Search

This is an accepted manuscript of an article published by Lippincott, Williams & Wilkins in Strength and Conditioning Journal (in press). The accepted version of the publication may differ from the final published version.

BACKGROUND AND PURPOSE Because of its high prevalence and association with negative health-related outcomes, frailty is considered one of the most important issues associated with human aging and its mitigation is among the essential public health goals for the 21st century. However, very few studies have focused on institutionalized older adults, despite the knowledge that frailty can be reversible when identified and treated from its earliest stages. Therefore, the objective of this study was to evaluate the effects of a supervised group-based multicomponent exercise program intervention with or without oral nutritional supplementation on functional performance in frail institutionalized older adults. METHODS This was a multicenter randomized controlled trial study with a 6-month intervention period. A total of 111 frail institutionalized older adults (75 years or older) who met at least 3 of the 5 Fried frailty criteria were randomly allocated to the control group (CG; n = 34, mean age = 87.3 ± 5.3 years), a supervised group-based multicomponent Otago Exercise Program group (OEP; n = 39, mean age = 86 ± 5.9 years), or a supervised group-based multicomponent exercise program intervention with oral nutritional supplementation (OEP+N; n = 38, mean age = 84.9 ± 6 years). Measurements included the Timed Up and Go test (TUG), Berg Balance Scale (BBS), Short Physical Performance Battery, repeated chair stand test (STS-5), handgrip strength (HGS), 10-m walking test, and 6-minute walking test, both at baseline and after the 6-month intervention period. RESULTS AND DISCUSSION The between-group analysis by 2-way analysis of covariance showed significant improvement in the TUG [{OEP vs CG: -8.2 seconds, 95% CI [-13.3 to -2.9]; P < .001}; {OEP vs OEP+N: -7.3 seconds, 95% CI [-12.4 to -2.2]; P = .002}], BBS [{OEP vs CG; 8.2 points, 95% CI [5.2 to 11.2]; P < .001}; [{OEP+N vs CG: 4.6 points, 95% CI [1.6 to 7.6]; P < .001}; {OEP vs OEP+N: 3.5 points, 95% CI [0.6 to 6.5]; P = .011}], and HGS [{OEP vs CG: 3.4 kg, 95% CI [1.5 to 5.3]; P < .001}; {OEP+N vs CG: 3.6 kg, 95% CI [1.7 to 5.5]; P < .001}]. Additionally, the within-group analysis showed a significant improvement in the TUG (-6.9 seconds, 95% CI [-9.8 to -4.0]; P < .001) and BBS (4.3 points, 95% CI [2.6 to 5.9]; P < .001) in the OEP group. A significant decrease in the BBS and HGS was shown in the CG. CONCLUSIONS A 6-month supervised group-based multicomponent exercise intervention improved the levels of mobility, functional balance, and HGS in frail institutionalized older adults. Further research will be required to evaluate the nutritional supplementation effects on functional performance to better determine its clinical applicability for tackling frailty.

Wilson, JC, Levek, C, Daoud, AK, Brewer, M, Brooks, K, Sochanska, A, Randall, M, and Provance, AJ. Web-based exercise program increases cervical strength in adolescent athletes. J Strength Cond Res 35(4): 1149-1155, 2021-This cohort study aimed to evaluate the efficacy of a web-based 6-week cervical strengthening program on cervical strength in adolescent athletes. It was hypothesized that subjects completing the program would demonstrate significant increase in cervical muscle strength compared with baseline strength. Eighty-three high school soccer athlete subjects were recruited from 2 local nationally competitive soccer clubs. Teams were assigned to either control or intervention groups to minimize information crossover. Fifty subjects were recruited to the intervention group (29 male, 21 female; average age 15.1 years). Thirty-three subjects were recruited to the control group (21 male, 12 female; average age 15.1 years). Intervention group subjects completed a web-based progressive cervical strengthening program over 6 weeks. Cervical strength in flexion, extension, right and left lateral flexion (LLF) was measured in Newton (N) of force at 3 time points during the competitive season for both control and intervention groups. Intervention group subjects significantly increased cervical strength [mean difference (95% confidence interval)] in LLF [24.1 (15.9-32.4)], extension [27.9 (18.4-37.5)], right lateral flexion [18.8 (11.6-26.1)], and flexion [mean ratio: 1.2 (1.1-1.2)] at follow-up testing; whereas control subjects did not see significant changes in strength. A web-based progressive cervical strengthening program improves cervical muscular strength in a population of adolescent athletes over a period of 6 weeks. Such a program could be used by researchers in future studies evaluating the influence on concussion risk and by practitioners as a means of reducing sport-related head and neck injuries.

OBJECTIVE To analyze the influence of a supervised concurrent exercise program on emotional well-being and emotional distress in middle-aged women. METHODS This randomized controlled trial included 150 middle-aged women recruited for the FLAMENCO project. Participants were allocated into counseling (n = 75) or exercise (n = 75) groups. The counseling group attended conferences on healthy lifestyle (including diet and physical activity topics). The exercise group followed a 60-min concurrent (aerobic + resistance) exercise training 3 days/wk for 16 weeks. Emotional health was assessed with the Positive and Negative Affect Schedule (PANAS) in two diverse timeframes, state (PANAS-S) and trait (PANAS-T) ranging from 10 to 50, where higher scores reflect greater affective emotional health/experience (positive affect subscale) and greater emotional distress (negative affect subscale). The differences between the counseling and exercise groups in PANAS were analyzed by linear regression. RESULTS The total number of women for the per-protocol analyses was 111 divided into the counseling (n = 53) and exercise (n = 58) groups. After adjusting for body mass index and Mediterranean diet adherence, PANAS-S and PANAS-T-positive affect scores increased by 3.81 and 3.02, respectively, in the exercise group whereas they decreased by 0.15 and increased by 0.51 in the counseling group (both, P

Non-homeostatic, or hedonic eating can be detrimental to weight control efforts, yet the effect of exercise on hedonic eating is unclear. PURPOSE: This efficacy trial tests the hypothesis that exercise training favorably impacts hedonic eating (i.e., overeating, stress-induced overeating, disinhibited eating, eating when tempted), in a sample of women who are overweight or obese. METHODS: Participants were inactive at baseline, self-identified as ‘stress eaters’, and were randomized to 12 weeks of moderate-intensity exercise training (EX; combination of supervised and objectively-confirmed unsupervised sessions) or to a no-exercise control condition (CON). EX participants were given an exercise goal of 200 min/week. No dietary instructions or weight control strategies were provided. Assessments occurred at baseline and 12 weeks. Overeating episodes, stress-induced overeating, and dietary temptations were measured over 14 days at each assessment using ecological momentary assessment (EMA). Disinhibition and dietary restraint were assessed via questionnaire. RESULTS: 49 participants (age: 40.4±10.8 years, BMI: 32.4±4.1 kg/m(2)) enrolled, and 39 completed this study. Adherence to the exercise intervention was high (99.4% of all prescribed exercise). At week 12, the proportion of eating episodes that were characterized as overeating episodes was lower in EX vs. CON (21.98% in EX vs. 26.62% in control; p=.001). Disinhibition decreased in EX, but not CON (p=.02), and was driven by internal factors. There was a trend, such that CON was more likely to give into dietary temptations (p=0.08). Stress-induced overeating was low, and did not differ between conditions (p=0.61). CONCLUSION: Exercise training reduced the likelihood of overeating, and eating in response to internal cues, in women who self-identified as stress eaters. This may be one pathway by which exercise impacts body weight.

PURPOSE There is a lack of knowledge as to how different exercise-based cardiac rehabilitation programming affects skeletal muscle adaptations in coronary artery disease (CAD) patients. We first characterized the skeletal muscle from adults with CAD compared with a group of age- and sex-matched healthy adults. We then determined the effects of a traditional moderate-intensity continuous exercise program (TRAD) or a stair climbing-based high-intensity interval training program (STAIR) on skeletal muscle metabolism in CAD. METHODS Sixteen adults (n = 16, 61 ± 7 yr), who had undergone recent treatment for CAD, were randomized to perform (3 d·wk-1) either TRAD (n = 7, 30 min at 60%-80% of peak heart rate) or STAIR (n = 9, 3 × 6 flights) for 12 wk. Muscle biopsies were collected at baseline in both CAD and healthy controls (n = 9), and at 4 and 12 wk after exercise training in CAD patients undertaking TRAD or STAIR. RESULTS We found that CAD had a lower capillary-to-fiber ratio (C/Fi, 35% ± 25%, P = 0.06) and capillary-to-fiber perimeter exchange (CFPE) index (23% ± 29%, P = 0.034) in Type II fibers compared with healthy controls. However, 12 wk of cardiac rehabilitation with either TRAD or STAIR increased C/Fi (Type II, 23% ± 14%, P < 0.001) and CFPE (Type I, 10% ± 23%, P < 0.01; Type II, 18% ± 22%, P = 0.002). CONCLUSION Cardiac rehabilitation via TRAD or STAIR exercise training improved the compromised skeletal muscle microvascular phenotype observed in CAD patients.

The implementation of protocolized care pathways has resulted in major improvements in surgical outcomes. Additional gains will require focused efforts to alter preexisting risk. Prehabilitation programs provide a promising avenue for risk reduction.This study used wearable technology to monitor activity levels before colorectal surgery to evaluate the impact of preoperative activity on postoperative outcomes.This was a prospective nonrandomized observational study.The study was conducted at a large academic medical center.Patients undergoing elective colorectal surgery from January 2018 to February 1, 2019, were included.Patients were trained in the usage of wearable activity-tracking devices and instructed to wear the device for 30 days before surgery. Patients were stratified as active (≥5000 steps per day) and inactive (5000 steps per day) based on preoperative step counts. Univariate analyses compared postoperative outcomes. Multivariable regression models analyzed the impact of preoperative activity on postoperative complications, adjusting for each patient's baseline risk as calculated using the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator. Models were rerun without the addition of activity and the predictive ability of the models compared.Ninety-nine patients were included, with 40 (40.4%) classified as active. Active patients experienced fewer overall complications (11/40 (27.5%) vs 33/59 (55.9%); p = 0.005) and serious complications (2/40 (5%) vs 12/59 (20.3%); p = 0.032). Increased preoperative activity was associated with a decreased risk of any postoperative complication (OR = 0.386; p = 0.0440) on multivariable analysis. The predictive ability of the models for complications and serious complications was improved with the addition of physical activity.The study was limited by its small sample size and single institution.There is significant room for improvement in baseline preoperative activity levels of patients undergoing colorectal surgery, and poor activity is associated with increased postoperative complications. These data will serve as the basis for an interventional trial investigating whether wearable devices help improve surgical outcomes through a monitored preoperative exercise program. See Video Abstract at http://links.lww.com/DCR/B145. TECNOLOGÍA PORTÁTIL EN EL PERÍODO PERIOPERATORIO: PREDICCIÓN DEL RIESGO DE COMPLICACIONES POSTOPERATORIAS EN PACIENTES SOMETIDOS A CIRUGÍA COLORRECTAL ELECTIVA: La implementación de vías de atención protocolizadas ha dado lugar a importantes mejoras en los resultados quirúrgicos. Para obtener más beneficios será necesario realizar esfuerzos concentrados para modificar el riesgo preexistente. Los programas de rehabilitación proporcionan una vía prometedora para la reducción del riesgo.Este estudio utilizó tecnología portátil para monitorear los niveles de actividad antes de la cirugía colorrectal para evaluar el impacto de la actividad preoperatoria en los resultados postoperatorios.Estudio observacional prospectivo no aleatorizado.Gran centro médico académico.Pacientes sometidos a cirugía colorrectal electiva desde enero de 2018 hasta el 1 de febrero de 2019.Los pacientes fueron entrenados en el uso de dispositivos portátiles para el seguimiento de la actividad y se les indicó usar el dispositivo durante 30 días antes de la cirugía. Los pacientes fueron estratificados como activos (5000 pasos / día) e inactivos (5000 pasos / día) en base a los recuentos de pasos preoperatorios. Los análisis univariados compararon los resultados postoperatorios. Los modelos de regresión multivariable analizaron el impacto de la actividad preoperatoria en las complicaciones postoperatorias, ajustando el riesgo de referencia de cada paciente según lo calculado utilizando la Calculadora de riesgo quirúrgico del Programa Nacional de Mejora de la Calidad Quirúrgica del Colegio Americano de Cirujanos. Los modelos se volvieron a ejecutar sin agregar actividad, y se comparó la capacidad de predicción de los modelos.Noventa y nueve pacientes fueron incluidos con 40 (40.4%) clasificados como activos. Los pacientes activos experimentaron menos complicaciones generales [11/40 (27,5%) frente a 33/59 (55,9%); p = 0,005] y complicaciones graves [2/40 (5%) frente a 12/59 (20,3%); p = 0,032]. El aumento de la actividad preoperatoria se asoció con una disminución del riesgo de cualquier complicación postoperatoria (OR 0.386, p = 0.0440) en el análisis multivariable. La capacidad predictiva de los modelos para complicaciones y complicaciones graves mejoró con la adición de actividad física.Tamaño de muestra pequeño, una sola institución.Existe un margen significativo para mejorar los niveles basales de actividad preoperatoria de los pacientes de cirugía colorrectal, y la escasa actividad se asocia con mayores complicaciones postoperatorias. Estos datos servirán de base para un ensayo intervencionista que investigue si los dispositivos portátiles ayudan a mejorar los resultados quirúrgicos a través de un programa de ejercicio preoperatorio monitoreado. Consulte Video Resumen en http://links.lww.com/DCR/B145.

Objective The cost-effectiveness of exercise interventions in lung cancer survivors is unknown. We performed a model-based cost-effectiveness analysis of an exercise intervention in lung cancer survivors. Design We used Markov modeling to simulate the impact of the Lifestyle Interventions and Independence for Elders exercise intervention compared with usual care for stage I-IIIA lung cancer survivors after curative-intent treatment. We calculated and considered incremental cost-effectiveness ratios of less than US $100,000/quality-adjusted life-year as cost-effective and assessed model uncertainty using sensitivity analyses. Results The base-case model showed that the Lifestyle Interventions and Independence for Elders exercise program would increase overall cost by US $4740 and effectiveness by 0.06 quality-adjusted life-years compared with usual care and have an incremental cost-effectiveness ratio of US $79,504/quality-adjusted life-year. The model was most sensitive to the cost of the exercise program, probability of increasing exercise, and utility benefit related to exercise. At a willingness-to-pay threshold of US $100,000/quality-adjusted life-year, Lifestyle Interventions and Independence for Elders had a 71% probability of being cost-effective compared with 27% for usual care. When we included opportunity costs, Lifestyle Interventions and Independence for Elders had an incremental cost-effectiveness ratio of US $179,774/quality-adjusted life-year, exceeding the cost-effectiveness threshold. Conclusions A simulation of the Lifestyle Interventions and Independence for Elders exercise intervention in lung cancer survivors demonstrates cost-effectiveness from an organization but not societal perspective. A similar exercise program for lung cancer survivors may be cost-effective.

Tietjen, AMJ and Devereux, GR. Physical demands of exergaming in healthy young adults. J Strength Cond Res 33(7): 1978-1986, 2019-The efficacy of whole-body exergaming (WBE) in healthy young adults remains largely unknown. This study aimed to: (a) compare the physical demands of WBE in healthy adults with traditional exercise; (b) determine whether the physical demands of WBE were reproducible. Twenty-five healthy adults (age: 22.9 ± 6.4 years; height: 1.7 ± 0.1 m; mass: 69.1 ± 12.2 kg) completed two 10-minute experimental conditions (WBE on the Xbox Kinect and treadmill walking) in a randomized cross-over design study. Whole-body exergaming produced a significant increase in the peak heart rate (138 ± 23 b·min), oxygen consumption (40 ± 13 ml·kg·min), metabolic equivalents (METs) (11 ± 4) compared with treadmill walking (115 ± 18 b·min, 25 ± 5 ml·kg·min, 7 ± 2 MET) and a modest increase in the mean heart rate (111 ± 19 b·min vs. 104 ± 15 b·min). Whole-body exergaming produced significantly greater vertical (381 ± 118 vs. 127 ± 14 % body mass [%BM]), anterior (70 ± 22 vs. 27 ± 4 %BW), and medial (56 ± 21 vs. 7 ± 2 %BW) ground reaction forces. No difference was present in mean oxygen consumption and MET. The reproducibility of WBE was assessed in a subgroup of 11 participants (age: 24.2 ± 6.7 years; height: 1.8 ± 0.1 m; mass: 75.3 ± 10.0 kg), who completed 2 additional 10-minute WBE sessions. No difference was observed between all outcome measures. These findings indicate that WBE can reliably replicate, or surpass, the physical demands of treadmill walking and may serve as an effective addition to a health-focused exercise program.

Background Cardiac rehabilitation (CR) is a structured exercise program prevalent in the United States for people with cardiovascular disease that has been shown to increase cardiovascular endurance and improve quality of life. Despite similar cardiovascular risk factors, stroke is not among the covered diagnoses for CR. The purpose of this study was to examine the participant impact of integrating survivors of stroke into the exercise portion of an existing hospital‐based CR program through measures of physical function and other health impacts and through qualitative evaluation of participant perception. Methods and Results Subacute and chronic survivors of stroke were integrated into a standard 12‐week, 3 sessions per week, exercise‐based CR program. A total of 29 began the program, 24 completed the program, and 18 were available for 6‐month follow‐up. Quantitative measures were compared preprogram with postprogram with t ‐test or equivalent, and preprogram with postprogram to 6‐month follow‐up with ANOVA or equivalent. Semistructured interviews were completed with 11 participants postprogram. Exercise‐based CR had significant impacts on cardiovascular endurance preprogram to postprogram, with maintenance at 6‐month follow‐up. The participants improved on the 6‐minute walk test on average by 61.92 m(95% CI, 33.99–89.84 m), and maximum metabolic equivalents improved by a median of 3.6 (interquartile range, 2.35). Five times sit to stand (functional strength) improved preprogram to postprogram by a median of 2.85 s (interquartile range, 4.03 s). Qualitative findings highlight additional health improvements. Most participants (83% [15/18]) reported continued exercise at follow‐up. Conclusions Exercise‐based CR has the potential to improve cardiovascular endurance, health status, and quality of life for survivors of stroke. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03706105.

A wide range of health benefits of exercise have been documented in clinical lifestyle medicine. However, many individuals fail to complete or maintain an exercise program. We hypothesized that this behavior has biological underpinnings. Thus, we conducted analyses of multi-omic data obtained from genomic, transcriptomic and metabolomic data specific to subjects (n=603) initiating a well-characterized exercise training trial (STRRIDE-Study of a Targeted Risk Reduction Intervention through Defined Exercise) to understand the biology of non-completion. GWAS detected the strongest evidence of association with non-completion was at SNP rs722069 (P = 2.2 х 10 -7 , OR=2.23, T/C, risk allele =C) on chromosome 16, with other 8 SNPs in a linkage disequilibrium block (pairwise R 2 > 0.74). These SNPs were eQTLs of the EARS2, COG7 and DCTN5 genes in skeletal muscle tissue in GTEx portal. In a subset of the STRRIDE sample, the C allele of rs722069 was associated with lower pre-exercise skeletal muscle expression of EARS2 (P < 0.016) using Affymetrix platform (n=37). This was further replicated (P=0.017) in another set of skeletal muscle expression data using the Illumina gene expression array (n=67). The C allele was associated with lower pre-exercise skeletal muscle concentrations of C2- and C3-acylcarnitines (P < 0.03) - the incomplete oxidation products of fatty acid and amino acid metabolism. Lower EARS2 skeletal muscle expression was also related to the lower C2- and C3-acylcarnitine concentrations in skeletal muscle ( P < 0.05) before exercise. Rs722069 variants were not related to maximal oxygen uptake and insulin sensitivity in the individuals completing the exercise intervention. The tests of glucose and lipids levels associated with the genetic variants in this LD block are ongoing. To further understand the systemic genetics and biology of non-completion, in silico functional analysis for the genes in this region such as UBFD1, NDUFAB1, PALB2 is also under way. Our results imply that non-completion is genetically moderated through differential gene expression and metabolic pathways in skeletal muscle. Impaired mitochondrial energetics in skeletal muscle may be partly responsible for non-completion. Individual genetic traits may allow development of a biomarker-approach to identify individuals that would benefit from more intensive counseling to maintain exercise programs.

This study investigated the effects of an exercise program on functional capacity and quality of life in patients with stage 3 and stage 4 sarcoidosis.Eighteen patients with stage 3 and 4 sarcoidosis were recruited; 9 received 12 wk of supervised exercise training and 9 received usual care. Patients underwent the following evaluations at baseline and follow-up: 6-min walk test, maximal inspiratory and expiratory pressure tests, back and leg dynamometer test, modified Medical Research Council Dyspnea Scale, Fatigue Severity Scale, St George Respiratory Questionnaire, Short Form-36 Quality of Life Questionnaire, Hospital Anxiety and Depression Questionnaire, body plethysmography, carbon monoxide diffusing capacity test, and blood gas analysis.The median (interquartile range) increase in 6-min walk distance in the intervention group was 40 (31-62) m. Improvement in functional capacity; perception of dyspnea; fatigue; anxiety; peripheral and inspiratory muscle strength; partial arterial oxygen pressure; arterial oxygen saturation; and the symptom, activity, and total scores of the St George Respiratory Questionnaire were significantly greater in the intervention group than in the usual care group at follow-up (P.05).Exercise training improves functional capacity, muscle strength, dyspnea, quality of life, anxiety, fatigue, and oxygenation in patients with stage 3 and stage 4 sarcoidosis. Standard treatment of patients with late-stage sarcoidosis should integrate exercise training and pulmonary rehabilitation.

Decreasing daily life physical activity (PA) outside an exercise program might hinder the benefit of that program on lower-extremity physical function (LEPF) in older adults. The purpose of this study was to investigate how daily life PA modulates the effects of an exercise program on LEPF. The participants were 46 community-dwelling older adults (mean age, 70.1 ± 3.5 years) in Kasama City, a rural area in Japan. All participated in a fall-prevention program called square-stepping exercise once a week for 11 weeks. We evaluated their daily life PA outside the exercise program with pedometers and calculated the average daily step counts during the early and late periods of the program. We divided participants into 2 groups on the basis of whether or not they decreased PA by more than 1000 steps per day between the early and late periods. To ascertain the LEPF benefits induced by participating in the exercise program, we measured 5 physical performance tests before and after the intervention: 1-leg stand, 5-time sit-to-stand, Timed Up and Go (TUG), habitual walking speed, and choice-stepping reaction time (CSRT). We used a 2-way analysis of variance to confirm the interaction between the 2 groups and the time effect before and after the intervention. During the exercise program, 8 participants decreased their daily life PA (early period, 6971 ± 2771; late period, 5175 ± 2132) and 38 participants maintained PA (early period, 6326 ± 2477; late period, 6628 ± 2636). Both groups significantly improved their performance in TUG and CSRT at the posttest compared with the baseline. A significant group-by-time interaction on the walking speed (P = .038) was observed: participants who maintained PA improved their performance more than those who decreased their PA. Square-stepping exercise requires and strengthens dynamic balance and agility, which contributed to the improved time effects that occurred in TUG and CSRT. On the contrary, because PA is positively associated with walking speed, maintaining daily life PA outside an exercise program may have a stronger influence on walking speed. To enhance the effectiveness of an exercise program for young-old adults, researchers and instructors should try to maintain the participant's daily life PA outside the program. Regardless of decreasing or maintaining daily life PA, the square-stepping exercise program could improve aspects of LEPF that require complex physical performance. However, a greater effect can be expected when participants maintain their daily life PA outside the exercise program.

The aim of this study was to assess effects of exercise on shoulder musculoskeletal symptoms among employees with overhead assembly work exposures.A voluntary workplace shoulder exercise program was offered to employees in two automotive assembly departments, while two similar departments served as controls. N = 76 total workers participated. Shoulder Rating Questionnaire (SRQ) and Discomfort of the Arm Shoulder and Hand (DASH) symptoms were queried monthly for 7 baseline months, followed by 6 months that included exercise.SRQ scores were higher for exercisers than among controls in the 6 exercising months, but not in the baseline months. Although the group x month interaction was significant (P 0.05), the temporal trend was inconsistent.Exercise may have temporarily lessened decline in SRQ. It is not clear whether shorter term differences were clinically meaningful or predictive of longer term disability prevention.

Glucose abnormality and diabetes are the most common comorbidities in cystic fibrosis (CF). Combined (aerobic and resistance) exercise program in type 2 patients with diabetes demonstrated an improvement of glycemic control. The aim of the study was to determine whether a combined exercise program is beneficial to improve plasma glucose at 2 h of the oral glucose tolerance test in CF.Eighteen adults with CF with glucose abnormality were recruited (Clinicaltrial.gov: NTC02127957), and 17 were randomly assigned to a control or exercise group for 12 wk. V˙O2max, oral glucose tolerance test, muscular endurance and strength, and quality of life were measured pre- and postintervention.Fourteen participants completed the protocol. Patients in the exercise group improved significantly their 2-h plasma glucose values (-2.34 ± 1.26 mmol·L, P0.007, confidence interval = 99.22%) and presented a reduction of 17.2% (P0.05) in total glucose excursion. No significant change for other parameters was observed.A combined exercise program improves glycemic control in CF.

Background:Physical activity has emerged as a promising intervention to decrease the severity of cancer side effects. To date, only a few community-based exercise programs have been described in the literature. Of these, none have been designed to be sustainable and available as programs for pediatr

ObjectiveThe objective of this pilot study was to explore whether or not the combination of using a residual limb cover to eliminate electromagnetic fields and a mirror therapy exercise program facilitates healing and decreases pain for individuals with lower-limb vascular amputation.Materia

BACKGROUND AND PURPOSE Pedometers are often used as motivational tools to increase physical activity. Hence, providing a pedometer during an exercise intervention may enhance the benefit of exercise on lower-extremity physical function (LEPF) by maintaining or increasing daily physical activity. The purpose of this study was to compare the effect on LEPF between an exercise intervention with and without the use of a pedometer. METHODS The subjects of this study were 68 community-dwelling older adults (mean age: 70.0 ± 3.6 years) in Kasama City, rural Japan. All subjects participated in a fall-prevention exercise program called square-stepping exercise (SSE) conducted once a week for 11 weeks. Participants were allocated to 2 groups: SSE with pedometer group (n = 34) and SSE without pedometer group (n = 34). We matched the participants of both groups by their standardized score of physical function tests. To ascertain the LEPF benefits induced by the exercise intervention, we measured 5 physical function tests: single-leg balance with eyes open, 5-repetition sit-to-stand, timed up and go, 5-m habitual walk, and choice stepping reaction time. We used a 2-way analysis of variance to confirm the interaction between the 2 groups. RESULTS Significant group-by-time interactions were observed on timed up and go (P < .01) and 5-m habitual walk (P = .02); participants in the SSE with pedometer group enhanced their physical function more than the SSE without pedometer group participants. CONCLUSIONS This study suggests that providing a pedometer during an exercise intervention is an effective addition to an exercise program to improve LEPF.

THIS ARTICLE IS A COMMENTARY TO OUTLINE THE POTENTIAL BENEFITS OF USING 2 SPECIFIC DIETARY SUPPLEMENTS DURING REHABILITATION FROM MUSCULOSKELETAL INJURY. JUSTIFICATION AND EXPLANATION ARE PROVIDED FOR THE USE OF PROTEIN AND CREATINE SUPPLEMENTS DURING AN EXERCISE PROGRAM TO INCREASE PROTEIN SYNTHESIS AND MUSCLE FUNCTION, AND TO IMPROVE ENERGY PRODUCTION TO PREVENT FATIGUE. EVIDENCE SUGGESTS POTENTIAL BENEFITS FOR THESE SUPPLEMENTS TO BE USED IN THIS POSTINJURY PERIOD, AT A TIME WHEN MANY INDIVIDUALS WILL ABSTAIN FROM SUPPLEMENTATION. SUGGESTIONS ARE MADE FOR PROFESSIONALS WORKING WITH INJURED OR RECOVERING INDIVIDUALS TO CONSIDER ADVISING THEM TO SUSTAIN THE SUPPLEMENTATION REGIMES.

Introduction: Female farmers commonly experience musculoskeletal pain in the back, knee, and shoulder. Despite their obvious advantages in reducing musculoskeletal pain, face-to-face exercise programs are limited by geographical and physical barriers. Thus, we decided to introduce eHealth technology to farmers’ musculoskeletal health care. Using a mobile application (app), we aim to provide a tailored self-exercise program for shoulder, knee, and back pain in female farmers in rural areas after a musculoskeletal health check-up. Methods: This study is planned as 2 randomized control studies (MObile Delivered self-Exercise [MODE] phase I and phase II). We plan to recruit 200 female farmers aged 41 to 70 years. Initially, the shoulders, knees, and low back will be evaluated to provide individualized exercise programs. In MODE-I (single-blinded: evaluator), the subjects will be randomly allocated to experimental (n = 100) and control (n = 100) groups using a computer-generated sequence. Both groups will perform a 3-month self-exercise using a smartphone app or physical education data (booklets), respectively. Outcomes including exercise completion will be assessed at 3 months. In MODE-II, after subject random allocation, the experimental and control groups will perform exercise using a smartphone app with and without real-time feedback, respectively. Every 3 months, the level of the exercise program will be evaluated and the difficulty level will be adapted accordingly. After MODE-II is completed, all subjects will undergo close-out assessment. Discussion: This will be the first attempt to compare methods using booklets and apps to identify effective ways of providing personalized self-exercise programs according to musculoskeletal health stages by evaluating female farmers (MODE-I). This will help clarify whether the mobile app is effective for self-exercise compared to a conventional booklet. The MODE-II study will help to assess the effect of providing feedback through the mobile app. Finally, we will evaluate musculoskeletal health according to the degree of participation over 12 months to confirm the effect of self-exercise. Our study should aid in managing musculoskeletal health for farmers living in rural areas and help promote health in the “untact” era. Trial registration: Clinical Research Information Service of the Korean National Institutes of Health (KCT0005245). Registered July 17, 2020.