Exercise Training Research Articles

The effect of Baduanjin on body mass and body composition of college students: A randomized controlled trial.

Previous studies have also found that Baduanjin training can improve health-related physical fitness in young adults. However, it is unclear whether Baduanjin training can improve body mass and body composition in young adults. The aim of this study was to investigate the effects of the Baduanjin training on body mass and body composition in college students. This was a single-center, randomized controlled trial comparing 12 weeks of Baduanjin exercise training group (BEG) at a frequency of 60 minutes per day, 4 days per week with no special exercise control group (CG) on the health-related physical fitness in college students. Body mass and body composition were assessed using the body mass index, waist-to-hip ratio, and Inbody 720 devices. A total of 93 college students (56 in the BEG and 37 in the CG) completed 2 body composition assessments and were included in the analysis. A mixed linear model was used to analyze the effect of the Baduanjin exercise intervention. After 12 weeks of intervention, the body mass index and waist-to-hip ratio in the BEG were significantly lower than that in the CG (P =.007 and P =.028) with a moderate effect size (Cohen d = 0.584 and 0.474) and a significant interaction effect of group by time (P =.007 and.028). The fat mass indicators of body composition including percent body fat, body fat mass, and body fat mass of both arms, both legs and trunk in the BEG were significantly lower than those in the CG (all P <.05), with a moderate effect size (Cohen d from 0.452 to 0.624) and a significant interaction effect of group by time (all P <.05); no significant differences were found in the total body composition indicators and the fat-free mass indicators of body composition between the 2 groups. Regular Baduanjin exercise training may be beneficial for improving body composition in young adults.

Lifestyle empowerment for Alzheimer's prevention prescribed by physicians: Methods and adaptations to COVID-19

The health care system is insufficiently capitalizing on the benefits of physical exercise in America's aging population. Few tools exist to help clinicians incorporate physical activity into their clinical care, and barriers limit older adults from initiating and maintaining exercise programs. The Lifestyle Empowerment for Alzheimer's Prevention (LEAP! Rx) Program has been designed to support providers and participants in lifestyle change. LEAP! Rx uses two forms of participant enrollment: physician referrals through electronic health records and self-referrals to test the efficacy of delivering a community-based exercise and healthy lifestyle program to older adults. After referral into the program, participants are randomized to receive the LEAP! Rx Program or are placed in a standard-of-care group to receive the program later. The LEAP! Rx program consists of a personalized and structured exercise program, lifestyle education, and mobile health monitoring. This includes a 12-week Empowerment phase with coaching and supervised exercise training, followed by a 40-week Lifestyle phase with intermittent supervised exercise and coaching. Lifestyle education includes monthly, evidence-based classes on optimal aging. The evaluation of LEAP! Rx focuses on 1) the assessment of implementation and scalability of the LEAP!Rx Program for clinicians and patients 2) the effect of the LEAP! Rx Program on cardiorespiratory fitness, 3) the impact of the LEAP! Rx Program on secondary intervention outcome measures of chronic disease risk factors, including insulin resistance, body composition, and lipids. If successful, this study's findings could advance future healthcare practices, providing a new and practical approach to aging and chronic disease prevention.

Effects of cardiac telerehabilitation during COVID-19 on cardiac hemodynamic and functional responses and quality of life: a randomized controlled trial

Purpose: This study aimed to assess the effects of a home-based cardiac telerehabilitation (HBCT) on cardiac hemodynamic and functional responses and health-related quality (HRQOL) of the patients undergoing percutaneous coronary intervention (PCI). Materials and methods: In this randomized controlled clinical trial, single-blinded. One hundred-fifty-five patients (mean age: 50.41±7.3 years, 41 women and 39 men) who underwent PCI were randomized into the two groups of intervention and control. The HBCT program included supervised exercise training, walking, phone calls, and a pedometer for 8 weeks. Hemodynamic changes, including systolic blood pressure (SBP) and diastolic blood pressure (DBP), resting heart rate (HRrest), maximum heart rate (HRmax), ejection fraction (EF), and rate pressure product (RPP), and functional parameters including the distance walked and metabolic equivalents (METS), also HRQOL were measured in all patients before and after the 8-week HBCT program. Results: Our results showed significant reductions in SBPrest (126.82±9.17 vs. 131.27±10.24; P =0.044), DBPrest (87.4±5.39 vs. 89.17±7.33; P=0.027), HRrest (76.15±3.01 vs. 77.65±4.16; P=0.041), HRmax (143.1±5.24 vs. 147.57±8.63; P=0.011), and RPP (9.64±0.81 vs. 10.07±0.99; P=0.007) and significant elevations in (45.75±4.31 vs. 43.5±5.21; P=0.039), distance walked (514.95±214.5 vs. 368.04±221.43; P=0.019), Mets (7.41±0.84 vs. 6.89±1.28; P=0.018), as well as HRQOL in the MCS (50.62±10.45 vs. 46.25±7.74; P=0.037), and HRQOL in the PCS (46.75±8.73 vs. 42.37±9.99; P=0.040) in the intervention group compared to the control group. Conclusion: An HBCT program consisting of supervised exercise training significantly improved hemodynamic response, exercise performance capacity, and HRQOL in patients following PCI.

The Effect of Multi-Ingredient Protein versus Collagen Supplementation on Satellite Cell Properties in Males and Females

ABSTRACT Introduction Skeletal muscle satellite cells (SC) contribute to the adaptive process of resistance exercise training (RET) and may be influenced by nutritional supplementation. However, little research exists on the impact of multi-ingredient supplementation on the SC response to RET. Purpose We tested the effect of a multi-ingredient supplement (MIS) including whey protein, creatine, leucine, calcium citrate, and vitamin D on SC content and activity as well as myonuclear accretion, SC and myonuclear domain compared with a collagen control (COL) throughout a 10-wk RET program. Methods Twenty-six participants underwent a 10-wk linear RET program while consuming either the MIS or COL supplement twice daily. Muscle biopsies were taken from the vastus lateralis at baseline and 48 h after a bout of damaging exercise, before and after RET. Muscle tissue was analyzed for SC and myonuclear content, domain, acute SC activation, and fiber cross-sectional area (fCSA). Results MIS resulted in a greater increase in type II fCSA following 10 wk of RET (effect size (ES) = 0.89) but not myonuclear accretion or SC content. Change in myonuclei per fiber was positively correlated with type I and II and total fiber hypertrophy in the COL group only, indicating a robust independent effect of MIS on fCSA. Myonuclear domain increased similarly in both groups, whereas SC domain remained unchanged following RET. SC activation was similar between groups for all fiber types in the untrained state but showed a trend toward greater increases with MIS after RET (ES = 0.70). Conclusions SC responses to acute damaging exercise and long-term RET are predominantly similar in MIS and COL groups. However, MIS can induce greater increases in type II fCSA with RET and potentially SC activation following damage in the trained state.

Exercise improves muscle mitochondrial dysfunction-associated lipid profile under circadian rhythm disturbance.

We investigated whether endurance exercise training (EXT) ameliorates circadian rhythm (CR)-induced risk factors by improving skeletal muscle (SKM) mitochondrial biogenesis, reducing oxidative stress, and modulating apoptotic protein expression. We distinguished between regular and shift workers using the National Health and Nutrition Examination Survey (NHANES) and investigated the health problems caused by shift work (CR disturbance) and the potential therapeutic effects of exercise. In our animal study, 36 rats underwent 12 weeks of CR disturbance, divided into regular and irregular CR groups. These groups were further split into EXT (n = 12) and sedentary (n = 12) for an additional 8 weeks. We analyzed SKM tissue to understand the molecular changes induced by CR and EXT. NHANES data were analyzed using SAS 9.4 and Prism 8 software, while experimental animal data were analyzed using Prism 8 software. The statistical procedures used in each experiment are indicated in the figure legends. Our studies showed that CR disturbance increases dyslipidemia, alters circadian clock proteins (BMAL1, PER2), raises apoptotic protein levels, and reduces mitochondrial biogenesis in SKM. EXT improved LDL-C and HDLC levels without affecting muscle BMAL1 expression. It also enhanced mitochondrial biogenesis (AMPK, PGC-1α, Tfam, NADH-UO, COX-I), antioxidant levels (Catalase, SOD1, SOD2), and apoptotic protein (p53, Bax/Bcl2) expression or activity in SKM. We demonstrated that shift work-induced CR disturbance leads to dyslipidemia, diminished mitochondrial biogenesis, and reduced antioxidant capacity in SKM. However, EXT can counteract dyslipidemia under CR disturbance, potentially lowering the risk of cardiovascular disorders.

EFFECTS OF EXERCISE TRAINING ON THE AUTONOMIC NERVOUS SYSTEM IN HYPERTENSION: A COMPREHENSIVE REVIEW

Background: Cardiovascular diseases, significant health burdens globally, and conditions, including prevalent heart failure and hypertension, lead to increased hospitalizations, especially in the elderly, and account for substantial medical expenditures in developed nations. The emergence of hypertension as major global health challenges has intensified the focus on understanding and managing these conditions. Central to this endeavour is the exploration of the autonomic nervous systems role, particularly sympathetic nerve activity (SNA), in the pathophysiology of these diseases.Exercise training, a key non-pharmacological approach, has shown promise in mitigating these effects and reducing CVD risks, though the exact mechanisms remain under investigation. Objectives: To evaluate the effects of exercise training on sympathetic nervous activity on hypertensive individuals Method:A comprehensive review of observational, experimental, randomized control trial, cross-sectional studies were performed. SCOPUS, Google scholar, EBSCO and PubMed were searched using the terms exercise training, autonomic nervous activity, hypertension. Result: A total of 426 studies were identified of which 13 studies were published between 2010-2023 and were included in the study. Out of 426 studies, 12 studies which were included in our study showed positive effects of exercise training on the autonomic nervous system on hypertensive individuals Conclusion: This study concluded that there is significant relation between the exercise training and autonomic nervous system in hypertension.

Effectiveness of biopsychosocial approach for subacute neck pain among geriatrics

Background: The geriatric Population faces common health challenges such as Frailty and neck Pain, which increases the risk for adverse ADL. It leads to a greater level of disability &amp; Headache risk, lower physical functioning and reduced quality of life. A Biopsychosocial Approach centred on activities, emphasizing the enhancement of Biological factors, Psychological factors and Social functional performance to achieve the goals of the Biopsychosocial Approach. This involves intensifying exercise training by leveraging the environment, conducting thorough task analysis, providing feedback and consistently repeating training sessions. Objective: To determine the effects of the Biopsychosocial Approach on Subacute Neck Pain in the geriatric population, focusing on pain, neck-specific disability and work status. Methods: 64 samples were randomly allocated into two groups. The experimental group received the Biopsychosocial Approach, which integrated biological, psychological and social aspects activity-centred, emphasizing repeated training sessions over 8 weeks. The control group underwent Conservative Management 3 days/week for the same duration. Pre and post-test assessments were conducted using the PCS, NDI and AQoL-8D. Results: The significant improvements in the experimental group compared to the control group were demonstrated by the Wilcoxon Signed Rank Test and Mann-Whitney Rank scores (p &lt; 0.001). Specifically, participants in the experimental group experienced reduced neck pain, enhanced neck function, and improved quality outcomes. The results suggest that the Biopsychosocial Approach effectively addressed the multifaceted nature of pain. Conclusion: The study provides compelling evidence supporting Biopsychosocial in reducing neck pain and improving overall quality of life among geriatric populations.

Shaping civic values of modern youth: Evaluating the influence of the international plein air as a specially organized artistic practice

Introduction. The article investigates the problem of patriotic education of modern youth. The purpose of the research is to identify and clarify the peculiarities of the influence of an international plein air as a specially organized artistic practice on the formation of modern youth civic values. Materials and Methods. The research is based on axiological and personality-centered approaches. The main research method is theoretical (reviewing regulatory documents and scholarly literature, analysis and synthesis, comparison, generalization and data interpretation). In addition, a practical method was used (students performing search and short-term training exercises, as well as long-term artistic compositions). The project of the International Art Competition called ‘Without Borders’ that is analyzed in the article is a new format of an online professional Internet competition for students majoring in Arts for partner pedagogical universities. Results. The article analyzes the results of the international project on patriotic education and formation of civic values in modern students, implemented within the framework of cooperation between pedagogical universities of Belarus and Russia. The study convincingly proves that it is the plein air that provides an effective environment for developing students’ artistic and creative skills, implementing patriotic education of students, as well as contributes to shaping their readiness to organize patriotic educational activities in the future. Conclusions. The article concludes about the specifics of the influence of the international plein air as a specially organized artistic practice on the formation of modern students’ civic values.

Whole-body-electro-myostimulation for the care of inclusion body myositis-A case report.

External muscle stimulation, possibly combined with active muscle contraction, could improve physical functioning and performance in inclusion body myositis. Inclusion body myositis (IBM) is a chronic, progressive inflammatory muscle disease with largely unknown causes. It typically affects men more than women, usually beginning in the latter half of life. IBM leads to muscle weakness and wasting, especially in the arms and legs, which significantly impairs daily functioning and complicates participation in exercise training. Few studies have examined the impact of physical training on fitness, inflammation markers, and quality of life in IBM patients. The patient, a Caucasian male (78.3 kg, 174.0 cm, born October 1948), was diagnosed with IBM in October 2011. From October 2017 to September 2019, he underwent exercise training focused on external muscle stimulation combined with active muscle contractions. Regular assessments included cardiopulmonary exercise testing, functional tests (6-min walking test, modified timed up and go test, modified chair rise test), lung function exams, blood parameters, body composition, and quality of life questionnaires. The decline in physical fitness may have been slowed during the intervention period, as indicated by some improvements like peak oxygen uptake and the functional test results while other parameters remained unchanged or declined like peak power output, fat-free mass or lung functioning. However, a recurrence of his prostate cancer after treatment with androgen deprivation therapy may have led to further declines and thus increased muscle wasting. The data may suggest that supportive exercise programs focusing on external muscle stimulation, possibly combined with active muscle contraction, might improve physical functioning, exercise performance, and quality of life in IBM management.

Genomic predictors of fat mass response to the standardized exercise training.

To explore the genetic architecture underlying exercise-induced fat mass change, we performed a genome-wide association study with a Chinese cohort consisting of 442 physically inactive healthy adults in response to a 12-week exercise training (High-intensity Interval Training or Resistance Training). The inter-individual response showed an exercise-induced fat mass change and ten novel lead SNPs were associated with the response on the level of P<1×10-5. Four of them (rs7187742, rs1467243, rs28629770 and rs10848501) showed a consistent effect direction in the European ancestry. The Polygenic Predictor Score (PPS) derived from ten lead SNPs, sex, baseline body mass and exercise protocols explained 40.3% of the variance in fat mass response, meanwhile importantly the PPS had the greatest contribution. Of note, the subjects whose PPS was lower than -9.301 had the highest response in exercise-induced fat loss. Finally, we highlight a series of pathways and biological processes regarding the fat mass response to exercise, e.g. apelin signaling pathway, insulin secretion pathway and fat cell differentiation biological process.

ВЗАИМОСВЯЗЬ УТОЛЩЕНИЯ СВОДА СТОПЫ И РАЗВИТИЯ ЦНС У ДЕТЕЙ. (ОБЗОР ЛИТЕРАТУРЫ)

Today, the World Health Organization believes that musculoskeletal disorders in children occupy a leading position. According to statistics provided by Russian orthopedists over the past year, 24.2 - 67.3% of schoolchildren, depending on the region, have longitudinal or transverse flat feet. The second most common disorder in children is developmental disorders in the field of intellectual activity. Motor activity is a natural need for people to move. Intellectual development is understood as a set of various cognitive functions of an individual in society: from thinking, as well as perception, to the imagination and thinking of a person. Therefore, studying the relationship between the musculoskeletal and nervous systems in children is an important task of our time. The purpose of our study was to assess the relationship between thickening of the arch of the foot and the development of the central nervous system in children, through the prism of scientific works of orthopedists, pediatricians, neurologists and psychologists. Our review of the literature proves the importance of studying this problem and the need for a clinical study. To improve diagnostics, it is necessary to create a combined universal assessment system that will allow comparing results and conducting a mathematical analysis of the initial state of the musculoskeletal system and intellectual level in children, as well as to analyze changes in the course of therapy. Also, in our opinion, it is necessary to develop a set of exercises for therapeutic physical training that will not only strengthen muscles, form the arches of the feet, but also simultaneously train the frontal lobes of the brain, which will enhance concentration and develop memory. Therefore, we consider it necessary to expand the range and conduct extensive studies with a large sample size.

Limb-girdle muscular dystrophies: A scoping review and overview of currently available rehabilitation strategies.

Limb-girdle muscular dystrophies (LGMDs) constitute a diverse group of inherited disorders primarily affecting skeletal muscle. Despite the absence of cures, rehabilitative treatments offer potential for preventing and mitigating loss of muscle strength. However, the role of exercise training in LGMD patients remains contentious. This review aims to provide an overview of the currently available motor rehabilitation strategies for the most common subtypes of LGMD. To identify relevant articles, we performed a systematic search in PubMed, Embase, Cochrane Library, and Web of Science, focusing on muscular and respiratory interventions. The search resulted in 560 potentially relevant articles, of which 16 were included in the review. Eight studies concentrated on neuromuscular functional rehabilitation therapy programs, seven combined both neuromuscular rehabilitation and interventions to maintain or enhance respiratory functionality and one focused on respiratory intervention only. Altogether, the papers examined offered a comprehensive view on the rehabilitative strategies available and provided an indication of the most valuable practices to deal with patients' health and needs. Upon analysis, we conclude that, when tailored to individual needs, muscle training can enhance strength and functional abilities, positively impacting psychological well-being. However, generic protocols may lead to limited benefits, fatigue, pain, and compliance issues. Moreover, early management of respiratory symptoms and personalized respiratory physiotherapy can enhance patients' well-being and their capability to participate in muscle training exercises. Future studies should not only refine rehabilitation approaches but also assess their impact on patients' quality of life, including psychological factors like depression and self-esteem.

Exercise training ameliorates carbon tetrachloride-induced liver fibrosis and anxiety-like behaviors.

Chronic liver diseases and cirrhosis are associated with mood disorders. Regular exercise has various beneficial effects on multiple organs, including the liver and brain. However, the therapeutic effect of exercise on liver fibrosis concomitant with mood disorders, such as anxiety, has not been evaluated. In this study, the effects of exercise training on liver fibrosis-related anxiety-like behaviors were evaluated. Male C57/BL6 mice were divided into four groups: vehicle-sedentary, vehicle-exercise, carbon tetrachloride (CCl4)-sedentary, and CCl4-exercise. Liver fibrosis was induced by CCl4 administration for 8 weeks, exercise was applied in the form of voluntary wheel running. After intervention, anxiety-like behavior was assessed using the elevated plus maze. CCl4 increased liver and serum fibrotic markers, as measured by blood analysis, histochemistry, and qRT-PCR, and these changes were attenuated by exercise training. CCl4 induced anxiety-like behavior, which was ameliorated by exercise training. In the hippocampus, CCl4-induced changes in mRNA and protein levels of factors related to anxiety, including BDNF and nNOS, were reversed by exercise. These results suggested that hepatic fibrosis-related anxiety-like behaviors are induced by excess hippocampal nNOS, and the beneficial effects of exercise were mediated by increases in BDNF and reductions in nNOS. The percentage of fibrotic area was negatively correlated with anti-anxiety behavior and positively associated with hippocampal nNOS protein levels. Liver fibrosis-related anxiety-like behaviors could be alleviated through the regulation of hippocampal BDNF and nNOS via exercise training. These results support the therapeutic value of exercise by targeting the mechanisms underlying liver fibrosis and associated anxiety.

Exercise-changed gut mycobiome as a potential contributor to metabolic benefits in diabetes prevention: an integrative multi-omics study

ABSTRACT Background The importance of gut microbes in mediating the benefits of lifestyle intervention is increasingly recognized. However, compared to the bacterial microbiome, the role of intestinal fungi in exercise remains elusive. With our established randomized controlled trial of exercise intervention in Chinese males with prediabetes (n = 39, ClinicalTrials.gov:NCT03240978), we investigated the dynamics of human gut mycobiome and further interrogated their associations with exercise-elicited outcomes using multi-omics approaches. Methods Clinical variations and biological samples were collected before and after training. Fecal fungal composition was analyzed using the internal transcribed spacer 2 (ITS2) sequencing and integrated with paired shotgun metagenomics, untargeted metabolomics, and Olink proteomics. Results Twelve weeks of exercise training profoundly promoted fungal ecological diversity and intrakingdom connection. We further identified exercise-responsive genera with potential metabolic benefits, including Verticillium, Sarocladium, and Ceratocystis. Using multi-omics approaches, we elucidated comprehensive associations between changes in gut mycobiome and exercise-shaped metabolic phenotypes, bacterial microbiome, and circulating metabolomics and proteomics profiles. Furthermore, a machine-learning algorithm built using baseline microbial signatures and clinical characteristics predicted exercise responsiveness in improvements of insulin sensitivity, with an area under the receiver operating characteristic (AUROC) of 0.91 (95% CI: 0.85–0.97) in the discovery cohort and of 0.79 (95% CI: 0.74–0.86) in the independent validation cohort (n = 30). Conclusions Our findings suggest that intense exercise training significantly remodels the human fungal microbiome composition. Changes in gut fungal composition are associated with the metabolic benefits of exercise, indicating gut mycobiome is a possible molecular transducer of exercise. Moreover, baseline gut fungal signatures predict exercise responsiveness for diabetes prevention, highlighting that targeting the gut mycobiome emerges as a prospective strategy in tailoring personalized training for diabetes prevention.

Comprehensive Approach to Training English Communicative Competence in Chemistry

Abstract The development of foreign language professional communicative competence (FLPCC) is crucial for professionals, considering communicative skills as an integral part of their competence. In Kazakhstan, acquiring a foreign language is a prerequisite for advancing chemistry education, enabling students to access global scientific advancements and exchange knowledge. Content and language-integrated learning (CLIL) stands out as an effective approach for cultivating FLPCC in future chemistry teachers. This study addresses the scarcity of theoretical and practical tools in content-language integrated learning in pedagogical universities. It aims to enhance the training quality for pedagogy bachelor’s degree students studying chemistry in a foreign language. By identifying active teaching forms, methodologies, and approaches in integrated learning, students’ foreign language competence can be successfully developed within the professional domain. A meticulously designed training model and exercises were developed to achieve these goals. The proposed modeling approach was evaluated using the Quasi research method, involving questionnaire data analysis. The results confirm that implementing this approach significantly improves future chemistry professionals’ training quality, enabling confident communication in English within their professional domains and demonstrating well-developed speaking skills. The practical value of this research extends to university educators implementing CLIL practices and researchers studying students’ FLPCC formation.

Effects of a 4–Week Detraining Period After 12 Weeks of Combined Training Using Different Weekly Frequencies on Health–Related Physical Fitness in Older Adults

Background: Detraining refers to the decline in physical fitness that occurs after the cessation of exercise, compromising the adaptations resulting from regular exercise training. To understand how long the benefits acquired from an exercise program can be maintained, the present study evaluated the detraining effects of a 4–week exercise cessation period in older adults who performed combined training at various weekly frequencies for 12 weeks. Methods: This randomized controlled trial assigned participants to one of two training programs: a combined training program twice a week (CT2) or four times a week (CT4) over a period of 12 weeks, followed by a four–week detraining period. The resistance training consisted of six bodyweight exercises, while the aerobic training involved either walking or running. Both the CT2 and CT4 groups completed the same total training volume and overload each week; the only difference was the number of training sessions per week. Assessments were conducted at baseline, after the training period, and after the detraining period, and included the 30–s and five–repetition chair–stand tests, isometric handgrip strength, body mass index (BMI), waist circumference, and waist–to–height ratio. Results: Thirty–one participants completed the study (CT2: 17 and CT4: 14). The groups presented similar attendance records during the training period (CT2: 96 ± 18% versus CT4: 94 ± 19%). After the 12–week training period, CT2 and CT4 improved lower limb strength, CT2 improved upper limb strength, and CT4 reduced waist circumference and waist–to–height ratio compared to baseline. After the 4–week detraining period, the lower limb strength remained improved in both groups (CT2: 4 ± 1 repetition; p &lt; 0.001 and CT4: 4 ± 1 repetition; p &lt; 0.001) when compared to the corresponding baseline values. The handgrip strength decreased in CT2 compared to post–training values. And the body composition benefit in CT4 was not sustained after detraining. Conclusions: The effects of 4 weeks of detraining after 12 weeks of training performed two or four times per week are similar on some but not all health-related physical fitness parameters.

The impact of exercise training in Fontan procedure patients: a systematic review and meta-analysis

Abstract Background Patients undergoing the Fontan procedure experience long-term complications related to decreased exercise capacity. Exercise training(ET) has emerged as a non-pharmacological solution for increasing cardiorespiratory fitness. However, the effect and safety of exercise training in patients following the Fontan procedure are still unclear. Objectives We aimed to perform a meta-analysis comparing ET versus no exercise intervention for patients following Fontan operation in efficacy and safety outcomes. Methods We systematically searched PubMed, Embase, and Cochrane databases on November 23, 2023, for randomized controlled trials (RCTs) comparing ET, including aerobic, endurance, or inspiratory muscle training, versus no exercise intervention in patients following Fontan operation. We computed mean differences (MD) with a 95% confidence interval (CI) for continuous endpoints. The primary endpoint was (1) peak O2 consumption. Our study also included the secondary endpoints of: (2) maximum workload; (3) peak heart rate(HR); and (4) peak saturation of O2. We performed a subgroup analysis between different exercise therapies. Results This meta-analysis included five RCTs and 154 patients. Follow-up ranged from 3 to 6 months. Regarding ET, two studies used aerobics, one used endurance, and three used inspiratory muscle therapy as exercise therapy for patients with Fontan operations. Our findings on the maximum workload endpoint were more significant for exercise therapy (MD 20.98W; 95% CI 5.32 to 36.65; p&amp;lt;0.01; Fig. 1A) compared to no intervention group. However, there was no significant difference in peak oxygen (MD 2.03 ml/kg/min; 95% CI -0.29 to 4.35; p=0.095; Fig. 1B), peak HR (MD 1.10 bpm; 95% CI -4.07 to 6.27; p=0.68); and peak saturation of O2 (MD 0.39%; 95% CI -1.93 to 2.72; p=0.74). A subgroup analysis between different ET types (aerobic vs. endurance vs. inspiratory muscle training) showed no significant subgroup interaction(p=0.91; Fig. 1B). Conclusion In this meta-analysis, ET is associated with a slight increase in maximum workload in patients following the Fontan procedure. Further multicenter RCTs are warranted to assess the efficacy of comparing different types of ET and their impact on peak oxygen consumption.

Physical activity habits among members of the Athens Medical Society in Greece

Abstract Introduction Benefits of regular physical activity and exercise are well documented. Healthcare workers play a crucial role in counseling and appropriately referring their patients to adopt physical activity. However, doctors’ exercise habits range between different medical specialties and health service infrastructure. Purpose In this study, we assess physicians’ exercise performance according to the recommendations of 2020 ESC Guidelines. Methods The population of this cross-sectional study comprised 742 physicians of the Athens Medical Society (AMS), Greece. The study instrument was a self-administered questionnaire mailed in October 2023 to investigate physicians’ exercise habits, baseline characteristics of population, specialty, and health service infrastructure [Greek National Healthcare System (GNHS) or Private Practice (PP)]. European Society of Cardiology (ESC) Guidelines recommend at least 150 min/week of moderate-intensity exercise in all healthy adults. Subjects were divided in two groups according to their compliance to ESC Guidelines: 1. Moderate-intensity endurance exercise training per week ≥ 150 min (Group A); 2. Moderate-intensity endurance exercise training per week &amp;lt;150 min (Group B). Results The recommended exercise training per week goal is achieved by the majority of AMS members (53.4%) with an estimated mean exercise endurance training time of 240 ± 285 minutes. Between Group A and Group B there was no difference in age (50±12years vs. 50±13years, p=0.73), whereas there was significant difference in male sex prevalence (58% vs. 43%, p &amp;lt;0.001), in Body Mass Index (24.7 ± 3.8 kg/m2 vs. 26.2 ± 4.7 kg/m2, p &amp;lt;0.001), in Smoking habits (17.4% vs. 23.5%, p=0.04), in diabetes mellitus incidence (6.6% vs. 11.8%, p= 0.01) and in the use of activity monitoring wearables (45.2% vs. 29.8%, p&amp;lt;0.001). Interestingly, there was significant difference between GNHS and PP doctors representation in Group A and B with more doctors in the PP categorized in the Group A (p=0.008) (Figure 1). Importantly, logistic regression analysis revealed that even after adjustment for the aforementioned confounders there was significant under-representation of the GNHS in the Group A or otherwise doctors in the GNHS have 33% decrease odds of achieving the recommended exercise training per week (Odds Ratio: 0.676, 95%CI 0.484, 0.943, p=0.02) (Table 1). Conclusion A significant proportion of the AMS members follows the recommended ESC guidelines for minimum exercise training per week. Several factors affect their adherence to exercise time recommendation. Interestingly, AMS doctors working on the GNHS independently of other factors are less adherent to exercise recommendations. These findings emphasize the need to strengthen prevention strategies to AMS.

Cardiac rehabilitation and prescription exercise training for heart failure’s patients

Cardiovascular rehabilitation is a multidisciplinary approach that includes exercise instruction, reduction of cardiac risk factors, psychosocial assessment, and result evaluation. Cardiovascular rehabilitation (CR), which includes exercise training, has been shown to significantly improve people with heart failure's quality of life, functional ability, and hospitalizations for heart failure-related conditions. There are so many benefits that are crucial for patients that they must be implemented fully in every health center. The objective for all healthcare practitioners must be to include CR in the regular, normal management of HF patients. Keyword: cardiac rehabilitation, exercise, exercise training, heart failure

A prehabilitation programme is feasible and acceptable for mild-to-moderately frail patients undergoing cardiac surgeries

Abstract Background Preoperative frailty is a strong prognostication in cardiac surgical patients to predict poorer health outcomes. Intervening at the preoperative stage through prehabilitation is gaining increasing research attention. Previous studies tested a single frailty-reversing strategy, either nutritional or exercise, the exercise protocols were mainly aerobic-focused, which deviates from the exercise prescription principles suggested for frailty management, rendering an effective prehabilitation intervention is yet to be developed in cardiac surgical patients. Purpose This study aimed to examine the preliminary effects and explore the feasibility of a multi-component frailty-specific prehabilitation programme for mild-to-moderately frail patients undergoing cardiac surgeries/procedures. We hypothesised that compared with patients who receive usual care, patients awaiting cardiac surgeries who participate in the prehabilitation programme would have improved functional capacity, frailty status, quality of life and psychological outcomes, increased serum albumin and reduced C-reactive protein. Methods This study adopted a mixed-method design comprising a pilot randomised controlled trial and a qualitative study. Adult patients with a Clinical Frailty Scale score between 4 and 6, waiting for coronary artery bypass grafting surgery and/or valve repair/replacement, with at least 5 weeks of procedural waiting time and without contraindications for exercise were recruited. They were randomized in a 1:1 ratio to receive the prehabilitation programme or usual care. The programme comprised a structured preoperative education, nutritional optimization, stress management; and a multi-component exercise training with 3 sessions/week and 60 minutes/session. The exercise training lasted at least 4 weeks and maintained throughout the preoperative period. Results Twenty participants were randomized into the intervention (n = 11) or control (n = 9) group. The programme was feasible, acceptable and no severe adverse events were recorded. The lost to follow-up rate was 7.9%, and the overall attendance was 96%. The intervention group showed significantly greater improvement in functional capacity, frailty status and psychological outcomes than the control group at post-intervention. Participants gave positive comments about the programme and its delivery mode. They expressed that the one-on-one home-based practice enabled them greater confidence to overcome kinesiophobia. Two participants voiced out the preference for exclusive home-based training, rather than having hospital-based training in the first two weeks. Conclusion(s) The prehabilitation programme is feasible and acceptable for patients waiting for cardiac surgeries. It improves the functional performance, frailty status and psychological outcomes in these patients. A full-scale randomised controlled trial is warranted to investigate its longer-term and clinical effects.