Exercise Training In Individuals Research Articles

Aerobic Exercise in Individuals with Restless Legs Syndrome: A Case Series Study

Purpose: Exercise has been demonstrated to alleviate restless legs syndrome (RLS) symptoms in individuals with RLS, but little studies are available on the physical health of primary RLS. This case series aim to describe outcome after the training of supervised aerobic exercise training in individuals with RLS. Case Report: Five individuals with RLS were received with a supervised aerobic exercise training 2 days per week for 12 weeks. The International Restless Legs Syndrome Study Group Rating Scale (IRLS) was used to detect the severity of RLS. The Turkish version of the Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. The functional effect of fatigue was evaluated with Fatigue Impact Scale (FIS). The Six-Minute Walk test (6MWT) were used to determine the functional exercise capacity. All assessments took place at baseline and post-intervention. Conclusion: Following aerobic exercise, clinically meaningful changes in the severity of RLS, PSQI, and 6MWT were reported in all individuals with severe RLS. Four of 5 patients improved their FIS at post-intervention. These results suggest that 24-session supervised aerobic exercise training might help to improve RLS severity, sleep quality, fatigue, and exercise capacity in an individual with RLS.

Common questions and misconceptions about protein supplementation: what does the scientific evidence really show?

Protein supplementation often refers to increasing the intake of this particular macronutrient through dietary supplements in the form of powders, ready-to-drink shakes, and bars. The primary purpose of protein supplementation is to augment dietary protein intake, aiding individuals in meeting their protein requirements, especially when it may be challenging to do so through regular food (i.e. chicken, beef, fish, pork, etc.) sources alone. A large body of evidence shows that protein has an important role in exercising and sedentary individuals. A PubMed search of "protein and exercise performance" reveals thousands of publications. Despite the considerable volume of evidence, it is somewhat surprising that several persistent questions and misconceptions about protein exist. The following are addressed: 1) Is protein harmful to your kidneys? 2) Does consuming "excess" protein increase fat mass? 3) Can dietary protein have a harmful effect on bone health? 4) Can vegans and vegetarians consume enough protein to support training adaptations? 5) Is cheese or peanut butter a good protein source? 6) Does consuming meat (i.e., animal protein) cause unfavorable health outcomes? 7) Do you need protein if you are not physically active? 8) Do you need to consume protein ≤ 1 hour following resistance training sessions to create an anabolic environment in skeletal muscle? 9) Do endurance athletes need additional protein? 10) Does one need protein supplements to meet the daily requirements of exercise-trained individuals? 11) Is there a limit to how much protein one can consume in a single meal? To address these questions, we have conducted a thorough scientific assessment of the literature concerning protein supplementation.

Cardiac hemodynamics phenotypes and individual responses to training in coronary heart disease patients.

In patients with coronary heart disease (CHD), individualized exercise training (ET) programs are strongly recommended to optimize peak oxygen uptake ( O2peak) improvement and prognosis. However, the cardiac hemodynamic factors responsible for a positive response to training remain unclear. The aim of this study was to compare cardiac hemodynamic changes after an ET program in responder (R) versus non-responder (NR) CHD patients. A total of 72 CHD patients completed a 3-month ET program and were assessed by cycle ergometer cardiopulmonary exercise test (CPET: O2peak assessment) with impedance cardiography (ICG) for hemodynamic measurements before and after training. Cardiac hemodynamics (e.g., CO, CI, SV, ESV, EDV, and SVR) were measured by ICG during CPET. The R and NR groups were classified using the median change in O2peak (>the median for R and ≤the median for NR). In the R group, O2peak (+17%, p < 0.001), CO, CI, SV, and HR increased by 17%, 17%, 13%, and 5%, respectively (p < 0.05) after the training program. In the NR group, O2peak, CO, CI, and SV increased by 0.5%, 5%, 8%, and 6%, respectively (p < 0.01). The SVR decreased in both groups (-19% in R and -11% in NR, p < 0.001). Among CHD patients, the R group showed a better improvement in peak cardiac output via an increase in peak stroke volume and heart rate and a reduced systemic vascular resistance than the NR group. Different cardiac phenotype adaptations and clinical individual responses were identified in CHD patients according to the aerobic fitness responder's status.

Long-term follow-up on patient-reported outcomes after supervised exercise training in individuals at risk of complications to type 2 diabetes

AimsWe investigated long-term changes of patient-reported outcomes after a supervised exercise intervention in individuals with type 2 diabetes (T2D). MethodsIn an intervention study without a control group, follow-up assessments were performed 12 months after initiating 12 weeks of physical exercise in individuals with T2D at intermediate or high risk of complications. Primary outcomes were health-related quality of life assessed with EQ-5D-5L, empowerment with Diabetes Empowerment Scale-Short Form, and self-reported physical activity with the Physical Activity Scale. Secondary outcomes were physical function (30-s chair-stand test) and working capacity (Aastrand or Graded Cycling Test). Results153 participants completed follow-up (35% women, age (mean ± SD) 67 ± 11 years, body mass index 33.1 ± 5.9 kg/m2, glycated haemoglobin A1c 7.8 ± 3.7%). No changes were reported in health-related quality of life (index score p = 0.444, visual analogue scale p = 0.270), empowerment (p = 0.232), and moderate intensity physical activity (p = 0.917). Vigorous intensity physical activity decreased (mean (95% CI) −25.5 (−37.14; −13.94) min/day, p < 0.001). Physical function increased (p < 0.001) and working capacity decreased (Aastrand p = 0.002, Graded Cycling Test p = 0.039). ConclusionsHealth-related quality of life, empowerment, and self-reported moderate intensity physical activity time remained elevated at the long-term follow-up after a supervised exercise intervention.

A Current State of the Art and Science of Exercise in Dialysis: A Narrative Review.

The purpose of the review is to discuss current proven benefits and problems of integrating exercise in the care of people receiving dialysis by reviewing literature from the last few years and identifying important questions that still need to be asked and answered. A focused review and appraisal of the literature were done. Original peer-reviewed articles, review articles, opinion pieces and guidelines were identified from PubMed and Google Scholar databases. Only sources in English were accessed. Search terms "exercise" and "dialysis" were used to find active recruiting randomized trials in various clinical trial registry platforms. Numerous studies have demonstrated the benefits of exercise training in individuals receiving dialysis, limited by factors such as short duration of follow-up and inconsistent adverse event reporting and outcomes selected. Notable gaps in exercise research in dialysis include ways to maintain programs and patient motivation, studies in peritoneal dialysis and home hemodialysis patients, and how best to define and measure outcomes of interest. This review summarizes the current state of exercise in people receiving dialysis and serves as a call to action to conduct large, randomized controlled trials to improve the quality of evidence needed to implement and sustain innovative, exercise interventions, and programs for this population.

Effects of combined interventions to optimize performance during high‐intensity exercise in trained individuals

AbstractDifferent interventions can independently improve athletic performance via different central or peripheral mechanisms, but little is known about their potential combination. We tested the effects of seven combined interventions (enhanced recovery package [ERP]) on performance during intermittent high‐intensity cycling compared with placebo. Sixteen trained men (maximal power output: 5.0 ± 0.5 W･kg−1) completed six 30‐s cycling sprints with 3‐min breaks in‐between under ERP, placebo, and control conditions. The ERP combined neck cooling, carbohydrate and caffeine mouth rinsing, carbohydrate and water ingestion, hyperventilation, hyperoxia, and potentiation maneuvers. Power output, heart rate, blood lactate concentration, rate of perceived exertion, and gas exchange were compared between the ERP and placebo conditions. Mean power output was higher during ERP compared with placebo (570 ± 74 W vs. 560 ± 71 W, p &lt; 0.001, dz = 1.15). Heart rate was higher (+3 ± 4 bpm, p = 0.012) during ERP, as was breathing frequency (+2.4 ± 4.0 breaths･min−1, p = 0.028) and respiratory exchange ratio (+0.12 ± 0.06, p &lt; 0.001). Oxygen uptake was 80 ± 109 mL･min−1 lower (p = 0.013) for ERP. No differences were found with regards to the rate of perceived exertion or blood lactate concentration. Performance gains with ERP were small in magnitude but consistent across individuals. The ERP might have prevented a loss of aerobic efficiency or increased reliance on anaerobic energy. Testing combined interventions might increase the chances to see beyond daily variability in practice.

Effects of exercise training after acute coronary syndromes in octogenarians - prospective 12-month evaluation.

Aim: To demonstrate the impact of individual exercise training on the course of the disease, exercise tolerance and quality of life (QoL) in patients over 75 years after acute coronary syndrome (ACS). Materials and methods: Study included octogenarians after ACS randomly assigned into two groups: a training group (ExT) subjected to individualized physical training and a control group (CG) with standard recommendations for activity. Patients underwent exercise tolerance test (ETT), 6-minute walk test (6-MWT), NHP and QoL questionnaires evaluation, lab tests, ECG, echocardiographic examination at the beginning and after 2, 6 and 12 months. Results: Study included 51 patients, mean age 80 years, 50% men, all patients completed the study. Initial physical capacity was comparable in both groups. After 2-month training the average ETT exercise time increased by 12.5% (p=0.0004), the load increased by 13% (p=0.0005) and the 6-MWT results improved by 8.3% (p=0.0114). Among CG these changes were not significant. But 6 and 12 months after training cessation 6-MWT results returned to the initial values (p=0.069, p=0.062 respecitvely). Average ETT exercise time and average load decreased significantly after 12 months (p=0.0009, p=0.0006). Level of pain was significantly lower at the end of the training in ExT group (p=0.007), but it returned to initial 12 months later (p=0.48). QoL deteriorated significantly in the ExT group 12 months after training cessation (p=0.04). Conclusions: Cardiac rehabilitation in octogenarians after ACS was safe and improved physical performance in a short period of time. Cessation of training resulted in a loss of achieved effects and deterioration of the QoL.

Alterations in RNA editing in skeletal muscle following exercise training in individuals with Parkinson's disease.

Parkinson's Disease (PD) is the second most common neurodegenerative disease behind Alzheimer's Disease, currently affecting more than 10 million people worldwide and 1.5 times more males than females. The progression of PD results in the loss of function due to neurodegeneration and neuroinflammation. The etiology of PD is multifactorial, including both genetic and environmental origins. Here we explored changes in RNA editing, specifically editing through the actions of the Adenosine Deaminases Acting on RNA (ADARs), in the progression of PD. Analysis of ADAR editing of skeletal muscle transcriptomes from PD patients and controls, including those that engaged in a rehabilitative exercise training program revealed significant differences in ADAR editing patterns based on age, disease status, and following rehabilitative exercise. Further, deleterious editing events in protein coding regions were identified in multiple genes with known associations to PD pathogenesis. Our findings of differential ADAR editing complement findings of changes in transcriptional networks identified by a recent study and offer insights into dynamic ADAR editing changes associated with PD pathogenesis.

Investigation of the Effects of Remote Online Exercise Training in Individuals Self-Isolating at Home Due to COVID-19 Disease: A Randomized Controlled Study

Objective: Effectiveness of a 4-week telerehabilitation program including thoracic expansion exercises (TEE), non-specific general body exercises (NSGBE), and physical activity recommendations (PAR) which started at quarantine in individuals with acute mild-COVID-19 was investigated in current study. Methods: This is a randomized controlled study which was performed between May 2021 and February 2022. Adult individuals with acute mild-COVID-19 were randomly grouped as training (TG) (telerehabilitation program under supervision for 3 days/week) and control (CG) (home program including TEE and PAR). Dyspnea (Modified Borg Scale and Modified Medical Research Council Dyspnea Scale), chronic fatigue (Checklist Individual Strength Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale), balance (Berg Functional Balance Scale) and lower body strength (a 30-s chair stand test) were evaluated remotely in the individuals before and after a 4-week follow-up. Results: Baseline characteristics and balance scores were similar between groups (p&gt;0.05). After 4-week from baseline, there were no significant differences in dyspnea, chronic fatigue, anxiety, depression, balance, and lower body strength between the groups (p&gt;0.05). However, as dyspnea, chronic fatigue, anxiety, and depression scores decreased, lower body strength increased significantly within TG after follow-up (p&lt;0.05). Dyspnea, chronic fatigue, and anxiety scores decreased while lower body strength increased significantly within CG after follow-up (p&lt;0.05). Conclusion: Dyspnea, severe fatigue, anxiety, and depression are commonly observed in individuals with mild-COVID-19 in the acute period. In these individuals, dyspnea perception, chronic fatigue, anxiety, depression, and functional performance improve after a 4-week light-intensity online tele-program applied either supervised or unsupervised. Mild exercises and PAR are safe and effective in these individuals.

Resistance Exercise Training in Individuals With and Without Cardiovascular Disease: 2023 Update: A Scientific Statement From the American Heart Association.

Resistance training not only can improve or maintain muscle mass and strength, but also has favorable physiological and clinical effects on cardiovascular disease and risk factors. This scientific statement is an update of the previous (2007) American Heart Association scientific statement regarding resistance training and cardiovascular disease. Since 2007, accumulating evidence suggests resistance training is a safe and effective approach for improving cardiovascular health in adults with and without cardiovascular disease. This scientific statement summarizes the benefits of resistance training alone or in combination with aerobic training for improving traditional and nontraditional cardiovascular disease risk factors. We also address the utility of resistance training for promoting cardiovascular health in varied healthy and clinical populations. Because less than one-third of US adults report participating in the recommended 2 days per week of resistance training activities, this scientific statement provides practical strategies for the promotion and prescription of resistance training.

Exercise and aerobic capacity in individuals with spinal cord injury: A systematic review with meta-analysis and meta-regression.

A low level of cardiorespiratory fitness [CRF; defined as peak oxygen uptake ([Formula: see text]O2peak) or peak power output (PPO)] is a widely reported consequence of spinal cord injury (SCI) and a major risk factor associated with chronic disease. However, CRF can be modified by exercise. This systematic review with meta-analysis and meta-regression aimed to assess whether certain SCI characteristics and/or specific exercise considerations are moderators of changes in CRF. Databases (MEDLINE, EMBASE, CENTRAL, and Web of Science) were searched from inception to March 2023. A primary meta-analysis was conducted including randomised controlled trials (RCTs; exercise interventions lasting >2 weeks relative to control groups). A secondary meta-analysis pooled independent exercise interventions >2 weeks from longitudinal pre-post and RCT studies to explore whether subgroup differences in injury characteristics and/or exercise intervention parameters explained CRF changes. Further analyses included cohort, cross-sectional, and observational study designs. Outcome measures of interest were absolute (A[Formula: see text]O2peak) or relative [Formula: see text]O2peak (R[Formula: see text]O2peak), and/or PPO. Bias/quality was assessed via The Cochrane Risk of Bias 2 and the National Institute of Health Quality Assessment Tools. Certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Random effects models were used in all meta-analyses and meta-regressions. Of 21,020 identified records, 120 studies comprising 29 RCTs, 67 pre-post studies, 11 cohort, 7 cross-sectional, and 6 observational studies were included. The primary meta-analysis revealed significant improvements in A[Formula: see text]O2peak [0.16 (0.07, 0.25) L/min], R[Formula: see text]O2peak [2.9 (1.8, 3.9) mL/kg/min], and PPO [9 (5, 14) W] with exercise, relative to controls (p < 0.001). Ninety-six studies (117 independent exercise interventions comprising 1,331 adults with SCI) were included in the secondary, pooled meta-analysis which demonstrated significant increases in A[Formula: see text]O2peak [0.22 (0.17, 0.26) L/min], R[Formula: see text]O2peak [2.8 (2.2, 3.3) mL/kg/min], and PPO [11 (9, 13) W] (p < 0.001) following exercise interventions. There were subgroup differences for R[Formula: see text]O2peak based on exercise modality (p = 0.002) and intervention length (p = 0.01), but there were no differences for A[Formula: see text]O2peak. There were subgroup differences (p ≤ 0.018) for PPO based on time since injury, neurological level of injury, exercise modality, and frequency. The meta-regression found that studies with a higher mean age of participants were associated with smaller changes in A[Formula: see text]O2peak and R[Formula: see text]O2peak (p < 0.10). GRADE indicated a moderate level of certainty in the estimated effect for R[Formula: see text]O2peak, but low levels for A[Formula: see text]O2peak and PPO. This review may be limited by the small number of RCTs, which prevented a subgroup analysis within this specific study design. Our primary meta-analysis confirms that performing exercise >2 weeks results in significant improvements to A[Formula: see text]O2peak, R[Formula: see text]O2peak, and PPO in individuals with SCI. The pooled meta-analysis subgroup comparisons identified that exercise interventions lasting up to 12 weeks yield the greatest change in R[Formula: see text]O2peak. Upper-body aerobic exercise and resistance training also appear the most effective at improving R[Formula: see text]O2peak and PPO. Furthermore, acutely injured, individuals with paraplegia, exercising for ≥3 sessions/week will likely experience the greatest change in PPO. Ageing seemingly diminishes the adaptive CRF responses to exercise training in individuals with SCI. PROSPERO: CRD42018104342.

A Pilot Study of the Effects of Collagen vs. Whey Protein Supplementation on Delayed Onset Muscle Soreness in Healthy Individuals

Introduction: Delayed onset muscle soreness (DOMS) is a common condition characterized by muscle stiffness, pain, and inflammation following intense or unaccustomed exercise. Despite its prevalence, the underlying mechanisms of DOMS remain unclear. This study aimed to investigate the effects of collagen supplementation on tissue repair and pain associated with DOMS in exercise-trained individuals. Methods: Fourteen exercise-trained men (n=7) and women (n=7) were enrolled in a randomized, counterbalanced, crossover trial. Participants were assigned to either a whey protein group (n=8) or a collagen protein group (n=6). Each participant consumed 40g of their respective protein supplement daily for four consecutive days. Peak soreness was assessed using self-reported ratings and algometer measurements. Statistical analysis included independent samples t-tests and Levene's test for equality of variances. Results: The analysis revealed no significant difference in peak soreness between the whey protein and collagen protein groups at the 24-hour time point (t(12) = 1.33, p = 0.208). Both groups experienced a decrease in peak soreness over the 24-hour period, but the reduction was not statistically different between the groups. No significant differences were observed in other variables measured. Conclusions: These findings suggest that collagen protein supplementation did not significantly reduce peak soreness associated with DOMS compared to whey protein supplementation in exercise-trained individuals. While collagen supplementation has shown potential benefits in tissue repair and joint health, further research is needed to explore its specific effects on DOMS. Larger studies with different dosages and participant populations are warranted to obtain a more comprehensive understanding of collagen's impact on muscle soreness and tissue repair.

The Effects of Exercise on Synaptic Plasticity in Individuals With Mild Cognitive Impairment: Protocol for a Pilot Intervention Study.

Mild cognitive impairment (MCI) is a syndrome preceding more severe impairment characterized by dementia. MCI affects an estimated 15% to 20% of people older than 65 years. Nonpharmacological interventions including exercise are recommended as part of overall MCI management based on the positive effects of exercise on cognitive performance. Interval training involves brief intermittent bouts of exercise interspersed with short recovery periods. This type of exercise promotes cognitive improvement and can be performed in individuals with MCI. Synaptic plasticity can be assessed in vivo by the neurophysiological response to repetitive transcranial magnetic stimulation (rTMS). A method to assess synaptic plasticity uses an intermittent theta burst stimulation (iTBS), which is a patterned form of rTMS. Individuals with MCI have decreased responses to iTBS, reflecting reduced synaptic plasticity. It is unknown whether interval training causes changes in synaptic plasticity in individuals living with MCI. This research will determine whether interval training performed using a cycle ergometer enhances synaptic plasticity in individuals with MCI. The three aims are to (1) quantify synaptic plasticity after interval training performed at a self-determined intensity in individuals with MCI; (2) determine whether changes in synaptic plasticity correlate with changes in serum brain-derived neurotrophic factor, osteocalcin, and cognition; and (3) assess participant compliance to the exercise schedule. 24 individuals diagnosed with MCI will be recruited for assignment to 1 of the 2 equally sized groups: exercise and no exercise. The exercise group will perform exercise 3 times per week for 4 weeks. Synaptic plasticity will be measured before and following the 4-week intervention. At these time points, synaptic plasticity will be measured as the response to single-pulse TMS, reflected as the percent change in the average amplitude of 20 motor-evoked potentials before and after an iTBS rTMS protocol, which is used to induce synaptic plasticity. In addition, individuals will complete a battery of cognitive assessments and provide a blood sample from the antecubital vein to determine serum brain-derived neurotrophic factor and osteocalcin. The study began in September 2023. The proposed research is the first to assess whether synaptic plasticity is enhanced after exercise training in individuals with MCI. If exercise does indeed modify synaptic plasticity, this will create a new avenue by which we can study and manipulate neural plasticity in these individuals. ClinicalTrials.gov NCT05663918; https://clinicaltrials.gov/study/NCT05663918. PRR1-10.2196/50030.

A Tablet-Based App to Support Nursing Home Staff in Delivering an Individualized Cognitive and Physical Exercise Program for Individuals With Dementia: Mixed Methods Usability Study.

The promotion of physical activity in individuals with dementia living in nursing homes is crucial for preserving physical and cognitive functions and the associated quality of life. Nevertheless, the implementation of physical activity programs in this setting is challenging, as the time and expertise of nursing home staff are limited. This situation was further exacerbated by the COVID-19 pandemic. Mobile health apps may be a sustainable approach to overcome these challenges in the long term. Therefore, the Individualized Cognitive and Physical Exercise-App (the InCoPE-App) was developed to support nursing home staff in delivering and implementing tailored cognitive and physical exercise training for individuals with dementia. This study aims to assess the usability of the InCoPE-App in terms of user performance and user perception in a laboratory setting using a mixed methods approach. Nursing home staff were encouraged to perform 5 basic tasks within the InCoPE-App. Their thoughts while using the app were captured by implementing a think aloud protocol. Then, participants completed the System Usability Scale questionnaire. The think aloud transcripts were qualitatively evaluated to unveil usability issues. All identified issues were rated in terms of their necessity to be fixed. Task completion (ie, success rate and time) and perceived usability were evaluated descriptively. A total of 14 nursing home employees (mean age 53.7, SD 10.6 years; n=13, 93% women) participated in the study. The perceived usability of the InCoPE-App, as assessed by the System Usability Scale questionnaire, can be rated as "good." The main usability issues concerned navigation logic and comprehensibility of app content. The InCoPE-App is a user-friendly app that enables nursing home staff to deliver and implement cognitive and physical exercise training for individuals with dementia in nursing homes. The InCoPE-App can be used with little training, even by people aged ≥50 years, who may have low digital literacy. To achieve sustainable use and high user satisfaction of the InCoPE-App in the long term, it should be implemented and evaluated in a field study.

Role of specialized pro-resolving mediators on inflammation, cardiometabolic health, disease progression, and quality of life after omega-3 PUFA supplementation and aerobic exercise training in individuals with rheumatoid arthritis: a randomized 16-week, placebo-controlled interventional trial.

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by autoantibody production and synovial membrane damage. It significantly impairs overall function and quality of life. Consumption of omega-3 (n-3) polyunsaturated fatty acids (PUFAs) and regular aerobic exercise (AEx) training are reported to have positive effects on the progression of RA. However, the mechanisms behind these benefits are still inconclusive. This study protocol will investigate the effects of n-3 PUFA supplementation and AEx training on disease progression, cardiometabolic health, and quality of life, and their association with the plasma and synovial fluid levels of specialized pro-resolving mediators (SPMs) in subjects with RA. Methods: The study consists of a 16-week intervention period, during which participants will be randomly assigned in a double-blinded manner to one of four groups: placebo control (PLA), PLA+AEx, n-3, or n-3+AEx. The PLA groups will be given a gelatin-filled capsule, while the n-3 groups will be given n-3 PUFAs equivalent to 2.5 g/d of docosahexaenoic acid and 0.5 g/d of eicosapentaenoic acid. The AEx groups will perform exercise three times per week on a stationary electronically braked cycle ergometer at 60-70% of their VO2peak for 50-60 minutes. Before and after the intervention, participants will undergo RA-specific and functional measurements, peak aerobic capacity test, and a dietary and physical activity assessment. Venous blood and synovial fluid from the knee joint will be collected. Changes in disease progression, cardiometabolic health, and quality of life, as well as erythrocyte membrane composition to assess n-3 incorporation, SPM levels, inflammatory markers, and gene expression from blood and synovial fluid will be analyzed. Conclusions: The study aims to elucidate the SPMs that regulate the inflammatory gene expression pathways and associate them with the improvements in disease progression, cardiometabolic health, and quality of life after n-3 PUFA supplementation and AEx training. Registration: ClinicalTrials.gov #NCT05945693.

Cardiac rehabilitation for heart failure and atrial fibrillation: a propensity- matched study

BackgroundAtrial fibrillation (AF) is common in individuals with heart failure (HF). Individuals with HF and AF may have a reduced functional capacity and quality of life (QoL) which leads to...

Cycle exercise training and muscle mass: A preliminary investigation of 17 lower limb muscles in older men.

Cycling exercise in older individuals is beneficial for the cardiovascular system and quadriceps muscles, including partially reversing the age-related loss of quadriceps muscle mass. However, the effect of cycling exercise on the numerous other lower limb muscles is unknown. Six older men (74 ± 8 years) underwent MRI before and after 12-weeks of progressive aerobic cycle exercise training (3-4 days/week, 60-180 min/week, 60%-80% heart rate reserve, VO2 max: +13%) for upper (rectus femoris, vastii, adductor longus, adductor magnus, gracilis, sartorius, biceps femoris long head, biceps femoris short head, semimembranosus, semitendinosus) and lower (anterior tibial, posterior tibialis, peroneals, flexor digitorum longus, lateral gastrocnemius, medial gastrocnemius, soleus) leg muscle volumes. In the upper leg, cycle exercise training induced hypertrophy (p ≤ 0.05) in the vastii (+7%) and sartorius (+6%), with a trend to increase biceps femoris short head (+5%, p = 0.1). Additionally, there was a trend to decrease muscle volume in the adductor longus (-6%, p = 0.1) and biceps femoris long head (-5%, p = 0.09). In the lower leg, all 7 muscle volumes assessed were unaltered pre- to post-training (-2% to -3%, p > 0.05). This new evidence related to cycle exercise training in older individuals clarifies the specific upper leg muscles that are highly impacted, while revealing all the lower leg muscles do not appear responsive, in the context of muscle mass and sarcopenia. This study provides information for exercise program development in older individuals, suggesting other specific exercises are needed for the rectus femoris and adductors, certain hamstrings, and the anterior and posterior lower leg muscles to augment the beneficial effects of cycling exercise for older adults.

A 21-Day Individual Rehabilitation Exercise Training Program Changes Irisin, Chemerin, and BDNF Levels in Patients after Hip or Knee Replacement Surgery.

Osteoarthritis (OA) is the most frequent worldwide cause of adult population disabilities. The study evaluated the effects of a 21-day individual rehabilitation exercise training program focused on improving patients' functional capacity. The study analyzed the changes in irisin, chemerin, and BDNF serum levels in 36 OA patients subjected to an individually-adjusted rehabilitation program 90 days after surgical hip or knee replacement. The changes in irisin, chemerin, and BDNF serum levels were measured using enzyme-linked immunosorbent assay (ELISA) kits. A 21-day individual rehabilitation exercise training program significantly increased irisin and BDNF, and decreased chemerin serum levels. The presented study indicates that individually-adjusted exercise training is an important modulator influencing serum levels of anti- and pro-inflammatory factors, leading to positive clinical outcomes in osteoarthritis therapy. Selected factors are considered potential markers of various pathophysiological conditions. The presented study brings new details to the discussion.

Associations between exercise training characteristics and change in peak oxygen consumption in patients with chronic ischaemic heart disease and type 2 diabetes

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Innovationsfonds des Gemeinsamen Bundesausschusses. Introduction Exercise interventions are well established in the treatment of chronic ischaemic heart disease (CIHD) and type 2 diabetes mellitus (T2DM). Yet, there remains a significant research gap when it comes to patients which suffer from both diseases. Purpose The aim of this study was to investigate the associations of training characteristics (average minutes of endurance training per week, average endurance training sessions per week and mean intensity) and change in peak V̇O2 following 6 months of a telemedicine supported exercise intervention in patients with CIHD and T2DM. Methods Among 251 intervention group patients of a randomised controlled trial that evaluated the effects of an individual home-based lifestyle intervention compared to usual care (N=502 patients), those who completed the 6-month follow-up (N=201) were included in this analysis. All patients received an individual exercise training plan via a smartphone application, which recorded training duration and heart rates (HR, utilizing a connected heart rate sensor, Polar H7, Polar, Finland). Patients also had the possibility to perform additional sessions without prescribed intensity zones. All recorded sessions were evaluated with a customized software and manually checked for plausibility. Intensities were calculated as the average % heart rate reserve (HRR) of all endurance exercise sessions. If HR measurements were classified as invalid/unreliable (e.g. very strong fluctuations), these sessions were excluded from the average HRR calculation but still included in the average minutes and sessions of endurance training per week. Associations between training characteristics and change in peak V̇O2 were evaluated via univariate regression analysis. Results Of the 201 patients (16% female, 68±8 years), 81 (40%) were classified as adherent to the exercise intervention (defined as having performed the prescribed training duration in ≥ 50% of the weeks and ≥ 66.7% of the recommended duration). On average, patients performed 78±94 minutes of endurance training per week across 3.26±3.13 sessions at an average of 51.6±18.2% HRR. Peak V̇O2 improved by a mean (SD) of 0.94±2.74 ml/kg/min. Change in peak V̇O2 was significantly associated with the average duration and number of sessions per week (p &amp;lt; 0.01), but not with mean intensity (p = 0.10) (Fig. 1). Conclusions Mean changes in peak V̇O2 were low, likely due to low overall adherence. Accordingly, we found a significant positive association between the average minutes as well as the average sessions of endurance training per week and change in peak V̇O2, whereas change in peak V̇O2 was not significantly associated with mean exercise training intensity. Therefore, future telemedical exercise interventions need to find ways to improve adherence of patients towards the provided exercise recommendations.

Survey of exercise testing and training in cystic fibrosis clinics in the UK: a decade of progress

ObjectivesRegular exercise testing is recommended for people with cystic fibrosis (pwCF), as is the provision and regular review of exercise training programmes. A previous survey on exercise testing and training...