Exercise Regimen Research Articles

Impact of Exercise on the Course of Dermatomyositis: A Narrative Review of Recent Studies

Introduction and Purpose: Dermatomyositis (DM) is a rare autoimmune inflammatory myopathy characterized by muscle weakness and distinctive skin manifestations, impacting both children and adults. This narrative review aims to examine the latest studies assessing the impact of physical activity on the course of dermatomyositis and determine which forms of exercise are beneficial for DM patients. Methods: A comprehensive literature review was conducted using the PubMed and Google Scholar databases, focusing on articles published between 2018 and 2024. State of Knowledge: The review identified consistent evidence supporting the safety and efficacy of exercise in DM patients. Exercise regimens, including resistance, aerobic, and stretching exercises, were found to improve muscle strength, aerobic capacity, and metabolic functions without increasing disease activity. Novel exercise approaches, such as blood flow restriction training and aquatic plyometric exercises, also showed promising results. However, the heterogeneity of the trials and small sample sizes highlight the need for larger, more diverse cohorts and long-term studies Summary: The findings underscore the potential of structured exercise programs to enhance muscle strength, aerobic capacity, and overall physical function in DM patients. These improvements are achieved without exacerbating disease activity, highlighting the safety of exercise interventions. The review emphasizes the importance of incorporating physical activity into treatment plans for DM, advocating for personalized exercise prescriptions tailored to the unique inflammatory nature of idiopathic inflammatory myopathies (IIM).

Clinical management of constipation – the role of physical activity - systematic review

Constipation is a prevalent gastrointestinal disorder that affects a significant portion of the global population, yet its management remains challenging due to its complex etiology. This review explores the potential benefits and mechanisms of physical activity in alleviating constipation symptoms. We examined recent studies on the physiological effects of various exercise types and intensities on bowel movements, gastrointestinal blood flow, and microbiome composition. Our findings suggest that aerobic exercise enhances colonic motility and accelerates gastrointestinal transit, though the effects vary depending on exercise duration and intensity. While light to moderate physical activity (less than 60 minutes) appears beneficial, prolonged or intense exercise may inhibit motility and exacerbate symptoms. Additionally, exercise-induced changes in the gut microbiome and blood flow dynamics were observed, influencing stool consistency and colonic function. However, the interplay between diet, hydration, and physical activity is crucial, as adequate dietary fiber and hydration are essential for optimizing exercise's impact on constipation. Although evidence supports the role of physical activity in managing constipation, further research is needed to clarify the most effective exercise regimens and their integration with dietary and lifestyle modifications.

Effects of concentric and eccentric exercise regimens on bioenergetic efficiency of lymphocytes in sedentary males

AbstractEccentric exercise training (EET) increases physical performance while having lower metabolic demand than concentric exercise training (CET). Whether EET influences bioenergetic efficiency in peripheral blood mononuclear cells (PBMCs) remains unclear. This study investigates the effects of EET and CET on PBMC phenotypes and mitochondrial functions in blood. Thirty three sedentary healthy males were randomly assigned to either EET (n = 11) or CET (n = 11) that performed at progressively increased from 60% to 80% of maximal absolute workload for 30 min/day, 5 days/week for 6 weeks, or a control group (n = 11) that did not receive any exercise intervention. A graded exercise stress test (GXT) was performed before and after the intervention. PBMC phenotypes and mitochondrial respiratory capacity were analyzed using flowcytometry and high‐resolution respirometry, respectively. In the same absolute workload, EET elicited lower heart rate and rating of perceived exertion than CET. However, EET as CET increased the VO2 level at the ventilatory threshold. Notably, both EET and CET increased central memory (CD45RO+/CD62+/CD3+) T cells and decreased effector memory T cells reexpressing CD45RA (CD45RA+/CD62‐/CD3+). Moreover, the two exercise regimens diminished the loss of mitochondrial membrane potential (ΔΨm) caused by GXT, increased maximal/reserve O2 consumption rates (OCR), and bioenergetic health index in intact PBMCs and enhanced complex I‐/II‐related OCR in PBMCs with a substrate‐rich environment. EET improves aerobic fitness with a lower cardiovascular response to exercise than CET. Moreover, EET as CET reduces senescent T‐cell distribution in blood and improves PBMC bioenergetic efficiency by stabilizing ΔΨm and increasing capacity of oxidative phosphorylation.

Study on anxiety, depression, and sleep conditions and their interrelations among vocational college students during the COVID-19 pandemic management normalization

ObjectiveThis study investigates the sleep patterns among vocational college students and examines their association with anxiety and depression amidst the ongoing normalization of COVID-19 management strategies.MethodsIn the period of January to February 2022, a comprehensive survey was conducted involving a random sample of 3,300 students. By employing face-to-face interviews, data on general demographics, along with levels of anxiety, depression, and sleep quality, were meticulously gathered and analyzed.ResultsOut of the 3,049 questionnaires deemed valid for analysis, the prevalence rates for anxiety, depression, and insomnia were found to be 9.7, 14.1, and 81.9%, respectively. Through regression analysis, several factors were identified as significant predictors of insomnia: female gender, a self-perceived average or poor family economic status over the last year, moderate psychological stress due to the pandemic and its associated restrictions, extended daily screen time during the pandemic, absence of a routine physical exercise regime, significant disruption or alteration of daily life routines due to the pandemic, presence of anxiety and depression symptoms during the pandemic, and only partial restoration of normal life routines post-pandemic control measures (p < 0.001, p < 0.005, or p < 0.050). A strong correlation was observed among the symptoms of anxiety, depression, and insomnia (all p < 0.001). The correlation between stress and depression, depression and insomnia, and anxiety and insomnia were 0.824, 0.714, 0.620, respectively, (all p < 0.001).ConclusionGiven the substantial impact of abrupt or prolonged crisis events, it is imperative to develop and implement specific intervention strategies aimed at safeguarding the psychological well-being of college students.

Identification of the serum metabolomic profile for acute ischemic preconditioning in athletes

PurposeIn recent years, ischemic preconditioning (IPC) has emerged as an effective strategy to increase tissue resistance against long-term ischemic damage and has been increasingly integrated into exercise regimens. However, further research is needed to explore the impact of IPC-mediated metabolic alterations from an exercise standpoint to conduct a comprehensive exploration of metabolic alterations and their exercise-related mechanisms during acute IPC.MethodsNontarget metabolomics was performed on blood samples obtained from 8 male athletes both before and after IPC. The studies included the identification of differentially abundant metabolites, analysis of receiver operating characteristic (ROC) curves, Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis for differentially abundant metabolites, and metabolite set enrichment analysis (MSEA).ResultsNineteen differentially abundant metabolites were identified, with increasing levels of five metabolites, such as O-desmethyltramadol and D-gluconate, whereas 14 metabolites, including 9-hydroxy-10e, 12z-octadecadienoic acid (9-HODE), tetradione, 2-hexenal, (2,4-dichlorophenoxy)acetic acid (2,4-D), and phosphatidylserine (PS), decreased. ROC curve analysis revealed an AUC of 0.9375 for D-gluconate. Both KEGG enrichment analysis and MSEA revealed enrichment in the pentose phosphate pathway (PPP).ConclusionThis study revealed that PPP, D-gluconate, O-desmethyltramadol, and D-2-aminobutyric acid could be upregulated within 5 min after acute IPC, whereas 2,4-D, PS, 9-HODE, 2-hexenal, and tetradinone could be downregulated. These identified metabolites show promise for improving physical functional status and could be harnessed to enhance athletic performance.

High-volume injections in Achilles tendinopathy: a systematic review.

Achilles tendinopathy (AT) is common, particularly in runners. High-volume injections (HVIs) may be beneficial in the management of AT compared to other conservative management options, including exercise regimens, platelet-rich plasma (PRP) injections, and extracorporeal shockwave therapy. The published research on the effectiveness of HVI in the treatment of AT was evaluated in this systematic review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed when conducting this systematic review. The electronic databases PubMed, Embase, Cochrane, Web of Science, CINAHL, and OVID were thoroughly searched, from inception to 13 September 2023, for articles assessing HVI for AT. A total of 10 studies with 460 participants met the inclusion criteria. HVI typically consisted of saline, local anaesthetic, and corticosteroids. HVI combined with corticosteroids demonstrated immediate and long-term improvements in ankle function. Compared to HVI without corticosteroids, HVI with corticosteroids exhibited greater, early improvements in pain and function, with no significant differences at later follow-up points. Significant reductions in tendon thickness and neovascularity were also found with HVI treatment over time. No adverse events were reported with HVI, despite the use of corticosteroids. HVI is an effective and safe modality, particularly in the short term, to significantly reduce pain and discomfort in the Achilles tendon, especially when supplemented with corticosteroids. More robust randomized controlled trials, with longer-term follow-ups and homogeneity, are needed to fully establish its efficacy for AT.

Evaluation of Splint and Exercise Interventions for Carpal Tunnel Syndrome: Insights from Ultrasonographic Measurements.

BACKGROUND Carpal tunnel syndrome (CTS) is a neuropathy caused by the entrapment of the median nerve, which requires effective management strategies. The median nerve is subjected to pressure within the carpal tunnel, resulting in tingling, numbness, and pain in the median side of the hand. We compared the efficacy of splint use with an exercise program vs exercise alone in patients with mild and moderate CTS. MATERIAL AND METHODS Forty-four patients with CTS were enrolled. The patients were randomly divided into 2 groups: splint+exercise and exercise only. A range of assessment tools were used, including ultrasonography, dynamometer, the Leeds Assessment of Neuropathic Symptoms & Signs Pain Score (LANSS), Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score, and 36-Item Short Form Quality of Life Scale (SF-36) score, to provide comprehensive evaluation. RESULTS The 2 groups had comparable outcomes at the end of treatment. There were no statistically significant differences in Q-DASH (P=0.326, Cohen's d=0.067), SF-36 (P=0.329, Cohen's d=0.218), VAS (P=0.521, Cohen's d=-0.299), or LANSS scores (P=0.627, Cohen's d=0.039) between the groups (P>0.05). The results demonstrate that a targeted exercise regimen, when used in isolation, can elicit outcomes that are comparable to those achieved through the integration of splinting techniques. CONCLUSIONS The study findings align with conflicting existing data on the effectiveness of splint immobilization in conjunction with exercises for CTS. The results support the significance of regular exercises, which can be applied in the home-based setting in CTS management, and offer alternative online management strategies.

Exploring Trismus Management in Australia: A Mixed Methods Evaluation of Surveys and Interviews With Health Professionals.

This study evaluates how health care professionals manage trismus in Australia and identifies facilitators and barriers experienced by clinicians in routine patient care. A mixed-methods approach was used to evaluate the experience of clinicians. Medical, nursing, and allied health practitioners in Australia were invited to participate if they had treated patients with trismus in the last 5 years. Participants completed an investigator-designed survey and were invited to participate in a semi-structured audio-recorded interview to explore practice in more depth. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed thematically using an inductive, data-driven approach. Fifty-six clinicians (38 speech pathologists, 9 physiotherapists, 7 medical doctors, 1 nurse, and 1 osteopath) completed the survey, 12 of which also participated in an interview. The most common assessment tool was a commercially available measurement tool (Therabite or Orastretch), the most common treatment approach was stacked tongue depressors, and the most common exercise regimen was a 30- s stretch 25 times per day. Common barriers to trismus management included the high cost of devices, lack of clinical experience, and lack of training opportunities outside their institution. Clinician-perceived facilitators were different modes of information provision and time to consider the exercise instructions and rationale. Several clinicians relied on telehealth to reach patients in remote locations and improve efficiency. A range of clinicians treat trismus arising from a variety of conditions. Training opportunities are critical for clinicians to develop and extend their skills in assessing and treating trismus. The morbidity associated with trismus, and the absence of a clinical guideline or consensus document warrants careful consideration as to the translation of evidence into the clinical context.

Short-term exercise counteracts accelerated ageing impacts on physical performance and liver health in mice.

Senescence impairs liver physiology, mitochondrial function and circadian regulation, resulting in systemic metabolic dysregulation. Given the limited research on the effects of combined exercise on an ageing liver, this study aimed to evaluate its impact on liver metabolism, circadian rhythms and mitochondrial function in senescence-accelerated mouse-prone 8 (SAMP8) and senescence-accelerated mouse-resistant 1 (SAMR1) mice. Histological, reverse transcription quantitative polymerase chain reaction (RT-qPCR) and immunoblotting analyses were conducted, supplemented by transcriptomic data sets and AML12 hepatocyte studies. Sedentary SAMP8 mice exhibited decreased muscle strength, reduced mitochondrial complex I levels and increased lipid droplet accumulation. In contrast, combined exercise mitigated muscle strength loss, upregulated proteins involved in mitochondrial complexes (CIII, CIV, CV) and increased Bmal1 messenger RNA (mRNA) expression in the liver. These molecular adaptations are associated with healthier liver phenotypes and may influence metabolic function and cellular longevity. Notably, elevated lipid content in aged mice was reduced post-exercise, indicating liver benefits even after a relatively short intervention. The combined exercise regimen did not improve aerobic capacity, likely due to the low volume and brief duration of running. Moreover, no significant effects were observed in SAMR1 mice, possibly because the training intensity was insufficient for younger, healthier animals. These findings underscore the potential of combined strength and endurance exercise to attenuate age-related liver dysfunction, particularly in ageing populations.

Effect of Lifestyle Modification on Plasma Lipids of Adults in a Part of North Central Nigeria

Background: Plasma lipids are precursors of adrenal and gonadal steroid hormones, bile acids as well as important component of animal cell wall. However, abnormal plasma lipids are major risk factor for cardiovascular diseases globally. Researchers are currently considering lifestyle modification such as exercise, as an approach to maintaining normal plasma lipids level as well as addressing abnormal ones. Methodology: This study investigated the effect of lifestyle modification (vigorous intensity aerobic exercise regimen) on plasma triglycerides and low density lipoprotein-cholesterol of adults in Benue State University, Makurdi. The design of the study was guided by two research questions. Two hypotheses were formulated and tested at 0.05 level of significance. The study adopted two group pretest posttest quasi experimental design. The study population comprises twenty-one (21) Benue State University staff in the experimental group, and another twenty-one (21) for the control group. The proforma used for the data collection was validated by three experts, one from measurement and evaluation, one from the Department of Human Kinetics and Health Education and one from College of Health Sciences; all in Benue State University, Makurdi. Data generated were analyzed using Statistical Package for Social Sciences (SPSS Version 25). A descriptive statistics, mean and standard deviation were used to answer the research questions, and inferential statistics, Analysis of Covariance (ANCOVA) and Paired Samples Test were used to test the hypotheses at 0.05 level of significance. Results: The findings revealed that out of the 21 participants in the two groups, 12(57.14%) were males, while 9(42.86%) were females. The age range in the control group was between 28 to 65years, while that of the experimental group was between 36-68years. Vigorous intensity aerobic exercise regimen was found to have statistically significant effect on plasma low density lipoprotein-cholesterol (P = 0.000<0.05). Even though plasma triglyceride was found to be reduced by vigorous intensity aerobic exercise regimen, the level of the reduction was found not to be statistically significant (P = 0.293 > 0.05). Conclusion: The study concluded that healthcare workers should henceforth incorporate vigorous intensity aerobic exercise regimen prescription in public health awareness on the maintenance of plasma level of triglycerides and low density lipoprotein-cholesterol, as well as clinical management of patients with abnormal plasma low density lipoprotein-cholesterol.

Nitric oxide: Potential therapeutic target in Heat Stress-induced Multiple Organ Dysfunction.

As climate change intensifies, urgent action is needed to address global warming and its associated health risks, particularly in vulnerable regions. Rising global temperature and increasing frequency of heatwaves present a hidden health risk, disrupting the body's temperature regulation and leading to severe consequences such as heat stress-induced multiple organ dysfunction (HS-MOD). Multiple organ injury triggered by heat stress involves complex molecular pathways such as nitric oxide dysregulation, inflammation, oxidative stress, mitochondrial dysfunction, calcium homeostasis disruption, and autophagy impairment that contribute to cellular damage. Understanding these molecular pathways is crucial for developing targeted therapeutic interventions to alleviate the impact of heat stress (HS). As we explore numerous therapeutic strategies, a remarkable molecule captures our attention: nitric oxide (NO). This colorless gas, mainly produced by nitric oxide synthase (NOS) enzymes, plays crucial roles in various body functions. From promoting vasodilation and neurotransmission to regulating the immune response, platelet function, cell signaling, and reproductive health, NO stands out for its versatility. Exploring it as a promising treatment for heat stress-induced multiple organ injury highlights its distinctive features in the journey towards effective therapeutic interventions. This involves exploring both pharmacological avenues, considering the use of NO donors and antioxidants, and non-pharmacological strategies, such as adopting nitrate-rich diets and engaging in exercise regimens. This review highlights the concept of heat stress, the molecular framework of the disease, and treatment options based upon some new interventions.

Physical Exercise and the Gut Microbiome: A Bidirectional Relationship Influencing Health and Performance

Background/Objectives: The human gut microbiome is a complex ecosystem of microorganisms that can influence our health and exercise habits. On the other hand, physical exercise can also impact our microbiome, affecting our health. Our narrative review examines the bidirectional relationship between physical activity and the gut microbiome, as well as the potential for targeted probiotic regimens to enhance sports performance. Methods: We conducted a comprehensive literature review to select articles published up till January 2024 on the topics of physical exercise, sports, probiotics, and gut microbiota from major scientific databases, incorporating over 100 studies. Results: We found that the impact of physical activity on the gut microbiome varies with the type and intensity of exercise. Moderate exercise promotes a healthy immune system, while high-intensity exercise for a long duration can cause a leaky gut and consequent systemic inflammation, which may disrupt the microbial balance. Combining aerobic and resistance training significantly affects bacterial diversity, linked to a lower prevalence of chronic metabolic disorders. Furthermore, exercise enhances gut microbiome diversity, increases SCFA production, improves nutrient utilization, and modulates neural and hormonal pathways, improving gut barrier integrity. Our findings also showed probiotic supplementation is associated with decreased inflammation, enhanced sports performance, and fewer gastrointestinal disturbances, suggesting that the relationship between the gut microbiome and physical activity is mutually influential. Conclusions: The bidirectional relationship between physical activity and the gut microbiome is exemplified by how exercise can promote beneficial bacteria while a healthy gut microbiome can potentially enhance exercise ability through various mechanisms. These findings underscore the importance of adding potential tailored exercise regimens and probiotic supplementation that consider individual microbiome profiles into exercise programs.

Single cell multi-omics analysis unveils a distinct mechanism of exercise-mediated cardioprotection in ischemic cardiomyopathy

Abstract Background Exercise is pivotal in heart disease prevention, with proven cardioprotective effects in clinical trials. However, its precise molecular mechanisms remain elusive. Recent advancements in single-cell omics have revealed cellular heterogeneity within heart tissues, offering a deeper understanding of the pathophysiology of cardiac diseases. Purpose To investigate the exercise-induced physiological changes in heart tissue at the single-cell level and elucidate the molecular mechanisms underlying its cardioprotective effect on ischemic cardiomyopathy. Methods Murine myocardial infarction (MI) model was established by ligating the left ascending coronary artery, and a six-week voluntary wheel running exercise regimen was implemented to investigate the effect of aerobic exercise on ischemic cardiomyopathy. Integrated multi-omics analyses of single-cell DNA methylation profiling, single-nucleus assay for transposase-accessible chromatin sequencing (snATAC-seq) and single-nucleus RNA sequencing (snRNA-seq) were conducted to clarify the molecular mechanism of exercise-mediated cardioprotection at single-cell resolution. Overexpression and short hairpin RNA-mediated knockdown of gene X were conducted for murine MI model using cardiomyocyte-specific Myo-AAV2a vector. snRNA-seq of heart tissues from heart failure patients was performed to validate the clinical significance of the expression of gene X in cardiomyocytes. Results Exercise attenuates pathological cardiac remodeling, inducing physiological hypertrophy in non-infarcted areas while suppressing pathological remodeling of cardiomyocytes in infarct border zones. Single-cell epigenetic analysis unveiled intricate molecular mechanisms underlying exercise-induced transcriptome changes, providing insights into the gene regulatory networks modulated by exercise in the heart. In addition, integrated with snRNA-seq, we identified exercise-specific cardiomyocyte clusters, highlighting the substantial role of gene X in the molecular mechanism of exercise. Functional studies confirmed the essential role of gene X in exercise-induced cardioprotection, as its overexpression suppressed the adverse remodeling after MI and knockdown abolished the beneficial effects of exercise. Furthermore, snRNA-seq of heart failure patients revealed that higher expression of gene X was associated with ventricular reverse remodeling and favorable clinical outcomes, underscoring its significance in the pathophysiology of patients with heart failure. Conclusion Our study elucidates exercise-specific gene expression regulation networks in ischemic cardiomyopathy by unraveling the cellular heterogeneity and molecular changes associated with exercise. We identified gene X as a central player in exercise-mediated cardioprotection and further confirmed its significance in clinical settings, providing a potential therapeutic target for heart failure.

The potential effect of mobile application-based telerehabilitation on physical activity levels in heart failure patients: insights from the intelliot EU project

Abstract Background Regular physical activity is paramount in heart failure (HF) patients and, due to its well-established benefit in quality of life, functional capacity and prognosis, carries a Class I indication in international guidelines. However, satisfactory compliance rates remain suboptimal, which is largely attributable to unavailability or suboptimal utilization of comprehensive cardiac rehabilitation programs. Digital health application-based telerehabilitation, on the other hand, has emerged as a potentially valuable tools in enhancing risk factor control and lifestyle modification rates in this high-risk patient population. Purpose In this study, we aimed to investigate whether the use of a purpose-designed Internet of Things (IoT)-based e-health system could lead to a clinically relevant increase in physical activity in a cohort of patients with HF across the spectrum of left ventricular ejection fraction (LVEF). Methods Nineteen HF patients were enrolled in the study. Subjects' key clinical characteristics are summarized in Picture 1. All subjects were provided with: a) a set of medical devices with wireless connectivity, b) a state-of-the-art smartwatch and c) a latest-generation smartphone, to which a dedicated patient application was installed. The latter was coupled with a web-based platform designed for physician use, forming the patient-physician interface (PFI). On top of standard-of-care verbal and written exercise recommendations, study physicians also prescribed individualized, guideline-directed exercise regimens for each patient via the PFI, which, in turn, delivered to subjects notifications upon detection of deviations (Picture 2). The first month of participation -during which the smartwatch was used as an activity tracker but exercise notifications had not been activated- served as the baseline period; baseline physical activity level in steps per day was then compared to the respective value measured during each of the 5 following months. Results Mean baseline-to-peak increase in daily step count was calculated at 23.34% (-20.33 - 103.63%). A baseline-to-peak increase in physical activity level of at least 20% was observed in 9/19 patients, with 6 more demonstrating a baseline-to-peak increase in the order of magnitude of 15-19.99%. Only 3 patients failed to achieve any increase in daily step count average. However, after the study month in which the peak physical activity value was observed (typically in the 2nd-4th study month), mean daily step count declined to baseline again in all but 2 patients. Conclusions Despite the study's non-randomized design and small sample size, our results suggest that mobile application-based telerehabilitation constitutes a promising approach in HF patients’ care, as it could aid them achieve a clinically relevant increase in physical activity; this effect, however, can be transient, and this highlights the importance of continued physician oversight.Picture 1: Clinical characteristicsPicture 2: Exercise prescription example

Enhancing chronic disease management through physical activity and pedometry-based health monitoring.

Physical activity (PA) is a vital component in the management of chronic diseases, including cardiovascular, metabolic, and musculoskeletal conditions. In rheumatic diseases (RDs) such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and osteoarthritis (OA), PA has been shown to alleviate symptoms, enhance functional capacity, and improve quality of life. Given these advantages, wearable trackers and smartphone apps have revolutionized PA monitoring, offering quantitative reports of step counts, sedentary behavior, intensity, and energy expenditure. Pedometry-based health monitoring aids in evaluating patients' adherence to exercise regimens, tracking disease progression, and customizing interventions to meet individual needs. Patients with RDs often encounter barriers to maintaining regular PA, including joint pain, fatigue, and comorbidities, which complicate adherence and elevate the risk of adverse events. This overview delves into the dual role of PA in fostering health and managing disease in RD patients. Despite enormous benefits, it is essential to recognize limitations and risks of PA, particularly for individuals with high disease burden and multiple comorbidities. The findings emphasize the importance of integrating tailored PA programs within a multidisciplinary care framework to optimize patient outcomes.

Physiological characteristics of blood pressure responses after combined exercise in elderly hypertensive patients: a systematic review and meta-analysis

ObjectiveThe aim of this investigation is to explore the efficacy of combined exercise in elderly patients with hypertension. Moreover, we aim to delve into the underlying mechanisms governing blood pressure regulation, with the objective of promoting the adoption of this exercise regimen among elderly hypertensive individuals.MethodsIn our study, we conducted a thorough search across multiple databases, including PubMed, Web of Science, Cochrane Library, Embase, and Scopus. This extensive search resulted in the preliminary screening of 2,347 articles. Among these, 9 studies were carefully selected for an in-depth analysis. For our meta-analysis, we employed Review Manager 5.3 and Stata 15.0, enabling us to perform detailed subgroup analyses and assess the possibility of publication bias.ResultsIn comparison to the control group (n = 194), individuals enrolled in the combined exercise group (n = 200) exhibited a notable decrease in both resting systolic blood pressure (SBP) [weighted mean difference (WMD) = −11.17 mm Hg, 95% confidence interval (CI) (−17.13, −5.22), Z = 3.68, P < 0.05] and diastolic blood pressure (DBP) [WMD = −5.93 mm Hg, 95% CI (−9.24, −2.61), Z = 3.51, P < 0.05]. Nonetheless, no statistically significant alteration was observed in pulse pressure (PP) [WMD = −9.05 mm Hg, 95% CI (−22.65, 4.55), Z = 1.3, P = 0.192]. Further subgroup analyses elucidated that combined exercise regimens, characterized by aerobic training intensities below 85% of HRmax, durations of up to 12 weeks, weekly frequencies of either ≥3 or <3 sessions, total session times under 60 min, and a sequence of aerobic exercise followed by resistance training (AE-RT), were particularly effective in enhancing SBP and DBP among elderly patients with hypertension. Additionally, regular engagement in combined exercise led to significant improvements in SBP and DBP across individuals aged 60–70, those older than 70 years, and regardless of whether participants were using antihypertensive medications or not.ConclusionCombined exercise serves as an efficacious adjunctive therapy for reducing blood pressure among elderly individuals with hypertension, exerting beneficial influences on multiple physiological mechanisms pertinent to blood pressure regulation. Moreover, the integration of aerobic exercise with resistance training presents a more varied training program, thereby eliciting wider-ranging positive effects on both the physical and mental well-being of elderly patients afflicted with hypertension.

Physical activity as a predictor of activities of daily living in older adults: a longitudinal study in China

ObjectiveThis study aimed to assess the prevalence of physical activity and its association with the progression of difficulty performing activities of daily living among older adults in China.MethodsA population-based prospective cohort study based on China Family Panel Studies (CFPS) data was conducted in 2018 and 2020. This study used a logistic model to empirically estimate the effects on daily living activities among older adults.ResultsA total of 2073 older adults aged 60 years and above were included, 78.0% of whom did not exercise. The logistic regression model revealed several predictive factors for activity of daily living decline among older adults. These included residence status (OR = 0.672; 95% CI 0.519–0.869; p = 0.002), age (OR = 0.307; 95% CI 0.169–0.557; p < 0.001), ethnicity (OR = 0.511; 95% CI 0.338–0.773; p = 0.001), education level (OR = 2.180; 95% CI 1.366–3.479; p < 0.001), job (OR = 0.601; 95% CI 0.447–0.810; p = 0.001), chronic disease (OR = 0.769; 95% CI 0.604–0.978; p = 0.032) and physical activity (less: OR = 0.464; 95% CI 0.300–0.720; p = 0.001; adequate: OR = 0.512; 95% CI 0.321–0.816; p = 0.005).ConclusionOur findings indicate that insufficient physical activity is particularly acute among the older adults. Physical activity has emerged as a significant predictor of decreased daily living activities among older adults. Our research underscores that less and adequate physical activity can prevent a reduction in daily living activities, in contrast to a lack of exercise. The most effective threshold for daily exercise frequency is a session per day, while the ideal exercise duration is 15 min. Additionally, the desired intensity for exercise is characterized by rapid breathing and a noticeable heartbeat, accompanied by slight perspiration. Community nurses play a pivotal role in providing health education on daily exercise to the older adults. It is crucial for nurses in community hospitals to closely monitor the daily exercise habits of the older adults, actively disseminate the benefits of exercise, and enhance their current exercise regimens through effective health education, ultimately improving their quality of life.

The effect of functional exercise program on physical functioning in older adults aged 60 years or more: A systematic review and meta-analysis of randomized controlled trials

ObjectiveIn this systematic review and meta-analysis, we assessed the impact of functional exercise training on physical functioning parameters in older adults 60 years and older. MethodDatabases including PubMed, MEDLINE, CINAHL, SPORTDiscus, and Cochrane Library were systematically searched. ResultsSixteen articles were included. Meta-analysis demonstrated that functional training significantly improved Barthel index (p = 0.01), gait speed (p = 0.002), gait cadence (p = 0.0002), Berg Balance Scale (p = 0.0003), Timed Up and Go test (TUG; p = 0.02), step length (p < 0.0001), Five Chair Stand (p < 0.0001) and physical activity questionnaire for the older adults score (p < 0.00001). However, hand grip strength remained unchanged. DiscussionThese findings underscore the significance of incorporating functional exercises in interventions for healthy aging and maintaining independence among older individuals. Further investigation is needed to explore long-term effects and optimal implementation strategies for functional exercise regimens in this populations.

Outcomes of the effect of exercise on cognitive function in patients with depression: A meta-analysis.

Major depressive disorder is a common mental disorder, characterized by a high rate of suicide and recurrence, which is frequently accompanied by cognitive impairments, particularly in executive function, memory, attention, and information processing speed. As such, improving the cognitive function in patients with depression and enhancing their quality of life are urgent issues. To perform a systematic review and meta-analysis of the effects of exercise on cognitive function in patients with depression. The PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Medical, VIP, and Biomedical Databases for randomized controlled trials (RCTs) databases were searched (from inception to October 19, 2023) for studies investigating improvements in cognitive function in patients with depression through exercise. Tools recommended by the Cochrane Handbook for RCT evaluation, and GRADEpro and Stata17 software, were employed for risk of bias assessment, evidence grading, forest plot construction, subgroup and sensitivity analyses, and assessment of publication bias. Seventeen RCTs (1173 patients with depression) were included. Exercise had a small but significant positive effect on attention, with an effect size of 0.21, 95%CI: 0.07-0.34, P < 0.01. Specifically, aerobic exercise regimens of 30-60 minute/session, thrice a week, at moderate intensity, and sustained over 3-12 weeks, were associated with the most pronounced benefits (P < 0.05), with effect sizes for executive function, memory, and information processing speed of 0.11, 95%CI: -0.11-0.32, P = 0.34; 0.08, 95%CI: 0.00-0.16, P = 0.05; and 0.14, 95%CI: 0.04-0.25, P = 0.01, respectively. The evidence levels for attention, information processing speed, and memory were rated as 'low,' whereas that for executive function was rated as 'very low'. Exercise could improve attention and information-processing speed in patients with depression, although improvements in executive function and memory are not significant.

Network meta-analysis evaluating the impact of diverse exercise regimens on quality of life in women post-breast cancer surgery.

This study used network meta-analysis to compare the effects of various exercise interventions, with the aim of identifying the most effective intervention measures. Data were extracted from 8 databases, comprising of PubMed, Web of Science, EBSCO, and Embase. The Cochrane risk of bias assessment tool was used to assess the quality of the research. Network meta-analysis and meta-analysis were performed using STATA15.0 and Review Manager 5.4, respectively. This analysis incorporated 58 research papers that had 4998 participants, of which 2480 were assigned to the test group and 2518 to the control group. As revealed by the data, the following is a descending order of the impact of various exercise regimens on the quality of life (QoL) of women who have undergone breast cancer surgery: For the MOS item short form health survey, the recommended sequence was as follows: aerobic + resistance exercise, football, baduanjin, walking, tai chi, yoga, resistance exercise, slow-moving qigong, aerobic exercise, and usual care; for functional assessment of cancer therapy for breast cancer, the sequence was as follows: aerobic + resistance exercise, resistance exercise, relaxation, baduanjin, square dance, aerobic exercise, tai chi, yoga, Pilates, mixer dance, aquatic sports, cycle ergometer, and usual care; and for European Organization for Research and Treatment of Cancer quality of life questionnaire, the sequence was aerobic + resistance exercise, aerobic + yoga, aerobic exercise, Pilates, yoga, muscle strengthening, resistance exercise, square dance, usual care, walking, and aerobic + edema massage. The majority of exercise interventions demonstrated a discernible impact on the QoL in women following breast cancer surgery. The effects of diverse exercise interventions on the 3 QoL outcome indicators in patients with breast cancer exhibited variability. However, irrespective of the QoL measurement technique used, aerobic and resistance exercise continue to be the most favorable choices.