Progressive Resistance Training Research Articles

The effects of neck exercise in comparison to passive or no intervention on quantitative sensory testing measurements in adults with chronic neck pain: A systematic review.

Previous systematic reviews have identified the benefits of exercise for chronic neck pain on subjective reports of pain, but not with objective measures such as quantitative sensory testing (QST). A systematic review was conducted to identify the effects of neck specific exercise on QST measures in adults with chronic neck pain to synthesise existing literature and provide clinical recommendations. The study protocol was registered prospectively with PROSPERO (PROSPERO CRD42021297383). For both randomised and non-randomised trials, the following databases and trial registries were searched: AMED, CINAHL, Embase, Google Scholar, Medline, PEDro, PubMed, Scopus, SPORTDiscus, Science Citation Index and Social Science Citation Index from Web of Science Core Collection, clinicaltrials.gov, GreyOpen, and ISRCTN registry. These searches were conducted from inception to February 2022 and were updated until September 2023. Reference lists of eligible studies were screened. Study selection was performed independently by two reviewers, with data extraction and quality appraisal completed by one reviewer and independently ratified by a second reviewer. Due to high heterogeneity, narrative synthesis was performed with results grouped by exercise type. Three trials were included. Risk of bias was rated as moderate and the certainty of evidence as low or moderate for all studies. All exercise groups demonstrated statistically significant improvement at an intermediate-term follow-up, with progressive resistance training combined with graded physical training demonstrating the highest certainty of evidence. Fixed resistance training demonstrated statistically significant improvement in QST measures at a short-term assessment. Fixed resistance training is effective for short-term changes in pain sensitivity based on low-quality evidence, whilst moderate-quality evidence supports progressive resistance training combined with graded physical training for intermediate-term changes in pain sensitivity.

A Prospective Randomized Controlled Trial Assessing the Impact of Preoperative Combined with Postoperative Progressive Resistance Training on Muscle Strength, Gait, Balance and Function in Patients Undergoing Total Hip Arthroplasty.

The aim of this study is to investigate the effects of a preoperative combined with postoperative moderate-intensity progressive resistance training (PRT) of the operative side in patients with hip osteoarthritis (HOA) who are undergoing total hip arthroplasty (THA). The study seeks to evaluate the impact of this combined intervention on muscle strength, gait, balance, and hip joint function in a controlled, measurable, and objective manner. Additionally, the study aims to compare the outcomes of this combined intervention with those of preoperative or postoperative muscle strength training conducted in isolation. A total of 90 patients with HOA scheduled for unilateral primary THA were randomly assigned to three groups: Pre group (preoperative PRT), Post group (postoperative PRT), and Pre& Post group (preoperative combined with postoperative PRT) focusing on hip flexion, extension, adduction, and abduction of operated side. Muscle strength, gait parameters, balance, and hip function were assessed at specific time points during a 12-month follow-up period. All three groups showed significant improvements in muscle strength, with the Pre& Post group demonstrating the most pronounced and sustained gains. Gait velocity and cadence were significantly improved in the Pre& Post group at 1-month and 3-month postoperative follow-ups compared to the other groups. Similarly, the Pre& Post group exhibited superior balance performance at 3-month and 12-month postoperative follow-ups. The Harris Hip Score also showed better outcomes in the Pre& Post group at all follow-up intervals. Preoperative combined with postoperative moderate-intensity PRT in HOA patients undergoing THA led to superior improvements in muscle strength, gait, balance, and hip joint function compared to preoperative or postoperative PRT alone. This intervention shows significant promise in optimizing postoperative rehabilitation and enhancing patient outcomes following THA.

THE EFFECTIVENESS OF PROGRESSIVE RESISTANCE TRAINING IN MANAGING PROGRESSIVE SUPRANUCLEAR PALSY: A CASE STUDY

SETTING The Centre for STRONG Medicine is an outpatient multidisciplinary geriatric service at Concord Hospital, Sydney. An 82-year-old male with a primary diagnosis of Progressive Supranuclear Palsy (PSP) with cardiac and metabolic comorbidities was referred in March 2023. PSP is a rare neurological disorder that affects gait, balance, vision, and cognition. The participant mobilised with a rollator and had previously sustained vertebral and wrist fractures secondary to falls. MANAGEMENT Management was to use progressive resistance training (PRT) to combat mobility decline, prevent falls and provide education to encourage independent exercise. Initial assessment determined current health status using Falls Self Efficacy Scale (FSE-I) and Fried Frailty Phenotype (FFP) questionnaires, and measured function and strength using maximal gait speed, five times sit-to-stand (5xSTS) and one repetition maximum (1RM), respectively. FSE-I determined a high fear of falling and FFP determined frail classification. Outcomes informed the PRT exercise prescription targeting the major muscle groups for 2-3 sets of 7-9 repetitions at 70-85% 1RM progressed gradually and preformed twice weekly in a supervised group. Education regarding breathing, exercise tempo, rest, progression, and risk mitigation were provided. All outcomes were reassessed after 12-weeks of training. RESULTS Attendance was 100% (23 sessions) with improvement in all outcomes. Functional improvements included 0.25metres/second increase in maximal gait speed, 2.5 second reduction in 5xSTS, and safe mobilisation without a rollator. Strength improvements included 101% increase in 1RM leg press, 100% increase in 1RM triceps extension and 72% increase in 1RM seated row. Frailty status improved to pre-frail and fear of falling reduced. Self-reported improvements included increased steadiness and confidence exercising unsupervised. DISCUSSION Although PSP is progressive, PRT resulted in meaningful benefits in strength and function that improved daily task performance and confidence. Further research is needed to investigate the effects of PRT on PSP management in a larger cohort.

Adapting a dyadic exercise program to be culturally relevant for Hispanic men with prostate cancer using community engagement studio: a brief report.

Cancer disparities exist for Hispanic men with prostate cancer and their caregivers that could be reduced through exercise. Exercising Together© is a six-month, evidence-based dyadic resistance training program that promotes teamwork between prostate cancer survivors and their spouses to improve physical, mental, and relational health outcomes. The purpose of this study was to elicit feedback and recommendations from stakeholders on the Exercising Together© intervention to inform the cultural adaptation of this program for Hispanic men with prostate cancer. We conducted a virtual Community Engagement Studio (V-CES) with community expert stakeholders representing the Hispanic and cancer care communities in Southern Arizona. The V-CES process included orientation, presentation of the research, guided discussion, and evaluation. The V-CES was audio recorded, transcribed, and rapidly analyzed to identify actionable feedback and contextual adaptations. Nine stakeholders (6/9 male; 5/9 Hispanic) completed all V-CES activities. Through stakeholder engagement and feedback from the V-CES, adaptations to the original Exercising Together© intervention included: (1) inclusion of the cancer survivor's identified caregiver, who may not be a spouse; (2) availability in English and Spanish; (3) shortening the intervention to 3 months; (4) remote delivery of the intervention; and (5) incorporation of low burden procedures. Findings from our V-CES informed the adaptation of a culturally relevant dyadic progressive resistance training program for Hispanic men with prostate cancer and their caregivers.

Progressive Resistance Training or Neuromuscular Exercise for Hip Osteoarthritis : A Multicenter Cluster Randomized Controlled Trial.

Exercise is recommended as first-line treatment for patients with hip osteoarthritis (OA). However, randomized controlled trials providing evidence for the optimal exercise type are lacking. To investigate whether progressive resistance training (PRT) is superior to neuromuscular exercise (NEMEX) for improving functional performance in patients with hip OA. Multicenter, cluster-randomized, controlled, parallel-group, assessor-blinded, superiority trial. (ClinicalTrials.gov: NCT04714047). Hospitals and physiotherapy clinics. 160 participants with clinically diagnosed hip OA were enrolled from 18 January 2021 to 28 April 2023 and randomly assigned to PRT (n = 82) or NEMEX (n = 78). Twelve weeks of PRT or NEMEX with 2 supervised 60-minute group sessions each week. The PRT intervention consisted of 5 high-intensity resistance training exercises targeting muscles at the hip and knee joints. The NEMEX intervention included 10 exercises and emphasized sensorimotor control and functional stability. The primary outcome was change in the 30-second chair stand test (30s-CST). Key secondary outcomes were changes in scores on the pain and hip-related quality of life (QoL) subscales of the Hip Disability and Osteoarthritis Outcome Score (HOOS). The mean changes from baseline to 12-week follow-up in the 30s-CST were 1.5 (95% CI, 0.9 to 2.1) chair stands with PRT and 1.5 (CI, 0.9 to 2.1) chair stands with NEMEX (difference, 0.0 [CI, -0.8 to 0.8] chair stands). For the HOOS pain subscale, mean changes were 8.6 (CI, 5.3 to 11.8) points with PRT and 9.3 (CI, 5.9 to 12.6) points with NEMEX (difference, -0.7 [CI, -5.3 to 4.0] points). For the HOOS QoL subscale, mean changes were 8.0 (CI, 4.3 to 11.7) points with PRT and 5.7 (CI, 1.9 to 9.5) points with NEMEX (difference, 2.3 [CI, -3.0 to 7.6] points). Participants and physiotherapists were not blinded. In patients with hip OA, PRT is not superior to NEMEX for improving functional performance, hip pain, or hip-related QoL. Independent Research Fund Denmark.

Effects of high-intensity and progressive volume resistance training on functional, mental states, and quality of life of people with spinal cord injury

Effects of high-intensity and progressive volume resistance training on functional, mental states, and quality of life of people with spinal cord injury

Resistance training effects on pubertal children with a risk of developing pediatric dynapenia.

Many modern-day children are at risk of pediatric dynapenia (muscle weakness). We examined the effects of a 12-week resistance training (RT) program on neuromuscular function and body composition parameters in pubertal children with a risk of dynapenia. Twelve children (13.4 ± 0.9 y) with dynapenia performed a progressive RT program consisting of knee extension and flexion, bench press, abdominal crunch, back extension, lateral pull-down, elbow flexion, and upright row (1-2 sets of 10-15 repetitions/exercise) twice/week for 12weeks. Outcome measures included one-repetition maximum (1-RM) strength, maximal voluntary isometric contraction (MVIC) torque, rate of torque development (RTD), electromyographic (EMG) activity, muscle thickness (MT), muscle quality (MQ) assessed by echo intensity (MQEI) of the knee extensors and specific tension of MVIC torque to thigh fat-free mass (MQST), and total and regional body and bone composition assessed by dual-energy X-ray absorptiometry. Changes in the measures before and after the 12-week RT and associations among the measures were analyzed by linear mixed models. Significant (p < 0.05) increases in 1-RM (63.9 ± 4.5%), MVIC torque (16.3 ± 17.8%), MT (18.8 ± 5.5%) and MQ (MQEI: -25.9 ± 15.2%; MQST: 15.1 ± 18.8%;) were evident from pre- to post-training. Total fat-free mass (FFM) increased by 2.3 ± 3.2% from baseline (p = 0.01), but no changes (p > 0.05) in the other measures were observed. Significant (p < 0.05) associations between the changes in 1-RM and/or MVIC torque and the changes in quadriceps MT, MQEI, MQST and total body FFM were evident. The 12-week RT was effective for improving neuromuscular and body composition parameters, and thereby reversed the risk of pediatric dynapenia.

Twelve Weeks of Progressive Resistance Training Positively Improves Physical Fitness and Golf Swing Performance in Talented Youth Golfers.

Shaw, J, Gould, ZI, Oliver, JL, and Lloyd, RS. Twelve weeks of progressive resistance training positively improves physical fitness and golf swing performance in talented youth golfers. J Strength Cond Res XX(X): 000-000, 2024-This aim of this study was to investigate the effects of a 12-week resistance training program in talented junior golfers. Eighteen talented youth golfers were pair matched by maturity status and handicap, and subsequently allocated to an experimental (EXP) or control group. During the 12-week intervention, both groups continued with their normal golf practice while the EXP group also completed a progressive twice-weekly resistance training program. At baseline, subjects performed multiple trials of an isometric midthigh pull (IMTP), countermovement jump (CMJ), standing long jump, golf movement screen (GMS), and isometric plank hold. Club head speed (CHS) and carry distance for a 6-iron and driver were also measured using a commercial launch monitor. When controlled for maturity offset, there were significant (p < 0.05) interaction effects in favor of the EXP group for absolute (g = 1.29) and relative (g = 2.06) peak force for the IMTP, CMJ absolute (g = 0.73) and relative (g = 0.66) peak power, jump height (g = 1.05), modified reactive strength index (g = 1.30), lateral (g = 0.48-0.88) and horizontal jump distance (g = 1.20), and GMS total score (g = 1.07). Significant interaction effects were also reported in 6-iron and driver CHS and carry distance in favor of the EXP group (p < 0.05; g = 0.41-1.64). These findings indicate that twice-weekly resistance training in combination with regular golf practice can stimulate increases in measures of strength, power, and movement competency in youth golfers, which should contribute to enhanced golf swing performance.

Multimodal and conventional resistance training interventions improve muscle function in older adults: Findings from the Training IMCT study

Age-associated remodeling processes affect the intramuscular connective tissue (IMCT) network, which may significantly impair muscle function. Thus, we aimed to test whether including exercises shown to efficiently target the IMCT to a conventional resistance exercise intervention (CONV) would result in greater functional gains as compared to CONV alone. Fifty-three men and women (66.2 ± 3.3 years) were assigned to either CONV (n = 15), multimodal training (MULTI; n = 17) or a control (CTRL; n = 21) group. All subjects were tested at baseline, and those assigned to CONV or MULTI underwent a 16-week training intervention. The CONV group followed a progressive resistance training program, in which the number of weekly training sessions gradually increased from 1 to 3. In the MULTI group, one of these sessions was replaced with plyometric training, followed by self-myofascial release. Testing included maximal strength and power, imaging-based muscle volume, architecture, and functional performance. The intervention effects were analyzed using two- or three-way repeated measures ANOVA models (α = 0.05). Briefly, the maximal knee extension isometric contraction, one-repetition maximum, and isokinetic peak torque increased in all groups (p < 0.05), albeit to a lesser extent in CTRL. On the other hand, quadriceps femoris muscle volume (p = 0.019) and vastus lateralis pennation angle (p < 0.001) increased only in the MULTI group. Handgrip strength did not change in response to the intervention (p = 0.312), whereas Sit-to-Stand performance improved in all groups after the first 8-wks, but only in MULTI and CONV after 16-wks (all p < 0.001). In conclusion, we found that a resistance training intervention in which one weekly training session is replaced by plyometric training is feasible and as effective as a program consisting solely of conventional strength training sessions for inducing gains in muscle strength and function in older adults. Muscle size and architecture improved only in the MULTI group. German Clinical Trials: DRKS00015750.

Efficacy of Modified Progressive Resistance Training on Knee Strength in Women with Early Onset of Knee Osteoarthritis

Background: The synovial joint capsule, subchondral bone, and joint cartilage are all impacted by the gradualdegenerative condition known as OA. This research work is designed to check the efficacy of modified progressiveresistance training for OA knee patients.Purpose: To compare the effectiveness of modified progressive resistance training and conventional treatment onknee strength in early onset knee OA.Materials and Methods: 370 subjects were screened for study from GNK physiotherapy clinic according toinclusion and exclusion criteria from november 2022 to june 2023. Patient’s authorization was acquired afterthe procedure was completely clarified to them. They were divided into two categories: Group A (n=185) andGroup B (n=185). The pre and post-test values measured by WOMAC questionnaire and MMT. Group A receivedconventional treatment that is strengthening and stretching exercises and Group B received modified progressiveresistance training using Thera band along with conventional treatment. Both training programs were given for 4weeks, weekly 5 daysResults: A statistically important distinction &lt;0.0001 between groups A and B was found via statistical analysis ofinformation that was quantitative.Conclusion: Modified progressive resistance training using Thera band of group A were proven to be moresuccessful than group A Traditional therapy.

Efficacy of Cervical Spinal Stabilization Exercise on Reducing Pain for People with Cervical Spondylosis

Background: The synovial joint capsule, subchondral bone, and joint cartilage are all impacted by the gradualdegenerative condition known as OA. This research work is designed to check the efficacy of modified progressiveresistance training for OA knee patients.Purpose: To compare the effectiveness of cervical stabilization exercises and conventional physiotherapy exercisein reducing pain for patients with cervical spondylosis.Materials and Methods: The study took place in Eyan Physiotherapy Centre, Sriperumbudur, A total no of 40subjects were recruited for this study through the purposeful sampling method. All subjects were recruited basedon the inclusion and exclusion criteria. The recruited subjects were assigned to two groups (Group A: 20 Subjects)underwent Cervical Stabilization Exercise and (Group B: 20 Subjects) underwent Conventional Exercise. Allindividuals are assessed for pain using Algometer as a pre-test prior to the intervention and again after 6 weeks ofintervention. The entire study process was performed from November 2022 to April 2023.Results: This study states that cervical stabilization exercises are found to be more significant and more effectivein reducing pain compared to conventional therapy. The comparison of post mean value of Algometer of both thegroups. Group-A(Cervical Stabilization Exercise) was 4.30 and Group B(Conventional Exercise) was 3.65 whichshows gradual increase with p value &lt;0.0001 statistically significant.Conclusion: This study recommended that clinicians consider incorporating cervical stabilization exercises intothe treatment plan for individuals with cervical spondylosis. The evidence supporting the efficacy of cervicalstabilization exercise in reducing pain in individuals with cervical spondylosis.

The Effectiveness of Toe Flexor Strengthening on Balance and Risk of Fall in Patients with Diabetic Polyneuropathy- A Pilot Study

Background:Diabetic polyneuropathy (DPN) is relatively common complication of long-term diabetes and isthought to be progressive and irreversible. The loss of sensations associated with Diabetic polyneuropathy isthought to contribute to impaired balance and increased risk of falling. Reduced toe flexor strength is an independentpredictor of falls. However, it is unknown whether strengthening programs can restore toe flexorstrength in patients with DPN.The aim of this study was to investigate whether a progressive resistance training program, focused specifically on the foot &amp; toe flexor muscles, could improve toe flexor strength in patients with DPN.Methods: A total of 20 patients were allocated into two groups of 10 each. Group A receive 12 sessions of (Conventional physiotherapy &amp; Modified toe training programme) and Group B (Conventional physiotherapy &amp; General toe exercise). Berg balance score (BBS), Fall efficacy scale international (FES-I) &amp; Time up and go test (TUG) were measured on first day (Week 1) and last day (Week 4) of intervention. Pre-test and post-test scores were compared and results were tabulated.Result: Both groups showed significant improvement in balance performance. The Group A showed statistically significant improvement in static &amp; functional balance when compared to Group B.Conclusion: The study demonstrated a significant improvement in balance and functional mobility was seenamong Group A.

Resistance training and inter-interindividual response differences on cardiorespiratory fitness in older adults: An ancillary meta-analysis of randomized controlled trials.

Examine true inter-individual response differences (IIRD) as a result of resistance training on cardiorespiratory fitness in older adults. Data from a recent meta-analysis of 22 randomized controlled trials representing 552 men and women (292 resistance training, 260 control) ≥ 60 years of age were included. The primary outcome was cardiorespiratory fitness (VO2max) in ml.kg-1.min-1. Using the inverse variance heterogeneity (IVhet) model, statistically significant treatment effect (resistance training minus control) increases in VO2max in ml.kg-1.min-1 were found (mean, 1.8, 95% CI, 0.4 to 3.3 ml.kg-1.min-1, p = 0.01; Q = 82.8, p < 0.001; I2 = 74.6%, 95% CI, 61.6 to 83.3%; =1.1). The 95% prediction interval (PI) was -0.8 to 4.5 ml.kg-1.min-1. However, no statistically significant IIRD was observed (mean, 0.6, 95% CI, -1.1 to 1.4 ml.kg-1.min-1; =1.5). The 95% PI was -1.8 to 2.0 ml.kg-1.min-1. In conclusion, while progressive resistance training may increase VO2max in ml.kg-1.min-1, a lack of true resistance-training-associated IIRD exist.

Health Benefits of Physical Therapy Interventions in Children Suffering from Down Syndrome. A Systematic Review

Background: Down syndrome is associated with a spectrum of physical and developmental challenges that can impact an individual's quality of life. Physical therapy interventions are commonly employed to address these challenges, aiming to improve physical fitness, strength, and achievement of developmental milestones. However, the extent of their effectiveness is not uniformly documented. Objective: This systematic review sought to evaluate the comparative effectiveness of various physical therapy interventions versus no intervention or standard care in enhancing physical fitness, strength, and developmental milestones in individuals with Down syndrome. Methods: Adhering to PRISMA guidelines, a comprehensive search of electronic databases including PubMed, MEDLINE, Cochrane Library, Embase, and Google Scholar was conducted for studies published between January 2000 and December 2022. RCTs and pre-post test studies in English that focused on physical therapy interventions for Down syndrome were included. The PEDro scale was utilized for quality assessment. Data synthesis provided a qualitative summary of the intervention outcomes. Results: Nine studies met the inclusion criteria, with a total sample size of 327 individuals with Down syndrome. The review highlighted significant improvements in balance, muscle strength, motor skills, and cognitive function following various physical therapy interventions such as progressive resistance training, treadmill exercises, and the use of virtual reality. The duration of these interventions ranged from 6 weeks to 1 year, demonstrating both short- and long-term benefits. Conclusion: The review substantiates that physical therapy interventions offer considerable benefits in improving the health and developmental outcomes for individuals with Down syndrome. These findings underscore the importance of integrating targeted physical therapy into standard care practices. Nevertheless, further research is warranted to explore the long-term impact and to develop optimal intervention strategies.

Ten weeks of Capsicum annuum L. extract supplementation did not change adipose tissue-derived hormones, appetite, body composition, and muscle strength when combined with resistance training in healthy untrained men: A clinical trial study

Capsiate (CAP) is a nonpungent capsaicin analog (Capsicum annuum L. extract) that has been studied as a potential antiobesity agent. However, the interaction between chronic CAP supplementation and resistance training is not clear. The purpose of this study was to examine the changes in adipose tissue–derived hormones, body composition, appetite, and muscle strength after 10 weeks of resistance training, combined with chronic CAP supplementation in healthy untrained men. We hypothesized that CAP could induce higher benefits when combined with resistance training after 10 weeks of intervention compared to resistance training alone. Twenty-four young men (age, 22.0 ± 2.9) were randomized to either capsiate supplementation (CAP = 12 mg/day) or placebo (PL), and both groups were assigned to resistance training. Body composition, leptin and adiponectin concentrations, subjective ratings of appetite, energy intake, and exercise performance were assessed at before and after 10 weeks of progressive resistance training. There was a significant increase in body mass (P < .001), fat-free mass (CAP: 58.0 ± 7.1 vs. post, 59.7 ± 7.1 kg; PL: pre, 58.4 ± 7.3 vs. post, 59.8 ± 7.1 kg; P < .001), resting metabolic rate (CAP: pre, 1782.9 ± 160.6 vs. post, 1796.3 ± 162.0 kcal; PL: pre, 1733.0 ± 148.9 vs. post, 1750.5 ± 149.8 kcal; P < .001), maximal strength at 45 leg press (P < .001) and bench press (P < .001) in both groups, but no significant (P > .05) supplementation by training period interaction nor fat mass was observed. For subjective ratings of appetite, energy intake, leptin, and adiponectin, no significant effect of supplementation by training period interaction was observed (P > .05). In conclusion, 10 weeks of resistance training increased total body weight, muscle mass, and maximum strength in healthy untrained men; however, CAP supplementation (12 mg, 7 days per week) failed to change adipose tissue–derived hormones, appetite, body composition and muscle strength in this population.Registered under Brazilian Registry of Clinical Trials (RBR-8cz9kfq).

Translating scientific recommendations into reality: a feasibility study using group-based high-intensity functional exercise training in adolescents with cerebral palsy

Purpose To examine the feasibility and effects of a functional high-intensity exercise intervention performed in a group-setting on functionality, cardiovascular health and physical performance in adolescents with cerebral palsy (CP). Methods Ten adolescents with a diagnosis of CP (2 females; 16.6 ± 3.4 years; GMFCS: I-II) participated in a 12-week training intervention, containing progressive resistance training using free weights and high-intensity workouts twice a week. The six-minute walking test, arterial stiffness and physical performance (strength and power tests) were measured before and after the intervention. Results No adverse events were reported. We measured small increases in the six-minute walking test (Δ = 28.8 m, 95% CI [-1.78;52.7]; g = 0.34 [-0.04;0.72]) and a small reduction in arterial stiffness (Δ = −4.65% [-10.90;1.25]; g = −0.46 [-1.36;0.21]). All measures of physical performance increased (0.24 ≤ g ≤ 0.88). Conclusion Functional training with free weights in high-functioning adolescents with CP is safe and effective in increasing parameters of physical performance and cardiovascular health. Positively influenced indicators of everyday independence (i.e. strength parameters) showed a transfer into movements of daily life. Concerns about adverse events through high-intensity training in adolescents with CP appear unjustified when training is performed progressively, following basic training principles.

Reshaping the path of vascular cognitive impairment with progressive resistance training: A 12‐Month Randomized Trial

AbstractBackgroundSubcortical ischaemic vascular cognitive impairment (SIVCI) is the most common form of vascular cognitive impairment. Importantly, SIVCI is considered the most treatable form of cognitive impairment, due to its modifiable risk factors such as hypertension and diabetes mellitus. Exercise training is a promising intervention to delay the progression of SIVCI, as it actively targets these cardiometabolic risk factors. Despite the demonstrated benefits of resistance training on cognitive function and emerging evidence suggesting resistance training may reduce the progression of white matter hyperintensities, research on SIVCI has predominantly focused on the use of aerobic exercise. Thus, we examined the efficacy of a 12‐month, twice‐weekly progressive resistance training (RT) program on cognitive function in older adults with SIVCI.MethodWe conducted a 12‐month single‐blinded, randomized controlled trial with 91 adults with SIVCI who were randomly allocated to: 1) progressive RT; or 2) balance and tone exercises (BAT; control). Study eligibility included: 1) age 55 years and older; 2) neuroimaging evidence of cerebral small vessel disease at study entry; 3) mild cognitive impairment, as indicated by Montreal Cognitive Assessment scores &lt; 26/30; and 4) the absence of dementia. Measurements occurred at baseline, 6 months, and 12 months. The primary outcome for cognitive function was the Alzheimer’s Disease Assessment Scale‐Cognitive‐Plus (ADAS‐Cog 13 with additional cognitive tests). Gait speed over 4 meters was also assessed as impaired mobility is common among those with SIVCI.ResultForty‐five participants were randomized to the RT group and 46 to the BAT group. Mean baseline age was 74.6 years (SD = 5.7 years), 66% of participants were female, and the median Fazekas score was 1. After adjusting for baseline, participants in the RT group had significantly better ADAS‐Cog Plus performance at 12 months vs. BAT (estimated mean difference [RT – BAT]:‐0.20; 95% CI:[‐0.39, ‐0.01]; p = 0.039). In addition, participants in RT had significantly faster gait speed at 12 months vs. BAT (estimated mean difference: ‐0.08 m/s; 95% CI: [‐0.16, 0.00]; p = 0.047).ConclusionThe prevalence and burden of SIVCI will only increase due to the world’s aging population. Our results suggest progressive resistance training should be considered in the management and treatment of individuals with SIVCI.

Can exercise benefit cerebral white matter myelin? Findings from a 12‐month randomized controlled trial in older adults with vascular cognitive impairment

AbstractBackgroundCerebral small vessel disease is a major underlying cause of subcortical ischemic vascular cognitive impairment (SIVCI). Myelin loss is a feature of cerebral small vessel disease, which may underly cognitive and functional decline in older adults living with SIVCI. Resistance training (RT) is a form of exercise associated with slower progression of white matter lesions, a cerebral small vessel disease marker. However, it remains to be determined whether RT can counteract myelin loss in individuals living with SIVCI. Thus, we examined the impact of a 12‐month, twice‐weekly progressive RT program on myelin content in those with SIVCI.MethodThis was a sub‐study of a 12‐month single‐blinded, randomized controlled trial. Participants (n = 91) were randomized to RT or an active control group (balance and tone exercises [BAT]). Study eligibility included: 1) age 55 years and older; 2) magnetic resonance imaging (MRI) evidence of cerebral small vessel disease; 3) mild cognitive impairment; and 4) the absence of dementia. Myelin was measured using a multi‐echo gradient and spin echo T2 relaxation MRI sequence, indexed as myelin water fraction (MWF). Differences between groups at 12 months were assessed via analysis of covariance adjusting for baseline MWF and estimated intracranial volume. MWF data from fifteen white matter tracts were analyzed. Post‐hoc regressions were conducted to determine if changes in MWF were associated with changes in mobility measured with the Short Physical Performance Battery (SPPB).ResultSeventy‐three participants (RT = 36) aged 74.1 (SD = 5.7), 64% females with high‐quality MRI data were included in the analyses. At 12 months, RT showed lower MWF levels compared with BAT in the genu of the corpus callosum (estimated mean difference [RT – BAT]: ‐0.610, 95% CI: ‐1.041 to ‐0.178, p = 0.006), fornix (‐0.883, 95% CI: ‐1.570 to ‐0.197, p = 0.012), and combined white matter tracts (‐0.326, 95% CI: ‐0.643 to ‐0.009, p = 0.044). Changes in MWF in the combined white matter tracs were positively associated with changes in SPPB (Unstandardized B = 0.124, SE = 0.061, p = 0.047).ConclusionContrary to our expectations, 12 months of balance and tone exercises, but not RT, showed positive changes in myelin. These improvements may result in better mobility in older adults with SIVCI.

Rehabilitation of Gate and Balance Disorders in Multiple Sclerosis using Progressive Resistance Power Training: a Randomized Controlled Study

INTRODUCTION. Progressive resistance training (PRT) has been recognized as an effective tool in the rehabilitation of patients with multiple sclerosis (MS), however its comparative efficacy remains has yet to be determined.&#x0D; AIM. In this study, we aimed to evaluate the efficacy and safety of the self-guided in-patient progressive resistance power training (PRT) program for improving gait and balance in patients with MS compared with the standard rehabilitation program.&#x0D; MATERIALS AND METHODS. 60 patients with MS were equally randomized into control group (CG) and the PRT group (PG). Training was performed 5 times/week, for 4 weeks in both groups. The primary endpoint was the percentage of patients with improvement in the 6-minute walking test above a minimal clinically significant difference in both groups. Tests of walking speed and balance (Timed 25-foot walking test (T25FW), Timed up-and-go (TUG) test, walking speed), mean voluntary muscle contraction on dominant and non-dominant legs as well as quality of life tests (cognitive and physical domains) at week 4 were used as secondary endpoints.&#x0D; RESULTS. In PG, 17/27 (63 %) patients reached the primary endpoint compared to 11/23 (48 %) in KG, which did not make a statistically significant difference (p = 0.89). Patients showed significant improvement in the T25FW test and TUG test in PG, but not in CG one. Muscle strength improved in both groups, however patients in PG showed mostly improvement in non-dominant leg and more on knee flexors and feet extensors, while patients in the CG showed improvement in hip flexors on both legs. Quality of life parameters improved in both groups. There were no statistically significant differences between the groups at all the endpoints studied at week 4.&#x0D; DISCUSSION. In both groups, significant increases in distance and walking speed prevented reaching the primary endpoint. PRT has been shown to provide a statistically significant improvement in short-distance walking speed, which may have been due to a positive effect on the rate of force development, increasing walking speed and improving walking balance. The increase in muscle strength occurred in trained muscle groups and had differences between the study groups. This result could be obtained both due to the direct training of certain muscle groups, and due to the phenomenon of contralateral transfer.&#x0D; CONCLUSION. Progressive resistance training may have some beneficial differences compared to non-progressive training that need to be elucidated further.

Effects of progressive intensity resistance training on the impact of fibromyalgia: protocol for a blinded randomized controlled trial

BackgroundFibromyalgia guidelines indicate that exercise is critical in the management of fibromyalgia, and there is evidence that patients with fibromyalgia can perform resistance training at moderate and high intensities. However, despite the biological plausibility that progression of intensity provides greater benefit to individuals, no studies have compared different intensities (progressive versus constant intensities) of the same exercise in this population.ObjectiveTo compare the effect of 24 sessions of resistance training (progressive vs. constant intensity) on impact of fibromyalgia, sleep quality, anxiety, depression, pain, walking ability, and musculoskeletal capacity.MethodsA protocol for a blinded randomized controlled trial. The sample will be randomized into three groups: group 1 (progressive intensity, experimental), group 2 (constant intensity, control A), and group 3 (walking, control B). Group 1 will perform resistance training at moderate intensity (50% of maximum dynamic strength), previously determined by the 1 repetition maximum (1-RM) test in the proposed exercises. The strength of each individual will be reassessed every 4 weeks (by 1-RM) and the intensity of each exercise will be positively adjusted by 20% of the value observed in kg (i.e., first month 50%; second month 70%; third month 90% of the maximum dynamic strength). Group 2 will perform the same procedure, but the intensity will be maintained at 50% of the maximum dynamic strength throughout the treatment (i.e., constant intensity from the first to the third month). Group 3 will perform a 40-minute treadmill walk at low intensity, defined by a walking speed corresponding to 60-70% of the maximum heart rate, which we will control with a heart rate monitor. All groups will receive a 45-minute pain education session prior to the exercise program, covering the pathophysiologic mechanisms of chronic pain, strategies for coping with pain, avoiding hypervigilance, and deconstructing beliefs and myths about chronic pain.DiscussionThe results of the present study may help health care professionals adjust the intensity of resistance training and thus plan the most effective intervention (progressive or constant intensity) to reduce the impact of fibromyalgia on patients’ lives.Trial registrationBrazilian Registry of Clinical Trials (ReBEC) ID: RBR-9pbq9fg, date of registration: October 06, 2022.