Resistance Exercise In Patients Research Articles

Resistance training and aerobic training improve muscle strength and aerobic capacity in chronic inflammatory demyelinating polyneuropathy.

We investigated the effects of aerobic and resistance exercise in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). Eighteen CIDP patients treated with subcutaneous immunoglobulin performed 12 weeks of aerobic exercise and 12 weeks of resistance exercise after a run-in period of 12 weeks without exercise. Three times weekly the participants performed aerobic exercise on an ergometer bike or resistance exercise with unilateral training of knee and elbow flexion/extension. Primary outcomes were maximal oxygen consumption velocity (VO2 -max) and maximal combined isokinetic muscle strength (cIKS) of knee and elbow flexion/extension. VO2 -max and muscle strength were unchanged during run-in (-4.9% ± 10.3%, P = 0.80 and -3.7% ± 10.1%, P = 0.17, respectively). Aerobic exercise increased VO2 -max by 11.0% ± 14.7% (P = 0.02). Resistance exercise resulted in an increase of 13.8% ± 16.0% (P = 0.0004) in cIKS. Aerobic exercise training and resistance exercise training improve fitness and strength in CIDP patients. Muscle Nerve 57: 70-76, 2018.

Effect of exercise in patients with diabetic kidney disease

Background/Aims: Chronic kidney disease (CKD) is an important epidemic and public health problem, which occurs in many countries with an increasing prevalence. Over 50 million people throughout the world are known to have CKD and of these, more than 1 million require renal replacement therapies such as dialysis and renal transplantation. In recent years, the rising incidence of diabetes and hypertension, the two most common causes of CKD, have caused an increase in the prevalence of CKD, being responsible for over 70% of all cases of CKD. The current study was conducted to detect the effect of aerobic exercise versus resistance exercise in patients suffering from diabetic kidney disease (DKD). Methods: Thirty patients with DKD, ranging from 18–46 years old, were included in this study from the Department of Internal medicine, Cairo University Hospitals. Subjects were divided randomly into two equal groups. Group 1 received aerobic exercises, and group 2 received resistance exercises for 3 months. All participants were evaluated before the first session of treatment and at the end of treatment through: creatinine, urea, sodium, potassium, haemoglobin, glucose, blood pressure, and physical performance, which includes walking speed, ascending stairs, descending stairs, return time, muscle power and muscle endurance. Results: Both groups showed a decrease in urea, creatinine, sodium, blood glucose, blood pressure, and an increase potassium and physical performance. Conclusions: Resistance exercises, as well as aerobic exercise, have a positive effect on decreasing urea, creatinine, glucose, blood pressure, and increasing physical performance and so it can be used safely in DKD patients.

The effects of resistance exercise in patients with knee osteoarthritis: a systematic review and meta-analysis

Objective: To analyze the effectiveness of resistance exercise in the treatment of knee osteoarthritis on pain, stiffness, and physical function. Design: Systematic review and meta-analysis of randomized controlled trials. Data sources: PubMed, Embase, Cochrane Central Register of Controlled Trials, the Web of Science, and Chinese Biomedical Literature Database were searched from the date of inception to August 2015. Methods: Trials comparing effects of resistance exercise intervention with either non-intervention or psycho-educational intervention were selected by two reviewers independently. The risk of bias was assessed and studies with similar outcomes were pooled using a fixed or random effects model. Results: Data from 17 randomized clinical trials including 1705 patients were integrated. The main source of methodological bias in the selected studies was lack of double blinding. The meta-analysis results suggested that resistance exercise training relieved pain (standard mean difference [SMD]: -0.43; 95% confidence interval [CI]: -0.57 to -0.29; P < 0.001), alleviated stiffness (SMD: -0.31; 95%: CI -0.56 to -0.05; P = 0.02), and improved physical function (SMD -0.53; 95% CI: -0.70 to -0.37; P < 0.001). Conclusion: Resistance exercise is beneficial in terms of reducing pain, alleviating stiffness, and improving physical function in patients with knee osteoarthritis.

Hemodynamic Responses to Resistance Exercise in Patients with Coronary Artery Disease.

Investigate hemodynamic responses of resistance exercise (RE) with moderate load (i.e., international guidelines for RE of patients) versus RE with high load in patients with coronary artery disease (CAD). Medically stable male (n = 11) and female patients (n = 4) treated with PCI or percutaneous coronary intervention, or coronary artery bypass surgery a minimum of 6 months before this study, performed three sets of 15RM and 4RM RE in a randomized order on separate days. Beat-to-beat systolic (SBP), diastolic (DBP) blood pressure, heart rate (HR), stroke volume (SV), cardiac output (CO), and systemic vascular resistance (SVR) were monitored at preexercise, and continuously during RE. Compared with preexercise, SBP and DBP (mean of three sets) increased by 12% to 13% (both; P < 0.001) and 35% to 40% after 15RM RE (both; P < 0.001). 15RM SBP and DBP were higher than 4RM SBP and DBP (both; P < 0.001). The SBP of the fourth repetition of 15 RM RE was similar to the SBP of the fourth repetition of 4RM RE. Compared with preexercise, SV increased moderately after 4RM and 15 RM RE, respectively (both, P < 0.001). HR increased more after 15RM compared with 4RM RE (P < 0.05); thus, higher CO after 15RM (compared with 4RM RE; P < 0.05) was mainly caused by higher HR. SVR decreased by 15% (P < 0.001) and 50% (P < 0.01) after 4RM and 15RM RE. SBP and DBP increased significantly more during moderate load RE; thus, the magnitude of the external load is not the prime determinant of the pressure response during RE. If management of blood pressure is of concern, high load/low rep RE is preferable to medium load/high rep RE.

Comparison of Outcome on Knee Related Function by 2 Different Mode of Progressive Resisted Exercises (PREx) Intervention in Patients with Knee Osteoarthritis

Background: Lower limb muscles strengthening are crucial in knee joint rehabilitation. Weight training as evolved by DeLorm is a more traditional robust form of Progressive resistive exercises (PREx) program in which muscles are exercised against constant resistance through the arc of motion. Use of Elastic bands is yet another tool used in strengthening exercise regimens. What popularly known as Theraband exercises, resistance varies through the arc and relies on various components such as modulus of elasticity. The characteristic differences of theses 2 modes of resisted exercise was assumed to result in different outcomes on measured knee related functions. Hence, this study has been undertaken to compare the short term effects PREx using weight cuffs versus Theraband resistance exercise in patients suffering from knee osteoarthritis. Methods: Eighty-nine participants completed this trial over the period of 14 months. Study participants were randomly allocated to 3 study groups which received PREx (DeLorm) (n=30), Theraband exercises (n=30) and conventional treatment (n=29) for 3 week period. Results: Interaction between time and function was significant when compared with control whereas both experimental groups improved equally (P>0.05) over the period of time. Post treatment Weight cuff (DeLorm) and Theraband PREx between group differences (median difference and probability of superiority (PS) is presented for 5 Knee injury and Osteoarthritis Outcome Score (KOOS) subscales and patient specific function are as follows. Pain: 6.5 (36%); symptoms 11(43%); ADL 5.5(45%), Sport and recreation 5(35%), QOL, PSFS 0.75(37%). Conclusion: Both the weight cuff PREx (DeLorm) and Theraband resistance exercises resulted in improvement of knee functions as measured on KOOS and patient specific functional scale in population suffering from knee osteoarthritis with better probability of superiority for weight cuff exercises.

Is heart rate variability a feasible method to determine anaerobic threshold in progressive resistance exercise in coronary artery disease?

ABSTRACTBackgroundRecent studies have shown that the magnitude of the metabolic and autonomic responses during progressive resistance exercise (PRE) is associated with the determination of the anaerobic threshold (AT). AT is an important parameter to determine intensity in dynamic exercise.ObjectivesTo investigate the metabolic and cardiac autonomic responses during dynamic resistance exercise in patients with Coronary Artery Disease (CAD).MethodTwenty men (age = 63±7 years) with CAD [Left Ventricular Ejection Fraction (LVEF) = 60±10%] underwent a PRE protocol on a leg press until maximal exertion. The protocol began at 10% of One Repetition Maximum Test (1-RM), with subsequent increases of 10% until maximal exhaustion. Heart Rate Variability (HRV) indices from Poincaré plots (SD1, SD2, SD1/SD2) and time domain (rMSSD and RMSM), and blood lactate were determined at rest and during PRE.ResultsSignificant alterations in HRV and blood lactate were observed starting at 30% of 1-RM (p<0.05). Bland-Altman plots revealed a consistent agreement between blood lactate threshold (LT) and rMSSD threshold (rMSSDT) and between LT and SD1 threshold (SD1T). Relative values of 1-RM in all LT, rMSSDT and SD1T did not differ (29%±5 vs 28%±5 vs 29%±5 Kg, respectively).ConclusionHRV during PRE could be a feasible noninvasive method of determining AT in CAD patients to plan intensities during cardiac rehabilitation.

Individual blood pressure responses to walking and resistance exercise in peripheral artery disease patients: Are the mean values describing what is happening?

The aim of this study was to analyze the average and individual blood pressure responses to walking and resistance exercise in patients with peripheral artery disease. Thirteen patients underwent three experimental sessions: walking exercise, resistance exercise, and control. Ambulatory blood pressure, heart rate, and rate pressure product were obtained before and until 24 hours after sessions. The mean cardiovascular values during 24 hours, awake, and sleep periods were similar (P > 0.05) after the three experimental sessions. The analysis of individual data revealed that during 24 hours, eight of 13 patients reduced systolic or diastolic blood pressure in ≥4.0 mm Hg in at least one of the exercise session; furthermore, most of these patients presented greater responses after resistance exercise. The clinical characteristics of patients seem to influence the blood pressure responses after exercises. Individual data showed that part of patients presented clinically significant decreases in blood pressure, showing that these patients have acute cardiovascular benefits after performing an acute bout of exercise. Although, in average, a bout of walking or resistance exercise did not decrease ambulatory blood pressure in peripheral artery disease patients, the individual data revealed that most patients presented clinically relevant blood pressure reductions, especially after resistance exercise.

Current Clinical Care of Older Adults With Sarcopenia

As sarcopenia is common and associated with risk of adverse health consequences, strategies for clinical care of such patients are needed. Individuals with slow gait speed (<0.8 m/s) should be evaluated for low grip strength and low muscle mass. Progressive resistance exercise in patients with sarcopenia is beneficial, but evidence for protein or vitamin D supplementation is inconclusive. Comprehensive geriatric assessment with involvement of a multidisciplinary team enables clinicians to optimize treatment of complex older individuals with sarcopenia.

(178) - Acute Blood Pressure Adaptations During Heavy Resistance Exercise in Patients With Heart Failure and Transplant Recipients: A Clinical Investigation Using Continued Blood Pressure Surveillance

Resistance training is recommended both in healthy subjects and in rehabilitation of cardiac patients with a dose-response correlation between intensity and effect (American Heart Association and European Society of Cardiology). Some concern exists in regards to the acute increase in systolic blood pressure (SBP) during exercise at 80% of maximum resistance (heavy resistance exercise).

Resistance training in hemodialysis patients: a review.

Few studies have examined the role of resistance training (RT) in chronic kidney patients on hemodialysis (HD). This study reviews the literature about resistance exercise for patients on HD and describes protocols and clinical outcomes. A search of the MEDLINE database found 21 eligible publications, of which 14 studies applied only RT and 7 combined RT and aerobic training. Regarding the period of exercise training, 14 studies applied intradialytic exercise. The main outcome reported was muscle strength, which was assessed through knee strength and handgrip measures. All studies reviewed presented at least one significant result in relation to biochemical parameters, physical capacity, strength, body composition, or quality of life. This review demonstrates that RT improves muscle strength, some biochemical parameters, and quality of life of the HD patients.

Noninvasive Ventilation Improves the Cardiovascular Response and Fatigability During Resistance Exercise in Patients With Heart Failure

Noninvasive ventilation may improve cardiovascular function and exercise performance. We evaluated the physiologic impact of noninvasive ventilation during isokinetic knee extension resistance exercise in patients with heart failure. This clinical trial included 10 male compensated patients with ischemic heart failure (age, 57 ± 9.1 years; ejection fraction, 28.5 ± 5.8%). Subjects underwent 2 bouts of exercise on an isokinetic dynamometer, separated by 72 hours of rest. The resistance exercise was concentric knee extension, at a speed of 60°/s. Five sets of 10 repetitions were performed during the 2 exercise bouts, and each set was separated by 2 minutes of rest. Subjects were administered either bilevel positive airway pressure ventilation (BV) or sham ventilation 20 minutes before and during the 2 exercise sessions in a randomized fashion. Heart rate, systolic blood pressure, and diastolic blood pressure were measured at rest, during exercise, and into recovery. Changes in peak torque (ΔPT), total work (ΔTW), and power (ΔPw) between the fifth and first sets were also measured. Compared with the sham intervention, BV significantly decreased heart rate, systolic blood pressure, and diastolic blood pressure at rest and during exercise (P < .01). There were no significant differences in these variables during recovery. Bi-level positive airway pressure ventilation also significantly reduced ΔPT, ΔTW, and ΔPw compared with the sham intervention (P < .01). Bi-level positive airway pressure ventilation significantly improved the cardiovascular response and fatigability during resistance exercise in patients with heart failure. These results suggest that use of BV during exercise training may be beneficial in this population with chronic disease.

Is Cardiovascular or Resistance Exercise Better to Treat Patients With Depression? A Narrative Review

Objectives: There is growing evidence regarding the efficacy of exercise as a treatment strategy for patients with depression. This paper summarises the benefits of both cardiovascular and resistance exercise for patients with depression. Design: A narrative review design was employed. Supporting literature for the individual and combined benefits of both modalities are presented. Studies comparing both modalities are then discussed. Results: The outcomes of the review indicate that there is evidence for the efficacy of both cardiovascular exercise and resistance exercise, either independently or combined, in the treatment of depression across the range of severity levels and age groups. Conclusion: Exercise interventions for the treatment of depression appear worthwhile and well tolerated. Exercise preference, access to resources and social support may shape the choice for the patient. The role of primary and allied health professionals in guiding this choice is discussed. Implications for clinical practice and further research are presented.

Pilot, randomized trial of resistance exercise during radiation therapy for head and neck cancer

The purpose of this study was to determine the feasibility of a randomized trial of resistance exercise in patients with head and neck cancer receiving radiation. Fifteen patients with head and neck cancer receiving radiation were randomized to resistance exercise (using resistance bands) or control group. Resistance exercise occurred at the radiation therapy site (weeks 1-6) and home (weeks 7-12). No serious adverse events occurred related to resistance exercise. Medium to large effect size differences favoring resistance exercise versus control group were noted for perceived fatigue at 6 weeks (smaller increase in fatigue for resistance exercise group; 7.4 vs 15.4, effect size [d] = -0.64), quality of life at 6 weeks (-7.0 vs -14.4, d = 0.52), and chair rise time (seconds) at 6 and 12 weeks (-1.6 vs 0.4, d = -.63 and -1.9 vs 0.1, d = -0.60, respectively). Resistance exercise is safe and feasible in patients with head and neck cancer receiving radiation; a definitive trial is warranted.

Autonomic changes after resistance exercise in individuals with untreated stage 1 hypertension

Aim: Subjects with hypertension have impaired autonomic modulation, whereas aerobic exercise training improves this profile. However, there is no clear evidence of autonomic modulation in response to resistance exercise. Our aim was to evaluate the autonomic response after one bout of resistance exercise in patients with untreated stage 1 hypertension.

Combined Aerobic and Resistance Exercise for Patients With Type 2 Diabetes

TYPE 2 DIABETES MELLITUS IS A MAJOR RISK FACTOR FOR excess morbidity and mortality. The excess vascular risk in type 2 diabetes is attributable both to hyperglycemia and to other metabolic disturbances associated with abdominal obesity, insulin resistance, and compensatory hyperinsulinemia. Sedentary lifestyle is also a major cardiovascular risk factor, and regular exercise attenuates the vascular risks associated with type 2 diabetes. Aerobic exercise refers to activities such as walking or jogging with continuous, repetitive movement of large muscle groups for at least 10 minutes at a time, whereas resistance exercise refers to activities such as weight lifting that use muscular strength to move a weight or work against a resistance load. Aerobic exercise for individuals with diabetes has been recommended for many decades, but the American Diabetes Association only began recommending resistance exercise in 2006. In this issue of JAMA, Church and colleagues report the results of the Health Benefits of Aerobic and Resistance Training in Individuals with Diabetes (HART-D) trial. This study provides important evidence on the effects of aerobic and resistance training on improving hemoglobin A1c (HbA1c) levels. In this trial, 262 previously sedentary patients with type 2 diabetes were randomized to a sedentary control group or to 1 of 3 exercise groups: aerobic exercise, resistance training, or a combination of both. Patients in the combined group performed smaller amounts of aerobic and resistance exercise than those in groups performing just one type of exercise so that the total amount of time devoted to exercise each week was similar among the 3 groups. The aerobic group performed 12 kcal/kg of body weight per week of aerobic exercise, equivalent to walking briskly at 4 mph for about 50 minutes per session 3 times a week. The resistance training group performed 2 to 3 sets of 10 to 12 repetitions of 9 exercises 3 times a week. The combined group performed 10 kcal/kg of body weight per week of aerobic exercise (equivalent to 42 minutes 3 times a week of walking at 4 mph, 83% of the amount done by the aerobic group) plus 1 set each of 9 exercises 2 times a week (less than a third of the resistance training volume performed by the resistance training group). No efforts were made to minimize changes in diet or medications. Only the combined training group achieved statistically significant reduction in absolute reduction in HbA1c in the HART-D trial compared with the control group (0.34%). The aerobic group had an absolute reduction of 0.24%; the resistance group, 0.16%. All groups had modest and similar decreases in waist circumference compared with the control group. In addition to the greatest HbA1c reduction, the combined training group also had the most decreases, and the least increases, in use of hypoglycemic medication. The findings of the HART-D trial are important for several reasons. First, the study duration was 9 months, making it longer than most exercise intervention trials involving patients with diabetes. Second, the study population was relatively large in number (n=262) and ethnically diverse, with almost 44% of participants being African American, and had a relatively high proportion of female participants (63%). Third, the total time spent exercising was roughly the same in the combined training group as in the other 2 singleexercise groups. Therefore, any difference between the combined exercise group and the other exercise groups can be confidently attributed to the combination of 2 types of exercise rather than the amount of time spent exercising. The HbA1c changes achieved in the HART-D trial were modest, perhaps because there was no effort to minimize medication changes. Participants whose HbA1c level did not improve with exercise were more likely to have their hypoglycemic therapy intensified, thus attenuating the difference in HbA1c that could be achieved between groups. It is likely that intergroup HbA1c differences in HART-D may have been greater if medication changes had been discouraged. The results are encouraging in that a significant incremental improvement in glycemic control was made in the HART-D combination group over and above that achieved through ongoing efforts by physicians and patients in both groups to optimize glycemic control with medications. Another possibility is that the higher proportion of women and

Qigong Therapy vs Progressive Resistance Exercise in Patients with Type 2 Diabetes: A Pilot Study

ObjectiveNutrition and physical activity are cornerstones of Type 2 diabetes management yet compliance with lifestyle recommendations is often poor. This study compared metabolic and psychological effects of Qigong therapy (a traditional Chinese energy medicine practice), progressive resistance training (PRT), or usual care in Type 2 diabetes.Methods32 adults with Type 2 diabetes (age 58 ± 7.3 yr, BMI 31.8±6.0 kg/m2), were randomly assigned to Qigong, PRT, or control for 12 weeks. Fasting plasma glucose, HbA1C, insulin, HOMA‐IR (an estimate of insulin resistance) and the Perceived Stress Scale (PSS) and Beck Depression Inventory (BDI) were determined before and after the intervention.ResultsQigong therapy reduced plasma glucose (184.9+35.3 to161.9+40.5, P=0.003), HOMA‐IR (5.3+2.3 to 4.7+2.2; NS) and HbA1c (8.8+1.1 to 8.1+1.3;NS). In contrast, both PRT and control groups had slight increases in glucose and HOMA‐IR (NS). Qigong decreased perceived stress by 29.3% (p=0.05) and depression scores by 14.3% (NS). PRT decreased BDI scores by 52% (p=0.03) but both PRT and control groups increased PSS scores. Dropout was greater in the PRT group (45%) than the Qigong group (18%).ConclusionQigong had beneficial effects on glycemia and psychological measures in patients with type 2 diabetes, while results were less consistent for PRT. Compliance and dropout were better with Qigong than with exercise.

The hemodynamic effects of isotonic exercise using hand-held weights in patients with heart failure

Background: Controversy surrounds the use of resistance exercise in patients with heart failure because of concerns that increases in rate-pressure product and systemic vascular resistance might lead to increased afterload and decreased cardiac output. Methods Following pharmacologic left ventricular unloading therapy using a pulmonary artery catheter, 34 patients with advanced heart failure performed isotonic weightlifting exercise at 50%, 65%, and 80% of the calculated one repetition maximum. Measurements were made of hemodynamics, ST segment, rate-pressure product, serum norepinephrine, rating of perceived exertion, and dysrhythmias following each exercise set. Results Repeated analysis of variance showed significant increases in systolic blood pressure ( p = 0.0005), diastolic blood pressure ( p = 0.01), rate-pressure product ( p = 0.005); serum norepinephrine ( p = 0.004), and rating of perceived exertion ( p = 0.0005). However, systemic vascular resistance and cardiac output did not change significantly ( p > 0.05). Pulmonary capillary wedge pressures, the incidence of dysrhythmias, and ST segments did not significantly differ from baseline. No patients experienced angina or dyspnea during the study. Conclusions Isotonic exercise using hand-held weights was well tolerated hemodynamically and clinically, and no patients experienced adverse outcomes during exercise.

Body composition, metabolism, and resistance exercise in patients with rheumatoid arthritis

Body composition, metabolism, and resistance exercise in patients with rheumatoid arthritis

Body composition, metabolism, and resistance exercise in patients with rheumatoid arthritis.

Body composition, metabolism, and resistance exercise in patients with rheumatoid arthritis.