Use Of Exercise Interventions Research Articles

The Use of Acute Exercise Interventions as Priming Strategies to Improve Physical Performance During Track-and-Field Competitions: A Systematic Review

ABSTRACT The use of exercise interventions to maximize athletes' performance is a common practice in competitions. This systematic review aimed to compile research that explored the effectiveness of priming strategies to maximize physical performance in track and field. The literature search was conducted from PubMed and Scopus. One hundred eighty-two studies were assessed against the inclusion criteria: (a) minimum 1-year participation/competition experience; (b) randomized controlled trials with pre-post intervention outcomes; and (c) studies involving exercise interventions applied ≤6 hours before outcome measures were collected. Fifteen studies satisfied the criteria and were categorized according to the exercise interventions used (i.e., resistance training, plyometric/ballistic training, resisted sprints, and modified warm-ups). Heavy-loaded resistance training (i.e., >85% 1 repetition maximum) and resisted sprints increased subsequent sprint performance. Plyometrics/ballistic training also positively impacted subsequent jumping (i.e., long jump) and throwing performance (i.e., shot put). Modified warm-ups (i.e., high-intensity sprints and heavier throwing implements) also improved subsequent running and throwing performance. Overall, exercise interventions performed at high intensity and low volume augment subsequent physical performance as close to 4 minutes before the event. However, a sufficient recovery interval must be considered for a positive performance response.

Exercise efficacy in management of Cervical Spondylotic Myelopathy – A case report

Cervical Spondylotic Myelopathy is an ageing, degenerative spinal condition and a common cause of myelopathy in adults, with the average age of presentation being 56 years. This case report was on a 63-year man who was apparently healthy until he was presented with grade v on Nurick Classification System for Myelopathy. Lhermitte Sign was present. The clinical presentations were motor deficit in the upper limbs (ULs), lower limbs (LLs) and hands; intermittent bouts of spasms in lower limbs; painfully reduced range of motion (ROM) in the shoulder, cervical and lumbosacral joints; impaired activity of daily living (ADL) including ambulation, and reduced sleeping hours. The treatment plan aimed to relieve pain at the affected joints; improve ROM in joints of ULs and LLs; strengthen weak muscles (ULs and LLs); improve trunk control; improve patella mobility and release of tight muscle/structures(hamstrings). The adopted Exercise protocols, which were done between 11 am-1 pm at thrice weekly appointments for four months, were Mobilization & Strengthening Exercises (all limbs); Back Flexibility Exercises; Quadriceps Strengthening Exercises both LLs and Neuromotor Exercises. The patient became stable on a tripod stand in the fourth month and was discharged on a home programme at the end of the fourth month. The observed improvement in the clinical condition of this Cervical Spondylotic Myelopathy patient lays credence to the efficacy of the use of exercise interventions in this condition.

Early Life Stress Affects Bdnf Regulation: A Role for Exercise Interventions.

Early life stress (ELS) encompasses exposure to aversive experiences during early development, such as neglect or maltreatment. Animal and human studies indicate that ELS has maladaptive effects on brain development, leaving individuals more vulnerable to developing behavioral and neuropsychiatric disorders later in life. This result occurs in part to disruptions in Brain derived neurotrophic factor (Bdnf) gene regulation, which plays a vital role in early neural programming and brain health in adulthood. A potential treatment mechanism to reverse the effects of ELS on Bdnf expression is aerobic exercise due to its neuroprotective properties and positive impact on Bdnf expression. Aerobic exercise opens the door to exciting and novel potential treatment strategies because it is a behavioral intervention readily and freely available to the public. In this review, we discuss the current literature investigating the use of exercise interventions in animal models of ELS to reverse or mitigate ELS-induced changes in Bdnf expression. We also encourage future studies to investigate sensitive periods of exercise exposure, as well as sufficient duration of exposure, on epigenetic and behavioral outcomes to help lead to standardized practices in the exercise intervention field.

Add-on exercise interventions for smoking cessation in people with mental illness: a systematic review and meta-analysis

BackgroundSmoking is the most common substance use disorder among people with mental illness. In contrast to people without mental illness, among whom the proportion of smokers has declined in recent decades, the proportion of smokers among people with mental illness remains high. There is a growing body of literature suggesting the use of exercise interventions in combination with smoking cessation in people without mental illness, but to our knowledge the available studies on this treatment option in people with mental illness have not been systematically reviewed. Therefore, this systematic review and meta-analysis aims to assess the effectiveness of exercise interventions as an adjunctive treatment for smoking cessation in people with mental illness.MethodsElectronic databases (PubMed, Web of Science, PsycInfo, Sport Discus and Base) were searched for randomised controlled trials and prospective single-group studies that investigated exercise interventions in combination with smoking cessation programmes alone or in comparison with a control group in people with mental illness. A meta-analysis using the Mantel–Haenszel fixed-effect model was conducted to estimate the overall effect of treatment on smoking cessation (abstinence rate at the end of the intervention and at 6-month follow-up).ResultsSix studies, five randomised controlled trials and one study with a prospective single-group design, were included in the systematic review and four randomised controlled trials were included in the meta-analysis. The meta-analysis found a significantly higher abstinence rate after additional exercise at the end of the intervention [risk ratio (RR) 1.48, 95% confidence interval (CI) 1.13–1.94], but not at the 6-month follow-up (RR 1.34, 95% CI 0.89–2.04).ConclusionsExercise appears to be an effective adjunctive therapy to temporarily increase abstinence rates in individuals with mental illness at the end of the intervention. However, due to the small number of included studies and some risk of bias in the included studies, the results should be treated with caution. Therefore, future studies with larger samples are needed to provide a more accurate estimate of the effect in people with mental illness.Registration The systematic review and meta-analysis were registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42020178630).

Rheumatology Practitioners' View of Exercise in Adults With Systemic Sclerosis or Systemic Lupus Erythematosus

ABSTRACT Background Exercise is part of the general recommendations for care of people with most arthropathies or connective tissue diseases, but it does not feature specifically in the clinical guidelines for management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) by rheumatology practitioners. In this study, we sought to explore rheumatologists' (RHs') and rheumatology nurses' (RNs') perspectives and use of exercise interventions for adults with SLE or SSc. Methods Semistructured interviews were conducted with Australian RHs and RNs online using Zoom (video conferencing software). Interviews were transcribed verbatim, then coded and analyzed using NVivo for content analysis of themes. Results Seventeen participants completed the interviews (RHs n = 12, RNs n = 5). Five themes were identified: rheumatology practitioners perceive that (1) exercise is beneficial for adults with SLE or SSc, especially in managing fatigue, pain, and wellbeing; (2) exercise presents some general, structural, and disease-related barriers for adults with SLE or SSc; (3) rheumatology practitioners are confident in providing general exercise advice but lack time and confidence in prescribing exercise; (4) rheumatology practitioners' concerns about exercise are limited to those with heart and lung disease, inflamed joints, ulcerated fingertips, and severe contractures; and (5) to facilitate safe and attainable exercise, rheumatology practitioners recommend long-term, supervised, gradual, and affordable exercise options. There were no clear differences identified between the views of RNs and RHs. Conclusion Rheumatology practitioners require information and options for long-term and affordable exercise for adults with SLE or SSc that are supervised, individualized, and focus on a gradual progressive approach.

Effects of aerobic exercise on the expressions and activities of nitric oxide synthases in the blood vessel endothelium in prediabetes mellitus.

Previous studies by our group have indicated that exercise intervention can ameliorate endothelial dysfunction, which is an early pathophysiological change of prediabetes mellitus. The present study aimed to test the hypothesis that nitric oxide synthases (NOSs), which are expressed in blood vessel endothelium, contribute to the mitigation of vascular endothelium-dependent dysfunction by aerobic exercise in prediabetes mellitus. A prediabetic rat model was established by feeding the rats an additional high-energy diet, and was confirmed by testing blood glucose levels, the area-under-the-curve for the blood glucose tests (P<0.05) and the changes to the histological morphology of the thoracic aorta. Further examination identified that NOS expression changed significantly between the control and prediabetes groups, indicating endothelial dysfunction in the prediabetic rats. Following aerobic exercise, a significant increase in NOS, endothelial (eNOS) mRNA and protein expression (P<0.05), and a significant decrease in NOS, inducible (iNOS) mRNA and protein expression (P<0.05) was identified in the prediabetic rats compared with the control group. No significant change in nitric oxide synthase, brain expression was observed in the prediabetic rat group compared with the control group. Notably, there was also a significant increase and decrease in eNOS and iNOS activity, respectively, in the prediabetes group compared with the control group (P<0.05). Furthermore, nitric oxide (NO) concentration in the vascular endothelium was detected, which revealed a significant increase in NO concentration in the prediabetic rats following aerobic exercise compared with the control (P<0.05). The present study provided results that demonstrated that aerobic exercise ameliorated the vascular endothelium-dependent dysfunction through the NOS/NO signaling pathway, which is primarily regulated by NOS expression and activity, in prediabetes mellitus. The current study provided the theoretical basis for the use of exercise intervention to prevent diabetes mellitus during the early stage.

Limitation of Maximal Heart Rate in Hypoxia: Mechanisms and Clinical Importance.

The use of exercise intervention in hypoxia has grown in popularity amongst patients, with encouraging results compared to similar intervention in normoxia. The prescription of exercise for patients largely rely on heart rate recordings (percentage of maximal heart rate (HRmax) or heart rate reserve). It is known that HRmax decreases with high altitude and the duration of the stay (acclimatization). At an altitude typically chosen for training (2,000-3,500 m) conflicting results have been found. Whether or not this decrease exists or not is of importance since the results of previous studies assessing hypoxic training based on HR may be biased due to improper intensity. By pooling the results of 86 studies, this literature review emphasizes that HRmax decreases progressively with increasing hypoxia. The dose–response is roughly linear and starts at a low altitude, but with large inter-study variabilities. Sex or age does not seem to be a major contributor in the HRmax decline with altitude. Rather, it seems that the greater the reduction in arterial oxygen saturation, the greater the reduction in HRmax, due to an over activity of the parasympathetic nervous system. Only a few studies reported HRmax at sea/low level and altitude with patients. Altogether, due to very different experimental design, it is difficult to draw firm conclusions in these different clinical categories of people. Hence, forthcoming studies in specific groups of patients are required to properly evaluate (1) the HRmax change during acute hypoxia and the contributing factors, and (2) the physiological and clinical effects of exercise training in hypoxia with adequate prescription of exercise training intensity if based on heart rate.

Kinetics of circulating progenitor cell mobilization during submaximal exercise.

Circulating progenitor cells (CPCs) are a heterogeneous population of stem/progenitor cells in peripheral blood that includes hematopoietic stem and progenitor cells (HSPCs and HSCs), endothelial progenitor cells (EPCs), and mesenchymal stem cells (MSCs) that are involved in tissue repair and adaptation. CPC mobilization during exercise remains uncharacterized in young adults. The purpose of this study was to investigate the kinetics of CPC mobilization during and after submaximal treadmill running and their relationship to mobilization factors. Seven men [age = 25.3 ± 2.4 yr, body mass index = 23.5 ± 1.0 kg/m2, peak O2 uptake (V̇o2peak) = 60.9 ± 2.74 ml·kg-1·min-1] ran on a treadmill for 60 min at 70% V̇o2peak Blood sampling occurred before (Pre), during [20 min (20e), 40 min (40e), 60 min (60e)], and after exercise [15 min (15p), 60 min (60p), 120 min (120p)] for quantification of CPCs (CD34+), HSPCs (CD34+/CD45low), HSCs (CD34+/CD45low/CD38-), CD34+ MSCs (CD45-/CD34+/CD31-/CD105+), CD34- MSCs (CD45-/CD34-/CD31-/CD105+), and EPCs (CD45-/CD34+/CD31+) via flow cytometry. CPC concentration increased compared with Pre at 20e and 40e (2.7- and 2.4-fold, respectively, P < 0.05). HSPCs and HSCs increased at 20e compared with 60p (2.7- and 2.8-fold, respectively, P < 0.05), whereas EPCs and both MSC populations did not change. CXC chemokine ligand (CXCL) 12 (1.5-fold; P < 0.05) and stem cell factor (1.3-fold; P < 0.05) were increased at 40e and remained elevated postexercise. The peak increase in CPCs was positively correlated to concentration of endothelial cells during exercise with no relationship to CXCL12 and SCF. Our data show the kinetics of progenitor cell mobilization during exercise that could provide insight into cellular mediators of exercise-induced adaptations, and have implication for the use of exercise as an adjuvant therapy for CPC collection in hematopoietic stem cell transplant.NEW & NOTEWORTHY Using a comprehensive evaluation of circulating progenitor cells (CPCs), we show that CPC mobilization during exercise is related to tissue damage, and not plasma concentrations of CXC chemokine ligand 12 and stem cell factor. These data have implications for the use of exercise interventions as adjuvant therapy for CPC mobilization in the context of hematopoietic stem cell transplant and also support the role of mobilized progenitor cells as cellular mediators of systemic adaptations to exercise.

The use of exercise interventions to overcome adverse effects of androgen deprivation therapy.

Androgen deprivation therapy (ADT) induces severe hypogonadism and is associated with several adverse effects that negatively affect health and quality of life in patients with prostate cancer. ADT changes body composition characterized by an increase in fat mass and a reduction in muscle mass and strength. Insulin sensitivity is also diminished and population-based studies indicate an increased risk of diabetes mellitus and cardiovascular disease in men receiving ADT. Particularly the first 6 months of treatment seem to hold an additional risk of new cardiovascular events for patients with already existing cardiovascular disease. In this initial phase of ADT, metabolic changes are also most prominent. In addition, ADT increases the rate of bone loss and fracture risk. Currently available evidence supports the use of exercise interventions to improve physical function and mitigate ADT-induced fatigue. Some studies also indicate that exercise might moderate ADT-related changes in body composition. However, beneficial effects of exercise interventions on other ADT-related conditions have not been conclusively proven. Trials investigating the effects of ADT on fracture risk and development of diabetes mellitus and cardiovascular disease are still warranted. Furthermore, studies investigating safety and effects of physical activity in men with bone metastases are lacking.

A systematic review on the use of exercise interventions for individuals with myeloid leukemia.

The aim of this study is to explore the current literature examining the feasibility, safety, and efficacy of exercise interventions for individuals with myeloid leukemia. A literature search was conducted in Ovid MEDLINE, AMED, Embase, PsycINFO, CINAHL, CENTRAL, and Web of Science using the terms "exercise" OR "physical activity" AND "myeloid leukemia." Two reviewers performed duplicate title/abstract and full text screening of clinical trials comparing outcomes for people with myeloid leukemia participating in an exercise program. Initial searches yielded 149 articles. Two reviewers independently extracted data using piloted forms and assessed risk of bias using Cochrane's tool. Data was extracted in relation to the study population, study intervention, comparator intervention, and outcomes assessed. Five trials were included in this review after 20 full-text articles were screened. Risk of bias was determined to be high in all five studies. Adherence rates were found to be low (<30 %) in all studies measuring this outcome. Positive improvements were found for fatigue, physical functioning, quality of life, and psychological distress for patients with AML; however, not all findings were significant. Leukocyte and BCR-ABL1 levels increased significantly post-exercise for participants with CML. Only one adverse event was reported. Exercise interventions appear safe and feasible for individuals with AML. Not enough evidence was presented to comment on the feasibility of exercise programs for individuals with CML. Inconclusive evidence was found on the effectiveness of exercise to minimize side effects for participants with AML.

Effects of a Single Bout of Aerobic Exercise Versus Resistance Training on Cognitive Vulnerabilities for Anxiety Disorders

The purpose of this study was to compare the relative effects of a single bout of aerobic exercise versus resistance training on cognitive vulnerabilities for anxiety disorders. Seventy-seven participants (60% female; 84% Caucasian) were randomized to complete 20 min of moderate-intensity aerobic exercise, resistance training, or rest, followed by a 35% CO2/65% O2 inhalation challenge task. Results indicated that aerobic exercise and resistance training were significantly and equally effective in reducing anxiety sensitivity (AS) compared with rest (), though only aerobic exercise significantly attenuated reactivity to the CO2 challenge task. Neither form of exercise generated observable effects on distress tolerance, discomfort intolerance, or state anxiety (all ps>.10). The results of this study are discussed with regard to their implications for the use of exercise interventions for anxiety and related forms of psychopathology, and potential directions for future research are discussed.

Effects of exercise intervention on vascular endothelium functions of patients with impaired glucose tolerance during prediabetes mellitus

Endothelial dysfunction (ED) is an early pathophysiological change in patients with impaired glucose tolerance (IGT) during prediabetes mellitus. This study was designed to test the hypothesis that exercise intervention contributes to the reversal of vascular endothelium-dependent dysfunction in middle-aged patients with IGT. Following exercise intervention, significant changes in endothelin (ET)-1, C-type natriuretic peptide (CNP), ΔDia-P, oral glucose tolerance test (OGTT)2h, fasting insulin, homeostasis model of assessment-insulin resistance (HOMA-IR), body fat percentage, waist circumference and waist to hip ratio were measured. However, no marked changes in carotid artery intima-media thickness (IMT), fasting blood glucose and BMI were observed following exercise intervention. Validity analysis of index changes in the two exercise intervention groups further confirmed there was no change. Exercise intervention increased CNP levels, decreased ET-1 levels and increased ΔDia-P, indicating improved vascular endothelium function. Decreased HOMA-IR following exercise suggests enhanced insulin sensitivity. Exercise intervention also improved glucose metabolism via decreased OGTT2h and fasting insulin. In addition, decreased waist circumference, ratio of waist to hip and body fat percentage following exercise intervention improved changes of body composition, including BMI, body fat and waist circumference. These results indicate that exercise intervention may reverse vascular endothelium-dependent dysfunction in middle-aged patients with IGT. This study also provided direct clinical data supporting the use of exercise intervention to prevent diabetes mellitus (DM) during the early stage.

Evidence of Improvement in Various Impairments by Exercise Interventions in Patients with Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Clinical Trials.

To investigate improvement in various impairments by exercise interventions in patients with knee osteoarthritis (OA). We collected data on randomized controlled trials (RCTs) comparing the effects of exercise intervention with those of either nonintervention or psychoeducational intervention in patients with knee OA. Data on pain, stiffness, muscle strength, range of motion, flexibility, maximal oxygen uptake, and position sense were synthesized. The Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the quality of the evidence. Thirty-three RCTs involving 3,192 participants were identified. Meta-analysis provided highquality evidence that exercise intervention improves maximal oxygen uptake, and moderate-quality evidence that exercise intervention also improves pain, stiffness, knee extensor and flexor muscle strength, and position sense. The evidence that exercise intervention improves knee extension and flexion range of motion was deemed as undetermined-quality. In patients with knee OA, improvement in pain, stiffness, muscle strength, maximal oxygen uptake, and position sense with the use of exercise intervention can be expected. Although the quality of evidence of the effect of exercise intervention on range of motion was inconclusive, exercise intervention should be recommended for patients with knee OA to improve various impairments.

Exercise is an effective treatment modality for reducing cancer-related fatigue and improving physical capacity in cancer patients and survivors: a meta-analysis

The use of exercise interventions to manage cancer-related fatigue (CRF) is a rapidly developing field of study. However, results are inconsistent and difficult to interpret across the literature, making it difficult to draw accurate conclusions regarding the true effectiveness of exercise interventions for CRF management. The aims of this study were to apply a meta-analysis to quantitatively assess the effects of exercise intervention strategies on CRF, and to elucidate appropriate exercise prescription guidelines. A systematic search of electronic databases and relevant journals and articles was conducted. Studies were eligible if subjects were over the age of 18 years, if they had been given a diagnosis of or had been treated for cancer, if exercise was used to treat CRF as a primary or secondary endpoint, and if the effects of the intervention were evaluated quantitatively and presented adequate statistical data for analysis. A total of 16 studies, representing 1426 participants (exercise, 759; control, 667) were included in a meta-analysis using a fixed-effects model. The standardized mean difference effect size (SMD) was used to test the effect of exercise on CRF between experimental and control groups. The results indicate a small but significant effect size in favour of the use of exercise interventions for reducing CRF (SMD 0.26, p < 0.001). Furthermore, aerobic exercise programs caused a significant reduction in CRF (SMD 0.21, p < 0.001) and overall, exercise was able to significantly improve aerobic and musculoskeletal fitness compared with control groups (p < 0.01). Further investigation is still required to determine the effects of exercise on potential underlying mechanisms related to the pathophysiology of CRF.

A systematic review and synthesis of higher quality evidence of the effectiveness of exercise interventions for non-specific low back pain of at least 6 weeks' duration

Systematic reviews and randomised controlled trials (RCTs) generally support the use of exercise interventions to reduce pain and improve function in patients with chronic non-specific low back pain (LBP). However, many RCTs in the field of LBP include small numbers of subjects, have significant methodological limitations and use diverse exercise interventions. This review shows that the smaller RCTs often overestimate the true effectiveness or fail to detect true benefits. Also, statistically significant results from RCTs of low methodological quality might not be valid. This review showed that evidence from RCTs that are larger (≥ 40 subjects in exercise group), score high on the adapted van Tulder methodological quality criteria (≥ 5/10) and have used adequate statistical tests, support the use of exercise for patients with LBP of at least 6 weeks' duration, although the effect sizes tend to be smaller. This higher quality evidence particularly supports the use of strengthening exercises, (organised) aerobic exercises, general exercises, hydrotherapy and McKenzie exercises for back pain of at least 6 weeks' duration.

IMPROVEMENT OF BALANCE AFTER 12-WK OF BALANCE TRAINING IN OLDER ADULTS

The use of exercise interventions to improve balance in older adults has recently been drawing increasing attention from scientists and practitioners. PURPOSE To determine the effect of a balance exercise program (BEX) on balance in a group of Japanese older adults. METHODS Static balance (eyes closed standing on one foot [one-leg balance]), and dynamic balance (limits of stability [LOS] while moving one □fs center of gravity in a given direction) were assessed in all participants before and after the intervention. Components of LOS (endpoint excursion [EPE], maximum excursion [MXE], and directional control [DCL] were evaluated in forward, backward, right, and left direction by a computerized balance assessment device. Thirty volunteers were randomly divided into a training group (TR: 5 men and 10 women, 75 ± 3 yr) and a control group (CN, 7 men and 8 women, 75 ± 7 yr). The TR participate d in a 12- wk (2d/wk, 60 min/day) of supervised BEX (10 min of warm-up, 40 min of balance exercises [BX], and 10 min of cool-down). BX was performed while standing on the floor (first 4 wk) and then progressed to standing on foam pads of different compliances. Exercises included placing the feet in various positions and standing on one leg while moving the head, with or without the eyes open. The CN continued their normal daily physical activity. RESULTS After 12-wk of training, the TR demonstrated improvements (p < 0.05) in one-leg balance (72%); EPE backward (67%), right (27%), and left (32%); MXE backward (61%), right (24%), and left (17%); DCL backward (54%), right (16%), and left (17%). No significant changes were noted in LOS components in forward direction in TR, and in any of the measured variables in CN after the 12-week period. CONCLUSION These results indicate that balance training is effective in improving both the static and dynamic balance in older adults. These improvements could reduce their risk of suffering a fall. Supported by JSPS (Japan), Monbusho (Japan), and Hygenic Corporation grants.

Sports therapy in mental illness

There is a popular belief that physical fitness and mental stability are related. In this article, Mike Sheehan reviews the history of sport in psychiatric nursing, establishes the theories behind using sport as an adjunctive therapy, explores the concepts of using sport as a specifically prescribed treatment and investigates the advantages which are available when using individual sports in conjunction with existing treatment options. He has looked at three main areas of psychiatric illness: schizophrenia, depression and anxiety disorders. The ‘exercise prescription' required in all three illnesses differs as much as the symptoms experienced by those who suffer from the conditions. The use of exercise intervention in the prevention and treatment of psychological illness is relatively safe, inexpensive and invokes no adverse side-effects. The role of the sports therapist, based on unique skills and knowledge, is described.