Habitual Exercise Training Research Articles

Lack Of Age And Gender Bias In Long-term Outcomes In Case Management-based Cardiovascular Rehabilitation

Randomized clinical trials have demonstrated the benefits of case management for patients with coronary heart disease (CHD). It is not known if case management in routine clinical practice, in the setting of an outpatient cardiovascular rehabilitation program (CRP), is feasible and effective in long-term secondary prevention. Purpose To determine the feasibility and clinical benefits of long-term case management of younger and older men and women with CHD in routine clinical practice using CRP staff. Methods Consecutive patients referred to CRP after an acute coronary event in 1999 and 2000 (n = 503, 75% men, age 66±12 yrs) and who were available for 3 years of case management served as subjects. Case managers assessed secondary prevention goals every 3–6 months and adjusted lifestyle factors and medications via face-to-face meetings with each patient. Outcome measures included amount of habitual exercise training, use of cardioprotective medications, coronary risk factors, and all-cause mortality. Results After 3 years of follow-up, secondary prevention variables were as follows: exercise training, minutes/wk (139±123), aspirin use (91%), statin use (91%), beta blocker use post myocardial infarction (78%), angiotensin converting enzyme inhibitor use if ejection fraction less than 40% (76%), LDL cholesterol, mg/dL (90±23), systolic blood pressure, mm Hg (126±19), smoking (9%), BMI (29.0±5.1). Over 3 years there were 29 deaths (annual mortality: 1.9%). There were no differences (p > 0.05) in medication use or risk factor control for men vs women or for age less than 65 yrs vs more than 65 yrs. Conclusions Long-term case management of CHD patients in routine clinical practice by CRP staff is both feasible and generally effective in achieving secondary prevention goals for both men and women irrespective of age. Overweight remains a persistent risk factor.

Differences in the cellular and humoral immune system between sedentary and endurance-trained elderly males

Aim. – This study aimed to examine the association between active vs. inactive lifestyle and cellular and humoral immune system in the elderly. Methods. – Eleven elderly male athletes (mean age ± S.D.: 67.1 ± 6.0 year) performing regular aerobic exercise for about 38.8 ± 18.5 yeasr (4.4 ± 1.4 d week –1; 10.0 ± 8.1 h week –1) and eleven male individuals at similar ages (mean age ± S.D.: 64.9 ± 4.6 year) leading a sedentary life were taken as control group. Immunological assessments were total leukocyte count, lymphocyte subpopulation, natural killer percentages, and IgA, IgG, and IgM concentrations. Results. – Baseline NK cell percentage, and serum IgA and IgM concentrations of master athletes were significantly higher than those of control group (29.3 ± 12.8% vs. 20.0 ± 7.5%; 2.4 ± 0.66 g/l vs. 1.6 ± 0.63 g/l; 1.0 ± 0.47 g/l vs. 0.58 ± 0.31 g/l, respectively; P < 0.05). No statistical differences were obtained in the total leukocyte counts and neutrophils, eosinophils, lymphocytes, monocytes, and the percentages of total T cells, B cells and T cell subsets (CD4+ T cells, CD8+ T cells), and IgG levels of the two groups. Conclusion. – Habitual exercise training may cause a slow down in the age-related decline in NK cell percentages and serum IgA and IgM levels of the elderly.

Daily physical activity and ageing.

A typical aspect of aging is the increase in variability of a feature within a population, suggesting individual variation in the decline with age. The decline is probably inevitable (predisposed), but some show slower declines than others. Physical activity might be one of the avenues to influence the aging process. There is still a need for validated techniques of estimating habitual physical activity to study the relationship between physical activity and health. Doubly labeled water studies show a decrease in the average proportion of daily energy expenditure for physical activity of about 35% at the age of 20 to 25% at the age of 90. In absolute figures, the activity-induced energy expenditure falls to one third of the initial value over the corresponding age interval. Exercise training does not seem to prevent the age-associated decline in physical activity because of compensation by a decrease in non-training physical activity, in contrast to younger age groups. The effects of the habitual activity level and of exercise on the age-related decline in muscle mass are small if present at all. There is, however, a clear-cut effect of habitual activity and exercise training on muscle function. The positive effects are reflected in muscle fiber type, capillary density, and aerobic capacity. Physical inactivity is an important determinant of disability and mortality risk. Even a recent increase in activity level can have an important effect, although the benefits are also easily lost when the activity level is again reduced.

Rating of perceived exertion and heart rate relative to ventilatory threshold in women.

Forty women took part in a study designed to investigate self-selected exercise intensity relative to ventilatory threshold during circuit weight training (CWT) and exercise-to-music (ETM) sessions. Subjects were assigned to one of two groups which were beginners (B) or habitual exercisers (HE) on the basis of their exercise habits. All subjects first underwent a laboratory cycle ergometer test involving a continuous incremental exercise protocol from which ventilatory threshold (VT) was determined using piecewise linear regression analysis. This point was expressed in terms of heart rate (VTHR) and rating of perceived exertion (VTRPE). These points were then compared with those determined during exercise training sessions (TRAHR and TRARPE respectively). The results showed that mean(s.d.) TRARPE (13.5(1.1) was not significantly different to mean(s.d.) VTRPE (12.8(0.5); P > 0.05) but that mean(s.d.) VTHR (134.8(13.5) beats min-1) and TRAHR (154.9(12.0) beats min-1) were different (P < 0.05). Beginners trained at a significantly higher percentage above VTHR than habitual exercisers (118(3.1) versus 111(2.8)% P < 0.05). During CWT the mean(s.d.) TRAHR for beginners (143.2(7.6) beats min-1) was significantly lower than that for habitual exercisers (152.5(10.1) beats min-1; P < 0.05), but not different during ETM (P < 0.05). When these TRAHR values were expressed relative to an estimated maximum heart rate (EMHR) they represented 86.5% in ETM and 80.5% in CWT which were different (P < 0.05). These results suggest that regardless of habitual exercise level and training mode, these women selected a common intensity of effort that was compatible with the described RPE.