Progressive Resistance Exercise Research Articles

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 < .05) and higher values in high-density lipoprotein by 10.2% (P < .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.

Sunbeam Program Reduces Rate of Falls in Long-Term Care Residents With Mild to Moderate Cognitive Impairment or Dementia: Subgroup Analysis of a Cluster Randomized Controlled Trial.

The Sunbeam trial significantly reduced falls in long-term aged care (LTC) residents. The current study's primary objective was to undertake subgroup analysis of the Sunbeam trial, to determine whether the intervention was effective for reducing falls in LTC residents with mild-moderate cognitive impairment/dementia. Secondary objectives were to determine intervention effects on cognitive and physical function. Subgroup analysis of a cluster randomized controlled trial (RCT). Permanent residents of LTC in Australia who participated in the Sunbeam trial with Addenbrooke's Cognitive Examination-Revised (ACE-R) scores <83 (Mini-Mental State Examination >14= main trial inclusion criteria). Of 221 participants, 148 had an ACE-R <83 and were included in this study. Sixteen LTC residences (clusters) were randomized to receive either the Sunbeam program or usual care. The Sunbeam program involved two 1-hour sessions/week of tailored and progressive resistance and balance training for 25weeks followed by a maintenance program (two 30-min sessions/week of nonprogressive exercise for 6months). Assessments were conducted at baseline, 6months, and 12months. Falls were recorded using routinely collected data from the LTC incident management systems. Rate of falls (50%) and risk of falls (31%), multiple falls (40%), and injurious falls (44%)were reduced in the intervention group. The intervention group had significantly better balance (static and dynamic) and sit-to-stand ability when compared with the control group at 6months and significantly better dynamic balance at 12months. There were no serious adverse events. The Sunbeam Program significantly reduced falls and improved physical performance in cognitively impaired LTC residents. This is a novel and important finding, as many previous studies have excluded people with cognitive impairment/dementia and inconsistent findings have been reported when this population has been studied. Our findings suggest that progressive resistance and balance exercise is a safe and effective fall prevention intervention in LTC residents with mild-moderate cognitive impairment/dementia.

Impact of beta‐Hydroxy‐beta‐methylbutyrate plus Vitamin D3 Supplementation on Skeletal Muscle Size, Function and Quality in Sedentary and Resistance Exercise Trained Women

The age‐related loss of skeletal muscle mass, quality, and strength can lead to the loss of independence later in life. Beta‐hydroxy‐beta‐methylbutyrate (HMB), a leucine metabolite, can increase skeletal muscle size and function. However, emerging evidence suggests HMB may be less effective at improving muscle function in people with insufficient Vitamin D3 levels (25‐hydroxy‐Vitamin D (25‐OH‐D) &lt;30 ng/mL,) common in middle‐aged and older adults. Therefore, our current study tested the hypothesis that combining HMB (Calcium salt) with Vitamin D3 (HMB+D) would increase skeletal muscle size, quality and function in middle aged women (53±1 yrs, 26±1 kg/m2, n=43) randomized to sedentary control (SED) or progressive resistance exercise training (RT). In a placebo‐controlled, double‐blinded fashion, women were further randomized to placebo or HMB+D (3g of HMB + 2000IU of Vitamin D3). Study enrollment and recruitment occurred before and after COVID‐19 stay at home measures. In both RT and SED, HMB+D raised circulating levels of 25‐OH‐D after 8 (33±2 ng/mL) and 12 (35±2 ng/mL) weeks to reach sufficient Vitamin D3 levels. In SED, HMB+D prevented the loss of lean arm mass observed in the placebo group (0.07±0.06 vs ‐0.19±0.06 kg; P&lt;0.05). HMB+D also increased thigh skeletal muscle (26±13 vs ‐5±8 cm3; P&lt;0.05) and decreased intermuscular adipose tissue (IMAT) volume (‐20±11 vs 5±6 cm3; P&lt;0.05) compared to placebo. However, 12‐weeks of HMB+D did not change skeletal muscle function. In the RT, 12‐weeks of HMB+D decreased IMAT compared to placebo (‐22±13 vs 6±4 cm3; P&lt;0.05) but did not influence the increase in skeletal muscle mass or function. These data show that 12‐weeks of HMB+D supplementation consistently decreased thigh IMAT volume in both SED and RT. HMB+D in sedentary middle‐aged women was beneficial for skeletal muscle size but did not lead to improved muscle function or quality. Further, HMB+D did not influence the hypertrophic or functional improvements after resistance exercise training in middle‐aged women. HMB+D may be able to help combat the age‐related loss of skeletal muscle mass in sedentary women. These results lend support to conducting a larger study for a longer duration to validate these findings as well as explore additional populations who may also benefit from HMB+D.

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...

Exercise may impact on lumbar vertebrae marrow adipose tissue: Randomised controlled trial.

Animal and human cross-sectional data suggest that bone marrow adipose tissue (MAT) may respond to mechanical loads and exercise. We conducted the first randomised controlled trial of exercise on MAT modulations in humans. Forty patients with chronic non-specific low back pain (NSCLBP) were enrolled in a six-month single-blinded randomised controlled trial (ACTRN12615001270505). Twenty patients loaded their spines via progressive upright aerobic and resistance exercises targeting major muscle groups (Exercise). Twenty patients performed non-weightbearing motor control training and manual therapy (Control). Testing occurred at baseline, 3-months (3mo) and 6-months (6mo). Lumbar vertebral fat fraction (VFF) was measured using magnetic resonance imaging axial mDixon sequences. When compared to baseline (percent change), lumbar vertebral fat fraction (VFF; measured using magnetic resonance imaging axial mDixon sequences) was lower in Exercise at 3mo at L2 (-3.7[6.8]%, p=0.033) and L4 (-2.6[4.1]%, p=0.015), but not in Control. There were no between-group effects. The effects of Exercise on VFF were sex-specific, with VFF lower in men at L2, L3, L4 at 3mo and at L1, L2, L3 and L4 at 6mo (p all≤0.05), but not in women. Leg and trunk lean mass were increased at 3mo in Exercise. Changes in VFF correlated significantly with changes in total fat (ρ=0.40) and lean (ρ=-0.41) masses, but not with lumbar BMD (ρ=-0.10) or visceral adipose tissue volume (ρ=0.23). This trial provided first prospective evidence in humans that a moderate exercise intervention may modulate lumbar VFF as a surrogate measure of MAT at 3mo, yet not 6mo. The effect of exercise on MAT may be more prominent in males than females.

EFFECTS OF LOWER LIMB PROGRESSIVE RESISTANCE TRAINING ON BALANCE IN CHILDRENS DIAGNOSED WITH SPASTIC DIPLEGIC CEREBRAL PALSY

Background and objectives: Balance is the ability to move or to remain in position without losing control or falling. Control of body balance is a complex involving postures, movements, sensation, vision and vestibular system. There is 2 types of balance – Static and dynamic. Both static and dynamic balance are very important for body to maintain equilibrium in standing or sitting position and able to perform without falling. Cerebral palsy happens due to abnormal brain development before birth of child which affects childs ability to move, maintain balance and posture and walking ability, resulting in ataxia. Diplegic cerebral palsy is also knows as spastic diaplegia. It is one of the three types of cerebral palsy which presents with lot of muscle stiffness and spasms and loss of Range of Motion. Spastic diplegia mostly affects the legs and sometimes the arms, making them stiff and contracted. This makes crawling and walking difficult and most often, children will walk on their toes or with a wide scissoring gait. Legs can also turn inwards and cross at the knees due to excessive muscle contractions. Other children may not be able to walk at all. The upper extremities of the body may not be affected at all and may function normally. The purpose behind this study was to find out whether progressive resistance exercises of lower limbs affects balance of childrens affected with spastic diplegic cerebral palsy, because balance is the biggest issue with diplegic cerebral palsy. The objective of the study is to analyze strength using FTSST (Five Time Sit to Stand Test) and balance using PBS (Pediatric Balance Scale). Design: Experimental study Method: Total 30 spastic diplegic Cerebral Palsy childrens, both boys and girls from the age group of 6-12 years were taken. Subjects were divided into experimental group (n=15) and control group (n=15). Pre and post values of FTSST (Five Time Sit to Stand Test) and PBS (Pediatric Balance Scale) were taken. Control group were given conventional treatment and the experimental group underwent progressive resistance exercise for 6 weeks. Strength training was given to quadriceps and hamstrings muscles using weight cuffs with 8 RM. Resistance was increased after every 2 weeks. At the end of 6th week post values were noted and compared with pre values. Result: PBS (Pediatric Balance Scale) was significantly improved in experimental group. FTSST (Five Time Sit to Stand Test) was also significantly improved in experimental group Conclusion: Result concluded that Progressive Resistance Exercises have significant beneficial effects on balance in spastic diplegic cerebral palsy patient preventing falls and improving walking ability.

Progressive resistance exercise as complementary therapy improves quality of life and body composition in anorexia nervosa: A randomized controlled trial

Backgroundand purpose: Exercise has not typically been used as an adjunct in treatment of anorexia nervosa (AN). This study aimed to examine the effects of progressive resistance exercise (PREx) on perceived quality of life (QoL) and body composition in adolescents with AN. Materials and methodsForty-four adolescents diagnosed with AN were randomly allocated to either PREx or control groups after hospitalization. The PREx group completed twenty-four PREx sessions over two months including three sets of 8–10 repetitions of eight whole-body exercises at a moderate intensity. QoL and body composition were evaluated at baseline and after two months using Health Questionnaire Short-Form 36 (SF-36) and anthropometric measurements. ResultsAt completion, forty-one participants (n = 19 PREx, and n = 22 controls) with mean age of 12.78 ± 0.88 years and mean body mass index of 18 ± 2.2 kg/m2 were analyzed. Significant group x time effects were found on SF-36 role physical (RP) scores. Significant improvements with large effect sizes (d > 0.72) were found in RP, and arm circumferences in the PREx group. Spearman association analyses between percent change in anthropometric variables and change in QoL scores showed positive associations with moderate-to-large effect sizes in the PREx group among the following variables: mid-thigh-circumference, physical functioning (PF) and general health (GH); calf-circumference relaxed and body pain; biceps skinfold and GH scores; triceps-skinfold, and role physical (RP) and vitality (VT); supraspinale-skinfold and RP and VT; mid-thigh-skinfold and calf-skinfold and VT. ConclusionPREx after hospitalization enables modest positive changes in QoL associated to anthropometric changes in adolescents with AN without adverse effects on weight recovery.

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.

Muscle-strengthening via resistance exercise with intensity progression adjusted through free-weights in individuals with chronic low back pain: A gap in the literature

Aim: To describe Randomized Controlled Trials (RCTs) that tested progressive muscle strength exercises in adult patients with chronic low back pain, and confirm the guidelines that guide the progression system of variables used in exercise programs for muscle strength.Methods: We searched RTCs in Medline and Cochrane with controlled descriptors for low back pain and exercise. Two reviewers independently assessed the quality of the studies using the PEDro scale score. Studies that developed the muscle strength exercise program according to the guidelines of the American College of Sports Medicine were included.Results: Twenty-eight articles were recruited, 22 RTCs retrieved from Medline and 6 from Cochrane, after the analysis, only one study partially met the eligibility criteria.Conclusion: It has a gap RTCs on progressive resistance exercises for muscle strength in patients with chronic non-specific low back pain, also, literature does not have guidelines to guide the progression system of variables used in exercise programs for muscle strength in this population.

Investigating the Relationship between Serum Glucose and Inflammatory Markers in Diabetic Rats with Progressive Resistance Exercise

Background &amp; Objective: Diabetes Mellitus (DM) is a condition that is associated with an increase in inflammatory markers and studies show that resistance exercise with appropriate intensity can reduce inflammation generally. The aim of this study was to investigate the relationship of serum glucose with Interlekin18 (IL-18) and Tumor Necrosis Factor-alpha (TNF-α) in Diabetic rats with progressive resistance exercise. Materials &amp; Methods: In this experimental study, 32 Wistar male rats were distributed to sedentary control, trained control, sedentary diabetic, and trained diabetic groups of 8. Diabetes was induced by Streptozotocin (55 mcg/bw-i.v.). The resistance training protocol consisted of elevating upward from a ladder with weight, supporting an overload equivalent to 5% of body weight, during 6 weeks. The data obtained were analyzed by ANOVA and Tukey's posthoc multiple comparison tests, and a significance level of 5% was considered. Results: According to results, serum concentrations of TNF-α and IL-18 decreased significantly in trained diabetic group compared to sedentary diabetic group after resistance training. While in the amount of TNF-α in the trained control group compared to the sedentary control group, a significant increase was observed, and in the amount of IL-18 in trained control group compared to the sedentary control group, a significant decrease was observed. But regarding the correlation between serum IL-18 concentration and glucose, only in sedentary control group, a significant correlation was observed. Conclusions: Resistance training was able to reduce TNF-α and IL-18 inflammatory markers in trained diabetic rats and improve metabolic and immune aspects in diabetes mellitus.

Impact of physical therapy on a patient with complex comminuted fracture of elbow

Elbow joint make up to 4.3% of all fractures. Elbow joint consists of humerus radius and ulna of which humerus forms the proximal attachment while radius and ulna forms distal attachment. humerus being one of the major bone of upper limb any fracture needs to be given special consideration. Early rehabilitation can make the difference between a functional limb and an extremity with permanent loss. The rehabilitation goal is the rapid restoration of function with the attention given to prevention of deformity. A 52 year old male patient accountant by occupation with right hand dominance came with the complaint of reduced range of motion and pain in the right elbow. Patient presented with the history of fall in his home 2 months back, following which he had fracture of elbow. Patient was brought by the relatives in the casualty. After that X-ray and CT was done which showed comminuted fracture in the distal end of humerus. Patient was diagnosed with displaced comminuted fracture of elbow right side. Therapeutic intervention for the patient comprised of patient education, thermotherapy, and range of motion exercises, joint mobilization and progressive resistive exercise. Final outcome of all this intervention showed improvement in function. Early physiotherapy intervention after surgical fixation should be started to improve quality of life, forearm functioning and prevent chronic disability. Keywords: Comminuted fracture of elbow, Physiotherapy, Rehabilitation, Physical therapy.

Relationship between protein intake and resistance training–induced muscle hypertrophy in middle-aged women: A pilot study

ObjectiveThe aim of this study was to observe the relationship of protein intake at each meal and daily total with change in lean tissue mass with progressive resistance exercise training (RET) in healthy middle-aged women. MethodsTwenty-two healthy Japanese women were recruited from Shiga Prefecture, Japan, and a supervised whole body RET program was conducted twice a week for 16 wk. The dietary intake was assessed using 3-d dietary records. Dual-energy x-ray absorptiometry was used to measure the whole body lean soft tissue mass (WLTM). Multiple regression analysis was performed to examine the relationship between the protein intake and RET-induced changes in the WLTM after adjusting for age, sleep quality, physical activity, and energy intake. ResultsThe 16-wk RET program caused a significant gain in the WLTM (1.46 ± 0.45%, P = 0.004). Multiple regression analysis showed that the baseline protein intake at breakfast was negatively associated with the percent change in the WLTM (β = –1.598; P = 0.022). Additionally, the percent change (β = 0.624; P = 0.018) in protein intake at breakfast was positively associated with the percent change in WLTM. ConclusionIncreasing protein intake at breakfast may contribute to RET-induced muscle hypertrophy in middle-aged women, especially among those who habitually consume low-protein levels at breakfast. However, future studies with larger sample sizes are required to confirm the importance of protein intake at breakfast.

A muscle cell-macrophage axis involving matrix metalloproteinase 14 facilitates extracellular matrix remodeling with mechanical loading.

The extracellular matrix (ECM) in skeletal muscle plays an integral role in tissue development, structural support, and force transmission. For successful adaptation to mechanical loading, remodeling processes must occur. In a large cohort of older adults, transcriptomics revealed that genes involved in ECM remodeling, including matrix metalloproteinase 14 (MMP14), were the most upregulated following 14 weeks of progressive resistance exercise training (PRT). Using single‐cell RNA‐seq, we identified macrophages as a source of Mmp14 in muscle following a hypertrophic exercise stimulus in mice. In vitro contractile activity in myotubes revealed that the gene encoding cytokine leukemia inhibitory factor (LIF) is robustly upregulated and can stimulate Mmp14 expression in macrophages. Functional experiments confirmed that modulation of this muscle cell‐macrophage axis facilitated Type I collagen turnover. Finally, changes in LIF expression were significantly correlated with MMP14 expression in humans following 14 weeks of PRT. Our experiments reveal a mechanism whereby muscle fibers influence macrophage behavior to promote ECM remodeling in response to mechanical loading.

Comparative effects of 6-weeks progressive resistance exercise and moderate intensity aerobic exercise on CD4 count and weights of people living with HIV/AIDS in Alex-Ekwueme Federal University Teaching Hospital Ebonyi State.

Introduction:The most significant clinical challenges in people living with HIV/AIDS (PLWHA) are decline in CD4+ T helper cells and abnormal weight reduction. Consequently, PLWHA who are on Anti-Retroviral Therapy (ART) or Highly Active Anti-Retroviral Therapy (HAART) are usually predisposed to coronary artery diseases due to abnormal weight gain (lipohypertrophy), though with improved and unstable Cluster of Differentiation 4 (CD4) counts.The main aim of this study was to compare the effects of 6 weeks progressive resistance exercise (PRE) and moderate intensity aerobic exercise (MIAE) on CD4 count, and weight of PLWHA in Alex-Ekwueme Federal University Teaching Hospital Ebonyi State.Method:The study adopted quasi experimental research design. The population of the study was 60 Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome patients that attended HIV clinics at Alex-Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA) which formed 58 sample sizes for this study.Simple random sampling technique was adopted for the study and flow cytometry, Heel Densitometer (X-rite 331C), and Omron BF 400 were the instrument used for data collection of CD4 counts and weight respectively; and they are standardized hence not validated. Mean, standard deviation and Analysis of Co-variance (ANCOVA) were used to analyze the data obtained. The reliability coefficient obtained from the pilot study was 0.848 and 0.994 for CD4 and WEIGHT respectively.Results:The major findings revealed a significant difference after 6 weeks’ PRE and MIAE on CD4 and Weight of PLWHA.Conclusion:Health promotion policy maker's arm of the government and Healthcare givers should integrate and enforce the use of exercises either as a single regimen or combined exercises into the management plan of PLWHA for greater boost in absolute CD4 count bearing in mind that both have positive effects. Physiotherapist should be integrated in the managements of PLWHA for appropriate prescription and education of therapeutic exercises for body weight.

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.

Implementation Of High Intensity Interval Training And Autoregulatory Progressive Resistance Exercise In A Law Enforcement Training Academy

Implementation Of High Intensity Interval Training And Autoregulatory Progressive Resistance Exercise In A Law Enforcement Training Academy

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.

Rehabilitation of Older Adults with Sarcopenia: From Cell to Functioning.

ABSTRACTThe 20th and 21st centuries have witnessed a substantial increase in human life expectancy and in the number of men and women aged 60 years and older. Aging is associated with a large number of health conditions, including sarcopenia, which has been the subject of important research in the past 30 years. Sarcopenia is characterized by an age-related loss of muscle mass, weakness, and impaired physical performance. The condition can be diagnosed with a combination of measurements of these three elements. The precise definition of sarcopenia and the selection of optimal assessment methods have changed significantly in the past 20 years; nonetheless, the prevalence of sarcopenia in the general older population is in the range of 5–15%. Molecular and cellular events at the muscle cell level impact the size and quality of muscles (force adjusted for size). The active and passive mechanical properties of single muscle fibers are altered by changes in the structure and function of various cellular elements. Systemic factors such as inflammation, loss of hormonal influence, and deleterious lifestyle choices also contribute to sarcopenia. The consequences of sarcopenia include many adverse effects such as impairments in activities of daily living, falls, loss of independence, and increased mortality. Several rehabilitative interventions have been tested, and the safest and most effective is the use of progressive resistance exercise. An increase in dietary protein intake has synergistic effects. Future research should focus on a consensus definition of sarcopenia, identification of the best assessment methods, understanding of biological mechanisms, and testing of innovative interventions.

Progressive resistance exercise training to prevent lower-limb lymphedema after cervical cancer surgery: A feasibility study

ObjectiveRadical hysterectomy with pelvic lymphadenectomy is the standard surgical treatment for early stage cervical cancer. One of the most common complications after this surgery is lower extremity lymphedema (LLL). Program of progressive resistance exercise training (PRET) is a possible way to prevent LLL for cervical cancer patients postoperatively. Before we start a randomized controlled trial to evaluate the preventive effect of PRET, we conducted this pilot study to assess the feasibility of PRET after cervical cancer surgery. MethodsThe primary purpose of the pilot study was the feasibility of PRET, as well as the satisfaction and adherence to the PRET assessed by a questionnaire. We conducted a single-arm prospective study involving cervical cancer patients who underwent radical hysterectomy with pelvic lymphadenectomy. Participants exercised twice a day for 24 weeks (two weeks of supervised in hospital and then 22 weeks of home-based training) after surgical treatment. All patients were followed up for 12 months. Information that included the limb volume, BMI, perceived difficulty level and adherence rate was collected. ResultsFrom February to April 2019, a total of 24 patients participated in the study. None of them dropped out. The adherence rate was more than 75% in majority of the patients, the perceived difficulty level of the PRET was high (for the first phase, the fourth phase and the fifth phase, more than half of the participants felt the intensity of the exercise appropriate), and no serious adverse events in the study were observed. ConclusionsExercise training was safe and feasible. The preliminary results offered us the possibility to further test the preventive effect of PRET in a full-scale randomized controlled trial.

Protocol for a pilot randomized controlled trial of a mobile health exercise intervention for older patients with myeloid neoplasms (GO-EXCAP 2)

IntroductionWe have shown the Exercise for Cancer Patients (EXCAP©®) exercise program improved physical function and symptoms and reduced inflammatory markers in patients with cancer. However, adherence to exercise was lower in older adults compared to their younger counterparts. We then leveraged a mobile app to deliver EXCAP©® and adapted the intervention [Geriatric-Oncology (GO)-EXCAP] for older patients with myeloid neoplasms. In this pilot randomized trial, the primary goal is to determine effect sizes. We propose to assess the preliminary efficacy of GO-EXCAP compared to a behavioral placebo control on physical function, patient-reported outcomes (fatigue, mood, and quality of life), and inflammatory markers in 100 patients aged ≥60 years with myeloid neoplasms receiving outpatient chemotherapy. MethodsGO-EXCAP consists of the EXCAP©® exercise prescription (daily home-based progressive aerobic walking and resistance exercises with rated perceived exercise of 5–8), EXCAP©® kit (i.e., activity tracker, resistance bands, print manual, bag), a mobile app, and an in-person or virtual session with the exercise physiologist to deliver exercise prescription. The intervention will last for three cycles of chemotherapy (approximately 12 weeks). The primary outcome measure will be physical function (Short Physical Performance Battery). Secondary outcome measures include fatigue (Brief Fatigue Inventory), mood (Center for Epidemiologic Studies Depression Scale), and quality of life (Functional Assessment of Cancer Therapy-Leukemia). Exploratory outcome measures include inflammatory markers. DiscussionOlder adults with myeloid neoplasms receiving outpatient chemotherapy serve as an ideal model for studying an individually tailored mobile health exercise intervention in vulnerable older patients receiving cancer treatments to prevent physical function decline and improve symptoms.