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Exercise Program (exercise + program)

Distribution by Scientific Domains

Medical Sciences	97%

Distribution within Medical Sciences

Geriatric Medicine	30%
Neurology	9%
15 Other Subdomains	61%

Selected Abstracts

A Study to Evaluate the Feasibility of an Aerobic Exercise Program in Patients With Migraine

HEADACHE, Issue 4 2009
Emma Varkey RPT
Objectives., The aim of this study was to develop and evaluate an exercise program to improve maximum oxygen uptake (VO2 max) in untrained patients with migraine without making their migraines worse. Patients and methods., Twenty-six patients were studied at a headache clinic in Sweden. The exercise program, based on indoor cycling, was performed 3 times per week during 12 weeks. VO2 max, migraine status, side effects, and quality of life were evaluated. Results., VO2 max increased from 32.9 mL/kg/minute to 36.2 mL/kg/minute (P = .044). Quality of life increased and significant improvements in migraine status (attack frequency, symptom intensity, and intake of medicine) were seen. During the 12 weeks of exercise, on one occasion one patient had a migraine attack, which started immediately after training. No other side effects were reported. Conclusions., The evaluated exercise program was well tolerated by the patients and improved their VO2 max with no deterioration of migraine status. [source]

The Effect of a High-Intensity Functional Exercise Program on Activities of Daily Living: A Randomized Controlled Trial in Residential Care Facilities

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2009
Håkan Littbrand PT
OBJECTIVES: To evaluate whether a high-intensity functional weight-bearing exercise program reduces dependency in activities of daily living (ADLs) in older people living in residential care facilities, focusing on people with dementia. DESIGN: Randomized, controlled trial. SETTING: Nine residential care facilities. PARTICIPANTS: One hundred ninety-one older people dependent in ADLs and with a Mini-Mental State Examination score of 10 or greater. One hundred (52.4%) of the participants had dementia. INTERVENTION: A high-intensity functional weight-bearing exercise program or a control activity consisting of 29 sessions over 3 months. MEASUREMENTS: The Barthel ADL Index; follow-up at 3 months (directly after the intervention) and 6 months with intention-to-treat analyses. RESULTS: There were no statistically significant differences between the groups regarding overall ADL performance. Analyses for each item revealed that a smaller proportion of participants in the exercise group had deteriorated in indoor mobility at 3 months (exercise 3.5% vs control 16.0%, P=.01) and 6 months (7.7% vs 19.8%, P=.03). For people with dementia, there was a significant difference in overall ADL performance in favor of the exercise group at 3 months (mean difference 1.1, P=.03) but not at 6 months. CONCLUSION: A high-intensity functional weight-bearing exercise program seems to reduce ADL decline related to indoor mobility for older people living in residential care facilities. The program does not appear to have an overall effect on ADLs. In people with dementia, the exercise program may prevent decline in overall ADL performance, but continuous training may be needed to maintain that effect. [source]

The effectiveness of exercise interventions for people with Parkinson's disease: A systematic review and meta-analysis

MOVEMENT DISORDERS, Issue 5 2008
Victoria A. Goodwin MSc
Abstract Parkinson's disease (PD) is a neurodegenerative disorder affecting the physical, psychological, social, and functional status of individuals. Exercise programs may be an effective strategy to delay or reverse functional decline for people with PD and a large body of empirical evidence has emerged in recent years. The objective is to systematically review randomized controlled trials (RCTs) reporting on the effectiveness of exercise interventions on outcomes (physical, psychological or social functioning, or quality of life) for people with PD. RCTs meeting the inclusion criteria were identified by systematic searching of electronic databases. Key data were extracted by two independent researchers. A mixed methods approach was undertaken using narrative, vote counting, and random effects meta-analysis methods. Fourteen RCTs were included and the methodological quality of most studies was moderate. Evidence supported exercise as being beneficial with regards to physical functioning, health-related quality of life, strength, balance and gait speed for people with PD. There was insufficient evidence support or refute the value of exercise in reducing falls or depression. This review found evidence of the potential benefits of exercise for people with PD, although further good quality research is needed. Questions remain around the optimal content of exercise interventions (dosing, component exercises) at different stages of the disease. © 2008 Movement Disorder Society [source]

A Study to Evaluate the Feasibility of an Aerobic Exercise Program in Patients With Migraine

The effects of exercise during hemodialysis on adequacy

HEMODIALYSIS INTERNATIONAL, Issue 1 2005
C. Caner
Pedalling during hemodialysis (HD) has been shown to increase solute clearance in a previous study. In the present study, we aimed to test whether an easy to perform exercise program, not requiring a special device, could yield similar outcomes. Fifteen HD patients with the mean age of 48.4 ± 3.8 years were enrolled into the study. Patients with significant access recirculation (>10%), moderate to severe coronary artery disease, moderate to severe heart failure, severe chronic obstructive lung disease, and history of lower extremity surgery during last three month period were excluded. All patients were studied on two consecutive HD sessions with identical prescriptions. At the first session, standard HD was applied without exercise, whereas in the second session lower extremity exercise of 30 minutes duration was added. Reduction rates and rebound for urea, creatinine, and potassium and Kt/V were calculated. Wilcoxon signed rank test was applied in analysis and p < 0.05 was accepted as significance level. All patients completed the study. When both sessions were compared, mean arterial blood pressure (97 ± 3 mmHg vs 120 ± 4 mmHg, p < 0.001) and heart rate (77 ± 1 beats/min vs 92 ± 3 beats/min, p < 0.001) were higher in the exercise group. On the other hand, urea reduction rates, rebound values of urea, creatinine, and potassium were similar in both groups. Conclusion:,In the study, we did not observe any changes in solute rebound and clearance with the exercise. Shorter duration of the exercise may be the explanation of failure to achieve desired outcomes. Increasing patients' tolerance and fitness levels by means of steadily increasing exercise programs may be of help. Additionally, mode of exercise may also be responsible for different outcomes. [source]

Interventions to reduce the incidence of falls in older adult patients in acute-care hospitals: a systematic review

INTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 4 2009
Cindy Stern BHS(Hons)
Abstract Aim, Falls can cause serious physical and emotional injuries to patients leading to poor quality of life and increased length of hospital stay. The aim of this study was to present the best available evidence regarding the effectiveness of risk assessment or other interventions that aimed to minimise the number of falls. Methods, A systematic review of randomised controlled trials was undertaken to determine the effectiveness of interventions that were designed to reduce the incidence of falls in older acute-care patients. Only trials published between 1998 and 2008 were considered. Results, Only seven studies were included in the review, indicating the evidence on this topic is sparse. There is some evidence to suggest that implementing the following interventions in acute hospitals may be effective in reducing the amount of falls of older adult inpatients: ,,A multidisciplinary multifactorial intervention program consisting of falls risk alert card, an exercise program, an education program and the use of hip protectors after approximately 45 days ,,A one-on-one patient education package entailing information on risk factors and preventative strategies for falls as well as goal setting ,,A targeted fall risk factor reduction intervention that includes a fall risk factor screen, recommended interventions encompassing local advice and a summary of the evidence There is also some evidence to suggest that implementing a multidisciplinary multifactorial intervention that consists of systematic assessment and treatment of fall risk factors, as well as active management of postoperative complications, can reduce the amount of falls in patients following surgery for femoral neck fracture. Conclusion, There is some evidence to suggest that certain multifactorial interventions are more effective than others and that increasing patient education or targeting fall risk factors may be of benefit. Further high-quality research is needed in order to ascertain effective fall-prevention strategies in acute-care facilities. [source]

Managing the wandering behaviour of people living in a residential aged care facility

INTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 4 2007
Brent Hodgkinson BSc MSc GradCertPubHealth GradCertHealthEcon
Abstract Background, Wandering behaviour is frequently seen in older people with cognitive impairment. The prevalence of patients exhibiting wandering behaviour has been estimated to be 11.6% on traditional units and 52.7% on Alzheimer's units. Wandering is one of the core behavioural characteristics that impact on familial carers and is likely to influence the decision to place a family member in an aged care environment. Considering the possible risks associated with wandering behaviour, the successful identification and management of wandering is essential. Wandering is also a problem for caregivers in the institutionalised setting, in terms of containment, usually being addressed by securing the environment. There has been some research conducted to assist in the understanding and management of wandering behaviour; however, the findings have been diverse resulting in a level of confusion about the best approaches to take. Objectives, This review aims to present the best available evidence on the management of wandering in older adults who reside in an aged care facility (both high and low care). Search strategy, An extensive search of keywords contained in the title and abstract, and relevant MeSH headings and descriptor terms was performed on the following databases: MEDLINE, CINAHL, PsychINFO, AGELINE, Cochrane Library, Embase, APAIS Health, Current Contents, Dare, Dissertation Abstracts, Personal Communication, Social Science Index. Selection criteria, Papers were selected if they focused on the treatment of wandering in an institutional setting. Some studies were not specifically examining wanderers over the age of 65 years as per the protocol requirements, but were included as it was felt that their findings could be applied to this age group. Data collection and analysis, Study design and quality were tabulated and relative risks, odds ratios, mean differences and associated 95% confidence intervals were calculated from individual comparative studies containing count data where possible. All other data were presented in a narrative summary. Results, Searches identified one care protocol, two systematic reviews and 24 other studies that satisfied the inclusion criteria. The following recommendations are divided into four categories of interventions (environmental, technology and safety, physical/psychosocial, and caregiving support and education) with only Level 1, 2 or 3 evidence presented. Environmental modifications, Gridlines placed in front of doors or covering exit door doorknobs or panic bars may be effective at reducing exit-seeking behaviour (Level 3b). Technology and safety, Mobile locator devices may be effective at enabling quick location of wandering residents (Level 3c). Physical/psychosocial interventions, Implementation of a walking group or an exercise program may reduce the incidence of disruptive wandering behaviour (Level 3b). Use of air mat therapy may reduce wandering behaviour for at least 15 min post therapy (Level 2). Providing music sessions (and reading sessions) may keep residents from wandering during the period of the session (Level 3b). Caregiving support and education, There is no evidence to support any interventions. Conclusions, The majority of the available research for which the guidelines are based upon was derived from observational studies or expert opinion (Level of evidence 3 or 4). More rigorous research is required to demonstrate the efficacy of these recommendations. [source]

Effects of a group-based exercise program on the mood state of frail older women after discharge from hospital

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2002
L. Timonen
Abstract Background Older people with somatic illnesses are at increased risk of depression. It is not known whether exercise alleviates depressive symptoms in frail, very old people recuperating from an acute illness. Objective To determine the effects of a group-based exercise training program on mood. Methods Sixty-eight women (mean age 83.0, SD 3.9 years) who were hospitalized due to an acute illness, and were mobility impaired at admission, were randomized into group-based 10-week strength training intervention (N=34) and home exercise control (N=34) groups. Twenty-four women in the training and 28 in the control group completed the follow-up. Measures of mood state with the Zung Self-Rating Depression Scale (ZSDS) were performed before and after the training intervention, and follow-up data was collected 3 and 9 months after the end of the intervention. Results After the intervention, there was a significant improvement in mood in the intervention group compared to the home exercise control group: ,3.1 (SD 9.0) points vs +1.3 (SD 7.6) points (p=0.048) and the positive effect was still apparent three months after the intervention ceased: ,2.6 (SD 7.7) points vs +3.5 (SD 9.7) points (p=0.015). Improvement of mood state at the first follow-up measurement was associated with the improvement in lower limb isometric muscle strength. Conclusions Group-based exercise program organized in the context of a Finnish health care organization improved mood in frail older women recuperating from an acute illness. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Dehydroepiandrosterone Combined with Exercise Improves Muscle Strength and Physical Function in Frail Older Women

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2010
Anne M. Kenny MD
OBJECTIVES: To investigate the effects of dehydroepiandrosterone (DHEA) combined with exercise on bone mass, strength, and physical function in older, frail women. DESIGN: Double-blind, randomized, placebo-controlled trial. SETTING: A major medical institution. PARTICIPANTS: Ninety-nine women (mean age 76.6 ± 6.0) with low sulfated DHEA (DHEAS) levels, low bone mass, and frailty. INTERVENTION: Participants received 50 mg/d DHEA or placebo for 6 months; all received calcium and cholecalciferol. Women participated in 90-minute twice-weekly exercise regimens. MEASUREMENTS: Hormone levels, bone mineral density (BMD), bone turnover markers, body composition, upper and lower extremity strength, physical performance. RESULTS: Eighty-seven women (88%) completed 6 months. There were no significant changes in BMD or bone turnover markers. DHEA supplementation resulted in gains in lower extremity strength (from 459 ± 121 N to 484 ± 147 N; P=.01). There was also improvement in Short Physical Performance Battery score, a composite score that focuses on lower extremity function, in those taking DHEA (from 10.1 ± 1.8 to 10.7 ± 1.9; P=.02). There were significant changes in all hormone levels, including DHEAS, estradiol, estrone, and testosterone, and a decline in sex hormone-binding globulin levels in those taking DHEA. CONCLUSION: DHEA supplementation improved lower extremity strength and function in older, frail women involved in a gentle exercise program of chair aerobics or yoga. No changes were found in BMD either due to small sample size, short duration of study or no effect. The physical function findings are promising and require further evaluation as frail women are at high risk for falls and fracture. [source]

The Effect of a High-Intensity Functional Exercise Program on Activities of Daily Living: A Randomized Controlled Trial in Residential Care Facilities

Effectiveness of a Falls-and-Fracture Nurse Coordinator to Reduce Falls: A Randomized, Controlled Trial of At-Risk Older Adults

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2008
(See editorial comments by Dr. Mary Tinetti on pp 156, 1565)
OBJECTIVES: To assess the effectiveness of a community-based falls-and-fracture nurse coordinator and multifactorial intervention in reducing falls in older people. DESIGN: Randomized, controlled trial. SETTING: Screening for previous falls in family practice followed by community-based intervention. PARTICIPANTS: Three hundred twelve community-living people aged 75 and older who had fallen in the previous year. INTERVENTION: Home-based nurse assessment of falls-and-fracture risk factors and home hazards, referral to appropriate community interventions, and strength and balance exercise program. Control group received usual care and social visits. MEASUREMENTS: Primary outcome was rate of falls over 12 months. Secondary outcomes were muscle strength and balance, falls efficacy, activities of daily living, self-reported physical activity level, and quality of life (Medical Outcomes Study 36-item Short Form Questionnaire). RESULTS: Of the 3,434 older adults screened for falls, 312 (9%) from 19 family practices were enrolled and randomized. The average age was 81±5, and 69% (215/312) were women. The incidence rate ratio for falls for the intervention group compared with the control group was 0.96 (95% confidence interval=0.70,1.34). There were no significant differences in secondary outcomes between the two groups. CONCLUSION: This nurse-led intervention was not effective in reducing falls in older people who had fallen previously. Implementation and adherence to the fall-prevention measures was dependent on referral to other health professionals working in their usual clinical practice. This may have limited the effectiveness of the interventions. [source]

Reduction in Fear of Falling Through Intense Tai Chi Exercise Training in Older, Transitionally Frail Adults

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2005
Richard W. Sattin MD
Objectives: To determine whether an intense tai chi exercise program could reduce fear of falling better than a wellness education (WE) program in older adults who had fallen previously and meet criteria for transitioning to frailty. Design: Cluster-randomized, controlled trial of 48 weeks' duration. Setting: Ten matched pairs of congregate living facilities in the greater Atlanta area. Participants: Sample of 291 women and 20 men, aged 70 to 97. Measurements: Activity-related fear of falling using the Activities-Specific Balance Confidence Scale (ABC) and the Fall Efficacy Scale at baseline and every 4 months for 1 year. Demographics, time to first fall and all subsequent falls, functional measures, Centers for Epidemiologic Studies Depression Scale, medication use, level of physical activity, comorbidities, and adherence to interventions. Results: Mean ABC was similar in both cohort groups at the time of randomization but became significantly higher (decreased fear) in the tai chi cohort at 8 months (57.9 vs 49.0, P<.001) and at study end (59.2 vs 47.9, P<.001). After adjusting for covariates, the mean ABC after 12 months of intervention was significantly greater in the tai chi group than in the WE group, with the differences increasing with time (mean difference at 12 months=9.5 points, 95% confidence interval=4.8,14.2, P<.001). Conclusion: Tai chi led to a significantly greater reduction in fear of falling than a WE program in transitionally frail older adults. The mean percentage change in ABC scores widened between tai chi and WE participants over the trial period. Tai chi should be considered in any program designed to reduce falling and fear of falling in transitionally frail older adults. [source]

Weighted Stair Climbing in Mobility-Limited Older People: A Pilot Study

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2002
MD Jonathan Bean MS
OBJECTIVES: To evaluate weighted stair climbing exercise (SCE) as a means of increasing lower extremity muscle power in mobility-limited older people. DESIGN: Single-blinded, randomized controlled pilot study INTERVENTIONS: Subjects were randomized into one of two 12-week exercise programs. The intervention group (SCE) (n = 23) ascended and descended stairs, at a set pace, while wearing a weighted vest. The control group (WALK) (n = 22) participated in a standardized walking program. MEASUREMENTS: Primary and secondary outcomes included measures of muscle power and strength, submaximal aerobic capacity, and physical performance. RESULTS: SCE produced 17% improvement in double leg press peak power in comparison with WALK (P = .013) and significant improvement in stair climbing power from baseline (12%). Improvement in submaximal aerobic performance was equivalent for both groups. Although not statistically significant, effect size estimates suggest that SCE can potentially influence knee extension power and strength. Stair climb time was improved in both groups, whereas SCE produced significant improvements from baseline SPPB score in a subcohort of participants. CONCLUSIONS: These findings suggest that SCE may be a useful component of a home exercise program designed to enhance lower extremity muscle power, aerobic capacity, and functional performance. Further investigation is needed involving larger sample sizes and direct comparisons with other forms of resistance training. [source]

Growth Hormone Administration and Exercise Effects on Muscle Fiber Type and Diameter in Moderately Frail Older People

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 7 2001
James V. Hennessey MD
OBJECTIVE: Reduced muscle mass and strength are characteristic findings of growth hormone deficiency (GHD) and aging. We evaluated measures of muscle strength, muscle fiber type, and cross sectional area in response to treatment with recombinant human growth hormone (rhGH) with or without a structured resistance exercise program in frail older subjects. DESIGN: Placebo-controlled, randomized, double blind trial. SETTING: Outpatient clinical research center at an urban university-affiliated teaching hospital. PARTICIPANTS: Thirty-one consenting older subjects (mean age 71.3 ± 4.5 years) recruited as a subset of a larger project evaluating rhGH and exercise in older people, who underwent 62 quadricep-muscle biopsies. INTERVENTION: Random assignment to a 6-month course of one of four protocols: rhGH administered subcutaneously daily at bedtime, rhGH and a structured resistance exercise program, structured resistance exercise with placebo injections, or placebo injections only. MEASUREMENTS: Muscle biopsy specimens were obtained from the vastus lateralis muscle. Isokinetic dynamometry strength tests were used to monitor individual progress and to adjust the weights used in the exercise program. Serum insulin-like growth factor-I (IGF-I) was measured and body composition was measured using a Hologic QDR 1000W dual X-ray densitometer. RESULTS: The administration of rhGH resulted in significant increase in circulating IGF-I levels in the individuals receiving rhGH treatment. Muscle strength increased significantly in both the rhGH/exercise (+55.6%, P = .0004) as well as the exercise alone (+47.8%, P = .0005) groups. There was a significant increase in the proportion of type 2 fibers between baseline and six months in the combined rhGH treated subjects versus those not receiving rhGH (P = .027). CONCLUSIONS: Our results are encouraging in that they suggest an effect of growth hormone on a specific aging-correlated deficit. IGF-I was increased by administrating rhGH and muscle strength was increased by exercise. The administration of rhGH to frail older individuals in this study resulted in significant changes in the proportions of fiber types. Whether changes in fiber cross-sectional area or absolute number occur with long-term growth hormone administration requires further study. [source]

Examining Implementation Intentions in an Exercise Intervention: The Effects on Adherence and Self-Efficacy in a Naturalistic Setting,

JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 10 2009
Terra C. Murray
Some studies have found positive associations between implementation intentions and exercise, independent of motivational factors. However, most research has not been conducted in actual exercise contexts. In a naturalistic setting, implementation intentions may be associated with self-efficacy (SE) beliefs. This study examined the effect of implementation intentions on adherence and SE over an 11-week exercise program. Women (N = 72) were randomly assigned to an experimental (i.e., implementation intention) or a control group, with 52 participants completing the study. Results showed that while adherence decreased over time in both groups, the experimental group had better adherence than did the control group. Scheduling SE was also higher in the experimental group. Implementation intentions may help to maintain adherence and scheduling SE. [source]

Parent Reactions to a School-Based Body Mass Index Screening Program

JOURNAL OF SCHOOL HEALTH, Issue 5 2009
Suzanne Bennett Johnson PhD
ABSTRACT Background:, This study assessed parent reactions to school-based body mass index (BMI) screening. Methods:, After a K-8 BMI screening program, parents were sent a letter detailing their child's BMI results. Approximately 50 parents were randomly selected for interview from each of 4 child weight,classification groups (overweight, at risk of overweight, normal weight, underweight) to assess parent recall of the letter, reactions to BMI screening, and actions taken in response to the child's BMI results. Results:, Most parents found the BMI screening letter easy to read and had poor recall of numerical information (eg, the child's BMI percentile) but good recall of the child's weight classification (eg, normal weight or overweight). Most parents, and ethnic-minority parents in particular, supported school-based BMI screening. Parents of children whose weight was outside of the normal range were more likely to recall receiving the letter and talking to the child and the child's doctor about it. Parents who recalled their child as being overweight were more likely to report changing the child's diet and activity level. Most parents, and ethnic-minority parents in particular, wanted their child to participate in an after-school exercise program. An overweight condition in parents, but not children, was associated with an interest in family-based cooking and exercise classes. Conclusions:, Most parents, and ethnic-minority parents in particular, viewed school-based BMI screening and after-school exercise programs favorably. Parents reported taking action in response to a BMI result outside of the normal range. Parents who were overweight themselves were particularly interested in family cooking and exercise classes. [source]

Cerebral Palsy: Results of Surgical Releases Augmented with Electrical Stimulation: A Case Study

NEUROMODULATION, Issue 2 2002
James J. McCarthy MD
Abstract The purpose of this case study was to evaluate a patient with diplegic cerebral palsy who underwent soft tissue lengthening augmented with intramuscular electrical stimulation. This is a prospective case study, pre- and post-test design. The patient underwent soft tissue lengthenings of the lower extremities, augmented with placement of intramuscular neuromuscular electrodes. Baseline, 4-, 8-, and 12-month follow-up data were obtained which included range of motion, manual muscle strength testing, motion analysis, oxygen consumption, Gross Motor Function Measure, and Pediatric Evaluation of Disability Inventory. All measured parameters, except knee extensor strength, improved during the postoperative period (baseline to 4-month follow-up) and continued to improve during the rehabilitative period (4,12 month follow-up), despite no formal therapy or home exercise program during this period. We conclude that surgical releases augmented with electrical stimulation resulted in a satisfactory clinic outcome, and may offer a new approach to the treatment of patients with cerebral palsy. [source]

Changes in body composition after a 12-wk aerobic exercise program in obese boys

PEDIATRIC DIABETES, Issue 2 2000
Richard A DeStefano
Previous studies have shown that vigorous aerobic training programs for obese children result in minimal weight changes, and concluded that they may not be beneficial. Weight change alone may not detect important beneficial changes in body composition associated with vigorous training in these children. Fifteen obese boys (aged 9,12 yr, body mass index (BMI) 31.8±6.5, average percent body fat (%BF) 41±4.2) underwent a supervised aerobic and resistance training program (12 wk, 2 days/wk for 30 min/session), to investigate the effects on weight and body composition. After the 3-month training period, weight loss averaged only 1.5±1.0 kg (not significant), but total body fat decreased by 4.1±1.8 kg (p<0.05) and fat-free mass (FFM) increased by 2.6±1.1 kg (p<0.05) based on hydrostatic weighing. As a result, %BF fell by 10% (p<0.01). There was a 5.8±2.8 mL/kg/min (p<0.05) increase in peak volume of oxygen uptake (VO2), along with a 248±120 kcal/d (p<0.05) increase in resting energy expenditure (REE). Activity questionnaires showed a significant increase in high intensity recreational activities (6.5±1.5 vs 3.5±0.5 h physical activity/wk; p<0.01) in the home and a significant decrease in low intensity activities (7±2.0 vs 12±3.5 h TV viewing/wk; p<0.01). Conclusions: Vigorous supervised aerobic training in obese boys has beneficial effects on body composition, fitness and leisure time activities that are not apparent by measurement of changes in body weight alone. [source]

Coronary Risk Factor Management in the Framework of a Community Hospital-Based Ambulatory Exercise Training Program

PREVENTIVE CARDIOLOGY, Issue 2 2004
Morton Leibowitz MD
Ischemic heart disease is a chronic illness that causes major mortality and morbidity. Angiographic studies have shown the effectiveness of exercise programs, in combination with aggressive lipid management, in reversing or slowing the progression of atherosclerotic coronary disease. Despite these studies, participation in supervised programs that combine exercise and risk-factor management is limited. The authors measured the ability of a community hospital-based ambulatory cardiac rehabilitation program to recruit patients and to facilitate reduction of risk factors that have been demonstrated to influence progression of disease. Patients were recruited from a single community hospital for an ambulatory exercise training and cardiac risk-factor management program, and clinical and laboratory data was collected periodically. Recruited patients participated in a minimum 3-month period of training and counseling by a multidisciplinary team with follow-up measurements of weight, lipid profile, blood pressure, and exercise capacity. Thirty-two percent of the eligible hospitalized patients were successfully recruited into the program. Dropout rates over the initial 3 months were low (25%). Improvement in low-density lipoprotein cholesterol level (,4.5%), high-density lipoprotein cholesterol level (+7%), body mass index (,2%), systolic blood pressure (,3%), and maximum metabolic equivalents (+25%) were comparable to levels achieved in studies showing angiographic stabilization and/or regression of disease. Implementation of a community hospital-based risk management exercise program is an effective method for improving the long-term management of patients with chronic ischemic heart disease. [source]

Exercise and quality of life during and after treatment for breast cancer: results of two randomized controlled trials

PSYCHO-ONCOLOGY, Issue 4 2009
Lisa A. Cadmus
Abstract Objective: To determine the effect of exercise on quality of life in (a) a randomized controlled trial of exercise among recently diagnosed breast cancer survivors undergoing adjuvant therapy and (b) a similar trial among post-treatment survivors. Methods: Fifty newly diagnosed breast cancer survivors were recruited through a hospital-based tumor registry and randomized to a 6-month, home-based exercise program (n=25) or a usual care group (n=25). In a separate trial, 75 post-treatment survivors were randomized to a 6-month, supervised exercise intervention (n=37) or to usual care (n=38). Participants in both studies completed measures of happiness, depressive symptoms, anxiety, stress, self-esteem, and quality of life at baseline and 6 months. Results: Forty-five participants completed the trial for newly diagnosed survivors and 67 completed the trial for post-treatment survivors. Good adherence was observed in both studies. Baseline quality of life was similar for both studies on most measures. Exercise was not associated with quality of life benefits in the full sample of either study; however exercise was associated with improved social functioning among post-treatment survivors who reported low social functioning at baseline (p<0.05). Conclusions: Exercise did not affect quality of life in either recently diagnosed or post-treatment breast cancer survivors; however this may be due in part to relatively high baseline functioning among participants in both studies. Strategies for future research include limiting enrollment to survivors who report reduced quality of life on screening questionnaires and targeting survivor subgroups known to be at particular risk for quality of life impairment. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Development, feasibility and efficacy of a community-based exercise training program in pediatric cancer survivors

PSYCHO-ONCOLOGY, Issue 4 2009
Tim Takken
Abstract Objective: The aim of this study was to develop a 12-week exercise training program (comprising aerobic and strength exercises), and to study the feasibility and efficacy of this exercise program in children who survived acute lymphoblastic leukemia. Sample and methods: A 12-week exercise program was developed and tested for feasibility in nine children who survived cancer. Results: From the 16 eligible children for the intervention, 9 participated, while 4 were able to complete the entire program. Feasibility of the program was scored by five children, two of them reported the program as being too demanding. The participating physiotherapists were satisfied with training methodology and training progress. The efficacy of the program on muscle strength, exercise capacity, functional mobility and fatigue showed no significant differences between pre and post training. Conclusion: In designing a community-based exercise training program, not only the stage of the disease needs to be considered, but more so the age of the children, the variety of exercises, the location of implementation and even more importantly the views and motivation of the parents concerning the execution of an exercise training program. A careful balance between these parameters could lead to a greater adherence and by that, to a better outcome of these programs. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Psychological and fitness changes associated with exercise participation among women with breast cancer

PSYCHO-ONCOLOGY, Issue 2 2003
Bernardine M. Pinto
Exercise participation has been shown to improve cardiovascular fitness and reduce psychological distress among women receiving chemotherapy and/or radiation. The purpose of this pilot study was to examine the changes in distress and body image, and fitness following exercise participation among 24 women who had been diagnosed with breast cancer within the previous 3 years. The women were randomly assigned to participate in a 12-week supervised aerobic exercise program in a hospital setting or a wait-list control group. Assessments of distress and body image were conducted at pre- and post-treatment. Data showed that the women in the exercise group improved significantly in body image (Physical Condition and Weight Concerns subscales) vs control group participants at post-treatment. Reductions in distress were also noted in the exercise group, but these were nonsignificant. At post-treatment, there were modest improvements in fitness in the exercise group. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Adherence to walking or stretching, and risk of preeclampsia in sedentary pregnant women,

RESEARCH IN NURSING & HEALTH, Issue 4 2009
SeonAe Yeo
Abstract Pregnant women at risk for preeclampsia may benefit from the positive effects of exercise, but they may be unlikely to adhere to an exercise program. A randomized trial was conducted with 124 sedentary pregnant women to compare the effects of walking exercise to a stretching exercise on adherence and on the preeclampsia risk factors of heart rate (HR), blood pressure, and weight gain. Walkers exercised less than stretchers both overall and as pregnancy advanced. HR and blood pressure were lower among stretchers than walkers, but weight gain did not differ between the groups. For sedentary pregnant women, a stretching exercise may be more effective than walking in mitigating the risk of preeclampsia due to higher adherence and possible cardiac,physiologic effects. © 2009 Wiley Periodicals, Inc. Res Nurs Health 32: 379,390, 2009 [source]

Aerodynamic Changes as a Result of Vocal Function Exercises in Elderly Men

THE LARYNGOSCOPE, Issue 10 2008
Stephen Gorman PhD
Abstract Objectives/Hypothesis: Voice therapy can improve the vocal quality of elderly patients with voice problems, but the changes in vocal aerodynamics associated with physiologic voice therapy are not well documented. The purpose of the present study was to determine the changes in vocal aerodynamics as a result of the management program known as Vocal Function Exercises (VFEs). Study Design: Pre- and post-treatment differences in VFE maximum phonation times (MPT) and measures of vocal aerodynamics were analyzed. Methods: There were 19 participants, aged 60 to 78 years, who performed VFEs twice a day for 12 weeks. Aerodynamic measures of glottal airflow and subglottic pressure were collected at comfortable, high, and low pitches both before the initiation of the exercise program and again at its conclusion. MPT data were collected weekly. Results: The participants showed continuous improvement in VFE MPT across the 12 weeks. Significant differences occurred from pre- to post-therapy on some measures of vocal aerodynamics relating to glottic closure. Conclusions: Decrease in glottic airflow was achieved, with a concomitant increase in subglottic pressure, but without an increase in acoustic power (comfortable and low pitch). Improvement in VFE MPT mirrored the improvement in vocal aerodynamics. [source]

Antenatal exercise and birthweight

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2000
Robin Bell
SUMMARY Does strenuous antenatal exercise reduce birth-weight? Does reducing maternal exercise increase birthweight? What to advise about exercise during pregnancy? We recruited 117 women who intended to exercise 5 or more times weekly during pregnancy to a study of whether reducing the amount of maternal exercise during pregnancy is associated with an increase in birthweight. Only 61/117 (52%) of women agreed to be randomised to either continue or to reduce (to 3 or fewer sessions of exercise weekly) their intended pregnancy exercise program. Most women who refused randomisation did not want to risk being asked to reduce their exercise during pregnancy. Within the randomised trial, there was no statistically significant difference between the mean birthweight of babies born to women who continued and those who reduced their intended exercise program. The high rate of refusal of randomisation limits the power of the study to find a difference in birthweight, limits the generalisability of the results and shows that many women intending to exercise at this level during pregnancy have an uncompromising attitude to exercise. [source]

A Survey of the Emergency Department Population and Their Interest in Preventive Health Education

ACADEMIC EMERGENCY MEDICINE, Issue 2 2003
Ingrid Llovera MD
Abstract Objective: To determine which preventive health information the emergency department (ED) population (patients and visitors) would be most interested in having available to them while they spend time in the waiting area. Methods: This was a prospective survey of consecutive adults seated in the ED waiting area during a representative week on predetermined shifts. The survey asked them to indicate whether they would be interested in obtaining information about the following preventive health issues: breast cancer, prostate cancer, smoking, obesity, stress reduction, exercise programs, alcohol/drugs, HIV, blood pressure screening, immunizations, referrals to primary care physicians, Pap smears, car safety, smoke detectors, domestic and youth violence, depression, gun safety, and safe sex. Results: Of the 1,284 subjects approached, 878 (68%) made up the study group (56% female, mean age = 44 years, 60% white); 406 refused. The information people were most interested in obtaining was the following: 52% of the respondents were interested in referral to stress reduction programs, 51% in information about exercise programs, 42% in blood pressure screening, 40% in information about breast cancer screening, 33% in depression information/screening, 33% in prostate cancer screening, 26% in immunization against pneumococcus, 24% in immunization against tetanus, 26% in smoking cessation programs, and 26% in safe driving information. Women were most interested in breast cancer screening (64%); and men, in prostate cancer screening (55%). Conclusions: Of the 878 subjects in the study group, 96% were interested in obtaining information about one or more preventive health issues. An opportunity exists to respond to this interest by providing material for public health education in the waiting area of EDs. [source]

The effects of exercise during hemodialysis on adequacy

Efficacy and Feasibility of a Novel Tri-Modal Robust Exercise Prescription in a Retirement Community: A Randomized, Controlled Trial

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2007
Michael K. Baker BAppSc
OBJECTIVES: To test the feasibility and efficacy of current guidelines for multimodal exercise programs in older adults. DESIGN: Randomized, controlled trial. SETTING: Retirement village. PARTICIPANTS: Thirty-eight subjects (14 men and 24 women) aged 76.6 ± 6.1. INTERVENTION: A wait list control or 10 weeks of supervised exercise consisting of high-intensity (80% of one-repetition maximum (1RM)) progressive resistance training (PRT) 3 days per week, moderate-intensity (rating of perceived exertion 11 to 14/20) aerobic training 2 days per week, and progressive balance training 1 day per week. MEASUREMENTS: Blinded assessments of dynamic muscle strength (1RM), balance, 6-minute walk, gait velocity, chair stand, stair climb, depressive symptoms, self-efficacy, and habitual physical activity level. RESULTS: Higher baseline strength and psychological well-being were associated with better functional performance. Strength gains over 10 weeks averaged 39±31% in exercise, versus 21±24% in controls (P=.10), with greater improvements in hip flexion (P=.01), hip abduction (P=.02), and chest press (P=.04) in the exercise group. Strength adaptations were greatest in exercises in which the intended continuous progressive overload was achieved. Stair climb power (12.3±15%, P=.002) and chair stand time (,7.1±15%, P=.006) improved significantly and similarly in both groups. Reduction in depressive symptoms was significantly related to compliance (attendance rate r=,0.568, P=.009, PRT progression in loading r=,0.587, P=.02, and total volume of aerobic training r=,0.541, P=.01), as well as improvements in muscle strength (r=,0.498, P=.002). CONCLUSION: Robust physical and psychological adaptations to exercise are linked, although volumes and intensities of multiple exercise modalities sufficient to cause significant adaptation appear difficult to prescribe and adhere to simultaneously in older adults. [source]

Exercise Training as a Therapy for Chronic Heart Failure: Can Older People Benefit?

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2003
Miles D. Witham BM
Despite recent advances in pharmacological therapy, chronic heart failure remains a major cause of morbidity and mortality in older people. Studies of exercise training in younger, carefully selected patients with heart failure have shown improvements in symptoms and exercise capacity and in many pathophysiological aspects of heart failure, including skeletal myopathy, ergoreceptor function, heart rate variability, endothelial function, and cytokine expression. Data on mortality and hospitalization are lacking, and effects on everyday activity, depression, and quality of life are unclear. Exercise therapy for patients with heart failure appears to be safe and has the potential to improve function and quality of life in older people with heart failure. To realize these potential benefits, exercise programs that are suitable for older, frail people need to be established and tested in an older, frail, unselected population with comorbidities. [source]