Strength-building Exercises Research Articles

The effect of osteoarthritis exercise on pain and joint range of motion in osteoarthritis patients

Aims. Osteoarthritis is a degenerative and progressive disease characterized by abrasion of joint cartilage and irregular formation of new bone on the surface of the joints. Pain becomes the main symptom followed by a decrease in joint range of motion, causing disability and interfering with daily activities. The purpose of this study was to determine the effect of osteoarthritis exercise on pain and joint range of motion in osteoarthritis patients. Methods. The research design used a quasy experiment with a non-equivalent control group design approach. The sample used was 70 respondents for each intervention group and control group. Intervention in the form of physical exercise osteoarthritis exercise guided by an instructor and using audio-visual media. Exercise is carried out 3 times a week for 2 weeks. For stretching and flexibility exercises using yoga mats and bath towels and for strength building exercises using chairs. The pain scale was measured with a numeric rating scale (NRS) instrument and measurement of joint range of motion using a goniometer. Data analysis used numerical comparative analytic paired-sample t test and independent t test. Findings. The results showed that the results of the paired t test (p) <0.05. thus indicating that there is an effect of providing osteoarthritis gymnastics training intervention on reducing the pain scale. The results of the paired t test (p) <0.05. thus indicating that there is an effect of providing osteoarthritis exercise training interventions on the scale of joint range of motion. The results of the independent t test (p) <0.05, meaning that there is a difference in the osteoarthritis pain scale before and after the intervention, while the test for differences in joint range of motion scale shows a non-significant value of p> 0.05. Conclusion. The conclusion of the study was that there was an effect of osteoarthritis gymnastics training in reducing the osteoarthritis pain scale and joint range of motion scale. Then there is no difference between the control group and the intervention group who get gymnastic exercises and do not get osteoarthritis gymnastic exercises. Keywords: Osteoarthritis exercise; Osteoarthritis; Pain, Joint range of motion

Ageing, sport and physical activity participation in Scotland.

As sport and physical activity are vital to support extended health spans, this study aimed to analyse the current trends in sports participation and physical activity rates among individuals aged 65 years and older in Scotland. Data were compared with the Chief Medical Officer (CMO) guidelines and analysed the influence of key factors on participation rates. The study used data from the Scottish Health Survey and the Scottish Household Survey (2019) to investigate self-reported participation in physical activity and sports across different age groups. Descriptive statistics and cross-tabulations were used to analyse the relationships between participation rates and influencing factors. Participation data for Parkrun events in Scotland were also analysed for the years 2008-2018. The study found a clear decline in sports participation with age, with a steep decline after the age of 65, particularly in women. The majority of participation among individuals aged 65+ was in walking, with a sport participation rate of only 31.2% when walking was excluded. Physical activity and sport participation was lower in women across all age ranges but particularly so in the 75+ age group. The most popular sporting activities in the older age group were keep fit/aerobics, swimming and golf. Additionally, the study found that social deprivation had a major impact on sports participation rates, with the most deprived households exhibiting the lowest participation levels irrespective of age. The prevalence of loneliness was lower among individuals who participated in sports or adhered to the CMO guidelines for moderate/vigorous physical activity and strength-building exercises. The findings of this study have implications for promoting physical activity and sports participation among older adults, particularly in deprived communities. This study highlights the importance of balance exercises within sport and the need for more targeted efforts to increase participation rates among older adults. The study also emphasizes the positive impact of sports participation on reducing loneliness among older adults. Overall, the findings suggest the need for ongoing efforts to promote physical activity and sports participation among older adults to improve their overall health and well-being.

Diagnosis and management of dogs with degenerative myelopathy: A survey of neurologists and rehabilitation professionals.

Antemortem diagnosis of degenerative myelopathy (DM) in dogs is presumptive and there are no accepted guidelines for the management of this condition. Describe current practices of neurology clinicians and physical rehabilitation professionals in the diagnosis and management of DM. None. Online surveys examining diagnosis and management of DM were constructed and distributed via neurology and rehabilitation listservs. One hundred ninety neurology and 79 rehabilitation professionals from 20 countries participated. Most neurology (142/189) and rehabilitation (23/39) respondents required genetic testing for the superoxide dismutase 1 (SOD1) mutation and 82/189 neurologists also required spinal magnetic resonance imaging (MRI) for presumptive DM diagnosis. Most neurology respondents recommended exercise (187/190) and physical rehabilitation (184/190). Over 50% (102/190) of neurology respondents perform rechecks on dogs diagnosed with DM. Rehabilitation respondents reported preservation or improvement of strength (78/79) and coordination (77/79) as therapeutic goals. At-home exercises (75/79), underwater treadmill (64/79), gait training (55/79), and strength building exercises (65/79) were used to maintain strength (58/79), coordination (56/79), muscle mass (56/79), and improve overall wellbeing (54/79). Neurology respondents reported that owners elect euthanasia when dogs become nonambulatory paraparetic whereas rehabilitation respondents report euthanasia when paraplegia and incontinence develop. The majority of dogs diagnosed with DM have not undergone advanced imaging, the combination of history, neurological findings, and genetic testing is heavily relied upon. Whereas the diagnosis of DM is frequently made by veterinary neurologists, continued care is often performed by rehabilitation professionals or primary veterinarians.

Perceptions of exercise interventions in pregnancy; A cross sectional survey of health care workers in Kaduna State

Context: The potential benefits of exercise to pregnant women and their unborn children are immense, yet regular exercise prescription may not be the norm. Aims: Our study aimed to investigate the perceptions and practices of obstetric care providers regarding exercise in pregnancy. Materials and Methods: The study was a cross-sectional survey done in Kaduna state between July and December 2020. A pretested questionnaire was given to obstetric care providers and information was obtained about demographics, professional and facility characteristics of respondents, their perceptions, and practices related to exercise in pregnancy, and information they routinely give pregnant women regarding exercise. Descriptive analysis was done using frequencies, percentages, mean, and standard deviation. Results: There were 265 respondents with a mean age of 34.23 ± 9.29 years. They were mostly females (215, 82.1%), married (171, 65.3%), Muslim (137, 52.3%), and Hausa (107, 40.8%). There were more nurses (153, 58.4%) from the public (212, 80.9%) and tertiary (133, 50.8%) health facilities. Almost all respondents agreed that exercise during pregnancy was beneficial (258, 98.5%). The commonest indication for exercise was cited as obesity and diabetes, whereas it was mostly contraindicated with bleeding while pregnant. The commonest barriers to exercise in pregnancy were the fear of pregnancy complications, inadequate knowledge, and high workload. Conclusion: Healthcare workers in this study generally had positive perceptions and practices toward exercise during pregnancy, except for the fact that they feel pregnant women should avoid strength-building exercises, and do not usually recommend individualized programs. Local guidelines need to be developed for EIP and providers better trained.

Physical Activity and Exercise Patterns After Spontaneous Coronary Artery Dissection: Insights From a Large Multinational Registry.

Objective: The objective of the study was to assess the physical activity (PA) and exercise patterns among participants in a large multinational spontaneous coronary artery dissection (SCAD) registry. Patients and Methods: Participants with SCAD enrolled from March 2011 to November 2019 completed surveys including details regarding PA and exercise habits prior to SCAD, and PA counseling received from their provider after SCAD. Demographics and clinical characteristics were collected by electronic record review. Exercise prescribed to patients after SCAD was categorized according to exercise components: type, intensity, frequency, time/session, and extreme environmental conditions.Results: We included 950 participants; mean ± age was 46.8 ± 9.5 years old at the time of first SCAD; most (96.3%) were women and (77.0%) attended ≥1 cardiac rehabilitation session. Hyperlipidemia (34.3%), hypertension (32.8%), and elevated body weight (overweight = 27.0%; obesity = 20.0%) were the most common comorbidities. Prior to SCAD, 48.5% performed aerobic exercise ≥3 times/week, and only 32.0% performed strength-building exercise regularly. PA counseling details after SCAD in 299/950 participants showed that most (93.3%) patients received some form of counseling including exercise prescription (EXP), non-specific recommendations, and discouraged from any exercise. Limits regarding exercise type and intensity were the most common advice among participants who received EXP.Conclusion: Insights from our study suggest that only 48% of the patients performed some aerobic exercise three or more times per week, and 32.0% performed strength-building exercises, which suggest that most of them may not be as active as assumed. Furthermore, 70% of the SCAD patients have ≥1 cardiovascular risk factors. We suggest guiding patients based on individual assessment, taking into consideration baseline PA habits, treatment, and risk factors. SCAD-tailored PA guidelines are needed for optimal EXP without compromising patient safety.

Abstract 16882: Exercise Prescription Patterns After Spontaneous Coronary Artery Dissection: Insights From a Large Multinational Registry

Introduction: Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction in otherwise healthy and most times presumably fit young women. In the absence of evidence for benefit or harm, exercise prescription (EXP) after SCAD remains arbitrary. We assessed EXP patterns among participants in a large multinational SCAD registry. Methods: Participants with SCAD as confirmed by coronary angiography completed surveys detailing exercise (EX) habits prior to SCAD (initial survey), and EXP from their provider on initial and subsequent visits after SCAD (follow-up survey). Demographic and clinical characteristics were collected by electronic health record review by trained nurse abstractors. EXP was categorized according to EX components that include: type, intensity, frequency, time/session, and external conditions. Results: Among 950 participants, mean ± age was 46.8 ± 9.5 years, 96% were women and 77% reported attending ≥1 Cardiopulmonary Rehabilitation session. Prior to SCAD, 49% were aerobically exercising ≥ 3times per week, and only 32% performed strength-building EX regularly. Initial and subsequent post-SCAD visit details in 299/950 participants showed that most (93%) patients received some form of EX (Figure 1-A) counseling, namely: EXP, unspecific advice or were discouraged from any EX (Figure 1-B) . Limits regarding EX type and intensity were the most common advice received among EXP group (Figure 1-C) . Conclusions: Insights from our study show that only 40% of patients were achieving current exercise recommendations for adults prior to SCAD (vs 53% adult U.S population; CDC, 2018) which suggests that SCAD patients may not be as active as previously described. Most patients receive some form of EX counseling after SCAD; however, a structured EXP is needed to avoid overly cautious approaches that could lead to uncertainty, deconditioning, impaired quality of life, or increase risks associated with a sedentary lifestyle.

Novel stretching and strength-building exercise recommendations for computer-based workers during the COVID-19 quarantine.

Prolonged home stays due to the COVID-19 quarantine can increase the use of computers and other technologies that may lead to significant reduction in activity, contributing to musculoskeletal problems, anxiety and depression. The aim of this study was to develop a novel multicomponent exercise program for individuals who work with computers during the COVID-19 quarantine. Researchers collaborating cross-institutionally and cross-nationally performed a careful literature search for exercise and stretching regiments with particular attention to methodologies that can be applied during the lockdown in the wake of the COVID-19 pandemic. Methodologies were then compiled and truncated for ease of use for the computer-based office worker during the COVID-19 pandemic quarantine. The resulting program is broken down into three categories: aerobic, strengthening and stretching components. Each component can then be further modified to meet the frequency, intensity, time and type (FITT) specifications for the participant. We present a novel, evidence-based strategy for functional fitness for office workers who have remained home-bound during the COVID-19 pandemic quarantine. Further research should seek to validate the efficacy of the proposed protocol.

REVERSAL OF METABOLIC SYNDROME WITH PLANT BASED DIET AND EXERCISE

This study aimed to investigate the effectiveness of a specified diet pattern and exercise like lymphatic and strength-building exercises (FFD protocol) to enhance weight and fat loss. A 45-year-old male with a history of obesity and diabetes mellitus (DM) enrolled in the study. The patient followed a specified diet along with lymphatic and strength-building exercises. Follow up was done for 6 months where, baseline characteristics, anthropometric measurements and biochemical parameters were measured in visit 1 and visit 2. The patient was off DM medication in 10 days. In first follow up (3 months) weight, BMI, waist circumference and body fat was significantly reduced. Whereas skeletal muscle mass was increased. A drop in HbA1C, fasting insulin, fasting blood sugar level and postprandial blood sugar levels were observed. In comparison to first follow up the second follow up after 6 months, shows substantial changes in the basal parameters. A drastic decline in HbA1c was reported from 6.1% to 5.5%. The FFD program comprehensively targets diabetes, ultimately clearing GTT the harbinger of the defeat of diabetes and visceral obesity, thereby successfully reversing the cluster of components of this morbid syndrome.

Adherence to national exercise guidelines by patients attending emergency departments: A multi-site survey.

The proportion of adults in Australia meeting or exceeding the national guidelines for physical activity has remained relatively static over the past 10 years. The research objective was to measure self-reported physical activity and sedentary behaviour among ED patients in accordance with Australia's current physical activity and sedentary behaviour guidelines, revised in 2014. A convenience sample of participants was recruited from three EDs in Melbourne between February and May 2016. Eligible participants were administered the International Physical Activity Questionnaire - Short Form plus researcher-derived questions. Participants were assessed as whether meeting the physical activity guidelines or not, using pre-defined criteria. The proportion of 18-64 year olds meeting all of the physical activity guidelines was 19.0% (95% confidence interval [CI] 15.2-22.8). A majority of participants (63.1%, 95% CI 58.5-67.7) met the aerobic component of the guidelines although only 28.9% (95% CI 24.5-33.3) of participants reported undertaking strength building exercises two or more times per week. Adults in the oldest age group were found to be less likely to engage in muscle strengthening exercises (23.3%, n = 30) than those in the youngest age group (40.0%, n = 60, P = 0.005). Average daily sitting time (minutes) did not differ between men (median = 300) and women (median = 360, P = 0.118). Overall adherence with physical activity guidelines is low among adults attending the ED. All adults need to be encouraged to undertake muscle strengthening activities, especially adults in older age groups.

The effect of participation in an incentive-based wellness program on self-reported exercise

Employers are increasingly trying to promote healthy behaviors, including regular exercise, through wellness programs that offer financial incentives. However, there is limited evidence that these types of programs affect exercise habits within employee populations. In this study, we estimate the effect of participation in an incentive-based wellness program on self-reported exercise. Since 2008, the University of Minnesota's Fitness Rewards Program has offered a $20 monthly incentive to encourage fitness center utilization among its employees. Using 2006 to 2010 health risk assessments and university administrative files for 2972 employees, we conducted a retrospective cohort study utilizing propensity score methods to estimate the effect of participation in the Fitness Rewards Program on self-reported exercise days per week from 2008 to 2010. On average, participation in the program led to an increase of 0.59 vigorous exercise days per week (95% Confidence Interval: 0.42, 0.78) and 0.43 strength-building exercise days per week (95% Confidence Interval: 0.31, 0.58) in 2008 for participants relative to non-participants. Increases in exercise persisted through 2010. Employees reporting less frequent exercise prior to the program were least likely to participate in the program, but when they participated they had the largest increases in exercise compared to non-participants. Offering an incentive for fitness center utilization encourages higher levels of exercise. Future policies may want to concentrate on how to motivate participation among individuals who are less frequently physically active.

Cervical Disk Arthroplasty Versus ACDF for Preoperative Reducible Kyphosis

Cervical total disk arthroplasty has proven to be an effective and safe alternative for anterior cervical diskectomy and fusion (ACDF) for the treatment of cervical disk degenerative disease. However, whether and when cervical disk arthroplasty is indicated for preoperative cervical spine kyphosis is unclear. In the authors' clinical experiences, preoperative kyphosis can generally be divided into reducible and irreducible forms according to the results of dynamic flexion-extension lateral radiographs. Reducible kyphosis is mostly related to local disk prolapse, clinical symptoms, and musculature weakness, but irreducible kyphosis is always associated with significant cervical degeneration or congenital bone malformation. In this study, 32 patients with preoperative reducible kyphosis were randomized in a 1:1 ratio to either single-level total cervical arthroplasty with the Discover cervical disk prosthesis (DePuy Spine, Raynham, Massachusetts) (arthroplasty group) or single-level ACDF with a polyetheretherketone cage and plate (ACDF group). No significant differences existed in clinical and radiological results at 2-year follow-up between the arthroplasty and ACDF groups. The global and functional spinal unit angles of the arthroplasty group were significantly lower than those of the ACDF group 6 months postoperatively, which was consistent with the result of the comparison in Neck Disability Index score. However, the sagittal alignment of the overall cervical spine and the treated segment and the Neck Disability Index score significantly improved after 6 months in the arthroplasty group but not in the ACDF group. Therefore, preoperative reducible kyphosis is not a contraindication for cervical total disk arthroplasty. However, neck strength-building exercises should be emphasized for the postoperative rehabilitation after cervical total disk arthroplasty.

Effect Of 8-week Weight Training Class On PSPP Among Weight-preoccupied College Age Women

PURPOSE The college years represent an ideal time to instill healthful lifestyle practices such as regular physical activity, however effective strategies for doing so have not yet been identified. Physical activity levels have been shown to be related to Physical Self-Perception Profile (PSPP) scores, but little is known about how PSPP changes in response to exercise and whether this survey can be used to assess program effectiveness. Weight training (WT) has many health benefits for women, yet women are less likely to engage in strength building exercise than men, perhaps because of misconceptions about the effect of WT on body size. Thus, one of the objectives of the current pilot study was to assess the effect of engaging in a formal WT program on PSPP scores in young women who have heightened concerns about body appearance and thus might be averse to engaging in WT. METHODS Subjects consisted of college age women who met the criteria of no regular WT within the last 12 mths and increased preoccupation with body weight. Subjects enrolled in an activity course and received comprehensive instruction on proper technique prior to beginning an 8-wk progressive program targeting all major muscle groups. They completed the PSPP and other surveys before and after the program. RESULTS WT significantly increased 1RM strength (bench press, p<0.001; leg press, p=0.001) and body weight (p<0.001). WT significantly increased (p<0.005) PSPP physical self-worth, indicating that the subjects felt happier overall in regards to their physical self. All other PSPP subscale scores increased, but not significantly. However, positive changes in the PSPP conditioning score (perceptions of physical conditioning) was significantly related to improved feelings assessed by the Eating Disorders Inventory, such as decreased drive for thinness (DT, p<0.05) and body dissatisfaction (BD, p<0.005). Also, improvements in the PSPP strength score (perceived strength and muscular development) was related to decreased DT (p<0.01) and BD (p=0.078). Positive change in the PSPP conditioning score was also significantly correlated to positive changes in global self-esteem (Rosenberg, 1965) and self-concept clarity (Campbell, 1996). CONCLUSIONS These results suggest that a brief, progressive WT program that improves muscular strength leads to improved feelings about the self in young women. Follow-up is needed to determine if immediate changes in PSPP predict long-term physical activity behavior and feelings about the self. These preliminary findings also suggest that college campuses are ideally suited to promote positive attitudes and behaviors that have significant health impact.

Effect Of 8-week Weight Training Class On PSPP Among Weight-preoccupied College Age Women

PURPOSE The college years represent an ideal time to instill healthful lifestyle practices such as regular physical activity, however effective strategies for doing so have not yet been identified. Physical activity levels have been shown to be related to Physical Self-Perception Profile (PSPP) scores, but little is known about how PSPP changes in response to exercise and whether this survey can be used to assess program effectiveness. Weight training (WT) has many health benefits for women, yet women are less likely to engage in strength building exercise than men, perhaps because of misconceptions about the effect of WT on body size. Thus, one of the objectives of the current pilot study was to assess the effect of engaging in a formal WT program on PSPP scores in young women who have heightened concerns about body appearance and thus might be averse to engaging in WT. METHODS Subjects consisted of college age women who met the criteria of no regular WT within the last 12 mths and increased preoccupation with body weight. Subjects enrolled in an activity course and received comprehensive instruction on proper technique prior to beginning an 8-wk progressive program targeting all major muscle groups. They completed the PSPP and other surveys before and after the program. RESULTS WT significantly increased 1RM strength (bench press, p<0.001; leg press, p=0.001) and body weight (p<0.001). WT significantly increased (p<0.005) PSPP physical self-worth, indicating that the subjects felt happier overall in regards to their physical self. All other PSPP subscale scores increased, but not significantly. However, positive changes in the PSPP conditioning score (perceptions of physical conditioning) was significantly related to improved feelings assessed by the Eating Disorders Inventory, such as decreased drive for thinness (DT, p<0.05) and body dissatisfaction (BD, p<0.005). Also, improvements in the PSPP strength score (perceived strength and muscular development) was related to decreased DT (p<0.01) and BD (p=0.078). Positive change in the PSPP conditioning score was also significantly correlated to positive changes in global self-esteem (Rosenberg, 1965) and self-concept clarity (Campbell, 1996). CONCLUSIONS These results suggest that a brief, progressive WT program that improves muscular strength leads to improved feelings about the self in young women. Follow-up is needed to determine if immediate changes in PSPP predict long-term physical activity behavior and feelings about the self. These preliminary findings also suggest that college campuses are ideally suited to promote positive attitudes and behaviors that have significant health impact.

Systematic muscle building exercises in the rehabilitation of stroke patients

The effects of targeted strength training in patients with muscle weakness of central origin following cerebrovascular accidents has hardly been investigated to date. This prospective non-randomized study of 56 patients was designed to shed light on the effects of strength building exercises on muscle tone and on the gain in muscle strength achieved with them. All patients underwent a full residential neurologic rehabilitation program for 4 weeks, which included an exercise program for restoring the extensor strength of the legs and the supporting strength of the arms by leg and arm presses. Throughout the rehabilitation program muscle spasticity was evaluated clinically and maximal muscle strength on completion of the exercise program was compared to baseline. The extensor strength of the legs increased by 31.0 (+/- 26.7)% by 40.2 (+/- 15)%. significant for both variables. The extent of strength gain was positively correlated with the intensity and the number of exercising units. Muscle tone, which was abnormally high at baseline, did not further increase in any one case. The results of this study showed that targeted strength training significantly increased muscle power in patients with muscle weakness of central origin without any negative effects on spasticity.

Prospective ten-month exercise intervention in premenarcheal girls: positive effects on bone and lean mass.

Enhancement of bone mineral acquisition during growth may be a useful preventive strategy against osteoporosis. The aim of this study was to explore the lean mass, strength, and bone mineral response to a 10-month, high-impact, strength-building exercise program in 71 premenarcheal girls, aged 9-10 years. Lean body mass, total body (TB), lumbar spine (LS), proximal femur (PF), and femoral neck (FN) bone mineral were measured using the Hologic QDR 2000+ bone densitometer. Strength was assessed using a grip dynamometer and the Cybex isokinetic dynamometer (Cybex II). At baseline, no significant difference in body composition, pubertal development, calcium intake, physical activity, strength, or bone mineral existed between groups. At completion, there were again no difference in height, total body mass, pubertal development, calcium intake, or external physical activity. In contrast, the exercise group gained significantly more lean mass, less body fat content, greater shoulder, knee and grip strength, and greater TB, LS, PF, and FN BMD (exercise: TB 3.5%, LS 4.8%, PF 4.5%, and FN 12.0%) compared with the controls (controls: TB 1.2%, LS 1.2%, PF 1.3%, and FN 1.7%). TB bone mineral content (BMC), LS BMC, PF BMC, FN BMC, LS bone mineral apparent density (BMAD), and FN bone area also increased at a significantly greater rate in the exercise group compared with the controls. In multiple regression analysis, change in lean mass was the primary determinant of TB, FN, PF, and LS BMD accrual. Although a large proportion of bone mineral accrual in the premenarcheal skeleton was related to growth, an osteogenic effect was associated with exercise. These results suggest that high-impact, strength building exercise is beneficial for premenarcheal strength, lean mass gains, and bone mineral acquisition.

Urinary 3-methylhistidine excretion increases with repeated weight training exercise

This investigation examines the effect of progressive resistance weight training exercise on urinary 3-methylhistidine (3-MH) excretions in untrained subjects. For 19 consecutive days, 11 males were fed a weight maintenance, lactovegetarian diet which contained the Recommended Dietary Allowance (0.8g.kg-1.d-1) for protein. No exercise was performed for the first 7 d of the study. Subjects were strength tested on day 8 and performed upper and lower body weight training exercises from days 9-19. Complete, 24-h urine collections were obtained from each subject on a daily basis. Samples were assayed for creatinine and 3-MH. Stable baseline 3-MH values were present during the pre-exercise control period. Significant increases in 3-MH occurred by study day 11, which was the third day of weight training exercise. This was true regardless of whether the data were expressed by daily excretions (microM.d-1; P less than 0.01), per unit of body weight (microM.kg-1.d-1; P less than 0.005), or per unit of creatinine excretion (microM.g Creat-1.d-1; P less than 0.001). Since urinary 3-MH is an index of actin and myosin catabolism, these data support the hypothesis that the rate of skeletal muscle degradation is increased during strength building exercises.

Failure of weight training to affect urinary indices of protein metabolism in men

It is commonly believed by some athletes that strength building exercise "tears down" skeletal muscle tissue, thereby enhancing the dietary need for protein, but this has not been demonstrated. Ten college-age males served as subjects in a 15-d, controlled feeding study. The men were 23.1 +/- 2.2 yr old (mean +/- SD), 177 +/- 5 cm in height, and 71.7 +/- 9.1 kg in body weight (study days = 1 to 15). The lacto-ovo-vegetarian diet provided 0.9 g/kg protein and 15.1 +/- 0.4 MJ (3,604 +/- 104 kcal) . d-1 energy (study days = 6 to 15). On days 8 and 12, subjects participated in a standardized strength building, weight training exercise regimen. Post-exercise days 9 to 11 and 13 to 15 were designated for recovery. Daily (24-h) urine collections were analyzed for ammonia, creatinine, 3-methylhistidine, total nitrogen, and urea. There was no acute (24-h) effect of weight training exercise on any excretion levels. In particular, urinary 3-methylhistidine excretion data indicate that skeletal muscle protein catabolism was not changed by isolated bouts of weight training exercise.

Long-range strenuous sports training for cardiac reconditioning and rehabilitation

An organization for the rehabilitation of cardiac patients (most of them afflicted with ischemic heart disease) and for reconditioning of sedentary middle-aged and elderly subjects by means of systematically graded and ultimately strenuous sports training has been conducted in Israel since 1955. After a specific procedure of testing for cardiovascular fitness and work tolerance (“circulatory profile”), the participants are exposed to several months' preparatory period of mild warm-up and strength-building exercises. Within approximately nine months they qualify for systematic training in rhythmic endurance and locomotive sports (hiking, swimming, cycling, rowing, running) and volley-ball. The program culminates in competitive team games for those who have progressed to the upper fitness categories. Physical activity is then continued either within the organization or independently. Of 1,103 trainees with ischemic heart disease who remained under our observation for five years, only 49 have died to date. Nine of these deaths occurred from noncardiac causes. Thus, the mortality rate over five years was only 3.6 per cent compared to 12 per cent in a comparable series of physically inactive postinfarction patients in Israel. The risk of supervised and systematically upgraded vigorous physical effort in middle-aged and elderly patients with cardiac disease has been greatly overrated in the past. Its cardioprotective and rehabilitative value is underscored by today's knowledge concerning myocardial pathophysiology and by the results of epidemiologic studies in various parts of the world.