Descriptive statistics.

<p>Descriptive statistics.</p

Recumbent Stepper Submaximal Test response is reliable in adults with and without stroke

<div><p>Purpose</p><p>The purpose of the present study was to determine the reliability of the exercise response (predicted peak VO₂) using the total body recumbent stepper (TBRS) submaximal exercise test in: 1) healthy adults 20–70 years of age and 2) adults participating in inpatient stroke rehabilitation. We hypothesized that the predicted peak VO₂ (Visit 1) would have an excellent relationship (r > 0.80) to predicted peak VO₂ (Visit 2). We also wanted to test whether the exercise response at Visit 1 and Visit 2 would be significantly different.</p><p>Methods</p><p>Healthy adults were recruited from the Kansas City metro area. Stroke participants were recruited during their inpatient rehabilitation stay. Eligible participants completed 2 TBRS submaximal exercise tests between 24 hours and 5 days at similar times of day.</p><p>Results</p><p>A total of 70 participants completed the study. Healthy adults (n = 50) were 36 M, 38.1 ± 10.1 years and stroke participants (n = 20) were 15 M, 62.5 ± 11.8 years of age. The exercise response was reliable for healthy adults (r = 0.980, p<0.01) and stroke participants (r = 0.987, p<0.01) between Visit 1 and Visit 2. Repeated Measures ANOVA showed a significant difference in predicted values between the two visits for healthy adults (47.2 ± 8.4 vs 47.7 ± 8.5 mL∙kg^-1∙min^-1; p = 0.04) but not for stroke participants (25.0 ± 9.9 vs 25.3 ± 11.4 mL∙kg^-1∙min^-1; p = 0.65).</p><p>Conclusion</p><p>These results suggest that the exercise response is reliable using the TBRS submaximal exercise test in this cohort of healthy adults and stroke participants.</p></div

Environment and physiologic measures.

<p>Environment and physiologic measures.</p

Cardiorespiratory fitness change mediates exercise duration effects on visuospatial performance.

<p>In the basic model without cardiorespiratory fitness change (%change in VO2 peak over 26 weeks) as a mediator, total number of minutes exercised (Exercise Duration) was associated with change in Visuospatial Processing. When change in cardiorespiratory fitness was added to the model as a potential mediator, it fully mediated the relationship of Exercise Duration and Visuospatial Processing improvement. Betas (Standard Error) are reported as the product of simultaneous regression with bootstrap replacement.</p

Demographic and descriptive baseline data.

<p>All values are group mean (standard deviation). LLFDI and SF-36 n = 100 due to computer malfunction. Baseline scores on component cognitive tests can be found in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0131647#pone.0131647.s005" target="_blank">S2 Table</a>.</p><p>Demographic and descriptive baseline data.</p

Visuospatial processing but not attention increases with increasing aerobic exercise dose.

<p>Percent change in VO₂ peak (blue bars) increases in a dose-response fashion across the PP exercise groups. The best fitting model of Visuospatial Processing (red bars) follows a similar dose-response pattern. The best fitting model of Simple Attention (green bars) shows that any exercise results in improvement.</p

Study enrollment flow.

<p>Baseline measures of enrolled participants are provided in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0131647#pone.0131647.t001" target="_blank">Table 1</a>. Of the intent-to-treat (ITT) cohort (n = 101), 8 individuals withdrew due to time or travel concerns, 8 withdrew due to medical issues, 1 was dissatisfied with his group allocation, and 1 was lost to follow-up. Another 6 individuals were non-adherent to the exercise prescription. Those who did not adhere had slightly more education (17.8yrs [3.2] vs 16.1yrs [2.4]) otherwise there were no significant differences. The remaining 77 individuals were included in per-protocol (PP) analyses: control (n = 23), 75min/wk (n = 18), 150min/wk (n = 21), and 225min/wk (n = 15).</p

Mean fitness and physical function change from baseline in both the intent-to-treat and per protocol cohorts.

<p>The Group * Time interaction tests for group differences in response to exercise. The Best Fitting Model was assessed using an orthogonal contrast to test the shape of the dose-response. Both the interaction and the contrast had to reach a level of significance to be adopted as the best fitting model. In the ITT cohort, eleven individuals did not return for follow-up physical function testing and an additional six refused follow-up cardiopulmonary exercise test. Nine individuals did not return for follow-up cognitive testing. All values mean (standard deviation) unless otherwise noted.</p><p>Mean fitness and physical function change from baseline in both the intent-to-treat and per protocol cohorts.</p

Aerobic exercise for Alzheimer's disease: A randomized controlled pilot trial

<div><p>Background</p><p>There is increasing interest in the role of physical exercise as a therapeutic strategy for individuals with Alzheimer’s disease (AD). We assessed the effect of 26 weeks (6 months) of a supervised aerobic exercise program on memory, executive function, functional ability and depression in early AD.</p><p>Methods and findings</p><p>This study was a 26-week randomized controlled trial comparing the effects of 150 minutes per week of aerobic exercise vs. non-aerobic stretching and toning control intervention in individuals with early AD. A total of 76 well-characterized older adults with probable AD (mean age 72.9 [7.7]) were enrolled and 68 participants completed the study. Exercise was conducted with supervision and monitoring by trained exercise specialists. Neuropsychological tests and surveys were conducted at baseline,13, and 26 weeks to assess memory and executive function composite scores, functional ability (Disability Assessment for Dementia), and depressive symptoms (Cornell Scale for Depression in Dementia). Cardiorespiratory fitness testing and brain MRI was performed at baseline and 26 weeks. Aerobic exercise was associated with a modest gain in functional ability (Disability Assessment for Dementia) compared to individuals in the ST group (X2 = 8.2, p = 0.02). There was no clear effect of intervention on other primary outcome measures of Memory, Executive Function, or depressive symptoms. However, secondary analyses revealed that change in cardiorespiratory fitness was positively correlated with change in memory performance and bilateral hippocampal volume.</p><p>Conclusions</p><p>Aerobic exercise in early AD is associated with benefits in functional ability. Exercise-related gains in cardiorespiratory fitness were associated with improved memory performance and reduced hippocampal atrophy, suggesting cardiorespiratory fitness gains may be important in driving brain benefits.</p><p>Trial registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT01128361" target="_blank">NCT01128361</a></p></div

Baseline and change at Week 26 secondary outcome measures.

<p>Baseline and change at Week 26 secondary outcome measures.</p