scholarly journals Feasibility of a postacute structured aerobic exercise intervention following sport concussion in symptomatic adolescents: a randomised controlled study

2018 ◽  
Vol 4 (1) ◽  
pp. e000404 ◽  
Author(s):  
Rachel Micay ◽  
Doug Richards ◽  
Michael G Hutchison
Keyword(s):  
Aerobic Exercise ◽  
Usual Care ◽  
Exercise Intervention ◽  
Cycle Ergometer ◽  
Phase Iii ◽  
Exercise Session ◽  
Controlled Study ◽  
Care Group ◽  
Activity Levels ◽  
Symptom Status

ObjectiveThe utility of structured exercise for rehabilitation purposes early in the postacute phase (ie, beyond the initial 24–48 hours of advised rest) following sport-related concussion (SRC) remains largely unexplored. This study examined the feasibility of implementing a standardised aerobic exercise (AE) intervention in the postacute stage of SRC recovery in a sample of adolescent students with SRC compared with usual care.MethodsSymptomatic adolescents with SRC were randomised to one of two groups: Aerobic Exercise (n=8) or Usual Care (n=7). The AE intervention, beginning on day 6 postinjury, comprised eight sessions with progressive increases in intensity and duration on a cycle ergometer. Usual care consisted of rest followed by physician-advised progressions in activity levels in an unsupervised setting. All participants were evaluated by physician at weeks 1, 2, 3 and 4 postconcussion. Outcome measures included: (1) Intervention feasibility: symptom status pre-post exercise sessions and completion of intervention and (2) Clinical recovery: symptom status at weeks 1, 2, 3 and 4 postinjury and medical clearance date.ResultsAll participants completed the exercise sessions as part of the AE intervention and symptom exacerbation was not associated with any exercise session. The AE group experienced greater symptom resolution compared with the Usual Care Group across the recovery timeline.ConclusionA structured AE protocol appears to be safe and feasible to administer in the postacute stage of SRC recovery in adolescents and should be explored as part of a full Phase III Clinical Trial.

scholarly journals Randomised controlled study of two counselling models at the Swedish alcohol helpline: Effectiveness and sustainability outcomes at 12-month follow-up

2021 ◽  
pp. 145507252110078
Author(s):  
Thi-Thuy-Dung Nguyen ◽  
Eleonor Säfsten ◽  
Filip Andersson ◽  
Maria Rosaria Galanti
Keyword(s):  
Alcohol Use ◽  
Usual Care ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Risk Level ◽  
Care Group ◽  
Structured Intervention ◽  
Randomised Controlled ◽  
Level Reduction

Aim: This two-arm parallel randomised controlled trial explored the effectiveness of a brief counselling model compared with the usual multi-session counselling at an alcohol telephone helpline. Methods: A total of 320 callers who contacted the Swedish Alcohol Helpline (SAH) because of hazardous or harmful alcohol use were randomised to either brief structured intervention (self-help booklet plus one proactive call) or usual care (multi-session telephone counselling). The primary outcome was a downward shift in risk level at 12-month follow-up compared with baseline, based on self-reports. Sustained risk level reduction throughout the whole follow-up was also assessed as secondary outcome. Results: Both interventions were significantly associated with a shift to a lower level of risky alcohol use (75% among participants in the brief structured intervention, and 70% in the usual care group) after 12 months. There was no difference between the two interventions in the proportions changing alcohol use or sustaining risk level reduction. Conclusion: In the context of telephone helplines, minimal and extended interventions appear to be equally effective in promoting long-term change in alcohol use.

scholarly journals EFFECT OF AEROBIC EXERCISE ON FATIGUE AND DEPRESSION IN INDIVIDUALS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 8 (6) ◽  
pp. 3674-3679
Author(s):  
Sanjeev Kumar Singh ◽  
◽  
Afsha Mulla ◽  
Farheen Farooque Khan ◽  
Ronika Agrawal ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Aerobic Exercise ◽  
Outcome Measures ◽  
Exercise Intervention ◽  
Depression Scale ◽  
Joint Disease ◽  
Exercise Session ◽  
P Value ◽  
Target Heart Rate ◽  
Convenience Sample

Background: Rheumatoid arthritis (RA) is an autoimmune, systemic, inflammatory condition causing pain, disability, and psychological distress. It is the most common chronic inflammatory joint disease, affecting 0.1-1% of the population. Women are affected 3 times more than men. Because of its chronic, painful, and disabling character, RA tends to have a profound impact on health-related quality of life (HRQOL). Materials and methods: In the present study a convenience sample of 30 individuals between 30 to 60 years of age group according to the inclusion and exclusion criteria. The exercise intervention was participation in aerobic exercise session 3 times weekly for 6 weeks. The session consisted of 3 phases –1)Warm-up phase 2).Aerobic period 3) Cool down phase.Subjects were given their target heart rate for 40% and 60% of their HRmax. They were instructed to start exercising at 40% and progress to 60% as tolerated given their subjective exertion using the Talk Test (being able to talk while exercising without being short of breath). Global Fatigue Index Of The Multidimensional Assessment Of Fatigue Questionnaire (GFI) and The Center for Epidemiologic Studies- Depression Scale (CES-D)were used as outcome measures for evaluating fatigue and severity of depression respectively in the subjects and the data was statistically analysed. Results: Paired t-test was done for pre and post mean values for MAF-GFI scale. The results showed statistically significant values for both the outcome measures (p value < 0.05). Conclusion: The present study concludes that 6 weeks of aerobic exercise showed significant effect in decreasing fatigue and depression in individuals with rheumatoid arthritis. KEY WORDS: Rheumatoid Arthritis, Fatigue, Depression, Aerobic Exercise.

scholarly journals Acute Citrulline-Malate Oral Supplementation does not Improve Post-Aerobic-Exercise Autonomic Response in Normotensive and Hypertensive Subjects: a Pilot Randomized Controlled Study

2020 ◽  
Vol 22 (4) ◽  
pp. 242-249
Author(s):  
Juliano Casonatto ◽  
Adeluci Moraes ◽  
Kamila Grandolfi
Keyword(s):  
Aerobic Exercise ◽  
Autonomic Response ◽  
Exercise Session ◽  
Controlled Study ◽  
Post Exercise ◽  
Oral Supplementation ◽  
Z Scores ◽  
Normotensive Subjects ◽  
Citrulline Malate ◽  
E 32

AbstractThe present study was designed to investigate whether citrulline malate (CM) supplementation might influence post-aerobic-exercise autonomic response in normotensive and hypertensive subjects. Forty individuals (20 normotensives and 20 hypertensives) were randomly assigned to one of the four experimental groups (normotensive-placebo [NP], normotensive-CM [NC], hypertensive-placebo [HP], and hypertensive-CM [HC]). The participants ingested CM (6 g) or placebo dissolved in water (100 ml) 120 min before the exercise session. The exercise session was conducted on a treadmill and consisted of 40 min of running/walking at 60-70% HRreserve. The heart rate variability (HRV) was recorded continuously for 60 min post-exercise. In normotensive subjects at “post-30”, LF increased and HF decreased after the CM supplementation (16% [P=0.041] and -32% [P=0.037], respectively). No significant differences were found in “pre”, “post-30” and “post-60” considering the pooled (NP, NC, HP, and HC) z-scores for time and frequency HRV domains. These results suggest that a single dose of CM supplementation does not promote significant effects on post-exercise autonomic modulation in normotensive and hypertensive subjects. Keywords: Autonomic Nervous System. Citrulline Malate. Hypertension. Exercise. ResumoO presente estudo foi desenvolvido para investigar se a suplementação de citrulina malato (CM) pode influenciar a resposta autonômica após exercício aeróbico em indivíduos normotensos e hipertensos. Quarenta indivíduos (20 normotensos e 20 hipertensos) foram aleatoriamente designados para um dos quatro grupos experimentais (normotenso-placebo [NP], normotenso-CM [NC], hipertenso-placebo [HP] e hipertenso-placebo [HP] e hipertenso-CM [HC]). Os participantes ingeriram CM (6 g) ou placebo dissolvido em água (100 ml) 120 minutos antes da sessão de exercícios. A sessão de exercícios foi realizada em esteira e consistiu em 40 minutos de corrida/caminhada a 60-70% da FCres. A variabilidade da frequência cardíaca (VFC) foi registrada continuamente por 60 minutos após o exercício. Nos normotensos “pós-30”, houve aumento para LF e redução para HF após a suplementação de CM (16% [P=0,041] e -32% [P=0,037], respectivamente). Não foram encontradas diferenças significativas nos momentos "pré", "pós-30" e "pós-60", considerando os escores-z combinados (NP, NC, HP e HC), tanto para os indicadores de domínio do tempo, quando para os de domínio da frequência. Estes resultados sugerem que uma dose única de suplementação de CM não promove efeitos significativos na modulação autonômica após exercício em indivíduos normotensos e hipertensos. Palavras-chave: Sistema Nervoso Autônomo. Citrulina Malato. Hipertensão, Exercício.

scholarly journals Reducing shoulder complaints in employees with high occupational shoulder exposures: study protocol for a cluster-randomised controlled study (The Shoulder-Café Study)

2019 ◽  
Author(s):  
Jeanette Trøstrup ◽  
Lone Ramer Mikkelsen ◽  
Poul Frost ◽  
Annett Dalbøge ◽  
Mette Terp Høybye ◽  
...  
Keyword(s):  
Usual Care ◽  
Mixed Model ◽  
Exercise Intervention ◽  
Randomised Trial ◽  
Self Report ◽  
Controlled Study ◽  
Cluster Randomised Trial ◽  
Cluster Randomised ◽  
First Choice ◽  
Randomised Controlled

Abstract Background: In Denmark, exercise therapy in combination with work modifications is the first choice treatment for persons with shoulder complaints and high occupational shoulder exposures. To obtain this treatment they must visit several healthcare providers, which makes usual care fragmented and uncoordinated. Therefore, we developed a new intervention which unifies the expertise that is needed. The main hypotheses are that a group-based Shoulder-Café intervention will reduce (I) shoulder complaints and (II) occupational shoulder exposures more effectively than an individual-based Shoulder-Guidance intervention (active control – enhanced usual care). Methods: A cluster-randomised trial is conducted including 120 employees with high occupational shoulder exposures. Companies (clusters) are randomised to either Shoulder-Café or Shoulder-Guidance with a 1:1 allocation ratio. Participants are 18–65 years old and have an Oxford Shoulder Score (OSS) ≤ 40. Both interventions include a home-based shoulder exercise programme, assessment of shoulder exposures by technical measurements and self-report, and general information on how to reduce shoulder exposures. The Shoulder-Café course also includes three café meetings with physiotherapist-supervised exercises, clinical shoulder evaluation, education on shoulder anatomy, workplace-oriented counselling, and an opportunity for a workplace visit by a health and safety consultant. The primary outcomes are the OSS at 6 month follow-up (hypothesis I), and the mean number of minutes/day with the arm elevated > 60° shortly after end of intervention (hypothesis II). We will use mixed model analysis that allows for company clustering, and data will be analysed according to the intention-to-treat principle. Discussion: Persons with shoulder complaints and high occupational shoulder exposures are an obvious target group for secondary prevention efforts. We developed the Shoulder-Café to reduce shoulder complaints and shoulder exposures while unifying the expertise that is needed to evaluate and treat shoulder complaints. If the intervention is effective, it would warrant widespread implementation. Trial registration: The trial was registered at Clinicaltrials.gov on 18 May 2017 (ID: NCT03159910). Keywords: Exercise, Intervention, Mechanical exposure, Occupation, Randomised controlled trial, Shoulder, Training programme.

scholarly journals Conservative Fluid Management After Sepsis Resuscitation: A Pilot Randomized Trial

2019 ◽  
Vol 35 (12) ◽  
pp. 1374-1382 ◽  
Author(s):  
Matthew W. Semler ◽  
David R. Janz ◽  
Jonathan D. Casey ◽  
Wesley H. Self ◽  
Todd W. Rice
Keyword(s):  
Usual Care ◽  
Randomized Trial ◽  
Phase Ii ◽  
Fluid Balance ◽  
Loop Diuretic ◽  
Fluid Management ◽  
Phase Iii ◽  
Care Group ◽  
Management Group ◽  
Management Protocol

Rationale: The feasibility and clinical outcomes of conservative fluid management after sepsis resuscitation remain unknown. Objectives: To evaluate the effect of a conservative fluid management protocol on fluid balance and intensive care unit (ICU)-free days among patients with sepsis. Methods: In a single-center phase II/III randomized trial, we enrolled adults with suspected infection, ≥2 systemic inflammatory response syndrome criteria, and either shock (mean arterial pressure <60 mm Hg or vasopressors) or respiratory insufficiency (mechanical ventilation or oxygen saturation <97% and fraction of inspired oxygen ≥0.3). Patients were randomized 1:1 to usual care or a conservative fluid management protocol. The protocol restricted intravenous fluid administration during shock to treatment of oliguria or increasing vasopressor requirement. In the absence of shock, loop diuretic infusion targeted equal fluid input and output each study day. The primary outcomes were mean daily fluid balance (phase II) and ICU-free days (phase III). Results: At the completion of phase II (n = 30), the difference in mean daily fluid balance between groups (−398 mL) was less than the prespecified threshold (−500 mL) and the trial was stopped. Patients in the conservative fluid management (n = 15) and usual care (n = 15) groups experienced similar cumulative fluid input (8450 mL vs 7049 mL; P = .90) of which only 14% was intravenous crystalloid or colloid. Loop diuretic infusion occurred more frequently in the conservative fluid management group (40% vs 0%; P = .02), and cumulative fluid output was 10 645 mL in the conservative fluid management group compared to 6286 mL in the usual care group ( P = .39). Hemodynamic, respiratory, and renal function did not differ between the groups. Conclusions: In this phase II trial, a conservative fluid management protocol did not decrease mean daily fluid balance by more than 500 mL among patients with sepsis. Registration: Clinicaltrials.gov ; NCT02159079.

A randomized controlled pilot of home-based exercise (HBEX) versus standard care (SC) among breast (BC) and prostate cancer (PC) patients receiving radiation therapy (RTH)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8504-8504 ◽  
Author(s):  
K. M. Mustian ◽  
G. R. Morrow ◽  
J. Yates ◽  
L. Gillies ◽  
C. Boles
Keyword(s):  
Aerobic Exercise ◽  
Aerobic Capacity ◽  
Exercise Intervention ◽  
Treatment Compliance ◽  
Positive Influence ◽  
Phase Iii ◽  
Post Intervention ◽  
Change Scores ◽  
Randomized Controlled ◽  
Home Based

8504 Background: Cancer-related fatigue (CRF) is reported in up to 97% of cancer patients during RTH. 60% rate it as moderate to severe. Fatigue can significantly reduce functional capacity (FC), treatment compliance, and QOL. Although there is no standard treatment for CRF, aerobic exercise has demonstrated a positive influence on CRF and FC during RTH, but the influence of combined resistance and aerobic exercise is not clear. We explored the efficacy of a low to moderate home-based exercise intervention, including resistance and aerobic training, to SC on CRF and domains of FC (aerobic capacity and strength), in a sample of BC and PC patients during RTH. Methods: BC and PC patients (N=38; ξ age=56; 71% BC), beginning at least 28 sessions of RTH were randomized to a 4wk HBEX (7 days/wk) or SC condition, with CRF (FACT subscale), aerobic capacity (6-min. walk), and strength (handgrip dynamometry) assessments pre and post-intervention. Results: Change scores indicated improvements in the HBEX group (N=19) in CRF (ξ=3.6, SE=2.1) and aerobic capacity (ξ=43.6, SE=52.3), while the SC group declined in CRF (ξ=-1.1, SE=1.1) and aerobic capacity (ξ=-28.5 SE=71.6). Change scores revealed declines in strength among both groups, however the HBEX group showed smaller declines in strength (ξ=-.05, SE=0.7) compared to the SC group (ξ=-.80, SE=.91). T-tests using intent-to-treat indicated statistically significant between group differences on changes in CRF (ES=.63; p=.05) from pre to post-intervention, as well as significantly higher aerobic capacity (ES=1.3; p<.001) with a statistical trend toward lower CRF (ES=.51; p=.09) between groups post-intervention. Conclusions: HBEX improved CRF and aerobic capacity, while SC resulted in declines. HBEX reduced declines in strength compared to SC. Future phase III randomized controlled trials are needed with larger samples to fully investigate the influence of this HBEX intervention on CRF, aerobic capacity and strength. Funded by NCI grant 1R25CA102618. No significant financial relationships to disclose.

A randomized trial of exercise on quality of life in men with metastatic prostate cancer: The ExPeCT Trial.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 97-97
Author(s):  
Grainne Sheill ◽  
Lauren Brady ◽  
Emer M. Guinan ◽  
Juliette M. Hussey ◽  
Brian Hayes ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Prostate Cancer ◽  
Aerobic Exercise ◽  
Metastatic Prostate Cancer ◽  
Exercise Intervention ◽  
Randomised Control Trial ◽  
Activity Levels ◽  
Physical Activity Levels

97 Background: All patients living with cancer, including those with metastatic cancer, are encouraged to be physically active. This paper examines the feasibility of an aerobic exercise intervention for men with metastatic prostate cancer. Methods: ExPeCT (Exercise, Prostate Cancer and Circulating Tumour Cells), was a multi-centre randomised control trial for men living with metastatic prostate cancer. Participants were randomized to either control or exercise arms. Participants in the exercise arm completed six- months of prescribed aerobic exercise. Quality of life assessments were completed at baseline, at 3 months and at 6 months using a standardised questionnaire derived from the Harvard Health Professionals Follow-up study. Physical activity was measured using a self-administered physical activity questionnaire. Exercise adherence data was collected via Polar heart rate monitors, worn by the patient for every exercise session undertaken. Results: A total of 61 patients were included (69.4±7.3 yr, Body Mass Index 29.2±5.8 kg/m2). The median time since diagnosis was 34 months (IQR 7-54). A total of 35 (55%) of participants had >1 region affected by metastatic disease. A total of 54 (81%) of participants completed the 3 month assessment and 52 (78%) of the participants completed the 6 month assessment. Adherence to the supervised sessions was 83% (329 out of 396 sessions attended). Participants were adherent to both the intensity (82%) and duration (83%) of the prescribed exercise programme during class sessions. No adverse events were reported by participants enrolled in this study. There was no significant difference in physical activity levels, sedentary time or quality of life between either group at baseline, 3 months or 6 months. Systolic blood pressure was significantly lower in the exercise group when compared to the control group at 3 months (p=.008) and 6 months (p=.011). Conclusions: The exercise intervention was tolerated well by a group of patients with a high burden of metastatic prostate cancer however did not lead to change in physical activity levels or quality of life. This trial provides proof of principle evidence for future exercise studies involving this patient group. Clinical trial information: NCT02453139.

scholarly journals Energy compensation after an aerobic exercise session in high-fat/low-fit and low-fat/high-fit young male subjects

2013 ◽  
Vol 110 (6) ◽  
pp. 1133-1142 ◽  
Author(s):  
Keyne Charlot ◽  
Didier Chapelot
Keyword(s):  
Aerobic Exercise ◽  
Young Male ◽  
Cycle Ergometer ◽  
Individual Variability ◽  
Exercise Session ◽  
High Fat ◽  
Energy Compensation ◽  
Group 2 ◽  
Exercise Induced ◽  
Male Subjects

There is general agreement that exercise-induced energy expenditure is not entirely compensated for at the next meal or over the following 24 h, but inter-individual variability is high. The role of ‘fatness and fitness’ in this variability has never been assessed. Therefore, eighteen non-obese male subjects aged 22·2 (sd2·0) years were selected and separated into a ‘high-fatness and low-fitness’ (Hfat/Lfit,n9) and a ‘low-fatness and high-fitness’ (Lfat/Hfit,n9) group, according to three criteria: maximal oxygen uptake; weekly hours of physical activity; fat mass index. At 1 h before lunch, they were subjected to 60 min of exercise on a cycle ergometer (70 % VO2max), or stayed at rest. Then, they self-reported food intake in diaries until the next breakfast. Intake at lunch was not different between conditions, but was higher after exercise than after rest over the 24 h, leading to a significant but partial mean level of compensation of 49·8 (sem16·5) and 37·8 (sem24·6) % for the Hfat/Lfit and Lfat/Hfit groups, respectively. Energy compensation at lunch and over the 24 h were strongly correlated (r0·76,P< 0·001). Both groups consumed more fat and protein after exercise than after rest over the 24 h, but the percentage of energy derived from fat increased only in the Hfat/Lfit group (2·1 (sem0·6) %,P= 0·026). Thus, the energy cost of an aerobic exercise session was partially compensated over the next 24 h independently of the ‘fatness and fitness’ status, but ‘high-fat and low-fit’ individuals compensated more specifically on fats.

scholarly journals Effect of Exercise on Metabolic Syndrome Variables in Breast Cancer Survivors

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Gwendolyn A. Thomas ◽  
Marty Alvarez-Reeves ◽  
Lingeng Lu ◽  
Herbert Yu ◽  
Melinda L. Irwin
Keyword(s):  
Breast Cancer ◽  
Metabolic Syndrome ◽  
Cancer Survivors ◽  
Aerobic Exercise ◽  
Usual Care ◽  
Breast Cancer Survivors ◽  
Exercise Intervention ◽  
Exercise Adherence ◽  
Postmenopausal Breast Cancer ◽  
Increased Risk

Objective. Breast cancer survivors are highly sedentary, overweight, or obese, which puts them at increased risk for comorbid chronic disease. We examined the prevalence of, and changes in, metabolic syndrome following 6 months of an aerobic exercise versus usual care intervention in a sample of sedentary postmenopausal breast cancer survivors.Design and Methods. 65 participants were randomized to an aerobic exercise intervention (EX) (n=35) mean BMI 30.8 (±5.9) kg/m2or usual care (UC) (n=30) mean BMI 29.4 (±7.4) kg/m2. Metabolic syndrome prevalence was determined, as well as change in criteria and overall metabolic syndrome.Results. At baseline, 55.4% of total women met the criteria for metabolic syndrome. There was no statistically significant change in metabolic syndrome when comparing EX and UC. However, adhering to the exercise intervention (at least 120 mins/week of exercise) resulted in a significant (P=.009) decrease in metabolic syndromez-score from baseline to 6 months (-0.76±0.36) when compared to those who did not adhere (0.80±0.42).Conclusions. Due to a higher prevalence of metabolic syndrome in breast cancer survivors, lifestyle interventions are needed to prevent chronic diseases associated with obesity. Increasing exercise adherence is a necessary target for further research in obese breast cancer survivors.

Improving Follow-Up Adherence in a Primary Eye Care Setting

2016 ◽  
Vol 32 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Catherine E. Callinan ◽  
Brianna Kenney ◽  
Lisa A. Hark ◽  
Ann P. Murchison ◽  
Yang Dai ◽  
...  
Keyword(s):  
Usual Care ◽  
Patient Adherence ◽  
Intervention Group ◽  
Appointment Scheduling ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Care Group ◽  
Eye Care ◽  
Primary Eye Care

Lack of patient adherence with eye appointments can decrease ocular outcomes. This prospective, randomized, single-blinded controlled study assessed the effectiveness of multiple interventions in improving follow-up adherence to recommended eye appointments. Patients due for follow-up appointments were randomly assigned to usual care, automated intervention, or personal intervention. Automated-intervention patients and personal-intervention patients received a call one month prior to the recommended follow-up date, and a mailed appointment reminder letter. The call was automated for automated-intervention patients and personalized for personal-intervention patients. The primary outcome was adherence to the follow-up appointment. The secondary outcome was rate of appointment scheduling. Patients in the personal-intervention group had greater adherence to follow-up recommendations (38%) than patients in the usual care group (28%) and the automated-intervention group (30%). Personal intervention significantly increased appointment scheduling (51%) over usual care (32%) and automated intervention (36%). These results support systems-level changes to improve patient follow-up adherence in urban primary eye care settings.

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