Post-exercise Program Research Articles

Targeting skeletal muscle health with exercise in people with type 1 diabetes: A protocol for HOMET1D, a prospective observational trial with matched controls.

Individuals with type 1 diabetes (T1D) experience a complex set of alterations to skeletal muscle metabolic, neuromuscular, and vascular health; collectively referred to as diabetic myopathy. While the full scope of diabetic myopathy is still being elucidated, evidence suggests that even when individuals with T1D are physically active, indices of myopathy still exist. As such, there is a question if adherence to current physical activity guidelines elicits improvements in skeletal muscle health indices similarly between individuals with and without T1D. The objectives of this trial are to: 1) compare baseline differences in skeletal muscle health between adults with and without T1D, 2) examine the association between participation in a home-based exercise program, detraining, and retraining, with changes in skeletal muscle health, and 3) examine the roles of age and sex on these associations. This will be a prospective interventional trial. Younger (18-30 years) and older (45-65 years) males and females with T1D and matched individuals without T1D will engage in a four-phase, 18-week study sequentially consisting of a one-week lead-in period, 12-week exercise training program, one-week detraining period, and four-week retraining period. The exercise program will consist of aerobic and resistance exercise based on current guidelines set by Diabetes Canada. Metabolic, neuromuscular, and vascular outcome measures will be assessed four times: at baseline, post-exercise program, post-detraining, and post-retraining. Differences in baseline metrics between those with and without T1D will be examined with independent sample t-tests, and with two-way analyses of variance for age- and sex-stratified analyses. Changes across the duration of the study will be examined using mixed-model analyses. Findings from this research will be shared locally and internationally with research participants, clinicians, diabetes educators, and patient advocacy organizations via in-person presentations, social media, and scientific fora. NCT05740514.

A 12 Week Remote Based Physical Activity Intervention In Young Adults With Autism Spectrum Disorder

Young adults with Autism Spectrum Disorder (ASD) tend to have low levels of physical activity (PA) due to a lack of opportunity or program accessibility. Participation in PA has been linked with positive mental health, which may be particularly beneficial for young adults with ASD who tend to report higher levels of stress and depression compared to their neurotypical counterparts. A remote-based exercise program may be more feasible and accessible to this population, however, no studies have tested such a program. PURPOSE: To determine the impact of a remote-based exercise intervention on stress and depression in young adults with ASD. METHODS: Sixteen participants were separated into a no-exercise control group (n = 6, 25 ± 2.92 yrs) and an exercise intervention group (n = 10, 26.5 ± 4.5 yrs). Individuals in the intervention group participated in two, 45-minute exercise sessions twice a week while the control group continued their usual routine. Self-reported PA levels, perceived stress, and symptoms of depression were assessed pre-post the 12-week program. Independent t-tests were conducted to compare the change in PA levels, perceived stress, and symptoms of depression between the exercise and control groups. RESULTS: There was a significant increase in PA scores (p < 0.001), and a significant decrease in symptoms of depression (p = 0.02) in the exercise intervention group, while neither PA levels or depression scores changed from baseline to post-exercise program in the control group. Neither the exercise intervention nor the control group showed a significant change in perceived stress levels following the end of the program. CONCLUSIONS: The exercise intervention group had a significant decrease in depression symptoms while there was no change in the control group. Participation in a remote-based exercise program may be more accessible to young adults with ASD, while still providing mental health benefits.

Minimal important difference of two methods for assessment of quadriceps femoris strength post exercise program in individuals with COPD

BackgroundThe assessment of quadriceps femoris (QF) strength is recommended by international guidelines as an outcome of exercise training (ET) programs in patients with chronic obstructive pulmonary disease (COPD). ObjectivesTo identify the minimal important difference (MID) of two methods for the assessment of improvement of QF strength after a high-intensity ET program in individuals with COPD: 1-repetition maximum (1RM) and maximal voluntary contraction (MVC). MethodsIndividuals with moderate to very-severe stable COPD were submitted to high-intensity ET (3 days/week, 36 sessions). Lung function (spirometry), exercise capacity (6-minute walk test [6MWT]) and QF strength (1RM test and MVC by using a strain-gauge) were assessed before and after the ET program. ResultsTwenty-one individuals were studied (65±8 years, BMI 27±6; FEV1 51±16%predicted). At the end of the ET program, QF strength improved significantly (10±4 Nm for MVC and 8 ± 6 kg for 1RM) (P<0.05 for both). The MID for improvement of the QF strength calculated by distribution-based methods ranged from 9.4 to 16 Nm (between 7.4% and 12.6% increase from baseline) for the MVC and from 2.5 to 3 kg (between 12% and 15% increase from baseline) for the 1RM test. Anchor-based MIDs could not be calculated since there was no correlation between the improvement of QF strength and the improvement of the proposed anchor (6MWT). ConclusionsThe MID for improvement of QF strength after a high-intensity ET program in individuals with moderate-to-severe stable COPD ranges between 9.4 and 16 Nm for the MVC assessed with a strain gauge and between 2.5 and 3 kg for the 1RM test.

Mobility Disability and Exercise: Health Outcomes of an Accessible Community-Based Center.

ObjectiveThe purpose of this study was to determine how support and guidance provided by trained professionals during a 12-week, community-based transition exercise program, impact health outcomes and continued engagement in physical activity for persons with a mobility disability (PwMD).DesignA single arm pre-post design was used.SettingAccessible community-based health and wellness center.ParticipantsThe study included 244 PwMD using a mobility device.InterventionsParticipants completed a 12-week transition exercise program provided through an accessible community facility that provided education and support to complete endurance and strength related exercises as well as programming to encourage transition to self-directed engagement in exercise.Main Outcome MeasuresBodyweight, BMI, pain, perceived exertion, speed, and distance during cardiovascular fitness testing, and strength were measured pre and post exercise program. The number of participants that signed up for a monthly membership after the program was also monitored.ResultsFor the total group, average pain reported over previous 30 days decreased significantly (p < 0.01), current daily pain decreased significantly (p < 0.05), perceived exertion at the end of the 9-min endurance test decreased significantly (p < 0.05), and the four upper extremity strength exercises showed large, significant strength gains (p < 0.01) after the program. There was no significant change in bodyweight, BMI, or speed and distance completed during endurance testing. At the completion of the program, 76% of participants enrolled in a monthly membership at the facility with the intentions to continue to exercise regularly.ConclusionsThis study provides evidence that an accessible community-based exercise program, with a transitional component supported by trained professionals, can support the exercise goals of PwMD and improve strength, decrease pain, and may promote regular exercise adoption for PwMD.

The exercise-instrumental music program and irisin levels in younger non-professional athletes

A passive lifestyle and lack of exercise are triggering factors in increasing metabolic syndrome, whereas metabolic syndrome is associated with increased morbidity and mortality. This study aimed to analyse an exercise-based non-pharmacological approach combined with instrumental music to the plasma levels of irisin. The study employed a randomised pretest-posttest-only group design recruiting 30 male participants. The individuals aged between 19-21 years, body mass index (BMI) 18.5-24.9 kg/m2, normal blood pressure, normal resting heart rate (RHR), VO2max 40-50 ml/kg bodyweight/min, normal haemoglobin (Hb). The subjects were randomly divided into three groups, MIE (n=10, moderate-intensity exercise), MIEM (n=10, moderate-intensity exercise + instrumental music), and HIE (n=10, high-intensity exercise). Blood sampling was collected from pre- and 5 min post-exercise treatment. ELISA method was used to measure the circulating irisin levels. The non-parametric Kruskal-Wallis test, Mann Whitney test and Spearman correlation were chosen to analyse the data. The results showed that there is no significant difference in pre-exercise irisin levels (ng/ml) in MIE (1.58±0.89), MIEM (1.77±3.12), and HIE (1.65±0.88) with a P-value of 0.098. Importantly, the alteration of irisin levels post-exercise program revealed that the level of this peptide (ng/ml) is higher in HIE (7.28±5.11) compared to MIE (1.95±1.85) and MIEM (4.16±3.40) with a P-value of 0.019. The plasma levels of irisin significantly correlate to energy expenditure (r=0.353, P≤0.01), plasma peroxisome proliferator-activated receptor gamma coactivator-1α (r=0.597, P≤0.001), and high-density lipoprotein (r=0.513, P≤0.01). In summary, increased irisin secretion may directly contribute to the gradual alteration of energy expenditure and correlate to physical exercise intensity-related musical treatment.

The effect of a six months multicomponent training in elderly’s body composition and functional fitness – A before-after analysis

The aim of this study was to assess elderly’s functional fitness and body composition effects between pre and post multicomponent training program with six months of intervention. The sample of this study was composed with 34 volunteered elderlies with 68 (± 7.55) years old. The body composition was evaluated with a Tanita BC-545 and functional fitness test assessed elderly’s functional fitness. The body composition did not presented significant changes between the pre and post exercise program intervention. The training program increased the upper limbs strength levels and upper body flexibility and aerobic endurance. Different associations between body composition and functional fitness variables were founded between pre and post multicomponent training program. In this study, body composition seems not to be affected. However, functional fitness in upper limbs strength, upper body flexibility and aerobic endurance improved under a six months of multicomponent training.

The Effect of a Selective Exercise Program on Motor Competence and Pulmonary Function of Asthmatic Children: A Randomized Clinical Trial

Background Physical activity in asthmatic children may be useful. But there is not adequate knowledge about it. In present study the effect of selective exercise on motor competency and pulmonary function in asthmatic pediatrics was evaluated. Materials and Methods In a randomized clinical trial study,fifteen asthmatic children aged 6 to 18 years were included. Patients were randomly divided into the experimental or control group. There was no difference in the routine pharmacotherapy. The aerobic group had an exercise program consisting of 45-minute sessions three times per week for 8 weeks. The outcome measures were the difference between the pre- and post-exercise program and also the experimental and control groups. Spirometry parameters (such as FEV1and FVC) were measured. Motor competency was measured by the Ozeretski test. Quality of life was evaluated by St. George's questionnaire. The data were analyzed using SPSS software (version 16.0). Results: A significant effect was observed for spirometry parameters, quality of life and the Ozeretski test in two studied groups. Aerobic exercise had a significant effect in improving FEF 25-75%, quality of life and the fine and gross motor performance in the experimental group (P< 0.05). A significant difference was observed between two groups for FEF, FEF25-75% and quality of life (P< 0.05). Conclusion Regular exercise improves the spirometric parameters and quality of life in studied asthmatic children. In present study, aerobic exercise and strength training were useful complementary means for the treatment of asthmatic children.

8주간의 복합운동프로그램이 여성들의 신체조성, 체력, 프레밍햄 리스크 스코어 및 혈관상태에 미치는 영향

The purpose of this study was to investigate the effects of combined exercise on physical fitness level, framingham risk score and vascular elasticity on women. All participants performed physical fitness test and measurement of vascular elasticity between pre and post exercise intervention program. Cardiovascular disease risk factor was assessed using the framingham risk score. Wilcoxon signed-rank test or paired t-test were performed to confirm changes in each factors pre and post the exercise program. The results were following : Except the hand grip strength and muscle power, all physical fitness levels such as muscular endurance, cardiovascular endurance, flexibility, agility, muscle power were significantly increases between pre and post exercise program. Furthermore, significant differences were found in the framingham risk score and vascular elasticity wave type between pre and post exercise program. In conclusion, we suggest that the combined exercise program reduces the cardiovascular disease risk and improve vascular elasticity on women.

Effect of a four-week exercise program on the secretion of IFN-γ, TNF-α, IL-2 and IL-6 cytokines in elite Taekwondo athletes.

The aim of the present study was to examine how a 4-week exercise program affects the serum levels of certain cytokines in Taekwondo athletes. The study involved 10 elite male Taekwondo athletes (mean age, 20.67±0.24 years; mean weight, 65.45±1.69 kg) who were studying at the Physical Education and Sports High School of Selçuk University (Konya, Turkey) in June 2014. The subjects were involved in a Taekwondo exercise program on every weekday for 4 weeks. The subjects were also engaged in an exercise to exhaustion session twice; once before starting the 4-week exercise program and once upon completion of the program. Blood samples were collected from the subjects in four rounds: During rest, upon fatigue, and before and after the 4-week exercise program. These samples were analyzed to establish the serum levels of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin (IL)-2 and IL-6 using enzyme-linked immunosorbent assay test kits. Pre- and post-exercise program, the IFN-γ and TNF-α levels did not show any significant difference. When compared with the pre-exercise levels, serum IL-2 levels of the subjects were found to be elevated after the 4-week exercise program. The highest serum IL-6 values were established after the subjects were exercised to fatigue before the exercise program was initiated (P<0.05). The 4-week exercise program resulted in a decrease in IL-6 levels (P<0.05). The findings of the study indicate that a 4-week exercise program did not result in significant changes in IFN-γ and TNF-α levels, but led to an increase in IL-2 levels. The notable finding of the present study is that a 4-week exercise program reduces cellular immune functions and, thus, the levels of IL-6, which negatively influences performance.

The Effect of Regular Senior Aerobics on TNF-α and IL-6 of Elderly Women with Abdominal Obesity

The purpose of this study is to find out the effect of regular senior aerobics on TNF-α and IL-6 of elderly women with abdominal obesity. This study was conducted on 18 elderly women with abdominal obesity as defined by the Korean Society for the Study of Obesity and these participants were selected among women who participated in the ‘Zero Abdominal Fat Exercise Class’ to get rid of abdominal fat at the health center in K city and were divided into two groups (exercise group: 9, non-exercise group: 9). Exercise intensities within the range of 70bpm~100bpm for 60 minutes a day, three times a week, for 12 weeks. The measurements performed before and after exercise. An independent t-test was conducted using SPSS 18.0. In results, we found a significant difference between bofore and after exercise on levels of TNF-α. Also, there was a siginificant difference in pre and post exercise program on the level of IL-6. In conclusions, the regular senior aerobics exercise may have positive influence on the levels of TNF-α and IL-6 of elderly women with abdominal odesity.

Effect of Nintendo Wii Fit Exercise Program to Health-Related Physical Fitness and Quality of Life among University Students

The purpose of this study is to investigate the effect of Nintendo Wii Fit exercise program to health-related physical fitness and quality of life among university students. Written, informed consent was obtained prior to the participation of the subjects. They participated in the exercise group (n = 25) and control group (n = 25) by themselves. Height, weight, body composition, BMI and WHR, blood pressure, HR and physical fitness (VO2max, muscular strength, muscular endurance, flexibility, etc.), and health-related quality of life (SF-36 questionnaire is used) were measured in the pre- and post-exercise program. In this result, we found interaction effects between the exercise group and control group in muscle mass. Further, the percentage of body fat, WHR, HR, maximum oxygen uptake (VO2 max), muscular strength, muscular endurance, and flexibility showed a significant difference in time between the two groups. Lastly, the physical functioning, body pain, and general health of SF-36 showed also statistical difference in duration between the two groups. The results in this paper suggested that the Nintendo Wii Fit exercise program during 12 weeks may influence the body composition, health-related physical fitness, and QOL of university students.

Interval and continuous exercise enhances aerobic capacity and hemodynamic function in CHF rats.

OBJECTIVE: The aim of the present study was to compare the effects of continuous versus interval aerobic exercise training on hemodynamic parameters, cardiac remodeling, and maximal exercise capacity (MEC) in chronic heart failure (CHF) rats. METHOD: Twenty-four male Wistar rats were subjected to myocardial infarction (MI) surgery. Five weeks post MI, the animals were assigned to one of three groups: sedentary group (CHF-Sed, n=8), aerobic continuous training group (CHF-ACT, n=8), and aerobic interval training group (CHF-AIT, n=8). Treadmill training was performed five times a week for 8 weeks (ACT: 50 min/day at 15 m/min and AIT: 40 min/day with 8 min of warm-up at 10 m/min and exercise at 15 m/min 4×4 min interspersed with 4×4 min at 23 m/min). MEC was evaluated pre and post exercise program. RESULTS: Left ventricular end-diastolic pressure (LVEDP), left ventricular mass/body mass ratio (LVM:BM), and total collagen volume fraction were lower in the trained groups compared with the sedentary group, but no difference was found between the trained groups. Systolic ventricular pressure (SVP) and maximum positive derivative of LV pressure (+dP/dtmax) were higher in the trained groups, but CHF-ACT showed higher +dP/dtmax compared to CHF-AIT. Both training regimens were able to increase MEC. However, the aerobic interval training was superior for improving MEC. CONCLUSION: Aerobic training is an important intervention to improve cardiac function and remodeling and physical capacity in CHF rats. Interval training is a potential strategy to maximize the results, but exercise type and intensity are still topics to be explored.

Aerobic training does not affect serum C reactive protein in smokers

A growing body of literature suggests that cigarette smoking is associated with systemic inflammation. This study was aimed to estimate the effect of aerobic training on serum C reactive protein (CRP) in smokers. For this purpose, thirty non-trained adult smoker men matched for age (41.6 +/- 4.2), height (175 +/- 5.7), and BMI (31.37 +/- 4.3) were divided into exercise or control groups by randomly. Pre and post exercise program (3 months/3 sessions per week) blood samples were collected after overnight fast in order to determine serum CRP in two groups. Student’s t-tests for paired samples were performed to determine significance of changes in variables by exercise program. Aerobic program resulted in significant decrease in anthropometrical parameters such as body weight and body mass index in exercise group but not in control group. In contrast, we did not change in serum CRP by exercise training when compared to pre training. Based on these data, we can say aerobic exercise training has not anti-inflammatory properties in smokers, although measuring of CRP alone can not predict anti-inflammatory property of exercise training.

Effect of selected exercise program on natural killer cytotoxic cells activity of post-mastectomy patients

The purpose of this present study is to define the role of cells of the innate immune system (i.e., NK cells) in infection and cancer and investigate the effect of selected exercise program on natural killer cytotoxic cells of post-mastectomy patients. Forty female patients have referred from an oncologist professor have undergone mastectomies and they have selected from the oncology surgery department, physical therapy clinic of National Cancer Institute (NCI), Cairo University. They have ranged between 40 and 60 years. They all were female patients. They all have undergone mastectomy. These patients have randomly divided into two equal groups, group A (an exercise group) (n=20) patients were received the selected exercise program and group B (a control group) (n=20) patients were received the routine postoperative physical therapy protocol of National Cancer Institute (NCI), Cairo University. All patients were assessed and pre- and post-exercise program measurements were taken by using Flow Cytometry [Dako Cytomation Corp., model Partec III] for concentrations of circulating natural-killer-cell cytotoxic activity (NKCA) using a CD56 stained with FITC (fluorescein isothiocyanate) dye. The results revealed a significant increase (P<0.05) in all measured circulating natural-killer-cell cytotoxic activity (NKCA) pretreatment and post 3 months of treatment in both exercise and control groups. But the rate of improvement in exercise group was more than that in control group which revealed the effect of the selected exercise program in circulating natural-killer-cell cytotoxic activity (NKCA). It could be concluded that, early moderate exercise has a beneficial effect on the function of in vitro NK cells in post-mastectomy patients rather than the routine postoperative physical therapy protocol.

Medida do tempo máximo de fonação de professoras do município de Niterói/RJ

OBJETIVO: medir os limites do tempo máximo de fonação pré e pós-aplicação do Programa de Exercícios Funcionais Vocais de Stemple e Gerdeman em professoras, com e sem alteração vocal, que atuam no ensino fundamental do Município de Niterói-RJ. MÉTODO: participaram do estudo 17 professoras, que aceitaram participar espontaneamente da aplicação do programa de exercícios: vogal /i/ sustentada, glissando ascendente e descendente da palavra /nol/, e escala de tons musicais Dó,Ré,Mi,Fá,Sol, com emissão de /ol/, pelo tempo máximo de fonação. A medida do tempo foi coletada pré e pós-aplicação do programa por meio da vogal [ε], após a participante ter sido submetida a exame de videolaringoestroboscopia. RESULTADOS: verificou-se expressivo ganho do tempo máximo de fonação do pré para o pós-exercício e o valor do programa, que em sua aplicação, prioriza a execução dos exercícios com o maior tempo possível de fonação. CONCLUSÃO: o Programa de Exercícios Funcionais Vocais de Stemple e Gerdeman favoreceu o aumento do tempo máximo de fonação intrassujeito, possibilitando melhores condições de saúde vocal no desempenho profissional e social.

PMO-029 Prehabilitation program for liver surgery

IntroductionRehabilitation exercise programs improve recovery from surgery and quality of life. Prehabilitation improves fitness prior to surgery. This is challenging before liver resection as patients tend to be sedentary and...

Feasibility of home-based functional electrical stimulation cycling: case report

Single-subject (male, 64 years of age) case. To determine the feasibility of a home-based FES-LEC (functional electrical stimulation lower extremities cycling) program and effects on body composition, quality of life (QOL) and seat pressure mapping in an older individual with spinal cord injured (SCI). Home-based FES-LEC with internet connection. Southeastern United States. FES-LEC three sessions per week for 9 weeks in the participant's home and monitored by the research staff via internet connection. Pre- and post-exercise program testing of seat pressure mapping, QOL and body composition including percent body fat (%BF), fat mass (FM), lean mass (LM) and bone mineral density (BMD). The participant completed 25 of 27 recommended exercise sessions over 9 weeks for a 93% compliance rate. Cycling distance increased from 3.98 to 9.00 km (126%). Total body LM increased from 48.94 to 53.02 kg (8.3%). The %BF decreased from 29.6 to 28.4(-1.2%). Total body weight, FM and BMD remained unchanged. Average static seat pressure decreased from 55.5 to 52.59 mm Hg (5%), whereas maximum seat pressure decreased from 120.76 to 91.5 mm Hg (24%). The psychological domain (perception of body image, appearance and self-esteem) of the QOL questionnaire improved from 12.67 to 14. Positive changes in this study regarding body composition, QOL and seat pressure mapping support results of clinical studies using FES-LEC training on younger adults with SCI. The high percentage of exercise adherence and positive results on body composition, QOL and seat pressure provide support for the feasibility of home-based FES-LEC.

Increased Oxidative Stress in Healthy Children Following an Exercise Program: A Pilot Study

Exercise can induce oxidative stress or an imbalance between reactive oxygen species and cellular antioxidant defenses. We investigated the effect of a real-life exercise program on systemic oxidative stress measured by urinary concentrations of 8-isoprostaglandin F2alpha (8-iso-PGF2 alpha), a noninvasive index of lipid peroxidation, in a well-characterized pediatric group. Healthy but primarily sedentary, 8- to 10-year-old children (n = 6, mean age 8.8 +/- 0.9 years) of equally distributed healthy weight, overweight, and obese categories, participated in a 5-week exercise program (track and field summer camp, 2 hours/day, 1-2 days/week). By using high-performance liquid chromatography with online electrospray ionization tandem mass spectrometry (LC/ESI/MS/MS), we found a significant (p = .028) increase in group mean urinary 8-iso-PGF2 alpha concentration from 8.163 +/- 6.919 ng/mg creatinine pre-exercise program to 32.320 +/- 16.970 ng/mg creatinine post-exercise program. The increase was also measured at each individual level. We found preliminary evidence that pre- and post-exercise program urinary 8-iso-PGF2 alpha concentrations selectively correlated with children's cardiometabolic characteristics and mood. Our results warrant further exploration of the relationships between pre/post-exercise oxidative stress marker 8-iso-PGF2 alpha and cardiometabolic characteristics, exercise habits, eating habits, and mood to determine whether increased post-exercise oxidative stress in healthy children is part of their normal adaptation to exercise or mediator of oxidative injury.

Supervised Exercise to Reduce Agitation in Severely Cognitively Impaired Persons

Several studies have shown an improvement in depression, activities of daily living, and agitation in cognitively impaired subjects who undergo a long-term exercise program. These studies have not considered the short-term effects of exercise. The purpose of this study was to investigate the short-term effects of a limited, supervised exercise program on agitation, depression, and activities of daily living in cognitively impaired patients residing in the special needs unit of a nursing home. This study was a prospective comparative study. A 3-week exercise program was implemented at the special needs units of 2 nursing homes. The exercise program involved 30 minutes of exercise (15 minutes of aerobic and 15 minutes of resistance), 3 days per week. There were 50 residents in this study (76% female, 24% male) and they had a mean age of 79.2 +/- 9.7 years. The subjects had a mean SLUMS (Saint Louis Mental Status Examination) score of 1.5 +/- 2.1 (SLUM score range 0-30, 30 meaning full cognitive faculty). Each subject had his or her depression, agitation, activities of daily living, and 6-meter walk time measured before and after the 3-week exercise program. The Cornell Scale for Depression, Pittsburgh Agitation Scale (PAS)/Cohen-Mansfield Agitation Inventory, and ADCS-ADL (Alzheimer's disease cooperative study-activities of daily living) were used to measure depression, agitation, and activities of daily living, respectively. Multiple paired t tests were calculated for each outcome measurement. The post-study scales showed an improvement in the 6-meter walk test and, using the PAS (0-16, 0 meaning no agitation), an improvement in agitation. The improvement in agitation in the entire population was P less than .05; mean PAS pre-study scores were 5.8 +/- 4.8 and mean PAS poststudy scores were 4.5 +/- 3.7 . Among the patients with PAS Pre-Exercise Program Scores greater than 3, thus categorized as agitated, there was a greater decrease in agitation; PAS Pre-Study Scores were 9.1 +/- 3.4 and PAS Study Scores were 6.1 +/- 3.4 (P < .001). There was also an improvement in 6-meter walk times; pre-study times were 12.5 +/- 5.2 and post-exercise program times were 10.1 +/- 4.4 (P < .001). There was an improvement in agitation scores and the 6-meter walk times in the subjects after their engagement in the 3-week exercise program. Further study is needed in order to expand on these results.

A supervised exercise program for dialysis patients: Effects of physical empowerment

Objective: The objective of this study was to determine the benefits, limitations, and physical capabilities resulting from a structured fitness program. Design: The perceptions of the 43 hemodialysis patients participating during the 5-month term of the study were subjected to statistical evaluation to determine any evidence of relationships between age, length of time in dialysis, and employment status versus ability to perform daily exercises, fitness level, fatigue, and energy level. Setting: The clinic from which the patients were selected includes three dialysis treatment facilities located in Pittsylvania, Halifax, and Henry Counties of Virginia. The clinical records of the 320 patients undergoing dialysis therapy at the time were evaluated based on selected medical criteria, and 256 patients were invited to participate in the program. Patients: A total of 43 patients participated in the exercycle component of the program whereas 33 elected to exercise independently through an approved YMCA or other community recreation program. Because of the anticipated difficulty in monitoring compliance of the patients exercising independently, only the 43 patients participating in the exercycle component were followed throughout the full course of the study. Among the 43 exercycle participants, 34 completed the full period of observation; 2 patients died for reasons unrelated to the exercise program; and 7 patients discontinued participation. Intervention: The program emphasized frequency, intensity, time, and type of exercise. The use of a stationary bike (exercycle) was selected as the method of evaluating patient progress resulting from the program. Main Outcome Measure: A questionnaire was administered pre-exercise and post-exercise program participation. Chi-squared analysis and percentages were used to assess the results of the study. Results: Although Kt V and hematocrit levels showed a trend toward improvement, it was not possible to definitively conclude this occurred as a function of participation in the exercycle component of the exercise program; and no statistically significant relationships attributable as study outcomes were identified. Conclusion: Improvements in Kt V and hematocrit levels suggested that a more extensive study with a substantially larger study group and a longer period of observation may yield more substantive and defining results. The small sample size of this study precluded definitive judgments.