Rehabilitation Exercise Training Research Articles

Rehabilitation exercises for kidney transplant recipients in an organ transplant ward: a best practice implementation project.

Kidney transplantation is an effective treatment for end-stage kidney disease. Kidney transplant recipients (KTRs) are prone to experiencing reduced physical function, depression, fatigue, and lack of exercise motivation due to their sedentary lifestyle before surgery. Exercise is an effective intervention for KTRs, but it has not been properly implemented in many practice settings. This project aimed to promote evidence-based exercises as part of KTRs' rehabilitation to improve their health outcomes. This project was informed by the JBI Evidence Implementation Framework. The project was conducted in the organ transplant ward of a tertiary comprehensive hospital in Changsha, China. Based on a summary of best evidence, 12 audit criteria were developed for the baseline and follow-up audits involving 30 patients and 20 nursing staff. The JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) tool were used to identify barriers and facilitators and develop targeted strategies to improve issues. Compared with the baseline audit, significant improvements were achieved in most of the criteria in the follow-up audit, with 9 of the 12 criteria reaching 100% compliance. Notably, the 6-minute walk distance test results were significantly higher, while the Self-Rating Depression Scale and Self-Rating Anxiety Scale scores were significantly lower (p < 0.05). This project demonstrates that evidence-based practice can improve the clinical practice of rehabilitation exercises for KTRs. The GRiP strategies proved to be extremely useful, notably, the formulation of a standardized rehabilitation exercise protocol, training, and enhancement of the exercising environment. Head nurses' leadership and decision-making also played an important role in the success of this project. http://links.lww.com/IJEBH/A180.

The Value of Proprioceptive Neuromuscular Promotion Combined with Exercise Rehabilitation Training in Rotator Cuff Injury

The Value of Proprioceptive Neuromuscular Promotion Combined with Exercise Rehabilitation Training in Rotator Cuff Injury

An Overview of Physiological Basis of Exercise Training in Pulmonary Rehabilitation

An Overview of Physiological Basis of Exercise Training in Pulmonary Rehabilitation

A Magnetic Field-Based Wearable Respiration Sensor for Real-Time Monitoring During Pulmonary Rehabilitation.

This work explores Hall effect sensing paired with a permanent magnet, in the context of pulmonary rehabilitation exercise training. Experimental evaluation was performed considering as reference the gold-standard of respiratory monitoring, an airflow transducer, and performance was compared to another wearable device with analogous usability - a piezoelectric sensor. A total of 16 healthy participants performed 15 activities, representative of pulmonary rehabilitation exercises, simultaneously using all devices. Evaluation was performed based on detection of flow reversal events and key respiratory parameters. Overall, the proposed sensor outperformed the piezoelectric sensor with a mean ratio, precision, and recall of 0.97, 0.97, and 0.95, respectively, against 0.98, 0.90, and 0.88. Evaluation regarding the respiratory parameters indicates an adequate accuracy when it comes to breath cycle, inspiration, and expiration times, with mean relative errors around 4% for breath cycle and 8% for inspiration/expiration times, despite some variability. Bland-Altman analysis indicates no systematic biases. Characterization of the proposed sensor shows adequate monitoring capabilities for exercises that do not rely heavily on torso mobility, but may present a limitation when it comes to activities such as side stretches. This work provides a comprehensive characterization of a magnetic field-based respiration sensor, including a discussion on its robustness to different algorithm thresholds. It proves the viability of the sensor in a range of exercises, expanding the applicability of Hall effect sensors as a feasible wearable approach to real-time respiratory monitoring.

Retracted: Application of Composite Nano-Bone Transplantation and Massage Exercise Rehabilitation Training in Patients Undergoing Limb Replantation

Retracted: Application of Composite Nano-Bone Transplantation and Massage Exercise Rehabilitation Training in Patients Undergoing Limb Replantation

Alterations in RNA editing in skeletal muscle following exercise training in individuals with Parkinson's disease.

Parkinson's Disease (PD) is the second most common neurodegenerative disease behind Alzheimer's Disease, currently affecting more than 10 million people worldwide and 1.5 times more males than females. The progression of PD results in the loss of function due to neurodegeneration and neuroinflammation. The etiology of PD is multifactorial, including both genetic and environmental origins. Here we explored changes in RNA editing, specifically editing through the actions of the Adenosine Deaminases Acting on RNA (ADARs), in the progression of PD. Analysis of ADAR editing of skeletal muscle transcriptomes from PD patients and controls, including those that engaged in a rehabilitative exercise training program revealed significant differences in ADAR editing patterns based on age, disease status, and following rehabilitative exercise. Further, deleterious editing events in protein coding regions were identified in multiple genes with known associations to PD pathogenesis. Our findings of differential ADAR editing complement findings of changes in transcriptional networks identified by a recent study and offer insights into dynamic ADAR editing changes associated with PD pathogenesis.

Melatonin supplementation enhances pulmonary rehabilitation outcomes in COPD: a randomized, double-blind, placebo-controlled study

Melatonin (MLT), the main product of the pineal gland, is involved in muscle tissue repair and regeneration, besides several other important physiologic functions. In COPD, MLT administration can improve lung oxidative stress and sleep quality, but its potential effects on the outcomes of pulmonary rehabilitation (PR) have not been previously investigated. A randomized controlled trial was undertaken to test the hypothesis that a combined approach of rehabilitative exercise training and MLT supplementation could maximize functional performance, health status and quality of life in patients with COPD. Thirty-nine individuals with COPD referred to a supervised PR program at the Federal University of Ceara, Brazil, were randomized to receive MLT (3 mg/day; n = 18) or placebo (n = 21). Exercise capacity (6-min walk test – 6MWT), health status (COPD assessment test), and quality of life (airways questionnaire 20) were investigated as primary outcomes. No differences were observed at baseline in demographic, anthropometric and clinical characteristics between MLT and placebo groups. At the end of PR, superiority of the MLT group was demonstrated in improvement in the distance covered in the 6MWT (71 ± 26 vs. 25 ± 36 m; p < 0.01), health status (−11 ± 6 vs. −3 ± 5; p < 0.01), and quality of life (−6.9 ± 3.0 vs. −1.9 ± 2.4; p < 0.01), compared to the placebo group. In conclusion, MLT supplementation during the course of 12 weeks of PR can improve functional capacity, health status and quality of life in patients with COPD. These findings may have significant implications for the management of this condition.

Relationship Between Number of Cardiac Rehabilitation Exercise Training Sessions, Muscle Mass, and Cardiorespiratory Fitness in Rural Elderly Patients with Coronary Artery Disease [Letter

Relationship Between Number of Cardiac Rehabilitation Exercise Training Sessions, Muscle Mass, and Cardiorespiratory Fitness in Rural Elderly Patients with Coronary Artery Disease [Letter

Relationship Between Number of Cardiac Rehabilitation Exercise Training Sessions, Muscle Mass, and Cardiorespiratory Fitness in Rural Elderly Patients with Coronary Artery Disease.

This study aimed to compare the effects of a cardiac rehabilitation (CR) exercise program on skeletal muscle index (SMI) and cardiorespiratory fitness (CRF) in patients aged ≥65 years. From January 2012 to December 2021, patients living in rural regions aged ≥65 who underwent percutaneous coronary intervention for acute myocardial infarction (AMI) and at least one CR exercise session were enrolled. We retrospectively reviewed the medical records of the patients who underwent an exercise tolerance test (ETT) at initial and 3-month follow-ups. A total of 36 patients were enrolled who underwent a mean of 6.56 exercise sessions and were divided into groups based on the number of center-based CR (CBCR) sessions: 14 in Group A (≥7 sessions) and 22 in Group B (<7 sessions). In CBCR session, we comprehensively counseled them about their nutrition, smoking cessation et al. Both groups underwent an ETT after 12 weeks. The outcomes were CRF parameters examined by a cardiorespiratory exercise test and the SMI examined by bioimpedance analysis (BIA). The number of exercise sessions was significantly correlated with the rate of SMI change. Group A showed significant increases in metabolic equivalent of task (MET), maximal oxygen uptake (VO2max), and SMI after 3 months. There were significant differences in the rates of change in MET, VO2max, and SMI between the two groups. CRF significantly improved in Group A in a short period. Further studies are required to increase long-term CBCR adherence in elderly patients with AMI in rural regions.

Effect of composite conjugated materials on tissue healing during exercise rehabilitation training.

The application of traditional materials to tissue healing in sports rehabilitation training has problems such as poor effect, high rejection reaction, and slow healing speed. It also brings many challenges to the development of sports rehabilitation training. This article aims to explore the impact of composite conjugated materials on tissue healing to promote rapid and efficient tissue healing and improve the effect of sports rehabilitation training. Through research and analysis, this article found that composite conjugated materials have unique biocompatibility and can promote cell growth and differentiation. In skin tissue healing, composite conjugated materials can control the release rate and duration of drugs to promote skin healing. During the fracture healing process, conjugated materials can provide growth factors and extracellular matrix components, stimulate bone cell proliferation and differentiation, and promote fracture healing. In terms of soft tissue injuries, composite conjugated materials serve as supporting structures or matrices, providing a favorable environment for the regeneration of damaged tissue. In the regulation of inflammatory responses, composite conjugated materials reduce inflammatory responses and accelerate the healing process by modulating immune responses. The results of this study show that 1week after the experiment, the skin healing rates of the control group and the experimental group were 42.55% and 58.17% respectively; 5weeks after the experiment, the skin healing rates of the control group and the experimental group were 51.28% and 73.24% respectively. After 1, 2, 3, 4, and 5weeks of experiment, it was found that the average tissue repair rates of the control group were 44.03%, 54.18%, 58.40%, 67.08%, and 72.09% respectively, and the average tissue repair rates of the experimental group were 52.18%, 61.91%, 63.40%, 74.61%, and 85.05% respectively. This study highlights the huge potential of composite conjugated materials in promoting tissue healing and tissue repair, and is of great significance for promoting technological progress in the field of sports rehabilitation and improving rehabilitation effects.

Fabrication of flexible accelerated-wound-healing chitosan/dopamine-based bilayer hydrogels for strain sensors

Flexible conductive hydrogels have great potential for healthcare and human motion sensing. However, it is difficult to simultaneously achieve conductive hydrogel epidermal sensors with reliable adhesion capabilities and excellent sensing properties, as well as accelerated wound healing performance in wearable hydrogels. Here, an epidermal sensor with excellent adhesion (0.6 kPa) and tensile strain (218.0 %) properties was assembled from an easy-to-prepare bilayer antimicrobial hydrogel, which effectively accelerates wound healing, as well as for human motion sensing. The upper hydrogel layer was composed of PVA, which could effectively enhance the mechanical properties of the bilayer hydrogel. The lower hydrogel layer consisted of polyacrylamide (PAm) and chitosan-dopamine (CC-DA). PAm with good adhesion properties adhered effectively to the skin surface. CC-DA not only had adhesion properties, but also has good antibacterial effects. It inhibited the growth of bacteria, which assisted in wound healing and infection prevention. Therefore, the design of the bilayer hydrogel combined the mechanical enhancement of PVA with the adhesion properties and antimicrobial effect of PAm and CC-DA to provide better wound repair. In addition, the double-layer hydrogel with good electrical conductivity (1.65 S·m−1) could sensitively monitor the tiny electrophysiological signals emitted by the human body during exercise rehabilitation training.

In persistent dyspnea after COVID-19 ARDS, exercise training rehabilitation vs. usual PT reduced dyspnea at 90 d.

Romanet C, Wormser J, Fels A, et al. Effectiveness of exercise training on the dyspnoea of individuals with long COVID: a randomised controlled multicentre trial. Ann Phys Rehabil Med. 2023;66:101765. 37271020.

The effects of cognitive rehabilitation combined with aerobic exercise or stretching-and-toning on new learning and memory in persons with moderate-to-severe TBI: Protocol for a randomized controlled trial

This paper describes the protocol for a Phase I/II, parallel-group, blinded randomized controlled trial that compares the effects of 12-weeks of combined learning and memory rehabilitation with either aerobic cycling exercise or stretching on cognitive, neuroimaging, and everyday life outcomes in 60 persons with moderate-to-severe traumatic brain injury (TBI) who demonstrate impairments in new learning. Briefly, participants will undergo baseline testing consisting of neuropsychological testing, neuroimaging, daily life measures, and cardiorespiratory fitness. Following baseline testing, participants will be randomized to one of 2 conditions (30 participants per condition) using concealed allocation. Participants will be masked as to the intent of the conditions. The conditions will both involve supervised administration of an enhanced, 8-week version of the Kessler Foundation modified Story Memory Technique, embedded within either 12-weeks of supervised and progressive aerobic cycling exercise training (experimental condition) or 12-weeks of supervised stretching-and-toning (active control condition). Following the 12-week intervention period, participants will complete the same measures as at baseline that will be administered by treatment-blinded assessors. The primary study outcome is new learning and memory impairment based on California Verbal Learning Test (CVLT)-III slope, the secondary outcomes include neuroimaging measures of hippocampal volume, activation, and connectivity, and the tertiary outcomes involve measures of daily living along with other cognitive outcomes. We further will collect baseline sociodemographic data for examining predictors of response heterogeneity. If successful, this trial will provide the first Class I evidence supporting combined memory rehabilitation and aerobic cycling exercise training for treating TBI-related new learning and memory impairment.

A 21-Day Individual Rehabilitation Exercise Training Program Changes Irisin, Chemerin, and BDNF Levels in Patients after Hip or Knee Replacement Surgery.

Osteoarthritis (OA) is the most frequent worldwide cause of adult population disabilities. The study evaluated the effects of a 21-day individual rehabilitation exercise training program focused on improving patients' functional capacity. The study analyzed the changes in irisin, chemerin, and BDNF serum levels in 36 OA patients subjected to an individually-adjusted rehabilitation program 90 days after surgical hip or knee replacement. The changes in irisin, chemerin, and BDNF serum levels were measured using enzyme-linked immunosorbent assay (ELISA) kits. A 21-day individual rehabilitation exercise training program significantly increased irisin and BDNF, and decreased chemerin serum levels. The presented study indicates that individually-adjusted exercise training is an important modulator influencing serum levels of anti- and pro-inflammatory factors, leading to positive clinical outcomes in osteoarthritis therapy. Selected factors are considered potential markers of various pathophysiological conditions. The presented study brings new details to the discussion.

Research progress of exercise training in rehabilitation of patients with chronic heart failure

Research progress of exercise training in rehabilitation of patients with chronic heart failure

Effectiveness of exercise training on the dyspnoea of individuals with long COVID: A randomised controlled multicentre trial.

COVID-19-related acute respiratory distress syndrome (CARDS) is a severe evolution of the Sars-Cov-2 infection and necessitates intensive care. COVID-19 may subsequently be associated with long COVID, whose symptoms can include persistent respiratory symptoms up to 1 year later. Rehabilitation is currently recommended by most guidelines for people with this condition. To evaluate the effects of exercise training rehabilitation (ETR) on dyspnoea and health-related quality of life measures in people with continuing respiratory discomfort following CARDS. In this multicentre, two-arm, parallel, open, assessor-blinded, randomised controlled trial, we enroled adults previously admitted with CARDS to 3 French intensive care units who had been discharged at least 3 months earlier and who presented with an mMRC dyspnoea scale score > 1. Participants received either ETR or standard physiotherapy (SP) for 90 days. The primary outcome was dyspnoea, as measured by the Multidimensional Dyspnoea Profile (MDP), at day 0 (inclusion) and after 90 days of physiotherapy. Secondary outcomes were the mMRC and 12-item Short-Form Survey scores. Between August 7, 2020, and January 26, 2022, 487 participants with CARDS were screened for inclusion, of whom 60 were randomly assigned to receive either ETR (n=27) or SP (n=33). Mean MDP following ETR was 42% lower than after SP (26.15vs. 44.76); a difference of -18.61 (95% CI -27.78 to -9.44; p<10-4). People who were still suffering from breathlessness three months after being discharged from hospital with CARDS had significantly improved dyspnoea scores when treated with ETR therapy for 90 days unlike those who only received SP. Study registered 29/09/2020 on Clinicaltrials.gov (NCT04569266).

The efficacy of high- and low-load resistance training in patients with coronary artery disease: a follow-up of a randomised controlled trial

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Slovenian Research Agency. Background Perseverance of beneficial effects of exercise training in cardiac rehabilitation remains understudied. Maximal aerobic capacity (VO2 max) and quality life were mostly maintained at 1 year follow-up after aerobic training (AT) or after a combination of AT and mostly low-load (LL) resistance training (RT), while the effects of high-load (HL) RT remain unknown in patients with coronary artery disease (CAD). Purpose This study investigated the effects of combination of AT with HL-RT or LL-RT in comparison to AT alone on maximal aerobic capacity, physical activity, and quality of life in patients with CAD at 1-year follow-up after cardiac rehabilitation. Methods We initially enrolled 79 patients with CAD to combined AT and HL-RT, combined AT and LL-RT or AT alone, and 59 patients completed the study. The assessments at 1-year follow-up were completed by 53 patients, with [mean (SD) or median (interquartile range)] age = 61 (8) years, height = 172.1 (8.4) cm, weight = 83.93 (14.03) kg and left ventricular ejection fraction = 50 (45,60) %. During the study, all patients performed the same interval aerobic cycling (40 min/session, intervals of 3-5 min of work-load cycling separated by 2 min of unloaded cycling, intensity progressed from 50% to 80% of maximal workload achieved at baseline cardiopulmonary exercise test). In HL-RT-group, the training load progressively increased from 70% of 1-RM (6–11 reps/set) to 80% of 1-RM (6–8 reps/set), while in LL-RT group the training load progressively increased from 35% of 1-RM (12–22 reps/set) to 40% of 1-RM (12–16 reps/set) in the first seven weeks of the intervention. Similar progression of RT was used after 1-RM re-evaluation following 7 weeks of training. After cardiac rehabilitation, patients were given written brochure with included advice on home-based physical activity with emphasis on aerobic and resistance exercises. Maximal aerobic performance, objectively measured physical activity and quality of life were measured after 1-year. Results At 1-year follow-up majority of the patients increased VO2max (62%). Patients increased VO2max (+0.08 l/min, p = 0.022) and had higher respiratory exchange ratio (+0.06, p &amp;lt; 0.001), regardless of the randomisation. There was no significant effect of time x group interaction on the outcomes. VO2max was increased in AT (+0.13 l/min, p = 0.026) and LL-RT (+0.12 l/min, p = 0.031) groups, while respiratory exchange ratio was greater in LL-RT (+0.6, p = 0.004) and HL-RT (+0.7, p = 0.003) groups at follow-up. Post-training physical activity and quality of life were high but remained unchanged after 1 year. Conclusions The combination of AT and HL-RT or LL-RT was not superior to AT alone in changes of maximal aerobic performance, physical activity and quality of life in patients with coronary artery disease at 1-year follow-up.

Effects of monitoring exercise rehabilitation with target intensity on the patient with twice PCI: A case report.

As the core of cardiac rehabilitation (CR), early exercise rehabilitation is beneficial for patients with coronary heart disease (CHD), and center-based CR with target intensity is superior to home-based CR. However, there was no research to observe the effects of exercise rehabilitation on cardiopulmonary exercise capacity, oxygen uptake efficiency slope, endothelial function evaluated as flow-mediated vasodilation (FMD), and blood plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) in CHD patients undergone percutaneous coronary intervention (PCI) for 3 months. A 57-year-old woman had been identified with triple vessel disease and undergone twice PCI for complete revascularization, however, there was no improvement in Lp-PLA2, FMD, and related indicators of cardiopulmonary exercise testing. Coronary angiography showed an 85% stenosis in the middle left anterior descending artery, an 85% stenosis in the proximity of a thick first-diagonal branch, a long 75 to 85% stenosis in the middle left circumflex artery, and a 90 to 95% stenosis in the proximal. The case was diagnosed as CHD. The patient obtained optimal medical therapy comprising therapeutic lifestyle changes, and began monitoring exercise rehabilitation with target intensity 3 months after the second PCI in the CR center. There were changes in cardiopulmonary exercise capacity, oxygen uptake efficiency slope, FMD, and Lp-PLA2 in the patient with 3 apparent stenotic coronary arteries who was done PCI twice, without or with postoperative exercise rehabilitation, respectively. We proved that monitoring exercise rehabilitation training with target intensity could improve the prognosis of chronic coronary syndrome patients, and it was never too late to do regular exercise rehabilitation.

The Exercise Intervention as Part of Rehabilitation in Intracranial Myxoid Chondrosarcoma: A Case Report

Malignant tumors after surgical trauma are frequently presented with unavoidable complications, such as physical dysfunction, decreased motor endurance, bowel disorders and cognitive impairment, and other symptoms. Due to the presence of malignant tumors, patients suffer from not only physical discomfort but also the presence of psychological and mental stress. Trauma often leads to poor emotional control and cannot cooperate with treatment. Exercise can not only change the function of the limbs but also have a positive effect on emotions. This case reports a 28-year-old male who experienced a decline in cognitive function and activities of daily living after undergoing tumor resection and radiotherapy. A year later, he was hospitalized and completed a four-week activity of daily living and exercise rehabilitation training. What’s more, his mood was managed along with the reintegration therapy. As the patient's mood improved, training coordination increased, quality of life and daily living ability gradually improved, and he recovered well during the follow-up period. Given this single case, multi-modal exercise rehabilitation can maintain or improve functional performance and QOL domains even during heavy treatments. When the patient is undergoing exercise rehabilitation, he also needs emotional management, and emotional intervention is required for the patient. Therefore, exercise and the emotional management of patients with malignancy are of great importance.

Rehabilitative exercise scheduling: Effects on balance, functional movement performance, and pain perception in middle-aged women with knee pain: A randomized controlled trial.

The scheduling of clinical rehabilitative exercise should combine best possible delivery of exercise with the most efficient use of time, facilities, equipment, and personnel. However, it is not clear whether distribution of a fixed amount of exercise volume is more efficient over a longer time period in a week (distributed manner) than over a shorter time period in a week (massed manner). To evaluate the effects of distributed versus massed within- and between-session exercise scheduling on balance, exercise performance, and pain perception in middle-aged women with knee pain. Thirty-four middle-aged female volunteers (mean age ± SD, 56.0 ± 5.2 years old; mean weight ± SD, 66.9 ± 7.6 kg; mean body mass index [BMI] ± SD, 27.7 ± 2.8 kg/m2 ) were randomly assigned to one of the three groups consisting of Rehabilitative Massed Scheduling (RMS); Rehabilitative Distributed Scheduling (RDS); or Control group (CG). Isometric strength, balance, functional movement performance, and pain perception were assessed at baseline (pre), at week 8 (mid), and 1 week after the full 12 weeks (post) of exercise training or nointervention (CG). Significant improvements in balance, functional movement performance, and pain perception were found after both RDS and RMS after 8 and 12 weeks compared to the control group (p˂.05). Examination of the net changes (% ∆) between RDS and RMS showed a statistically significant difference only in the right 30-second arm curl records of individuals in the RDS group, which were significantly higher than the RMS group at the post-test (p˂.05). Rehabilitative training providers are advised to distribute the drills of rehabilitative exercise training within and between the sessions of exercise per week only when a positive Bottom-Up Rise Strength Transfer effect (BURST) effect of exercise training is needed. Otherwise, if the whole amount of rehabilitative exercise work is identical the benefit of going five versus three times per week to the rehabilitation centers would be similar.