Monitoring different types of resistance training using session rating of perceived exertion

The purpose of the study was to evaluate the effectiveness of using the session rating of perceived exertion (RPE) scale to measure physical effort during different types of resistance training exercises and to examine the validity of this scale in rating the entire resistance training sessions of different workouts and intensities. Fifteen male subjects (26.7 ± 4.3 years) performed three different types of resistance training protocols. All protocols consisted of the same five exercises (bench press, back squat, bench pull, shoulder press, and leg extension) but the intensities, rest periods, and numbers of repetitions were different. The strength protocol consisted of 3 sets of 5 repetitions per exercise at a load of 90% of 1-RM of the subject with a 3-minute rest period between sets. The hypertrophy session was performed with 3 sets of 10 repetitions per exercise at 70% of 1-RM with 1-minute of rest between sets. The power session required subjects to perform at a fast lifting speed for 5 repetitions for 3 sets per exercise at 50% of 1-RM with a 3-minute rest period. The order of the sessions was also randomised. RPE was measured using the CR-10 Borg scale following the completion of each set. Session RPE was collected 30 minutes postexercise. Within-subjects repeated measures ANOVA showed a significant difference among the mean RPE and the session RPE values of both the strength and hypertrophy protocol (p≤0.05) but mean and session RPE values for the power protocol showed no significant difference. During the familiarisation session, the session RPE was measured at 5-minute time intervals for thirty minutes after the completion of the entire workout. The data of the test collected during the familiarisation session was compared between the different time intervals. It was found that there was a significant difference (p≤0.05) between the mean RPE values at the fifth minute mark and tenth minute mark when compared to the thirty minute mark. All other session RPE values showed no significant difference. It was concluded that the session RPE method appears to be an effective and valid method in monitoring different types of resistance training and a useful tool of measuring the different intensities of different resistance training session. It was also demonstrated that the session RPE taken after 30 minutes was a better indicated of the overall resistance training workout sessions and its intensities

Does gender and cultural diversity matter for sustainability in healthcare? evidence from global organizations

Global healthcare organizations are fundamental in addressing the healthcare needs of local and global communities. This highly regulated sector means it is under constant scrutiny for health, safety, and ethical compliance risks by federal regulatory bodies. Despite higher monitoring, an increasing number of healthcare companies receive fines for their irresponsible practices, manifesting significant questions about their corporate governance and sustainability practices. Against this backdrop, this study examines the relationship between boardroom diversity on the sustainability performance of companies operating in healthcare. Utilizing a global sample of publicly listed healthcare companies, using panel regression data and the system-GMM estimator accounting for endogeneity, we find evidence of a positive association between board diversity (gender and culture) and sustainability performance. These findings support critical mass theoretical expectations for board diversity and sustainability performance, suggesting that a meaningful representation (three or more) of women and ethnic directors on the board of healthcare organizations significantly improves sustainability performance. The findings remain robust in a series of robustness tests and continue to hold after accounting for potential endogeneity concerns. This paper has important implications for global healthcare organizational policy concerning diversity management practices and their implications for sustainability performance

Eccentric-only versus concentric-only resistance training effects on biochemical and physiological parameters in patients with type 2 diabetes

Background: The benefits of resistance training for patients with type 2 diabetes (T2D) are well documented; however, the effects of exercise with different muscle contraction types such as eccentric versus concentric contractions on physiological outcomes for this population are not clear. This study compared eccentric-only (ECC) and concentric-only resistance training (CON) to test the hypothesis that ECC would be superior to CON to improve insulin sensitivity, lipid profile, body composition, muscle strength and physical function of patients with T2D. Methods: Adults with T2D (50–79 years) were allocated to the ECC (n = 9) or CON group (n = 9). Resistance exercises (chest press, lateral pulldown, bicep curl, triceps extension, leg extension, leg curl, calf raise, abdominal crunch) consisting of 2–3 sets of 10 eccentric-only (5 s) or concentric-only contractions (1–2 s) was performed twice a week for 12 weeks. Changes in blood biomarkers, body composition, muscle strength and physical function from pre- to post-intervention were compared between groups. Results: Overall rating of perceived exertion (RPE, 1–10 Borg scale) was lower (p \u3c 0.05) for ECC (2.9 ± 1.2) than CON (5.4 ± 1.1). No significant changes in blood biomarkers were found for both groups. Lean mass increased [effect size (ES) = 0.148, ECC 3.2 ± 6.9%; CON 3.6 ± 2.3%], and fat mass decreased (ES = 0.545, ECC − 6.1 ± 12.4%; CON − 7.1 ± 16.4%) (p \u3c 0.05) similarly. One-repetition maximal strength of each exercise increased (p \u3c 0.05) for both ECC (12–37%) and CON (27–68%). Both groups improved (p \u3c 0.05) 6-min walk distance (ES = 0.083, ECC 12.2 ± 2.3%; CON 12.5 ± 15.3%) and chair rise time (ES = 0.463, ECC − 13.4 ± 25.4%; CON − 20.0 ± 53.3%) but only ECC improved (p \u3c 0.05) the timed up-and-go test (− 11.3 ± 13.6%, ES 0.014). No significant changes in balance tests were found for both groups. Conclusion: These results did not fully support the hypothesis but showed that ECC was as effective as CON to improve body composition, muscle strength, and physical function with lesser RPE. Future studies should investigate whether larger differences between ECC and CON are evident when increasing the exercise frequency and matching the intensities of the two-exercise protocols. Trial registration ACTRN12621001026819 (retrospectively registered on 5th Aug 2021)

Feasibility and preliminary efficacy of a 10-week resistance and aerobic exercise intervention during neoadjuvant chemoradiation treatment in rectal cancer patients

Background: Neoadjuvant chemoradiation treatment (CRT) in rectal cancer patients is associated with a reduction in physical capacity, lean mass and increased fatigue. As a countermeasure to these treatment-related adverse effects, we examined the feasibility and preliminary efficacy of a 10-week exercise program during CRT. Methods: Ten rectal cancer patients (7 men, aged 27-70 years, body mass index = 26.4 ± 3.8 kg/m2) receiving CRT undertook supervised resistance and aerobic exercise twice weekly. Assessments were undertaken pre- and post-intervention for upper and lower body muscle strength by 1-RM, muscle endurance, physical performance tests, body composition by dual X-ray absorptiometry, quality of life, and fatigue. Results: There was a significant loss in appendicular skeletal muscle (−1.1 kg, P =.012), and fat mass (−0.8 kg, P =.029) following CRT. Despite the loss in skeletal muscle, leg press (P =.030) and leg extension (P =.046) strength improved by 27.2% and 22.7%, respectively, and leg press endurance by 76.7% (P =.007). Changes in strength were accompanied by improved performance (P\u3c .05) in 6-m fast walking speed (6.9%) and dynamic balance as determined by the 6-m backwards walk (15.5%). There was minimal change in quality of life and fatigue, and no adverse events related to training. Conclusions: Exercise during neoadjuvant CRT appears to be feasible and well tolerated in rectal cancer patients and may enhance physical function while minimizing adverse changes in body composition and cancer-related fatigue. These initial findings need to be confirmed in randomized controlled trials

Feasibility and preliminary efficacy of a 10-week resistance and aerobic exercise intervention during neoadjuvant chemoradiation treatment in rectal cancer patients

Background: Neoadjuvant chemoradiation treatment (CRT) in rectal cancer patients is associated with a reduction in physical capacity, lean mass and increased fatigue. As a countermeasure to these treatment-related adverse effects, we examined the feasibility and preliminary efficacy of a 10-week exercise program during CRT. Methods: Ten rectal cancer patients (7 men, aged 27-70 years, body mass index = 26.4 ± 3.8 kg/m2) receiving CRT undertook supervised resistance and aerobic exercise twice weekly. Assessments were undertaken pre- and post-intervention for upper and lower body muscle strength by 1-RM, muscle endurance, physical performance tests, body composition by dual X-ray absorptiometry, quality of life, and fatigue. Results: There was a significant loss in appendicular skeletal muscle (−1.1 kg, P =.012), and fat mass (−0.8 kg, P =.029) following CRT. Despite the loss in skeletal muscle, leg press (P =.030) and leg extension (P =.046) strength improved by 27.2% and 22.7%, respectively, and leg press endurance by 76.7% (P =.007). Changes in strength were accompanied by improved performance (

Feasibility of Presurgical Exercise in Men with Prostate Cancer Undergoing Prostatectomy

Background: Prostatectomy is associated with short- and long-term morbidity, which includes attenuation of muscle function and deterioration of lean body mass. Physical function is a known predictor of morbidity and mortality, with initial evidence indicating that presurgical exercise is associated with fewer postsurgical complications and shorter hospitalization. The aim was to determine the feasibility of a supervised presurgical exercise program for prostate cancer (PCa) patients scheduled for prostatectomy. Methods: Ten men (68+6.4 years old) with localized PCa undertook a 6-week resistance and aerobic exercise program prior surgery. Training was undertaken twice weekly and patients were assessed at baseline, presurgery, and 6 weeks postsurgery. Outcome measures included muscle and physical performance, body composition, urinary incontinence and questionnaire. Results: Muscle strength increased by 7.5% to 24.3% (P \u3c .05) from baseline to presurgery but decreased to pretraining levels postsurgery, except for knee extensor strength (P =.247). There were significant improvements (P \u3c .05) in the 6-m fast walk (9.3%), 400-m walk (7.4%), and chair rise (12.3%) at presurgery. Following surgery, improvements in physical performance were maintained. There was no change in lean or fat mass prior to surgery, but lean mass declined by 2.7 kg (P =.014) following surgery. There were no adverse effects from the exercise program. Conclusions: Exercise undertaken prior to prostatectomy improved muscle and physical performance, with functional benefits maintained 6 weeks postsurgery. Presurgical exercise for PCa patients has the potential to facilitate recovery by improving physical reserve capacity, especially in men with poor muscle nd physical performance

Association of computed tomography measures of muscle and adipose tissue and progressive changes throughout treatment with clinical endpoints in patients with advanced lung cancer treated with immune checkpoint inhibitors

To investigate the association between skeletal muscle mass and adiposity measures with disease-free progression (DFS) and overall survival (OS) in patients with advanced lung cancer receiving immunotherapy, we retrospectively analysed 97 patients (age: 67.5 ± 10.2 years) with lung cancer who were treated with immunotherapy between March 2014 and June 2019. From computed tomography scans, we assessed the radiological measures of skeletal muscle mass, and intramuscular, subcutaneous and visceral adipose tissue at the third lumbar vertebra. Patients were divided into two groups based on specific or median values at baseline and changes throughout treatment. A total number of 96 patients (99.0 %) had disease progression (median of 11.3 months) and died (median of 15.4 months) during follow-up. Increases of 10 % in intramuscular adipose tissue were significantly associated with DFS (HR: 0.60, 95 % CI: 0.38 to 0.95) and OS (HR: 0.60, 95 % CI: 0.37 to 0.95), while increases of 10 % in subcutaneous adipose tissue were associated with DFS (HR: 0.59, 95 % CI: 0.36 to 0.95). These results indicate that, although muscle mass and visceral adipose tissue were not associated with DFS or OS, changes in intramuscular and subcutaneous adipose tissue can predict immunotherapy clinical outcomes in patients with advanced lung cancer

Prehabilitative versus rehabilitative exercise in prostate cancer patients undergoing prostatectomy

Purpose: The study compared the efficacy of commencing supervised exercise in men with prostate cancer before and after prostatectomy on objective and patient-reported outcomes, hospital length of stay, and urinary incontinence. Methods: Forty-one men were randomised to a 6-week prehabilitation or rehabilitation exercise programme. Prehabilitation involved resistance and aerobic exercise thrice weekly pre-surgery, while rehabilitation comprised the same commencing 6-weeks post-surgery. Assessments included strength, function (chair rise, stair climb, 400-m, 6-m usual, fast, and backwards walk), body composition, fatigue and quality of life, undertaken at pre-surgery, early post-surgery and late post-surgery phase, with urinary incontinence (24-h pad test) assessed at 2, 6, and 12-weeks post-surgery. Intention-to-treat and sensitivity analyses were undertaken. Results: Of thirty-eight men (48–73 years), 29 completed all assessments with most undergoing robotic-assisted laparoscopic prostatectomy (92.1%). In the pre-surgery phase, prehabilitation improved muscle strength (leg press: 17.2 kg; chest press: 2.9 kg; p ≤ 0.001), 400-m, chair rise, 6-m fast and backward walk tests (p ≤ 0.001–0.028). Strength and function declines in the early post-surgery phase were maintained late post-surgery. Rehabilitation showed declines of these outcomes after surgery with improvement late post-surgery (leg press: 14.6 kg, p \u3c 0.001; chest press: 6.8 kg, p \u3c 0.001; 400-m walk: -12.0 s, p = 0.005), resulting in no difference between groups at 12 weeks. There were no significant differences between groups for patient-reported outcomes, hospital length of stay or urinary incontinence. Conclusion: Pre-surgical exercise enhanced strength and function, protecting against post-surgery declines. Although exercise post-surgery is beneficial for recouping strength and function, where possible men undergoing prostatectomy are encouraged to exercise pre-surgery. Trial registration: ACTRN12617001115325 registered 31 July 2017

Associations of fat and muscle mass with overall survival in men with prostate cancer: A systematic review with meta-analysis

Background To systematically review and analyse the associations between fat and muscle mass measures with overall survival in men with prostate cancer. Methods A systematic search was conducted in CINAHL, Cochrane Library, EMBASE, PubMed, and Web of Science databases from inception to December 2020, while abstracts from the American Society of Clinical Oncology (ASCO), Clinical Oncology Society of Australia (COSA), and the American College of Sports Medicine (ACSM) conferences were searched from 2014 to 2020. Eligible articles examined the association of body composition measures, such as fat mass (e.g., fat mass, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and VAT/SAT) and muscle mass measures, with overall survival in prostate cancer patients at any treatment stage. The primary endpoint was overall survival. Random-effect meta-analysis was conducted for studies reporting multivariable or univariable analysis assessing the associations of fat mass measures (i.e., fat mass, VAT, SAT, VAT/SAT) and muscle mass measures with overall survival. Results Sixteen cohort studies that comprised 4807 men with prostate cancer were included. Total adiposity (hazard ratio (HR) 0.98, 95% CI: 0.75–1.28, p = 0.888) and VAT (HR 1.03, 95% CI: 0.74–1.43, p = 0.873) were not significantly associated with overall survival, while higher subcutaneous adipose tissue levels were associated with higher survival (HR 0.68, 95% CI: 0.54–0.84, p = 0.001). Greater mortality risk was found in patients with localised (HR 1.91, 95% CI: 1.40–2.62, p \u3c 0.001) and advanced disease (HR 1.43, 95% CI: 1.07–1.92, p = 0.020) presenting with low levels of muscle mass compared to those presenting with high levels. Discussion These results indicate that although overall adiposity should be cautiously interpreted in regards to survival, high muscle mass and SAT, and low VAT/SAT ratio values are associated with overall survival in men with prostate cancer

What are the most effective exercise, physical activity and dietary interventions to improve body composition in women diagnosed with or at high-risk of breast cancer? A systematic review and network meta-analysis

Background: Obesity has been recognized as a risk factor in the development and recurrence of breast cancer and is also associated with poor prognostic outcomes. This systematic review and network meta-analysis aimed to identify the most effective exercise, physical activity, and dietary interventions to reduce fat mass, body fat percentage and body weight as well as potentially increase lean mass in women diagnosed with or at high risk of breast cancer. Methods: A systematic search of databases was performed up to May 2022. Eligible randomized controlled trials examined the effects of exercise, physical activity and/or dietary interventions on fat mass and lean mass in women diagnosed with or at high risk of breast cancer. A random-effects network meta-analysis was conducted to determine the effects of different interventions across outcomes when sufficient studies were available. Results: Eighty-four studies (n = 6428) were included in this review. Caloric restriction and combined exercise + caloric restriction significantly reduced fat mass (range, –3.9 to –3.7 kg) and body weight (range, –5.3 to –4.7 kg), whereas physical activity + caloric restriction significantly reduced body fat percentage (–2.4%; 95% confidence interval [CI], –3.4% to –13%) and body mass index (–2.2 kg × m–2; 95% CI, –3.0 to –1.4 kg × m–2) in breast cancer patients. Resistance exercise was the most effective intervention to increase lean mass (0.7 kg; 95% CI, 0.5–1.0 kg) in breast cancer patients. Conclusion: Multimodal exercise and diet programs were the most effective interventions to reduce fat mass, body fat percentage, and body weight and increase and/or preserve lean mass