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Pubblicazioni recenti - cardiorespiratory
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A Chest Patch for Continuous Vital Sign Monitoring: Clinical Validation Study During Movement and Controlled Hypoxia.
J Med Internet Res2021 Sep;23(9):e27547. doi: 10.2196/27547.
Morgado Areia Carlos, Santos Mauro, Vollam Sarah, Pimentel Marco, Young Louise, Roman Cristian, Ede Jody, Piper Philippa, King Elizabeth, Gustafson Owen, Harford Mirae, Shah Akshay, Tarassenko Lionel, Watkinson Peter,
Abstract
BACKGROUND:
The standard of care in general wards includes periodic manual measurements, with the data entered into track-and-trigger charts, either on paper or electronically. Wearable devices may support health care staff, improve patient safety, and promote early deterioration detection in the interval between periodic measurements. However, regulatory standards for ambulatory cardiac monitors estimating heart rate (HR) and respiratory rate (RR) do not specify performance criteria during patient movement or clinical conditions in which the patient's oxygen saturation varies. Therefore, further validation is required before clinical implementation and deployment of any wearable system that provides continuous vital sign measurements.
OBJECTIVE:
The objective of this study is to determine the agreement between a chest-worn patch (VitalPatch) and a gold standard reference device for HR and RR measurements during movement and gradual desaturation (modeling a hypoxic episode) in a controlled environment.
METHODS:
After the VitalPatch and gold standard devices (Philips MX450) were applied, participants performed different movements in seven consecutive stages: at rest, sit-to-stand, tapping, rubbing, drinking, turning pages, and using a tablet. Hypoxia was then induced, and the participants' oxygen saturation gradually reduced to 80% in a controlled environment. The primary outcome measure was accuracy, defined as the mean absolute error (MAE) of the VitalPatch estimates when compared with HR and RR gold standards (3-lead electrocardiography and capnography, respectively). We defined these as clinically acceptable if the rates were within 5 beats per minute for HR and 3 respirations per minute (rpm) for RR.
RESULTS:
Complete data sets were acquired for 29 participants. In the movement phase, the HR estimates were within prespecified limits for all movements. For RR, estimates were also within the acceptable range, with the exception of the sit-to-stand and turning page movements, showing an MAE of 3.05 (95% CI 2.48-3.58) rpm and 3.45 (95% CI 2.71-4.11) rpm, respectively. For the hypoxia phase, both HR and RR estimates were within limits, with an overall MAE of 0.72 (95% CI 0.66-0.78) beats per minute and 1.89 (95% CI 1.75-2.03) rpm, respectively. There were no significant differences in the accuracy of HR and RR estimations between normoxia (?90%), mild (89.9%-85%), and severe hypoxia (
CONCLUSIONS:
The VitalPatch was highly accurate throughout both the movement and hypoxia phases of the study, except for RR estimation during the two types of movements. This study demonstrated that VitalPatch can be safely tested in clinical environments to support earlier detection of cardiorespiratory deterioration.
TRIAL REGISTRATION:
ISRCTN Registry ISRCTN61535692; https://www.isrctn.com/ISRCTN61535692.
©Carlos Morgado Areia, Mauro Santos, Sarah Vollam, Marco Pimentel, Louise Young, Cristian Roman, Jody Ede, Philippa Piper, Elizabeth King, Owen Gustafson, Mirae Harford, Akshay Shah, Lionel Tarassenko, Peter Watkinson. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 15.09.2021.
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BAILAMOS With mHealth Technology! Improving Physical Activity and Well-Being in Middle-Aged and Older Latinxs: A Pre-Post Feasibility Study.
Health Educ Behav2021 Oct;48(5):575-583. doi: 10.1177/10901981211027517.
Aguiñaga Susan, Marques Isabela G, Kitsiou Spyros, Balbim Guilherme M, Gerber Ben S, Buchholz Susan W, Bustamante Eduardo E, Marquez David X,
Abstract
Older Latinxs engage in lower levels of leisure-time physical activity (PA) compared with non-Latinx Whites. Latin dance is a culturally relevant type of leisure-time PA that may engage older Latinx populations, particularly when coupled with mobile health technologies (mHealth). This single group pre-post feasibility study described the PA and health outcomes of middle-aged and older Latinxs participating in BAILA TECH-an intervention that combines the BAILAMOS Latin dance program with mHealth (Fitbit Charge 2, Fitbit app, and motivational text messages). Participants ( = 20, = 67 ± 7.1, female = 15, 75%) were enrolled in the 16-week BAILA TECH intervention held twice a week. Participants received a Fitbit Charge 2 to assess PA at baseline, during the intervention, and postintervention. An mHealth platform (iCardia) collected Fitbit data and staff delivered weekly motivational and informational text messages. Participants completed questionnaires about PA, sedentary behavior, cardiorespiratory fitness, social support, quality of life, and cognitive function at baseline and postintervention. Paired tests evaluated change in pre-post measures. There was a significant increase in device-assessed moderate-to-vigorous PA ( = 0.69), self-reported light-leisure ( = 1.91) and moderate-to-vigorous PA ( = 1.05), moderate-to-vigorous leisure PA ( = 1.55), predicted cardiorespiratory fitness ( = 1.10), and PA social support ( = 0.81 [family]; = 0.95 [friends]) from baseline to postintervention. Although nonsignificant, there was a small effect on physical health-related quality of life ( = 0.32) and executive function ( = 0.29). These data describe an increase in PA levels and health-related outcomes of middle-aged and older Latinxs from participation in an mHealth-infused Latin dance intervention. An adequately powered trial is necessary to establish efficacy.
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Twelve weeks of water-based circuit training exercise improves fitness, body fat and leg strength in people with stable coronary heart disease: a randomised trial.
J Physiother2021 Sep;():. doi: S1836-9553(21)00092-8.
Scheer Anna, Shah Amit, Ito Ramos de Oliveira Beatriz, Moreno-Suarez Ignacio, Jacques Angela, Green Daniel, Maiorana Andrew,
Abstract
QUESTION:
In people with stable coronary heart disease, what are the effects of water-based circuit training exercise on aerobic capacity, strength and body composition? How do these effects compare with those of gym-based exercise?
DESIGN:
Parallel group, randomised controlled trial with concealed allocation and intention-to-treat analysis.
PARTICIPANTS:
Fifty-two participants with stable coronary heart disease.
INTERVENTIONS:
Twelve weeks of: three 1-hour sessions per week of moderate-intensity water-based circuit training exercise with alternating aerobic and resistance stations (WEX); three 1-hour sessions per week of moderate-intensity gym-based circuit training exercise (GEX); or continuing usual activities (control).
OUTCOME MEASURES:
Aerobic capacity (VO), upper and lower limb one repetition maximum strength (biceps curl, latissimus dorsi pulldown, hamstring curl and leg press), anthropometry (weight, body mass index and girth) and dual energy x-ray absorptiometry.
RESULTS:
Forty-five participants completed the study (WEX n = 15, GEX n = 18, control n = 12). Both training groups significantly improved VO compared with control: WEX by 2.5 ml/kg/min (95% CI 0.6 to 4.4) and GEX by 2.3 ml/kg/min (95% CI 0.6 to 4.0). WEX and GEX improved hamstring strength compared with control: WEX by 6.3 kg (95% CI 1.2 to 11.3) and GEX by 7.6 kg (95% CI 2.9 to 12.2). Compared with control, GEX increased leg press strength by 15.5 kg (95% CI 5.7 to 25.3), whereas the effect of WEX was less clear (MD 7.1 kg, 95% CI -3.5 to 17.7). Only GEX improved latissimus dorsi pulldown strength. Compared with control, total body fat was reduced with WEX (-1.1 kg, 95% CI -2.3 to 0.0) and GEX (-1.2 kg, 95% CI -2.3 to -0.1). There were negligible between-group differences in weight or waist circumference.
CONCLUSION:
WEX was well tolerated and improved aerobic capacity, leg strength and body fat to a similar degree as GEX in people with coronary heart disease. These findings suggest that WEX is an effective exercise training alternative to GEX for people with coronary heart disease.
TRIAL REGISTRATION:
ANZCTR12616000102471.
Copyright © 2021 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.
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The novel effectiveness of Tai Chi on cardiopulmonary fitness among stroke patients in the recovery phase: a study protocol for a randomized controlled trial.
Trials2021 Sep;22(1):614. doi: 10.1186/s13063-021-05565-2.
Tan Tianyang, Meng Yanyan, Li Xinyu, Bai Ruina, Wang Chengchao, Lyu Jiaxuan, Yan Kang, Liu Meng, Zhang Chaoyang, Wei Yulong,
Abstract
BACKGROUND:
Stroke is the leading cause of death worldwide. China faces a similar risk of stroke as developed countries because of considerable changes in lifestyle, such as overeating and smoking. Tai Chi is a traditional form of mind-body exercise that has been widely practiced in China for thousands of years. However, there are few studies on the effect of Tai Chi on the cardiopulmonary function of stroke patients in the recovery phase. Therefore, it is necessary to observe the effect of Tai Chi on the cardiorespiratory fitness of patients after stroke.
METHODS:
This is a parallel-design, two-arm, analyst assessor-blinded, randomized controlled trial. A total of 226 stroke patients in the recovery phase will be recruited and assigned randomly to a control group or Tai Chi group at a 1:1 ratio. The patients in the Tai Chi group will perform the Tai Chi exercise. The patients in the control group will perform walking exercises. Patients in both groups will receive conventional treatments and healthy education. The primary outcomes will be VO and scores on the MOS item short form health survey (SF-36) scale. Secondary outcomes will include vital capacity (VC), ejection fractions (EF), and cardiac output (CO). The assessments of the tests will be performed at three time points (before exercise, at the end of exercise, and 6?weeks after exercise). Adverse events will be recorded faithfully during the study.
DISCUSSION:
If the results are positive, this study will contribute to the establishment of further guided Tai Chi rehabilitation programs.
TRIAL REGISTRATION:
Chinese Clinical Trial Registry ChiCTR2000034719 . Registered on 16 July 2020.
© 2021. The Author(s).
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Cardiorespiratory Fitness as Protection Against the Development of Memory Intrusions: a Prospective Trauma Analogue Study.
Biol Psychol2021 Sep;():108189. doi: S0301-0511(21)00182-4.
Voorendonk Eline M, Meyer Thomas, Duken Sascha B, van Ast Vanessa A,
Abstract
Intrusive and distressing memories are at the core of post-traumatic stress disorder (PTSD). Since cardiorespiratory fitness (CRF) has been linked with improved mental health, emotion regulation, and memory function, CRF may, by promoting these capabilities, protect against the development of intrusions after trauma. We investigated the CRF-intrusion relationship and its potential mediators in 115 healthy individuals, using a trauma film to induce intrusions. As potential mediators, we assessed indices of pre-trauma mental health such as heart rate variability, subjective and psychobiological peri-traumatic responses, and memory. Critically, results showed that higher CRF was related to fewer intrusions, but no mediators emerged for the CRF-intrusion relationship. These results indicate that individuals displaying higher CRF are less prone to develop traumatic memory intrusions. Future studies may want to investigate whether promoting fitness prior to possible trauma exposure can boost resilience against the development of debilitating re-experiencing symptoms of PTSD.
Copyright © 2021. Published by Elsevier B.V.
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Acute exercise effects on inhibitory control and the pupillary response in young adults.
Int J Psychophysiol2021 Sep;():. doi: S0167-8760(21)00878-3.
Shigeta Tatsuya T, Morris Timothy P, Henry Donovan H, Kucyi Aaron, Bex Peter, Kramer Arthur F, Hillman Charles H,
Abstract
Previous research has established an impact of acute exercise on cognitive performance, which has inspired investigations into neurobiological mechanisms that may underlie the observed benefits. Pupillary responses have been posited to reflect activation of such underlying neurobiological mechanisms. The current study recruited healthy young adults to investigate the effects of a single bout of moderate-to-vigorous intensity aerobic exercise on subsequent performance and pupillary responses during an inhibitory control task. Results showed that an acute bout of exercise was related to shorter reaction times and increased tonic pupil dilation during an inhibitory control task. Although pupillary responses did not mediate the acute exercise effect on inhibitory control, higher cardiorespiratory fitness was associated with greater phasic pupil dilation following exercise relative to seated rest. The current study supported the plausibility of the pupillary response as a marker of LC-NE system activation that is sensitive to acute exercise. Whether pupillary responses could account for transient benefits of acute exercise on brain and cognition remains unclear.
Copyright © 2018. Published by Elsevier B.V.
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The Roles of Sex and Minority Status in Children's Motivation and Psychomotor Learning.
Percept Mot Skills2021 Sep;():315125211046446. doi: 10.1177/00315125211046446.
Zhang Xiaoxia, Gu Xiangli, Chen Senlin, Keller M Jean, Lee Jihye,
Abstract
In this study, we had two inter-related goals: (a) to examine sex and minority status differences on children's motivation for physical education (PE; i.e., their expectancy beliefs, subjective task values, and situational interest) and their psychomotor learning outcomes (i.e., motor competence, cardiorespiratory fitness, and in-class physical activity); and (b) to examine the relationships between children's motivation and their psychomotor learning outcomes while testing the moderation effects of sex and minority status. We recruited 195 fourth and fifth-grade students (101 boys; 94 girls; ?=?10.7, 0.7?years) from three elementary schools in North Texas. Using multivariate analysis of variance, we identified a significant sex difference that favored boys in motivation and psychomotor learning outcomes, with no significant minority status difference in relation to these variables. Regression analysis revealed that children's expectancy beliefs were significantly associated with both motor competence (?=?11%) and cardiorespiratory fitness (?=?16%), while both situational interest and sex were associated with in-class physical activity (?=?18%). Thus, improving children's expectancy beliefs may be a means of enhancing psychomotor learning outcomes in PE, especially for girls. Enhancing children's beliefs in their own ability and offering diversified PE content so as to generate greater interest may facilitate psychomotor learning.
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Associations Between Cardiorespiratory Fitness, Cardiovascular Risk, and Cognition Are Mediated by Structural Brain Health in Midlife.
J Am Heart Assoc2021 Sep;():e020688. doi: 10.1161/JAHA.120.020688.
España-Irla Goretti, Gomes-Osman Joyce, Cattaneo Gabriele, Albu Sergiu, Cabello-Toscano María, Solana-Sanchéz Javier, Redondo-Camós María, Delgado-Gallén Selma, Alviarez-Schulze Vanessa, Pachón-García Catherine, Tormos Josep M, Bartrés-Faz David, Morris Timothy P, Pascual-Leone Álvaro,
Abstract
Background Evidence in older adults suggests that higher cardiorespiratory fitness and lower cardiovascular risk are associated with greater cognition. However, given that changes in the brain that lead to cognitive decline begin decades before the onset of symptoms, understanding the mechanisms by which modifiable cardiovascular factors are associated with brain health in midlife is critical and can lead to the development of strategies to promote and maintain brain health as we age. Methods and Results In 501 middle-aged (aged 40-65 years) adult participants of the BBHI (Barcelona Brain Health Initiative), we found differential associations among cardiorespiratory fitness, cardiovascular risk, and cognition and cortical thickness. Higher cardiorespiratory fitness was significantly associated with better visuospatial abilities and frontal loading abstract problem solving (?=3.16, =0.049) in the older middle-aged group (aged 55-65 years). In contrast, cardiovascular risk was negatively associated with better visuospatial reasoning and problem-solving abilities (?=-0.046, =0.002), flexibility (?=-0.054,
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Adaptation of a mouse Doppler echocardiograph system for assessing cardiac function and thermal performance in a juvenile salmonid.
Conserv Physiol2021 ;9(1):coab070. doi: 10.1093/conphys/coab070.
Muir Carlie A, Neff Bryan D, Damjanovski Sashko,
Abstract
Measures of cardiac performance are pertinent to the study of thermal physiology and exercise in teleosts, particularly as they pertain to migration success. Increased heart rate, stroke volume and cardiac output have previously been linked to improved swimming performance and increased upper thermal tolerance in anadromous salmonids. To assess thermal performance in fishes, it has become commonplace to measure the response of maximum heart rate to warming using electrocardiograms. However, electrocardiograms do not provide insight into the hemodynamic characteristics of heart function that can impact whole-animal performance. Doppler echocardiography is a popular tool used to examine live animal processes, including real-time cardiac function. This method allows for nonsurgical measurements of blood flow velocity through the heart and has been used to detect abnormalities in cardiovascular function, particularly in mammals. Here, we show how a mouse Doppler echocardiograph system can be adapted for use in a juvenile salmonid over a range of temperatures and timeframes. Using this compact, noninvasive system, we measured maximum heart rate, atrioventricular (AV) blood flow velocity, the early flow-atrial flow ratio and stroke distance in juvenile Atlantic salmon () during acute warming. Using histologically determined measures of AV valve area, we show how stroke distance measurements obtained with this system can be used to calculate ventricular inflow volume and approximate cardiac output. Further, we show how this Doppler system can be used to determine cardiorespiratory thresholds for thermal performance, which are increasingly being used to predict the consequences that warming water temperatures will have on migratory fishes.
© The Author(s) 2021. Published by Oxford University Press and the Society for Experimental Biology.
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Pathophysiology of Advanced Heart Failure: What Knowledge Is Needed for Clinical Management?
Heart Fail Clin2021 Oct;17(4):519-531. doi: S1551-7136(21)00067-2.
Biegus Jan, Niewinski Piotr, Josiak Krystian, Kulej Katarzyna, Ponikowska Barbara, Nowak Krzysztof, Zymlinski Robert, Ponikowski Piotr,
Abstract
Understanding of heart failure (HF) has evolved from a simple hemodynamic problem through a neurohormonally and proinflammatory-driven syndrome to a complex multiorgan dysfunction accompanied by inadequate energy handling. This article discusses the most important clinical aspects of advanced HF pathophysiology. It presents the concept of neurohormonal activation and its deleterious effect on cardiovascular system and reflex control. The current theories regarding the role of inflammation, cytokine activation, and myocardial remodeling in HF progression are presented. Advanced HF is a multiorgan syndrome with interplay between cardiovascular system and other organs. The role of iron deficiency is also discussed.
Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
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Prognostic Value of Cardiorespiratory Fitness in Patients with Chronic Kidney Disease: The FIT (Henry Ford Exercise Testing) Project.
Am J Med2021 Sep;():. doi: S0002-9343(21)00560-X.
Chu Daniel J, Ahmed Amjad M, Qureshi Waqas T, Brawner Clinton A, Keteyian Steven J, Nasir Khurram, Blumenthal Roger S, Blaha Michael J, Ehrman Jonathan K, Cainzos-Achirica Miguel, Patel Kershaw V, Rifai Mahmoud Al, Al-Mallah Mouaz H,
Abstract
PURPOSE:
To study the association of cardiorespiratory fitness (cardiorespiratory fitness) and all-cause mortality among patients with chronic kidney disease.
METHODS:
We studied a retrospective cohort of patients from the Henry Ford Health System who underwent clinically indicated exercise stress testing with baseline cardiorespiratory fitness and estimated glomerular filtration rate measurement. Cardiorespiratory fitness was expressed as metabolic equivalents of task and kidney function was categorized into stages according to estimated glomerular filtration rate. Multivariable-adjusted Cox proportional hazard models were used to examine the association between metabolic equivalents of task and all-cause mortality among patients with chronic kidney disease stages 3 to 5. Discrimination of mortality was assessed using receiver operating characteristic curves, while reclassification was evaluated using net reclassification index (NRI).
RESULTS:
Among 50,121 participants, the mean age was 55 ± 12.6 years, 47.5% were women, 64.5% were white, and 6,877 (13.7%) participants had chronic kidney disease stage 3-5. Over a median follow-up of 6.7 years, 6,308 participants died (12.6%). Each 1-unit higher metabolic equivalents of task was associated with a significant 15% reduction in all-cause mortality (Hazard Ratio?=?0.85, 95% Confidence Interval [CI] 0.84-0.87). Metabolic equivalents of task improved discriminatory ability of mortality prediction when added to traditional risk factors and estimated glomerular filtration rate (area under the curve=0.7996; 95% CI 0.789-0.810 vs 0.759; 95% CI 0.748-0.770, respectively; p-value
CONCLUSIONS:
Cardiorespiratory fitness improves mortality risk prediction among patients with chronic kidney disease. Cardiorespiratory fitness provides incremental prognostic information when added to traditional risk factors and may help guide treatment options among patients with renal dysfunction.
Copyright © 2021. Published by Elsevier Inc.
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Cardiorespiratory Abnormalities in Patients Recovering from COVID-19.
J Am Soc Echocardiogr2021 Sep;():. doi: S0894-7317(21)00701-X.
Szekely Yishay, Lichter Yael, Sadon Sapir, Lupu Lior, Taieb Philippe, Banai Ariel, Sapir Orly, Granot Yoav, Hochstadt Aviram, Friedman Shirley, Laufer-Perl Michal, Banai Shmuel, Topilsky Yan,
Abstract
BACKGROUND:
Large number of patients around the world are recovering from COVID-19; many of them report persistence of symptoms.
OBJECTIVES:
We sought to test pulmonary, cardiovascular and peripheral responses to exercise in patients recovering from COVID-19.
METHODS:
We prospectively evaluated patients who recovered from COVID-19 using a combined anatomic/functional assessment. All patients underwent clinical examination, laboratory tests, and a combined stress echocardiography and cardiopulmonary exercise test. We measured left ventricular volumes, ejection fraction, stroke volume, heart rate, E/e' ratio, right ventricular function, VO, lung volumes, Ventilatory efficiency, O saturation and muscle O extraction in all effort stages and compared them to historical controls.
RESULTS:
A total of 71 patients were assessed 90.6±26 days after onset of COVID-19 symptoms. Only 23 (33%) were asymptomatic. The most common symptoms were fatigue (34%), muscle weakness/pain (27%) and dyspnea (22%). VO was lower among post-COVID-19 patients compared to controls (p=0.03, group by time interaction p=0.007). Reduction in peak VO was due to a combination of chronotropic incompetence (75% of post-COVID-19 patients vs. 8% of controls, p
CONCLUSIONS:
Patients recovering from COVID-19 have symptoms associated with objective reduction in peak VO. The mechanism of this reduction is complex and mainly involves a combination of attenuated heart rate and stroke volume reserve.
Copyright © 2021 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.
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Cancer and cardiovascular disease: The impact of cardiac rehabilitation and cardiorespiratory fitness on survival.
Int J Cardiol2021 Sep;():. doi: S0167-5273(21)01326-7.
Williamson Tamara, Moran Chelsea, Chirico Daniele, Arena Ross, Ozemek Cemal, Aggarwal Sandeep, Campbell Tavis, Laddu Deepika,
Abstract
BACKGROUND:
Cancer survivors are at increased risk for cardiovascular disease (CVD)-related morbidity and mortality. Exercise-based cardiac rehabilitation (CR) programs improve CVD risk factors, including cardiorespiratory fitness (CRF). The purpose of this study was to investigate: (1) the association between CR completion and survival, and (2) whether CRF improvements translate to increased survival among patients with comorbid cancer and CVD.
METHODS:
Patients with CVD and pre-existing cancer (any type) were referred to a 12-week exercise-based CR program between 01/1996 and 03/2016. Peak metabolic equivalents (METs) were assessed by graded exercise test pre-CR and at 12-weeks. Kaplan-Meier survival and multivariate cox regressions were performed to evaluate impact of CR completion and clinically-meaningful CRF improvements [?METs?1] on survival, adjusting for relevant covariates.
RESULTS:
Among 442 patients with CVD and cancer referred to CR (67 ± 10 years; 22% women), 361 (82%) completed CR. 102 deaths were recorded during the 12-year observation period. Compared to patients who did not complete CR, patients with comorbid cancer who completed CR demonstrated a survival advantage (63% vs 80.1%, p
CONCLUSION:
Completing a 12-week exercise-based CR program improved CRF and increased survival in patients with CVD and comorbid cancer. The results highlight the survival benefits of completing a CR program among CVD patients who experience added barriers imposed by cancer treatment and survival.
Copyright © 2021 Elsevier B.V. All rights reserved.
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Effects of an Eight-Week Concurrent Training Program with Different Effort Character over Physical Fitness, Health-Related Quality of Life, and Lipid Profile among Hospital Workers: Preliminary Results.
Int J Environ Res Public Health2021 Sep;18(17):. doi: 9328.
Pérez-Bilbao Txomin, García-González David, Martos-Bermúdez Álvaro, Nieto Sandra, Del Campo Teresa, Pérez-Ruiz Margarita, San Juan Alejandro F,
Abstract
BACKGROUND:
The "effort character" (EC) is a resistance training method without reaching muscle failure. It was defined by González-Badillo and Gorostiaga Ayestarán (2002) as the relationship between the repetitions performed and the repetitions achievable. Then, the EC is at its maximum (i.e., 100%) when the subject realizes all the repetitions possible in a series with any load. Therefore, an EC of 50% indicates execution of 50% of the repetitions achievable in a series. This study aimed to determine the effects of two programs of eight weeks of concurrent training (CT) with different EC over muscle strength (MS), cardiorespiratory fitness (CRF), functional mobility (FM), health-related quality of life (HRQoL), and lipid profile (LP) among hospital workers.
METHODS:
Fourteen hospital workers (age: 41.1 ± 10.8 years; body mass: 63.0 ± 10.8 kg; height: 165.2 ± 6.5 cm; body mass index (BMI): 23.0 ± 3.4 kg/m) were randomly assigned to an EC 50% ( = 7) or EC 100% ( = 7) group.
RESULTS:
The main finding was that both groups significantly improved in MS and FM levels but not HRQoL, with no statistical differences between EC 50% and EC 100% in adherence and any test despite performing half the volume of the strength workout.
CONCLUSIONS:
An eight-week CT program with different EC (i.e., EC 50% vs. EC 100%) seems to improve the MS and FM levels in hospital workers similarly. These findings could be very useful in health-training practices because of the possibility of planning training loads with half the volume of strength workouts without the loss of any training adaptation.
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Overshoot of the Respiratory Exchange Ratio during Recovery from Maximal Exercise Testing in Kidney Transplant Recipients.
Int J Environ Res Public Health2021 Sep;18(17):. doi: 9236.
Patti Alessandro, Neunhaeuserer Daniel, Gasperetti Andrea, Baioccato Veronica, Vecchiato Marco, Battista Francesca, Marchini Francesco, Bergamin Marco, Furian Lucrezia, Ermolao Andrea,
Abstract
The overshoot of the respiratory exchange ratio (RER) during recovery from exercise has been found to be reduced in magnitude among patients with heart failure. The aim of this study is to investigate whether this phenomenon could also be present in patients with peripheral, and not cardiac, limitations to exercise such as kidney transplant recipients (KTRs). In this retrospective cross-sectional study, KTRs were evaluated with maximal cardiopulmonary exercise testing (CPET) assessing the RER overshoot parameters during recovery: the RER at peak exercise, the maximum RER value reached during recovery, the magnitude of the RER overshoot (RER mag = (RER max-peak RER)/peak RER%) and the linear slope of the RER increase after the end of exercise. A total of 57 KTRs were included in the study (16 females), all of them showing a significant RER overshoot (RER mag: 28.4 ± 12.7%). Moreover, the RER mag showed significant correlations with the fitness of patients (peak VO: ? = 0.57,
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Can Exercise Help Regulate Blood Pressure and Improve Functional Capacity of Older Women with Hypertension against the Deleterious Effects of Physical Inactivity?
Int J Environ Res Public Health2021 Aug;18(17):. doi: 9117.
Leitão Luis, Marocolo Moacir, Souza Hiago L R de, Arriel Rhai André, Vieira João Guilherme, Mazini Mauro, Louro Hugo, Pereira Ana,
Abstract
BACKGROUND:
Sedentarism and inactivity are risk factors for the development of hypertension. Thus, the prevention of the natural process of biological and physiological aging of older women through physical exercise results in higher benefits in preventing cardiovascular diseases and can be a key factor for its treatment. Multicomponent exercise (METP) is a training method that may help older women with hypertension by improving their quality of life and their response to treatment.
METHODS:
Twenty-eight older Caucasian women with hypertension (66.7 ± 5.3 years, 1.59 ± 0.11 m) performed a supervised METP program of nine months followed by three months of detraining (DT), and seventeen older women (68.2 ± 4.7 years, 1.57 ± 0.16 cm) with hypertension maintained their daily routine, without exercise. Blood pressure (BP), resting heart rate, and functional capacity (FC) were evaluated at the beginning and at the end of the program, and after three months of DT.
RESULTS:
The ME program improved (
CONCLUSION:
Nine months of multicomponent exercise were sufficient to improve functional capacity and promote benefits in blood pressure, although was not sufficient to allow BP to reach the normal values of older women. The three month DT period without exercise caused the reversal of BP improvements but maintained the functional capacity of older women.
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Is the Clinical Delivery of Cardiac Rehabilitation in an Australian Setting Associated with Changes in Physical Capacity and Cardiovascular Risk and Are Any Changes Maintained for 12 Months?
Int J Environ Res Public Health2021 Aug;18(17):. doi: 8950.
Price Kym Joanne, Gordon Brett Ashley, Bird Stephen Richard, Benson Amanda Clare,
Abstract
Long-term maintenance of changes in cardiovascular risk factors and physical capacity once patients leave the supervised program environment have not previously been reported. This study investigated the changes in physical capacity outcomes and cardiovascular risk factors in an Australian cardiac rehabilitation setting, and the maintenance of changes in these outcomes in the 12 months following cardiac rehabilitation attendance. Improvements in mean (95% CI) cardiorespiratory fitness (16.4% (13.2-19.6%),
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Ethnic Differences on Cardiac Rhythms and Autonomic Nervous System Responses During a High-Altitude Trek: A Pilot Study Comparing Italian Trekkers to Nepalese Porters.
Front Physiol2021 ;12():709451. doi: 10.3389/fphys.2021.709451.
Verratti Vittore, Tonacci Alessandro, Bondi Danilo, Chiavaroli Annalisa, Ferrante Claudio, Brunetti Luigi, Crisafulli Antonio, Cerretelli Paolo,
Abstract
Altitude hypoxia exposure results in increased sympathetic activity and heart rate due to several mechanisms. Recent studies have contested the validity of heart rate variability (HRV) analysis on sympathetic activity measurement. But the plethora of HRV metrics may provide meaningful insights, particularly if linked with cardiovascular and autonomic nervous system parameters. However, the population-specific nature of HRV and cardiorespiratory response to altitude hypoxia are still missing. Six Italian trekkers and six Nepalese porters completed 300 km of a Himalayan trek. The ECG analysis was conducted at baseline, and before () and after () the high-altitude (HA) circuit. Urine was collected before and after the expedition in Italians, for assessing catecholamines. Heart rate increased with altitude significantly (
Copyright © 2021 Verratti, Tonacci, Bondi, Chiavaroli, Ferrante, Brunetti, Crisafulli and Cerretelli.
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High-Intensity Interval Training and Cardiometabolic Risk Factors in Children: A Meta-analysis.
Pediatrics2021 Sep;():. doi: e2021050810.
Solera-Martínez Monserrat, Herraiz-Adillo Ángel, Manzanares-Domínguez Ismael, De La Cruz Lidia Lucas, Martínez-Vizcaíno Vicente, Pozuelo-Carrascosa Diana P,
Abstract
CONTEXT:
High-intensity interval training (HIIT) has been widely used to prevent and treat cardiovascular risk factors in adolescents and adults; nevertheless, the available evidence in children is scarce.
OBJECTIVE:
To synthesize evidence regarding the effectiveness of HIIT interventions on improving cardiovascular risk factors and cardiorespiratory fitness (CRF) in children from 5 to 12 years old.
DATA SOURCES:
We searched 5 databases, Medline, Embase, SPORTDiscus, the Cochrane Library, and Web of Science.
STUDY SELECTION:
Randomized controlled trials (RCTs) evaluating the effectiveness of HIIT interventions on cardiometabolic risk factors and CRF in children were included.
DATA EXTRACTION:
Meta-analyses were conducted to determine the effect of HIIT on body composition, cardiometabolic and CRF variables in comparison with nontraining control groups.
RESULTS:
A total of 11 RCTs and 512 participants were included. The results of the meta-analysis revealed a significant improvement in peak oxygen uptake (standardized mean difference [SMD] = 1.05, 95% confidence interval [CI] = 0.34 to 1.77; = .004), in total cholesterol (SMD = -1.50, 95% CI = -2.51 to -0.48; = .004), in low-density lipoprotein cholesterol (SMD = -1.76, 95% CI = -3.12 to -0.40; = .011) and triglycerides (SMD = -1.29, 95% CI = -2.40 to -0.19; = .022) levels.
LIMITATIONS:
Because of the small number of available RCTs, it was not possible to conduct a subgroup analysis or a linear meta-regression analysis.
CONCLUSIONS:
HIIT is a feasible and time-efficient approach for improving CRF, total cholesterol, low-density lipoprotein cholesterol, and triglycerides levels in children.
Copyright © 2021 by the American Academy of Pediatrics.
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Evaluating the reach, effectiveness, adoption, implementation and maintenance of the Resistance Training for Teens program.
Int J Behav Nutr Phys Act2021 09;18(1):122. doi: 10.1186/s12966-021-01195-8.
Kennedy Sarah G, Smith Jordan J, Estabrooks Paul A, Nathan Nicole, Noetel Mike, Morgan Philip J, Salmon Jo, Dos Santos Gessika C, Lubans David R,
Abstract
BACKGROUND:
Physical activity guidelines recommend young people engage in regular muscle-strengthening activities (e.g., resistance training [RT]). However, few school-based physical activity interventions have been delivered at-scale or promoted RT. The aim of this study was to evaluate the reach, effectiveness, adoption, implementation and maintenance of the Resistance Training for Teens (RT for Teens) program.
METHODS:
Data were collected between August 2015 and October 2020. RE-AIM was operationalized as: (i) Reach: number and characteristics of students estimated to be exposed to the program; (ii) Effectiveness: impact of the program on student-level outcomes measured in a subsample of 750 students from 17 schools; (iii) Adoption: number and representativeness of schools with one or more teachers trained to deliver the program; (iv) Implementation: extent to which the program was delivered as intended; and (v) Maintenance: extent to which the program was sustained in schools.
RESULTS:
The estimated program reach was?~?10,000 students, out of a total student population of?~?200,000 (~?5%). Students were from diverse socioeconomic and ethnic backgrounds. Improvements in muscular fitness, RT self-efficacy, perceived cardiorespiratory fitness and flexibility, and participation in muscle-strengthening physical activities were documented. A total of 30 workshops were delivered, involving 468 teachers from 249 schools from diverse geographical regions. Implementation varied considerably, with teachers adapting the program to suit the context of their school and student cohorts. However, RT skill development and the promotion of muscular fitness were the session components delivered most during sessions. Teachers' adherence to the SAAFE (Supportive, Active, Autonomous, Fair and Enjoyable) teaching principles was high. Approximately 30% of teachers (144/476) registered to use the RT for Teens app. At the school-level, 37% (93/249) of schools had at least one registered user (teacher and/or student). A total of 2,336 workouts and 3,116 fitness tests were completed by registered users. Of the 249 schools represented, 51 (20.5%) sent an additional (previously untrained) teacher to a second workshop.
CONCLUSIONS:
The RT for Teens program had broad reach and adoption. However, intervention delivery varied considerably across schools and additional support strategies are required to optimize intervention implementation and maintain program delivery over time. Future studies will benefit from the utilization of accepted frameworks, recommendations and guidelines for implementation research.
TRIAL REGISTRATION:
Australian New Zealand Clinical Trials Registry (ACTRN12621000352808), retrospectively registered 1 February 2021.
© 2021. The Author(s).
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