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Exercise Programme (exercise + programme)
Selected AbstractsThe Specificity of Self-Efficacy over the Course of a Progressive Exercise ProgrammeAPPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 2 2009Wendy M. Rodgers Regular physical exercise is an important health-promoting behaviour. Self-efficacy has been demonstrated to be a robust predictor of health behaviour in general and physical activity in particular. Two studies are reported where the change in task self-efficacy, scheduling self-efficacy, and coping self-efficacy for two types of physical activity (walking or traditional fitness activity) was examined over time in a progressive exercise programme. A progressive programme increases in intensity and duration over the course of the study. A sample of 115 people completed a 6-month activity trial where they were assigned to a walking group, a traditional exercise group, or no activity control group. Repeated measures MANOVAs for each type of self-efficacy revealed quadratic patterns of change that were specific to the type of exercise engaged in. The results suggest that self-efficacy is behaviour specific and can be expected to be responsive to overt experiences with specific exercise modalities. Results also suggest that additional support might be necessary as late as 3 months into the programme to maintain levels of exercise consistent with public health guidelines. [source] Comprehensive elements of a physiotherapy exercise programme in haemophilia , a global perspectiveHAEMOPHILIA, Issue 2010G. BLAMEY Summary., Exercise programmes for people with haemophilia are usually designed and implemented to help manage the recovery after a haemarthrosis or a muscle bleed, or as a tool to help prevent bleeding episodes from occurring. In this article, we have identified individual components of exercise that are often applied as separate entities, but may also need to be implemented in concert for optimized impact. Although it may be necessary on occasion to bias an exercise programme towards one component over the others, it is important to recognize that the various elements of exercise are not mutually exclusive. Decreased flexibility, strength and proprioception, will result in an impairment of balance and a loss of function. Programme design should whenever possible be guided by proven methodology in terms of how each component is incorporated, and more specifically how long to perform the exercise for and how many repetitions should be performed. We recognize, however, that this is not always possible and that there is significant value in drawing from the experience of clinicians with specialized training in the management of haemophilia. In this study, both perspectives are presented, providing reference-based reviews of the mechanics of the various elements of exercise as well as the expert opinions of the authors. Research that has been completed using patients with conditions other than haemophilia may or may not have a direct application with the bleeding disorders population, but the programme design based on principles of tissue healing in addition to disease specific knowledge should be encouraged. [source] Effects of physical exercise versus rosiglitazone on endothelial function in coronary artery disease patients with prediabetesDIABETES OBESITY & METABOLISM, Issue 9 2010S. Desch We conducted a three-arm, parallel-group, randomized, controlled trial to compare the effects of rosiglitazone and physical exercise on endothelial function in patients with coronary artery disease and impaired fasting glucose or impaired glucose tolerance over a 6-month period. Group A received rosiglitazone tablets 8 mg daily (n = 16), group B underwent a structured physical exercise programme (n = 15) and group C served as a control group (n = 12). At baseline and after 6 months, brachial artery ultrasound imaging was performed to assess reactive flow-mediated dilation (FMD). Rosiglitazone treatment and exercise both led to significant improvements in insulin resistance at 6 months, whereas no change was observed in control patients. FMD improved significantly in physical exercise patients, whereas no change could be observed in patients receiving rosiglitazone or in the control group. Between-group comparisons also showed a significant relative improvement in FMD in exercise patients compared with rosiglitazone. [source] Changes in serum leptin concentrations in overweight Japanese men after exerciseDIABETES OBESITY & METABOLISM, Issue 5 2004N. Miyatake Aim:, To investigate the link between serum leptin concentrations and exercise. Design:, Cross-sectional and longitudinal studies of an exercise intervention. Subjects:, 110 Japanese overweight men aged 32,59 years were recruited. At baseline, the average body mass index (BMI) was 28.5 ± 2.5 kg/m2. From this group, we used data of 36 overweight men (BMI, 28.9 ± 2.3) for a 1-year exercise programme. Measurements:, Leptin was measured at baseline and after 1 year. Fat distribution was evaluated by visceral fat (V) and subcutaneous fat (S) areas measured with computed tomography (CT) scanning at umbilical levels. Anthropometric parameters, aerobic exercise level, muscle strength and flexibility were also investigated at baseline and after 1 year. Results:, In the first analysis, using cross-sectional data, leptin was significantly correlated with total body fat (r = 0.760, p < 0.01), V (r = 0.383, p < 0.01) and S (r = 0.617, p < 0.01) areas. In the second analysis, using longitudinal data, leptin was significantly reduced after 1 year (pre 6.7 ± 4.0 ng/ml vs. post 5.1 ± 3.1 ng/ml, p < 0.01). Results showed that steps per day were increased, and aerobic exercise level, weight-bearing index (WBI) and insulin resistance were significantly improved. Although, there was a positive correlation between , leptin(positive changes in leptin after 1 year) and anthropometric measurements such as , body weight, , BMI and , body fat, leptin/body weight, leptin/BMI and leptin/body fat ratios were significantly reduced during exercise intervention. Conclusion:, The present study indicated exercise significantly lowers serum leptin concentrations, and thus it may improve the leptin resistance observed in overweight Japanese men. [source] The vitamin D receptor gene variant and physical activity predicts fasting glucose levels in healthy young menDIABETIC MEDICINE, Issue 6 2003J. R. Ortlepp Abstract Aims Vitamin D can influence lipolysis and insulin secretion. A common genetic polymorphism of the vitamin D receptor (VDR), which has been found to be associated with bone mineral density, has been reported to be also associated with Type 2 diabetes mellitus (DM). To test the influence of the VDR polymorphism on fasting glucose in healthy young men before the onset of Type 2 DM, we studied a homogeneous population of aircrew members. Methods A total of 1539 individuals were recruited during routine medical qualification for flying duty. Physical activity was assessed in all individuals and categorized into low physical activity (, 3 h per week) and high physical activity (> 3 h per week). The BsmI VDR polymorphism was analysed by polymerase chain reaction. On the day of blood testing the individuals were fasting for at least 8 h overnight. Serum glucose was measured within 60 min after sampling venous blood. Results In young males with low physical activity (n = 752) gene carriers with the VDR genotype BB (n = 137) have significantly (P < 0.001) higher levels of fasting glucose (5.61 ± 0.49 mmol/l) than gene carriers with the genotype Bb (n = 370; 5.44 ± 0.44 mmol/l) or bb (n = 245; 5.38 ± 0.44 mmol/l). Of BB gene carriers, 47% had fasting glucose levels > 5.55 mmol/l compared with 36% of Bb gene carriers and 34% of bb gene carriers (P = 0.018). This effect is absent in gene carriers with high physical activity (n = 787). Conclusions The VDR genotype is associated with altered fasting glucose levels in young men with low physical activity. If this association is confirmed in other populations it might be worthwhile studying the particular benefits of an exercise programme in dependents of the VDR genotype. Diabet. Med. 20, 451,454 (2003) [source] Follow-up of an exercise-based treatment for children with reading difficultiesDYSLEXIA, Issue 2 2007David Reynolds Abstract This study reports the results of a long-term follow-up of an exercise-based approach to dyslexia-related disorders (Reynolds, Nicolson, & Hambly, Dyslexia, 2003; 9(1): 48,71). In the initial study, children at risk of dyslexia were identified in 3 years of a junior school. One half then undertook a 6 month, home-based exercise programme. Evaluation after 6 months indicated that the exercise group improved significantly more than the controls on a range of cognitive and motor skills. Critics had suggested that the improvement might be attributable to artifactual issues including Hawthorne effects; an initial literacy imbalance between the groups; and inclusion of non-dyslexic participants. The present study evaluated the issue of whether the gains were maintained over the following 18 months, and whether they were in some sense artifactual as postulated by critics of the original study. Comparison of (age-adjusted) initial and follow-up performance indicated significant gains in motor skill, speech/language fluency, phonology, and working memory. Both dyslexic and non-dyslexic low achieving children benefited. There was also a highly significant reduction in the incidence of symptoms of inattention. Interestingly there were no significant changes in speeded tests of reading and spelling, but there was a significant improvement in (age-adjusted) reading (NFER). It is concluded that the gains were indeed long-lasting, and that the alternative hypotheses based on potential artifacts were untenable, and that the exercise treatment therefore achieved its applied purpose. Further research is needed to determine the underlying reasons for the benefits. Possible (and potentially synergistic) explanations include: improved cerebellar function (neural level); improved learning ability and/or attentional ability (cognitive level); improved self-esteem and self-efficacy (affective level); and improved parental/familial support (social level). Copyright © 2006 John Wiley & Sons, Ltd. [source] Tiludronate infusion in the treatment of bone spavin: A double blind placebo-controlled trialEQUINE VETERINARY JOURNAL, Issue 5 2010M. R. GOUGH Summary Reasons for performing study: Tiludronate regulates bone remodelling through a decrease of the resorptive process and should therefore ameliorate the remodelling processes active in osteoarthritis of the distal tarsal joints (,bone spavin') and alleviate pain associated with abnormal bone lysis. Objective: To confirm the efficacy of tiludronate, administered as a single infusion at a dose of 1 mg/kg bwt, in the treatment of bone spavin in the horse. Methods: A double blind placebo controlled trial on 108 clinical cases of bone spavin was undertaken. The lameness score of the lamest limb was assessed following distal tarsal analgesia of the contralateral limb and followed-up using the same procedure throughout the study. Bone spavin in the lamest limb was confirmed by distal tarsal analgesia and radiography. Horses were treated at Day 0 and reassessed 60 days later after controlled exercise. A second nonblinded treatment was given to unresponsive horses and all horses were re-examined at Day 120. Exercise levels were recorded at each examination. Results: Eighty-seven horses completed the trial as per the protocol. The tiludronate horses were significantly less lame than the placebo horses (P = 0.0318). Horses treated at Day 60 with tiludronate showed further improvement in lameness at Day 120 (P = 0.0096 and P = 0.0034 for horses treated with tiludronate and placebo at Day 0, respectively). The only significant difference in radiographic findings between tiludronate and placebo was for presence of periarticular osteophytes (P = 0.006). Conclusions: Tiludronate treatment is proven to be effective in bone spavin in horses in association with a controlled exercise programme. Clinical relevance: Tiludronate in combination with controlled exercise offers an alternate medical treatment for bone spavin. [source] Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horseEQUINE VETERINARY JOURNAL, Issue 4 2004O. M. CROWE Summary Reasons for performing study: Proximal suspensory desmitis (PSD) is diagnosed with increasing frequency in horses and radial pressure wave therapy (RPWT) is a widely used therapy for painful orthopaedic conditions in man and dogs. There are, however, few published data as to the outcome of its use in PSD. Objective: To evaluate the use of RPWT in the treatment of chronic or recurrent PSD in the horse, an injury which carries a poor prognosis for return to athletic function with conservative management alone. Hypothesis: RPWT and controlled exercise improves the prognosis of chronic or recurrent PSD in the horse when compared to previously published results of controlled exercise alone. Methods: The use of RPWT in the management of chronic or recurrent proximal suspensory desmitis (PSD) was evaluated in 65 horses. Diagnosis was based on response to local analgesia, ultrasonography and radiography. Horses were classified according to severity of ultrasonographic lesions, whether fore- or hindlimbs were affected, and duration of lameness prior to diagnosis. Horses were treated 3 times at 2-week intervals and followed a controlled exercise programme; they were reassessed clinically and ultrasonographically 10,12 weeks after diagnosis, when further exercise recommendations were made dependent upon the animal's progress. Results: Forty-one percent of horses with hindlimb lameness and 53% with forelimb lameness were nonlame and returned to full work 6 months after diagnosis. The prognosis was significantly affected by the ultrasonographic grade at the time of diagnosis and by ultrasonographic evidence of resolution of the lesion in hindlimb cases. Conclusions: These findings, when compared to previously published results of treatment using controlled exercise alone, suggest that RPWT improves the prognosis for PSD in the hindlimb. Potential relevance: RPWT is a useful treatment modality for chronic or recurrent PSD when combined with controlled exercise. Further studies are required on the effect of RPWT employing histology and biomechanics in order to fully evaluate its use on equine tissues. [source] Feasibility of an exercise rehabilitation programme for cancer patientsEUROPEAN JOURNAL OF CANCER CARE, Issue 4 2006C. STEVINSON bsc, research fellow A growing body of evidence indicates the benefits of exercise as a rehabilitation intervention for cancer patients. However, few hospitals offer exercise-based rehabilitation programmes to patients. This study evaluated the feasibility and acceptability of a group-based exercise programme for cancer patients attending a local oncology centre. The intervention consisted of a weekly instructor-led circuit training class supplemented by home-based activity 4 days/week for 10 weeks. From 28 eligible patients, 12 were recruited (43%), of whom nine completed the intervention (75%). The three withdrawals were due to worsening of disease. Adherence (mean of 7.5 classes attended and 4 days/week of home activity performed) and tolerability (no adverse events) were good. Positive features of the programme identified in interviews with participants included the variety and scope of the exercises, and the empathetic but positive approach of the instructors. The small group format was highly valued with participants receiving social support and inspiration from each other. Perceived outcomes included improved fitness, reduced fatigue, enjoyment, enhanced mood and a sense of achievement. Several participants felt that the intervention represented a stepping stone to becoming habitual exercisers. Results suggested that the programme was feasible and acceptable to patients, but uptake was low, indicating a need for more effective recruitment strategies in order for a cost-effective service to be implemented. [source] Comprehensive elements of a physiotherapy exercise programme in haemophilia , a global perspectiveHAEMOPHILIA, Issue 2010G. BLAMEY Summary., Exercise programmes for people with haemophilia are usually designed and implemented to help manage the recovery after a haemarthrosis or a muscle bleed, or as a tool to help prevent bleeding episodes from occurring. In this article, we have identified individual components of exercise that are often applied as separate entities, but may also need to be implemented in concert for optimized impact. Although it may be necessary on occasion to bias an exercise programme towards one component over the others, it is important to recognize that the various elements of exercise are not mutually exclusive. Decreased flexibility, strength and proprioception, will result in an impairment of balance and a loss of function. Programme design should whenever possible be guided by proven methodology in terms of how each component is incorporated, and more specifically how long to perform the exercise for and how many repetitions should be performed. We recognize, however, that this is not always possible and that there is significant value in drawing from the experience of clinicians with specialized training in the management of haemophilia. In this study, both perspectives are presented, providing reference-based reviews of the mechanics of the various elements of exercise as well as the expert opinions of the authors. Research that has been completed using patients with conditions other than haemophilia may or may not have a direct application with the bleeding disorders population, but the programme design based on principles of tissue healing in addition to disease specific knowledge should be encouraged. [source] Promising outcomes of an adolescent chronic fatigue syndrome inpatient programmeJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 5 2009Brett Gordon Introduction: Chronic fatigue syndrome (CFS) is a condition of prolonged and disabling fatigue, which is accompanied by characteristic constitutional and neuropsychiatric symptoms. In children and adolescents, this condition occurring at a developmentally vulnerable time adds to the disability affecting self-concept, autonomy, body image, socialisation, sexuality and academic problems. This case series looks at the effects of a graded exercise programme on physical outcomes, fatigue and mental state in an adolescent population. Methods: Data sets from 16 adolescents who completed combined exercise training as part of the 4-week inpatient intensive CFS programme at the Austin Hospital, Melbourne were analysed. All patients completed an exercise assessment and three questionnaires before beginning any training. A paediatrician (LL) confirmed the diagnosis according to the Fukuda criteria in all patients. Exercise was carefully supervised and prescribed daily by an exercise physiologist (BG) according to each individual's ability and response with the basic aim of increasing exercise tolerance and improving muscle strength and endurance. Results: There was an 18% improvement in volitional time to fatigue (P= 0.02) and 17% improvement in peak oxygen uptake (VO2peak) (P= 0.01). Upper body strength and function improved with a remarkable 70% increase in the number of push-ups. Fatigue severity was reported to improve by 13% (P= 0.01) and depression index improved significantly by 42% (P= 0.02). Conclusions: The significance of these improvements cannot be underestimated as an improvement in physical capacity through increased time to fatigue and less severe fatigue allows adolescents to resume school, social and family activities. [source] A prospective pilot study of a multidisciplinary home training programme for lateral epicondylitisMUSCULOSKELETAL CARE, Issue 1 2007Pia Nilsson PTR Abstract Objective:,To evaluate a new multidisciplinary structured home training programme for patients with lateral epicondylitis compared to conventional attendance. Design:,This study utilized a prospective non-randomized design to compare the effect of a home exercise programme against a pragmatic approach to managing patients with lateral epicondylitis in a primary care setting in Sweden. Subjects:,A total of 78 patients, presenting to their general practitioner with lateral epicondylitis were recruited from two separate geographical areas. The patients were divided into two group, 51 entered the intervention group and 27 entered the control group. Methods:,The intervention group was treated with a specific home training programme, ergonomic advice and when necessary wrist and/or night bandages. The control group was treated with conventional treatment, e.g. corticosteroid injections, stretching or no intervention. Pain and function were evaluated by the PRFEQ. An electronic hand-power gauge measured strength and stamina. Sick-leave absence was collected via the regional Social Insurance Office. Results:,After four weeks the intervention group experienced less sick-leave, less pain, better function and returned to work earlier than the control group. After 16 weeks the intervention group still had significantly better function than the control group and were taking less sick-leave. Pain decreased more in the intervention group but this was not significant. There was no difference in grip strength between the two groups. Conclusion:,A structured home training programme can improve function and reduce sick leave in patients with lateral epicondylitis. Copyright © 2006 John Wiley & Sons, Ltd. [source] Physiotherapy rehabilitation in patients with massive, irreparable rotator cuff tearsMUSCULOSKELETAL CARE, Issue 3 2006Roberta Ainsworth FSCP SRP MSc BA (Hons) Abstract Background:,Massive rotator cuff tears provide a challenge for effective rehabilitation. Work has been ongoing at Torbay Hospital, Devon since 2000 to develop an exercise programme for the management of this patient group. This programme has been evaluated in a pilot study and a further randomised controlled trial is currently taking place which will enable us to estimate the treatment effect. This paper discusses the background to the development of the rehabilitation programme, the programme itself and the results of the pilot study. The pilot study was an evaluation of the rehabilitation programme. Objectives:,This study examined the effectiveness of a physiotherapy regime for the treatment of patients with massive rotator cuff tears. Methods: Patients identified through primary and secondary care referrals to physiotherapy with a clinical diagnosis of a massive rotator cuff tear underwent an ultrasound scan to confirm the diagnosis. A massive cuff tear was one where the leading edge of the tear had retracted past the glenoid margin. The clinical diagnosis was based on the presence of some or all of the following signs: positive humeral thrust on elevation, gross weakness and wasting of supraspinatus and infraspinatus, infraspinatus lag and rupture of the long head of biceps. Eligible patients were invited to take part in the study and informed consent was obtained. The baseline assessment was carried out and then the patient undertook the treatment programme. Outcome measures were reassessed 12 weeks from the baseline assessment. Design:,A cohort study of 10 patients evaluating the change from baseline to twelve weeks in the shoulder function of patients undergoing a programme of anterior deltoid strengthening and functional rehabilitation. The outcome measures used were the Oxford Shoulder Disability Questionnaire (OSDQ) and SF36. The OSDQ is validated for use with the UK population and has 12 questions with 5 point responses. The lowest (best) score is 12 and the highest (worse) score is 60. Results: Scores on the OSDQ improved with all patients. The mean improvement was 9 (range 3 to 16, standard deviation 10.3). The SF36 showed an improvement in the pain scores for all patients (mean 22 points) and an overall improvement of 10 points for the sections on role limitation due to physical health. There was an overall decline in perceived general health (9 points) and in role limitation due to emotional health (23 points). Conclusions:,As all 10 patients showed improved scores on the OSDQ, in spite of the long-standing nature of many of their shoulder problems, this rehabilitation programme was shown to improve shoulder function in this group of patients. The variation shown in the quality of life scores reflects the age group of this cohort who had a mean age of 75.5 years. All patients deemed their pain and function to have improved over the three-month period. [source] Does the addition of non-invasive ventilation during pulmonary rehabilitation in patients with chronic obstructive pulmonary disease augment patient outcome in exercise tolerance?PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2010A literature review Abstract Background.,Non-invasive ventilation (NIV) during exercise in patients with chronic obstructive pulmonary disease (COPD) has been shown to increase exercise time and intensity. Feasibly then, NIV during pulmonary rehabilitation will enhance post-rehabilitation training effects. The purpose of this review is to systematically consider and critique the literature concerning the effects of NIV, when used during an exercise programme in COPD patients on exercise tolerance.,Method.,An electronic literature search was completed and the reference lists of the articles that fitted the following inclusion criteria were screened. Studies that used any mode of NIV during an exercise programme with a primary outcome measure focusing on exercise tolerance and were written after the year 2000 to reflect current practice. Studies that were not written in English or had been included in previous literature reviews were excluded. The studies were then critically appraised and assigned a level of evidence based upon Scottish Intercollegiate Guidelines Network.,Results.,Twenty-eight articles were screened, of which six fitted the inclusion criteria. The methodological quality ranged from level 1, to 1+. All but one study by Bianchi et al. (2002) demonstrated a statistically significant improvement in exercise tolerance with the addition of some form of NIV during pulmonary rehabilitation. The benefits may be greater in patients with more severe airway obstruction as determined by Forced Expiration Volume (FEV), (%pred).,Conclusion.,This review would suggest that NIV may allow an increased exercise intensity and duration during pulmonary rehabilitation in patients with moderate to very severe COPD, (according to the American Thoracic Society guidelines), resulting in a greater training effect and a prolonged exercise capacity. Further research looking at long-term follow-up is recommended. Copyright © 2009 John Wiley & Sons, Ltd. [source] The effectiveness of a pre-operative home-based physiotherapy programme for chronic anterior cruciate ligament deficiencyPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 4 2006SL Keays Abstract Background and Purpose.,Little evidence supports the prescription of pre-operative rehabilitation in the treatment of chronic anterior cruciate ligament-deficient (ACLD) subjects. The aim of the present study was to assess the effectiveness of a specific six-week pre-operative exercise programme on ACLD knees.,Method.,A single, masked, controlled study was designed. This comprised two matched groups of 12 chronically ACLD patients awaiting reconstruction and a group of 12 matched uninjured control subjects. Only one ACLD group received a home-based exercise and educational programme. Assessment before and after the exercise intervention included: knee joint stability (clinical and KT1000 evaluation); muscle strength (Cybex II); standing balance and functional performance (agility, hop and subjective tests).,Results.,At the time of initial assessment there were no statistically significant differences in any measures for the two ACLD groups but both ACLD groups were significantly different from the uninjured control group as regards quadriceps strength and function. Measures taken after six weeks showed no significant improvement in the untreated ACLD group or in the uninjured control group The treated ACLD group showed significant improvement in the following measures: quadriceps strength measured at 60° and 120° per second (p < 0.001); single leg standing balance with eyes closed (p < 0.001); instrumented passive stability at 20,lb (89N) force (p = 0.003); agility and subjective performance (p < 0.001). The incidence of unstable episodes had decreased in the treated ACLD group, reducing further damage to the joint.,Conclusion.,This study leaves little doubt that pre-operative physiotherapy had a positive effect on motor function in ACLD subjects and should be prescribed routinely to maximize muscle stabilizing potential prior to reconstruction. Patients report improved stability and, in certain cases, may avoid surgery. The finding that exercise increased the passive stability of the joint was unexpected and requires further investigation. Copyright © 2006 John Wiley & Sons, Ltd. [source] Exercises and education as secondary prevention for recurrent low back painPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2001Margret Grotle Soukup Abstract Background and Purpose Exercise and education is a common physiotherapy approach in the prevention of low back pain. A Mensendieck exercise programme consisting of exercises and ergonomical education has, in a previous study, been shown to be effective in preventing recurrent low back pain during one-year follow-up. The purpose of the present study was to evaluate the long-term effect of the Mensendieck exercise programme on people with recurrent episodes of low back pain who, when entering the study, had finished treatment for their last episode of low back pain. Method A randomized controlled clinical trial in which 41 women and 36 men were allocated to either a Mensendieck or control group. The Mensendieck subjects received 20 group sessions of exercises and ergonomical education over 13 weeks. The control subjects were not offered any prophylactic therapy, but were free to receive treatment or exercises. Outcome measures were the number of recurrences of low back pain, sick leave, low back function and general functional status. Results At three-year follow-up, 11 subjects had been lost to the study. Survival analysis showed a significant reduction (p=0.02) in subjects experiencing recurrent low back pain in the Mensendieck group compared to the control group. Significant improvements in pain and function scores were reported in both groups. There was no significant difference between the groups in pain, function or sick leave. Conclusion A Mensendieck exercise programme seems efficient in reducing recurrent episodes of low back pain at three-year follow-up, but it did not influence sick leave, pain or function scores. Copyright © 2001 Whurr Publishers Ltd. [source] The Specificity of Self-Efficacy over the Course of a Progressive Exercise ProgrammeAPPLIED PSYCHOLOGY: HEALTH AND WELL-BEING, Issue 2 2009Wendy M. Rodgers Regular physical exercise is an important health-promoting behaviour. Self-efficacy has been demonstrated to be a robust predictor of health behaviour in general and physical activity in particular. Two studies are reported where the change in task self-efficacy, scheduling self-efficacy, and coping self-efficacy for two types of physical activity (walking or traditional fitness activity) was examined over time in a progressive exercise programme. A progressive programme increases in intensity and duration over the course of the study. A sample of 115 people completed a 6-month activity trial where they were assigned to a walking group, a traditional exercise group, or no activity control group. Repeated measures MANOVAs for each type of self-efficacy revealed quadratic patterns of change that were specific to the type of exercise engaged in. The results suggest that self-efficacy is behaviour specific and can be expected to be responsive to overt experiences with specific exercise modalities. Results also suggest that additional support might be necessary as late as 3 months into the programme to maintain levels of exercise consistent with public health guidelines. [source] Influence of muscle training on resting blood flow and forearm vessel diameter in patients with chronic renal failure,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2010S. Kumar Background: Blood flow and vessel diameter are predictors of the success of vascular access procedures. This study investigated whether a simple exercise programme could influence these variables. Methods: Twenty-three patients with chronic kidney disease were prescribed a simple exercise programme for one arm only; the investigators were blinded to the patients' choice. All underwent arterial and venous duplex imaging, handgrip strength and blood pressure measurements before and 1 month after the exercise programme. Results: Twelve patients exercised their dominant and 11 their non-dominant arm. In the trained arm, the exercise programme resulted in a significant increase in handgrip strength, by a median (interquartile range) of 4 (0,8) kg (P < 0·001), and in the diameter of the brachial artery (0·2 (0·1,0·3) mm; P < 0·001), radial artery (0·3 (0·2,0·4) mm; P < 0·001), and cephalic vein (0·6 (0·4,1·2) mm in the forearm and 1·1 (0·4,1·2) mm above the elbow; P < 0·001). There was an increase in brachial artery mean velocity (3 (1,7) cm/s; P = 0·009) and peak systolic velocity (8 (1,15) cm/s; P = 0·020), despite a marginally lower systolic blood pressure (,8 (,16 to 0) mmHg; P = 0·007). There was no change in any of these parameters in the non-exercised arm. Conclusion: In patients with chronic kidney disease, forearm exercise increased blood flow and vessel diameters. This may be beneficial before vascular access formation. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Effectiveness of exercise programmes on shoulder mobility and lymphoedema after axillary lymph node dissection for breast cancer: systematic reviewJOURNAL OF ADVANCED NURSING, Issue 9 2010Dorothy N.S. Chan chan d.n.s., lui l.y.y. & so w.k.w. (2010) Effectiveness of exercise programmes on shoulder mobility and lymphoedema after axillary lymph node dissection for breast cancer: systematic review. Journal of Advanced Nursing,66(9), 1902,1914. Abstract Aim., This article is a report of a review of the effectiveness of exercise programmes on shoulder mobility and lymphoedema in postoperative patients with breast cancer having axillary lymph node dissection, as revealed by randomized controlled trials. Background., Breast cancer is the most common malignancy in women. After surgery, the most common postoperative complications are reduced range of motion in the shoulder, muscle weakness in the upper extremities, lymphoedema, pain and numbness. To reduce these impairments, shoulder exercises are usually prescribed. However, conflicting results regarding the effect and timing of such exercises have been reported. Data sources., Studies were retrieved from a systematic search of published works over the period 2000,2009 indexed in the Cumulative Index to Nursing and Allied Health Literature, Ovid Medline, the British Nursing Index, Proquest, Science Direct, Pubmed, Scopus and the Cochrane Library, using the combined search terms ,breast cancer', ,breast cancer surgery', ,exercise', ,lymphoedema', ,shoulder mobility' and ,randomized controlled trials'. Methods., A quantitative review of effectiveness was carried out. Studies were critically appraised by three independent reviewers, and categorized according to levels of evidence defined by the Joanna Briggs Institute. Results., Six studies were included in the review. Early rather than delayed onset of training did not affect the incidence of postoperative lymphoedema, but early introduction of exercises was valuable in avoiding deterioration in range of shoulder motion. Conclusion., Further studies are required to investigate the optimal time for starting arm exercises after this surgery. Nurses have an important role in educating and encouraging patients to practise these exercises to speed up recovery. [source] Exercise parameters in the treatment of clinical depression: a systematic review of randomized controlled trialsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2010Luke G. Perraton BPT MPT Abstract Rationale, aims and objectives, Previous systematic reviews have concluded that exercise programmes are effective in the management of clinical depression. The aim of this review was to analyse the parameters of exercise programmes reported in the primary research, in order to provide clinicians with evidence-based recommendations for exercise prescription for clinical depression. Methods, A systematic review of randomized controlled trials was undertaken. Only trials that reported exercise to be effective in treating depression were included and our review was limited to adults. Appropriate databases and reference lists were searched using established keywords. Data relating to the type, intensity, frequency, duration, mode of exercise and mode of application of exercise was extracted and collated. Results, A total of 14 randomized controlled trials were included in this review and from these trials 20 intervention arms were analysed. The majority of trials used an aerobic exercise intervention and were supervised. The most common exercise parameters were 60,80% of maximum heart rate for 30 minutes three times per week for an overall duration of 8 weeks. There is an equal volume of evidence supporting group as opposed to individually completed exercise programmes and no trends were identified which would support one mode of exercise over another. Conclusions, Currently the primary research on this topic supports the use of aerobic exercise which is supervised in some capacity. The current evidence base supports a prescription of three 30-minute sessions per week of aerobic exercise at 60,80% of maximum heart rate for at least 8 weeks. [source] The Treatment of Cognitive Impairment Associated with Parkinson's DiseaseBRAIN PATHOLOGY, Issue 3 2010David J. Burn FRCP Abstract Cognitive impairment and dementia associated with Parkinson's disease (PD) are common and often have devastating effects upon the patient and their family. Early cognitive impairment in PD is frequent, and the functional impact may be underestimated. Optimal management will rely upon better identification of the predominant symptoms and greater knowledge of their pathophysiological basis. The management of dementia in PD (PD-D) also has to consider the significant neuropsychiatric burden that frequently accompanies the cognitive decline, as well as fluctuations in attention. Atypical anti-psychotics have a limited role at present in treating PD-D, although new drugs are under development. The mainstay of drug management for people with PD-D is cholinesterase inhibitors, although recent trials have suggested that the N-methyl-D aspartate antagonist memantine may also have some benefit. Disease modification remains the ultimate goal for preventing the inexorable decline in PD-D, although effective interventions are still some way off. Limited benefit may, however, be possible through exercise programmes and so-called "medical foods", although randomised trials are required to confirm largely anecdotal observations. [source] Assessment of quality of life in adults receiving long-term growth hormone replacement compared to control subjectsCLINICAL ENDOCRINOLOGY, Issue 1 2003I. A. Malik Summary objective There are few studies of quality of life (QOL) in adults with growth hormone deficiency (GHD) compared to matched control populations without GHD. These have shown impairments in a variety of QOL measures, which improve but do not normalize after short-term replacement with GH. There is little information on QOL in long-term treated GHD patients compared with controls without GHD. patients and methods A total of 120 adults with GHD who had received GH replacement for at least 1 year were identified from the neuroendocrine clinic. Patients were asked to complete eight QOL questionnaires and an Energy Visual Analogue Scale (VAS). Results were compared with 83 control subjects without GHD from the local population who agreed to complete seven of the QOL questionnaires (excluding Disease Impact scale) and the energy VAS. The eight questionnaires were a combination of generic and disease-specific questionnaires used to assess health related QOL, namely: Short Form-36 (SF-36), Nottingham Health Profile (NHP), Disease Impact, Life Fulfilment and Satisfaction scales, Mental Fatigue Questionnaire (MFQ) and Self Esteem scale, Hospital Anxiety Depression (HAD) scale and QOL-AGHDA (assessment of GHD in adults). results Eighty-nine patients returned questionnaires and 85 (71%) had complete data for analysis. The mean (SD) duration of GH replacement was 36·0 ± 26·4 (range 13,159) months. Mean age was 43·9 ± 15·8 years (37 males) in treated GHD patients compared to a mean age 41·7 ± 10·5 years (32 males) in the controls. Mean IGF-1 levels were 22·5 ± 13·6 nmol/l in the GHD patients and the mean dose of GH replacement was 1·2 ± 0·4 IU daily. Analysis of the QOL questionnaires from the GH treated patients revealed highly significant impairments in all measures (most P , 0·0001, except life fulfilment-material, P = 0·33) compared to the control population. conclusions This large population with treated GH deficiency have significant impairments in multiple aspects of QOL despite replacement with GH and other pituitary hormones for at least 1 year (mean 3 years). It is likely therefore that other factors in addition to GH deficiency must influence QOL in these patients. Further strategies to improve QOL in these individuals should therefore be considered, e.g. psychological support and treatments and physical treatments (such as exercise programmes). [source] | |||||||||||||||||||||||||