions per week. Exercise training (ExT) protocol consists of a combination of endurance [(at 60%–80% of peak oxygen uptake (VO2peak)] and resistance training (elastic bands). Those allocated to the home-based program will start with 4–5 supervised ExT sessions to familiarize themselves with the training protocol and then will continue the remaining sessions at home. The primary endpoint is the change in VO2peak at the end of the 12-week program. Secondary outcomes include alterations in circulating biomarkers, physical fitness, physical activity, quality of life, diet, psychological wellbeing, dyspnea, and cost-effectiveness analyses. ResultsPatients are currently being recruited for the study. The study started in November 2019 and data collection is anticipated to be completed by December 2022. This is the first study in Portugal comparing the traditional CR program with a home-based program in HF patients. Our study results will better inform healthcare professionals who care for HF patients regarding CR.

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.

Interdialytic Exercise Reduces Fatigue in Chronic Kidney Failure Patients: Systematic Literature Review

Hemodialysis therapy that is carried out for a long time can cause physical stress in the form of fatigue and have an impact on the patient’s quality of life. Giving intradialytic exercise intervention is believed to reduce the level of fatigue. The purpose of this study was to determine the effect of intradialytic exercise on the level of fatigue in chronic kidney failure patients undergoing hemodialysis. This study used a systematic literature review method based on data from Google Schoolar, Garuda, Science Direct, and the Directory of Open Access Journal (DOAJ), by including key words are fatigue, chronic kidney failure, hemodialysisi, and intradialytic exercise. Article were selected through screening according to inclusion criteria, including publications within the last 10 years (2011 – 2022), original articles, Indonesian and English, descriptive analytic study types, and quasi experiments. The results show that Intradialytic exercises applied include breathing exercise, Range of Motion (ROM), slow deep breathing, Progressive Muscle Relaxation (PMR), Pursed Lip Breathing and Physical Exercise. Based on the 9 articles found that intradialytic exercise has an effect on the level of fatigue. The average p-value &lt;0.05, the average post-test fatigue score is smaller than the pre=test, the smaller the average value fatigue score then the level of fatigue decreases. In conclusion, Intradialytic exercise affects the fatigue level of chronic kidney failure patients undergoing hemodialysis. Suggestions are given to HD nurses to be able to implement an intradialytic exercise intervention in patients undergoing hemodialysis to reduce fatigue.

#5042 ASSOCIATIONS BETWEEN SARCOPAENIA, CARDIOVASCULAR HEALTH AND HABITUAL PHYSICAL ACTIVITY IN PATIENTS ON HAEMODIALYSIS

Abstract Background and Aims Patients with end-stage kidney disease (ESKD) show skeletal muscle abnormalities such as sarcopenia (presence of low muscle mass, strength, and physical performance). Severe sarcopenia and its components are associated with poor clinical outcomes, decreased quality of life (QoL), and mortality. The direction of the relationships between sarcopenia and cardiovascular disease are less clear as are the impact of exercise interventions in patients with severe sarcopenia. Method This is a post-hoc analysis of the CYCLE-HD study, which was a randomised controlled trial assessing the effects of a 6-month structured intradialytic cycling intervention on cardiovascular health in those on haemodialysis. Presence of sarcopenia was established using the European Working Group of Sarcopenia in Older People (EWGSOP) definition. A cut off of &amp;lt;17.5 kg/m2 in men and &amp;lt;14.5 kg/m2 in women were used for fat free mass to establish muscle quantity using bioimpedance. The cut off of 15 seconds on the sit to stand 5 tests was used to establish muscle strength and a score of ≤8 on the short physical performance battery was used to assess physical performance. If all three criteria were met, severe sarcopenia was confirmed. Accelerometery assessed habitual physical activity (PA) and the general practice physical activity questionnaire assessed self-reported PA. Magnetic resonance imaging (MRI) measured left ventricular mass, pulse wave velocity, and global native T1 mapping (measure of myocardial fibrosis). Mann - Whitney U or unpaired t-tests explored differences in cardiac MRI, and physical activity (PA) outcomes between sarcopenic and non-sarcopenic patients. Linear regressions were used to investigate whether sarcopenia or its components predict cardiovascular health, and habitual PA outcomes cross-sectionally at baseline and following the 6-month programme of intradialytic exercise. Multinomial regressions were used to explore if sarcopenia or its components predicted self-reported PA. Results 130 patients (57 [±15] years, 95 [73.08%] male) were included in the analysis of whom 65 patients underwent the intradialytic cycling intervention. 31 (23.85%) patients had severe sarcopenia. 107(82.31%) had low muscle mass, 92(70.77%) had low strength, and 48 (36.92%) had low physical performance. Severe sarcopenia was a significant predictor for self-reported PA status (p = .042, Pseudo R2 = 0.043) at baseline but not for any other outcomes. However, low muscle mass was a significant predictor for LV mass (p = .014, R2 = 0.04, Β = -6.76). Low muscle strength was a significant predictor for higher pulse wave velocity (p = .010, R2 = 0.056, Β = 2.57) and global native T1 (p = .001, R2 = 0.091, Β = 26.79). Low fat mass (p = .005, R2 = 0.07, Β = -2198.63) and physical performance were significant predictors for mean steps (p&amp;lt;.001, R2 = 0.12, Β = -209.16). Baseline severe sarcopenia or its components were not predictors for cardiovascular or habitual PA changes following intradialytic exercise. Conclusion Severe sarcopenia was present in nearly quarter of the participants, but the majority showed at least one muscle health related abnormality (low muscle mass, strength or physical performance). These markers of sarcopenia showed associations with habitual PA and structural markers of cardiovascular disease. However, the presence of sarcopenia may not limit the benefits offered by intradialytic exercise. Patients with sarcopenic traits should be encouraged to participate in appropriate interventions to improve health and wellbeing.

The Rehabilitative Effect of Archery Exercise Intervention in Patients with Parkinson's Disease.

Archery exercise exerts a rehabilitative effect on patients with paraplegia and might potentially serve as complementary physiotherapy for patients with Parkinson's disease. This study aimed to examine the rehabilitative effects of an archery intervention. A randomized controlled trial of a 12-week intervention was performed in patients with idiopathic Parkinson's disease. Thirty-one of the 39 eligible patients recruited from a medical center in Taiwan participated in the trial, of whom 16 were in the experimental group practicing archery exercises and 15 were in the control group at the beginning; twenty-nine completed the whole process. The Purdue pegboard test (PPT), the Unified Parkinson's Disease Rating Scale I to III (UPDRS I to III), physical fitness test, and timed up and go test (TUG) were used to assess the intervention effects of archery exercise. Compared to the control group, the outcome differences between the posthoc and baseline tests in PPT, UPDRS I to III, lower extremity muscular strength, and TUG in the experimental group (between-group difference in difference's mean: 2.07, 1.59, 1.36, -2.25, -3.81, -9.10, 3.57, and -1.51, respectively) did show positive changes and their effect sizes examined from Mann-Whitney U tests (η: 0.631, 0.544, 0.555, 0.372, 0.411, 0.470, 0.601, and 0.381, respectively; Ps < 0.05) were medium to large, indicating that the archery intervention exerted promising effects on improving hand flexibility and finger dexterity, activity functions in motor movement, lower extremity muscular strength, and gait and balance ability. Traditional archery exercise was suggested to have a rehabilitative effect for mild to moderate Parkinson's disease and could be a form of physiotherapy. Nevertheless, studies with larger sample sizes and extended intervention periods are needed to ascertain the long-term effects of archery exercise.

Associations between exercise training characteristics and change in peak oxygen consumption in patients with chronic ischaemic heart disease and type 2 diabetes

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Innovationsfonds des Gemeinsamen Bundesausschusses. Introduction Exercise interventions are well established in the treatment of chronic ischaemic heart disease (CIHD) and type 2 diabetes mellitus (T2DM). Yet, there remains a significant research gap when it comes to patients which suffer from both diseases. Purpose The aim of this study was to investigate the associations of training characteristics (average minutes of endurance training per week, average endurance training sessions per week and mean intensity) and change in peak V̇O2 following 6 months of a telemedicine supported exercise intervention in patients with CIHD and T2DM. Methods Among 251 intervention group patients of a randomised controlled trial that evaluated the effects of an individual home-based lifestyle intervention compared to usual care (N=502 patients), those who completed the 6-month follow-up (N=201) were included in this analysis. All patients received an individual exercise training plan via a smartphone application, which recorded training duration and heart rates (HR, utilizing a connected heart rate sensor, Polar H7, Polar, Finland). Patients also had the possibility to perform additional sessions without prescribed intensity zones. All recorded sessions were evaluated with a customized software and manually checked for plausibility. Intensities were calculated as the average % heart rate reserve (HRR) of all endurance exercise sessions. If HR measurements were classified as invalid/unreliable (e.g. very strong fluctuations), these sessions were excluded from the average HRR calculation but still included in the average minutes and sessions of endurance training per week. Associations between training characteristics and change in peak V̇O2 were evaluated via univariate regression analysis. Results Of the 201 patients (16% female, 68±8 years), 81 (40%) were classified as adherent to the exercise intervention (defined as having performed the prescribed training duration in ≥ 50% of the weeks and ≥ 66.7% of the recommended duration). On average, patients performed 78±94 minutes of endurance training per week across 3.26±3.13 sessions at an average of 51.6±18.2% HRR. Peak V̇O2 improved by a mean (SD) of 0.94±2.74 ml/kg/min. Change in peak V̇O2 was significantly associated with the average duration and number of sessions per week (p &amp;lt; 0.01), but not with mean intensity (p = 0.10) (Fig. 1). Conclusions Mean changes in peak V̇O2 were low, likely due to low overall adherence. Accordingly, we found a significant positive association between the average minutes as well as the average sessions of endurance training per week and change in peak V̇O2, whereas change in peak V̇O2 was not significantly associated with mean exercise training intensity. Therefore, future telemedical exercise interventions need to find ways to improve adherence of patients towards the provided exercise recommendations.

Exercise interventions for patients with type 1 diabetes mellitus: A narrative review with practical recommendations

Type 1 diabetes mellitus (T1DM) is a chronic endocrine disease that results from autoimmune destruction of pancreatic insulin-producing β cells, which can lead to microvascular (e.g., retinopathy, neuropathy, and nephropathy) and macro-vascular complications (e.g., coronary arterial disease, peripheral artery disease, stroke, and heart failure) as a consequence of chronic hyperglycemia. Despite the widely available and compelling evidence that regular exercise is an efficient strategy to prevent cardiovascular disease and to improve functional capacity and psychological well-being in people with T1DM, over 60% of individuals with T1DM do not exercise regularly. It is, therefore, crucial to devise approaches to motivate patients with T1DM to exercise, to adhere to a training program, and to inform them of its specific characteristics (e.g., exercise mode, intensity, volume, and frequency). Moreover, given the metabolic alterations that occur during acute bouts of exercise in T1DM patients, exercise prescription in this population should be carefully analyzed to maximize its benefits and to reduce its potential risks.

Pre- and Postoperative Exercise Effectiveness in Mobility, Hemostatic Balance, and Prognostic Biomarkers in Hip Fracture Patients: A Study Protocol for a Randomized Controlled Trial.

Hip fractures are a major health concern, particularly for older adults, as they can reduce life quality, mobility loss, and even death. Current evidence reveals that early intervention is recommended for endurance in patients with hip fractures. To our knowledge, preoperative exercise intervention in patients with hip fractures remains poorly researched, and no study has yet applied aerobic exercise preoperatively. This study aims to investigate the short-term benefits of a supervised preoperative aerobic moderate-intensity interval training (MIIT) program and the added effect of an 8-week postoperative MIIT aerobic exercise program with a portable upper extremity cycle ergometer. The work-to-recovery ratio will be 1-to-1, consisting of 120 s for each bout and four and eight rounds for the pre- and postoperative programs, respectively. The preoperative program will be delivered twice a day. A parallel group, single-blinded, randomized controlled trial (RCT) was planned to be conducted with 58 patients each in the intervention and control groups. This study has two primary purposes. First, to study the effect of a preoperative aerobic exercise program with a portable upper extremity cycle ergometer on immediate postoperative mobility. Second, to investigate the additional effect of an 8-week postoperative aerobic exercise program with a portable upper extremity cycle ergometer on the walking distance at eight weeks after surgery. This study also has several secondary objectives, such as ameliorating surgical and keeping hemostatic balance throughout exercise. This study may expand our knowledge of preoperative exercise effectiveness in hip fracture patients and enhance the current literature about early intervention benefits.

Risk factors of reoperative post anterior cruciate ligament reconstruction

Background: ACL reconstruction (ACLR) is a surgical procedure to graft the ACL using tendon tissue to restore joint fixation and stabilization functions. Rehabilitation management is performed by physiotherapy in ACLR phase III patients to increase strength, balance, and functional motion control of patients with rehabilitation and exercise adaptation interventions. Case Description: On June 09, 2022, the patient was playing basketball, when the patient heard his leg "pop" due to sudden stopping and turning movements while playing basketball. The patient took the initiative to go to the hospital because his leg was painful and was advised to do an MRI, the results of the MRI examination stated that the patient had an ACL and Meniscus rupture. The patient has undergone ACL reconstruction surgery and partial lateral meniscectomy on July 20, 2022, the patient has been doing physiotherapy since the first postoperative day until now entering the 10th week, the patient still feels something is stuck in the knee, and feels that left leg is stiff and weak when moved. Conclusion: There is an increase in ROM measurement results, muscle strength, segment circumference, hamstring and trunk flexibility, functional knee, and decreased pain scale. It is hoped that this case can be used as a reference for providing exercise interventions in patients with ACL postoperative conditions, especially phase III with other comorbidities.

An Adaptive Pedaling Assistive Device for Asymmetric Torque Assistant in Cycling.

Dynamic loads have short and long-term effects in the rehabilitation of lower limb joints. However, an effective exercise program for lower limb rehabilitation has been debated for a long time. Cycling ergometers were instrumented and used as a tool to mechanically load the lower limbs and track the joint mechano-physiological response in rehabilitation programs. Current cycling ergometers apply symmetrical loading to the limbs, which may not reflect the actual load-bearing capacity of each limb, as in Parkinson's and Multiple Sclerosis diseases. Therefore, the present study aimed to develop a new cycling ergometer capable of applying asymmetric loads to the limbs and validate its function using human tests. The instrumented force sensor and crank position sensing system recorded the kinetics and kinematics of pedaling. This information was used to apply an asymmetric assistive torque only to the target leg using an electric motor. The performance of the proposed cycling ergometer was studied during a cycling task at three different intensities. It was shown that the proposed device reduced the pedaling force of the target leg by 19% to 40%, depending on the exercise intensity. This reduction in pedal force caused a significant reduction in the muscle activity of the target leg (p < 0.001), without affecting the muscle activity of the non-target leg. These results demonstrated that the proposed cycling ergometer device is capable of applying asymmetric loading to lower limbs, and thus has the potential to improve the outcome of exercise interventions in patients with asymmetric function in lower limbs.

Functional Capacity in Cardiotoxicity: Effects of Physical Exercise

Heart failure induced by chemotherapy is an adverse event of cancer treatment that results in high morbidity and mortality. Previous studies have shown that physical exercise improves functional capacity in patients with heart failure due to other etiologies. However, studies with a multimodal approach, including exercise interventions in patients with cardiotoxicity, are still scarce in the literature. The objective of this article was to discuss the effects of physical training in patients with heart failure induced by chemotherapy and [...]