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Pubblicazioni recenti - cardiorespiratory
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Effects of a functional training programme in patients with Fibromyalgia: A 9-years prospective longitudinal cohort study.
Scand J Med Sci Sports2020 Feb;():. doi: 10.1111/sms.13640.
Santos E Campos M A, Párraga-Montilla J A, Aragón-Vela J, Latorre-Román P Á,
Abstract
There are evidences that physical exercise is an effective instrument for improving physical fitness, health and quality of life and causes beneficial effects on the symptoms of patients with fibromyalgia. The purpose of this study was to analyse effects of a functional training programme on pain, fitness and quality of life in patients with fibromyalgia in a 9-year prospective longitudinal cohort study. Forty women with fibromyalgia participated in this study; 24 received an exercise programme and were called the active group, and 16 were the control group. Tender points, visual analogical scale (VAS) of pain, physical fitness, Fibromyalgia Impact Questionnaire (FIQ) and Short Form Health Survey 36 (SF-36) were analysed. The active group experienced significant improvements in FIQ, TP, and VAS (P<0.001), whereas the control group showed significant worsening in the FIQ scale (P=0.004). Moreover, the active group experienced significant improvements in leg strength (P<0.001), balance (P=0.033), cardiorespiratory fitness (P<0.001), emotional role (P=0.024) and mental health (P=0.025); whereas the control group significantly worsened on handgrip strength (P=0.017), balance (P=0.043), cardiorespiratory fitness (P=0.020) and in general health (P<0.001). A Pearson correlation analysis revealed a significant relationship between the improvement in physical fitness variables and the improvements in FIQ, TP and VAS. In conclusion, a regular practice of moderate-intensity physical activity shows a positive effect long-term on fitness, pain, the impact of the disease and the quality of life in women with fibromyalgia.
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The Effect of an 8 Week Prescribed Exercise and Low-Carbohydrate Diet on Cardiorespiratory Fitness, Body Composition and Cardiometabolic Risk Factors in Obese Individuals: A Randomised Controlled Trial.
Nutrients2020 Feb;12(2):. doi: E482.
Perissiou Maria, Borkoles Erika, Kobayashi Kent, Polman Remco,
Abstract
BACKGROUND:
Low-carbohydrate (LC) diets are an effective method for treating obesity and reducing cardiometabolic risk. However, exposure to LC diets is associated with reductions in muscle mass and increased osteoporosis risk in obese individuals. The combination of exercise with a LC diet appears to attenuate muscle mass loss induced by LC diets alone, and to further improve cardiometabolic profile. However, evidence to date in obese individuals is limited. We assessed the effect of LC diet in combination with supervised exercise on cardiorespiratory fitness, body composition and cardiometabolic risk factors in obese individuals. Male and female participants in the experimental (EX-LC; structured supervised exercise program + low-carbohydrate meals; n = 33; 35.3 years) and control (EX-CO; structured supervised exercise program + standard dietary advice; n = 31; 34.2 years) conditions underwent measurements of cardiorespiratory fitness (Opeak), body fat, lean muscle mass (LMM), and cardiometabolic biomarkers before and after an 8 week intervention. : Participants in the EX-LC condition demonstrated greater improvements in Opeak ( = 0.002) and fat mass index (FMI, = 0.001) compared to the EX-CO condition. Achieving a ketogenic state (?-hydroxybutyrate, ?HB ?0.3 mmol/L) was associated with greater reductions in total body fat ( = 0.011), visceral adipose tissue ( = 0.025), FMI ( = 0.002) and C-reactive protein (CRP, = 0.041) but also with greater reductions in LMM ( = 0.042). : Short-term LC diet combined with prescribed exercise enhanced cardiorespiratory fitness and the cardiometabolic profile of obese individuals but was also associated with greater muscle mass loss compared to similar exercise training and standard dietary advice. The long-term effects of the LC diet should be further explored in future studies.
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Effects of interval training versus continuous training on coronary artery disease: an updated meta-analysis of randomized controlled trials.
Physiother Theory Pract2020 Feb;():1-10. doi: 10.1080/09593985.2019.1706213.
Chen Lei, Tang Lin,
Abstract
: Exercise training-based cardiac rehabilitation is a safe intervention to improve aerobic exercise capacity, metabolic parameters, muscle strength, quality of life, and survival in patients with coronary artery disease (CAD). This study aimed to evaluate the effects of interval training (IT) and continuous training (CT) on CAD for appropriate treatment. : We retrieved 12 high-quality randomized controlled trials (RCTs) till August 13, 2019, focused on the effects of IT and CT on patients with CAD from the Pubmed, Embase, and Cochrane Library databases. The following disease-related parameters were collected: peak oxygen uptake (peak O), peak heart rate (HR), respiratory exchange ratio (RER) at the peak O, heart rate recovery, resting HR, resting systolic blood pressure (SBP), and resting diastolic blood pressure. Additionally, study quality was assessed using the Cochrane risk assessment tool, and heterogeneity was estimated using -statistic and -test. The effect size was presented with weighted mean difference (WMD) and 95% confidence intervals (CIs). : No publication bias was identified in the selected 12 RCTs. The pooled data showed a significant increase in the peak O (WMD = -2.00, < .0001), peak HR (WMD = -5.88, = .0003), and RER at the peak O (WMD = -0.02, = .0001) in the IT group compared to the CT group. SBP (WMD = -3.23, = .0498) showed significant improvement in the IT group compared to the CT group. : IT helps improve cardiorespiratory fitness in patients with CAD because it brings about greater improvement in the peak exercise capacity and resting SBP compared to CT.
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[Measuring physical fitness in the German National Cohort-methods, quality assurance, and first descriptive results].
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz2020 Feb;():. doi: 10.1007/s00103-020-03100-3.
Kluttig Alexander, Zschocke Johannes, Haerting Johannes, Schmermund Axel, Gastell Sylvia, Steindorf Karen, Herbolsheimer Florian, Hillreiner Andrea, Jochem Carmen, Baumeister Sebastian, Sprengeler Ole, Pischon Tobias, Jaeschke Lina, Michels Karin B, Krist Lilian, Greiser Halina, Schmidt Gerhard, Lieb Wolfgang, Waniek Sabina, Becher Heiko, Jagodzinski Annika, Schipf Sabine, Völzke Henry, Ahrens Wolfgang, Günther Kathrin, Castell Stefanie, Kemmling Yvonne, Legath Nicole, Berger Klaus, Keil Thomas, Fricke Julia, Schulze Matthias B, Loeffler Markus, Wirkner Kerstin, Kuß Oliver, Schikowski Tamara, Kalinowski Sonja, Stang Andreas, Kaaks Rudolf, Damms Machado Antje, Hoffmeister Michael, Weber Barbara, Franzke Claus-Werner, Thierry Sigrid, Peters Anette, Kartschmit Nadja, Mikolajczyk Rafael, Fischer Beate, Leitzmann Michael, Brandes Mirko,
Abstract
Physical fitness is defined as an individual's ability to be physically active. The main components are cardiorespiratory fitness (CRF), muscle strength, and flexibility. Regardless of physical activity level, physical fitness is an important determinant of morbidity and mortality.The aim of the current study was to describe the physical fitness assessment methodology in the German National Cohort (NAKO) and to present initial descriptive results in a subsample of the cohort.In the NAKO, hand grip strength (GS) and CRF as physical fitness components were assessed at baseline using a hand dynamometer and a submaximal bicycle ergometer test, respectively. Maximum oxygen uptake (VO) was estimated as a result of the bicycle ergometer test. The results of a total of 99,068 GS measurements and 3094 CRF measurements are based on a data set at halftime of the NAKO baseline survey (age 20-73 years, 47% men).Males showed higher values of physical fitness compared to women (males: GS?=?47.8?kg, VO?=?36.4?ml·min?·?kg; females: GS?=?29.9?kg, VO?=?32.3?ml?·?min?·?kg). GS declined from the age of 50 onwards, whereas VO levels decreased continuously between the age groups of 20-29 and ?60 years. GS and VO showed a linear positive association after adjustment for body weight (males ??=?0.21; females ??=?0.35).These results indicate that the physical fitness measured in the NAKO are comparable to other population-based studies. Future analyses in this study will focus on examining the independent relations of GS and CRF with risk of morbidity and mortality.
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Cardiorespiratory fitness and mnemonic discrimination across the adult lifespan.
Learn Mem2020 Mar;27(3):91-103. doi: 10.1101/lm.049197.118.
Nauer Rachel K, Schon Karin, Stern Chantal E,
Abstract
With a rising aging population, it is important to develop behavioral tasks that assess and track cognitive decline, and to identify protective factors that promote healthy brain aging. Mnemonic discrimination tasks that rely on pattern separation mechanisms are a promising metric to detect subtle age-related memory impairments. Behavioral performance on these tasks rely on the integrity of the hippocampus and surrounding circuitry, which are brain regions known to be adversely affected in aging and neurodegenerative disorders. Aerobic exercise, which improves cardiorespiratory fitness (CRF), has been shown to counteract aging-related decreases in structural and functional brain integrity and attenuate decline of cognitive performance. Here, we tested the hypothesis that higher CRF attenuates age-related deficits in mnemonic discrimination in both a nonspatial mnemonic discrimination (Mnemonic Similarity Task) and a virtual navigation task (Route Disambiguation Task). Importantly, we included individuals across the lifespan (aged 18-83 yr), including the middle-age range, to determine mnemonic discrimination performance across adulthood. Participants completed two mnemonic discrimination tasks and a treadmill test to assess CRF. Our results demonstrate robust negative age-related effects on mnemonic discrimination performance across both the nonspatial and spatial domains. Critically, higher CRF mitigated age-related attenuation in spatial contextual discrimination task performance, but did not show an attenuation effect on performance for object-based mnemonic discrimination. These results suggest that performance on spatial mnemonic discrimination may be a useful tool to track vulnerability in older individuals at risk for cognitive decline, and that higher CRF may lead to cognitive preservation across the adult lifespan, particularly for spatial disambiguation of similar contexts.
© 2020 Nauer et al.; Published by Cold Spring Harbor Laboratory Press.
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Urban Form, Air Quality, and Cardiorespiratory Mortality: A Path Analysis.
Int J Environ Res Public Health2020 Feb;17(4):. doi: E1202.
Li Chaosu, Song Yan, Tian Li, Ouyang Wei,
Abstract
With the unprecedented urbanization during the past three decades, air quality in many Chinese cities has been a serious issue which poses great challenges for urban sustainability. This study examines the health consequences of development patterns in China by establishing the linkage between urban form, air pollution level, and cardiorespiratory mortality rate. We assembled a dataset by compiling a series of variables from multiple sources, including China's Disease Surveillance Points (DSP) system, which forms a nationally representative sample of mortality for the year 2005, Chinese census, satellite imagery, and the Chinese National Land Use Database. After controlling for local climate, demography, socioeconomics, and other pollution factors, this study finds that urban form elements (e.g., urban density, fragmentation level, forest/green space ratio) have significant influences on PM (atmospheric particulate matter with a diameter of less than 2.5 micrometers) concentration, thus influencing the incidence of cardiorespiratory mortality at the county level. These results may help explain how the type and pattern of development shape public health by influencing air quality and form an evidence-based land use policy to improve environmental quality and public health.
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School-Based Sedentary Behavior, Physical Activity, and Health-Related Outcomes among Hispanic Children in the United States: A Cross-Sectional Study.
Int J Environ Res Public Health2020 Feb;17(4):. doi: E1197.
Gu Xiangli, Zhang Tao, Chen Senlin, Keller M Jean, Zhang Xiaoxia,
Abstract
The main purpose of this study was to examine the relationships between school-based sedentary behavior, physical activity, and health-related outcomes, including cardiorespiratory fitness, weight status, and health-related quality of life (HRQOL) among Hispanic children. The participants were 374 children (192 boys, 182 girls; = 9.64) recruited from four elementary schools from 3rd grade through to 5th grade. Sedentary behavior and physical activity behaviors (light physical activity [LPA] and moderate-to-vigorous physical activity (MVPA)) during school were measured by accelerometers. Cardiorespiratory fitness and weight status were measured using the FITNESSGRAM, while HRQOL was measured using the PedsQL 4.0 Spanish version, a validated questionnaire. Sedentary behavior was negatively correlated with cardiorespiratory fitness and HRQOL but positively associated with weight status. MVPA was positively correlated with cardiorespiratory fitness and HRQOL, but negatively associated with weight status and sedentary behavior. Multiple regressions demonstrated that sedentary behavior significantly predicted cardiorespiratory fitness and weight status, whereas MVPA significantly predicted HRQOL. With the current public health priority aiming to reduce health disparities in minority populations, the findings of this study provide important insights. Educators, health care providers, or other professionals working with Hispanic children are encouraged to focus on reducing sedentary behavior and promoting physical activity to improve their health-related outcomes.
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Nutrients and Microbiota in Lung Diseases of Prematurity: The Placenta-Gut-Lung Triangle.
Nutrients2020 Feb;12(2):. doi: E469.
Piersigilli Fiammetta, Van Grambezen Bénédicte, Hocq Catheline, Danhaive Olivier,
Abstract
Cardiorespiratory function is not only the foremost determinant of life after premature birth, but also a major factor of long-term outcomes. However, the path from placental disconnection to nutritional autonomy is enduring and challenging for the preterm infant and, at each step, will have profound influences on respiratory physiology and disease. Fluid and energy intake, specific nutrients such as amino-acids, lipids and vitamins, and their ways of administration -parenteral or enteral-have direct implications on lung tissue composition and cellular functions, thus affect lung development and homeostasis and contributing to acute and chronic respiratory disorders. In addition, metabolomic signatures have recently emerged as biomarkers of bronchopulmonary dysplasia and other neonatal diseases, suggesting a profound implication of specific metabolites such as amino-acids, acylcarnitine and fatty acids in lung injury and repair, inflammation and immune modulation. Recent advances have highlighted the profound influence of the microbiome on many short- and long-term outcomes in the preterm infant. Lung and intestinal microbiomes are deeply intricated, and nutrition plays a prominent role in their establishment and regulation. There is an emerging evidence that human milk prevents bronchopulmonary dysplasia in premature infants, potentially through microbiome composition and/or inflammation modulation. Restoring antibiotic therapy-mediated microbiome disruption is another potentially beneficial action of human milk, which can be in part emulated by pre- and probiotics and supplements. This review will explore the many facets of the gut-lung axis and its pathophysiology in acute and chronic respiratory disorders of the prematurely born infant, and explore established and innovative nutritional approaches for prevention and treatment.
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Validation of Maximal, Submaximal, and Nonexercise Indirect Omax Estimations at 2600?m Altitude.
High Alt Med Biol2020 Feb;():. doi: 10.1089/ham.2019.0097.
Duperly John, Serrato Mauricio, Forero Nestor I, Jimenez-Mora Mario A, Mendivil Carlos O, Lobelo Felipe,
Abstract
To study the criterion validity of three indirect maximal oxygen uptake (Omax) assessment equations at altitude. We studied 64 young adults (53% men) at Bogota, Colombia (2600?m altitude). Direct Omax was measured by indirect calorimetry using a maximal incremental treadmill protocol. Indirect Omax was estimated by two exercise field tests (the 20-m shuttle-run test [20-MST] and the 2-km walking test (UKK)) and one nonexercise method (the perceived functional ability-physical activity rating questionnaire [PFA-PAR]). Altitude-adjusted PFA-PAR was estimated as a 13% linear reduction in PFA-PAR. We calculated Lin concordance coefficients (LCC) and standard error of the estimates (SEEs), and we performed Bland-Altman analyses for each indirect method. Mean Omax was 41.2?±?5.8?mL/kg/min in men and 32.2?±?3.6?mL/kg/min in women. We found the highest agreement with direct Omax for the 20-MST (LCC?=?0.79, SEE?=?3.91?mL/kg/min), followed in order by the altitude-adjusted PFA-PAR (LCC?=?0.71, SEE?=?4.12?mL/kg/min), the UKK (LCC?=?0.67, SEE?=?5.48?mL/kg/min), and the unadjusted PFA-PAR (LCC?=?0.57, SEE?=?4.75?mL/kg/min). The unadjusted PFA-PAR tended to overestimate Omax, but Bland-Altman analysis showed that this bias disappeared after altitude adjustment. Several maximal, submaximal, and nonexercise methods provide estimates of Omax with acceptable validity for use in epidemiological studies of populations living at moderate altitude.
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Association of objectively measured physical fitness during pregnancy with maternal and neonatal outcomes. The GESTAFIT Project.
PLoS One2020 ;15(2):e0229079. doi: 10.1371/journal.pone.0229079.
Baena-García Laura, Coll-Risco Irene, Ocón-Hernández Olga, Romero-Gallardo Lidia, Acosta-Manzano Pedro, May Linda, Aparicio Virginia A,
Abstract
AIM:
To analyse i) the association of physical fitness during early second trimester and late pregnancy with maternal and neonatal outcomes; and ii) to investigate whether physical fitness is associated with the type of birth (vaginal or caesarean section).
METHODS:
Pregnant women from the GESTAFIT Project (n = 159) participated in this longitudinal study. Maternal physical fitness including upper- and lower-body strength, cardiorespiratory fitness (CRF) and flexibility were measured through objective physical fitness tests at the 16th and 34th gestational weeks. Maternal and neonatal outcomes were collected from obstetric medical records. Umbilical arterial and venous blood gas pH and partial pressure of carbon dioxide (PCO2) and oxygen (PO2), were assessed.
RESULTS:
At the 16th week, greater upper-body muscle strength was associated with greater neonatal birth weight (r = 0.191, p<0.05). Maternal flexibility was associated with a more alkaline arterial pH (r = 0.220, p<0.05), higher arterial PO2 (r = 0.237, p<0.05) and lower arterial PCO2 (r = -0.331, p<0.01) in umbilical cord blood. Maternal CRF at the 16th gestational week was related to higher arterial umbilical cord PO2 (r = 0.267, p<0.05). The women who had caesarean sections had lower CRF (p<0.001) at the 16th gestational week and worse clustered overall physical fitness, both at the 16th (-0.227, p = 0.003, confidence interval (CI): -0.376, -0.078) and 34th gestational week (-0.223; p = 0.018; CI: -0.432, -0.015) compared with the women who had vaginal births.
CONCLUSION:
Increasing physical fitness during pregnancy may promote better neonatal outcomes and is associated with a decrease in the risk of caesarean section. This trial was registered at ClinicalTrials.gov (NCT02582567) on October 20, 2015.
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Beyond general resistance training. Hypertrophy versus muscular endurance training as therapeutic interventions in adults with type 2 diabetes mellitus: A systematic review and meta-analysis.
Obes Rev2020 Feb;():. doi: 10.1111/obr.13007.
Acosta-Manzano Pedro, Rodriguez-Ayllon María, Acosta Francisco M, Niederseer David, Niebauer Josef,
Abstract
Resistance training (RT) is a powerful first-line intervention for the management of type 2 diabetes mellitus (T2DM). Nonetheless, the effects of the most frequent RT (hypertrophy training [HT] and muscular endurance training [MERT]) employed for the management of T2DM, and which type of RT might exert superior effects, remain elusive. Thus, this review aims to assess the effects of HT and MERT on glycaemic control, physical fitness, body composition, lipid profile, blood pressure, C-reactive protein, and quality of life in patients with T2DM; to analyse which particular RT is more effective; to assess the effects of general RT; and to identify RT components, characteristics of patients, and medications that could mediate the effects of RT. Randomized controlled trials (RCT) and non-RCT (RT? 4 weeks) in adults with T2DM were selected. Both HT and MERT improved HbA1c, insulin levels and sensitivity, muscle strength, body mass index, waist circumference, and fat mass. Additionally, HT improved glucose, cardiorespiratory fitness, fat percentage, lean body mass, lipid profile, systolic blood pressure, and C-reactive protein, and MERT improved weight. Overall, HT and MERT exert beneficial effects well comparable with aerobic training. Both types of RT can be used as potent therapeutic interventions for the management of T2DM depending on patients' limitations/preferences.
© 2020 World Obesity Federation.
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Can childcare work be designed to promote moderate and vigorous physical activity, cardiorespiratory fitness and health? Study protocol for the Goldilocks-childcare randomised controlled trial.
BMC Public Health2020 Feb;20(1):237. doi: 10.1186/s12889-020-8291-y.
Lidegaard Mark, Lerche Anders Fritz, Munch Pernille Kold, Schmidt Kathrine Greby, Rasmussen Charlotte Lund, Rasmussen Charlotte Diana Nřrregaard, Mathiassen Svend Erik, Straker Leon, Holtermann Andreas,
Abstract
BACKGROUND:
Despite extensive efforts, issues like obesity and poor physical capacity remain challenges for a healthy work life in several occupations. The Goldilocks work principle offers a new approach, encouraging design of productive work to promote physical capacity and health. This paper presents the protocol for the Goldilocks-childcare study, a randomised controlled intervention trial aiming to evaluate the effectiveness of implementing the Goldilocks work principle in childcare. The primary aim of the intervention is to increase time in moderate to vigorous physical activity (MVPA) by having the childcare workers act as active role models for children in daily playful physical activities, and thereby improve cardiorespiratory fitness and health of the workers.
METHODS:
The study is a cluster-randomised trial with a usual-practice wait-list control group. The 10-week intervention consists of two phases. In the first, the childcare workers will participate in two participatory workshops aiming to a) develop playful physical activities ('Goldilocks-games') for children in which childcare workers participate as active role models at MVPA intensity, and b) develop action plans for implementation of the Goldilocks-games in daily work routines. In the second phase, childcare institutions will implement the Goldilocks-games. The primary outcome is working time spent in MVPA, and secondary outcomes are cardiorespiratory fitness, sleeping heart rate, perceived need for recovery, and productivity. Primary outcome and process evaluation will be based on direct measurements of physical activity and heart rate, determination of cardiorespiratory fitness, and questionnaires.
DISCUSSION:
If proven effective, the Goldilocks work principle has a large potential for promoting sustainable health and working lives of childcare workers.
TRIAL REGISTRATION:
ISRCTN, ISRCTN15644757, Registered 25th December 2019.
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Effects of Exercise Therapy Dosing Schedule on Impaired Cardiorespiratory Fitness in Patients With Primary Breast Cancer: A Randomized Controlled Trial.
Circulation2020 Feb;141(7):560-570. doi: 10.1161/CIRCULATIONAHA.119.043483.
Scott Jessica M, Thomas Samantha M, Peppercorn Jeffrey M, Herndon James E, Douglas Pamela S, Khouri Michel G, Dang Chau T, Yu Anthony F, Catalina Diane, Ciolino Cristi, Capaci Catherine, Michalski Meghan G, Eves Neil D, Jones Lee W,
Abstract
BACKGROUND:
Current exercise guidelines for clinical populations recommend an exercise therapy (ET) prescription of fixed intensity (moderate), duration (40-50 minutes per session), and volume (120-160 min/wk). A critical overarching element of exercise programming that has received minimal attention is dose scheduling. We investigated the tolerability and efficacy of 2 exercise training dose regimens on cardiorespiratory fitness and patient-reported outcomes in patients with posttreatment primary breast cancer.
METHODS:
Using a parallel-group randomized trial, we randomly allocated 174 postmenopausal patients (2.8 years after adjuvant therapy) with impaired peak oxygen consumption (VOpeak) to 1 of 2 supervised exercise training interventions delivered with a standard linear (LET) (fixed dose intensity per session for 160 min/wk) or nonlinear (NLET) (variable dose intensity per session for ?120 min/wk) schedule compared with a stretching attention control group for 16 consecutive weeks. Stretching was matched to exercise dosing arms on the basis of location, frequency, duration, and treatment length. The primary end point was change in VOpeak (mL O·kg·min) from baseline to after intervention. Secondary end points were patient-reported outcomes, tolerability, and safety.
RESULTS:
No serious adverse events were observed. Mean attendance was 64%, 75%, and 80% for attention control, LET, and NLET, respectively. In intention-to-treat analysis, VOpeak increased 0.6±1.7 mL O·kg·min (=0.05) and 0.8±1.8 mL O·kg·min (=0.07) in LET and NLET, respectively, compared with attention control. Change in VOpeak ranged from -2.7 to 4.1 mL O·kg·min and from -3.6 to 5.1 mL O·kg·min in LET and NLET, respectively. Approximately 40% of patients in both exercise dosing regimens were classified as VOpeak responders (ie, ? ?1.32 mL O·kg·min). NLET improved all patient-reported outcomes compared with attention control.
CONCLUSIONS:
Short-term exercise training, independently of dosing schedule, is associated with modest improvements in cardiorespiratory fitness in patients previously treated for early-stage breast cancer.
CLINICAL TRIAL REGISTRATION:
URL: https://www.clinicaltrials.gov. Unique identifier: NCT01186367.
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A Rapidly Incremented Tethered-Swimming Maximal Protocol for Cardiorespiratory Assessment of Swimmers.
J Vis Exp2020 Jan;(155):. doi: 10.3791/60630.
Pessôa Filho Dalton M, Massini Danilo A, Siqueira Leandro O C, Santos Luiz Gustavo A, Vasconcelos Camila M T, Almeida Tiago A F, Espada Mário A C, Reis Joana F, Alves Francisco B, DiMenna Fred J,
Abstract
Incremental exercise testing is the standard means of assessing cardiorespiratory capacity of endurance athletes. While the maximal rate of oxygen consumption is typically used as the criterion measurement in this regard, two metabolic breakpoints that reflect changes in the dynamics of lactate production/consumption as the work rate is increased are perhaps more relevant for endurance athletes from a functional standpoint. Exercise economy, which represents the rate of oxygen consumption relative to performance of submaximal work, is also an important parameter to measure for endurance-athlete assessment. Ramp incremental tests comprising a gradual but rapid increase in work rate until the limit of exercise tolerance is reached are useful for determining these parameters. This type of test is typically performed on a cycle ergometer or treadmill because there is a need for precision with respect to work-rate incrementation. However, athletes should be tested while performing the mode of exercise required for their sport. Consequently, swimmers are typically assessed during free-swimming incremental tests where such precision is difficult to achieve. We have recently suggested that stationary swimming against a load that is progressively increased (incremental tethered swimming) can serve as a "swim ergometer" by allowing sufficient precision to accommodate a gradual but rapid loading pattern that reveals the aforementioned metabolic breakpoints and exercise economy. However, the degree to which the peak rate of oxygen consumption achieved during such a protocol approximates the maximal rate that is measured during free swimming remains to be determined. In the present article, we explain how this rapidly incremented tethered-swimming protocol can be employed to assess the cardiorespiratory capacity of a swimmer. Specifically, we explain how assessment of a short-distance competitive swimmer using this protocol revealed that his rate of oxygen uptake was 30.3 and 34.8 mL?min?kgBM at his gas-exchange threshold and respiratory compensation point, respectively.
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Athletes for life: Rationale and methodology of a community- and family-based randomized controlled trial to promote cardiovascular fitness among primarily Latino families.
Contemp Clin Trials2020 Feb;():105956. doi: S1551-7144(20)30034-3.
Szeszulski Jacob, Vega-López Sonia, Todd Michael, Ray Frank, Behar Alma, Campbell Maria, Chavez Adrian, Eckert Ryan, Lorenzo-Quintero Anabell, Manrique Leopoldo Hartmann, Crespo Noe C,
Abstract
BACKGROUND:
Community-based programs have had modest success in combating obesity in Latino populations. Latino families' norms and beliefs about weight often hold larger body sizes to be normal, leading to lower engagement in weight-focused programs. Because improvements in cardiorespiratory fitness confer health benefits, regardless of weight, they offer an alternative to obesity-focused approaches. We describe the rationale and design of Athletes for Life (AFL), a community- and family-based intervention for Latino families.
METHODS/DESIGN:
This two-group randomized controlled trial will test the efficacy of AFL for improving cardiorespiratory fitness and diet in 6- to 11-year-old children (N?=?160) and their parents, relative to a wait-list control group. Children will participate in 12?weeks of semiweekly sports skill programing and nutrition sessions. Concurrently, parents will participate in sports-focused activity and behavior change sessions that focus on nutrition, chronic disease prevention, and healthy eating. Cardiovascular fitness will be measured by the 1-mile run and 3-min step-test for both parents and children. Secondary outcomes include changes in objectively measured physical activity, dietary measures, body composition, and cardiometabolic risk (waist circumference, blood pressure, blood lipids, glucose, insulin, and C-reactive protein).
DISCUSSION:
AFL, implemented with a strong community partnership, will provide a test of the efficacy of culturally tailored intervention programming to promote positive health behaviors and improve health outcomes in Latino families. Intervention content, structure, and messaging will provide guidance for future methods to engage Latino families in health promotion programs that highlight their cultural norms, and beliefs.
TRIAL REGISTRATION:
Clinicaltrials.gov Identifier NCT03761589 (12/3/2018).
Copyright © 2020. Published by Elsevier Inc.
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Exercise-associated dyspnea and stridor: thinking beyond asthma.
J Allergy Clin Immunol Pract2020 Feb;():. doi: S2213-2198(20)30145-8.
Hull J H, Godbout Krystelle, Boulet Louis-Philippe,
Abstract
Breathlessness during sport can be caused by a variety of cardiorespiratory conditions, but when associated with stridor, usually arises from an upper airway etiology. The term exercise-induced laryngeal obstruction (EILO) is now used to describe the phenomonen of transient glottic closure occurring in association with physical activity. Exercise related laryngeal closure is most commonly encountered in athletic individuals and likely affects between 5-7% of all young adults and adolescents. The diagnosis of EILO is not always straightforward as features can overlap with exercise-induced asthma / exercise-induced bronchoconstriction. EILO can therefore remain misdiagnosed for years and most patients receive inappropriate asthma therapy. In contrast with asthma, EILO symptoms are usually most prominent at maximal exercise intensity and resolve quickly on exercise cessation. It is important to recognize that EILO and asthma can co-exist in a proportion of athletes. . The gold standard test for diagnosing EILO is continuous laryngoscopy during exercise (CLE) testing, although eucapnic voluntary hyperpnea testing has also been utilized. Various surgical or pharmacological interventions can be used to treat EILO but first-line treatment is breathing technique work. Further esearch is needed to establish the optimal treatment algorithm and more work is needed to increase awareness of this important clinical entity.
Copyright © 2020. Published by Elsevier Inc.
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Prostaglandin E1 in infants with congenital diaphragmatic hernia (CDH) and life-threatening pulmonary hypertension.
J Pediatr Surg2020 Jan;():. doi: S0022-3468(20)30033-6.
Le Duc Kévin, Mur Sébastien, Sharma Dyuti, Aubry Estelle, Recher Morgan, Rakza Thameur, Storme Laurent, ,
Abstract
BACKGROUND:
Suprasystemic pulmonary hypertension (PH) is highly predictive of pulmonary morbidity and death in infants with congenital diaphragmatic hernia (CDH).
OBJECTIVES:
To report the effects and tolerability of Prostaglandin E (PGE) in newborns with severe CDH and life-threatening PH.
METHODS:
Newborn infants with isolated CDH and life-threatening PH defined by an acute worsening of the cardiorespiratory function, and bidirectional or exclusive right-to-left shunting across the ductus arteriosus (DA) with an acceleration of the blood flow >1.5?m.s assessed by Doppler echocardiography. Serial measurements of cardiorespiratory variables have been recorded before and after PGE.
RESULTS:
18 infants (out of 102 in the cohort) were included in the study (gestational age: 39?±?2?weeks). The median FiO, and preductal and postductal SpO were 80% [50; 100], 91% [88; 95] and 86% [82; 91], respectively, before treatment. FiO decreased to 35% [30-40] (p?=?0.001) at H6. Maximal blood flow velocities in the DA decreased after starting PGE from 2.2?m.s [1.5-2.5] to 1?m.s [0.55-1.2] (p?
CONCLUSIONS:
PGE treatment improved oxygenation and circulatory function in newborn infants with severe CDH and life-threatening PH. Our data provide evidence that restrictive DA may result in suprasystemic pulmonary hypertension in CDH infants, and that PGE may improve cardiorespiratory failure through reopening of the DA.
TYPE OF STUDY:
Treatment study.
LEVEL OF EVIDENCE:
Level III.
Copyright © 2020 Elsevier Inc. All rights reserved.
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Association Between Muscular Strength and Bone Health from Children to Young Adults: A Systematic Review and Meta-analysis.
Sports Med2020 Feb;():. doi: 10.1007/s40279-020-01267-y.
Torres-Costoso Ana, López-Muńoz Purificación, Martínez-Vizcaíno Vicente, Álvarez-Bueno Celia, Cavero-Redondo Iván,
Abstract
BACKGROUND:
Osteoporosis is a major worldwide health concern. The acquisition of bone mass during growth decreases the risk of osteoporosis later in life. Muscular strength is an important and modifiable factor to improve bone development in this period.
OBJECTIVE:
The aim of this review was to summarize the relationship between muscular strength and bone health.
METHODS:
Cross-sectional data from studies addressing this association from childhood to young adulthood were systematically searched. The DerSimonian and Laird method was used to compute pooled estimates of effect size and respective 95% CI. The meta-analyses were conducted separately for upper limbs or lower limbs muscular strength and for bone regions. Additionally, a regression model was used to estimate the influence of determinants such as age, lean mass, fat mass, height, weight and cardiorespiratory fitness in this association.
RESULTS:
Thirty-nine published studies were included in the systematic review. The pooled effect size for the association of upper limbs muscular strength with upper limbs, spine and total body BMD ranged from 0.70 to 1.07 and with upper limbs, spine and total body BMC ranged from 1.84 to 1.30. The pooled effect size for the association of lower limbs muscular strength with lower limbs, spine and total body BMD ranged from 0.54 to 0.88 and with lower limbs, spine and total body BMC ranged between 0.81 and 0.71. All reported pooled effect size estimates were statistically significant.
CONCLUSION:
This systematic review and meta-analysis supports that muscular strength should be considered as a useful skeletal health marker during development and a target outcome for interventions aimed at improving bone health.
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Cardiorespiratory Fitness Is Associated With Better Cardiometabolic Health and Lower PTSD Severity in Post-9/11 Veterans.
Mil Med2020 Feb;():. doi: usaa005.
Whitworth James W, Hayes Scott M, Andrews Ryan J, Fonda Jennifer R, Beck Brigitta M, Hanlon Lilly B, Fortier Catherine B, Milberg William P, McGlinchey Regina E,
Abstract
INTRODUCTION:
Post-traumatic stress disorder (PTSD) is associated with an increased risk of cardiovascular and metabolic diseases and physical inactivity. Cardiorespiratory fitness (CRF), which is modifiable by physical activity, is a strong independent predictor of cardiometabolic health. However, the relationship between CRF and cardiometabolic health in veterans with PTSD is unknown. Thus, this study aimed to explore the cross-sectional relationships among CRF, indices of cardiometabolic health (ie, HbA1c, blood lipids, blood pressure, waist-hip ratio, and body mass index), and PTSD severity in veterans with PTSD.
MATERIALS AND METHODS:
This study was approved by the local Institutional Review Board. All participants were informed of the study risks and provided consent prior to participation. Participants (n = 13) completed a cardiopulmonary exercise test, a fasting blood draw, and the Clinician Administered PTSD Scale. Correlations between CRF and cardiometabolic health were examined with Spearman's rank correlations, and differences in PTSD symptom severity were explored as a function of CRF (ie, low-to-moderate vs. high CRF), using multiple linear regression.
RESULTS:
Peak oxygen uptake ($\dot{\mathrm{V}}$O2peak) was correlated with high-density lipoproteins rho = 0.60, P = 0.04 and diastolic blood pressure rho = -0.56, P = 0.05. Ventilatory threshold was correlated with HbA1c rho = -0.61, P = 0.03 and diastolic blood pressure rho = -0.56, P = 0.05. Higher CRF was associated with lower total PTSD severity standardized ? = -0.84, P = 0.01, adjusted R2 = 0.47, total Cluster C symptoms (avoidance/numbing) ? = -0.71, P = 0.02, adjusted R2 = 0.49, and total Cluster D symptoms (hyperarousal) ? = -0.89, P = 0.01, adjusted R2 = 0.41, while adjusting for age and smoking status.
CONCLUSIONS:
These preliminary findings suggest that CRF and by proxy physical activity may be important factors in understanding the increased risk of cardiovascular and metabolic disease associated with PTSD.
Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2020. This work is written by US Government employees and is in the public domain in the US.
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Addition of proprioceptive neuromuscular facilitation to cardiorespiratory training in patients poststroke: study protocol for a randomized controlled trial.
Trials2020 Feb;21(1):184. doi: 10.1186/s13063-019-3923-1.
de Souza Renata Janaína Pereira, Brandăo Daniella Cunha, Martins José Vicente, Fernandes Juliana, Dornelas de Andrade Armele,
Abstract
BACKGROUND:
Individuals affected by stroke present with changes in cardiovascular and respiratory functions. Cardiorespiratory training (CRT) is one of the classic intervention guidelines for cardiorespiratory fitness. CRT in association with the proprioceptive neuromuscular facilitation (PNF) technique for respiratory muscles could improve the quality of life, cardiorespiratory function and gait parameters of patients after stroke.
OBJECTIVE:
To assess the effects of respiratory and trunk patterns of CRT associated with PNF on the quality of life, gait, oxygen consumption, respiratory muscle strength and thoracic volumes.
METHODS/DESIGN:
A blind, randomized clinical trial with allocation confidentiality will be performed. Forty patients will be randomized into four groups: CRT-lower limb (LL) plus PNF; CRT-LL and respiration; CRT-upper limb (UL) plus PNF; or CRT-UL and respiration. Individuals will be evaluated at three different times (pretreatment, after 20?days of treatment and 1 month after the end of treatment). The treatment protocol consists of respiratory exercises, 30?min of CRT (cycle ergometer) and then repetition of the respiratory exercises, performed three times a week over a period of 20?days. Primary outcome measures are quality of life, gait, balance, peak oxygen uptake and rib cage compartment volumes. As secondary outcomes, respiratory function and maximal inspiratory and expiratory pressures will be measured.
DISCUSSION:
The association of PNF with CRT may be a viable and accessible alternative to increase cardiorespiratory function in patients with stroke.
TRIAL REGISTRATION:
ClinicalTrials.gov, NCT03171012. Registered on 6 June 2017.
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