Exercise Program For Adults Research Articles

A 10-week multicomponent outdoor exercise program improves hemodynamic parameters and physical fitness in cardiovascular disease adult and elderly patients

AbstractThis study aimed to assess the effects of a 10-week multicomponent outdoor exercise program on hemodynamic, physical fitness and psychological variables in subjects with CVDs. Twenty participants (12 M and 8 F; age 68.5 ± 8.6 years; BMI 28.49 ± 4.98 kg/m2) suffering from CVDs participated in this randomized controlled study and were allocated into two groups: an experimental group (EG; 6 M, 5 F) who underwent a multicomponent training (i.e., cardiorespiratory, resistance, mobility and breathing exercises; 60’, 2d·wk-1), or a wait-list control group (CG; 6 M, 3 F) who did not engage in any PA. Hemodynamic parameters were assessed through resting heart rate (RHR) and peripheral blood pressure (P-SBP/P-DBP). Physical fitness was assessed via a 30″ chair stand test (30CST), timed up and go (TUG) test, handgrip strength (HGS) test, and 2’ step test (TMST). The health status and quality of life (QoL) were evaluated with short form-12 (SF-12) and World Health Organization QoL (WHOQoL-bref), respectively. After the intervention, EG showed significant reduction in hemodynamic parameters (RHR p < 0.001, ES = 0.98; P-SBP p < 0.001, ES = 0.53; P-DBP: p < 0.001, ES = 0.78), physical fitness (30CST p < 0.001, ES = 0.92; TUG p = 0.001, ES = 0.67; TMST p < 0.05, ES = 0.79) and physical component of SF-12 (PSC-12 p < 0.05, ES = 0.42) compared to CG; no significant changes were observed in HGS, QoL and mental health component of the SF-12 (p > 0.05). The findings showed significant improvements in hemodynamic parameters and physical fitness suggesting the effectiveness of the multicomponent outdoor exercise program in adults and elderly with stabilized CVDs.

Types of Social Support Predicting Physical Activity and Quality of Life in Group Exercise Programs for Adults Living with Cancer

ABSTRACT Social support (SS) and physical activity (PA) can improve quality of life (QoL) in cancer, meaning group PA programs are important for rehabilitation. However, there are many types of SS, and few studies have compared which SS concepts are more strongly associated with PA and QoL. This exploratory cross-sectional study examined the association between several types of SS provided by other people in group exercise oncology classes and PA and QoL among adults living with cancer. It was hypothesized all types of SS would be positively associated with PA and QoL. Participants (N = 72) completed a questionnaire assessing 11 SS predictors, five QoL outcomes, and one self-reported PA outcome, and wore a Fitbit to assess step count for 1 week. Hypotheses were tested using multiple regression. Reassurance of worth support predicted self-reported moderate-to-vigorous PA (R 2 = .07, p = .03). Relatedness thwarting negatively predicted general (R 2 = .07, p = .03) and social well-being (R 2 = .10, p = .01). Social network predicted physical well-being (R 2 = .07, F(1, 66) = 4.93, p = .03). There were no significant SS predictors of the other outcomes. Group exercise oncology programs should train instructors to promote reassurance of worth by recognizing or facilitating other participants to recognize participants’ PA competence and skills, encourage developing social relationships by creating opportunities to connect over time, and minimize relatedness thwarting by promoting belonging and inclusion. Future research should compare different types of SS in larger samples and diverse populations of adults living with cancer.

Factors influencing older adult community fall prevention exercise implementation: a scoping review.

Exercise that challenges balance is the most effective fall prevention intervention in community-dwelling older adults. Identifying factors influencing implementation of community fall prevention exercise programs is a critical step in developing strategies to support program delivery. To identify implementation facilitators, barriers, and details reported in peer-reviewed publications on community fall prevention exercise for older adults. Scoping review. We searched multiple databases up to July 2023 for English-language publications that reported facilitators and/or barriers to implementing an evidence-based fall prevention exercise program in adults aged 50+ years living independently. At least two reviewers independently identified publications and extracted article, implementation, and exercise program characteristics and coded barriers and facilitators using the Consolidated Framework for Implementation Research (CFIR). We included 22 publications between 2001 and July 2023 that reported factors influencing implementation of 10 exercise programs. 293 factors were reported: 183 facilitators, 91 barriers, 6 described as both a facilitator and barrier, and 13 unspecified factors. Factors represented 33 CFIR constructs across all five CFIR domains: implementation inner setting (n = 95 factors); innovation (exercise program) characteristics (n = 84); individuals involved (n = 54); implementation process (n = 40) and outer setting (n = 20). Eight publications reported implementation strategies used; 6 reported using a conceptual framework; and 13 reported implementation outcomes. The high number of factors reflects the complexity of fall prevention exercise implementation. The low reporting of implementation strategies, frameworks and outcomes highlight the ongoing need for work to implement and sustain community fall prevention exercise programs.

Safety and efficacy of a medically guided home-based exercise program in adults with congenital heart disease: a proof-of-concept study

Safety and efficacy of a medically guided home-based exercise program in adults with congenital heart disease: a proof-of-concept study

Using the behavior change wheel to design a novel home-based exercise program for adults living with overweight and obesity: Comprehensive reporting of intervention development.

Physical activity and exercise are movement behaviors that support the lifestyle management of overweight and obesity. However, home-based exercise programs are commonly generic, and inconsistently undertake a holistic approach to program design. This work applied the Behavior Change Wheel, supplemented with previously conducted interviews, to the development of a home-based exercise program, specifically for people living with overweight and obesity. This provided an understanding of the target behavior and identified a behavioral diagnosis. These findings were mapped onto the Capability, Opportunity, Motivation-Behavior model and Theoretical Domains Framework, identifying changes needed and corresponding intervention functions. Suitable Behavior Change Techniques were identified, alongside Capability Opportunity Motivation-Behavior components needed to facilitate an increase in exercise behaviors, and five key intervention functions. This housed the delivery of 24 Behavior Change Techniques, including goal setting, feedback, monitoring and repetition. Applying the Behavior Change Wheel has enabled detailed development of a home-based exercise program for adults living with overweight and obesity.

"It gave me a sense of achievement and a sense of purpose"-a qualitative study of patient experiences of a virtually supervised exercise program for adults with advanced cancer and cachexia.

To explore patient experiences completing a structured, supervised exercise program for people with cachexia due to advanced cancer. Semi-structured interviews were conducted with participants enrolled in a phase II feasibility, randomized controlled trial to explore their experiences of an 8-week virtually supervised exercise program delivered via videoconference technology. Interviews were analysed using reflexive thematic analysis. Seventeen participants completed interviews (female n = 9, 53%). Main interview themes included the following: (1) Deciding to exercise involves balancing concerns and expectations, (2) the exercise program is a positive experience, and (3) moving forward after the exercise program. While some participants initially held doubts about their physical capabilities and exercise safety, most wanted to exercise to enhance their wellbeing. Participants described the exercise program as a positive experience, offering diverse benefits. Some would have preferred in-person exercise, but all agreed the virtual format increased convenience. Participants emphasized the need to recommend the program to others in similar circumstances. They underscored the necessity and desire for ongoing support to sustain their new exercise habits. Based on patient experiences, virtually supervised exercise programming appears to be feasible and meaningful to people with advanced cancer and cachexia.

Evaluations of virtual exercise programmes for adults with mobility limitations: a scoping review protocol incorporating an equity lens to inform the development of strategies to optimise participation of under-represented groups

IntroductionFor individuals with mobility limitations, virtual exercise programmes can address the challenges of in-person participation in community exercise programmes. A synthesis of studies of virtual exercise programmes targeting mobility limitations...

The Outcome of Exercise for Adults and Older Adults with Visual Impairment: A Scoping Review Protocol

Introduction: Exercise programs provide numerous health benefits, including improved physical fitness, psychosocial status, and sense of well-being. Previous research has identified a range of positive outcomes as a result of exercise for most populations; however, the current understanding of the exercise outcomes for adults from 18 to 65 years and older adults over 65 years with visual impairment is limited. Objective: The proposed scoping review aims to allow a better understanding of current exercise outcomes for adults (including older adults) with visual impairment. This protocol enhances the research quality and the transparency of the proposed scoping review. It pre-defines the objective and methods of the scoping review, including details of the criteria of inclusion and exclusion for evidence sources and the way the data will be identified, extracted, and presented. Inclusion criteria: Articles involving participants with visual impairment aged 18 and over will be the focus of the proposed scoping review. All English-language peer-reviewed studies with a focus on outcomes of exercise programs and interventions for adults with visual impairment, including quantitative, qualitative, and mixed methods study designs, will be considered. In order to make the result more applicable for future research and practice, studies published from 2000 to present will be included, given consideration of the changing concept and format of exercise since 2000. The exercise-related programs and interventions to be included can be delivered via any format in any geographical area. Methods: The search strategy will aim to locate all eligible published studies in the following databases: Ovid MEDLINE, Embase, CINAHL Complete, PsycInfo, AMED, and SPORTDiscus. Full text review will be undertaken of articles that meet criteria on initial review of title and abstract. Reference lists and citations of studies selected for full text review will be further reviewed to identify any additional studies that meet inclusion. Data from the selected studies will be extracted and tabulated based on the exercise and the key findings relevant to the research question. Findings from this scoping review will be presented as a summary of the data from the selected studies in a tabular form, which will categorize exercise outcomes and the corresponding exercise along with a narrative summary. Conclusion: It is expected that the results of this scoping review will enable a better understanding of exercise for adults with visual impairments and inform future exercise programs for adults with visual impairment.

Both moderate- and high-intensity exercise training increase intramyocellular lipid droplet abundance and modify myocellular distribution in adults with obesity.

Exercise training modifies lipid metabolism in skeletal muscle, but the effect of exercise training on intramyocellular lipid droplet (LD) abundance, size, and intracellular distribution in adults with obesity remains elusive. This study compared high-intensity interval training (HIIT) with more conventional moderate-intensity continuous training (MICT) on intramyocellular lipid content, as well as LD characteristics (size and number) and abundance within the intramyofibrillar (IMF) and subsarcolemmal (SS) regions of type I and type II skeletal muscle fibers in adults with obesity. Thirty-six adults with obesity [body mass index (BMI) = 33 ± 3 kg/m2] completed 12 wk (4 days/wk) of either HIIT (10 × 1 min, 90% HRmax + 1-min active recovery; n = 19) or MICT (45-min steady-state exercise, 70% HRmax; n = 17), while on a weight-maintaining diet throughout training. Skeletal muscle biopsies were collected from the vastus lateralis before and after training, and intramyocellular lipid content and intracellular LD distribution were measured by immunofluorescence microscopy. Both MICT and HIIT increased total intramyocellular lipid content by more than 50% (P < 0.01), which was attributed to a greater LD number per µm2 in the IMF region of both type I and type II muscle fibers (P < 0.01). Our findings also suggest that LD lipophagy (autophagy-mediated LD degradation) may be transiently upregulated the day after the last exercise training session (P < 0.02 for both MICT and HIIT). In summary, exercise programs for adults with obesity involving either MICT or HIIT increased skeletal muscle LD abundance via a greater number of LDs in the IMF region of the myocyte, thereby providing more lipid in close proximity to the site of energy production during exercise.NEW & NOTEWORTHY In this study, 12 wk of either moderate-intensity continuous training (MICT) or high-intensity interval training (HIIT) enhanced skeletal muscle lipid abundance by increasing lipid droplet number within the intramyofibrillar (IMF) region of muscle. Because the IMF associates with high energy production during muscle contraction, this adaptation may enhance lipid oxidation during exercise. Despite differences in training intensity and energy expenditure between MICT and HIIT, their effects on muscle lipid abundance and metabolism were remarkably similar.

What are the effects of exercise programs for adults with cancer receiving radiation therapy?

What are the effects of exercise programs for adults with cancer receiving radiation therapy?

O.1.1-8 Impact on health-related quality of life after a concurrent exercise program in adults with treatment resistant depression: TRACE-RMD study

Abstract Purpose Treatment-resistant depression (TRD) is defined as those who do not remit to major depressive disorder with pharmacological treatment. TRD is associated with a worse health-related quality of life (QoL). Thus, people with TRD have reported greater disability than those healthy control (HC) in QoL, assessed by the 36-Item Short-Form Health Survey questionnaire (SF-36). Concurrent exercise training (i.e., a combination of aerobic and resistance exercise in the same session) could be an efficient non-pharmacological treatment strategy for improving QoL. Exercise is recommended as a non-pharmacological adjuvant program for patients with TRD. Therefore, this study aimed to determine the effectiveness of a concurrent exercise program on QoL in a TRD population. Methods Participants (n = 15, 73.3% women, 57.7±13.7 yr old) with TRD carried out a concurrent exercise program (2 days/week and 12 weeks of intervention). The SF-36 questionnaire was used to assess health-related QoL. At baseline, the TRD population showed lower scores (P ≤ 0.001) in physical function, role-physical, bodily pain, general health, vitality, social functioning, emotional role, mental health, and physical and mental component summaries compared to HC. Results After 12-week of intervention, general health (↑50.5%), vitality (↑41.2%), social functioning (↑76.4%), and mental component summary (↑24.9%) were increased (P &amp;lt; 0.05). However, there was not a significant (P &amp;gt; 0.05) change increase in physical functioning, role physical, bodily pain, emotional role, mental health, and physical component summary. Conclusion In conclusion, beneficial effects on QoL variables in patients with TRD after concurrent exercise should lead to considering exercise as an adjuvant program in their treatment.

Specific versus general exercise programme in adults with subacromial impingement syndrome: a randomised controlled trial

ObjectivesCurrent evidence on the clinical effectiveness about the different types of exercises in the subacromial impingement syndrome (SIS) remains controversial. This study aims to compare the short-term (at 5 weeks)...

P436 Feasibility and effectiveness of a low-impact, virtual exercise programme for adults with cystic fibrosis

The benefits of exercise in the management of cystic fibrosis (CF) are well established. Improved aerobic fitness is positively linked to a slower rate of decline and improved quality of life. The Covid-19 pandemic left a cohort of people with CF reluctant to re-access group exercise environments and lacking the confidence to undertake home exercise.

Feasibility and tolerability of moderate intensity regular physical exercise as treatment for core symptoms of attention deficit hyperactivity disorder: a randomized pilot study.

Attention deficit hyperactivity disorder (ADHD) is associated with sedentary lifestyle, low quality of life and low physical fitness. Studies in children with ADHD have shown that regular physical exercise can help reduce core ADHD symptoms, but evidence for this is lacking in adults. Although guidelines recommend multi-modal treatment, central stimulants (CS) remain the mainstay of treatment. CS are effective in the short-term, but their long-term efficacy remains to be established. There is thus huge unmet need for developing non-pharmacological treatment options, and for well-designed randomized controlled trials (RCTs). The study aimed to test the feasibility and tolerability of structured moderate-intensity 12-week physical exercise program for adults with ADHD, as a prelude to an adequately powered RCT which includes long-term follow-up. Fourteen adults with ADHD were recruited, 9 randomized to an intervention group and 5 to a control group. The intervention group received physiotherapist-led 50-minute mixed exercise program, three times a week for 12 weeks, and the control group treatment as usual. Participants were assessed at baseline and after 6 and 12 weeks using clinical and physical evaluations, self-rating questionnaires, and functional magnetic resonance imaging (fMRI) together with paradigms that tested attention, impulsivity and emotion regulation. Three participants (21%) dropped out shortly after inclusion before receiving any intervention, while roughly 80% completed the intervention according to protocol. One participant from the intervention group participated in less than 60% of treatment sessions, and one who had done baseline fMRI was unwilling to do post-intervention imaging. Four participants in the intervention group (67%) reported increased stress in prioritizing the intervention due to time-management difficulties. Overall, consistent trends were observed that indicated the feasibility and potential benefits of the intervention on core ADHD symptoms, quality of life, body awareness, sleep and cognitive functioning. Physiotherapist-led twelve-week regular physical exercise is a feasible and potentially beneficial intervention for adults with ADHD. There was a 20% drop-out initially and 67% of those who completed the intervention reported stress with time management difficulties due to participation. A third arm was thus added to the planned RCT where cognitive intervention administered by an occupational therapist will be given together with physical exercise.Clinical Trial Registration: https://clinicaltrials.gov, identifier NCT05049239.

Co-Designing and Refining a Home-Based Exercise Programme for Adults Living with Overweight and Obesity: Insight from People with Lived Experience

Undertaking a home-based exercise programme should be a positive, health-enhancing lifestyle behaviour, particularly for adults living with overweight and obesity. However, exercise programmes are seldom designed in collaboration with people with lived experience, limiting adherence, efficacy, and effectiveness. Two focus groups (in-person n = 6 and virtual n = 7) were undertaken in the United Kingdom, to glean feedback and further refine a home-based exercise programme, developed from previously conducted semi-structured interviews with adults living with overweight and obesity. Both focus groups provided an opportunity for participants to discuss the proposed programme, highlighting strengths and areas for further improvement. Three key priorities were identified for consideration throughout the design process, specifically for adults living with overweight and obesity: (1) individualisation—a person-centred programme was non-negotiable; (2) motivation—integration of motivational features affected adherence and engagement; (3) more than just weight loss—consideration of other outcomes aside from solely numerical weight loss. These priorities provide direction for further refinement of the proposed home-based exercise programme, in an effort to ensure the final intervention is truly population-specific and needs-sensitive. Following completion, the programme will be assessed using a feasibility randomised controlled trial design.

Development of a Physical Therapy-Based Exercise Program for Adults with Down Syndrome.

In adults with Down syndrome, the combination of low physical activity and fitness levels and the high prevalence of musculoskeletal co-morbidities stresses the need for specialized exercise programs. The goal of this research study was to develop a specialized exercise program for individuals with Down syndrome using the physical therapy approach of a systems review as the foundation. We first conducted an overview of the literature on co-morbidities in adults with Down syndrome using the systems review method to categorize these findings. We extracted recommendations for content and delivery of an exercise program based on the literature review, and finally composed a specialized exercise program for individuals with Down syndrome adhering to these recommendations.

Exercise in adults admitted to hospital with diabetes-related foot ulcers: a pilot study of feasibility and safety

BackgroundDiabetes-related foot ulcers result in significant mortality, morbidity and economic costs. Pressure offloading is important for ulcer healing, but patients with diabetes-related foot ulcers are presented with a dilemma, because whilst they are often advised to minimise standing and walking, there are also clear guidelines which encourage regular, sustained exercise for patients with diabetes. To overcome these apparently conflicting recommendations, we explored the feasibility, acceptability and safety of a tailored exercise program for adults admitted to hospital with diabetes-related foot ulcers.MethodsPatients with diabetes-related foot ulcers were recruited from an inpatient hospital setting. Baseline demographics and ulcer characteristics were collected, and participants undertook a supervised exercise training session comprising aerobic and resistance exercises followed by prescription of a home exercise programme. Exercises were tailored to ulcer location, which complied with podiatric recommendations for pressure offloading. Feasibility and safety were assessed via recruitment rate, retention rate, adherence to inpatient and outpatient follow up, adherence to home exercise completion, and recording of adverse events.ResultsTwenty participants were recruited to the study. The retention rate (95%), adherence to inpatient and outpatient follow up (75%) and adherence to home exercise (50.0%) were all acceptable. No adverse events occurred.ConclusionsTargeted exercise appears safe to be undertaken by patients with diabetes-related foot ulcers during and after an acute hospital admission. Recruitment in this cohort may prove challenging, but adherence, retention and satisfaction with participation in exercise were high.Trial registrationThe trial is registered in the Australian NewZealand Clinical Trials Registry (ACTRN12622001370796).

Effects of Physical Exercise Program in Adults with Intellectual and Developmental Disabilities-A Study Protocol.

We developed a physical exercise (PE) program for people with Intellectual and Developmental Disabilities (IDD), aiming to determine the effects on physical fitness, health, cognitive ability, and quality of life (QoL). Using experimental methodology, this intervention study recruited 21 adults (18 to 65 years old), institutionalized and with no other associated pathology, who will be allocated to one of the different groups: (i) gym/indoor intervention group (using weight machines), (ii) outdoor intervention group (using low-cost materials), or (iii) control group (without specific intervention, who continue with their normal daily activities). Both intervention groups will engage in 45 min of training per session, twice a week, for 24 weeks. Assessments will be conducted at baseline (initial assessment), 3 months (mid-term assessment), and 6 months (final assessment). Variables assessed include anthropometrics, body composition, functional capacity, muscle strength, general health, cognitive ability, and QoL. The results of this study will assist in the development of more effective strategies, recommendations, and interventions to ensure better and greater adherence to PE by institutionalized individuals with IDD, namely, recommendations for assessment, prescription, and implementation of PE for this population. Additionally, we intend to make available two PE programs, if they are adapted and promote positive effects.

Effects of Physical Exercise on Executive Function in Adults with Depression: A Systematic Review and Meta-Analysis Protocol

Physical exercise is a low-cost and easy-to-implement therapeutic option proposed to reduce the negative effect of depression on the executive function cognitive dimension, including working memory, inhibition, and cognitive flexibility. Although a considerable amount of scientific literature on the topic is currently available, the effects of physical exercise interventions on the executive functions in adults with depression remain unclear. The aim of this review protocol is to synthesize the effects of physical exercise interventions on executive functions in adults with depression. Databases including Web of Science, PubMed, Scopus, and EBSCO will be searched for studies by combining keywords and different medical subject headings to identify and evaluate the relevant studies from inception up to September 2022. This study will consider longitudinal studies (duration, ≥3 weeks) with a minimum of one experimental group and pre- and post-intervention measurements involving adults with depression aged 18–65 years. Studies will be included if these reported ≥1 measures of executive function, including dimensions of working memory, inhibition, and cognitive flexibility. The Physiotherapy Evidence Database (PEDro) scale will be used to assess the methodological quality of studies. The DerSimonian and Laird random-effects model will be used for meta-analyses, with effect size (ES, i.e., Hedges’ g) values reported with 95% confidence intervals (95% CIs), and p ≤ 0.05 will indicate statistical significance. The ES values will be calculated for working memory, inhibition, and cognitive flexibility in the experimental and control groups before and after the intervention program. Our results can help professionals and stakeholders in making better evidence-based decisions regarding the implementation of physical exercise programs in adults with depression and providing relevant information to facilitate the functional performance of this population in complex daily tasks where executive functions are essential. No ethical approval is required for this study. PROSPERO registration number: CRD42022358339.

Abstract 13573: Machine Learning to Identify Predictors of Lapses in a Beginners’ Exercise Program for Adults With Type 1 Diabetes

Introduction: People with type 1 diabetes (T1D) are advised to perform the amounts of exercise recommended for the general population but encounter additional barriers including blood glucose management and fear of hypoglycemia. We previously reported that 20 adults with T1D (55% female) that received personalized biosensor feedback, completed mood diaries, and accessed on-demand instructional videos for 10 weeks increased their exercise to levels that partially met recommendations (median 64 [IQR 20, 129] minutes/week). Herein we use machine learning methods to predict the occurrence of lapses (i.e., days when exercise was not performed). Methods: We modeled exercise lapses using 95 possible predictive features derived from the prior 7 days of: 1) continuous glucose monitor summary statistics (mean, variability, time &gt;180, 70-180, &lt;70 mg/dL) for each daytime, nighttime, and 24hr window; 2) negative glycemic experiences around exercise (hypo/hyperglycemia, excessive insulin-on-board, nocturnal hypoglycemia); 3) subjective fear of hypoglycemia entered each morning and evening; 4) subjective sleep quality; and 5) illness. We created three different models using Random Forest (RF), Support Vector Machine (SVM), and Deep Neural Network (DNN) with an 80:20 train-test split of the data (960 training &amp; 240 testing days). We used upsampling to balance the data between lapse and non-lapse days. Results: First, the SVM achieved 71.2% with the most important features being sickness, mean nighttime glucose levels, 24hr time &lt;70 mg/dL, and variability. Next, the RF achieved a higher accuracy (74.1%) with the most important feature being sleep (significance 0.16) followed by the negative glycemic experiences around exercise (0.09 - 0.14). The most accurate model was the DNN with 5-fold cross-validation (75.2% accuracy, 77.5% precision, 71.4% sensitivity). Conclusion: Machine learning models that leverage biosensor, mood, and sleep data may be used to predict exercise lapses for adults with T1D, which could inform just-in-time motivational prompts in future mobile exercise interventions. Model performance might be improved by including subject-level features (e.g., demographics) and adding a sleep biosensor to complement sleep ratings.