Self-reported Exercise Research Articles

Physical exercise during acute exacerbations of chronic obstructive pulmonary disease: Australian physiotherapy practice.

Evidence supports an important role for pulmonary rehabilitation (PR) after acute exacerbations of chronic obstructive pulmonary disease (AECOPD); however, the role of physical exercise during hospitalisation is less clear. This study evaluated Australian physiotherapy practice and clinical perspectives regarding exercise and physical activity for patients with AECOPD. A national survey of 123 Australian public hospitals was conducted from 2016 to 2017 using a purpose-designed survey measuring self-reported physical exercise prescription, objective measure use, referral patterns and factors influencing service delivery. The response rate was 72% (88 hospitals; 176 physiotherapists). Most physiotherapists (92%) prescribed physical exercise frequently for patients with AECOPD and perceived their role to be important (81%). The most commonly prescribed modalities were ground walking (94%), sit-to-stand (89%) and non-equipment-based lower limb strengthening (79%). Only 32% of respondents offered physiotherapy evaluation during post-discharge outpatient clinic appointments at their hospital. While 71% of respondents indicated they frequently referred patients to PR after AECOPD, rates were significantly higher in those with more cardiorespiratory experience (82%) than those with less experience (66%; p = 0.026). Australian physiotherapists frequently prescribe simple physical exercise modalities for patients with AECOPD. PR referral rates appear influenced by clinician experience, which may need consideration in future remedial strategies.

Comparison of Traditional Chinese Exercises and Nontraditional Chinese Exercise Modalities on Cognitive and Executive Function in Community Middle‐Aged and Older Adults: A Cross‐Sectional Study

Background Current evidence indicates that regular exercise can have a positive impact on cognitive function in older adults, but whether different exercise modalities may induce differential protective effects in different cognitive domains is uncertain. Objective To compare the effect of traditional Chinese exercise (TCE) modalities and non-traditional Chinese exercise (non-TCE) modalities on cognitive and executive function in community middle-aged and older adults through a cross-sectional study. Methods A total of 350 community middle-aged and older adults aged over 55 years participated in this study. Information on demographic characteristics, lifestyle and behavioural habits, and regular exercise was collected by a self-designed questionnaire. Global cognitive ability and executive function were assessed using the Montreal Cognitive Assessment (MoCA) scale, the clock drawing test (CDT), the animal naming test (ANT), and the trail making test (TMT). Eligible subjects were categorized into the no regular exercise (no-RE), non-TCE, or TCE groups according to their self-reported exercise information. Comparisons of global cognitive and executive function among the three groups were conducted using ANOVA or the general linear model with adjustment for potential confounding factors. Results The results showed that for the non-TCE or TCE groups, the MoCA and CDT scores were significantly higher, and the TMT-A test time was significantly shorter than those in the no-RE group (all P < 0.05), but no significant difference was observed for the TMT-B and ANT tests. After adjustment for potential confounding factors, the MoCA, the CDT, and TMT-A scores in the TCE group were significant compared to those in the no-RE group. In addition, subgroup analysis showed that in the TCE group, the MoCA scores were significantly higher than those in the non-TCE group. Furthermore, in the TCE group, the CDT scores for those with an exercise duration of <5 years were higher and the TMT-A test time for those with an exercise duration of ≥5 years was shorter than those in the non-TCE group. Conclusions Both TCE and non-TCE have potential protective effects on global cognitive and executive function in community middle-aged and older adults. Compared to the non-TCE modality, the TCE modality may have a more positive association with these protective effects. Furthermore, prospective studies are needed to confirm these findings.

Emergency personnel neuroticism, health and lifestyle: A UK Biobank study.

BackgroundEmergency personnel face unpredictable and challenging incidents and their resilience and ability to cope influences their well-being. Personality traits, such as neuroticism, are postulated to be robust predictors of health and health behaviours. Despite evidence in the general population that neuroticism can positively impact health and health behaviours; to date neuroticism in emergency personnel has primarily been associated with adverse health outcomes.AimsTo assess whether neuroticism has a negative or positive impact on subjective and objective health and health behaviours in emergency personnel.MethodsThis study used cross-sectional UK Biobank baseline data of emergency personnel (police, firemen and paramedics). Logistic regression models examined the strength of the associations of neuroticism tertiles with subjective (self-reported overall health and chronic conditions) and objective health (abdominal obesity) and self-reported smoking, sleeping, alcohol use and exercise levels.ResultsHigh neuroticism was positively associated with poorer subjective health outcomes in all emergency personnel (n = 2483). The association between neuroticism and chronic disease/s was significant for police in the second (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.15–1.94) and third (OR = 1.62, 95% CI = 1.21–2.16) neuroticism tertiles. Neuroticism in firemen was associated with reduced abdominal obesity (OR = 0.49, 95% CI = 0.25–0.96) and increased exercise (OR = 2.14, 95% CI = 1.07–4.25).ConclusionsWe observed positive and negative associations between neuroticism and health outcomes and behaviours. While differences were observed across the emergency personnel groups, more research is needed to better understand how personality traits may impact health in workers with physically and mentally intense jobs.

Walking the boundaries: using the 6-min walk test for accurate assessment of the level of fitness in breast clinic outpatients.

Healthy levels of physical activity and improved fitness have shown better quality of life outcomes and improved survival in women with breast cancer. There is a lack of baseline data for fitness levels in breast cancer outpatients in Australia. A single centre cross-sectional study was performed to provide a snapshot of the fitness levels of women attending the Surgical and Oncology Breast Outpatient Clinic at Western Health, Melbourne. A total of 200 women (aged 18-85 years) were surveyed and the 6-min walk test (6MWT) was performed. Single and multiple linear regression analyses were performed. The mean 6-min walk distance (6MWD) was 486.6 m (95% CI ±12.8 m), which was comparable with reference ranges. The mean age of participants was 47.5 years. Ninety-seven (48.5%) participants had diagnosis of breast cancer. Breast cancer diagnosis had a negative effect on 6MWD of -33.6 m walked (P = 0.010). However, multiple regression analysis showed that only age (-2.6 m walked per year older; P < 0.001), body mass index (-4.2 m walked per unit of body mass index increase; P < 0.001) and presence of comorbidities (-56.9 m walked; P < 0.001) had statistically significant negative effects on 6MWD. Self-reported exercise tolerance correlated significantly with 6MWD (walking: P < 0.001 and stairs: P = 0.014). The 6MWT was easily performed within outpatient environment to accurately assess baseline level of fitness in breast cancer clinic outpatients. This indicates that 6MWT can be used as a valuable adjunctive tool to assess the level of fitness in breast cancer patients to make therapeutic recommendations in improving breast cancer outcomes.

Self-Reported Sleep and Exercise Patterns in Patients with Schizophrenia: a Cross-Sectional Comparative Study

BackgroundAdequate sleep and physical activity have been linked to the overall well-being of both medical and psychiatric patients. Patients with schizophrenia have shown abnormal sleep patterns and decreased physical activity that were linked to their psychopathology and physical health. These phenomena are not studied yet in Arab patients with schizophrenia. The purpose of this study is to study the sleep and exercise patterns in Arab patients with schizophrenia compared with those of healthy controls.MethodA total of 99 patients with schizophrenia and 101 controls were recruited. Arabic versions of sleep, exercise, socio-demographic, and clinical questionnaires were administered as well as the validated scales to measure psychopathology, depression, and suicidality in these participants.ResultsThe majority of patients with schizophrenia slept more than 8 h per day and exercised less when compared with controls. Sleep quality was worse in those with higher depression score and higher suicidality scores were seen in patients with lower sleep duration. Multinomial regression showed that patients with schizophrenia have higher odds of sleeping more than 8 h even after controlling for the intake of antipsychotics, age, gender, smoking status, and other confounding factors.ConclusionOur results showed that Arab patients with schizophrenia are at increased risk of having longer sleep duration with inadequate physical activity, which are correlating with worsening of depressive symptoms and suicidality. Thus, more attention should be paid to the changes in sleep patterns and level of exercise when treating Arab patients with schizophrenia.

Individualised behaviour change strategies for physical activity in multiple sclerosis (IPAC-MS): protocol for a randomised controlled trial

BackgroundMultiple sclerosis (MS) is a chronic, degenerative disease of the central nervous system. Because of the long-term and unpredictable nature of the disease, the burden of MS is significant from both a patient and societal perspective. Despite a recent influx of disease-modifying therapies to treat MS, many individuals continue to experience disability that negatively affects productivity and quality of life. Previous research indicates that physical activity has a positive impact on walking function in individuals with MS, in addition to the usual beneficial effects on overall health. However, most people with MS are not active enough to gain these benefits, and a lack of support to initiate and maintain physical activity has been identified as a major barrier. This study will evaluate the impact of a novel intervention involving individualised behaviour change strategies delivered by neurophysiotherapists on increasing physical activity levels in individuals with MS who are currently inactive.Methods/designThis single-blind, parallel-group, randomised controlled trial will be conducted in Saskatchewan, Canada. Eligible participants include individuals with MS who are ambulatory but identified as currently inactive by the self-reported Godin Leisure-Time Exercise Questionnaire (GLTEQ). The intervention will be delivered by neurophysiotherapists and includes individualised behaviour change strategies aimed at increasing physical activity over a 12-month period. The control group will receive usual care during the 12-month study period. The primary outcome is the change in physical activity level, as measured by the change in the GLTEQ score from baseline to 12 months. Secondary outcomes include the change in patient-reported outcome measures assessing MS-specific symptoms, confidence and quality of life.DiscussionPhysical activity has been identified as a top research priority by the MS community. Findings from this novel study may result in new knowledge that could significantly impact the management and overall health of individuals with MS.Trial registrationClinicalTrials.gov, NCT04027114. Registered on 10 July 2019.

The Unique Clinical Phenotype and Exercise Adaptation of Fontan Patients With Normal Exercise Capacity

BackgroundExercise limitation is almost universal among Fontan patients. Identifying unique clinical features in the small fraction of Fontan patients with normal exercise capacity (high-capacity Fontan [HCF]) provides potential to inform clinical strategies for those with low exercise capacity (usual Fontan). MethodsWe performed a retrospective chart review of all patients with single-ventricle physiology palliated with a Fontan operation who underwent incremental cardiopulmonary exercise testing at Cincinnati Children’s Hospital Medical Center from 2013 to 2018. Comparison was between patients with peak oxygen uptake < vs ≥ 80% predicted. ResultsA total of 22 of 112 patients were classified as HCF (68% were female; aged 18 ± 7 years). During incremental exercise, peak oxygen uptake (86.1% ± 6.1% vs 62% ± 12.2% predicted; P < 0.001) was greater in HCF vs usual Fontan despite similar chronotropic impairment, resulting in a greater oxygen pulse in HCF. Pulmonary function, breathing reserve, and ventilatory equivalent for CO2 output slope were not different between groups. Those in the HCF group were more likely to self-report exercise ≥ 4 days/week for at least 30 minutes (77% vs 10%, P < 0.001), have normal systolic function (95% vs 74%, P = 0.003), have fewer postoperative complications (8% vs 36%, P = 0.04), and have shorter post-Fontan length of stay (8 ± 2.8 vs 12.4 ± 0.9 days, P = 0.04). ConclusionsApproximately 1 in 5 Fontan patients who undergo cardiopulmonary exercise testing have normal exercise capacity despite chronotropic impairment. This implies a better preserved stroke volume, perhaps due to greater muscle pump-mediated preload. Additionally, a complicated perioperative Fontan course is associated with eventual impaired functional capacity.

No decrease of muscle strength, function and exercise found after reverse shoulder arthroplasty follow-up

Purpose To assess muscle strength and the correlation with physical functioning, pain, time interval since surgery and self-reported exercise after reverse shoulder arthroplasty (RSA). Materials and methods Fourteen patients with primary RSA (mean age 68.9 years; mean follow-up 48.6 months), were assessed twice within a 9-month interval. Outcome measures were the Bostrom function test, the Shoulder Pain and Disability Index (SPADI), isometric strength measured with a handheld dynamometer, and the self-reported amount of specific shoulder exercises. Results The mean isometric strength did not significantly change on the operated side over 9 months (flexion: –1.6 N, p = .638; abduction: 6.1 N, p = .433) nor between the operated and nonoperated sides (flexion: 5.1 N, p = .551; abduction: 2.8 N, p = .826). There was no significant correlation between strength and time interval since surgery or self-reported amount of exercise. Abduction strength showed a small to moderate correlation with SPADI at baseline (–0.529, p = .05) and the Bostrom function score at follow-up (0.573, p = .05). Strength difference between the operated and nonoperated sides for abduction showed a small to moderate correlation with the Bostrom pain score at baseline (–0.565, p = .05). Conclusions In this study, we found that strength after RSA did not decrease over time and was not associated with self-reported exercise. A small to moderate correlation was found between absolute strength in abduction and SPADI at baseline and the Bostrom function score at follow-up. Strength difference between the operated and nonoperated sides for abduction showed a small to moderate correlation with the Bostrom pain score at baseline.

Effectiveness of Community-Links Practitioners in Areas of High Socioeconomic Deprivation.

To assess the effect of a primary care-based community-links practitioner (CLP) intervention on patients' quality of life and well-being. Quasi-experimental cluster-randomized controlled trial in socioeconomically deprived areas of Glasgow, Scotland. Adult patients (aged 18 years or older) referred to CLPs in 7 intervention practices were compared with a random sample of adult patients from 8 comparison practices at baseline and 9 months. health-related quality of life (EQ-5D-5L, a standardized measure of self-reported health-related quality of life that assesses 5 dimensions at 5 levels of severity). well-being (Investigating Choice Experiments for the Preferences of Older People Capability Measure for Adults [ICECAP-A]), depression (Hospital Anxiety and Depression Scale, Depression [HADS-D]), anxiety (Hospital Anxiety and Depression Scale, Anxiety [HADS-A]), and self-reported exercise. Multilevel, multiregression analyses adjusted for baseline differences. Patients were not blinded to the intervention, but outcome analysis was masked. Data were collected on 288 and 214 (74.3%) patients in the intervention practices at baseline and follow-up, respectively, and on 612 and 561 (92%) patients in the comparison practices. Intention-to-treat analysis found no differences between the 2 groups for any outcome. In subgroup analyses, patients who saw the CLP on 3 or more occasions (45% of those referred) had significant improvements in EQ-5D-5L, HADS-D, HADS-A, and exercise levels. There was a high positive correlation between CLP consultation rates and patient uptake of suggested community resources. We were unable to prove the effectiveness of referral to CLPs based in primary care in deprived areas for improving patient outcomes. Future efforts to boost uptake and engagement could improve overall outcomes, although the apparent improvements in those who regularly saw the CLPs may be due to reverse causality. Further research is needed before wide-scale deployment of this approach.

Green Exercise: How Are Characteristics of Urban Green Spaces Associated with Adolescents' Physical Activity and Health?

This study investigates associations between characteristics of urban green spaces (UGSs) and adolescents’ self-reported green exercise (GE), general health, and body mass index (BMI). Data were collected through face-to-face personal interviews with 384 adolescents ages 13–19 between 1 March and 31 May, 2018 in UGSs in Aydın, Turkey. Multivariate regression analyses were conducted to examine associations controlling for confounding factors. Stratified analyses were also conducted to determine differences between boys and girls. Positive associations with the duration of GE included many trees, lawns, soccer fields and basketball courts, play equipment, and self-reported general health. Whereas increased BMI was associated with increased benches/ seating, lawns and exercise trails were positively associated with self-reported general health. Negative relationships with increased BMI included many trees, open areas, and outdoor fitness equipment. Increased distance from UGSs was negatively associated with the frequency of GE. In stratified analyses, positive associations between boys’ duration of GE and self-reported general health were found. Whereas soccer fields and basketball courts were associated with girls’ frequency of GE, exercise trails and play equipment were correlated with girls’ self-reported general health. Negative associations with the boys’ frequency of GE included increased BMI and screen time. Whereas increased distance from UGSs was negatively associated with girls’ frequency of GE, many trees, lawns, exercise trails, play equipment, open areas, flowerbeds, and outdoor fitness equipment were negatively correlated with girls’ increased BMI. Findings suggest that adolescents’ GE and health could be promoted with many trees, lawns, flowerbeds, open areas, play and outdoor fitness equipment, exercise trails, and soccer fields and basketball courts. Findings of this study should be tested with longitudinal or intervention studies in future research.

P4165Influence of restrictive right ventricular physiology in outcomes after transcatheter pulmonary valve implantation in adult patients

Abstract Background A restrictive right ventricular (RV) physiology (r-RVP) is present in almost half of the patients with repaired tetralogy of Fallot (ToF), but its effect on later patients' clinical status is controversial. Purpose Evaluate the outcomes after transcatheter pulmonary valve implantation (TPVI) in patients with restrictive versus non-restrictive RV. Methods Single-center retrospective study of patients who underwent TPVI for pulmonary regurgitation between 2008 and 2017. Electrocardiogram, transthoracic echocardiogram, cardiac magnetic resonance and cardio-pulmonary exercise test were performed previous to TPVI and repeated 12 months after. For statistical analysis restrictive physiology was defined as the presence of end-diastolic forward flow (EDFF) and RVEDVi &lt;150ml/m2. Results Fifty-nine patients, 55 with tetralogy of Fallot, were included. R-RVP was present in 23 patients (39.0%). At the baseline, the majority of the patients were symptomatic, in NYHA functional class II–III (n=48, 81.4%) and with reduced cardiopulmonary performance (VO2max = 20.5mL/min/kg), both worse among patients with r-RVP (p=0.018 and p=0.018). During a mean follow-up of 446.4±226.1 days after TPVI one patient died. BNP levels were not significantly different from baseline. Despite self-reported functional capacity and exercise capacity improvement after TPVI (p&lt;0.001), all parameters remained lower in r-RVP group. One year after TPVI, pulmonary and tricuspid regurgitation decrease significantly, as well as RVEDV, in both groups. However, RV systolic function remained unchanged in both groups. Regarding to the dysrhythmic profile, all patients with need for an implantable cardiac defibrillator and seven of the eight patients requiring radiofrequency ablation for sustained supraventricular arrhythmias during follow-up were in the group without r-RVP (p=0.038). Kaplan-Meier survival curve Conclusion TPVI had a positive impact in clinical status in a cohort of patients with predominant PR regardless the presence of restrictive physiology. Moreover, besides higher VO2max and anaerobic threshold in the non-restrictive group, the magnitude of the improvement was not statistically different between the two groups. Nevertheless, in patients without r-RVP, a peculiar caution has to be focused regarding rhythmic issue during follow-up, despite the TPVI.

Effects of Mobile Health Prompts on Self-Monitoring and Exercise Behaviors Following a Diabetes Prevention Program: Secondary Analysis From a Randomized Controlled Trial.

BackgroundA number of mobile health (mHealth) apps exist that focus specifically on promoting exercise behavior. To increase user engagement, prompts, such as text messages, emails, or push notifications, are often used. To date, little research has been done to understand whether, and for how long, these prompts influence exercise behavior.ObjectiveThis study aimed to assess the impact of prompts on mHealth self-monitoring and self-reported exercise in the days following a prompt and whether these effects differ based on exercise modality.MethodsOf the possible 99 adults at risk for developing type II diabetes who participated in a diabetes prevention program, 69 were included in this secondary analysis. Participants were randomly assigned to 1 of the following 2 exercise conditions: high-intensity interval training or moderate-intensity continuous training. In the year following a brief, community-based diabetes prevention program involving counseling and supervised exercise sessions, all participants self-monitored their daily exercise behaviors on an mHealth app in which they were sent personalized prompts at varying frequencies. mHealth self-monitoring and self-reported exercise data from the app were averaged over 1, 3, 5, and 7 days preceding and following a prompt and subsequently compared using t tests.ResultsIn the year following the diabetes prevention program, self-monitoring (t68=6.82; P<.001; d=0.46) and self-reported exercise (t68=2.16; P=.03; d=0.38) significantly increased in the 3 days following a prompt compared with the 3 days preceding. Prompts were most effective in the first half of the year, and there were no differences in self-monitoring or self-reported exercise behaviors between exercise modalities (P values >.05). In the first half of the year, self-monitoring was significant in the 3 days following a prompt (t68=8.61; P<.001; d=0.60), and self-reported exercise was significant in the 3 days (t68=3.7; P<.001; d=0.37), 5 days (t67=2.15; P=.04; d=0.14), and 7 days (t68=2.46; P=.02; d=0.15) following a prompt, whereas no significant changes were found in the second half of the year.ConclusionsThis study provides preliminary evidence regarding the potential influence of prompts on mHealth self-monitoring and self-reported exercise and the duration for which prompts may be effective as exercise behavior change tools. Future studies should determine the optimal prompting frequency for influencing self-reported exercise behaviors. Optimizing prompt frequency can potentially reduce intervention costs and promote user engagement. Furthermore, it can encourage consumers to self-monitor using mHealth technology while ensuring prompts are sent when necessary and effective.International Registered Report Identifier (IRRID)DERR2-10.2196/11226

Factors Associated With Ongoing Participation in Structured Exercise Among People Aged 50 Years and Older.

To document the characteristics of participants aged 50 years and older in a local government group exercise program (Strong Seniors), to investigate the motivators and barriers to ongoing exercise, and to identify factors associated with more frequent exercise class attendance. Ninety-three participants completed a survey about exercise class attendance, motivators and barriers to participation, and exercise perceptions and self-reported exercise. The authors conducted a mixed-methods study involving both quantitative and qualitative analyses. Personal benefits of exercise and social influences were the most common motivators for regular exercise. Barriers to participation included health problems and lack of time (competing priorities). A higher score on the perceived exercise benefits scale is the only factor associated with a higher frequency of attendance at Strong Seniors classes. Exercise programs for people aged 50 years and older that emphasize associated health benefits and promote social support may be more likely to facilitate long-term attendance.

Using animated visualization to improve postoperative mobilization: A randomized controlled trial.

Enhanced recovery after surgery (ERAS) programs fast-track recovery for surgical procedures, including colorectal and gynecological oncology surgery. Early mobilization is a postoperative ERAS module that can be self-managed by patients, but poor adherence is common. Visualization is increasingly being used to improve patient understanding and adherence to health behaviors. This study tested whether an animated visualization intervention could improve adherence to postoperative mobilization. Ninety six colorectal and gynecological oncology surgery patients were randomized to intervention, active control, or standard care groups. Intervention participants saw an animated intervention on a computer tablet at Day 1 postsurgery. All participants wore fitness trackers from day of discharge to 7 days postdischarge, and completed psychological measures at baseline, Day 1 postsurgery, and 7 days postdischarge. Step count data was available for 57 colorectal surgery participants. A main effect of group demonstrated that intervention participants had a significantly higher average daily step count from discharge across the week following discharge (Madj = 2,294.60, 95% confidence interval [CI] [1,746.11, 2,744.89]) compared with control participants (Madj = 1,347.25, 95% CI [826.51, 1,871.20]; p = .05). At postsurgery, intervention participants reported significantly greater perceived quality of recovery and less difficulty in being mobile compared with control participants. There were no between-group differences in self-reported exercise or perceptions of surgery and recovery. This brief intervention appears effective in improving perceptions of early mobilization, and initial evidence suggests improvements in adherence to postsurgical mobilization. This intervention has high clinical applicability and could be incorporated into postoperative standard care. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The Association of Sport and Exercise Activities With Cardiovascular Disease Risk: The Atherosclerosis Risk in Communities (ARIC) Study.

This study assessed the independent associations between participation in self-reported sport and exercise activities and incident cardiovascular disease (CVD). Data were from 13,204 participants in the Atherosclerosis Risk in Communities Study cohort (1987-2015). Baseline sport and exercise activities were assessed via the modified Baecke questionnaire. Incident CVD included coronary heart disease, heart failure, or stroke. Multivariable-adjusted Cox proportional hazard models assessed the association of participation in specific sport and exercise activities at enrollment with risk of CVD. During a median follow-up time of 25.2 years, 30% of the analytic sample (n = 3966) was diagnosed with incident CVD. In fully adjusted models, participation in racquet sports (hazard ratio [HR] 0.75; 95% confidence interval [CI], 0.61-0.93), aerobics (HR 0.75; 95% CI, 0.63-0.88), running (HR 0.68; 95% CI, 0.54-0.85), and walking (HR 0.89; 95% CI, 0.83-0.95) was significantly associated with a lower risk of CVD. There were no significant associations for bicycling, softball/baseball, gymnastics, swimming, basketball, calisthenics exercises, golfing with cart, golfing with walking, bowling, or weight training. Participation in specific sport and exercises may substantially reduce the risk for CVD.

Performing different kinds of physical exercise differentially attenuates the genetic effects on obesity measures: Evidence from 18,424 Taiwan Biobank participants.

Obesity is a worldwide health problem that is closely linked to many metabolic disorders. Regular physical exercise has been found to attenuate the genetic predisposition to obesity. However, it remains unknown what kinds of exercise can modify the genetic risk of obesity. This study included 18,424 unrelated Han Chinese adults aged 30–70 years who participated in the Taiwan Biobank (TWB). A total of 5 obesity measures were investigated here, including body mass index (BMI), body fat percentage (BFP), waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR). Because there have been no large genome-wide association studies on obesity for Han Chinese, we used the TWB internal weights to construct genetic risk scores (GRSs) for each obesity measure, and then test the significance of GRS-by-exercise interactions. The significance level throughout this work was set at 0.05/550 = 9.1x10-5 because a total of 550 tests were performed. Performing regular exercise was found to attenuate the genetic effects on 4 obesity measures, including BMI, BFP, WC, and HC. Among the 18 kinds of self-reported regular exercise, 6 mitigated the genetic effects on at least one obesity measure. Regular jogging blunted the genetic effects on BMI, BFP, and HC. Mountain climbing, walking, exercise walking, international standard dancing, and a longer practice of yoga also attenuated the genetic effects on BMI. Exercises such as cycling, stretching exercise, swimming, dance dance revolution, and qigong were not found to modify the genetic effects on any obesity measure. Across all 5 obesity measures, regular jogging consistently presented the most significant interactions with GRSs. Our findings show that the genetic effects on obesity measures can be decreased to various extents by performing different kinds of exercise. The benefits of regular physical exercise are more impactful in subjects who are more predisposed to obesity.

Using a written, self-reported exercise history in a Pediatric Sports Medicine Clinic: A retrospective assessment of the utility of the written, self-report method, and analysis of collected pediatric exercise data.

Using a written, self-reported exercise history in a Pediatric Sports Medicine Clinic: A retrospective assessment of the utility of the written, self-report method, and analysis of collected pediatric exercise data.

Factors associated with exercise preferences, barriers and facilitators of prostate cancer survivors.

The purpose of this study was to understand the exercise levels, preferences and interests of prostate cancer survivors in Canada. An electronic survey was administered via a prostate cancer-specific website and assessed self-reported exercise levels, exercise preferences and interests, exercise barriers and facilitators to exercise. Based on 103 participants, the majority (75.7%) of prostate cancer survivors did not meet both aerobic and resistance exercise guidelines, despite an interest in exercise. Strongest exercise preferences were shown for resistance exercise, walking, flexibility and bicycling and for performing exercise from a community-based gym or from home. Significant differences in exercise interests and facilitators were found between individuals who were meeting exercise guidelines compared to those who were not. The majority of Canadian prostate cancer survivors are insufficiently active. Exercise preferences and facilitators appear to be influenced by current exercise levels. Resistance and aerobic exercise should be considered when programming exercise for prostate cancer survivors.

Effects of exercise dose and type during breast cancer chemotherapy on longer-term patient-reported outcomes and health-related fitness: A randomized controlled trial.

The Combined Aerobic and Resistance Exercise (CARE) Trial compared different types and doses of exercise performed during breast cancer chemotherapy. Here, we report the longer-term follow-up of patient-reported outcomes, health-related fitness and exercise behavior at 6, 12 and 24 months postintervention. A multicenter trial in Canada randomized 301 breast cancer patients initiating chemotherapy to thrice weekly, supervised exercise consisting of a standard dose of 25-30 min of aerobic exercise (STAN; n = 96), a higher dose of 50-60 min of aerobic exercise (HIGH; n = 101) or a combined dose of 50-60 min of aerobic and resistance exercise (COMB; n = 104) performed for the duration of chemotherapy (median of 17 weeks). Primary outcomes were patient-reported outcomes including quality of life, cancer-related symptoms and psychosocial outcomes. Secondary outcomes were objective health-related fitness (assessed at 12 months only) and self-reported exercise behavior. A total of 269 (89.4%) participants completed patient-reported outcomes at all three follow-up time points and 263 (87.4%) completed the health-related fitness assessment at 12-month follow-up. COMB was significantly superior to (i) STAN for sleep quality at 6-month follow-up (p = 0.027); (ii) HIGH for upper body muscular endurance at 12-month follow-up (p = 0.020); and (iii) HIGH for meeting the resistance exercise guideline at 6-month follow-up (p = 0.006). Moreover, self-reported meeting of the combined exercise guideline during follow-up was significantly associated with better patient-reported outcomes and health-related fitness. Performing combined exercise during and after breast cancer chemotherapy may result in better longer-term patient-reported outcomes and health-related fitness compared to performing aerobic exercise alone.

Self-reported sleep quality and depression in post myocardial infarction patients attending cardiology outpatient clinics in Oman

ObjectiveThis study aimed to examine the sleep quality and prevalence of depression in post myocardial infarction patients attending cardiology outpatient clinics of selected hospitals in Oman. MethodsA descriptive cross-sectional design was used to collect data from patients (n = 180) who were at least 4 weeks post myocardial infarction diagnosis and receiving follow-up care in the outpatient clinic. The Arabic version of the Pittsburgh Sleep Quality Index and Patient Health Questionnaire-9 were used to assess sleep quality and depressive symptoms, respectively. ResultsThe sample mean age was 62.0 ± 11.3 years. Poor sleep quality affected 61.1% of the participants. The significant predictors of poor sleep quality were gender (P ≤ 0.05), body mass index (P ≤ 0.05), and self-reported regular exercise (P ≤ 0.01). The most impacted domains of sleep quality were sleep latency, sleep duration, and sleep disturbances. The prevalence of major depression was low (5%) and the rate of re-infarction was 27.2%. The prevalence of minimal to mild major depression with a potential of transitioning into major depression overtime was very high. Self-reported regular exercise (P ≤ 0.01) was the only significant predictor of depressive symptoms. ConclusionThe sleep quality of post myocardial infarction patients was poor and the prevalence of depression was low. There was no significant relationship between sleep quality or depression with re-infarction.