The effects of exercise training in patients with peripheral vascular disease - a review

Patients with peripheral vascular disease (PVD) suffer from the symptom of intermittent claudication and are therefore intolerant to walking. Exercise training has been shown to be a beneficial treatment for patients with PVD. Therefore studies have aimed to assess the efficacy of exercise training programmes. This review summarises the data on the efficacy of exercise training programmes in patients with PVD. Recommendations are made for the mode, duration, frequency and intensity of exercise training programmes. A systematic review of Medline, Pubmed and Science Direct was done of studies on exercise training and patients with PVD, particularly those using randomised controlled trials. Exercise training improves walking tolerance in patients with PVD. The common mode of training in patients with PVD in the past decade has been walking on a treadmill; however recently an upper-limb cycle ergometry programme proved to be as effective as lower-limb cycle ergometry in improving walking tolerance in patients with PVD. As weight-bearing walking programmes are uncomfortable for patients with PVD, this is an important development in exercise prescription for these patients. Most successful exercise programmes have been 3-6 months in duration for a period of 30 minutes to 1 hour, 2-3 times per week. However, 1 study showed that a shorter period (6 weeks) was of sufficient duration to improve functional capacity in patients with PVD. This is helpful for practitioners as exercise programmes of 3 or 6 months can be daunting for a patient to embark on. Finally, patients should exercise to maximal claudication pain in order to elicit the best training response. South African Journal of Sports Medicine Vol. 18 (4) 2006: pp. 116-12

Chronic anterior knee pain in athletes: Common causes

Anterior knee pain is a very common clinical presentation. In this article, the classification of anterior knee pain syndromes according to the anatomy of the knee extensor mechanism is described. The clinical diagnosis, special investigations, and principles of management of the more common causes of anterior knee pain are discussed.For full text, click here:SA Fam Pract 2005;47(8):20-2

Common injuries in cycling: prevention, diagnosis and management

No Abstract. South African Family Practice Vol. 47(7) 2005: 14-1

Peripheral arterial disease and intermittent claudication: Efficacy of short-term upper body strength training, dynamic exercise training, and advice to exercise at home

Objective. To compare the effect of two training programmes and advice to exercise at home on physiological adaptations in patients with peripheral arterial disease (PAD).Design. 30 patients with a typical history of PAD and intermittent claudication were randomised to either an upper body strength training programme (UBST), a dynamic (walking, cycling, circuit) conventional exercise rehabilitation programme (CER), or advice to ‘walk as much as possible at home’ (CONT). Before and after intervention groupsperformed a standard graded treadmill exercise test (GTET) and a 6-minute walk test (SMWT) to determine peak physiological parameters and walking distances. Maximal walking distance (MWD), pain-free walking distance (PFWD), peak oxygen uptake (VO2) , heart rate and perceived pain were measured.Results. MWD on the GTET increased significantly in the CER group compared with the CONT and UBST groups (93.9±79% v. 7.0±19.8% v. 7.3±46%; CER v. UBST v. CONT p=0.003). Similarly, peak VO2 increased with CER compared with the CONT and UBST groups (28.4±20 v. –6.2±15 v. –1.0±21%; CER v. UBST v. CONT p=0.004). During the SMWT the CER and UBST groups improved in PFWD compared with the CONT group (37±47% v. 27±71% v. –30±29%; CER v. UBST v. CONT p=0.03), and perceived pain decreased in the CER group compared with the UBST group (–24±39% v. 27±48%; CER v. UBST p=0.01).Conclusion. CER improves physiological parameters and walking distances more than UBST does. CER is effective within 6 weeks. Verbal encouragement to exercise is an ineffective form of managemen

Healthy lifestyle interventions in general practice: Part 1: An introduction to lifestyle and diseases of lifestyle

Poor lifestyle choices including physical inactivity, adverse nutrition and tobacco use are strongly associated with heart disease, diabetes, respiratory disease and cancer. These four diseases are responsible for over 50% of mortality worldwide. Yet lifestyle intervention is underemphasised in the undergraduate training of doctors and other health professionals. This article reviews the lifestyle factors related to chronic non-communicable disease and suggests small but meaningful interventions for general practitioners to incorporate into daily practice. The upcoming series to be published in Family Practice regarding “lifestyle modification in chronic disease states” is introduced. South African Journal of Family Practice Vol. 50 (4) 2008: pp.6-1

The effects of exercise training in patients with peripheral vascular disease - a review

Patients with peripheral vascular disease (PVD) suffer from the symptom of intermittent claudication and are therefore intolerant to walking. Exercise training has been shown to be a beneficial treatment for patients with PVD. Therefore studies have aimed to assess the efficacy of exercise training programmes. This review summarises the data on the efficacy of exercise training programmes in patients with PVD. Recommendations are made for the mode, duration, frequency and intensity of exercise training programmes. A systematic review of Medline, Pubmed and Science Direct was done of studies on exercise training and patients with PVD, particularly those using randomised controlled trials. Exercise training improves walking tolerance in patients with PVD. The common mode of training in patients with PVD in the past decade has been walking on a treadmill; however recently an upper-limb cycle ergometry programme proved to be as effective as lower-limb cycle ergometry in improving walking tolerance in patients with PVD. As weight-bearing walking programmes are uncomfortable for patients with PVD, this is an important development in exercise prescription for these patients. Most successful exercise programmes have been 3-6 months in duration for a period of 30 minutes to 1 hour, 2-3 times per week. However, 1 study showed that a shorter period (6 weeks) was of sufficient duration to improve functional capacity in patients with PVD. This is helpful for practitioners as exercise programmes of 3 or 6 months can be daunting for a patient to embark on. Finally, patients should exercise to maximal claudication pain in order to elicit the best training response. South African Journal of Sports Medicine Vol. 18 (4) 2006: pp. 116-12

Mechanisms of the training response in patients with peripheral arterial disease – a review

Exercise training has proved to be a beneficial treatment for patients with peripheral arterial disease (PAD) suffering from the symptom of intermittent claudication. The mechanism by which symptomatic improvement occurs is unclear. The review summarises the mechanism of the training response in patients with PAD, focusing on improvements in bloodflow as well as biochemical, muscle recruitment and psychological adaptations. Possible areas of future research are suggested

International Olympic Committee Consensus Statement: Molecular Basis of Connective Tissue and Muscle Injuries in Sport

Tendon and ligament injures cause significant loss of performance in sport and decreased functional capacity in the workplace. Many of these injures remain difficult to treat, and many individuals have long-term pain and discomfort. Animal studies of growth factor and cell-based therapies have shown promising results, but these treatments also can be misused to enhance athletic performance. The International Olympic Committee (IOC) now has high-level scientific advisors who can advise the IOC as to the use and abuse of these technologies

The logic of kinetic regulation in the thioredoxin system

<p>Abstract</p> <p>Background</p> <p>The thioredoxin system consisting of NADP(H), thioredoxin reductase and thioredoxin provides reducing equivalents to a large and diverse array of cellular processes. Despite a great deal of information on the kinetics of individual thioredoxin-dependent reactions, the kinetic regulation of this system as an integrated whole is not known. We address this by using kinetic modeling to identify and describe kinetic behavioral motifs found within the system.</p> <p>Results</p> <p>Analysis of a realistic computational model of the <it>Escherichia coli </it>thioredoxin system revealed several modes of kinetic regulation in the system. In keeping with published findings, the model showed that thioredoxin-dependent reactions were adaptable (i.e. changes to the thioredoxin system affected the kinetic profiles of these reactions). Further and in contrast to other systems-level descriptions, analysis of the model showed that apparently unrelated thioredoxin oxidation reactions can affect each other via their combined effects on the thioredoxin redox cycle. However, the scale of these effects depended on the kinetics of the individual thioredoxin oxidation reactions with some reactions more sensitive to changes in the thioredoxin cycle and others, such as the Tpx-dependent reduction of hydrogen peroxide, less sensitive to these changes. The coupling of the thioredoxin and Tpx redox cycles also allowed for ultrasensitive changes in the thioredoxin concentration in response to changes in the thioredoxin reductase concentration. We were able to describe the kinetic mechanisms underlying these behaviors precisely with analytical solutions and core models.</p> <p>Conclusions</p> <p>Using kinetic modeling we have revealed the logic that underlies the functional organization and kinetic behavior of the thioredoxin system. The thioredoxin redox cycle and associated reactions allows for a system that is adaptable, interconnected and able to display differential sensitivities to changes in this redox cycle. This work provides a theoretical, systems-biological basis for an experimental analysis of the thioredoxin system and its associated reactions.</p

A Fragment of the LG3 Peptide of Endorepellin Is Present in the Urine of Physically Active Mining Workers: A Potential Marker of Physical Activity

Biomarker analysis has been implemented in sports research in an attempt to monitor the effects of exertion and fatigue in athletes. This study proposed that while such biomarkers may be useful for monitoring injury risk in workers, proteomic approaches might also be utilised to identify novel exertion or injury markers. We found that urinary urea and cortisol levels were significantly elevated in mining workers following a 12 hour overnight shift. These levels failed to return to baseline over 24 h in the more active maintenance crew compared to truck drivers (operators) suggesting a lack of recovery between shifts. Use of a SELDI-TOF MS approach to detect novel exertion or injury markers revealed a spectral feature which was associated with workers in both work categories who were engaged in higher levels of physical activity. This feature was identified as the LG3 peptide, a C-terminal fragment of the anti-angiogenic/anti-tumourigenic protein endorepellin. This finding suggests that urinary LG3 peptide may be a biomarker of physical activity. It is also possible that the activity mediated release of LG3/endorepellin into the circulation may represent a biological mechanism for the known inverse association between physical activity and cancer risk/survival