Effectiveness of Non-Presential Individualized Exercise Training PrOgram(NIETO) in Lower Limb Physical Performance in Advanced COPD

Muscle training, a component of pulmonary rehabilitation (PR), improves the physical performance of patients with chronic obstructive pulmonary disease (COPD). Despite the existing evidence, the traditional center-based PR model is applied to a small percentage of patients and presents numerous problems of accessibility, adherence, and costs. This study presents a home model of simple muscle training, non-presential, monitored by telephone and individualized, according to the severity of the COPD. In addition, to evaluate the results, simple tests associated with the physical performance of the lower limbs, previously validated in COPD, have been used, such as the four-meter walk, speed test (4MGS) and the five-repetition test sitting and standing (5STS). The objective was to evaluate whether the Individualized Non-Presential Exercise Training PrOgram (NIETO) induces improvements in the 4MGS, 5STS and quadriceps muscle strength (QMS) tests in outpatients with advanced COPD (FEV1 ≤ 50%). After one year, the QMS was significantly higher in the intervention group (IG) than in the control group (CG) (2.44 ± 4.07 vs. 0.05 ± 4.26 kg; p = 0.009). The 4MGS and 5STS tests were significantly shorter in IG than in CG (−0.39 ± 0.86 vs. 0.37 ± 0.96 s; p = 0.001) and (−1.55 ± 2.83 vs. 0.60 ± 2.06 s; p = 0.001), respectively. A home model of simple muscle training monitored by telephone such as NIETO, can improve 4MGS, 5STS, and quadriceps strength tests in outpatients with advanced COPD.

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How to Improve the Functional Capacity of Frail and Pre-Frail Elderly People? Health, Nutritional Status and Exercise Intervention. The EXERNET-Elder 3.0 Project

Sustainability ◽

10.3390/su12156246 ◽

2020 ◽

Vol 12 (15) ◽

pp. 6246 ◽

Cited By ~ 3

Author(s):

Ángel Iván Fernández-García ◽

Alba Gómez-Cabello ◽

Ana Moradell ◽

David Navarrete-Villanueva ◽

Jorge Pérez-Gómez ◽

...

Keyword(s):

Exercise Training ◽

Training Program ◽

Functional Capacity ◽

Exercise Intervention ◽

Intervention Group ◽

Residual Effects ◽

Control Group ◽

Healthy Habits ◽

Exercise Training Program ◽

Frail Elderly People

Aging is associated with the impairment of health and functional capacity, and physical exercise seems to be an effective tool in frailty prevention and treatment. The purpose of this study was to present the methodology used in the EXERNET-Elder 3.0 project that aims to evaluate the immediate and residual effects and of a multicomponent exercise training program called Elder-fit on frailty, fitness, body composition and quality of life, and also to analyse a possible dietary intake interaction according to health and metabolic status. A total of 110 frail and pre-frail elders participated in this study and were divided into a control group (CG = 52) and an intervention group (IG = 58). The IG performed a supervised multicomponent exercise training program of 6 months and 3 days per week, which included strength, endurance, balance, coordination and flexibility exercises, while the CG continued with their usual daily activities. Both groups received four speeches about healthy habits along the project. Four evaluations were performed: at baseline, after 3 months of training, at the end of the training program (6 months) and 4 months after the program had ended to examine the effects of detraining. Evaluating the efficacy, safety and feasibility of this program will help to develop efficacious physical interventions against frailty. Further, protocols should be described accurately to allow exercise programs to be successfully replicated.

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Evaluation of the Implementation of a Home-Based Exercise Training Program for People With COPD: A Mixed-Methods Study

Frontiers in Rehabilitation Sciences ◽

10.3389/fresc.2021.743588 ◽

2021 ◽

Vol 2 ◽

Author(s):

Tamara Cerini ◽

Ramona Kunz ◽

Kaba Dalla Lana ◽

Thomas Radtke ◽

Ashley Polhemus ◽

...

Keyword(s):

Mixed Methods ◽

Exercise Training ◽

Training Program ◽

Intervention Group ◽

Mixed Methods Study ◽

Chronic Obstructive ◽

Daily Routine ◽

Home Based ◽

Exercise Training Program

Introduction: Recently, we developed a home-based, minimal-equipment exercise training program HOMEX for people with chronic obstructive pulmonary disease (COPD) and tested its effectiveness over 1 year in a randomized controlled trial. The aims of the current study were to evaluate the implementation of HOMEX from the perspectives of all involved persons and to optimize the program to ensure its long-term sustainability.Methods: In this mixed-methods study, we used qualitative and quantitative approaches to evaluate the implementation of the intervention on the level of patients with COPD and coaches who provided the intervention and relevant stakeholders. To assess the implementation outcomes dose, reach, fidelity, and adherence, we summarized information recorded in the notes of the coaches and the diaries of patients, complemented with results from qualitative assessments. To assess acceptability and appropriateness, we conducted surveys with patients and coaches, and semistructured interviews with selected patients, coaches, and stakeholders.Results: The coaches delivered the three home visits with one exception according to the protocol (fidelity). Of the 53 intervention group participants, 37 (70%) conducted HOMEX training until the end of the study and 43 (79%) trained for at least 10 months. The exercise behaviors of the participants could be separated into the phases “Starting the training and stabilizing into regular training routine” and “Managing training disruptions” (adherence). Overall, patients, coaches, and stakeholders conveyed a very high “acceptability” of HOMEX, noting the home-based aspect as a particular strength and interaction with other patients as future need. All involved groups perceived the strength-training exercises as appropriate, efficient for people with COPD, and relevant to maintain improvements after pulmonary rehabilitation. The most important facilitators of the patients for long-term motivation were self-perceived improvement in strength, supervision by a coach, and integration of the training in daily routine. Based on these insights, we redesigned and reworded the exercise cards, introduced three new exercises, and refined the training book.Discussion: The results of this study provided insights of the involved persons in the frame of the HOMEX intervention implementation with a particular focus on the long-term training behavior of the participants and their perception and experience with the exercise program. These findings enabled us to optimize the training material and adapt the structure of the program for sustainable further use in clinical and other settings.

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Physical Therapy and Rehabilitation Ideas for Inspiratory Muscle Training in Patients With Subacute Stroke

Iranian Rehabilitation Journal ◽

10.32598/irj.19.4.1290.1 ◽

2021 ◽

Vol 19 (4) ◽

pp. 455-464

Author(s):

Irma Ruslina Defi ◽

◽

Novitri Novitri ◽

Ilin Nurina ◽

◽

...

Keyword(s):

Muscle Strength ◽

Lung Function ◽

Walking Speed ◽

Intervention Group ◽

Quadriceps Strength ◽

Control Group ◽

Muscle Training ◽

Stroke Patients ◽

Paretic Side ◽

Subacute Stroke

Objectives: This study aimed to elucidate the outcome of an Inspiratory Muscle Training (IMT) rehabilitation intervention on the lung function, functional mobilization, balance, and peripheral muscle strength of the paretic side in patients with subacute stroke. Methods: This double-blind, randomized controlled trial study was conducted on patients with stable subacute stroke. For 8 weeks, the intervention group (n=16) received 40% intensity IMT while the control group (n=16) received 10% intensity IMT. We assessed the patients’ lung function (spirometer) before and after the intervention, as well as their pulmonary muscle strength (micro-respiratory pressure meter [RPM]), quadriceps strength (handheld dynamometer), grip strength (Jamar), walking speed (10-m walk test), balance (Berg Balance Scale [BBS]), and functional mobilization (sit-to-stand test). Results: There were significant differences between the intervention group and the control group after IMT for forced vital capacity (FVC)% (P<0.01; d=3.20), forced expiratory volume in the first second (FEV1)/FVC (P<0.001; d=2.55), FEV1% (P<0.001; d=5.10), walking speed (P<0.05; d=1.62), hand grip (P<0.001; d=2.45), quadriceps strength (P<0.001; d=4.18), functional mobilization (P<0.01; d=2.41), and maximal inspiratory mouth pressure (P<0.001; d=1.62), but no significant changes were seen in balance (P=0.304; d=0.57). Discussion: IMT improved lung function, functional mobilization, handgrip strength, and quadriceps strength on the paretic side of subacute stroke patients and is expected to improve functional status and allow the patient to participate in social activities. IMT exercise can be included in the rehabilitation program for subacute stroke patients.

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Effects of a 10-Week Inspiratory Muscle Training Program on Lower-Extremity Mobility in People with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073-13.1.32 ◽

2011 ◽

Vol 13 (1) ◽

pp. 32-42 ◽

Cited By ~ 11

Author(s):

Lucinda Pfalzer ◽

Donna Fry

Keyword(s):

Multiple Sclerosis ◽

Lower Extremity ◽

Physical Performance ◽

Intervention Group ◽

Inspiratory Muscle ◽

Inspiratory Muscle Training ◽

Control Group ◽

Muscle Training ◽

Home Based ◽

Edss Score

Pulmonary muscle weakness is common in ambulatory people with multiple sclerosis (MS) and may lead to deficits in mobility function. The purpose of this study was to examine the effect of a 10-week home-based exercise program using an inspiratory muscle threshold trainer (IMT) on the results of four lower-extremity physical performance tests in people with MS. The study design was a two-group (experimental-control), pretest-posttest study. Outcome measures consisted of pulmonary function measures including maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and maximal voluntary ventilation (MVV), and the following lower-extremity physical performance measures: the 6-Minute Walk (6MW) distance, gait velocity (GV), the Sit-to-Stand Test (SST), the Functional Stair Test (FST), and a balance test (BAL). A total of 46 ambulatory participants (Expanded Disability Status Scale [EDSS] score, 2.0–6.5) with MS were randomly assigned to an intervention group (mean EDSS score, 4.1) that received 10 weeks of home-based inspiratory muscle training or a nontreatment control group (mean EDSS score, 3.2). Of the original 46 participants, 20 intervention group participants and 19 control group participants completed the study. Compared with the control group, the intervention group made significantly greater gains in inspiratory muscle strength (P = .003) and timed balance scores (P = .008). A nonsignificant improvement in 6MW distance (P = .086) was also noted in the IMT-trained group as compared with the control group. This is the first study directly linking improvement in respiratory function to improvement in physical performance function in people with mild-to-moderate disability due to MS.

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Increased VO2 peak after a structured exercise-training program is associated with reduced levels of cardiac myosin binding protein C in patients with symptomatic chronic heart failure

European Heart Journal ◽

10.1093/eurheartj/ehab724.0874 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

E.A Riveland ◽

T Valborgland ◽

A Ushakova ◽

T Karlsen ◽

C Delagardelle ◽

...

Keyword(s):

Heart Failure ◽

Exercise Training ◽

Training Program ◽

Plasma Levels ◽

Intervention Group ◽

Cardiac Myosin ◽

Myosin Binding Protein ◽

Myosin Binding Protein C ◽

Exercise Training Program ◽

Myosin Binding

Abstract Background Cardiac myosin-binding protein C (cMyC), a cardiac contractile protein, is a novel biomarker of myocardial injury, rising earlier and disappearing faster than cardiac troponins. It is a promising biomarker for use in triage of patients with chest pain presenting in the emergency department. It also has prognostic significance in patients with heart failure. However, the effects of systematic exercise training on plasma levels of cMyC has previously not been evaluated. Purpose The aim of this study was to assess the effect of a 12-week exercise training program on changes in plasma levels of cMyC in patients with chronic symptomatic heart failure with reduced ejection fraction (HFrEF). The changes in plasma levels of cMyC in an intervention group, performing structured exercise programs, were compared to those in a control group, instructed to perform regular recommended exercise (RRE) according to current guidelines. Methods This was a post hoc analysis of the SMARTEX-HF trial in 215 patients with symptomatic HF with Left Ventricular Ejection Fraction (LVEF) <35% and NYHA II-III. The patients were randomly assigned to High Intensity Interval Training (HIIT, n=77), Moderate Continuous Training (MCT, n=65) or RRE, (n=73) for 12 weeks. HIIT and MCT groups constituted the intervention group (IG). Measurements and clinical data were acquired before and after the 12-week intervention. Statistical analysis We divided the patients in two groups with Δ VO2Peak above and below the median of the sample. The absolute changes of cMyC were then compared between the two groups. Mann-Whitney U test was used to compare continuous variables between the groups. Chi-squared test and Fisher exact test were used to compare categorical variables, as appropriate. A two-tailed p<0.05 was considered significant. Results There were no differences in changes of cMyC plasma levels, measured at baseline and after the intervention, between patients in the IG and RRE-group (p=0.580). When dividing the entire study population according to Δ VO2Peak higher or lower than median value 0.48 ml/kg/min, we found a statistically significant greater reduction of cMyC values after 12 weeks of exercise training for those with higher than median Delta VO2Peak values compared to those with lower values (p=0.012). This finding was even stronger for the percentage change in cMyC levels (p=0.004 between groups). Conclusion In patients with symptomatic chronic HFrEF performing a structured 12-week exercise training program, a greater increase in Δ VO2Peak is significantly associated with a reduction in cMyC, suggesting cMyC may provide a dynamic measure of cardiorespiratory state. FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Central Norwegian Health authority,Norwegian University of Science and Technology Baseline characteristics Boxplot cMyC vs peak VO2

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Perceives and experiences of participating in a combined biofeedback with pulmonary rehabilitative exercise training program for patients with chronic obstructive pulmonary disease

10.1183/13993003.congress-2016.pa1387 ◽

2016 ◽

Author(s):

Yu-Ju Chen ◽

Shing-Shan Guo

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Exercise Training ◽

Training Program ◽

Pulmonary Disease ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Exercise Training Program

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Effects of a one-year exercise training program in adults over 70 years old: a study with a control group

Aging Clinical and Experimental Research ◽

10.1007/bf03324707 ◽

2007 ◽

Vol 19 (4) ◽

pp. 310-315 ◽

Cited By ~ 41

Author(s):

Gaëlle Deley ◽

Gaëlle Kervio ◽

Jacques Van Hoecke ◽

Bénédicte Verges ◽

Bruno Grassi ◽

...

Keyword(s):

Exercise Training ◽

Training Program ◽

Control Group ◽

Exercise Training Program ◽

One Year

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Plasma levels of troponin I is reduced after a 12 week exercise training program in patients with uncomplicated heart failure. A substudy of the SMARTEX-HF study

European Heart Journal ◽

10.1093/ehjci/ehaa946.1072 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

E Riveland ◽

T Valborgland ◽

A Ushakova ◽

Ø Skadberg ◽

T Karlsen ◽

...

Keyword(s):

Heart Failure ◽

Exercise Training ◽

Training Program ◽

Plasma Levels ◽

Troponin I ◽

Intervention Group ◽

Funding Source ◽

Exercise Training Program ◽

Complicating Factors ◽

Cardiac Troponins

Abstract Background Low-level elevation of cardiac troponins has been associated with adverse outcome, and concentrations even within the normal range provide independent information concerning risk in heart failure (HF). Exercise training exerts many beneficial effects on the cardiovascular system, and longitudinal observational data from epidemiological studies suggest that higher physical activity (PA) is associated with lower concentrations of cardiac troponins. Purpose Our aim was to compare changes in plasma troponin I (TnI) levels (Abbott Diagnostics) in patients with symptomatic heart failure undergoing a 12 week structured exercise training program (Intervention group, IG) with changes in controls on a recommendation of regular exercise (RRE); control group, (CG) in a randomized clinical trial. Methods This was a post hoc analysis of the SMARTEX-HF trial in 199 patients with symptomatic HF with LVEF <35% and NYHA II-III. The patients were randomly assigned to High Intensity Interval Training (HIIT, n=73), Moderate Continuous Training (MCT, n=59) or RRE, (n=67) for 12 weeks. HIIT and MCT groups constituted the intervention group (IG). Measurements and clinical data acquired before and after the 12-week exercise training intervention were analysed. Statistical analysis Changes of TnI levels from baseline to 12 weeks are presented as medians and interquartile ranges. One-sample Wilcoxon sign rank test was used to determine if for a specific group of patients, the median change of troponin levels was equal to zero. In addition, Mann-Whitney U test was used to compare reductions of TnI between two groups. Results After 12 weeks plasma levels of TnI were reduced for all patients (median 11.9 to 11.4 ng/L, p=0.032) and there was no difference between the study groups (p=0.072). However, when the groups were studied separately, reduction of plasma levels of TnI was statistically significant in the IG only (12.5 to 11.7 ng/L, p=0.011), (CG 11.4 to 10.7 ng/L, p=0.955). For the study cohort restricted to patients without additional complicating factors (i.e. no atrial fibrillation, no history of hypertension, diabetes or chronic obstructive pulmonary disease, n=77), difference in changes of plasma levels of TnI between IG (n=54) and CG (n=23) was found to be statistically significant (p=0.004). IG changed from 11.3 to 9.5 ng/L (p=0.002), (CG 12.6 to 12.7 ng/L, p=0.467). Conclusions A 12 weeks exercise-training program was associated with a reduction of plasma TnI levels in patients with mild to moderate HFrEF without additional complicating factors. Figure 1 Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Western Norway Regional; Health Authority [Grant Number 911 715]. St. Olavs Hospital; Faculty of Medicine, Norwegian University of Science and Technology; Norwegian Health Association

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The Role of Cardiac Magnetic Resonance in Assessment of Myocardial Contractile Function After Exercise Training Based Cardiac Rehabilitation Program in Anterior ST-Elevated Myocardial Infarction Patients Treated with Primary Percutaneous Coronary Intervention

QJM ◽

10.1093/qjmed/hcab090.034 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Rana Lateef Hasan ◽

Mohamed Ayman Abdel Wahab Saleh Ahmed Samir Ibrahim ◽

Hazem Reda Khorshid Ahmed Mohamed Elshazly

Keyword(s):

Myocardial Infarction ◽

Cardiac Magnetic Resonance ◽

Magnetic Resonance ◽

Exercise Training ◽

Training Program ◽

Training Group ◽

Coronary Intervention ◽

Control Group ◽

Anterior Myocardial Infarction ◽

Exercise Training Program

Abstract Back ground Regular exercise training program has been shown to reduce mortality, improve functional capacity and control risk factors in myocardial infarcted patients. Wall motion score index (WMSI) is a strong independent mortality predicator in patient with previous MI AIM The main objective of this study was to investigate the impact of exercise training on regional left ventricular systolic function, in patients post anterior myocardial infarction. using cardiac magnetic resonance imaging Methods We recruited twenty-six adult patients on optimal medical therapy one month after an anterior myocardial infarction underwent successful percutaneous coronary intervention (PCI) were assigned to a three-month exercise training program group or to a control group, (control group: n = 10, training group: n = 16). Symptom limited treadmill exercise (Modified Bruce Protocol) test was done to exercise training group before and repeated after finishing the CR program. Cardiac Magnetic Resonance (CMR) was performed for all patients 4 weeks after PCI and was repeated after completion of the study period that was lasted for 12 weeks. Results A total number of patients, included 26 (100%) males, assigned to control group n:10 without an exercise mean age 50± 8 years, weigh 84 ±17 kg, height 175±7.7 cm and EF was 36.62 ±14.23 and to training group n:16 with 3-months exercise training program, the mean age, weight, height and EF were 50.19±8.68 years, 82.69±16 kg, 172.81±7.74 cm, 36.62±14.32% respectively While there was significant improvement in EF (P < 0.0008), WMSI (P < 0.00003) without significant change in LVESV and LVEDV in exercise training group, there was no significant change in EF, WMSI, LVESV and LVEDV in control group. Conclusion CMR revealed that exercise training in post-myocardial infarction patients could have beneficial effects on LV global and regional function without adversely affecting LV remodeling or causing serious cardiac complications with significant improvement in exercise capacity after 3 months of exercise training program.

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Recovery of the decline in activities of daily living after hospitalization through an individualized exercise programme: Secondary Analysis of a Randomized Clinical Trial

The Journals of Gerontology Series A ◽

10.1093/gerona/glab032 ◽

2021 ◽

Author(s):

Nicolás Martínez-Velilla ◽

Mikel L Sáez de Asteasu ◽

Robinson Ramírez-Vélez ◽

Fabricio Zambom-Ferraresi ◽

Antonio García-Hermoso ◽

...

Keyword(s):

Exercise Training ◽

Daily Living ◽

Group Analysis ◽

Intervention Group ◽

Training Programme ◽

Control Group ◽

Bladder Control ◽

Patient Profile ◽

Climbing Stairs ◽

Exercise Training Programme

Abstract Background During the period of hospitalization patients can develop functional decline. The main aim of our study was to assess the natural trajectory of each Activity of Daily Living (ADL) and to assess how in-hospital exercise could influence short-term trajectory of ADLs. Methods Acutely hospitalized patients (n=297, 56.5% women) were randomly assigned to the intervention or control (usual care) group within the first 48 hours of admission. An exercise training programme was prescribed in two daily sessions (morning and evening) of 20 minutes duration during 5–7 consecutive days for the intervention group. The primary end-point was the change in every ADL (assessed with the Barthel Index) from 2 weeks before admission to hospital discharge. Results Acute hospitalization per se led to significant in-patient’s functional ability impairment in ADLs during hospitalization, whereas the exercise intervention reversed this trend (3.7 points; 95% CI, 0.5 to 6.8 points). After analyzing the trajectory of each one of the ADLs, patients in the control group significantly worsened all activities, but with a different degree of loss. For the between-group analysis, significant differences were obtained in many ADLs including bathing, dressing, grooming, bladder control, toilet use, transfers, mobility and climbing stairs (p<0.05). The control group had the greatest impairment in all domains analyzed (i.e., feeding, bathing, dressing, grooming, bowel control, bladder control, toilet use, transfers, mobility, and climbing stairs), p<0.05. Conclusions An individualized multicomponent exercise training programme in older adults is effective to reverse the loss of specific ADLs that frequently occurs during hospitalization. Each patient profile should receive an individualized prescription of exercise during hospitalizations.

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