Exercise Recommendations For Patients Research Articles

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.

Impact of an AI app-based exercise program for people with low back pain compared to standard care: A longitudinal cohort-study.

Low Back Pain (LBP) is a common health problem worldwide. In recent years, the use of mobile applications for the treatment of various diseases has increased, due to the Corona pandemic. The aim of this study is to investigate the extent to which artificial intelligence (AI)-assisted exercise recommendations can reduce pain and pain-related impairments in daily life for patients with LBP, compared to standard care. To answer the research question, an 8-week app-based exercise program was conducted in the intervention group. To measure the influence of the exercise program, pain development and pain-related impairment in daily life have been evaluated. A so-called rehabilitation sports group served as the control group. The main factors for statistical analysis were factor time and group comparison. For statistical calculations, a mixed analysis of variance for pain development was conducted. A separate check for confounders was made. For pain impairment in daily life nonparametric tests with the mean of change between the time points are conducted. The intervention group showed a reduction in pain development of 1.4 points compared to an increase of 0.1 points in the control group on the numeric rating scale. There is a significant interaction of time and group for pain development. Regarding pain-related impairments in daily life, the intervention group has a reduction of the oswestry disability index scores by 3.8 points compared to an increase of 2.3 in the control group. The biggest differences become apparent 8 weeks after the start of treatment. The significant results have a medium to strong effect. The results shown here suggest that the use of digital AI-based exercise recommendations in patients with LBP leads to pain reduction and a reduction in pain-related impairments in daily living compared to traditional group exercise therapy.

Recommendations on sports cardiology and exercise in patients with cardiac arrhythmias, channelopathies, CARDIOMOPATHIA AND implanted dEVICES ACCORDING TO THE LATEST GUIDELINES OF European Society of Cardiology – part 2

Competitive athletes should be screened for cardiovascular diseases associated with an increased risk of sudden cardiac death. Patients with arrhythmias, channelopathies, cardiomyopathies and cardiac implantable electronic devices should be assessed, and the level of acceptable physical activity should be established. It is crucial to personalize the guidelines and involve the patients in shared decision making. The following article provides an overview of exercise recommendations for patients with arrhythmias and cardiac implantable electronic devices on the basis of the 2020 ESC Guidelines on Sports Cardiology and Exercise. It was divided into two parts.

Physical activity and exercise in cancer patients with bone metastases

Physical activity and exercise can have numerous positive effects on various disease- and therapy-related symptoms across the continuum of cancer disease. These include an improvement in quality of life, physical function, aerobic fitness, muscle strength and muscle mass, bone density and a reduction of insomnia, psychological distress, pain and fatigue. Although no higher fracture incidence could be found in several studies, exercise is still often considered contraindicated in patients with bone metastases due to concerns about skeletal-related events such as pathologic fractures, spinal cord compression, aggravating pain, increased mortality and higher health care costs. This short, narrative review reports general considerations about physical activity in patients with cancer. In particular, it focuses on principles, precautions and contraindications regarding exercise recommendations for patients with metastatic bone disease in order to implement safe and efficient exercise interventions.

Exercise is Associated With Impaired Left Ventricular Systolic Function in Patients With Lamin A/C Genotype.

BackgroundLamin A/C cardiomyopathy is a malignant and highly penetrant inheritable cardiomyopathy. Competitive sports have been associated with adverse events in these patients, but data on recreational exercise are lacking. We aimed to explore associations between exercise exposure and disease severity in patients with lamin A/C genotype.Methods and ResultsLamin A/C genotype positive patients answered a questionnaire on exercise habits from age 7 years until genetic diagnosis. We recorded exercise hours >3 metabolic equivalents and calculated cumulative lifetime exercise. Patients were grouped in active or sedate based on lifetime exercise hours above or below median. We performed echocardiography, 12‐lead ECG, Holter monitoring, and biomarkers including NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide). We defined left ventricular ejection fraction <45% as a clinically significant impairment of left ventricular function. We included 69 patients (age 42±14 years, 41% probands, 46% women) with median lifetime exercise 4160 (interquartile range 1041–6924) hours. Active patients were more frequently probands (53% versus 29%, P=0.04), had lower left ventricular ejection fraction (43±13% versus 51±11%, P=0.006), and higher NT‐proBNP (78 [interquartile range 32–219] pmol/L versus 30 [interquartile range 13–64] pmol/L, P=0.03) compared with sedate, while age did not differ (45±13 years versus 40±16 years, P=0.16). The decrease in left ventricular ejection fraction per tertile increment in lifetime exercise was 4% (95% CI −7% to −0.4%, P=0.03), adjusted for age and sex and accounting for dependence within families. Left ventricular ejection fraction <45% was observed at a younger age in active patients (log rank P=0.007).ConclusionsActive lamin A/C patients had worse systolic function compared with sedate which occurred at younger age. Our findings may improve exercise recommendations in patients with lamin A/C.

Exercise recommendations in patients with valvular heart disease.

Valvular heart disease affects 1%-2% of young individuals, many of whom aspire to partake in competitive sport or high intensity recreational exercise. There are limited reports on the impact of intensive physical activity on the progression of valvular heart disease; therefore, current recommendations are based on consensus opinion. The management of exercising individuals with valvular heart disease requires a structured approach that incorporates several key factors including symptomatic status, functional capacity, type and nature of the valvular lesion, impact on ventricular structure and function and effect on pulmonary artery pressure. Asymptomatic individuals with minor valvular abnormalities may engage in all forms of competitive sport, whereas those with lesions of moderate severity may exercise intensively if an exercise stress test tailored to the relevant physical activity reveals good functional capacity without myocardial ischaemia, haemodynamic disturbances or arrhythmia. Symptomatic athletes and those with severe valvular heart disease, impaired ventricular function, pulmonary hypertension and arrhythmias should refrain from most competitive sports. Athletes with a bicuspid aortic valve and aortic root diameter >40 mm should avoid sport with a strong isometric component even with minimal valvular dysfunction. There is an association between mitral valve prolapse and sudden cardiac death in the general population; however, there is limited evidence of increased risk with competitive sport. Athletes undergoing corrective surgery may return to exercise after 3 months if ventricular function and exercise capacity are preserved. Individuals anticoagulated for mechanical bioprosthetic valves should avoid contact or collision sport to minimise the risk of bleeding.

Exercise recommendations for patients with type 2 diabetes.

The American College of Sports Medicine and American Diabetes Association recommend that patients with type 2 diabetes participate in at least 150 minutes of moderate exercise weekly with resistance training two or three times weekly. This article reviews the guidelines, preparticipation cardiovascular screening recommendations, and considerations for patients with diabetes and comorbidities who are planning to participate in regular exercise regimens.

Evidence Based Therapeutic Exercise Recommendations for Patients with Multiple Sclerosis: A Physical Therapy Approach

Multiple Sclerosis (MS) is a chronic demyelinating disease of the central nervous system affecting over a million people worldwide. The demyelinating process begins when inflammatory T cells of the immune system attack the oligodendrocytes after infiltrating the blood-brain barrier, creating a cascade effect of neurological symptoms. MS presents itself through physical symptoms including fatigue, depressed mood and motor deficits. Current research has shown promise in using exercise intervention to curb the symptoms of this autoimmune disease. This brief review evaluated studies that utilized exercise to decrease fatigue, improve quality of life (QoL), and improve ability to perform activities of daily living. Assessments utilized to examine efficacy of exercise include the Fatigue Severity Scale, Multidimentional Fatigue Inventory-20, and the Major Depression Inventory. These tests provide both an objective and subjective view of the MS disease process. The purpose of this review is to provide information related to resistance exercise recommendations for physical therapists to use as a guide when prescribing exercise interventions to patients with MS. The training program aims to reduce mobility related impairments, decrease fatigue and improve QoL in individuals with MS. After review of this article the reader should ascertain a newfound comfort and knowledge for delivering progressive resistance training to persons with MS. This guide provides both novice and intermediate-advanced recommendations for exercise. The exercise recommendations are indicated for patients with less than or equal to a 6.0 on the Expanded Disability Status Scale. MS patients should consult a physician before actively engaging in any exercise program.

Exergaming in older adults: A scoping review and implementation potential for patients with heart failure

Background:Physical activity can improve exercise capacity, quality of life and reduce mortality and hospitalization in patients with heart failure (HF). Adherence to exercise recommendations in patients with HF is low. The use of exercise games (exergames) might be a way to encourage patients with HF to exercise especially those who may be reluctant to more traditional forms of exercise. No studies have been conducted on patients with HF and exergames.Aim:This scoping review focuses on the feasibility and influence of exergames on physical activity in older adults, aiming to target certain characteristics that are important for patients with HF to become more physically active.Methods:A literature search was undertaken in August 2012 in the databases PsychInfo, PUBMED, Scopus, Web of Science and CINAHL. Included studies evaluated the influence of exergaming on physical activity in older adults. Articles were excluded if they focused on rehabilitation of specific limbs, improving specific tasks or describing no intervention. Fifty articles were found, 11 were included in the analysis.Results:Exergaming was described as safe and feasible, and resulted in more energy expenditure compared to rest. Participants experienced improved balance and reported improved cognitive function after exergaming. Participants enjoyed playing the exergames, their depressive symptoms decreased, and they reported improved quality of life and empowerment. Exergames made them feel more connected with their family members, especially their grandchildren.Conclusion:Although this research field is small and under development, exergaming might be promising in order to enhance physical activity in patients with HF. However, further testing is needed.

Exercise in Cardiovascular Diseases

AbstractAnalysis of extensive data has shown that exercise training provides significant impact on prevention and modification of cardiovascular diseases and mortality. In general, exercise recommendations for patients with cardiovascular diseases are based on individual aerobic capacity and comorbidities. Patients with acute syndromes benefit from participating in a cardiac rehabilitation program, whereas patients with chronic syndromes benefit from a life-long home-based program. In general, exercise prescription should involve aerobic activities in combination with resistance, flexibility, and balance exercises. This review will discuss an exercise prescription for patients with coronary artery disease, heart failure, and after heart transplantation. Detailed precautions for particular groups of patients will be discussed.

Cardiac Rehabilitation Participant With Sickle Cell Trait and Statin-Related Hepatotoxicity

Exercise recommendations for patients with sickle cell trait (SCT) and myocardial infarction (MI) are limited. This case report describes such a patient, who subsequently participated in cardiac rehabilitation (CR). Patient experienced sudden intense chest pressure and shortness of breath while singing in church. Electrocardiogram and cardiac enzymes confirmed acute ST elevation MI. Laboratory tests indicated hyperlipidemia and elevated liver enzyme levels >4 times the upper normal limit (UNL). Day 40 post-MI, the patient returned to the hospital complaining of daily chest discomfort, atypical for angina pectoris. Following an unremarkable stress test result, the patient was encouraged to proceed with CR. Patient made regular progress through CR, although continued to experience paroxysmal chest discomfort away from CR, which he denied having during exercise. On day 75, his lipid profile met recommended targets while taking atorvastatin, but with liver enzymes >38 times UNL. Atorvastatin was discontinued at day 85, to which his enzymes responded appropriately, but by day 165, hyperlipidemia had returned. Rosuvastatin was started but was discontinued (day 197), with liver enzymes 6 times UNL. He continued CR without lipid therapy but at CR completion, the lipid panel did not meet targets. However, fitness and social indices improved significantly, although he occasionally still experienced chest pain, but with lesser frequency and intensity, and never with exercise. CR in a patient with SCT, MI, and statin-related hepatotoxicity requires several specific considerations. Although SCT-exercise associated deaths are described in the literature, this case suggests that such patients can benefit from CR and can exercise safely.

Exercise Recommendations in Patients With Newly Diagnosed Fibromyalgia

To evaluate exercise recommendations in patients newly diagnosed with fibromyalgia. A retrospective chart review. A public university rheumatology clinic. Patients newly diagnosed with fibromyalgia (N = 122). Frequency and type of exercise recommendations. The mean (standard deviation) age of these patients with fibromyalgia was 45 ± 12 years; 91% were women. Exercise was recommended as part of the documented treatment plan in 47% of these patients (57/122); only 3 patients had a documented contraindication for exercise. Aquatic exercise was most frequently recommended (56% [32/57]), followed by combined aquatic-aerobic exercise (26% [15/57]), and, infrequently, aerobic exercise only (5% [3/57]); only 7% of these patients (4/57) were referred for physical therapy. The primary method of communication was verbal discussion (94% [54/57]). Although there is well-documented evidence that exercise is beneficial for patients with fibromyalgia, we found that less than half of patients with newly diagnosed fibromyalgia in our study were provided recommendations to initiate an exercise program as part of their treatment plan. Further investigation of these findings are warranted, including evaluation of other university and community rheumatology practices as well as that of other physicians caring for patients with fibromyalgia. However, our findings indicate that there appears to be an opportunity to provide more specific and practical education regarding the implementation of an exercise regimen for patients with newly diagnosed fibromyalgia. Physiatrists may be particularly well suited to manage the exercise component of patients with fibromyalgia because of their specialized training in exercise prescription.

Poster 349 Exercise Recommendations in Patients With Newly Diagnosed Fibromyalgia

Poster 349 Exercise Recommendations in Patients With Newly Diagnosed Fibromyalgia

Screening and Counseling for Childhood Obesity: Results from a National Survey

To examine family physicians' beliefs and practices about using body mass index (BMI) percentiles to screen for childhood overweight and obesity. Surveys about management of childhood overweight were mailed to 1800 American Academy of Family Physician members in 2006. 729 surveys were returned; 445 were eligible. Most (71%) members were familiar with BMI guidelines; 41% were familiar with American Academy of Family Physician recommendations about overweight. Most (78%) had tools available to calculate BMI; fewer have enough time for overweight screening (55%), and only 45% reported computing BMI percentile at most or every well visit for children older than 2. Having an electronic health record increased BMI screening rates. Family physicians felt prepared to discuss weight, but only 43% believed their counseling was effective and many (55%) lack community or referral services. Most (72%) wanted simple diet and exercise recommendations for patients. Reimbursement for weight-related services is insufficient: 86% say that patients cannot pay for services not covered by insurance. Factor analysis identified clinician self-efficacy, resources, and reimbursement as factors related to calculating BMI percentiles. BMI is underutilized by family physicians. Most believe they should try to prevent overweight and have tools to use BMI, but clinicians have few resources available for treatment, have low self-efficacy, and report inadequate reimbursement.

Exercise, Fluid, and Nutrition Recommendations for the Postgastric Bypass Exerciser

To review the literature for nutritional, fluid, and exercise recommendations in patients who have undergone bariatric surgery. PubMed (1980 - October 2008). The bibliographies of selected literature were reviewed for additional sources. A systematic review of the literature is presented. There is little high-quality evidence to support any recommendations currently. Most recommendations are expert opinion. Nutritional deficiencies are common. Routine screening and nutrient replacement is adequate for most deficiencies. Increased physical activity before surgery is associated with improved quality of life. Walking is adequate as a primary activity after surgery. Pedometers may serve as a useful tool to help guide exercise recommendations. There is need for further research upon specific exercise recommendations.