Linking cardiorespiratory fitness classification criteria to early subclinical atherosclerosis in children

It is unclear if cardiorespiratory fitness (CRF) can be used as a screening tool for premature changes in carotid intima-media thickness (cIMT) in paediatric populations. The purpose of this cross-sectional study was 3-fold: (i) to determine if CRF can be used to screen increased cIMT; (ii) to determine an optimal CRF cut-off to predict increased cIMT; and (iii) to evaluate its ability to predict increased cIMT among children in comparison with existent CRF cut-offs. cIMT was assessed with high-resolution ultrasonography and CRF was determined using a maximal cycle test. Receiver operating characteristic analyses were conducted in boys (n = 211) and girls (n = 202) aged 11-12 years to define the optimal sex-specific CRF cut-off to classify increased cIMT (≥75th percentile). Logistic regression was used to examine the association between the CRF cut-offs with the risk of having an increased cIMT. The optimal CRF cut-offs to predict increased cIMT were 45.81 and 34.46 mL·kg(-1)·min(-1) for boys and girls, respectively. The odds-ratios for having increased cIMT among children who were unfit was up to 2.8 times the odds among those who were fit (95% confidence interval: 1.40-5.53). Considering current CRF cut-offs, only those suggested by Adegboye et al. 2011. (Br. J. Sports Med. 45(9): 722-728) and Boddy et al. 2012 (PLoS One, 7(9): e45755) were significant in predicting increased cIMT. In conclusion, CRF cut-offs (boys: ≤ 45.8; girls: ≤ 34.5 mL·kg(-1)·min(-1)) are associated with thickening of the arterial wall in 11- to 12-year-old children. Low CRF is an important cardiovascular risk factor in children and our data highlight the importance of obtaining an adequate CRF.info:eu-repo/semantics/publishedVersio

The Effects of Fire Fighting and On-Scene Rehabilitation on Hemostatis

Fire fighting is a dangerous occupation – in part because firefighters are called upon to perform strenuous physical activity in hot, hostile environments. Each year, approximately 100 firefighters lose their lives in the line of duty and tens of thousands are injured. Over the past 15 years, approximately 45% of line of duty deaths have been attributed to heart attacks and another 650-1,000 firefighters suffer non-fatal heart attacks in the line of duty each year. From 1990 to 2004, the total number of fireground injuries has declined, yet during this same period, the number of cases related to the leading cause of injury - overexertion/strain – remained relatively constant. It is well recognized that fire fighting leads to increased cardiovascular and thermal strain. However, the time course of recovery from fire fighting is not well documented, despite the fact that a large percentage of fire fighting fatalities occur after fire fighting activity. Furthermore, on scene rehabilitation (OSR) has been broadly recommended to mitigate the cardiovascular and thermal strain associated with performing strenuous fire fighting activity, yet the efficacy of different rehabilitation interventions has not been documented. Twenty-five firefighters were recruited to participate in a “within-subjects, repeated measures” study designed to describe the acute effects of fire fighting on a broad array of physiological and psychological measures and several key cardiovascular variables. This study provided the first detailed documentation of the time course of recovery during 2½ hours post-fire fighting. Additionally, we compared two OSR strategies (standard and enhanced) to determine their effectiveness.published or submitted for publicationnot peer reviewe

Impact of Combined Exercise on Chronic Obstructive Pulmonary Patients' State of Health

AIM: The aim of the study was to evaluate the effectiveness of a 10-week combined training programme (aerobic and strength exercise) compared to an aerobic training programme, and respiratory physiotherapy on COPD patients' health. METHODS: Fifty subjects with moderate to severe COPD were randomly assigned to two groups. Combined group (CG, n=25) who underwent combined training, and aerobic group (AG, n=25) who underwent aerobic training. These were compared with fifty COPD subjects who underwent respiratory physiotherapy, breathing control and bronchial clearance techniques (RP group, n = 50). We evaluated health state through two questionnaires, St. George's Respiratory Questionnaire (SGRQ) and SF-36, at the beginning and at the end of the programme. RESULTS: The CG group showed differences (p<0.0001) in modification rates in state of health compared to the AG and RP groups in the activity (64 ± 9%, 19 ± 7%, 1 ± 15%) , impact (35 ± 5%, 20 ± 18%, 1 ± 14%) and total (41 ± 9%, 26 ± 17%, 1 ± 15%) domains assessed by the SGRQ, and the physical function (109 ± 74%, 22 ± 12%, 0.1 ± 18%), physical role (52 ± 36%, 11 ± 15%, 1.3 ± 21%) and vitality (83 ± 39%, 14 ± 38%) domains assessed by SF-36. CONCLUSION: These results suggest that combined training in subjects with COPD appears to be a more effective method, with better clinical changes, and improvements in health state perception

The impact of exercise training on liver transplanted familial amyloidotic polyneuropathy (FAP) patients

Liver transplantation is nowadays the only effective answer to adjourn the outcome of functional limitations associated with familial amyloidotic polyneuropathy (FAP), a neurodegenerative disease characterized by sensory and motor polyneuropathies. Nevertheless, there is a detrimental impact associated with the after-surgery period on the fragile physical condition of these patients. Exercise training has been proven to be effective on reconditioning patients after transplantation. However, the effects of exercise training in liver transplanted FAP patients have not been scrutinized yet

Body fat responses to a 1-year combined exercise training program in male coronary artery disease patients

Objective: To analyze the body fat (BF) content and distribution modifications in coronary artery disease (CAD) patients in response to a 1-year combined aerobic and resistance exercise training (CET) program. Design and Methods: We followed two groups of CAD male patients for 12 months. One group consisted of 17 subjects (57 6 12 years) who engaged in a CET program (CET group) and the other was a age-matched control group of 10 subjects (58 6 11 years). BF content and distribution were measured through dual energy X-ray absorptiometry (DXA) at baseline and follow-up. Results: We found no differences on body mass and BMI between baseline and end of follow-up in both groups but, in CET group, we found significant reductions in all analyzed BF depots, including total BF (21.60 6 6.00 vs. 20.32 6 5.89 kg, P < 0.01), % total BF (27.8 6 5.5 vs. 26.4 6 5.4%, P < 0.05), trunk fat (12.54 6 3.99 vs. 11.77 6 4.01 kg, P < 0.05), % trunk fat (31.1 6 6.9 and 29.2 6 7.1%, P < 0.05), appendicular fat (8.22 6 2.08 vs. 7.72 6 2.037 kg, P < 0.01), % appendicular fat (25.7 6 4.9 and 24.5 6 4.9%, P < 0.05), and abdominal fat (2.95 6 1.06 vs. 2.75 6 1.10 kg, P < 0.05). Control group showed significant increase in appendicular fat (7.63 6 1.92 vs. 8.10 6 2.12 kg, P < 0.05). Conclusions: These results confirm the positive effect of CET on body composition of CAD patients, despite no changes in body mass or BMI. In this study, we observed no alterations on BF distribution meaning similar rate of fat loss in all analyzed BF depots. These results also alert for the limitations of BMI for tracking body composition changes.info:eu-repo/semantics/publishedVersio

A Post Hoc Analysis on Rhythm and High Intensity Interval Training in Cardiac Resynchronization Therapy

Objectives. Evaluate the effects of a 6-month High Intensity Interval Training (HIIT) program on (1) functional capacity and health-related quality of life, (2) multiple blood biomarkers, (3) echocardiographic parameters, and (4) exercise performance, in patients in cardiac resynchronization therapy (CRT) stratified by the presence of atrial fibrillation (AF), targeting the following questions: (1) Does CRT provide similar benefits in patients in AF and sinus rhythm (SR)?; and (2) Does HIIT provides similar benefits in patients in AF and SR? Design. Estimates were available at baseline and 6 months after CRT implantation in 37 patients with heart failure. Patients were randomized after CRT to a 24-week HIIT group or to a usual care group (CON). In this sub-analysis, HIIT (AF = 7; SR = 11) and CON (AF = 9; SR = 10) were stratified by the presence of AF. Results. Patients in AF benefitted to a lesser degree from CRT in functional status than patients in SR (23.8-46.0%). However, HIIT induced superior improvements in patients in AF compared to CON (23.9-61.0%). Decreases in TNF-α (8.5-42.9%), BNP (15.3-34.6%) and left ventricular mass (9.6-26.2%) were only observed in patients in SR, whereas increases in peak oxygen uptake were only observed in patients in AF (19.5-23.2%). HIIT improved exercise capacity (8.8-59.4%) in patients in SR. Conclusions. Patients in AF or SR undergoing CRT demonstrated distinct benefits from device implantation and from HIIT as an adjunctive therapeutic strategy. This suggests that both mainstay and adjunctive therapeutics may need to be managed differently in patients in AF and SR.info:eu-repo/semantics/publishedVersio

Wellness and Multiple Sclerosis: The National MS Society Establishes a Wellness Research Working Group and Research Priorities

Background: People with multiple sclerosis (MS) have identified “wellness” and associated behaviors as a high priority based on “social media listening” undertaken by the National MS Society (i.e. the Society). Objective: The Society recently convened a group that consisted of researchers with experience in MS and wellness-related research, Society staff members, and an individual with MS for developing recommendations regarding a wellness research agenda. Method: The members of the group engaged in focal reviews and discussions involving the state of science within three approaches for promoting wellness in MS, namely diet, exercise, and emotional wellness. Results: That process informed a group-mediated activity for developing and prioritizing research goals for wellness in MS. This served as a background for articulating the mission and objectives of the Society’s Wellness Research Working Group. Conclusion: The primary mission of the Wellness Research Working Group is the provision of scientific evidence supporting the application of lifestyle, behavioral, and psychosocial approaches for promoting optimal health of mind, body, and spirit (i.e. wellness) in people with MS as well as managing the disease and its consequences

High-Intensity Interval Training in Cardiac Resynchronization Therapy: a Randomized Control Trial

AIMS: To determine the effects of high-intensity interval training (HIIT) following cardiac resynchronization therapy (CRT) implantation in patients with chronic heart failure (CHF), on noninvasive estimates of systolic ventricular function, exercise performance, severity of symptoms and quality of life. METHODS: Cardiopulmonary exercise testing, resting transthoracic echocardiogram and health-related quality of life assessment were obtained before and at 6 months after CRT implantation in 37 patients with moderate-to-severe CHF. Patients were randomized after CRT to either a 24-week HIIT group (90-95% peak heart rate, 2 days per week) or to a usual care group (CON). Mixed design 2 × 2 repeated measures ANOVA were used to test for differences within and in-between groups. RESULTS: Improvements in health-related quality of life (HIIT = 98.54%, CON = 123.47%), NYHA class (HIIT = 43.44%, CON = 38.30%) HR recovery at minute 1 (HIIT = 32.32%, CON = 42.94%), pulse pressure at peak effort (HIIT = 14.06%, CON = 9.52%, LVEF (HIIT = 42.17%, CON = 51.10%) and LV Mass (HIIT = 13.26%, CON = 11.88%) were similar in both groups (p > 0.05). Significant increases in CPET duration in the HIIT group (25.94%), and increases in peak VO2 (HIIT = 8.64%, CON = 4.85%) and percent-predicted VO2 (HIIT = 10.57%, CON = 4.26%) in both groups, were observed in the intention-to-treat analysis. CONCLUSION: Six months of HIIT in patients in CRT did not further improved indices of functional capacity and health-related quality of life, and LV structure and function, compared to CRT alone. However, HIIT led to further improvements in exercise performance. It remains unclear whether HIIT benefits patients in CRT to a similar degree as more conventional forms of exercise training previously shown to maximize benefits in CRT.info:eu-repo/semantics/publishedVersio

A study protocol of a randomised controlled trial to investigate if a community based strength training programme improves work task performance in young adults with Down syndrome

<p>Abstract</p> <p>Background</p> <p>Muscle strength is important for young people with Down syndrome as they make the transition to adulthood, because their workplace activities typically emphasise physical rather than cognitive skills. Muscle strength is reduced up to 50% in people with Down syndrome compared to their peers without disability. Progressive resistance training improves muscle strength and endurance in people with Down syndrome. However, there is no evidence on whether it has an effect on work task performance or physical activity levels. The aim of this study is to investigate if a student-led community-based progressive resistance training programme can improve these outcomes in adolescents and young adults with Down syndrome.</p> <p>Methods</p> <p>A randomised controlled trial will compare progressive resistance training with a control group undertaking a social programme. Seventy adolescents and young adults with Down syndrome aged 14-22 years and mild to moderate intellectual disability will be randomly allocated to the intervention or control group using a concealed method. The intervention group will complete a 10-week, twice a week, student-led progressive resistance training programme at a local community gymnasium. The student mentors will be undergraduate physiotherapy students. The control group will complete an arts/social programme with a student mentor once a week for 90 minutes also for 10 weeks to control for the social aspect of the intervention. Work task performance (box stacking, pail carry), muscle strength (1 repetition maximum for chest and leg press) and physical activity (frequency, duration, intensity over 7-days) will be assessed at baseline (Week 0), following the intervention (Week 11), and at 3 months post intervention (Week 24) by an assessor blind to group allocation. Data will be analysed using ANCOVA with baseline measures as covariates.</p> <p>Discussion</p> <p>This paper outlines the study protocol for a randomised controlled trial on the effects of progressive resistance training on work task performance and physical activity for adolescents and young adults with Down syndrome. The intervention addresses the impairment of muscle weakness which may improve work task performance and help to increase physical activity levels.</p> <p>Clinical trial registration number</p> <p>Australian New Zealand Clinical Trials Registry ACTRN12609000938202</p

Body composition and body fat distribution are related to cardiac autonomic control in non-alcoholic fatty liver disease patients

BACKGROUND/OBJECTIVES: Heart rate recovery (HRR), a cardiac autonomic control marker, was shown to be related to body composition (BC), yet this was not tested in non-alcoholic fatty liver disease (NAFLD) patients. The aim of this study was to determine if, and to what extent, markers of BC and body fat (BF) distribution are related to cardiac autonomic control in NAFLD patients. SUBJECTS/METHODS: BC was assessed with dual-energy X-ray absorptiometry in 28 NAFLD patients (19 men, 51±13 years, and 9 women, 47±13 years). BF depots ratios were calculated to assess BF distribution. Subjects’ HRR was recorded 1 (HRR1) and 2 min (HRR2) immediately after a maximum graded exercise test. RESULTS: BC and BF distribution were related to HRR; particularly weight, trunk BF and trunk BF-to-appendicular BF ratio showed a negative relation with HRR1 (r 1⁄4 0.613, r 1⁄4 0.597 and r 1⁄4 0.547, respectively, Po0.01) and HRR2 (r 1⁄4 0.484, r 1⁄4 0.446, Po0.05, and r 1⁄4 0.590, Po0.01, respectively). Age seems to be related to both HRR1 and HRR2 except when controlled for BF distribution. The preferred model in multiple regression should include trunk BF-to-appendicular BF ratio and BF to predict HRR1 (r2 1⁄4 0.549; Po0.05), and trunk BF-to-appendicular BF ratio alone to predict HRR2 (r2 1⁄4 0.430; Po0.001). CONCLUSIONS: BC and BF distribution were related to HRR in NAFLD patients. Trunk BF-to-appendicular BF ratio was the best independent predictor of HRR and therefore may be best related to cardiovascular increased risk, and possibly act as a mediator in age-related cardiac autonomic control variation.info:eu-repo/semantics/publishedVersio