Intensive Exercise Program Research Articles

Development of bone mineral density and content in children with cerebral palsy: a retrospective, longitudinal study.

The aim of this study was to investigate long-term bone development in children with cerebral palsy (CP) using longitudinal measurements of total body less head bone mineral content (TBLH-BMC) and bone mineral density (TBLH-BMD). A retrospective longitudinal analysis was performed on 109 children with CP who participated in a rehabilitation programme from 2006 to 2018. Dual-energy X-ray absorptiometry (DXA) scans were performed at the beginning of the programme and repeated as clinically indicated. The study used SITAR growth curve analysis and the LMS method within the GAMLSS model to generate developmental trajectories for TBLH-BMC and TBLH-BMD. The findings suggest that the expected developmental trajectories of TBLH-BMC and TBLH-BMD in children with CP approximately follow the third percentile of healthy children. The median annual increase in bone mineral density was similar between GMFCS I-II and III-V groups at 5.12 and 5.79 %, respectively. Girls with CP reached age at peak velocity (APV) earlier than boys. The intensive exercise programme may have contributed to greater annual bone growth in children with more severe CP. Children with CP have bone growth trajectories close to the third percentile of their healthy peers, suggesting that age-adjusted z-scores for TBLH-BMC and BMD remain relatively stable throughout childhood and adolescence. Early and targeted interventions, including improving muscle strength and mobility and optimising nutritional and hormonal status, are essential to promote better bone health and quality of life in children with CP.

Physiological comparison of conditioned and non-conditioned university horses following semester break

Periods of limited activity during semester break may reduce performance during return to ridden work. This study evaluated fitness and muscling of horses when returning to work, following a 12-week period during which horses either continued (conditioned) or discontinued (non-conditioned) ridden work. It was hypothesized that non-conditioned horses would have a lower level of fitness, resulting in higher resting and peak heart rates and lower levels of muscling. Twelve mature, stock type horses aged 16 ± 5 years were assigned to either a conditioned group that maintained light-to-moderate riding or a non-conditioned group receiving no formal exercise. All horses had access to voluntary exercise for 12-24hr/d on grass pasture (1.5-2.5 hectares). Following the 12-week period, all horses were placed into a light-to-moderate intensity exercise program with resting heart rate, peak heart rate, body condition score, gaskin and forearm circumference, and topline muscle measurements performed on d 0, 14, and 28. Peak and resting heart rates were not different between groups (P > 0.05) but increased for both groups throughout the study (P = 0.04). Gaskin circumference of non-conditioned horses was larger (P = 0.04), although non-conditioned horses tended to be heavier (551.4 versus 491.4 ± 21.4 kg; P = 0.07). Conditioned horses had greater average topline muscling scores (P = 0.02). Horses that were conditioned over a 12-week break had greater muscling, but changes in fitness were not detected. Pasture access could contribute to maintenance of fitness during unridden periods.

Severely reduced physical performance is already present at the time of admission for stem cell transplantation

ObjectivesPaediatric patients with cancer undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) face a high risk for life-threatening infections and transplant-related complications. Therefore, these children should be in the best possible...

Article RETRACTED due to manipulation by the authors Exercise for health in old age: Comprehensive review examining the benefits and efficacy of interven-tions

The elderly are a growing age group and an integral part of modern society. The aging process brings significant health challenges, and therefore, exercise has an important role to play in maintaining the quality of life and well-being of older adults. This review aims to explore the role of health exercise in older adults, including its benefits, appropriate types of activities, and factors that influence exercise participation in this age group. Health exercise among older adults was the subject of this systematic review, focusing on the benefits and effectiveness of interventions. This study conducted a keyword search ("exercise activity of the elderly" OR "physical activity for the elderly" AND "benefits of exercise in the elderly" OR "effects of exercise in the elderly" AND "effectiveness of health interventions" OR "physical health of the elderly" AND "exercise health intervention" OR "fitness in old age") on databases (ScienceDirect: 1,2011 and PubMed 1,039) following the Preferred Report-ing Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify articles that addressed the benefits and effectiveness of exercise health interventions in the elderly. Following the exclusion criteria, a total of 15 relevant articles were categorized. The review presented the benefits of health exercise in older adults. In the first group, a 12-week moderate-to-high intensity exercise program was shown to improve various aspects of physical and cognitive health in older adults. These included increases in body mass, functional capacity, muscle strength and reduced risk of age-related diseases. The second group highlighted the benefits of exercise through specific sporting activities, with improved sleep, decreased pain perception and protection from death anxiety. In addition, this group also demonstrated the effectiveness of various exercise therapies in supporting healthy aging. In the third group, the implementation of physical activity and lifestyle was shown to be effective in increasing physical activity levels among older adults and helping to prevent decline in physical function. This review highlights the importance of health exercise in improving the health and well-being of older adults. The findings can serve as a foundation for designing more effective interventions to support active and healthy lifestyles among older adults. This comprehensive strategy aims to enhance the overall well-being of the elderly population, fostering a better quality of life and mitigating the impact of age-related ailments. As such, it necessitates an approach that takes into account individual requirements and constraints. Beyond its health advantages, exercise holds significant social implications. Engaging in physical activity facilitates social interaction for older adults, helping them sustain connections with their community, friends, and family, thereby addressing the prevalent issue of social isolation. In this context, the involvement of family, healthcare professionals, and the community plays a pivotal role in supporting the elderly's participation in physical activities. Providing education, assistance, and cultivating a conducive environment for exercise are crucial measures to ensure an optimal quality of life for the elderly demographic. Keywords: Sports health, sports benefits, physical activity, older age, active lifestyle

PAINFUL VS NON-PAINFUL EXERCISE ON CREPITUS IN PEOPLE WITH KNEE OSTEOARTHRITIS: A MIXED-METHODS ANALYSIS

INTRODUCTION & AIMS Crepitus (or physiological noise) is a key criterion in the diagnosis of knee osteoarthritis (OA). Exercise is foundational to guideline-based care for knee OA, however the effect exercise on knee crepitus is unknown. This study aimed to explore the perceptions of people with knee OA following a 6-week accredited exercise physiologist (AEP) led intervention involving painful vs non-painful exercise, especially in relation to their knee crepitus. METHODS Participants were randomly assigned to either a painful (higher intensity) or non-painful (lower intensity) exercise program supervised by an AEP twice a week for six weeks with concurrent education. Volunteers partook in a post-intervention semi-structured interview with questions surrounding their experience and perceived outcomes of the program. Thematic qualitative analysis was conducted and compared to the Knee Injury and Osteoarthritis Outcome Score (KOOS) crepitus question (0 - 4 scale). RESULTS Eleven participants volunteered. Qualitatively, approximately half of the participants self-reported a decrease in their knee crepitus following the program “I haven’t had the creaky knees so much”, with the rest stating their crepitus did not change. No participants perceived their crepitus increased (n=9 no change, n=2 decreased) or said that their crepitus was worse, “the noise and grinding doesn’t become evident (now) until the weights become higher”. Quantitatively, KOOS crepitus scores also did not change following the intervention [mean (SD) (2.4(1.0) to 2.1(1.3), p=0.19)]. There were no differences between exercise groups in self-perceived crepitus results, and most said that the exercise program was beneficial “Right after this whole program, I find that I can move much easier.” CONCLUSION Exercise at higher intensities (into painful range) does not change crepitus or may improve it for some. People with OA perceive that exercise at both higher and lower intensity is beneficial and enjoyable.

Measuring Heart Rate Accurately in Patients With Parkinson Disease During Intense Exercise: Usability Study of Fitbit Charge 4.

Parkinson disease (PD) is the second most common neurodegenerative disease, affecting approximately 1% of the world's population. Increasing evidence suggests that aerobic physical exercise can be beneficial in mitigating both motor and nonmotor symptoms of the disease. In a recent pilot study of the role of exercise on PD, we sought to confirm exercise intensity by monitoring heart rate (HR). For this purpose, we asked participants to wear a chest strap HR monitor (Polar Electro Oy) and the Fitbit Charge 4 (Fitbit Inc) wrist-worn HR monitor as a potential proxy due to its convenience. Polar H10 has been shown to provide highly accurate R-R interval measurements. Therefore, we treated it as the gold standard in this study. It has been shown that Fitbit Charge 4 has comparable accuracy to Polar H10 in healthy participants. It has yet to be determined if the Fitbit is as accurate as Polar H10 in patients with PD during rest and exercise. This study aimed to compare Fitbit Charge 4 to Polar H10 for monitoring HR in patients with PD at rest and during an intensive exercise program. A total of 596 exercise sessions from 11 (6 male and 5 female) participants were collected simultaneously with both devices. Patients with early-stage PD (Hoehn and Yahr ≤2) were enrolled in a 6-month exercise program designed for patients with PD. They participated in 3 one-hour exercise sessions per week. They wore both Fitbit and Polar H10 during each session. Sessions included rest, warm-up, intense exercise, and cool-down periods. We calculated the bias in the HR of the Fitbit Charge 4 at rest (5 min) and during intense exercise (20 min) by comparing the mean HR during each of the periods to the respective means measured by Polar H10 (HRFitbit - HRPolar). We also measured the sensitivity and specificity of Fitbit Charge 4 to detect average HRs that exceed the threshold for intensive exercise, defined as 70% of an individual's theoretical maximum HR. Different types of correlations between the 2 devices were investigated. The mean bias was 1.68 beats per minute (bpm) at rest and 6.29 bpm during high-intensity exercise, with an overestimation by Fitbit Charge 4 in both conditions. The mean bias of the Fitbit across both rest and intensive exercise periods was 3.98 bpm. The device's sensitivity in identifying high-intensity exercise sessions was 97.14%. The correlation between the 2 devices was nonlinear, suggesting Fitbit's tendency to saturate at high values of HR. The performance of Fitbit Charge 4 is comparable to Polar H10 for assessing exercise intensity in a cohort of patients with PD (mean bias 3.98 bpm). The device could be considered a reasonable surrogate for more cumbersome chest-worn devices in future studies of clinical cohorts.

Efficacy of morning versus afternoon aerobic exercise training on reducing metabolic syndrome components: A randomized controlled trial.

A supervised intense aerobic exercise program improves the health of individuals with metabolic syndrome (MetS). However, it is unclear whether the timing of training within the 24h day would influence those health benefits. The present study aimed to determine the influence of morning vs. afternoon exercise on body composition, cardiometabolic health and components of MetS. One hundred thirty-nine individuals with MetS were block randomized into morning (AMEX; n=42) or afternoon (PMEX; n=59) exercise training groups, or a non-training control group (Control; n=38). Exercise training was comprised of 48supervised high-intensity interval sessions distributed over 16weeks. Body composition, cardiorespiratory fitness (assessed by ), maximal fat oxidation (FOmax), blood pressure and blood metabolites were assessed before and after the intervention. Compared with the non-training Control, both exercise groups improved similarly body composition (-0.7% fat loss; P=0.002), waist circumference (-2.1 cm; P<0.001), diastolic blood pressure (-3.8mmHg; P=0.004) and (3.5mLkg-1 min-1; P<0.001) with no differences between training groups. AMEX, in comparison with PMEX, reduced systolic blood pressure (-4% vs. -1%; P=0.019), plasma fasting insulin concentration (-12% vs. -5%; P=0.001) and insulin resistance (-14% vs. -4%; P=0.006). Furthermore, MetS Zscore was further reduced in the AMEX compared to PMEX (-52% vs. -19%; P=0.021) after training. In summary, high-intensity aerobic exercise training in the morning in comparison to training in the afternoon is somewhat more efficient at reducing cardiometabolic risk factors (i.e. systolic blood pressure and insulin sensitivity). KEY POINTS: The effect of exercise time of day on health promotion is an area that has gained interest in recent years; however, large-scale, randomized-control studies are scarce. People with metabolic syndrome (MetS) are at risk of developing cardiometabolic diseases and reductions in this risk with exercise training can be precisely gauged using a compound score sensitive to subtle evolution in each MetS component (i.e. Z score). Supervised aerobic exercise for 16weeks (morning and afternoon), without dietary restriction, improved cardiorespiratory and metabolic fitness, body composition and mean arterial pressure compared to a non-exercise control group. However, training in the morning, without changes in exercise dose or intensity, reduced systolic blood pressure and insulin resistance further compared to when training in the afternoon. Thus, high-intensity aerobic exercise training in the morning is somewhat more efficient in improving the health of individuals with metabolic syndrome.

Mechanisms of adaptation to high intensity exercise in hypertrophic cardiomyopathy

Abstract Background Many individuals with hypertrophic cardiomyopathy (HCM) demonstrate exercise limitation. For a proportion this may be related to their overall cardiorespiratory fitness influenced by physical activity habits, body mechanics, or habitus. In others there is evidence of central and/or peripheral pathophysiology. However, some individuals with HCM demonstrate favourable adaptation to exercise. In the SAFE-HCM study, participants who underwent 12 weeks of high intensity exercise showed significant improvement in exercise indices including peak VO2, VO2/kg at anaerobic threshold (AT), time to AT, and overall exercise time compared to a usual care group. Purpose There have been no studies investigating the mechanistic adaptation(s) to exercise in HCM. This sub-study aimed to identify whether the observed improvements in exercise indices were attributable to central or peripheral adaptation. Methods Eighty patients with HCM (45.7±8.6 years) underwent baseline clinical, quality of life and psychological assessment. Individuals were randomised to a 12-week high intensity exercise programme (n=40) or usual care (n=40). Baseline evaluation was repeated at 12 weeks. The Fick equation (oxygen uptake (VO2) = cardiac output (CO) X (arterial-venous oxygen content (a-vO2 difference)) was used to assess whether central and/or peripheral adaptation was responsible for observed improvements. 2D speckle tracking imaging was utilised to calculate left ventricular longitudinal strain from the apical 2-, 3- and 4 chamber views (EchoPAC, V202, GE Healthcare). Results 12-weeks of high intensity exercise training produced a statistically significant increase in CO (1.1±0.4 L/min, CI (0.2,2.0), p=0.016) compared with the usual care group. There was no difference in the change in a-vO2 difference between groups (p=0.682) suggesting central adaptation to high intensity exercise. This was driven by an increase in stroke volume (SV) (6.1±3.0ml, CI (0.1,12.2), p=0.047) rather than an increase in heart rate (0.6±3.6 bpm, CI (-6.6,7.7), p=0.874). However, there was no change in resting myocardial deformation to account for the observed improvement in CO. Analysis of strain data demonstrated no difference in resting regional 4Ch (-0.7±0.6, CI (-1.9, 0.5), p=0.270) 3Ch (-1.1±0.9, CI (-2.8, 0.6), p=0.201), 2Ch (-1.3±0.9, CI (-3.1, 0.5), p=0.162) or average global longitudinal strain (0.9±0.6, CI (-2.2,0.3), p=0.144) between groups at 12 weeks. Conclusion Favourable central adaptations, predominantly driven by an increase in SV, enable improvements in exercise capacity following a high intensity exercise programme. Further studies are required to understand the physiological processes underlying this adaptation including assessment of myocardial deformation at peak exercise

Impact of Mild Level Exercise Program on Incidence of Falls, Gait and Balance Among Elderly People at Selected Rural Areas of Belagavi District.

Context: Exercises that are low-intensity can aid with balance and gait. Regular low-intensity exercise is a beneficial substitute for treating balance and gait issues brought on by ageing. Objective: To assess incidence of falls, gait and balance of elderly people before and after low intensity exercise program and to assess effectiveness of low intensity exercise program on incidence of falls, gait and balance of elderly people.&#x0D; Setting and design: The study was conducted in selected rural areas of Belgaum district and pre experimental one group pretest post test study design was used.&#x0D; Materials and Methods: Population was comprised of elderly people aged 60 years and above. The sample size was 30 and non probability purposive sampling technique was used to select the samples. Berg balance scale and Performance oriented mobility assessment scale for gait was used to assess gait and balance..&#x0D; Statistical Analysis used:Descriptiveand inferential statistics were used with the helpof SPSSversion 20.&#x0D; Results: In pretest12 (40%) of elders had incidence of fall during the one month prior to pre test and is reduced in post test as 7(23.3%) were had incidence of fall after one month to interventional program. The obtained value of ‘ t’ (29) = 6.97 for gait and ‘ t’ (29) = 2.65 for balance are found significant at 0.05 level of significance, indicating that the low intensity exercise program has helped elderly to improve their gait and balance.&#x0D; Conclusions: Low intensity exercise program helped elderly people to improve their gait and balance. So, such programs need to be implemented in community area to prevent incidence of fall and improve gait and balance among the elderly population.

“Impact of Mild Level Exercises on Gait, Balance, Functional Status to Prevent Fall Among Elderly In Selected Areas of Belagavi District, Karnataka – A Study Protocol”

Context: Falls, a frequent and preventable cause of morbidity, raise the likelihood of functional independence loss and the requirement for hospitalization and institutionalization, placing a strain on the healthcare system. The annual expenses for acute care linked to fractures from falls are estimated at $10 billion, despite the fact that the entire expenditures for acute care connected to falls remain unclear.&#x0D; Aims: To administer the mild level exercise programme of elderly among experimental group and to determine the effect of mild level exercise program on improvement of gait, balance and functional status of elderly among experimental group.&#x0D; Settings and Design: The samples from the selected rural areas of Belagavi district were selected using convenient sampling technique. A quantitative approach with post test only control group design was adopted for the study.&#x0D; Subjects and Methods: Elderly above the age of 60 years of selected rural areas of gokak taluka belagavi district and total 250 samples selected by using convenient sampling technique and my research approach is Quantitative Research Approach, Research deign is Post test only control group design and Sampling technique is Non-Probability; Convenient Sampling Technique respectively.&#x0D; Conclusions: The mild level exercise program was very much effective and the elders had great interest to learn and to do the exercises to improve their gait, balance, functional and to reduce the incidence of fall. Continuing nursing education programs can be conducted in hospitals and community regarding the importance of low intensity exercise program in improving gait, balance, functional status and in reducing the incidence of falls in the elderly people.

The Effect of an Intensive Hand Exercise Program on Muscle Strength and Hand Functions in Patients with Rheumatoid Arthritis

Aim: This study investigated the effectiveness of classic and intensive exercise programs in patients with rheumatoid arthritis (RA) and their relationship with disease activity and patient functional well-being.&#x0D; Material and Methods: Sixty patients aged 18 to 65, diagnosed with RA in our clinic, were randomly divided into two groups of 30 each. The first group received an intensive exercise program, while the second group received a classic exercise program. Disease activity was evaluated using erythrocyte sedimentation rate, C-reactive protein, DAS28Sedim, and DAS28Crp. Daily life activities were assessed using the HAQ score and Duruöz hand index. Joint mobility measurements were taken with a goniometer, and muscle strength measurements were taken using a manual dynamometer and pinch meter. Hand and wrist radiographs were taken and evaluated according to Steinbroker stages before exercise therapy.&#x0D; Results: Improvement was observed in both groups' Visual Analog Scale (VAS) and Health Assessment Questionnaire (HAQ) scores, with a significant improvement in VAS scores favoring the intensive exercise group.&#x0D; Conclusions: The study concluded that exercise therapy had positive effects on patients' hand functions, and the intensive exercise program was more effective.

O.3.2-3 ‘It helped me to disconnect from the problems’: a qualitative study exploring the subjective experiences of people with schizophrenia in a concurrent exercise program

Abstract Purpose The relationship between exercise and its role in mental health is extensively documented and has led to the inclusion of exercise into adjuvant programs for people with mental health disorders. However, considerably less attention is devoted to the experience of taking part in exercise and perceived health outcomes for people with specific mental health disorders. The aim of this study was therefore to investigate the subjective experiences of a concurrent exercise program designed to improve both physical and mental health, through participation, for people with schizophrenia. Methods Participants diagnosed with schizophrenia (n = 35, 41.6±10.3 years) from two locations (a psychiatric hospital and a mental health community support group) received an intensive concurrent exercise program (i.e., aerobic interval training and resistance training within the same session) for a five-month duration, three times a week, at out-of-hospital facilities. Qualitative data was collected via individual, semi-structured interviews, organized, and analyzed with thematic analysis using NVivo software. Results A conceptual model developed from the analysis explains the participants’ subjective experiences, opinions, and perceptions of the role of exercise and their perceived outcomes from participation in the program. Six themes emerged from the analysis. The themes ‘expectations about taking part’ and ‘attitude to exercise, the program, and general lifestyle’ appeared to influence participants to take part. The act (and factors associated with it) of ‘taking part’ then led to subsequent ‘perceived outcomes’ and ‘plans’. Conclusions Findings from the study support the case for the strategic use of exercise as an adjuvant program and maintenance of holistic health for people with schizophrenia. However, this study also demonstrates the paramount importance of building a continuation plan for participation to ensure sustainable and long-term adherence to exercise. The location of the program appears important to consider (i.e., out-of-hospital), as does the constitution of the group, the type of people, and the exercise program itself. For this clinical group, the exercise intervention not only serves a physical and mental enhancement function but also appears to achieve holistic health benefits such as well-being and important opportunities for social interaction.

Telerehabilitation Is a Valid Option for Total Knee Arthroplasty Patients: A Retrospective Pilot Study Based on Our Experience during the COVID-19 Pandemic.

Total knee arthroplasty is an effective operation. Post-surgery rehabilitation, based on early and intensive progressive exercise programs, plays a substantial role and telerehabilitation can be an effective safe option. This retrospective study aimed to compare traditional in-presence rehabilitation and telerehabilitation for total knee arthroplasty, based on our experience during the Italian COVID-19 lockdown. We retrospectively analyzed 164 patients (94 females and 70 males) enrolled in 2020 within 2 weeks after total knee replacement to perform post-operative outpatient rehabilitation. The clinical results of 82 patients (mean age 66.8 ± 10.2 years) performing telerehabilitation with those obtained from a similar cohort of 82 patients (mean age 65.4 ± 11.8 years) performing traditional in-presence outpatient rehabilitation were compared. Clinical outcomes were examined by comparing the gait speed (Time Up and Go-TUG test), the range of motion, the pain intensity (VAS), the functional status (Oxford Knee Score-OKS and Knee injury and Osteoarthritis Outcome Score-KOOS) and the overall satisfaction (Self-administered patient satisfaction scale) 12 weeks after the beginning of the physiotherapeutic protocol. Telerehabilitation was non-inferior to traditional in-presence rehabilitation in all of the investigated areas and no statistical difference in terms of effectiveness was detected at 12 weeks, as confirmed by the respective patient-reported outcome scores such as TUG test (reduced from 20 ± 2 s to 12 ± 1.5 s for the telerehab cohort and from 18 ± 1.5 s to 13.1 ± 2 s for the in-presence rehabilitation one), pain VAS, OKS (improved from 22 ± 1.3 to 36 ± 2.7 for the telerehab cohort and from 23 ± 2.1 to 35.1 ± 4.2 for the in-presence group), KOOS (improved from 46.2 ± 10.2 to 67.4 ± 3.8 for the telerehabilitation cohort and from 48.4 ± 8.4 to 68.3 ± 6.6 for the other group), and the Self-administered patient satisfaction scale (more than two-thirds of patients globally satisfied with the results of their surgery in both groups). The telerehabilitation program was effective after total knee replacement and yielded clinical outcomes that were not inferior to conventional outpatient protocols.

An Intensive Exercise Program Using a Technology-Enriched Rehabilitation Gym for the Recovery of Function in People With Chronic Stroke: Usability Study.

Rehabilitation improves poststroke recovery with greater effect for many when applied intensively within enriched environments. The failure of health care providers to achieve minimum recommendations for rehabilitation motivated the development of a technology-enriched rehabilitation gym (TERG) that enables individuals under supervision to perform high-intensity self-managed exercises safely in an enriched environment. This study aimed to assess the feasibility of the TERG approach and gather preliminary evidence of its effect for future research. This feasibility study recruited people well enough to exercise but living with motor impairment following a stroke at least 12 months previously. Following assessment, an 8-week exercise program using a TERG (eg, virtual reality treadmills, power-assisted equipment, balance trainers, and upper limb training systems) was structured in partnership with participants. The feasibility was assessed through recruitment, retention, and adherence rates along with participant interviews. Effect sizes were calculated from the mean change in standard outcome measures. In total, 70 individuals registered interest, the first 50 were invited for assessment, 39 attended, and 31 were eligible and consented. Following a pilot study (n=5), 26 individuals (mean age 60.4, SD 13.3 years; mean 39.0, SD 29.2 months post stroke; n=17 males; n=10 with aphasia) were recruited to a feasibility study, which 25 individuals completed. Participants attended an average of 18.7 (SD 6.2) sessions with an 82% attendance rate. Reasons for nonattendance related to personal life, illness, weather, care, and transport. In total, 19 adverse events were reported: muscle or joint pain, fatigue, dizziness, and viral illness, all resolved within a week. Participants found the TERG program to be a positive experience with the equipment highly usable albeit with some need for individual tailoring to accommodate body shape and impairment. The inclusion of performance feedback and gamification was well received. Mean improvements in outcome measures were recorded across all domains with low to medium effect sizes. This study assessed the feasibility of a holistic technology-based solution to the gap between stroke rehabilitation recommendations and provision. The results clearly demonstrate a rehabilitation program delivered through a TERG is feasible in terms of recruitment, retention, adherence, and user acceptability and may lead to considerable improvement in function, even in a chronic stroke population. RR2-doi.org/10.3389/fresc.2021.820929.

Conceptual development of an intensive exercise program for glioma patients (ActiNO): summary of clinical experience

PurposeExercise proved to reduce cancer-related symptoms and prolong survival in some cancer types. However, brain tumor patients are often advised against strenuous exercise. Here, we summarize our experience with a submaximal exercise program for glioma patients: ActiNO (Active in Neuro-Oncology).MethodsGlioma patients were invited to participate in the program. Since 2011, a sports scientist individualized two one-hour sessions per week adapted to the patients’ symptoms. One session consisted of bicycle ergometry (average workload: 75% of maximum heart rate), the other of whole-body resistance training. Both sessions were further complimented by coordinative elements. Cardiorespiratory fitness was assessed using the ”Physical Work Capacity” procedure. Patients were followed up regularly to assess adherence to the program and disease activity.ResultsUntil December 2019, 45 glioma patients, median-aged 49 years (IQR 42–59), were included in the analysis. Most patients suffered from glioblastoma (58%), followed by diffuse lower-grade astrocytoma (29%). In overall 1828 training sessions, two minor epileptic events occurred (1 speech arrest; 1 focal seizure). During fitness assessment, all patients achieved at least 75% of their age-adjusted maximum heart rate. Peak workload averaged 172 W (95% CI 156–187). Median survival of participating glioblastoma patients was 24.1 months (95% CI 8.6–39.5).ConclusionThis supervised training program with submaximal exertion was feasible and safe in glioma regardless of WHO grading. Based on these experiences, we initiated a prospective multicenter study to objectify improvements in physical performance and quality of life in patients with glioblastoma.

Physical Activity and Cardiac Morphologic Adaptations.

Chronic and intense exercise programs lead to cardiac adaptations, followed by increased left ventricular wall thickness and cavity diameter, at times meeting the criteria for left ventricular hypertrophy (LVH), commonly referred to as "athlete's heart". Recent studies have also reported that extremely vigorous exercise practices have been associated with heightened left ventricular trabeculation extent, fulfilling noncompaction cardiomyopathy criteria, as part of exercise-induced structural adaptation. These changes are specific to the exercise type, intensity, duration, and volume and workload demands imposed on the myocardium. They are considered physiologic adaptations not associated with a negative prognosis. Conversely, hypertrophic cardiac adaptations resulting from chronic elevations in blood pressure (BP) or chronic volume overload due to valvular regurgitation, lead to compromised cardiac function, increased cardiovascular events, and even death. In younger athletes, hypertrophic cardiomyopathy (HCM) is the usual cause of non-traumatic, exercise-triggered sudden cardiac death. Thus, an extended cardiac examination should be performed, to differentiate between HCM and non-pathological exercise-related LVH or athlete's heart. The exercise-related cardiac structural and functional adaptations are normal physiologic responses designed to accommodate the increased workload imposed by exercise. Thus, we propose that such adaptations are defined as "eutrophic" hypertrophy and that LVH is reserved for pathologic cardiac adaptations. Systolic BP during daily activities may be the strongest predictor of cardiac adaptations. The metabolic demand of most daily activities is approximately 3-5 metabolic equivalents (METs) (1 MET = 3.5 mL of kg of body weight per minute). This is similar to the metabolic demand of treadmill exercise at the first stage of the Bruce protocol. Some evidence supports that an exercise systolic BP response 150 mmHg at the end of that stage is a strong predictor of left ventricular hypertrophy, as this BP reflects the hemodynamic burden of most daily physical tasks. Aerobic training of moderate intensity lowers resting and exercise systolic BP at absolute workloads, leading to a lower hemodynamic burden during daily activities, and ultimately reducing the stimulus for LVH. This mechanism explains the significant LVH regression addressed by aerobic exercise intervention clinical studies.

‘It Helped Me to Disconnect My Mind from the Problems’: The Subjective Experiences of People with Schizophrenia Taking Part in a Concurrent Exercise Program

The aim of this study was to investigate the subjective experiences of a concurrent exercise program designed to improve both physical and mental health, through participation, for people with schizophrenia. Participants diagnosed with schizophrenia (n = 35, 41.6 ± 10.3 years) received an intensive concurrent exercise program for a 5-month duration, three times a week, at out-of-hospital facilities. Qualitative data was collected via individual, semi-structured interviews, organized, and analyzed with thematic analysis. The findings highlight the participants’ perspective in supporting an out-of-hospital exercise program as an acceptable and beneficial adjunct to usual treatment in people with schizophrenia for holistic health improvements.

EFEITOS DO TREINAMENTO FíSICO DE INTENSIDADE MODERADA SOBRE A RECUPERAçãO DA SAúDE MENTAL DOS ESTUDANTES

ABSTRACT Introduction Moderate-intensity physical training effectively improves physical fitness and promotes an important impact on restoring human mental health. Objective This study aims to explore the effect of moderate-intensity physical training on students’ mental health. Methods 100 students presented themselves as research volunteers. The moderate-intensity sport the students played was badminton. Each exercise lasted 30 minutes. A scale was used to detect the students’ emotional changes after exercise. Different intensity exercise programs were formulated according to the improvement in the student’s mood. The mechanism of the impact of moderate-intensity exercise on mental health was also compared. Results Students’ emotional state before the exercise intervention was affected by physical exhaustion. After the exercise intervention, the emotional state of college students was shown to be more resilient to physical exhaustion. The dynamic changes in students’ states before and after the intervention were statistically significant (P&lt;0.05). Conclusion Moderate-intensity sports positively affect students’ mental health recovery. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

High-Intensity Functional Training For Children With Autism Improves Social Skills, ASD Symptoms And Physical Performance

PURPOSE: This study assessed the feasibility and effectiveness of a 10-wk high intensity exercise program offered after-school for children with autism spectrum disorder (ASD) without intellectual disability. METHODS: Children with ASD (n = 11, M age: 9.53 ± 2.1 yr) engaged in a 1 hr after-school high intensity functional training exercise session, 2 d/wk for 10 wks that targeted social skills, ASD symptoms, and physical performance. Each group exercise session included an instruction period, warm-up, high intensity workout, related game, and cool-down. Social skill and symptom outcome measures included the Adapted Skillstreaming Checklist (ASC) and Social Responsiveness Scale 2nd Edition, School Age Form (SRS-2). Physical performance data (i.e., strength, flexibility, PACER aerobic fitness, power) were also collected. Paired t-tests were used to assess pre to post program performance differences. Participant and parent/guardian satisfaction surveys (7-point Likert scale) were administered following completion of the program. RESULTS: Feasibility and safety were supported in high levels of fidelity (96%), participant and parental satisfaction (4.66, 6.53 out of 7, respectively), and attendance (90% of all sessions), and there were no adverse events or injuries. Pre-post comparisons indicated significant improvements and large effects in social skills (ASC = 87.5 to 118.73; d = 1.95) and ASD symptoms (SRS-2 = 83.6 to 71.36; d = .98) and medium-to-large effects on tests of physical performance (PACER [6.9 to 9.9 laps; d = .86], 60 sec max sit-ups [13.3 to 23.5 reps, d = .58], 60 sec max body weight squats [19.5 to 29.6; d = .61]). CONCLUSION: This after-school high intensity exercise program for children with ASD without intellectual disability was feasible (high fidelity, satisfaction) and improved social functioning, ASD symptoms and physical performance.

Effects of Sport-Based Interventions on Executive Function in Older Adults: A Systematic Review and Meta-Analysis Protocol.

Background: Moderate-to-vigorous intensity exercise programs have proven to exert positive effects on the cognitive performance of older people. However, the specific effects sport-based exercise programs have on cognitive performance, upon executive functions, remain unclear. Therefore, the purpose of this study is to clarify the effects of sport-based exercise programs on executive functions in older adults, through a systematic review protocol of the scientific literature, with a meta-analysis. Methods: The search was performed in the Web of Science, PubMed, Scopus, and EBSCO electronic databases by combining keywords and different medical subject headings (MeSH) to identify and evaluate the relevant studies from inception up until June 2022. This study considers longitudinal studies with at least one experimental group and pre- and post-intervention measurements involving healthy older adults of 60 years of age or older. Studies have to consider one or more measures of executive function, including dimensions of working memory, inhibition, and cognitive flexibility, in order to meet the eligibility criteria for inclusion in this report. The Physiotherapy Evidence Database (PEDro) scale was used for methodological quality assessment studies. The DerSimonian and Laird random-effects model was used to compute the meta-analyses and report effect sizes (ES, i.e., Hedges’ g) with 95% confidence intervals (95% CIs), and a statistical significance set at p ≤ 0.05. The ES values were calculated for executive function globally and for each dimension of executive function (e.g., working memory, inhibition, cognitive flexibility) in the experimental and control/comparator groups using the mean and standard deviation values before and after the intervention period. Conclusions: Our systematic review aims to clarify the effects of sport-based exercise programs on executive functions in older adults. The results may help practitioners and stakeholders to provide better evidence-based decisions regarding sport-based exercise program implementation for older adults, and to help them to optimize cognitive functions during the aging process. Ethical permission is not required for this study. Systematic review registration: this systematic review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42022284788).