Multidimensional Exercise Research Articles

Impairment of Cardiovascular Functional Capacity in Mild-to-Moderate Kidney Dysfunction.

Traditional diagnostic tools that assess resting cardiac function and structure fail to accurately reflect cardiovascular alterations in patients with chronic kidney disease (CKD). This study sought to determine whether multidimensional exercise response patterns related to cardiovascular functional capacity can detect abnormalities in mild-to-moderate CKD. In a cross-sectional study, we examined 3,075 participants from the Framingham Heart Study (FHS) and 451 participants from the Massachusetts General Hospital Exercise Study (MGH-ExS) who underwent cardiopulmonary exercise testing (CPET). Participants were stratified by estimated glomerular filtration rate (eGFR): eGFR ≥90; eGFR 60-89; eGFR 30-59. Our primary outcomes of interest were peak oxygen uptake (VO 2 Peak),VO 2 at anaerobic threshold (VO 2 AT), and the ratio of minute ventilation to carbon dioxide production (VE/VCO 2 ). Multiple linear regression models were fitted to evaluate the associations between eGFR group and each outcome variable adjusted for covariates. In the FHS cohort, N=1,712 (56%) had an eGFR ≥90 ml/min/1.73m 2 , N=1,271 (41%) had an eGFR 60-89 ml/min/1.73m 2 , and N=92 (3%) had an eGFR 30-59 ml/min/1.73m 2 . In the MGH-ExS cohort, N=247 (55%) had an eGFR ≥90 ml/min/1.73m 2 , N=154 (34%) had an eGFR 60-89 ml/min/1.73m 2 , and N=50 (11%) had an eGFR 30-59 ml/min/1.73m 2 . In FHS, VO 2 Peak and VO 2 AT were incrementally impaired with declining kidney function ( p <0.001); however this pattern was attenuated following adjustment for age. Percent-predicted VO 2 Peak at AT was higher in the lower eGFR groups ( p <0.001). In MGH-ExS, VO 2 Peak and VO 2 AT were incrementally impaired with declining kidney function in unadjusted and adjusted models ( p <0.05). VO 2 Peak was associated with eGFR ( p <0.05) in all models even after adjusting for age. On further mechanistic analysis, we directly measured cardiac output (CO) at peak exercise via right heart catheterization and found impaired CO in the lower eGFR groups ( p ≤0.007). CPET-derived indices may detect impairment in cardiovascular functional capacity and track cardiac output declines in mild to moderate CKD.

Effect Of Incorporating Dexterity Function In A Multi-Dimensional Exercise Program On Functional Performance In Elderly Population.

Effect Of Incorporating Dexterity Function In A Multi-Dimensional Exercise Program On Functional Performance In Elderly Population.

Clusters of multidimensional exercise response patterns and estimated heart failure risk in the Framingham Heart Study.

New tools are needed to identify heart failure (HF) risk earlier in its course. We evaluated the association of multidimensional cardiopulmonary exercise testing (CPET) phenotypes with subclinical risk markers and predicted long-term HF risk in a large community-based cohort. We studied 2532 Framingham Heart Study participants [age 53±9years, 52% women, body mass index (BMI) 28.0±5.3kg/m2, peak oxygen uptake (VO2) 21.1±5.9kg/m2 in women, 26.4±6.7kg/m2 in men] who underwent maximum effort CPET and were not taking atrioventricular nodal blocking agents. Higher peak VO2 was associated with a lower estimated HF risk score (Spearman correlation r: -0.60 in men and -0.55 in women, P<0.0001), with an observed overlap of estimated risk across peak VO2 categories. Hierarchical clustering of 26 separate CPET phenotypes (values residualized on age, sex, and BMI to provide uniformity across these variables) identified three clusters with distinct exercise physiologies: Cluster 1-impaired oxygen kinetics; Cluster 2-impaired vascular; and Cluster 3-favourable exercise response. These clusters were similar in age, sex distribution, and BMI but displayed distinct associations with relevant subclinical phenotypes [Cluster 1-higher subcutaneous and visceral fat and lower pulmonary function; Cluster 2-higher carotid-femoral pulse wave velocity (CFPWV); and Cluster 3-lower CFPWV, C-reactive protein, fat volumes, and higher lung function; all false discovery rate<5%]. Cluster membership provided incremental variance explained (adjusted R2 increment of 0.10 in women and men, P<0.0001 for both) when compared with peak VO2 alone in association with predicted HF risk. Integrated CPET response patterns identify physiologically relevant profiles with distinct associations to subclinical phenotypes that are largely independent of standard risk factor-based assessment, which may suggest alternate pathways for prevention.

Effects of multidimensional exercise management on self-efficacy, blood glucose control, and delivery outcomes in pregnant women with gestational diabetes mellitus.

This study aimed to evaluate the effects of multidimensional quantitative exercise management on self-efficacy, blood glucose control, and delivery outcomes in pregnant women with gestational diabetes mellitus (GDM). A randomized controlled trial was conducted with 150 pregnant women diagnosed with gestational diabetes mellitus (GDM). Participants were randomly assigned to either the experimental group (Exp), which received a multidimensional quantitative exercise management intervention, or the control group (Con), which received standard GDM management. Results were compared between the groups included self-efficacy scores, blood glucose levels, and delivery outcomes. Exp group of pregnant women exhibited drastically superior self-efficacy scores as well as more stable blood glucose levels during pregnancy relative to Con group (P < 0.05). Moreover, visual analogue scale (VAS) of pregnant women and Apgar scores of infants in Exp group were considerably better than those in Con group (P < 0.05). In contrast to Con group, pregnant women in Exp group had considerably better labor outcomes along neonatal complication rates (P < 0.05). Multidimensional quantitative exercise management had a positive impact on pregnant women with GDM. This intervention method can improve self-efficacy levels along better blood glucose control, and enhance delivery outcomes. These findings suggested that multidimensional quantitative exercise management has potential clinical value in the management of GDM, providing an effective management strategy to improve the health conditions of both pregnant women and infants.

Effectiveness of magnetic therapy versus exercise in elderly patients with chronic mechanical neck pain: A randomized clinical trial

&lt;b&gt;Background:&lt;/b&gt; Mechanical neck pain (MNP) affects all age groups, it has a substantial physical, psychological, and economic impact, especially in elderly. This study aimed to evaluate effect of addition of magnetic therapy (MT) to exercise versus exercise therapy alone on neck pain (NP), proprioception, and balance in elderly patients with chronic MNP.&lt;br /&gt; &lt;b&gt;Materials &amp;amp; Methods:&lt;/b&gt; 50 elderly patients with chronic MNP were assigned to magnetic group (25 patients who practiced exercise program for 35-40 minutes/session three sessions per week for four weeks in addition exposure to MT for 20 minutes each session three sessions per week for four weeks) and control group (25 patients who practiced only the exercise program). The severity of pain, cervical joint position sense (JPS) and balance performance were measured by using the visual analogue scale (VAS) goniometer and the both single-leg stance time (SLST), and timed up and go (TUG) tests, respectively. ANOVA and Independent t-tests were used to determine significant differences within and between two groups for normal variables, whereas the Mann-Whitney and Kruskal-Wallis tests were used for not normal variables.&lt;br /&gt; &lt;b&gt;Results:&lt;/b&gt; The results show significant improvements in VAS, SLST (with open and closed eyes), TUG, and JPS after interventions in both groups, p-value &amp;lt;0.05, while addition of MT to exercise program induced only significant differences in VAS, SLST (with open &amp;amp; closed eyes), TUG, except JPS, p-value = 0.002, 0.047 &amp;amp; 0.037, 0.001, and 0.928 respectively, in favor to the magnetic group.&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; Multi-dimensional exercise program is effective in relieving NP and improving balance in elderly with MNP, addition of MT to exercise program could induce superior effects only on pain and balance for elderly patients with MNP.

Arterial Stiffness and Cardiorespiratory Fitness Impairment in the Community.

Background During exercise, a healthy arterial system facilitates increased blood flow and distributes it effectively to essential organs. Accordingly, we sought to understand how arterial stiffening might impair cardiorespiratory fitness in community-dwelling individuals. Methods and Results Arterial tonometry and maximum effort cardiopulmonary exercise testing were performed on Framingham Heart Study participants (N=2898, age 54±9 years, 53% women, body mass index 28.1±5.3 kg/m2). We related 5 arterial stiffness measures (carotid-femoral pulse wave velocity [CFPWV]: a measure of aortic wall stiffness; central pulse pressure, forward wave amplitude, characteristic impedance: measures of pressure pulsatility; and augmentation index: a measure of relative wave reflection) to multidimensional exercise responses using linear models adjusted for age, sex, resting heart rate, habitual physical activity, and clinical risk factors. Greater CFPWV, augmentation index, and characteristic impedance were associated with lower peak oxygen uptake (VO2; all P<0.0001). We observed consistency of associations of CFPWV with peak oxygen uptake across age, sex, and cardiovascular risk profile (interaction P>0.05). However, the CFPWV-peak oxygen uptake relation was attenuated in individuals with obesity (P=0.002 for obesity*CFPWV interaction). Higher CPFWV, augmentation index, and characteristic impedance were also related to cardiopulmonary exercise testing measures reflecting adverse O2 kinetics and lower stroke volume and peripheral O2 extraction but not to ventilatory efficiency, a prognostic measure of right ventricular-pulmonary vascular performance. Conclusions Our findings delineate relations of arterial stiffness and cardiorespiratory fitness in community-dwelling individuals. Future studies are warranted to evaluate whether the physiological measures implicated here may represent potential targets for improving cardiorespiratory fitness in the general population.

Adherence to cognitive and physical exercise engagement: a challenge to successful dementia risk reduction and prevention efforts.

With human life expectancy and proportion of older adults increasing, global use of evidence-supported preventative methods to minimize risk of brain-related disabilities such as Alzheimer's disease and other dementias-as well as interventions to slow rate of disease progression-is important. Sustained engagement in cognitive and physical exercise programs may prevent or delay dementia onset as well as maximize health and function of those with dementia. Despite awareness of the importance of cognitive and physical exercise to brain health, exercise program adherence by older adults is extremely challenging. In this Perspective article, we summarize what is known about contributors to exercise program adherence and strategies to promote it. We discuss our viewpoint on knowledge gaps regarding exercise adherence and research that needs to be conducted. We conclude by proposing a multi-dimensional exercise adherence assessment framework that includes portable neurophysiologic technologies to inform initial design and updating of individualized exercise programs that optimize sustained exercise program engagement and, ultimately, maximize brain health in older adults with and without mild cognitive impairment and dementia.

Changes in Selected Cognitive and Motor Skills as Well as the Quality of Life After a 24-Week Multidimensional Music-Based Exercise Program in People With Dementia.

The loss of independence is one of the greatest consequences of dementia. Multidimensional music-based exercise programs could counteract. The present study investigates the effects of such a program on people with dementia and bases on a 24-week intervention with three measurement time points. Sixty-nine people with dementia were randomly assigned to the intervention (n = 43) and control group (n = 26). The following outcome parameters were measured: leg strength, gait, grip strength, balance, reaction time, selected cognitive abilities, and quality of life. A mixed ANOVA with repeated measurement showed significant interaction effects between group and time. After 24-weeks in contrast to the control group the intervention group significantly improved in leg strength (P = .001), balance (P = .001), gait (P = .001), grip strength (right P = .002, left P = .011), reaction time (P = .003), global cognition (P = .039), verbal fluency (P = .002), attention (P = .013) and quality of life (P = .011). In conclusion, the program enhanced selected cognitive and motor skills and quality of life.

The effects of exercise therapy feedback on subjective treatment outcome and patient satisfaction: study protocol for a mono-centric, randomized, controlled trial in orthopedic rehabilitation (FeedYou)

BackgroundThe disease burden of musculoskeletal disorders necessitates multidisciplinary and patient-centered models of care. Exercise therapy represents a first-line treatment strategy and a central component of medical rehabilitation. In order to realize the goals of long-term physical activity and participation as proposed by the ICF, exercise therapy can be supplemented by interventional techniques from the field of psychotherapy. Although psychotherapist feedback has been shown to improve therapeutic outcome and patient satisfaction, feedback use in exercise therapy is mostly limited to motor learning and exercise instruction. The present paper therefore describes the use of multidimensional exercise therapy feedback in medical rehabilitation. The aims of the trial presented in this study protocol are to evaluate the effects of this novel feedback approach on rehabilitation outcomes in comparison to usual care.MethodsThe study is designed as a prospective, mono-centric, randomized controlled, superiority trial (RCT) with two parallel groups and three measuring points: T0 = start of three-week inpatient rehabilitation, T1 = end of three-week inpatient rehabilitation, T2 = 12-week follow-up. In total, 132 patients suffering from chronic neck, shoulder and/or lumbar spine disorders will be recruited. The intervention involves multidimensional exercise therapy feedbacks during the initial and final physical therapist examination, as well as short exercise therapy feedbacks during the course units of the mandatory group-based exercise therapy program. Primary outcomes are the subjective treatment outcome, assessed by BPI and indication-specific questionnaires, as well as patient satisfaction, assessed by ZUF-8 and an intervention-specific questionnaire. The final data collection is expected by May 2023.DiscussionThis study may provide a valuable insight into the effectiveness of multidimensional exercise therapy feedback to improve treatment outcomes and patient satisfaction in medical rehabilitation. This could contribute to rehabilitation quality assurance and the long-term physical activity behavior of rehabilitation patients.Trial registration The trial has been registered with the German Clinical Trial Register (DRKS) under the Registration Number DRKS00027263.

Time-Course of Changes in Multidimensional Fatigue and Functional Exercise Capacity and Their Associations during a Short Inpatient Pulmonary Rehabilitation Program

This study aimed to assess the time-course of changes in multidimensional fatigue and functional exercise capacity and their associations during an inpatient pulmonary rehabilitation (PR) program. Seventy COPD patients from three centres were enrolled for a four-week PR program and were evaluated before (T0) and at the end of each week (T1, T2, T3, and T4). Weekly change in multidimensional fatigue was assessed by the multidimensional inventory questionnaire (MFI-20) and functional exercise capacity by the 6-minute walking distance (6MWD). Reaction time (RT) and heart rate variability (HRV) were also assessed as complementary markers of fatigue. HRV did not change during the study (all p > 0.05). MFI-20 score and RT decreased during the first part of the program (p < 0.001) and levelled off at T2 (all p > 0.05 compared with each preceding time). While 6MWD improved by almost 70% during the first part of the PR, it continued to increase, albeit at a greatly reduced pace, between T2 and T4 (p < 0.05). In parallel, a negative association was found between MFI-20 score and 6MWD at each evaluation time (r ranged from 0.43 to 0.71), with a significantly stronger T3 correlation compared with the other time periods (all p < 0.05). The strengthening of the association between fatigue and functional exercise capacity at T3, which occurred concomitantly with the slowdown of functional exercise capacity improvement, is consistent with a role for fatigue in the limitation of performance changes during PR. The limitation of fatigue during PR is thus an interesting aspect to improve the magnitude of performance changes.

COMPARISION OF MULTIDIMENSIONAL HOME-BASED EXERCISE VERSUS RESISTANCE EXERCISE ON GRIP STRENGTH AND HAND FUNCTIONS IN ELDERLY POPULATION

Background of the study: In people aged 20-29 years old, average grip strength is 46 kg for men and 29kg for women. This decrease to 39 kg-23kg by the time when people reach 60 – 69 years of age. Aim &amp; objective of the study is to study the comparative effects of multidimensional home-based exercise Vs resistance exercise to improve grip strength and hand functions in elderly population. Methodology: This experimental study of comparative type (pre and post) with 30 subjects the study was carried out at ACS medical college and hospital OPD for four weeks after the approval from institution of review board (IRB). there are selected for the study after getting consent for participation. the subjects were selected based on the inclusion and exclusion criteria and they assigned into two groups by simple randomized sampling method. The Group A (multidimensional home-based exercise) consists of 15 and the Group B (resistance exercise) consists of 15, the hand-held dynamometer is used as outcome measures. Result: Comparative study between Group A and Group B showed significant difference found in effectiveness in Right, Left hand power with P value &lt;0.0001 on hand grip among elderly people. Conclusion: Comparative study between Group A and Group B showed significant difference found in effectiveness in Right, Left hand power with P value &lt;0.0001 on hand grip among elderly people. Group B found more significant compare with Group A with mean difference of 4.800, 5.34 respectively on right and left hand by resisted exercise on hand grip among elderly people.

Functional Stupidity in the Boardroom

This study provides a better understanding of the dynamics of knowledge and expertise in the context of public companies’ compensation committees (CCs), through a focus on CC members’ cognitive limitations. Drawing on semi-structured interviews, we mobilize the concepts of reflexive thinking and functional stupidity (Alvesson and Spicer 2012) to document and analyze CC members’ difficulties and/or unwillingness “to use cognitive and reflective capacities in anything other than narrow and circumspect ways” (Alvesson and Spicer, 2012: 1201). Overall, our findings indicate that CC members, although being firmly committed to knowledge development and problem solving, are disinclined to mobilize three key aspects of cognitive capacity (i.e., reflexivity, meaningful justification and substantive reasoning) in the design of remuneration policies. Our study also shows that these cognitive limitations are fuelled by a multidimensional exercise of power, which we conceive of as a form of “stupidity management” (Alvesson and Spicer 2012). The latter aims to limit CC members’ meaningful communicative action by constraining disruptive thinking and preventing critical issues from impacting committees’ agenda and deliberations – all of this in the name of aspirational yet superficial forms of decision-making leadership in the boardroom. Our analysis also highlights the central role of compensation consultants as “stupidity managers”, involved in the orchestration of the constraining of committee members’ mind. Significant implications of these findings for research and policy-making are discussed.

Brain default mode network mediates the association between negative perfectionism and exercise dependence.

Perfectionism is correlated with the occurrence of exercise dependence. We aim to reveal the role of functional connectivity (FC) between gray matter (GM) and white matter (WM) networks in the association between perfectionism and exercise dependence. In this cross-sectional study, one hundred ten participants with exercise dependence underwent behavioral evaluation and resting-state functional magnetic resonance imaging. Perfectionism and exercise dependence were quantified using the Frost Multidimensional Perfectionism Scale (FMPS) and Exercise Dependence Scale (EDS). We used a K-means clustering algorithm to identify functional GM and WM networks and obtained the FCs of the GM-GM, GM-WM, and WM-WM networks. Partial correlation and mediation analyses were performed to explore the relationships among FCs, FMPS, and EDS. We identified ten stable GM networks and nine WM networks. Of these, FCs existed between the corona radiata network (WM1) and default mode network (DMN, GM8), WM1 network and WM DMN (WM4), WM1 network and midbrain WM network (WM7), and WM4 network and inferior longitudinal fasciculus network (WM9). The WM1-GM8 and WM1-WM4 FCs were positively correlated with the EDS and negative FMPS. The mediating effects of the WM1-GM8 and WM1-WM4 FCs were established in the association between the negative dimensional FMPS and EDS. The WM1 network anatomically linked the subregions within the GM8 and WM4 networks, and WM1-GM8 and WM1-WM4 FCs mediated the association between negative dimensional FMPS and EDS. These findings indicated that DMN function might be involved in the increased risks of exercise dependence promoted by negative perfectionism.

Bibliometric analysis of research trends of physical activity intervention for autism spectrum disorders.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social impairment, restricted interests, and repetitive stereotyped behaviors. At present, its pathogenesis has not been fully understood. Various methods are used for clinical treatment and intervention, among which physical activity (PA) intervention also has an obvious effect. This study has used bibliometric methods and visual analysis methods to analyze 885 studies of PA intervention in ASD from 2003 to 2022 in the Web of Science (WoS) database in order to provide theoretical support for the follow-up research on the effect of PA with ASD. The main findings of this study are as follows. First, the literature on PA interventions in ASD research showed a growing trend. The leading institution in this field is the University of Delaware, forming a core group of authors represented by authors such as Sean Healy and Carol Curtin et al. Second, the research focus of this research area mainly includes PA interventions for children and adolescents with ASD. PA can improve symptoms such as stereotyped behaviors and motor function in patients with ASD as well as can reduce childhood obesity rates and improve quality of life. Third, skill, youth, prevalence, and meta-analysis systematic reviews were found. It is the long-term concern and focus of researchers. In conclusion, the current research is only a short-term analysis, and it is not possible to verify the long-term effect; thus, future data analysis should evaluate and explore the long-term effects of PA interventions on ASD including cohort and longitudinal study types focused on the rehabilitation of patients with ASD. Moreover, testing the sustainability of benefits for children with ASD and constructing a multidimensional exercise integrated intervention model are the main directions for future research in this field.

The Italian Puzzle of the European Youth Guarantee

Focusing on the European Youth Guarantee (YG), this chapter explores why the funds for a specific EU co-financing 2014‒20 programme actually got to be spent in Italy—completely and on time. Thanks to a methodology that combines a set of indicators—spending input and output, regional divide proxies, the positive exit of young beneficiaries, outcomes, target achievement, the penetration rate of actions, and the logical framework approach to detecting problems and finding solutions—the chapter analyses why the same initiative may, in certain areas of the country, provide counterexamples to the overall mapping of the spending of EU funds, due to regional economic and social gaps and unclear multilevel governance, targets and sets of indicators. By conducting a multidimensional exercise, the chapter shows that an evaluation focused on national data input and output does not reveal the real impact of the YG on the country. It argues that national monitoring does not necessarily reveal the limits and causes of the efficiency and effectiveness of such an initiative. Lack of spending, late spending, low target achievement and misdirection of resources are examined in order to shed light on the effectiveness of YG measures in facilitating young individuals’ transition into the labour market. While a macro-regional and regional analysis of input, output and outcome data will show how the Youth Guarantee success is mainly linked to the development of local youth labour markets, the logical framework problem tree will help identify the primary causes of the limited impact of the national YG scheme and identify efforts to be made to remove these causes. Such a removal would in the future increase the impact of the YG if accompanied by a higher level of management skills among the Public Employment Services personnel involved and the full digitalisation of the public bodies involved in the process.

Teaching Innovation and Practice of Communication Principle Course

Communication principle course is the core basic professional course of communication engineering major. It is theoretical and practical very much. Because boring and difficult to learn, it is easy to become a "bird course". By reshaping the course content with the main line of "system" and "connection", the Trinity course education scheme is established, including the professional knowledge based on connection view, multi-dimensional practical exercise, and quality improving integrated with ideological and political education in courses. The results of feedback survey show that the reformed teaching of communication principle course has achieved good effect.

Influence of a\xa0multidimensional music-based exercise program on selected cognitive and motor skills in dementia patients\u2014a\xa0pilot study

One of the most common causes of needing care in old age is dementia. In order to enjoy a pleasant retirement for people with dementia, it is essential for them to maintain their independence. Studies have shown that a combination of physical activity and music has positive effects on dementia patients. Therefore, this study aimed to investigate the feasibility of implementing a multidimensional music-based exercise program for dementia patients and the effects on an intervention group (IG) compared to a control group (CG, usual care). The study design was based on a 12-week intervention with two (IG/CG) by two (pretest/posttest) parallel groups and block randomization with unequal group sizes. Participants had to be able to move independently or with a walker and not have severe cardiovascular disease or cardiac arrhythmias. Fifty-three blinded dementia patients (age: 83.63 ± 6.03 years) from inpatient facilities participated in the study and were assigned from the exercise instructors to IG (n = 34) and CG (n = 19). The primary outcomes were feasibility (Observation sheet), modified Chair Rising test, Timed Up and Go test, hand dynamometer test, FICSIT‑4 (Frailty and Injuries: Cooperative Studies of Intervention Techniques), and drop bar test. Secondary endpoints included: verbal fluency (“animals”), the Mini-Mental State Examination, memory, Trail Making Test A, and Qualidem. Forty-nine subjects were analyzed (IG = 32; CG = 17). There were significant differences between the groups in the modified Chair Rising test (p = 0.033), FICSIT‑4 (p = 0.035), and Timed Up and Go test (p = 0.005) at posttest, which showed improved performance of the IG compared to the CG. The IG additionally showed improvements in the modified Chair Rising test (p = 0.000), drop bar test (p = 0.033), hand dynamometer test (p = 0.001), Timed Up and Go test (p = 0.000), verbal fluency (p = 0.002) and Trail Making Test A (p = 0.04) after 12 weeks. There were no adverse events or side effects. The multidimensional music-based exercise program could be performed by the dementia patients and was well received. The improved functional mobility could contribute to a lower risk of falls and thus maintain independence. For the follow-up study, the number of subjects, randomization, and parameters should be considered.

Chinese expert consensus on cardiac rehabilitation in patients with atrial fibrillation

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias. More and more attention has been paid to its risk factor control and multidisciplinary management. A number of studies have proved that patients with AF benefit from cardiac rehabilitation. However, a unified management plan of cardiac rehabilitation for patients with AF is lacking in China. Thus, a Chinese expert consensus on the rehabilitation of AF (including valvular AF and non-valvular AF) is compiled based on newly issued related guidelines at home and abroad, in which the updated important academic content is included. This consensus mainly includes the upstream management of AF, multidimensional rehabilitation evaluation and exercise prescription.

Group-Based Exercise as a Therapeutic Strategy for the Improvement of Mental Outcomes in Mild to Moderate Alzheimer’s Patients in Low Resource Care Facilities

Background: Exercise is related to enhanced cognitive functioning and brain plasticity. Exercise might represent a potential adjunctive treatment for neuropsychiatric disorders, such as Alzheimer's disease (AD). Furthermore, group exercise may prove especially useful due to its additional benefits. Objectives: This study aimed to determine the effect of low-cost, group-based exercise on mental outcomes in patients with mild to moderate AD. Methods: Participants with mild to moderate AD were randomized to either a non-exercising control (CON) group or a group-exercise (GEX) group (n = 20 each). The GEX participated in eight weeks of three-times-weekly non-consecutive 45-minute sessions consisting of balance, resistance, aerobic, and flexibility exercises to determine their effect on mental outcomes, namely, cognitive function, activities of daily living (ADLs), and quality of life (QOL). Results: The intervention program showed a significant (P ≤ 0.05) increase in Mini-Mental State Examination (MMSE) scores (P = 0.023). While the GEX were found to have no change in their (Alzheimer’s disease cooperative study activities of daily living) ADCS-ADL scores (P = 0.574). The CON demonstrated a significant, but deleterious 13.77% decrease in their ADCS-ADL scores from pre- to mid-test (P = 0.023) and from pre- to post-test (P = 0.038). Quality of Life-Alzheimer’s Disease (QOL-AD) scores were unchanged in both the GEX and CON. Conclusions: Our results indicate that a low-cost, multidimensional group exercise intervention can positively influence cognitive function and improve patients with mild to moderate AD ability to perform ADLs.

The Relationship of Self-efficacy and Explicit and Implicit Associations on the Intention-Behavior Gap.

Recent physical activity research is limited by intention-behavior discordance and is beginning to recognize the importance of automatic processes in exercise. The purpose of the current study was to examine the role of multidimensional exercise self-efficacy (SE), explicit-implicit evaluative discrepancies (EIEDs) for health, and appearance on the intention-behavior gap in exercise. A total of 141 middle-aged inactive participants (mean age = 46.12 [8.17]y) completed measures of intentions, SE, and explicit and implicit evaluations of exercise outcomes. The participants were classified as inclined actors (n = 107) if they successfully started the exercise program and inclined abstainers (n = 35) if they were not successful. The inclined actors and abstainers did not differ on intentions to exercise; however, the inclined actors had higher coping SE and lower EIEDs for health. In addition, the coping SE (Exp [β] = 1.03) and EIEDs for health (Exp [β] = -0.405) were significant predictors of being an inclined actor. The interaction between explicit and implicit processes in regard to health motives for exercise appears to influence the successful enactment of exercise from positive intentions. As most physical activity promotion strategies focus on health as a reason to be active, the role of implicit and explicit evaluations on behavioral decisions to exercise may inform future interventions.