General Exercise Training Research Articles

Can general exercise training and pelvic floor muscle training be used as an empowering tool among women with endometriosis? Experiences among women with endometriosis participating in the intervention group of a randomized controlled trial

BackgroundThe potential benefit of exercise in alleviating symptoms of endometriosis is unclear. Still, exercise may be used to empower women and manage disease symptoms. The purpose of this study was to explore how regular supervised group- and individual exercise training, including pelvic floor muscle training (PFMT), is experienced among women with endometriosis after participating in a randomized controlled trial (RCT).MethodsAmong 41 women randomized to exercise training for four months, ten women were interviewed about their experiences with exercise training after participation in the trial. The weekly group training was led by women’s health physiotherapists and included individualized and progressive muscular strength training of large muscle groups and the pelvic floor muscles, in addition to endurance-, flexibility, and relaxation training. An individual training program followed the same principles as the group training and was to be performed 3–5 times per week, depending on the level of intensity. PFMT was recommended daily. The women also received a group pain management course emphasizing exercise training as self-management. Using inductive reflexive thematic analysis, responses to the question “Did participation in the study change your view of exercise as part of the treatment for endometriosis?“ were analyzed.ResultsThe women brought forward the importance of knowledge about the benefits of exercise to make informed decisions in disease management. Further, the women described how exercise training was perceived as less frightening and manageable when exposed to various intensities, dosages, and types of exercises in a safe and supportive environment. PFMT was especially brought forward as something new and appreciated, and for some of the women, to be performed on days when their bodies could not handle the general exercise training. They also expressed that the supervised exercise brought an extra dimension of belonging through group participation.ConclusionsIndividualization and regular supervision seem important to empower women with knowledge about exercise training as self-management and to experience exercise training as safe and non-threatening. Further, creating a sense of belonging through group training may improve social support and build active coping strategies that are essential for disease management of endometriosis.Trial registrationNCT05091268 (registered 23.09.2021).

Effect of Inspiratory Muscle Training on Cough Strength in Older People With Frailty: A Single-Blind Randomized Controlled Trial

ObjectiveTo investigate the effect of inspiratory muscle training (IMT) on cough strength in older people with frailty. DesignSingle-blind randomized controlled trial. SettingDay health care centers at 2 sites. ParticipantsOlder people with frailty (N=60). InterventionsEligible people were randomly assigned to receive IMT program in addition to general exercise training (IMT group), or general exercise training alone (control group). The IMT group performed training using a threshold IMT device with the load set at 30% of maximum inspiratory mouth pressure in addition to the general exercise training program throughout the 8 weeks. The IMT took place twice a day and each session consisted of 30 breaths. Main Outcome MeasuresPrimary outcome was cough strength, measured as the cough peak flow (CPF), at the beginning and the end of the program. ResultsData from 52 participants (26 in each group) were available for the analysis. The mean age was 82.6 years; 33% were men. The change in CPF at the end of the program was 28.7±44.4 L/min in the IMT group and −7.4±26.6 L/min in the control group. A linear regression model showed that the presence or absence of IMT was associated with changes in CPF (mean difference between groups, 36.3; 95% confidence interval, 16.7-55.9; effect size, 0.99). ConclusionsIMT may be a useful intervention to improve cough strength in frail older people.

What improvements do general exercise training and traditional Chinese exercises have on knee osteoarthritis? A narrative review based on biological mechanisms and clinical efficacy.

Knee osteoarthritis (KOA) is a disease that significantly affects the quality of life of patients, with a complex pathophysiology that includes degeneration of cartilage and subchondral bone, synovitis, and associations with mechanical load, inflammation, metabolic factors, hormonal changes, and aging. This article aims to comprehensively review the biological mechanisms and clinical effects of general exercise training and traditional Chinese exercises (such as Tai Chi and Qigong) on the treatment of KOA, providing references for the development of clinical exercise prescriptions. A systematic search of databases including PubMed, Web of Science, Google Scholar, and China National Knowledge Infrastructure (CNKI) was conducted, reviewing studies including randomized controlled trials (RCTs), observational studies, systematic reviews, and meta-analyses. Keywords included "knee osteoarthritis," "exercise therapy," "physical activity," and "traditional Chinese exercise." General exercise training positively affects KOA by mechanisms such as promoting blood circulation, improving the metabolism of inflammatory factors, enhancing the expression of anti-inflammatory cytokines, and reducing cartilage cell aging. Traditional Chinese exercises, like Tai Chi and Qigong, benefit the improvement of KOA symptoms and tissue repair by regulating immune function and alleviating joint inflammation. Clinical studies have shown that both types of exercise can improve physical function, quality of life, and pain relief in patients with KOA. Both general exercise training and traditional Chinese exercises are non-pharmacological treatment options for KOA that can effectively improve patients' physiological function and quality of life. Future research should further explore the long-term effects and biological mechanisms of these exercise interventions and develop personalized exercise programs based on the specific needs of patients.

The Effect of Aerobic and Resistance Exercise after Bariatric Surgery: A Systematic Review

Understanding the optimal time, length, intensity, and type of exercise program for bariatric surgery patients is crucial due to increased obesity prevalence and the number of performed bariatric procedures. Our aim for this review is to identify the effects of exercise on all aspects of health regarding the most recent and randomized studies. A total of 120 articles were reviewed through PubMed. As a result of the research, 11 studies that met the inclusion criteria were included. A quality analysis and a risk of bias assessment of the trials included in this systematic review were performed using the Physiotherapy Evidence Database (PEDro) scoring and classification system. Narrative syntheses were given for this systematic review. The articles’ intervention description, outcomes, and results are given in detail in the Results Section. Most exercise interventions were carried out in the post-op stage in bariatric surgery patients. Only two studies were conducted before the scheduled procedure. Overall, aerobic training (AT) and resistance training (RT) combined exercise programs effectively improved clinical parameters, including cardiac function, lower extremity function, muscle strength and endurance, cardiovascular parameters, and functionality. Exercise training caused no additional effects on inflammation and endothelial dysfunction biomarkers. In the literature, no research identifies the effects of only AT on bariatric surgery patients. Therefore, this aspect should be considered when interpreting all the studies’ results. In conclusion, there is a need for research to examine only AT in bariatric surgery patients and for general exercise training studies, including better randomization and quality.

The Western and Chinese exercise training for blood pressure reduction among hypertensive patients: An overview of systematic reviews.

Hypertension remains the world's leading cause of premature death. Interventions such as exercise, diet modification, and pharmacological therapy remain the mainstay of hypertension treatment. Numerous systematic reviews and meta-analyses demonstrated the effectiveness of western exercises, such as aerobic exercise and resistance exercise, in reducing blood pressure in hypertensive patients. There is recently emerging evidence of blood pressure reduction with Chinese exercises, such as Tai Chi, Baduanjin, and Qigong. The current overview of systematic reviews aims to evaluate the quality and descriptively summarize the evidence for the effectiveness of western and Chinese exercises for hypertension management. Thirty-nine systematic reviews were included in this overview, with 15 of those being on Chinese exercise. Evidence suggests that exercise training, regardless of Western or Chinese exercise, generally reduced both systolic and diastolic blood pressure. High-intensity intermittent training did not further reduce blood pressure when compared to moderate-intensity continuous training. Conflicting results on the effectiveness of blood pressure reduction when comparing Chinese and Western exercise training were observed. This suggests the comparable effectiveness of Chinese exercise training, in particularly Tai Chi, to general or aerobic exercise training in terms of blood pressure reduction. The Chinese exercise modality and intensity may be more suitable for the middle-aged and elderly population.

Neuromuscular Aging: A Case for the Neuroprotective Effects of Dancing

Aim: We planned a cross-sectional investigation (study 1) and a longitudinal training intervention (study 2) to investigate whether recreational dancing affords greater neuroprotective effects against age-related neuromuscular junction (NMJ) degeneration compared to general fitness exercise training. Methods: In study 1, we recruited 19 older volunteers regularly practising dancing (older dancers [OD]) and 15 recreationally physically active older individuals (OA) and physical performance, muscle morphology, muscle function, and NMJ stability (from serum C-terminal agrin fragment [CAF] concentration) were assessed. In study 2, employing a longitudinal study design in a different cohort (composed of 37 older adults), we aimed to study whether a 6-month dancing intervention decreased CAF concentration compared to general fitness exercise training in older adults. Results: Our findings show that OD had a lower CAF concentration (suggesting an increased NMJ stability) compared to OA. This result was accompanied by superior functional performance despite no differences in muscle size. In study 2, we observed a reduction in CAF concentration only in the dancing group. Conclusion: Overall, these findings suggest that dancing is an effective training modality to promote neuroprotection and increase muscle function in healthy older individuals.

Characteristics of transplant athletes competing at national and international transplant games

ObjectiveTo describe the characteristics of athletes with solid-organ transplants (TxA) attending the British and World Transplant Games.Methods220 TxA completed an online survey to explore transplant history, medications, training advice and...

An Exercise Training and Healthy Eating Group Program (ATHENA) for Overweight and Obese Women with Urinary Incontinence: An Intervention Description.

Background: Despite strong evidence for supervised pelvic floor muscle training (PFMT) for women with urinary incontinence (UI), and weight loss and exercise for overweight and obese women with UI, implementation literature on these combined interventions is limited. This paper aimed to describe the rigorous and systematic processes involved in the collaborative development, implementation, refinement and evaluation of a novel, holistic 12 week exercise training and healthy eating group program (ATHENA) for overweight and obese women with UI. Methods/Design: This intervention description paper is part of a larger mixed-methods feasibility study of implementing the ATHENA intervention within a physiotherapy service at a public hospital in Australia. The collaborative intervention design had input from clinicians, researchers and a consumer representative. Results: The intervention involved four evidence-based components—(1) supervised PFMT; (2) general exercise training; (3) pelvic health education; and (4) healthy eating education—delivered face to face over a 12 week period. Supporting resources developed included a Facilitator’s Guide and Participant Workbook. Conclusion: ATHENA is an evidence-based, multifaceted, group-based intervention targeting exercise training and healthy eating for management of UI for overweight and obese women. The structured development process and transparency of intervention content and resources aims to enhance practical application and success in future studies.

Systematic review on the effect of core stability training for the patients with non-specific low back pain

Objective To systematically evaluate the rehabilitation efficacy of core stability training versus general exercises or manual therapy in patients with non-specific low back pain. Methods The Medline, EMBASE, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL) , PsycINFO, China Biology Medicine (CBM) , CNKI, VIP and Wanfang database were searched by computer, and the retrieval time was from the establishment of the database to 20th October, 2018. All randomized controlled trials (RCT) and clinical control studies of the rehabilitation effects of core stability training on patients with non-specific low back pain were collected. According to the inclusion and exclusion criteria, 2 researchers independently searched the literature, screened the literature and evaluated the quality of the included literature. And the data were extracted for Meta-analysis using Revman 5.3 software. Results A total of 14 articles were included, all of which were RCTs. The results of Meta-analysis showed that the comparison of pain improvement between core stability training group and general exercise training group was (Z=4.67, P 0.05) . Conclusions The core stability training group and manual therapy group can effectively reduce pain in patients with non-specific low back pain, and core stability training can promote the relief of dysfunction in patients with non-specific low back pain, and core stability training should be encouraged as part of musculoskeletal rehabilitation for patients with non-specific low back pain. Key words: Meta-analysis; Rehabilitation; Pain; Core stability training; Low back pain; Systematic review

Effect of Group Counseling Plus Tailored Exercise on Mobility Function in Multiple Sclerosis.

Multiple sclerosis (MS) impairs muscular function and limits individuals' ability to perform everyday activities requiring mobility. People with MS frequently exhibit mobility problems (ie, slower walking speed, shorter strides). General exercise training (eg, resistance, aerobic) provides modest physiological and walking mobility benefits. However, researchers suggest tailoring of interventions to address mobility specifically. We conducted a phase 2a pre-post intervention development study (Obesity-Related Behavioral Intervention Trials [ORBIT] intervention development model) of mobility exercise plus cognitive behavioral counseling to improve function and social cognitions known to encourage exercise. The intervention was conducted twice per week for 8 weeks followed by 1 month of self-managed mobility exercise. Participants (N = 29; mean ± SD age = 52.24 ± 11.36 years, mean time since MS diagnosis ≥11 years) were assessed at baseline and after follow-up for mobility function, social cognitions, and intervention fidelity indicators. Results indicated significant improvements in a variety of valid measures of mobility function (eg, 400-m walk), self-regulatory efficacy for mobility exercise and symptom control, and fidelity measures with small to medium effect sizes. Positive findings suggest that the intervention seems to merit testing as a randomized pilot study following the ORBIT model.

Beta event-related desynchronization can be enhanced by different training programs and is correlated with improved postural control in individuals with Parkinson's disease.

The purpose of this study was to investigate the effects of a specific exercise (SE) training program focusing on balance and muscle strengthening and a turning-based treadmill (TT) training program on cortical desynchronization and postural control in Parkinson's disease (PD). Eighteen patients with PD were recruited and randomly assigned to the SE group, TT training group or control exercise (CE) group and participated in 12 30-min training sessions focusing on balance and strengthening, turning-based treadmill training, or general exercise training, respectively, followed by 10 minutes of over-ground walking in each session for 4 to 6 weeks. The outcomes included alpha event-related desynchronization (ERD), beta ERD, postural control ability indicated by postural instability and gait disorder (PIGD), the step/quick turn test (SQT), and the sensory organization test (SOT). All measurements were assessed at baseline and after training. The results (n=6 for each group) showed that both the SE and TT groups had improved beta ERD, but not alpha ERD, in the Cz area, PIGD score, and turn sway/time in the SQT compared with the CE group. Furthermore, postural control ability was positively correlated with beta ERD in the Cz area. However, there was no significant correlation between SOT total score and alpha ERD in the Cz area. This study showed that beta ERD in the central area and postural control can be improved with balance training, along with lower extremity muscle strengthening exercise and turning-based treadmill training, in patients with PD. Furthermore, improvement in beta ERD in the central area correlated with improvements in postural control ability. This trial was registered at http://www.anzctr.org.au/ (ACTRN12616000198426).

Effect of General Versus Specialized Exercises on Movement Control of Lumbo- Pelvic Region in Subjects with Chronic Low Back Pain

Research background and hypothesis. Low back pain is a huge problem in the world. One of the main reasons why the low back pain problems arise is lumbo-pelvic motor control dysfunction. Specialized exercises are the basis of physical therapy for low back pain patients. Hypothesis: specialized exercises can be more effective for movement control of lumbo-pelvic region in subjects with chronic low back pain.Research aim was to assess the effect of general versus specialized exercises for movement control of lumbo-pelvic region in subjects with chronic low back pain.Research methods. The study involved 60 subjects with chronic low back pain, 29 women and 31 men, aged 21.5 years on average. All subjects were submitted to the Low Back Pain Duration and Beacke Habitual Physical Activity Assessment questionnaires (Baecke et al., 1982). Lumbo-pelvic motion control was evaluated by six Hannu Luomajoki movement control tests (Luomajoki et al., 2008). Specialized and general training programs were prescribed and performed under supervision of physical therapist. Video materials expert analysis was used for the evaluation of the study data.Research results. The results showed that a specialized training program was more effective than general exercises in improving movement control in lumbo-pelvic region for patients with low back pain.Discussion and conclusions. General exercise training program for general exercise group had no effect for all test results. Specialized exercise training program results showed that lumbo-pelvic movement control improved in five of the six control tests (p < 0.05).Keywords: motor control, physical therapy program, stability, mobility.

Study regarding the use of gymnastics - related alternative methods during the physical education class

The improvement of motor qualities and skills represents the main concern of the Physical Education lesson. In the present paper we present a general motor exercise training routine, designed as an alternative to the traditional approach of the PE lessons. The routine was divided into three components, namely a cross fit exercise routine, an aerobics routine and an acrosport routine. This routine was implemented in the 5th grade syllabus. The test group was represented by 207 pupils, out of which 114 girls (55.07%) and 93 boys (44.93%). Most participants came from rural areas (66.18%) and 33.82% came from urban areas. The routine was implemented during the first semester of the current school year (2017-2018) in one of the two compulsory lessons. The topics from the traditional PE lesson were replaced by the proposed routines and used alternatively. The assessment consisted of 4 tests from the national assessment system. The results showed significant progress obtained in the final tests for all the 4 trials used (p < 0,001).

Resistance training vs general physical exercise in multidisciplinary rehabilitation of chronic neck pain: A randomized controlled trial.

To investigate whether progressive resistance training using elastic resistance bands improves neck-related disability more than general physical exercise in multidisciplinary rehabilitation of chronic neck pain. Researcher-blinded, randomized controlled trial. A total of 59 patients with non-specific, chronic neck pain (mean age 46 years, disability (Neck Disability Index 0-100): 35.4, worst neck pain last 2 weeks (numerical pain rating scale 0-10): 6.3) were randomized to 3-week multidisciplinary rehabilitation including either general physical exercise or progressive resistance training with elastic bands. Participants were instructed to continue their respective home-based training programmes for 9 additional weeks. Outcomes were assessed at baseline, after 3 weeks and after 12 weeks. Primary outcome was the between-group difference in change in the Neck Disability Index from baseline to 12 weeks. Thirty-four and 31 participants were followed up at 3 and 12 weeks, respectively. No between-group differences were observed, apart from a greater increase in shoulder abduction strength for the progressive resistance-training group at 12 weeks. This study provides no evidence in favour of replacing general physical exercise with progressive resistance training using elastic resistance bands in multidisciplinary rehabilitation of chronic neck pain. We recommend clinicians to advise either of these exercise-types, based on the patient's interests and motivation.

Effects of curved-walking training on curved-walking performance and freezing of gait in individuals with Parkinson's disease: A randomized controlled trial

IntroductionThe purpose of this study was to investigate the effects of curved-walking training (CWT) on curved-walking performance and freezing of gait (FOG) in people with Parkinson's disease (PD). MethodsTwenty-four PD subjects were recruited and randomly assigned to the CWT group or control exercise (CE) group and received 12 sessions of either CWT with a turning-based treadmill or general exercise training for 30 min followed by 10 min of over-ground walking in each session for 4–6 weeks. The primary outcomes included curved-walking performance and FOG. All measurements were assessed at baseline, after training, and at 1-month follow-up. ResultsOur results showed significant improvements in curved-walking performance (speed, p = 0.007; cadence, p = 0.003; step length, p < 0.001) and FOG, measured by a FOG questionnaire (p = 0.004). The secondary outcomes including straight-walking performance (speed, cadence and step length, p < 0.001), timed up and go test (p = 0.014), functional gait assessment (p < 0.001), Unified Parkinson's disease Rating Scale III (p = 0.001), and quality of life (p < 0.001) were also improved in the experimental group. We further noted that the improvements were maintained for at least one month after training (p < 0.05). ConclusionA 12-session CWT program can improve curved-walking ability, FOG, and other measures of functional walking performance in individuals with PD. Most of the improvements were sustained for at least one month after training.

Exercise interventions in multiple sclerosis rehabilitation need better reporting on comorbidities: a systematic scoping review

Objective: To identify the extent to which exercise intervention studies in multiple sclerosis rehabilitation are addressing comorbidities and if researchers consider comorbidities as possible moderators or mediators of exercise outcomes. Methods: Five databases were searched from inception to January 8, 2016, for exercise-related terms in combination with multiple sclerosis. Studies were screened and limited to randomized control trials, full text, and English language. We assessed whether comorbidities were excluded or included, how they were reported and described, and if they were examined as possible moderators or mediators of exercise outcomes. Results: We reviewed 99 articles that included various exercise interventions, where the most common were general multi-faceted exercise training (n=34), cardiovascular training (n=18), progressive-resistance training (n=12), and balance and gait training (n=12). In total, 77 of 99 studies reported one or more comorbidities as an exclusion criterion. The most commonly excluded comorbidities were cardiovascular diseases, cognitive impairments or psychiatric disorders, and unspecified conditions or contraindications. Only nine studies reported details on excluded participants with comorbidities. Across studies that reported comorbidities of included participants (n=8), none examined comorbidities as possible moderators or mediators of exercise outcomes. Conclusion: Although a variety of exercise interventions have positive outcomes, there is limited evidence that these interventions are generalizable to people with multiple sclerosis who have comorbid conditions.

Positive Effects of Specific Exercise and Novel Turning-based Treadmill Training on Turning Performance in Individuals with Parkinson's disease: A Randomized Controlled Trial.

Two different training strategies to improve turning performance in individuals with Parkinson’s disease (PD) were designed and investigated in this study. Subjects were randomly assigned to a specific exercise group, turning-based training group, or control group to receive training that emphasized balance and strengthening, turning-based treadmill training, and general exercise training, respectively. A total of 12 30-min training sessions followed by 10 min of turning training on a level surface were administered over 4 to 6 weeks. The results (n = 12 for each group) showed that both the specific exercise and turning-based training group experienced improved turning performance, the primary outcome, compared with the control group (specific exercise, 33% change, p = 0.016; turning-based training, 35% change, p = 0.021). For the secondary outcomes, the specific exercise group performed better than the control group on the Tinetti balance scale, limit of stability test and lower extremity extensor and abductor strength. The turning-based training groups performed better than the control group in sensory organization and ankle plantar flexor strength. In summary, specific exercise training and turning-based treadmill training were both effective in improving turning performance in participants with PD. However, the improvements in turning performance of these two groups resulted from improving different aspects of impairment in individuals with PD.

Comprehensive exercise training improves ventilatory muscle function and reduces dyspnea perception in patients with COPD

Comprehensive exercise training (CET) is an efficient strategy to decrease dyspnea perception in chronic obstructive pulmonary disease (COPD) and may result in significant improvement in ventilatory muscles function. Our aim was to evaluate the effects of general exercise training on dyspnea perception and on respiratory muscles strength in COPD patients. Consecutive COPD patients were enrolled to complete a CET programme. The patients underwent a routine that included a global warm up, upper and lower limbs endurance exercise as well as stretching and relaxation. Before and after the CET programme, patients completed maximal inspiratory (PImax) and expiratory (PEmax) pressures measurements, maximal incremental test, endurance test, and 6-min walk distance (6MWD). 71 patients (52 male). Mean age 67.6 +/- 8.6 years, FEV1 (%) 44.2 +/- 16.2 and Mahler dyspnea scale 6.4 +/- 1.8. The results before and after the exercise programme were: PImax 64.7 +/- 22.9 vs. 75.5 +/- 23.7 cmH2O (p=0.001), PEmax 110.8 +/- 28.1 vs. 120.4 +/- 28.1 cmH2O (p=0.004), 6MWD 510.6 +/- 90.3 vs. 528.2 +/- 99.7 metres (p=0.88), time of incremental test 672 +/- 135 vs. 856 +/- 226 sec (p<0.0001). Compared with the pre exercise programme, we observed a significant reduction on Borg dyspnea scale (6.1 +/- 2.8 to 3.6 +/- 2.3, p<0.0001) as well as a longer test time (504 +/- 218 to 1.038 +/- 841, p<0.0001) at the end of the endurance test after CET programme. Improvement of PImax correlated negatively with dyspnea perception at iso-time during the endurance test (r = -0.33, p=0.03). Our results confirm that CET is associated with significant improvement in PImax, PEmax and provide evidence demonstrating that CET reduces dyspnea perception in patients with COPD.

Does general exercise training before and during pregnancy influence the pelvic floor “opening” and delivery outcome? A 3D/4D ultrasound study following nulliparous pregnant women from mid-pregnancy to childbirth

BackgroundIt has been suggested that women who are regular exercisers have a tighter pelvic floor and thereby have more difficulty during childbirth than non-exercising women. We investigated whether women exercising...

Inspiratory muscle training protocol for patients with chronic obstructive pulmonary disease (IMTCO study): a multicentre randomised controlled trial

IntroductionInspiratory muscle training (IMT) has been applied during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). However, it remains unclear if the addition of IMT to a general...