Abstract 3111: Contribution of Improved Cardiorespiratory Functions to Increased Pain-Free and Maximal Walking Distance in Patients with Claudication Following Arm Ergometer or Treadmill Exercise Training

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Ulf G Bronas ◽  
Diane Treat-Jacobson ◽  
Arthur S Leon
Keyword(s):  
Exercise Training ◽  
Usual Care ◽  
Treadmill Exercise ◽  
Treadmill Training ◽  
Walking Distance ◽  
Control Group ◽  
Supervised Exercise ◽  
Ergometer Exercise ◽  
Arm Ergometer ◽  
Usual Care Control Group

Introduction: We previously reported that arm ergometer exercise training improves walking distance in patients with claudication similar to treadmill exercise training through unknown mechanisms. This is the first study to investigate the effects of 12 weeks of arm ergometer or treadmill training on cardiorespiratory functions during treadmill exercise testing in patients with claudication, as compared to a usual care control group. Hypothesis: Both arm ergometer and treadmill training will significantly improve cardiorespiratory functions, which will contribute to improvement in both pain-free walking distance (PFWD) and maximal walking distance (MWD). Methods: Participants (21m, 7f, mean age 65.6 yrs, 86 % smoke hx., 27% diabetes) with claudication were randomly assigned to supervised exercise training [arm ergometry (n=10) or treadmill (n=10) ] for 12 weeks, 3h/week, or to a usual care control group (n=8). Double product at stage 1 and at MWD, anaerobic threshold, and VO 2 at onset of claudication pain and VO 2 peak were assessed during a symptom-limited, graded treadmill exercise test. Changes in these functions from baseline were analyzed between groups via ANCOVA and associations between variables were determined by Pearson’s partial correlations. Results: Groups did not differ in baseline demographic, medical or exercise variables. There were significant differences in response of cardiorespiratory variables to training in both exercise groups compared to the control group, but no statistical differences between exercise groups. Significant moderate correlations were found between changes in all cardiorespiratory variables and changes in PFWD or MWD (Table 1 ). Conclusion: Improvements in cardiorespiratory functions following arm ergometer or treadmill training were significantly associated with changes in PFWD and MWD, supporting systemic contributions to exercise training-related improvements seen in patients with claudication. Changes from Baseline in Submaximal and Maximal Cardiorespiratory Variables and Walking Improvement

scholarly journals Standardized exercise training is feasible, safe, and effective in pulmonary arterial and chronic thromboembolic pulmonary hypertension: results from a large European multicentre randomized controlled trial

2020 ◽  
Author(s):  
Ekkehard Grünig ◽  
Alison MacKenzie ◽  
Andrew J Peacock ◽  
Christina A Eichstaedt ◽  
Nicola Benjamin ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Exercise Training ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Functional Class ◽  
European Countries ◽  
Walking Distance ◽  
Control Group ◽  
Randomized Controlled ◽  
Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Arterial

Abstract Aims This prospective, randomized, controlled, multicentre study aimed to evaluate efficacy and safety of exercise training in patients with pulmonary arterial (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Methods and results For the first time a specialized PAH/CTEPH rehabilitation programme was implemented in 11 centres across 10 European countries. Out of 129 enrolled patients, 116 patients (58 vs. 58 randomized into a training or usual care control group) on disease-targeted medication completed the study [85 female; mean age 53.6 ± 12.5 years; mean pulmonary arterial pressure 46.6 ± 15.1 mmHg; World Health Organization (WHO) functional class II 53%, III 46%; PAH n = 98; CTEPH n = 18]. Patients of the training group performed a standardized in-hospital rehabilitation with mean duration of 25 days [95% confidence interval (CI) 17–33 days], which was continued at home. The primary endpoint, change of 6-min walking distance, significantly improved by 34.1 ± 8.3 m in the training compared with the control group (95% CI, 18–51 m; P < 0.0001). Exercise training was feasible, safe, and well-tolerated. Secondary endpoints showed improvements in quality of life (short-form health survey 36 mental health 7.3 ± 2.5, P = 0.004), WHO-functional class (training vs. control: improvement 9:1, worsening 4:3; χ2  P = 0.027) and peak oxygen consumption (0.9 ± 0.5 mL/min/kg, P = 0.048) compared with the control group. Conclusion This is the first multicentre and so far the largest randomized, controlled study on feasibility, safety, and efficacy of exercise training as add-on to medical therapy in PAH and CTEPH. Within this study, a standardized specialized training programme with in-hospital start was successfully established in 10 European countries.

Structured Exercise Improves Physical Functioning in Women With Stages I and II Breast Cancer: Results of a Randomized Controlled Trial

2001 ◽  
Vol 19 (3) ◽  
pp. 657-665 ◽  
Author(s):  
Roanne Segal ◽  
William Evans ◽  
Darren Johnson ◽  
Julie Smith ◽  
Sal Colletta ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Body Weight ◽  
Usual Care ◽  
Aerobic Capacity ◽  
Physical Functioning ◽  
Control Group ◽  
Supervised Exercise ◽  
Related Quality

PURPOSE: Self-directed and supervised exercise were compared with usual care in a clinical trial designed to evaluate the effect of structured exercise on physical functioning and other dimensions of health-related quality of life in women with stages I and II breast cancer. PATIENTS AND METHODS: One hundred twenty-three women with stages I and II breast cancer completed baseline evaluations of generic and disease- and site-specific health-related quality of life, aerobic capacity, and body weight. Participants were randomly allocated to one of three intervention groups: usual care (control group), self-directed exercise, or supervised exercise. Quality of life, aerobic capacity, and body weight measures were repeated at 26 weeks. The primary outcome was the change in the Short Form-36 physical functioning scale between baseline and 26 weeks. RESULTS: Physical functioning in the control group decreased by 4.1 points, whereas it increased by 5.7 points and 2.2 points in the self-directed and supervised exercise groups, respectively (P = .04). Post hoc analysis showed a moderately large (and clinically important) difference between the self-directed and control groups (9.8 points; P = .01) and a more modest difference between the supervised and control groups (6.3 points; P = .09). No significant differences between groups were observed for changes in quality of life scores. In a secondary analysis of participants stratified by type of adjuvant therapy, supervised exercise improved aerobic capacity (+3.5 mL/kg/min; P = .01) and reduced body weight (−4.8 kg; P < .05) compared with usual care only in participants not receiving chemotherapy. CONCLUSION: Physical exercise can blunt some of the negative side effects of breast cancer treatment, including reduced physical functioning. Self-directed exercise is an effective way to improve physical functioning compared with usual care. In participants not receiving chemotherapy, supervised exercise may increase aerobic capacity and reduce body weight compared with usual care.

scholarly journals Is four-week underwater treadmill exercise regimen compared to home exercise efficacious for pain relief and functional improvement in obese patients with knee osteoarthritis? A randomized controlled trial

2018 ◽  
Vol 33 (1) ◽  
pp. 85-93 ◽  
Author(s):  
Vilai Kuptniratsaikul ◽  
Chawalit Kittichaikarn ◽  
Phitsanu Suntornpiyapan ◽  
Kriangkrai Kovintaset ◽  
Suwicha Inthibal
Keyword(s):  
Body Weight ◽  
Knee Osteoarthritis ◽  
Treadmill Exercise ◽  
Controlled Trial ◽  
Quadriceps Strength ◽  
Walking Distance ◽  
Functional Improvement ◽  
Home Exercise ◽  
Control Group ◽  
Exercise Regimen

Objective: To investigate the efficacy of a four-week underwater treadmill exercise regimen compared to a home exercise regimen relative to pain relief and functional improvement in obese patients with knee osteoarthritis. Design: Single-blind randomized controlled trial. Setting: Outpatient. Participants: Eighty primary knee osteoarthritis with pain ⩾5/10 and body mass index ⩾25 kg/m2. Interventions: Daily quadriceps exercise at home for 30 minutes (control group) or underwater treadmill exercise (study group) for 30 minutes/day, three times/week for four weeks. Main outcomes: Pain score, six-minute walking distance, quadriceps strength, and body weight were evaluated at baseline and after four weeks. Adverse events, global assessment, and satisfaction index were assessed at the end of study. Results: All outcomes in both groups were significantly improved at the end of the study, except for body weight. The mean difference (95% confidence interval (CI)) in outcomes between groups were −0.53 (−1.31, 0.26) for pain; 10.81 (−11.9, 33.53) meters for 6-minute walking distance; 0.67 (−0.10, 1.44) kilograms for quadriceps strength; and 0.01 (−0.66, 0.68) kilograms for body weight. No significant differences were observed between groups, for the per protocol analysis or the intention-to-treat analysis. Participants in the study group evaluated significantly better global improvement and higher patient satisfaction than those in control group (13 (39.4%) vs. 4 (10.8%); P = 0.014 and 23 (69.7%) vs. 16 (43.2%); P = 0.021, respectively). Conclusion: Exercise using an underwater treadmill was found to be as efficacious as home exercise for relieving pain and improving function in obese people with mild to moderate knee osteoarthritis.

scholarly journals Supervised Exercise Therapy using Mobile Health Technology in Patients with Peripheral Arterial Disease: Randomized Controlled Pilot Trial. (Preprint)

2020 ◽  
Author(s):  
Katrin Paldán ◽  
Martin Steinmetz ◽  
Jan Simanovski ◽  
Christos Rammos ◽  
Greta Ullrich ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Usual Care ◽  
Outcome Measure ◽  
Arterial Disease ◽  
Control Group ◽  
Study Group ◽  
Supervised Exercise ◽  
Relevant Outcome Measure ◽  
Peripheral Arterial ◽  
Relevant Outcome

BACKGROUND Mobile interventions are intended to digitally nurse complex health care needs in chronic diseases, but they are mainly targeted at general health improvement and neglect disease-specific requirements. Therefore, we designed TrackPAD, a smartphone app to support supervised exercise training (SET) in patients with peripheral arterial disease (PAD). OBJECTIVE The aim of the present pilot study was to evaluate suitability, feasibility, and the impact on a prognosis relevant outcome measure for patients with PAD, the 6-minutes walking test, by using TrackPAD. METHODS Twenty-nine participants with symptomatic PAD were randomized. The study group (n=19) received usual care with additional use of TrackPAD. The control group (n=20) only received usual care. RESULTS The study group improved their 6-minutes walking distance, while the control group decreased their mean distance after 3 months of follow-up (83±72.2 vs. -38.8±53.7 m; p<0.01). The PAD-related quality of life improved significantly in terms of ‘symptom perception’ and ‘limitations in physical functioning’. Users’ feed-back showed increased motivation and a changed attitude to perform SET, while raising the educational background. CONCLUSIONS Besides the rating as a valued support tool by the user group, the mobile intervention TrackPAD was linked to an improvement in prognosis relevant outcome measure combined with an enhanced disease coping. CLINICALTRIAL International Registered Report Identifier (IRRID): DERR1-10.2196/13651

scholarly journals Feasibility and Clinical Relevance of a Mobile Intervention Using TrackPAD to Support Supervised Exercise Therapy in Patients With Peripheral Arterial Disease: Study Protocol for a Randomized Controlled Pilot Trial (Preprint)

2019 ◽  
Author(s):  
Katrin Paldán ◽  
Jan Simanovski ◽  
Greta Ullrich ◽  
Martin Steinmetz ◽  
Christos Rammos ◽  
...  
Keyword(s):  
Arterial Disease ◽  
Walking Distance ◽  
Control Group ◽  
Study Group ◽  
Walk Test ◽  
Patient Centered ◽  
Supervised Exercise ◽  
Mobile Intervention ◽  
Peripheral Arterial

BACKGROUND Peripheral arterial disease (PAD) is a common and severe disease with a highly increased cardiovascular morbidity and mortality. Through the circulatory disorder and the linked undersupply of oxygen carriers in the lower limbs, the ongoing decrease of the pain-free walking distance occurs with a significant reduction in patients’ quality of life. Studies including activity monitoring for patients with PAD are rare and digital support to increase activity via mobile health technologies is mainly targeted at patients with cardiovascular disease in general. The special requirement of patients with PAD is the need to reach a certain pain level to improve the pain-free walking distance. Unfortunately, both poor adherence and availability of institutional resources are major problems in patient-centered care. OBJECTIVE The objective of this trackPAD pilot study is to evaluate the feasibility of a mobile phone–based self tracking app to promote physical activity and supervised exercise therapy (SET) in particular. We also aim for a subsequent patient centered adjustment of the app prototype based on the results of the app evaluation and process evaluation. METHODS This study was designed as a closed user group trial, with assessors blinded, and parallel group study with face-to-face components for assessment with a follow-up of 3 months. Patients with symptomatic PAD (Fontaine stage IIa or IIb) and possession of a mobile phone were eligible. Eligible participants were randomly assigned into study and control group, stratified by their distance covered in the 6-min walk test, using the software TENALEA. Participants randomized to the study group received usual care and the mobile intervention (trackPAD) for the follow-up period of 3 months, whereas participants randomized to the control group received only usual care. TrackPAD records the frequency and duration of training sessions and pain level using manual user input. Clinical outcome data were collected at the baseline and after 3 months via validated tools (6-min walk test, ankle-brachial index, and duplex ultrasound at the lower arteries) and self-reported quality of life. Usability and quality of the app was determined using the user version of the Mobile Application Rating Scale. RESULTS The study enrolled 45 participants with symptomatic PAD (44% male). Of these participants, 21 (47%) were randomized to the study group and 24 (53%) were randomized to the control group. The distance walked in the 6-min walk test was comparable in both groups at baseline (study group: mean 368.1m [SD 77.6] vs control group: mean 394.6m [SD 100.6]). CONCLUSIONS This is the first trial to test a mobile intervention called trackPAD that was designed especially for patients with PAD. Its results will provide important insights in terms of feasibility, effectiveness, and patient preferences of an app-based mobile intervention supporting SET for the conservative treatment of PAD. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13651

Randomized clinical trial of medical qigong on quality of life, fatigue, side effects, mood, status, and inflammation of cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9617-9617
Author(s):  
B. Oh ◽  
P. Butow ◽  
B. Mullan ◽  
S. Clarke ◽  
P. Beale ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Side Effects ◽  
Sleep Disturbance ◽  
Usual Care ◽  
Cancer Patients ◽  
Intervention Group ◽  
Control Group ◽  
Usual Care Control Group

9617 Background: The quality of life (QOL) of cancer patients is often diminished due to the side effects of treatment and symptoms of the disease itself. This study examines the impact of Medical Qigong (MQ), including gentle exercise and relaxation through meditation and breathing exercise based on the Chinese Medicine theory of energy channels, on quality of life (QOL), fatigue, side effects, mood status and inflammation. Methods: One hundred sixty two patients diagnosed with a range of cancers recruited from three university teaching hospitals were randomly assigned to two groups: a control group (n=83) that received usual health care and an intervention group (n=79) who participated in a MQ program for 10 weeks in addition to receiving usual health care at the hospital. Quality of life and symptoms were measured by the FACT-G, cancer related fatigue by FACT-F and mood status by POMS. The inflammatory marker serum C-reactive protein (CRP) was also monitored serially. Results: Regression analysis indicated that the MQ intervention group significantly improved on measures of overall QOL (t144= -5.761, p<0.001), fatigue (t153= -5.621, p<0.001), mood disturbance (t122=2.346, p=0.021) and inflammation (CRP) (t99=2.042, p<0.044) compared to the usual care control group after controlling for baseline variables. Analysis of the FACT-G subscales revealed that the MQ intervention group also significantly improved in satisfaction with sex life (t92=-3.783, p<0.001) and reduced side effects of nausea (t152=-2.071, p=0.040) and sleep disturbance (t150=-2.603, p=0.010) compared to the usual care control group. Pain was improved in both intervention and control groups. Conclusions: This study suggests that MQ with usual health care can improve overall QOL, fatigue, positive mood status and reduce the side effects of nausea, sleep disturbance and inflammation of cancer patients. This study supports the use of MQ as an intervention for cancer care. No significant financial relationships to disclose.

The impact of different supervised exercise regimens on endothelial function in patients with intermittent claudication

Vascular ◽  
2014 ◽  
Vol 23 (6) ◽  
pp. 561-569 ◽  
Author(s):  
Christopher L Delaney ◽  
Michelle D Miller ◽  
Richard B Allan ◽  
J Ian Spark
Keyword(s):  
Nitric Oxide ◽  
Exercise Training ◽  
Endothelial Function ◽  
Walking Distance ◽  
Reactive Hyperaemia ◽  
Supervised Exercise ◽  
Flow Mediated Dilatation ◽  
Group 2 ◽  
The Impact ◽  
Group 1

Background and objectives The impact of supervised exercise training on endothelial function in patients with intermittent claudication is unclear. This study assesses the impact of treadmill-based supervised exercise training alone or in combination with resistance training on pain free walking distance, flow-mediated dilatation, reactive hyperaemia index, nitric oxide and asymmetric dimethylarginine. Methods Thirty-five patients with intermittent claudication were randomised to 12 weeks of treadmill-only supervised exercise training (Group 1) or a combination of treadmill and lower-limb resistance supervised exercise training (Group 2). Pain free walking distance was assessed by six-minute walk test. Endothelial function was assessed by brachial artery flow-mediated dilatation, reactive hyperaemia index and serum analysis of asymmetric dimethylarginine and nitric oxide. Results Pain free walking distance improved within Group 1 (160 m to 204 m, p = 0.03) but not Group 2 (181 m to 188 m, p = 0.82), no between group difference. No significant change in flow-mediated dilatation or reactive hyperaemia index in either group. Nitric oxide decreased in Group 1 (15.0 µmol/L to 8.3 µmol/L, p = 0.003) but not Group 2 (11.2 µmol/L to 9.1 µmol/L, p = 0.14), p = 0.07 between groups. Asymmetric dimethylarginine decreased in Group 2 (0.61 µmol/L to 0.56 µmol/L, p = 0.03) but not Group 1 (0.58 µmol/l to 0.58 µmol/L, p = 0.776), no between group difference. Conclusion Supervised exercise training does not improve endothelial function as measured by flow-mediated dilatation, reactive hyperaemia index and nitric oxide bioavailability.

scholarly journals Effects of Exercise Intervention on Mitochondrial Stress Biomarkers in Metabolic Syndrome Patients: A Randomized Controlled Trial

2021 ◽  
Vol 18 (5) ◽  
pp. 2242
Author(s):  
Jae Seung Chang ◽  
Jun Namkung
Keyword(s):  
Metabolic Syndrome ◽  
Exercise Training ◽  
Healthy Volunteers ◽  
Stress Responses ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Fibroblast Growth Factor 21 ◽  
Control Group ◽  
Serum Triglycerides ◽  
Supervised Exercise

Metabolic syndrome (MetS) pathogenesis involves oxidative stress associated with mitochondrial dysfunction, which triggers integrated stress responses via various compensatory metabolic modulators like mitokines and hepatokines. However, the regulatory mechanisms underlying the exercise-derived benefits with respect to mitokines and hepatokines (potential MetS biomarkers) are unknown. Thus, we investigated the effects of exercise training on MetS biomarkers and their associations with clinical parameters. In this single-center trial, 30 women with MetS were randomly assigned to 12-week supervised exercise or control groups (1:1) and compared with 12 age-matched healthy volunteers. All participants completed the study except one subject in the control group. Expectedly, serum levels of the mitokines, fibroblast growth factor-21 (FGF21), growth differentiation factor-15 (GDF15), and the hepatokine, angiopoietin-like 6 (ANGPTL6), were higher in MetS patients than in healthy volunteers. Moreover, their levels were markedly attenuated in the exercise group. Further, exercise-mediated changes in serum FGF21 and GDF15 correlated with changes in the homeostasis model of assessment of insulin resistance (HOMA-IR) and appendicular lean mass (ALM), respectively. Additionally, changes in serum triglycerides and ANGPTL6 were correlated with changes in leptin. Aberrant mitokine and hepatokine levels can be rectified by relieving metabolic stress burden. Therefore, exercise training may reduce the need for the compensatory upregulation of MetS metabolic modulators by improving gluco-lipid metabolism.

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