Progressive Resistance Exercise Program Research Articles

Feasibility of an early progressive resistance exercise program for acute Achilles tendon rupture

BackgroundLong-term strength deficits are common after Achilles tendon ruptures. Early use of progressive resistance exercises may help reduce strength deficits, but the feasibility of this approach is unknown. The aim was to investigate the feasibility of early progressive resistance exercises regarding patient acceptability and compliance with the intervention.MethodsWe recruited patients with an acute Achilles tendon rupture treated non-surgically. During 9 weeks of immobilisation with a walking boot, participants attended weekly supervised physiotherapy sessions of progressive resistance exercises and performed home exercises, consisting of isometric ankle plantarflexion, seated heel-rise, and elastic band exercises. Acceptability was evaluated using a 7-point Likert scale (1 = very unacceptable and 7 = very acceptable) with feasibility threshold at 80% of the participants rating ≥ 4. Adherence to the exercises was defined as 80% of the participants performing at least 50% of the home exercises. During the intervention, tendon healing and adverse events were monitored.ResultsSixteen participants (mean age 46 (range 28–61), male/female = 13/3) completed the intervention. Pre-injury Achilles tendon total rupture score was 98 (SD 8). All participants rated the acceptability of the exercises ≥ 5 (moderate acceptable to very acceptable) at 9- and 13-week follow-up and 9/16 rated 7 points (very acceptable). Participants performed 74% (range 4–117) of the total prescribed home exercises and 15/16 performed > 50%. One participant was not compliant with the home exercises due to feeling uncomfortable performing these independently. There were no re-ruptures, but one case of deep venous thrombosis.ConclusionsThe early progressive resistance exercise program for treatment of non-surgically treated Achilles tendon rupture was feasible. Future studies should investigate the efficacy of the progressive intervention.Trial registrationThe study was registered at Clinical Trials (NCT04121377) on 29 September 2019. ClinicalTrials: NCT04121377.

Changing Practice: Clinical Application of Resistance Training Evidence for Children With Cerebral Palsy.

Describe the development and application of a progressive resistance exercise (PRE) program for children with cerebral palsy (CP), which became a standard care model at an urban specialty hospital network. Muscle structure and performance have been shown to impact function and participation in children with CP. Use of PRE to achieve function and participation goals is supported by a growing body of evidence. A novel guideline, focused on individualized, goal-focused PRE dosing, professional development, program monitoring, and outcome measures use, facilitated application of a new clinical practice. Practice change was accomplished by translating evidence using a clinical guideline resulting in positive child function and participation outcomes. This Special Communication provides an example of addressing goal-related muscle performance impairments in children with CP. Clinicians should consider updating long-standing physical therapy intervention strategies by incorporating goal-specific PRE into practice.

Vegan and Omnivorous High Protein Diets Support Comparable Daily Myofibrillar Protein Synthesis Rates and Skeletal Muscle Hypertrophy in Young Adults

BackgroundIt remains unclear whether non–animal-derived dietary protein sources (and therefore vegan diets) can support resistance training-induced skeletal muscle remodeling to the same extent as animal-derived protein sources. MethodsIn Phase 1, 16 healthy young adults (m = 8, f = 8; age: 23 ± 1 y; BMI: 23 ± 1 kg/m2) completed a 3-d dietary intervention (high protein, 1.8 g·kg bm−1·d−1) where protein was derived from omnivorous (OMNI1; n = 8) or exclusively non-animal (VEG1; n = 8) sources, alongside daily unilateral leg resistance exercise. Resting and exercised daily myofibrillar protein synthesis (MyoPS) rates were assessed using deuterium oxide. In Phase 2, 22 healthy young adults (m = 11, f = 11; age: 24 ± 1 y; BMI: 23 ± 0 kg/m2) completed a 10 wk, high-volume (5 d/wk), progressive resistance exercise program while consuming an omnivorous (OMNI2; n = 12) or non–animal-derived (VEG2; n = 10) high-protein diet (∼2 g·kg bm−1·d−1). Muscle fiber cross-sectional area (CSA), whole-body lean mass (via DXA), thigh muscle volume (via MRI), muscle strength, and muscle function were determined pre, after 2 and 5 wk, and postintervention. ObjectivesTo investigate whether a high-protein, mycoprotein-rich, non-animal-derived diet can support resistance training-induced skeletal muscle remodeling to the same extent as an isonitrogenous omnivorous diet. ResultsDaily MyoPS rates were ∼12% higher in the exercised than in the rested leg (2.46 ± 0.27%·d−1 compared with 2.20 ± 0.33%·d−1 and 2.62 ± 0.56%·d−1 compared with 2.36 ± 0.53%·d−1 in OMNI1 and VEG1, respectively; P < 0.001) and not different between groups (P > 0.05). Resistance training increased lean mass in both groups by a similar magnitude (OMNI2 2.6 ± 1.1 kg, VEG2 3.1 ± 2.5 kg; P > 0.05). Likewise, training comparably increased thigh muscle volume (OMNI2 8.3 ± 3.6%, VEG2 8.3 ± 4.1%; P > 0.05), and muscle fiber CSA (OMNI2 33 ± 24%, VEG2 32 ± 48%; P > 0.05). Both groups increased strength (1 repetition maximum) of multiple muscle groups, to comparable degrees. ConclusionsOmnivorous and vegan diets can support comparable rested and exercised daily MyoPS rates in healthy young adults consuming a high-protein diet. This translates to similar skeletal muscle adaptive responses during prolonged high-volume resistance training, irrespective of dietary protein provenance.This trial was registered at clinicaltrials.gov as NCT03572127.

Collaborative Therapist-Patient Decision Making: A Power-Based Exercise Program for an Adolescent With CMT1A.

The purpose of this case report is to describe an episode of care for an adolescent with Charcot Marie Tooth disease (CMT) using a power-based progressive resistance exercise (PRE) and balance program to improve performance of participant-defined goals with added description through the voice of the patient as "participant lived experience." Participant discussion demonstrates improvement of functional performance for an adolescent with CMT subtype 1A (CMT1A), a progressive neuromuscular disorder. Function and participation-specific movement observation, clinical evaluation, and resistance training fostered appropriate program design and intervention dosing. A power-based progressive resistance exercise and balance program with design based on participant-defined goals was feasible, well tolerated, and successful for an adolescent with CMT1A. Inclusion of viewpoints of the "lived experience" provides deeper insight into patient perspective and clinical outcomes. Outcomes may improve when intervention is specifically dosed to participant goals and individual muscle performance requirements for targeted tasks.

PSAT187 Bone Mineral Density Normalization in a Young Patient With a Physician Guided Nutrition and Exercise Intervention.

Abstract Lack of consensus on the type and amount of exercise to safely increase bone mineral density (BMD) prevents many clinicians from providing detailed recommendations on how to increase physical activity. We present a young man with low bone density, who was initiated on a non-pharmacologic regimen of physician-directed high intensity resistance exercise (HIRE) and adequate nutrition support. A 28-year-old male was found to have a low bone density attributed to autoimmune hepatitis, chronic systemic glucocorticoids used for 7 years and poor lifestyle habits. Despite stopping steroids since 2014, his BMD was worsening in the femoral neck (FN) to 0.723 g/cm2 (Z-score -2.7) in 2018, representing a 3% loss from the prior year. His BMD in the total hip (TH) site also decreased from 0.775 g/cm2 (Z-score -2.1) to 0.751 g/cm2 (Z-score -2.3) in the same 1-year period (3.1% loss). The patient had no personal or family history of fractures, smoking or alcohol use, but did have a sedentary lifestyle and ate highly processed foods with poor nutritional value. After unremarkable evaluation for further causes of ongoing bone loss, in 09/2018 we initiated a tailored progressive high intensity resistance exercise (HIRE) program. Major compound movements such as squats, deadlifts, military press, and dynamic impact exercises such as medicine ball throws, jumps and farmers carry were performed 3 times a week, maintaining an intensity of &amp;gt;80% 1-repetition maximum with 5 repetitions. The HIRE program was modified every 3 months at endocrinology clinics. After the first year, one on one training with expert kinesiologist was introduced to correct exercise form. Nutrition recommendations were simple, focused on increasing weight, adequate dairy intake, and protein intake at 1.6g/kg of body mass. He maintained adherence to exercise and diet throughout 2018-2021. BMD measured by the same Lunar iDXA increased by 10.8% at the FN from 09/2018 to 09/2019. As often occurs in clinical practice, the patient had bone density scans performed at various centers throughout his years of care. Using BMD standardization algorithms, we estimate that after initiation of our HIRE and nutrition intervention, BMD increased at all sites (LS +9.7%, FN +17.7%, TH +12.7%) when compared to pre-intervention values. His most recent DXA scan on 12/2020 (Hologic Discovery) revealed a Z-score of -1.7 (LS), -1.5 (FN) and -1.5 (TH). We conclude that our HIRE and nutrition intervention lead to clinically significant bone density increases which are expected to lead to a reduction in fracture risk. Additionally, improved lifestyle habits and nutrition are expected to have multiple benefits beyond bone health. It is important that clinicians learn about different types of exercise programs to properly guide patients which could benefit. A HIRE program should be considered in select, able bodied patients with low bone density. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

Reducing Metabolic Dysregulation in Obese Latina and/or Hispanic Breast Cancer Survivors Using Physical Activity (ROSA) Trial: A Study Protocol.

BackgroundLatina and Hispanic breast cancer survivors (LHBCS) are at increased risk for long-term complications and poorer metabolic health, including metabolic dysregulation (MetD) before and following breast cancer diagnosis. MetD can increase risk of cancer recurrence, death, and comorbid conditions by increasing inflammation and cancer cell proliferation. While exercise improves physical fitness and metabolic outcomes in breast cancer survivors, there is a lack of studies including underrepresented and disadvantaged minority groups such as LHBCS.MethodsOur 12-month randomized (exercise or attention control) controlled trial (the ROSA trial) aims to utilize a progressive combined aerobic and resistance exercise program to improve MetD, insulin resistance, and visceral adiposity among obese LHBCS. We aim to recruit 160 women with Stage I-III breast cancer who are sedentary, centrally obese, and have completed treatment (e.g., surgery, radiation, chemotherapy) prior to enrollment. Participants randomized to the exercise group receive 16-weeks of virtually supervised aerobic and resistance training, followed by 16-weeks of unsupervised home-based aerobic and resistance exercise, and 16-weeks of follow-up. The attention control group receive a 12-month home-based stretching program. Primary and secondary outcomes are measured every 4-weeks during study visits.DiscussionThe ROSA trial is the first exercise oncology trial targeting high-risk sedentary, obese LHBCS to improve MetD-related outcomes. Results of this trial will help illuminate how exercise impacts health-related outcomes, survivorship, and recurrence, and inform future exercise oncology guidelines to reduce health disparities among minority cancer survivors.

MO1014: The Effects of a 6-Month Exercise Training Programme on Glycemic Control, Lipid Profile and Functional Capacity of Diabetic Kidney Transplant Recipients

Abstract BACKGROUND AND AIMS The effects of exercise training in kidney transplant (KT) recipients with diabetes mellitus remain unclear [1]. This randomized controlled trial aimed to investigate the effects of a 6-month home-based exercise training programme on functional capacity, glucose levels and lipid profile of diabetic KT patients. METHOD A total of 21 type II diabetic KT recipients were randomly assigned into two groups: exercise (n = 11, aged 52.9 + 10.1 years) and control (n = 10, aged 53.01 + 9.5 years). All participants at baseline and at the end of the study underwent biochemical tests for fasting plasma glucose (FPG) levels, glycated haemoglobin (HbA1c) and lipid profile and cardiopulmonary exercise testing for maximum oxygen uptake (VO2peak) estimation. The exercise group followed a 6-month supervised home-based aerobic and progressive resistance exercise programme of moderate intensity, 3 times/week, while the control group continued to receive usual care. RESULTS At the end of the 6-month study, the exercise group had significantly lower values in FBG by 13.4% (P = .01), HbA1c by 1.5% (P = .01) and triglycerides by 8.5% (P &amp;lt; .05) and higher values in high-density lipoprotein by 10.2% (P &amp;lt; .05) and VO2peak by 4.7% (P = .02) than the control group. Moreover, there were statistically significant differences between the two groups at the end of the study for FBG, triglycerides and VO2peak. Finally, after training there was a moderate, positive linear relationship between VO2peak and HbA1c in the exercise group (r = 0.408, P = .03). CONCLUSION The results of this study demonstrated that a 6-month home-based mixed-type exercise training programme can improve the functional capacity, levels of glucose and lipid profile of diabetic KT recipients.

Decongestive progressive resistance exercise with an adjustable compression wrap for breast cancer-related lymphoedema (DREAM): protocol for a randomised controlled trial

IntroductionBreast cancer-related lymphoedema (BCRL) is a chronic swelling in the arm on the side of the breast cancer surgery, affecting one in five women. Recent studies in BCRL have demonstrated...

A single-arm pilot study of a mobile health exercise intervention (GO-EXCAP) in older patients with myeloid neoplasms

AbstractMany older patients with myeloid neoplasms experience treatment-related toxicities. We previously demonstrated that a home-based, progressive aerobic walking and resistance exercise program (EXCAP) improved physical and psychological outcomes in patients with cancer. However, older patients have more difficulty adhering to exercise than younger patients. Reasons may include low motivation, difficulty with transportation, and limited access to exercise professionals. To improve exercise adherence, we integrated a mobile app with EXCAP (GO-EXCAP) and assessed its feasibility and usability in a single-arm pilot study among older patients with myeloid neoplasms undergoing outpatient chemotherapy. GO-EXCAP intervention lasts for 2 cycles of treatment, and the primary feasibility metric was data reporting on the app. Usability was evaluated via the system usability scale (SUS). Patients were interviewed at mid and postintervention to elicit their feedback, and deductive thematic analysis was applied to the transcripts. Twenty-five patients (mean age, 72 years) were recruited. Recruitment and retention rates were 64% and 88%, respectively. Eighty-two percent (18/22) of patients entered some exercise data on the app at least half of the study days, excluding hospitalization (a priori, we considered 70% as feasible). Averaged daily steps were 2848 and 3184 at baseline and after intervention, respectively. Patients also performed resistance exercises 26.2 minutes per day, 2.9 days per week at low intensity (rate of perceived exertion 3.8/10). Usability was above average (SUS, 70.3). In qualitative analyses, 3 themes were identified, including positive experience with the intervention, social interactions, and flexibility. The GO-EXCAP intervention is feasible and usable for older patients with myeloid neoplasms undergoing outpatient chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT04035499.

Perceptions and Experiences of a Progressive Resistance Exercise Program in People with Chronic Kidney Disease

Muscle wasting is highly prevalent in chronic conditions, such as chronic kidney disease (CKD), and can result in decreased physical functioning and strength, and impaired ability to perform daily tasks, thus impacting quality of life. Exercise, particularly resistance training, promotes a multitude of benefits, including prevention and management of muscle dysfunction; however, engagement in resistance training is poor. The aim of this study was to understand the views of people with CKD who participated in a research study evaluating a progressive resistance exercise program. Semi-structured interviews were conducted with 11 people with CKD Stage 3 and 4. Five themes were identified: experiences of muscle weakness; preconceptions of resistance exercise; experiences of participating in a resistance exercise program; perceived impact of the resistance exercise program; and maintenance of resistance exercise. Parti - cipants believed the resistance exercise program could improve their functional performance and quality of life. They disclosed factors that can enable or deter both uptake and maintenance in training, which can be considered when developing resistance-based exercise programs. Findings highlight the need for patient education and counselling about the importance and implementation of appropriate and progressive resistance exercise training.

The effects of a strengthening program on walking and stair-climbing ability of adolescents and young adults with cerebral palsy: a randomized controlled trial

PurposeThe study aim was to examine the effects of a 10-week school-based strengthening program on walking and stair-climbing ability of adolescents and young adults with cerebral palsy.MethodsOverall, 35 participants, aged 12–19 years, were classified in 3 levels in accordance with the Gross Motor Function Classification System and randomly assigned to the experimental and control group. The experimental group participated in a 10-week progressive resistance exercise program during the adapted physical education class and performed functional strength exercises (sit-to-stand, lateral and front step-up), with a frequency of 3 times per week. The experimental and control groups continued their usual care at school regarding physical therapy and/or occupational therapy. Stair-climbing ability was assessed with the Timed Up and Down Stairs test and walking ability was evaluated with the 10-m walk test and the 1-minute walk test.ResultsThere was a significant between-group improvement for stair-climbing ability favouring the intervention group (F = 6.519, p = 0.016, ƞ2 = 0.169), whereas walking ability as assessed with the 10-m walk test and the 1-minute walk test remained unchanged.ConclusionsA functional strengthening program administered in adolescents and young adults with cerebral palsy may positively influence their stair-climbing ability, without any adverse effects.

Effects of a progressive resistance exercise program in patients with hand osteoarthritis: A randomized, controlled trial with a blinded assessor

Objective: To assess the effectiveness of a progressive resistance strength program on pain, function and strength in hand osteoarthritis patients. Design: Randomized controlled trial. Settings: Outpatients, University Hospital. Subjects: Sixty hand osteoarthritis patients were randomly allocated to exercise group (n = 30) or control group (n = 30). Intervention: The exercise group performed a progressive resistance strength program for hand muscles over 12 weeks. Both groups had a single education session. Main measures: The primary outcome was pain intensity (numeric pain scale). The secondary outcomes were – AUSCAN Hand Osteoarthritis Index, Cochin Hand Functional Scale for function and grip and pinch strength. A blinded evaluator performed the evaluations at baseline, 6 and 12 weeks. Results: The mean age were 68.9 (8.8) and 64.7 (8.9) for control and exercise groups, respectively. No significant differences between-group was observed for pain after 12 weeks (mean difference between groups was −1.30 (−0.02 to 2.62) for dominant hand and −1.33 (0.01–2.65) for non-dominant hand at T12, with P = 0.085 and 0.295, respectively). Regarding secondary outcomes, statistically significant differences between groups were found in exercise group: AUSCAN index – total score (P = 0.005), pain (P = 0.006), function (P = 0.047), and Cochin scale (P = 0.042) with the following mean difference between groups: −9.9 (4.07–15.73), −3.26 (1.06–5.46), −5.03 (1.20–8.86), and −6.27 (0.18–12.36), respectively. Conclusion: No difference was observed for pain (numerical pain scale) after the progressive resistance exercise program performed, however in exercise group, an improvement was observed on secondary outcomes such as pain during activities and function for patients with hand osteoarthritis. Level of evidence: 1b

Developing and adapting a mobile health exercise intervention for older patients with myeloid neoplasms: A qualitative study

IntroductionOlder patients with myeloid neoplasms (MN) receiving outpatient chemotherapy are at risk of experiencing treatment-related toxicities such as functional decline. A mobile health (mHealth) exercise intervention may ameliorate these toxicities. This qualitative study aimed to inform the design of a mHealth exercise intervention for this population. MethodsThis was a qualitative study of thirteen patients aged ≥60 years receiving hypomethylating agents for MN. EXCAP©® is a home-based walking and progressive resistance exercise program. We combined EXCAP©® with a mobile app; the combination (GO-EXCAP Mobile App) has not been previously tested. A brief verbal description about the intervention was provided to the participants but they did not perform it. Participants were interviewed and inductive thematic analysis was used to analyze the data. ResultsMean age was 71.6 (SD 8.5). Three themes were identified: 1) Perceptions of the intervention feasibility, 2) Ways to leverage the app to deliver the exercise intervention, and 3) Personalized exercise goals. Walking and resistance exercises were perceived to be feasible. Patients were comfortable initiating the intervention in cycle 2 of chemotherapy, with exercise increments occurring from week 2–4 of the cycle. Ways to leverage the app to deliver EXCAP©® include 1) Video feature for exercise demonstration and interactions, and 2) Exercise data and symptom surveys to be communicated to the exercise physiologist and primary oncology team. Preservation of existing function and activity was an important goal to participants. ConclusionsOur findings provide insights about the preferences of older adults with MN for a mHealth exercise intervention.

EHealth to empower patients with musculoskeletal pain in rural Australia (EMPoweR) a randomised clinical trial: study protocol

BackgroundLow back pain (LBP) and knee osteoarthritis (OA) are major contributors to disability worldwide. These conditions result in a significant burden at both individual and societal levels. Engagement in regular physical activity and exercise programs are known to improve physical function in both chronic LBP and knee OA populations. For people residing in rural areas, musculoskeletal conditions are often more frequent and disabling compared to urban populations, which could be the result of reduced access to appropriate health services and resources in rural settings. EHealth is an innovative solution to help provide equitable access to treatment for people with musculoskeletal pain living in rural settings.Methods/designWe will conduct a randomised clinical trial investigating the effects of an eHealth intervention compared to usual care, for people with chronic non-specific LBP or knee OA in rural Australia. We will recruit 156 participants with non-specific chronic LBP or knee OA. Following the completion of baseline questionnaires, participants will be randomly allocated to either the eHealth intervention group, involving a tailored physical activity and progressive resistance exercise program remotely delivered by a physiotherapist (n = 78), or usual care (n = 78) involving referral to a range of care practices in the community. Outcomes will be measured at baseline, 3 and 6 months post-randomisation. The primary outcome will be physical function assessed by the Patient-Specific Functional Scale (PSFS). Secondary outcomes include pain intensity, physical activity levels, activity limitations, quality of life, pain coping. We will also collect process evaluation data such as recruitment rate, attendance and adherence, follow-up rate, participants’ opinions and any barriers encountered throughout the trial.DiscussionThe findings from this trial will establish the effectiveness of eHealth-delivered interventions that are known to be beneficial for people with LBP and knee OA when delivered in person. As a result, this trial will help to inform health care policy and clinical practice in Australia and beyond for those living in non-urban areas.Trial registrationThis study was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12618001494224) registered 09.05.2018.

Effect of 17 weeks Progressive Elastic Band Resistance Exercise Program on Bone Mineral Density and Selected Physical Fitness Components of Indian Women

Effect of 17 weeks Progressive Elastic Band Resistance Exercise Program on Bone Mineral Density and Selected Physical Fitness Components of Indian Women

Exercise in older women with breast cancer during systemic therapy: study protocol of a randomised controlled trial (BREACE)

IntroductionExercise interventions have been widely investigated in patients with cancer and demonstrate beneficial effects. However, intervention studies that include older women with breast cancer exercising during medical treatment are scarce....

Exercise And Compression Therapy To Improve Lymphedema In Breast Cancer: A Pilot Randomized Controlled Trial

Breast cancer related lymphedema (BCRL) is a chronic swelling that may develop in breast, trunk and arm on the side of the surgery. More than one in five women with breast cancer develop BCRL. Recent studies in BCRL have demonstrated that resistance exercise can improve symptoms and quality of life without worsening the lymphedema. Few studies, however, have controlled for the use of a compression garment during or following exercise. Moreover, no studies have explored the potential of combining resistance exercise with therapeutic strategies to help reduce arm lymphedema volume. We hypothesize that a progressive resistance exercise program that incorporates compression therapy and follows the decongestive exercise sequence (DPRE) has the potential to reduce arm lymphedema volume. PURPOSE: To investigate the feasibility of a 12-week DPRE with compression therapy among women with BCRL. METHODS: A randomized controlled pilot trial was conducted involving 20 women with stable BCRL, recruited through the Cross Cancer Institute in Edmonton, Canada. As per standard of care, all women were required to wear their day-time compression sleeve daily for 12 hours. Women were randomly assigned to one of three groups: (i) Standard care: home decongestive exercise regimen (n=6), (ii) DPRE plus use of a daytime compression sleeve during exercise (n=7), and (iii) DPRE plus use of an adjustable compression wrap (AC) garment during exercise (n=7). Approval was obtained from the Health Research Ethics Board. Feasibility outcomes were analyzed descriptively. Due to the pilot nature of the study and the small sample size, no inferential analyses were performed. RESULTS: Feasibility data demonstrate high study completion (95%), attendance (94%) and adherence to prescribed protocol of DPRE program (97%). A mean reduction in arm lymphedema volume of 35 mls (-5.1%) was observed in the DPRE with day-time sleeve group and a 45 mls (-6.7%) in the DPRE with AC group. In contrast, a mean increase of 68 ml (+14.6%) was observed in the standard care group. CONCLUSION: DPRE with use of compression is feasible and shows promise in reducing arm lymphedema volume. A large-scale RCT is being conducted to examine the efficacy of this program on arm lymphedema volume, with the addition of imaging techniques to further inform changes to tissue composition.

Effectiveness of a progressive resistance exercise program for industrial workers during breaks on perceived fatigue control: a cluster randomized controlled trial

BackgroundThere is strong evidence that physical exercise in the workplace is effective for reducing workers’ musculoskeletal complaints. Studies with industrial workers and studies on progressive resistance exercises during breaks are scarce. Our aim was to evaluate the effects of a resistance exercise program on perceived fatigue control among industrial workers.Methods204 employees from the dairy industry were allocated to two groups, the intervention group (IG) (n = 98) and the control group (CG) (n = 106). The primary outcome measures were perceived fatigue control and maximum muscle strength, measured through the Need for Recovery Scale and one-repetition maximum contraction (1-RM), respectively. Secondary outcome measures were musculoskeletal complaints, physical activity level, perceived risk factors, physical fitness (BMI, vital signs, and body fat percentage), and workers´ productivity. All outcomes were assessed at baseline and then again after 4 months. The IG performed resistance exercises using progressively greater loads while the CG performed general exercise using elastic bands. The exercise protocols were performed three times per week for 20 min. An intention-to-treat analysis was performed using the mixed linear model. Results were considered significant when p < 0.05.ResultsThe IG did not show to be superior to the CG, although both groups improved perceived fatigue control and muscle strength after the resistance physical exercise program in the worplace. There was also no significant difference between the groups for musculoskeletal complaints and other secondary variables analyzed. However, both groups showed significant improvements between baseline and after 4 months of intervention for all evaluated outcomes (p < 0.05).ConclusionThe implementation of a progressive resistance exercise program during work breaks for perceived fatigue control was no more effective than exercises using elastic bands. However, resistance exercises during work breaks presented better results on all measured outcomes regardless of the exercise protocol used.Trial registrationU.S. National Institutes of Health, ClinicalTrials.gov Identifier: NCT02172053. Registered 19 June 2014.

Chest Expander Spring a Low Cost Home Physiotherapy-Based Exercise Rehabilitation after Total Hip Arthroplasty

Background: The demand for total hip arthroplasty (THA) is rising. Postoperative exercise rehabilitation helps patients recover normal joint functions by strengthening the muscles surrounding the replaced hip joint. In the face of rapidly increasing health care costs, ensuring widespread, cost-effective rehabilitation is a priority. However, the high cost of professionally supervised exercise rehabilitation programs limits access to program participation and, thus, to optimal recover of normal joint functions. Therefore, the development of an effective home-based, self-monitored exercise rehabilitation program is critical to promote the optimal recovery of THR patients. Purpose: The aim of this study was to assess the feasibility, evaluate the effectiveness of a specific Progressive Resistance Exercise program for improving hip muscles strength, resorting hip joint mobility and address the functional needs of the patient treated with primary total hip arthroplasty. Additionally; spreading the idea of a low-cost post-operative rehabilitation program using chest expander spring. Study Design: Prospective case series study. Patients and Methods: This was a prospective single-center clinical study with a 12-week intervention program carried out in an outpatient clinic and in home based. 120 patients (84 males) had been enrolled in this study to which primary total hip arthroplasty had been done. Patients were evaluated preoperatively, at baseline, 2 weeks postoperative, one week following last visit of follow-up and at 6 months postoperatively. Clinical outcome measures involved: Harris Hip Score (HHS), Oxford Hip Score (OHS), WOMAC activity score, range of hip movements (ROM), Timed Get Up and GO Test and 6 Minutes walking test. Results: The study included 120 patients (84 males). The mean age 65.3 years (range = 53-76 years). Results of clinical functional outcomes showed a progressive improvement at follow ups regarding : Harris Hip Score, Oxford Hip Score, WOMAC activity score ( related to pain, stiffness and physical functions), range of hip motions, time effect for Get up-and-go test and 6-minute walking distance test. The improvement is more achieved in last follow up visit and after 6 months postoperative. Conclusions: The study demonstrates that this novel low-cost solution holds promise in rehabilitation after THA, ensuring better clinical outcomes than conventional rehabilitation while reducing dependence on human resources. Considering the low cost and convenience of a home-based resistance training program, health professionals should consider this and similar exercise programs when providing guidance to THR patients particularly in low-income countries.

Resistance Exercise Reduces Kynurenine Pathway Metabolites in Breast Cancer Patients Undergoing Radiotherapy.

Purpose: Evidence from preclinical studies and trials in healthy volunteers suggests that exercise may modulate the levels of tryptophan (TRP) metabolites along the kynurenine (KYN) pathway. As KYN and downstream KYN metabolites are known to promote cancer progression by inhibiting anti-tumor immune responses and by promoting the motility of cancer cells, we investigated if resistance exercise can also control the levels of KYN pathway metabolites in breast cancer patients undergoing radiotherapy (NCT01468766).Patients and Methods: Chemotherapy-naïve breast cancer patients (n = 96) were either randomized to an exercise/intervention group (IG) or a control group (CG). The IG participated in a 12-week supervised progressive resistance exercise program twice a week, whereas the CG received a supervised relaxation program. Serum levels of TRP and KYN as well as urine levels of kynurenic acid (KYNA) and neurotoxic quinolinic acid (QUINA) were assessed before (t0), after radiotherapy, and mid-term of the exercise intervention (t1) and after the exercise intervention (t2). Additionally, 24 healthy women (HIG) participated in the exercise program to investigate potential differences in its effects on KYN metabolites in comparison to the breast cancer patients.Results: At baseline (t0) the breast cancer patients showed a significantly elevated serum KYN/TRP ratio and urine QUINA/KYNA ratio, as well as increased urine QUINA levels in comparison to the healthy women. In response to exercise the healthy women and the breast cancer patients differed significantly in the levels of urine QUINA and the QUINA/KYNA ratio. Most importantly, serum KYN levels and the KYN/TRP ratio were significantly reduced in exercising patients (IG) compared to non-exercising patients (CG) both at t1 and t2.Conclusion: Resistance exercise may represent a potent non-pharmacological avenue to counteract an activation of the KYN pathway in breast cancer patients undergoing radiotherapy.