Exercise Interventions For Individuals Research Articles

The neurobiological mechanisms underlying the effects of exercise interventions in autistic individuals.

Autism spectrum disorder is a pervasive and heterogeneous neurodevelopmental condition characterized by social communication difficulties and rigid, repetitive behaviors. Owing to the complex pathogenesis of autism, effective drugs for treating its core features are lacking. Nonpharmacological approaches, including education, social-communication, behavioral and psychological methods, and exercise interventions, play important roles in supporting the needs of autistic individuals. The advantages of exercise intervention, such as its low cost, easy implementation, and high acceptance, have garnered increasing attention. Exercise interventions can effectively improve thecore features and co-occurring conditions of autism, buttheunderlying neurobiological mechanisms are unclear. Abnormal changes in the gut microbiome, neuroinflammation, neurogenesis, and synaptic plasticity may individually or interactively be responsible for atypical brain structure and connectivity, leading to specific autistic experiences and characteristics. Interestingly, exercise can affect these biological processes and reshape brain network connections, which may explain how exercise alleviates core features and co-occurring conditions in autistic individuals. In this review, we describe the definition, diagnostic approach, epidemiology, and current support strategies for autism; highlight the benefits of exercise interventions; and call for individualized programs for different subtypes of autistic individuals. Finally, the possible neurobiological mechanisms by which exercise improves autistic features are comprehensively summarized to inform the development of optimal exercise interventions and specific targets to meet the needs of autistic individuals.

Impact of rehabilitation unit-based physical activity therapy versus symptomatic supportive treatment on older patients with advanced cancer: a non-randomized controlled study

ObjectivesRelatively few studies have investigated the effects of rehabilitation-based physical activity therapy as a treatment for older patients with advanced cancer. This study evaluated the effects of individualized precise and structured exercise interventions, prescribed by a rehabilitation physician, on fatigue, quality of life (QOL), and physical activity in older patients with advanced cancer.MethodsAfter admission to the rehabilitation department, older cancer patients were divided into groups receiving conventional symptomatic supportive therapy (SST) or physical activity therapy plus conventional symptomatic supportive therapy (PAT). The SST group was given symptomatic supportive treatment, exercised on their own, and were observed at home after their symptoms improved. The PAT group was required to implement physical exercise along with SST, involving 30 min of moderate-intensity exercise per day and 5 days per week, and were discharged after 4 weeks and instructed to continue to exercise outside the hospital. Cancer-related fatigue (CRF) at 4 and 8 weeks was the primary endpoint of the study, while the secondary endpoints included patients’ QOL, physical activity, and exercise adherence rate.ResultsSixty-five patients were included; 37 (56.92%) chose to enter the PAT group, and 28 (43.08%) chose to enter the SST group. After 4 and 8 weeks of treatment, CRF relief and QOL improvement were significantly better in the PAT group than in the SST group (p < 0.05), whereas global health status did not differ between the two treatment groups (T1: p = 0.84; T2: p = 0.92). Mild physical activity significantly increased for the PAT group at T1 and T2 (T1: p = 0.03; T2: p = 0.005). At the T2 time point, the PAT group exhibited a higher level of participation in moderate-intensity physical activities as well as a higher total leisure activity score (p < 0.05). Thirty-three patients (94.29%) completed the PAT exercise program during hospitalization. Only four (12.12%) patients achieved moderate-intensity exercise, while the other 29 (87.88%) patients were able to continue exercising after their exercise intensity was decreased.ConclusionsImplementation of precise and individualized exercise interventions, prescribed by the rehabilitation team, can lead to the reduction of CRF and improvement of QOL, and change in behavior related to physical activity.

Results of neck-specific exercise for altered postural sway in individuals with chronic whiplash-associated disorders: a longitudinal case–control study

Postural sway has not been investigated before or after a neck exercise intervention in individuals with chronic whiplash-associated disorders (WAD). The aim of the study was to investigate postural sway in individuals with chronic WAD grades 2 and 3: (a) compared with healthy matched controls at baseline; (b) after three months of neck-specific exercise and (c) to investigate the correlation between postural sway with self-reported dizziness during motion and balance problems/unsteadiness. This is a longitudinal prospective experimental case–control intervention study. Individuals with WAD (n = 30) and age- and gender-matched healthy volunteers (n = 30) participated. Postural sway was assessed using an iPhone application. Measurements were carried out at baseline, and for those with WAD a second measurement was performed at the three-month follow-up when neck-specific exercise intervention ended. The WAD group performed significantly worse than the healthy group in both pathway and ellipse area double stance eyes closed at baseline (main outcome), but not at the three-month follow-up. The WAD group significantly improved after rehabilitation in both pathway double stance eyes closed and pathway single stance eyes open. The correlation between postural sway and self-rated dizziness during motion and balance problems was low to moderate. One may conclude that postural sway was improved after a neck-specific exercise programme. The study results strengthen earlier findings that individuals with WAD have worse balance outcome when they have to rely on neck proprioception (eyes closed). The study results may be important for the development of improved rehabilitation methods for WAD.

Developing a mobile exercise program for individuals with Spinal Cord Injury: Stakeholder perceptions of app features and implementation determinants

BackgroundIndividuals with Spinal Cord Injury (SCI) often experience physical deconditioning, leading to long-term health challenges. While regular exercise can offer substantial health benefits, adherence to exercise guidelines among individuals with SCI is hindered by barriers such as inaccessibility. Exercise programs using the mobile application (App) tailored to individual needs present a promising solution for promoting exercise adherence among individuals with SCI. ObjectiveThis study aimed to identify factors contributing to the successful implementation of an app-based home exercise program for individuals with SCI and gather user feedback on app preferences, functionality, and features. MethodsGuided by the Consolidated Framework for Implementation Research (CFIR), twenty-six clinicians completed an expert panel survey to rank factors influencing the implementation of an app-based intervention for increasing exercise adherence for individuals with SCI. CFIR-selected factors and app quality features obtained from the Mobile Application Rating Scale (MARS) framework were discussed in seven focus groups with 23 individuals with SCI, 6 caregivers, and 6 clinicians. ResultsThe expert survey identified adaptability, complexity, evidence strength/quality, relative advantage, knowledge/beliefs about the initiative, and execution as the key CFIR factors that affected the intervention's success. Major themes emerging from focus groups with individuals with SCI and caregivers included usability, instruction and guidelines, user-friendly interface, and clinician interaction. In contrast, clinicians mentioned themes such as the representation of the SCI population, time commitment, accessibility, and equipment. ConclusionsThe study highlights the significance of incorporating these determinants into future designs to develop app-based home exercise interventions for individuals with SCI.

#1192 Impact of intradialytic exercise on all-cause mortality in frail patients undergoing hemodialysis: a three-year multicenter cohort study

Abstract Background and Aims Frailty prevalence is notably high among older hemodialysis patients, correlating with poorer prognoses. Prior smaller-scale studies have underscored the benefits of various exercise interventions in individuals with Chronic Kidney Disease and those receiving dialysis treatments. Addressing frailty in older hemodialysis patients by exercise therapy is crucial for healthcare professionals aiming to enhance patient outcomes. Despite this, a standardized exercise therapy protocol for this demographic has not been broadly implemented in clinical practice. Our study sought to evaluate the impact of intradialytic resistance exercise programs on the prognosis of frail individuals undergoing hemodialysis. Method This retrospective, multicenter, non-randomized clinical trial encompassed 2006 participants (mean age 70.1±11.7 years) from 17 outpatient clinics within the Kaikoukai Medical Group. Enrollment spanned from April to December 2018, with patients stratified according to baseline frailty levels, determined by the Japanese Frailty Criteria for the Diagnosis of Frailty in the Elderly. In this study, patients meeting the criteria for frailty or pre-frailty, as defined by the Japanese Criteria for Health and Social Services (J-CHS), were collectively classified as 'frail’. Participants were invited to join a voluntary exercise program during dialysis, which included stretching and four types of resistance exercises using elastic tubes. The cohort was divided into four groups based on their frailty status and participation in the exercise program. Patient outcomes were monitored until either death or the study's conclusion in December 2021. Kaplan-Meier and log-rank analyses were utilized to assess prognostic differences among the groups, with significance levels adjusted using the Bonferroni correction. Ethical approval was granted by the Nagoya Kyoritsu Hospital's ethical committee. Results The study comprised 112 non-frail exercising, 398 frail exercising, 205 non-frail non-exercising, and 1287 frail non-exercising patients. Over the study period (median 25 months), mortality was recorded in 338 (16.9%) patients, including 8 (7.1%) non-frail exercising, 50 (12.6%) frail exercising, 16 (7.8%) non-frail non-exercising, and 264 (20.5%) frail non-exercising participants. Prognostic analysis revealed that the frail non-exercising group had a significantly poorer prognosis than both the non-frail exercising and non-frail non-exercising groups, as well as the frail exercising group (p&amp;lt;0.05). Conclusion This investigation is pioneering in establishing a link between intradialytic resistance exercise interventions and prognosis in frail patients. The findings indicate that, although frail patients inherently face a more challenging prognosis, participation in intradialytic exercise can yield substantial improvements. Therefore, clinicians are encouraged to advocate for exercise therapy as a means to enhance prognosis in frail patients undergoing hemodialysis.

Chronic exercise effects on overall depression severity and distinct depressive symptoms in older adults: A protocol of a systematic and meta-analytic review.

There is high evidence that chronic exercise benefits overall depression severity in older adults. However, late-life depression is characterized by considerable heterogeneity in clinical manifestation emphasizing the need for more individualized exercise intervention programs. Therefore, the objective of the proposed review is to investigate the effects of chronic exercise on overall depression severity and on different symptoms of depression in randomized controlled trials (RCTs) including older adults with a mean age of at least 60 years, and by considering the moderating effects of intervention characteristics and individual characteristics. This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). We will use the Population-Intervention-Comparator-Outcomes-Study design (PICOS) criteria for study inclusion and will search the following database sources for relevant RCTs: Web of Science, Academic Search Complete, CINAHL, APA Psycinfo, SPORTDiscuss, Cochrane. Two independent reviewers will conduct the study selection, data extraction, and quality assessment. Disagreement will be solved by a third reviewer. Primary outcome will be changes in overall depression severity and secondary outcomes will encompass changes in symptoms of depression as defined by the DSM-5, such as sleep quality, fatigue, anxiety, mood, apathy, changes in weight, information processing speed, and executive functions, from baseline until the end of the intervention and to any available intermediary measurement or follow up. Meta-analysis will be undertaken to synthesize the effects of chronic exercise on primary and secondary outcomes. Subgroup analysis will investigate the moderating effects of intervention characteristics (frequency, intensity, duration, type of exercise, cognitive demand, social interactions, exercise supervision, behavioral change techniques, compliance, study design, dropout-rate, type of control group) and individual characteristics (age, sex, education, functional capacity, global cognition, population) on primary and secondary outcomes. Additionally, we plan to assess quality of evidence and publication bias, and to carry out sensitivity analysis. The results of the proposed review are anticipated to have a substantial impact on research and clinical practice. On the one hand, the review's conclusions could form the foundation for developing evidence-based recommendations for individualized exercise programs that alleviate depression in older adults. On the other hand, by revealing research gaps, the review results could encourage the formulation of research questions for further RCTs. This protocol has been published in the Prospero repository (PROSPERO 2022 CRD42022361418, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022361418).

Benefits of Individualized Training in Fatigued Patients with Multiple Sclerosis.

Chronic fatigue is the most common and debilitating symptom in people with multiple sclerosis (PwMS). Recently, exercise has been proven to alleviate chronic fatigue and improve physical functions. Tailoring the training intervention to the potential fatigue causes could optimize the beneficial effects of training on fatigue. The objective of this study was to compare the effectiveness of an individualized (IND) vs a traditional (TRAD) exercise intervention in reducing chronic fatigue. Twenty-nine PwMS with high chronic fatigue were randomly assigned to 12 weeks of either a TRAD or IND exercise intervention. TRAD comprised aerobic and resistance exercises according to the guidelines for PwMS. IND specifically addressed identified individual weaknesses. Participants visited the laboratory before and after training for the following assessments: patient reported outcomes (fatigue, quality of life, depression questionnaires), incremental cycling test (V̇O2peak), and cycling fatigue test (maximal voluntary contraction, MVC; rating of perceived exertion, RPE). Similar improvements in fatigue, depression and quality of life were observed between groups (p > 0.05). Compared to TRAD, IND induced a significant greater increase in V̇O2peak (+21.0 ± 13.9 vs 6.8 ± 11.5%, p < 0.05) and a greater reduction in RPE at a given submaximal intensity (-30.3 ± 18.9 vs -12.1 ± 20.4%, p < 0.001), whereas MVC increased similarly in both groups (p > 0.05). Although tailored exercise improved similarly fatigue and other subjective parameters (depression, quality of life, sleep quality) compared to than traditional exercise interventions, prescribing an individualized intervention led to greater improvement in V̇O2peak (but not maximal strength) and perception of effort. This may have positive functional consequences for patients.

Can just 15 minutes of moderate-intensity exercise mobilize cytotoxic NK cells into circulation?

Intro: Acute exercise transiently mobilizes natural killer (NK) cells into the bloodstream with the degree of mobilization directly related to the intensity of the exercise. This increase in NK cells is thought to offer a period of heightened immune activity during exercise and is of particular interest to cancer patients as NK cells can kill tumor cells without prior sensitization. Previous work demonstrating the benefits of exercise on NK cells used vigorous bouts of exercise lasting 30 minutes or longer, which may not be attainable for cancer patients. The objective of this study was to determine whether a short bout of moderate-intensity exercise can mobilize activated, cytotoxic NK cells into circulation. We hypothesized that i) a bout of moderate-intensity exercise would significantly increase NK cells in the blood and ii) the exercise-induced NK-cell mobilization would occur rapidly, such that the relative increase in blood NK cells would not differ after 15 minutes of exercise and 30 minutes of exercise. Methods: In this pilot study, ten healthy, non-athletes (4 female; aged 18-40 years) cycled for 30 minutes at 55% of their heart rate reserve. Venous blood was obtained pre-, after 15 minutes, and after 30 minutes of exercise, and was analyzed by flow cytometry. The proportion of NK cells, CD16+ and CD57+ NK-cells were compared between the three time points by repeated measures ANOVA with Greenhouse Geisser corrections. Sidak-corrected post-hoc tests were used to further analyze significant main effects. Results: All subjects successfully completed the exercise (mean ± standard deviation heart rate: 144 ± 2 bpm; rating of perceived exertion: 11 ± 0.25 (of 20)). There was a significant main effect of time on the proportion of NK cells present in the blood (F(1.253, 10.025)= 7.719, p= 0.016). Post-hoc analyses indicate that there was a significant increase at minute 15 relative to baseline (p=.050), with no further increase at minute 30 relative to minute 15 (p=.175). There was no main effect of time on the proportion of CD57+NK cells (F(1.451, 10.159)= 0.335, p= 0.656) or CD16+ NK cells (F(1.154, 9.231)= 3.020, p= 0.113) in our sample. Conclusion: The results from this pilot study indicate that 15 minutes of moderate-intensity cycling mobilizes NK cells into the bloodstream. However, we did not detect significant differences in NK cells with an activated, highly cytotoxic phenotype. While limited by a small sample, these results build upon prior work demonstrating a significant effect of longer-lasting, vigorous-intensity exercise. The current results suggest that a more accessible exercise intervention for individuals with health limitations can also significantly increase NK cells into the blood, but that greater intensity exercise may be required to mobilize particular subsets of NK cells. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Myokine Secretion following an Aerobic Exercise Intervention in Individuals with Type 2 Diabetes with or without Exercise Resistance.

Type 2 diabetes (T2D) is characterized by muscle metabolic dysfunction that exercise can minimize, but some patients do not respond to an exercise intervention. Myokine secretion is intrinsically altered in patients with T2D, but the role of myokines in exercise resistance in this patient population has never been studied. We sought to determine if changes in myokine secretion were linked to the response to an exercise intervention in patients with T2D. The participants followed a 10-week aerobic exercise training intervention, and patients with T2D were grouped based on muscle mitochondrial function improvement (responders versus non-responders). We measured myokines in serum and cell-culture medium of myotubes derived from participants pre- and post-intervention and in response to an in vitro model of muscle contraction. We also quantified the expression of genes related to inflammation in the myotubes pre- and post-intervention. No significant differences were detected depending on T2D status or response to exercise in the biological markers measured, with the exception of modest differences in expression patterns for certain myokines (IL-1β, IL-8, IL-10, and IL-15). Further investigation into the molecular mechanisms involving myokines may explain exercise resistance with T2D; however, the role in metabolic adaptations to exercise in T2D requires further investigation.

The Effects of Different Exercise Interventions on Patients with Subjective Cognitive Decline: A Systematic Review and Network Meta-Analysis

Background and ObjectiveExercise is a promising non-pharmacological therapy for subjective cognitive decline, but it is unclear which type of exercise is most effective. The objective was to assess the comparative effects and ranks of all exercise-based interventions on cognitive function in patients with subjective cognitive decline (SCD).MethodIn this network meta-analysis, Online databases for Web of Science, PubMed, Embase, Medline, Cochrane Library and PsycINFO were searched from inception to April 30, 2023. The included studies are randomized controlled trials assessing the efficacy of exercise interventions for individuals with SCD. The primary outcome measure is memory, while secondary outcome measures encompass executive function, attention, verbal fluency, and global cognitive function. Represented using Standardized Mean Differences (SMDs) along with their 95% Confidence Intervals (CIs). Bias assessment was conducted in accordance with the ‘Cochrane Risk of Bias Assessment Tool, 2nd Edition’ (RoB 2). Pairwise meta-analysis was carried out using the ‘meta-analysis’ module within STATA 14.0, and network meta-analysis was performed using the ‘mvmeta’ and ‘network’ packages available in STATA 14.0. Registration number CRD42023289687.ResultThis study included a total of 11 randomized controlled trials, encompassing 1,166 patients. Mind-body exercise was found to be efficacious in enhancing or sustaining memory (SMD: 0.58, 95%CI: 0.06 ∼ 1.10) and executive function (SMD: 0.41, 95%CI: 0.09 ∼ 0.73) in individuals with subjective cognitive decline. Furthermore, mind-body exercise exhibited the highest probability of being the most effective measures for improving or preventing the decline in memory (surface under cumulative ranking curve (SUCRA) value: 90.4) and executive function (SUCRA value: 91.8). The second-ranked moderate-intensity aerobic exercise has also shown a positive effect on the improvement of executive function in patients with subjective cognitive decline (SMD: 0.23, 95%CI: 0.03 ∼ 0.43, SUCRA value: 68.2). However, we did not observe a significant effectiveness of exercise interventions on verbal fluency, attention, and overall cognitive function in subjective cognitive decline.ConclusionMind-body exercise may potentially be the optimal strategies for enhancing memory and executive function in individuals with subjective cognitive decline. Additionally, moderate-intensity aerobic exercise has shown a modest positive effect on executive function in subjective cognitive decline. When resources permit, practical application of these findings may be considered. Nevertheless, further support for the conclusions of this study is warranted through larger sample sizes and well-designed multicenter trials.

Exercise intervention in middle-aged and elderly individuals with insomnia improves sleep and restores connectivity in the motor network

Exercise is a potential treatment to improve sleep quality in middle-aged and elderly individuals. Understanding exercise-induced changes in functional plasticity of brain circuits that underlie improvements in sleep among middle-aged and older adults can inform treatment of sleep problems. The aim of the study is to identify the effects of a 12-week exercise program on sleep quality and brain functional connectivity in middle-aged and older adults with insomnia. The trial was registered with Chinese Clinical Trial Register (ChiCTR2000033652). We recruited 84 healthy sleepers and 85 individuals with insomnia. Participants with insomnia were assigned to receive either a 12-week exercise intervention or were placed in a 12-week waitlist control condition. Thirty-seven middle-aged and older adults in the exercise group and 30 in the waitlist group completed both baseline and week 12 assessments. We found that middle-aged and older adults with insomnia showed significantly worse sleep quality than healthy sleepers. At the brain circuit level, insomnia patients showed decreased connectivity in the widespread motor network. After exercise intervention, self-reported sleep was increased in the exercise group (P < 0.001) compared to that in the waitlist group. We also found increased functional connectivity of the motor network with the cerebellum in the exercise group (P < 0.001). Moreover, we observed significant correlations between improvement in subjective sleep indices and connectivity changes within the motor network. We highlight exercise-induced improvement in sleep quality and functional plasticity of the aging brain.

The Effects of High Intensity Interval Training (HIIT) on Asthmatic Adult Males

Background – This study explored the effects of High-Intensity Interval Training (HIIT) on pulmonary function, exercise tolerance, and fractional concentration of exhaled nitric oxide (FeNO) in asthmatic and healthy adults. FeNO levels, associated with lung inflammation, are a diagnostic tool for asthma treatment, making this study significant for understanding HIIT's impact on asthma management. Materials and Methods: Fourteen male subjects (7 asthmatic, 7 healthy) participated in a two-week HIIT protocol. Pulmonary function was assessed using peak expiratory flow (PEF), forced vital capacity (FVC), and the FEV1/FVC ratio. FeNO was measured with a NIOX portable device. Subjects underwent a progressive exercise test on a cycle ergometer to determine peak oxygen uptake (VO2 peak), CO2 output (VCO2 peak), ventilation (VE), and time to exhaustion (TTE). HIIT sessions included warm-ups, 10 x 60-second high-intensity bouts with 60-second recovery intervals, and cool-downs. Intensity targeted 75% peak work rate (WR) for asthmatics and 80% for controls. Results: Significant differences were observed between groups in FeNO, VO2 peak, TTE, and peak WR, with no significant changes in pulmonary function measures. Pre-HIIT, asthmatics showed a mean FeNO of 28 ± 2 ppb compared to controls at 18 ± 1 ppb, with post-HIIT levels remaining stable. TTE and peak WR improved in both groups post-HIIT, indicating enhanced exercise tolerance and performance capacity. Specifically, asthmatics showed an increase in TTE from 691 ± 40 s to 781 ± 41 s and in peak WR from 175 ± 13 W to 203 ± 14 W. Conclusion: HIIT was well-tolerated by asthmatic subjects, leading to improved exercise tolerance, higher ventilation, CO2 output, and work rate performance, without significant changes in pulmonary function or FeNO levels. These findings suggest that HIIT can be a safe and effective exercise intervention for asthmatic individuals to enhance exercise performance.

Aerobic exercise interventions for promoting cardiovascular health and mobility after stroke: a systematic review with Bayesian network meta-analysis

ObjectiveTo determine the superiority of aerobic exercise (AE) interventions on key outcomes of stroke recovery, including cardiorespiratory fitness (V̇O2peak, primary outcome), systolic blood pressure (SBP) and mobility (6 min Walk...

Can physical exercise help people with irritable bowel syndrome? How substantial is the evidence?

Purpose: Irritable bowel syndrome is one of the most common gastrointestinal disorders worldwide that negatively affect health and quality of life and imposes high costs. Increasing attention is being paid to non-pharmacological therapies, like physical exercise, to manage and alleviate irritable bowel syndrome symptoms, but the underlying mechanism is unclear, and the evidence is inconclusive. This article aims to provide an overview analysis of the recent evidence that links physical exercise with irritable bowel symptoms.&#x0D; Material and methods. For the last five years of research (2018-2023), we searched several international scientific databases, including Web of Science, Scopus, Science Direct, ADI, the Cochrane Central Register of Controlled Trials, PubMed, Medline, Clinical trials.gov, Google Scholar, and the WHO database.&#x0D; Results. Generally, exercise exerts variable effects on gut physiology, integrity, and health. Much research recommended adopting regular light-to-moderate aerobic exercise and relaxation anaerobic exercise to enhance the patient’s psychological well-being and alleviate global irritable bowel syndrome symptoms. These types of exercise are purported to improve bowel function, motility, tone, habits, immunity, microbial diversity, and quality of life due to a decrease in psychological stress, depression, anxiety index, irritable bowel syndrome symptom severity score, intestinal hypersensitivity, and gut permeability. In contrast, more studies reported several disruptive effects of vigorous aerobic exercise on gut integrity and physiology that can compromise irritable bowel syndrome symptoms by inducing splanchnic hypoperfusion, gastrointestinal epithelial wall damage, malabsorption, dysbiosis, and bacterial translocation, thus calling into question the positive outcomes of the exercise.&#x0D; Conclusions. There is overwhelming evidence recommending regular light-to-moderate aerobic exercise and anaerobic relaxation exercises for patients with IBS. However, this evidence seems low-quality, making it challenging to confirm the actual impacts of exercise. Ethnicity, study design, type and intensity of exercise, and methodological issues are among the reasons that are put forward to account for this low-quality evidence. Thus, well-designed plausible studies, particularly randomized controlled trials and research on individualized exercise intervention settings that consider exercise frequency, intensity, time, type, volume, and progression, are highly demanded to enable drawing specific exercise recommendations for irritable bowel syndrome patients without adverse effects.

Exploring needs, barriers to, and facilitators of rehabilitation exercise following revision hip replacement – A grounded theory study

Purpose Evidence on rehabilitation after revision total hip replacement (THR) is inadequate and development of rehabilitation interventions is warranted. Even so, little is known about patients’ experiences with revision THR rehabilitation. This study aimed to explore patients’ rehabilitation exercise experiences after revision THR. Materials and methods Using constructivist grounded theory, we conducted semi-structured qualitative interviews with twelve patients with completed or almost completed rehabilitation exercise after revision THR. Data collection and analysis were a constant comparative process conducted in three phases; initial, focused, and theoretical. Findings From the data, we generated a substantial theory of the participant’s circumstances and ability to integrate rehabilitation exercise into their everyday life after revision THR. Four categories were constructed based on patients’ experiences in different contexts: hesitance, fear avoidance, self-commitment, and fidelity. Conclusions This study highlighted that patients’ expectations, past experiences, attitudes, trusts, and circumstances interact to influence engagement and adherence to rehabilitation exercise and described four categories relating to the integration of revision THR rehabilitation exercise into their everyday life. Clinicians should be aware of and account for these categories during rehabilitation exercise. Tailored individual rehabilitation exercise interventions and clinician approaches to optimize engagement and adherence are needed among patients with revision THR.

Progressive Individualized Exercise Intervention Impacted the Cecal Microbiota Composition in a Rat Model of CKD

Progressive Individualized Exercise Intervention Impacted the Cecal Microbiota Composition in a Rat Model of CKD

The Relationship between Exercise Capacity and Muscle Strength, Physical Activity, Fatigue and Quality of Life in Patients with Cancer Cachexia

Background Exercise capacity is a significant determinant of mortality for cancer patients, so knowing the possible determinants of exercise capacity will produce physical and psychological benefits for individuals with cancer cachexia. Purpose To investigate the relationship between exercise capacity on peripheric and respiratory muscle strength, physical activity, fatigue and quality of life in subjects with cancer cachexia. Methods The study included 31 patients diagnosed with cancer cachexia. Functional capacity was assessed by 6-Minute Walk Test, hand grip strength and proximal muscle mass by hand dynamometer, respiratory muscle strength by the Maximum Expiratory Pressure and Maximum Inspiratory Pressure measurements, physical activity by International Physical Activity Questionnaire Short Form, fatigue by Brief Fatigue Inventory, and quality of life by EORT-QLQ-C30. The relationship between functional capacity and continuous independent variables was determined using Spearman’s or Pearson’s tests. Results A strong positive correlation was observed between exercise capacity and expiratory muscle strength (r = 0.75, p < 0.001), activity level (r = 0.68, p < 0.001), and quality of life global health status (r = 0.74, p < 0.001). Conversely, a strong negative correlation was found between exercise capacity and fatigue severity (r = −0.64, p < 0.001). Conclusion Higher exercise capacity in cancer cachexia patients is linked to reduced fatigue, improved respiratory muscle strength, increased physical activity levels, and enhanced quality of life. When designing rehabilitation programs or exercise interventions for individuals with cancer cachexia, it is crucial to assess their exercise capacity and tailor the programs accordingly.

Elevated biomarkers of neural injury in older adults following head-down bed rest: links to cardio-postural deconditioning with spaceflight and aging.

Prolonged physical inactivity with bed rest or spaceflight is associated with cardiovascular and neuromuscular deconditioning; however, its impact on neural integrity of cardio-postural reflexes and possible mitigation with exercise has not been examined. We assessed the association between the physiological deconditioning of bed rest immobilization with neural injury markers and the effects of 60-75 min of daily exercise. Data were collected as part of a randomized clinical trial (clinicaltrials.gov identifier: NCT04964999) at the McGill University Medical Centre. Twenty-two 55- to 65-year-old healthy volunteers gave informed consent and took part. Within sex, participants were randomly assigned to exercise (60- to 75-min daily) or control (inactive) groups and spent 14 days in continuous 6° head-down tilt. Neural injury [neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), total tau (t-Tau), myelin basic protein (MBP), brain-derived neurotrophic factor (BDNF), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1)], as well as interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and insulin-like growth factor 1 (IGF-1) biomarkers were measured before, during, and after bed rest. The false discovery rate with Huber M-estimation was used to correlate changes in biomarkers with cardiovascular and muscular function changes over bed rest. Bed rest elevated NfL, GFAP, TNF-α, and IL-6 in all participants and reduced IGF-1 in females only. With standing, changes in heart rate, blood pressure, and lower limb muscle motoneuron activity correlated with changes in TNF-α and BDNF. Baroreflex control, leg muscle maximal voluntary contraction, and postural sway are correlated with GFAP and NfL. Exercise participants had fewer interactions than control participants, but significant correlations still existed, with both groups exhibiting similar reductions in orthostatic tolerance. An hour of daily exercise in older persons otherwise immobilized for 2 weeks did not abate bed rest-induced increases in serum signatures of neural injury or pro-inflammatory markers. Exercise reduced the number of physiological interactions of biomarkers, but significant cardio-postural correlations remained with no protection against post-bed rest orthostatic intolerance. The identification of associations of inflammatory and neural injury biomarkers with changes in cardio-postural physiology and exercise points to biotherapeutic opportunities and improved exercise interventions for astronauts and individuals in bed rest. https://www.clinicaltrials.gov/search?cond=NCT04964999, identifier: NCT04964999.

Effects of the EXECP Intervention on Motor Function, Muscle Strength and Joint Flexibility in Individuals with Cerebral Palsy.

Numerous exercise interventions to enhance motor function in cerebral palsy (CP) have been proposed, with varying degrees of effectiveness. Since motor function requires a combination of muscle strength, joint flexibility and motor coordination, we designed a supervised multicomponent exercise intervention (EXECP) for individuals with CP. Our aim was to evaluate the effects of the EXECP intervention and its retention after it ceased. The EXECP intervention combined strength training for the lower limbs and trunk muscles, passive stretching for the lower limb muscles and inclined treadmill gait training. Eighteen participants with CP (mean age: 14, 13 males) were tested twice before the three-month intervention and twice after the intervention, each test separated by three months. Seventeen typically developing age and sex-matched controls were tested twice. Motor function was assessed with the six minutes walking test (6MWT) and the gross motor function measure (GMFM) dimensions D and E. Passive joint flexibility was measured with goniometry. Isometric and concentric muscle strength were assessed at the knee, ankle and trunk joints. The EXECP intervention successfully increased 6MWT (p < 0.001), GMFM (p = 0.004) and muscle strength for knee and trunk muscles (p < 0.05), although no changes were observed for ankle joint muscles. Hip and knee joint flexibility also increased (p < 0.05). After the retention period, all tested variables except the 6MWT and knee joint flexibility regressed and were not different from the pre-tests. The improvements in strength, flexibility, and possibly motor coordination brought by the EXECP intervention were transferred to significant functional gains. The regression towards baseline after the intervention highlights that training must be a life-long decision for individuals with CP.

Effects of Physical Exercise Interventions for Individuals With Gynecologic Cancer: A Systematic Review and Meta-Analysis.

Data on the efficacy of physical exercise interventions for individuals with gynecologic cancer are limited and discordant. The purpose of this review was to determine the benefits of exercise interventions in this population. The PubMed®, Web of Science, Embase® (Ovid), and Cochrane Central Register of Controlled Trials databases were searched for studies published from January 1, 2010, to November 9, 2022. 12 randomized controlled trials were included. A quantitative synthesis method was used to investigate the effects of exercise interventions on individuals with gynecologic cancer. The findings indicate that physical exercise interventions may have beneficial effects on the fatigue, depression, and health-related quality of life of this patient population. However, because of the small group of studies available, the evidence must be regarded as preliminary. Clinicians and oncology nurses should recommend and refer individuals with gynecologic cancer to clinic- or community-based physical exercise programs.