Effects of moderate-intensity intermittent hypoxic training on health outcomes of patients recovered from COVID-19: the AEROBICOVID study protocol for a randomized controlled trial

Abstract Background Recent studies point to a lower number and reduced severity of cases in higher altitude cities with decreased oxygen concentration. Specific literature has shown several benefits of physical training, so, in this sense, physical training with hypoxic stimulus appears as an alternative that supports the conventional treatments of the COVID-19 patient’s recovery. Thus, this study’s primary aim is to analyze the effects of moderate-intensity intermittent hypoxic training on health outcomes in COVID-19 recovered patients. Methods A clinical trial controlled double-blind study was designed. Participants (30–69 years old) will be recruited among those with moderate to severe COVID-19 symptoms, approximately 30 days after recovery. They will be included in groups according to the training (T) and recovery (R) association with hypoxia (H) or normoxia (N): (a) TH:RH, (b) TN:RH, (c) TN:RN, and last (d) the control group. The 8-week exercise bike intervention will be carried out with a gradual load increase according to the established periods, three times a week in sets of 5 min, 90 to 100% of the anaerobic threshold (AT), and a 2.5-min break. Blood will be collected for genotyping. First, after 4 weeks (partial), after 8 weeks, and later, 4 weeks after the end of the physical training intervention, participants will perform assessments. The primary outcome is the maximum oxygen consumption (VO2peak). The secondary outcomes include lung function, inflammatory mediators, hematological, autonomic parameters, AT, body composition analysis, quality of life, mental health, anthropometric measurements, and physical fitness. The statistical analysis will be executed using the linear regression model with mixed effects at a 5% significance level. Discussion This study is designed to provide evidence to support the clinical benefits of moderate-intensity intermittent hypoxic training as a part of the treatment of patients recovered from COVID-19. It may also provide evidence on the efficacy and safety of intermittent hypoxic training in different health conditions. Lastly, this study presents an innovative strategy enabling up to 16 participants in the same training session. Trial registration ClinicalTrials.gov RBR-5d7hkv. Registered after the start of inclusion on 3 November 2020 with the Brazilian Clinical Trials Registry

Download Full-text

Effects of moderate-intensity intermittent hypoxic training on health outcomes of patients recovered from covid-19: the AEROBICOVID study protocol for a randomised controlled trial

10.21203/rs.3.rs-435258/v1 ◽

2021 ◽

Author(s):

Atila Alexandre Trapé ◽

Marta Camacho-Cardenosa ◽

Alba Camacho-Cardenosa ◽

Eugenio Merellano-Navarro ◽

Jhennyfer Aline Lima Rodrigues ◽

...

Keyword(s):

Health Outcomes ◽

Physical Training ◽

Controlled Trial ◽

Training Session ◽

Moderate Intensity ◽

Control Group ◽

Composition Analysis ◽

Double Blind Study ◽

Intermittent Hypoxic Training ◽

Hypoxic Training

Abstract Background: Recent studies point to a lower number and a reduction in the severity of cases in higher altitude cities, with decreased oxygen concentration. Specific literature has shown several benefits of physical training, so, in this sense, physical training with hypoxic stimulus appears as an alternative that supports the conventional treatments of the COVID-19 patient's recovery. Thus, this study's primary aim is to analyse the effects of moderate-intensity intermittent hypoxic training on health outcomes in COVID-19 recovered patients. Methods: A clinical trial controlled double-blind study was designed. Participants (30-69 years old) will be recruited among those with moderate to severe COVID-19 symptoms, approximately 30 days after recovery. They will be included in groups according to the training (T) and recovery (R) association with hypoxia (H) or normoxia (N): a) TH:RH, b) TN:RH, c) TN:RN, and, last, d) the control group. The 8-week exercise bike intervention will be carried out with a gradual load increase according to the established periods, three times a week in sets of 5 minutes, 90 to 100% of the anaerobic threshold (AT), and a 2,5-minute break. Blood will be collected for genotyping. First, after four weeks (partial), after eight weeks, and later, four weeks after the end of the physical training intervention, participants will perform assessments. The primary outcome is the maximum oxygen consumption (VO2max). The secondary outcomes include lung function, inflammatory mediators, haematological, autonomic parameters, AT, body composition analysis, quality of life, mental health, anthropometric measurements, and physical fitness. The statistical analysis will be executed using the linear regression model with mixed effects at a 5% significance level. Discussion: This study is designed to provide evidence to support the clinical benefits of moderate-intensity intermittent hypoxic training as a part of the treatment of patients recovered from COVID-19. It may also provide evidence on the efficacy and safety of intermittent hypoxic training in different health conditions. Lastly, this study presents an innovative strategy enabling up to 16 participants in the same training session.Trial registration: Brazilian Clinical Trials Registry, RBR-5d7hkv. Registered after the start of inclusion; 3 November 2020; https://ensaiosclinicos.gov.br/rg/RBR-5d7hkv

Download Full-text

The Effects of Intermittent Hypoxic Training on Anaerobic and Aerobic Power in Boxers

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249361 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9361

Author(s):

Tadeusz Ambroży ◽

Marcin Maciejczyk ◽

Andrzej T. Klimek ◽

Szczepan Wiecha ◽

Arkadiusz Stanula ◽

...

Keyword(s):

Peak Power ◽

Anaerobic Power ◽

Training Session ◽

Endurance Performance ◽

Peak Oxygen Uptake ◽

Control Group ◽

Intermittent Hypoxic Training ◽

Time To Peak ◽

Hypoxic Training ◽

Before And After

Background: The aim of the study was to evaluate the effects of intermittent hypoxic training (IHT) on anaerobic and aerobic fitness in elite, national boxers. Methods: The study was conducted over a period of 6 weeks. It comprised 30 national championship boxers, divided into 2 groups: the experimental and control. Both groups performed the same boxing training twice a day (morning and afternoon training). In the afternoon, the experimental group performed training under normobaric conditions in a hypoxic chamber (IHT), while the control group undertook exercise in standard normoxic conditions. In both groups, before and after the 6-week programme, basic anthropometric indices as well as anaerobic (Wingate Test) and aerobic (graded test) fitness were assessed. Results: There was a significant increase in anaerobic peak power (988.2 vs. 1011.8 W), mean anaerobic power (741.1 vs. 764.8 W), total work (22.84 vs. 22.39 kJ), and a decrease in fatigue index (20.33 vs. 18.6 W·s−1) as well as time to peak power (5.01 vs. 4.72 s). Such changes were not observed in the control group. In both groups, no significant changes in endurance performance were noted after the training session – peak oxygen uptake did not significantly vary after IHT. Conclusions: Our results have practical application for coaches, as the IHT seems to be effective in improving anaerobic performance among boxers.

Download Full-text

Effect of intermittent hypoxic training on orthostatic tolerance in humans before and after simulated microgravity

10.47183/mes.2020.022 ◽

2020 ◽

Author(s):

VP Katuntsev ◽

TV Sukhostavtseva ◽

AN Kotov ◽

MV Baranov

Keyword(s):

Orthostatic Intolerance ◽

Bed Rest ◽

Daily Basis ◽

Tilt Test ◽

Control Group ◽

Orthostatic Tolerance ◽

Pronounced Increase ◽

Intermittent Hypoxic Training ◽

Hypoxic Training ◽

Before And After

Reduced orthostatic tolerance (OT) is a serious concern facing space medicine. This work sought to evaluate the effects of intermittent hypoxic training (IHT) on OT in humans before and after 3 days of head-down bed rest (HDBR) used to model microgravity. The study was carried out in 16 male volunteers aged 18 to 40 years and included 2 series of experiments with 11-day and 21-day IHT administered on a daily basis. During the first IHT session, the concentration of oxygen in the inspired gas mixture was 10%; for other sessions it was adjusted to 9%. OT was assessed by a 20-minute-long orthostatic tilt test (OTT) conducted before and after HDBR. Before HDBR, orthostatic intolerance was observed in 3 participants, while after HDBR, it was observed in 9 of 16 volunteers (p < 0.05). During OTT conducted after HDBR, the heart rate (HR) exceeded control values by 26.8% (p < 0.01). Preexposure to any of the applied IHT regimens led to a reduction in the number of volunteers with orthostatic intolerance. After the 11-day IHT program, there was a less pronounced increase in HR during OTT before HDBR; with the extended IHT regimen, less pronounced changes were observed for HR, systolic, diastolic and mean blood pressure (BP). The increase in HR during OTT after HDBR was significantly lower in the group that had completed the 11-day IHT program, while BP remained stable. The changes in HR and systolic BP were less pronounced in the group that had completed the 21-day IHT program than in the control group (p < 0.05). Thus, IHT reduced the risk of orthostatic disorders and mitigated changes in cardiovascular parameters during the orthostatic test.

Download Full-text

Effects of a home-based physical training and activity promotion program in community-dwelling older persons with cognitive impairment after discharge from rehabilitation: A randomized controlled trial

The Journals of Gerontology Series A ◽

10.1093/gerona/glac005 ◽

2022 ◽

Author(s):

Phoebe Ullrich ◽

Christian Werner ◽

Anton Schönstein ◽

Martin Bongartz ◽

Tobias Eckert ◽

...

Keyword(s):

Physical Training ◽

Controlled Trial ◽

Intervention Group ◽

Physical Capacity ◽

Control Group ◽

Promotion Program ◽

Home Based ◽

Activity Promotion ◽

Secondary Outcomes

Abstract Background Older people with cognitive impairment (CI) are at high risk for mobility limitations and adverse outcomes after discharge from geriatric rehabilitation settings. Study aim was to estimate the effects of a specifically designed home-based physical training and activity promotion program on physical capacity, different aspects of physical activity (PA), and psychosocial status. Methods Patients with mild-to-moderate CI (Mini-Mental State Examination [MMSE]: 17-26 points) discharged home after rehabilitation were included in this randomized, double-blind, placebo-controlled trial with a 12-week intervention and 12-week follow-up period. The intervention group performed a CI-specific, autonomous, home-based strength, balance and walking training supported by tailored motivational strategies to foster training adherence and promote PA. The control group participated in an unspecific motor placebo activity. Primary outcomes were physical capacity (Short Physical Performance Battery [SPPB]) and PA (sensor-based activity time). Results Among 118 randomized participants (82.3±6.0 years) with CI (MMSE: 23.3±2.4) and high levels of multi-morbidity, those participants undergoing home-based training demonstrated superior outcomes to the control group in SPPB (mean difference between groups 1.9 points; 95%-CI: 1.0-2.8; p<.001), with persistent benefits over the follow-up (1.3 points; 95%-CI: 0.4-2.2; p<.001). There were no differences in PA across any time points. Among secondary outcomes, fear of falling and activity avoidance behavior were reduced in the intervention group at all time points, life-space mobility improved short-term. Conclusions Study results demonstrate clinically important benefits of an individually tailored autonomous physical training and activity promotion program on physical capacity and secondary outcomes in different domains in a vulnerable, multi-morbid population.

Download Full-text

Open-labelled randomised controlled trial of 12 hours versus 24 hours modified Pritchard regimen in the management of eclampsia and pre-eclampsia in Ghana (MOPEP Study): study protocol

BMJ Open ◽

10.1136/bmjopen-2019-032799 ◽

2019 ◽

Vol 9 (10) ◽

pp. e032799 ◽

Cited By ~ 1

Author(s):

Titus Beyuo ◽

Emma Lawrence ◽

Elizabeth S Langen ◽

Samuel A Oppong

Keyword(s):

Randomised Controlled Trial ◽

Health Outcomes ◽

Magnesium Sulfate ◽

Controlled Trial ◽

Secondary Outcome ◽

Control Group ◽

University Of Michigan ◽

Clinical Trial Registry ◽

Randomised Controlled ◽

Study Participants

IntroductionHypertensive disorders of pregnancy continue to be a major contributor to maternal and perinatal morbidity and mortality. Magnesium sulfate therapy is the standard of care for seizure prophylaxis and treatment for pre-eclampsia and eclampsia respectively, despite wide disparities in dosing regimens and routes of administration. This study compares the clinical efficacy of magnesium sulfate in the reduction of seizure occurrence or recurrence with the 12 hours versus 24 hours modified Pritchard regimens in the management of severe pre-eclampsia and eclampsia.Methods and analysisThis study is an open labelled randomised controlled trial. The study participants are patients admitted to the Korle Bu Teaching Hospital (KBTH) in Accra, Ghana with a diagnosis of antepartum, intrapartum or postpartum eclampsia or pre-eclampsia with severe features. All study participants will be administered a loading dose of magnesium sulfate, followed by maintenance dosing. Participants in the control group will receive magnesium sulfate for 24 hours after diagnosis, while those in the treatment group will receive magnesium sulfate for 12 hours after diagnosis. The primary outcome of this study is the occurrence of a seizure any time after the completion of treatment in the assigned group. Secondary outcome measures include maternal health outcomes, magnesium sulfate toxicities and fetal health outcomes. Data collection was started in October 2018 with a target enrolment of 1245 participants with severe pre-eclampsia and 844 participants with eclampsia with a projected study period of 2–3 years.Ethics and disseminationEthical approval was obtained from the KBTH Institutional Review Board (IRB) in Ghana. University of Michigan involvement is limited to protocol development and statistical analysis of de-identified data, and has been granted a Not Regulated Determination by the University of Michigan IRB. Results of the study will be shared at clinical forums at the KBTH and will be submitted for publication in an international peer-reviewed journal.Trial registration numberPan African Clinical Trial Registry through the South African Medical Research Council (PACTR201811515303983).

Download Full-text

Experimental Effects of Acute Exercise on Prospective Memory and False Memory

Psychological Reports ◽

10.1177/0033294118782466 ◽

2018 ◽

Vol 122 (4) ◽

pp. 1313-1326 ◽

Cited By ~ 12

Author(s):

David Green ◽

Paul D. Loprinzi

Keyword(s):

False Memory ◽

Prospective Memory ◽

Acute Exercise ◽

Controlled Trial ◽

Memory Performance ◽

Word List ◽

Moderate Intensity ◽

Control Group ◽

Group Time ◽

Group 15

Research demonstrates that acute exercise can enhance retrospective episodic memory performance. However, limited research has examined the effects of acute exercise on prospective memory, and no studies have examined the effects of exercise on false memory performance. This study examined the potential effects of acute exercise on prospective memory and false memory performance. A between-group randomized controlled trial was employed, with participants (college students; Mage = 20 years) randomized into an exercise group (15-minute acute bout of treadmill walking; N = 25) or a control group (15 minutes of sitting; N = 26). Prospective memory was assessed from two laboratory and two naturalistic assessments outside the lab. False memory was assessed using a word-list trial. There were no statistically significant differences in prospective memory based on group allocation (FGroup×Time = 1.17; P = 0.32; η2 = 0.06). However, the control group recalled more false words and had a higher rate of false memory recognition (FGroup×Time = 3.15; P = 0.01; η2 = 0.26). These findings indicate that acute moderate-intensity aerobic exercise is not associated with prospective memory performance but provides some suggestive evidence that acute exercise may reduce the rate of false memories.

Download Full-text

Substantial and sustained improvement of serrated polyp detection after a simple educational intervention: results from a prospective controlled trial

Gut ◽

10.1136/gutjnl-2019-319804 ◽

2020 ◽

Vol 69 (12) ◽

pp. 2150-2158 ◽

Cited By ~ 1

Author(s):

Arne G C Bleijenberg ◽

Monique E van Leerdam ◽

Marloes Bargeman ◽

Jan Jacob Koornstra ◽

Yasmijn J van Herwaarden ◽

...

Keyword(s):

Educational Intervention ◽

Controlled Trial ◽

Training Session ◽

Primary Outcome Measure ◽

Population Screening ◽

Control Group ◽

Polyp Detection ◽

Serrated Polyps ◽

Serrated Polyp

ObjectiveSerrated polyps (SPs) are an important cause of postcolonoscopy colorectal cancers (PCCRCs), which is likely the result of suboptimal SP detection during colonoscopy. We assessed the long-term effect of a simple educational intervention focusing on optimising SP detection.DesignAn educational intervention, consisting of two 45 min training sessions (held 3 years apart) on serrated polyp detection, was given to endoscopists from 9 Dutch hospitals. Hundred randomly selected and untrained endoscopists from other hospitals were selected as control group. Our primary outcome measure was the proximal SP detection rate (PSPDR) in trained versus untrained endoscopists who participated in our faecal immunochemical test (FIT)-based population screening programme.ResultsSeventeen trained and 100 untrained endoscopists were included, who performed 11 305 and 51 039 colonoscopies, respectively. At baseline, PSPDR was equal between the groups (9.3% vs 9.3%). After training, the PSPDR of trained endoscopists gradually increased to 15.6% in 2018. This was significantly higher than the PSPDR of untrained endoscopists, which remained stable around 10% (p=0.018). All below-average (ie, PSPDR ≤6%) endoscopists at baseline improved their PSPDR after training session 1, as did 57% of endoscopists with average PSPDR (6%–12%) at baseline. The second training session further improved the PSPDR in 44% of endoscopists with average PSPDR after the first training.ConclusionA simple educational intervention was associated with substantial long-term improvement of PSPDR in a prospective controlled trial within FIT-based population screening. Widespread implementation of such interventions might be an easy way to improve SP detection, which may ultimately result in fewer PCCRCs.Trial registration numberNCT03902899.

Download Full-text

Exposure to Normobaric Hypoxia Combined with a Mixed Diet Contributes to Improvement in Lipid Profile in Trained Cyclists

Nutrients ◽

10.3390/nu13103481 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3481

Author(s):

Kamila Płoszczyca ◽

Miłosz Czuba ◽

Józef Langfort ◽

Marcin Baranowski

Keyword(s):

Lipid Profile ◽

Lactate Threshold ◽

National Level ◽

Control Group ◽

Mixed Diet ◽

Training Method ◽

Training Experience ◽

Intermittent Hypoxic Training ◽

Hypoxic Conditions ◽

Hypoxic Training

This study aimed to analyze the effects of live high-train low method (LH-TL) and intermittent hypoxic training (IHT) with a controlled mixed diet on lipid profile in cyclists. Thirty trained male cyclists at a national level with at least six years of training experience participated in the study. The LH-TL group was exposed to hypoxia (FiO2 = 16.5%) for 11–12 h a day and trained under normoxia for 3 weeks. In the IHT group, participants followed the IHT routine three times a week under hypoxia (FiO2 = 16.5%) at lactate threshold intensity. The control group (N) lived and trained under normoxia. The results showed that the 3-week LH-TL method significantly improved all lipid profile variables. The LH-TL group showed a significant increase in HDL-C by 9.0% and a decrease in total cholesterol (TC) by 9.2%, LDL-C by 18.2%, and triglycerides (TG) by 27.6%. There were no significant changes in lipid profiles in the IHT and N groups. ∆TG and ∆TC were significantly higher in the LH-TL group compared to the N group. In conclusion, hypoxic conditions combined with a mixed diet can induce beneficial changes in lipid profile even in highly trained athletes. The effectiveness of the hypoxic stimulus is closely related to the hypoxic training method.

Download Full-text

Does a brief work-stress intervention prevent sick-leave during the following 24 months? A randomized controlled trial in Swedish primary care

Work ◽

10.3233/wor-205029 ◽

2021 ◽

pp. 1-10

Author(s):

Jenny Hultqvist ◽

Pernilla Bjerkeli ◽

Gunnel Hensing ◽

Kristina Holmgren

Keyword(s):

Health Care ◽

Primary Health Care ◽

Sick Leave ◽

Early Identification ◽

Controlled Trial ◽

Intervention Group ◽

Training Session ◽

Control Group ◽

Treatment As Usual ◽

Primary Health

BACKGROUND: Work-related stress (WRS) presents a risk for sick leave. However, effective methods to identify people at risk for sick leave due to WRS at an early stage are lacking in primary health care. OBJECTIVE: To evaluate whether a systematic early identification of WRS can prevent sick leave over 24 months after the intervention. METHODS: Study participants (n = 132 intervention; n = 139 control) were employed, non-sick-listed persons seeking care at primary health care centres. The intervention included early identification of WRS by a validated instrument, general practitioner (GP) awareness supported by a brief training session, patients’ self-reflection by instrument completion, GP giving the patient feedback at consultation and GP identifying preventive measures. The control group received treatment as usual. Outcome data were retrieved from the Swedish Social Insurance Agency. RESULTS: The intervention group had less registered median sick leave days (n = 56) than the control group (n = 65) but the difference was not statistically significant. CONCLUSIONS: The brief intervention was not proven effective in preventing sick leave in the following 24 months compared to treatment as usual. Further research on how to identify, advice and treat those at high risk for sick leave in primary health care is needed.

Download Full-text

Body mass index and physical activity in seven-year-old children whose mothers exercised during pregnancy: follow-up of a multicentre randomised controlled trial

BMC Pediatrics ◽

10.1186/s12887-021-02952-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Karen Alterhaug Bjøntegaard ◽

Signe Nilssen Stafne ◽

Siv Mørkved ◽

Kjell Åsmund Salvesen ◽

Kari Anne I. Evensen

Keyword(s):

Controlled Trial ◽

Intervention Group ◽

University Hospital ◽

Moderate Intensity ◽

Control Group ◽

Exercise Protocol ◽

Moderate Intensity Exercise ◽

Randomised Controlled ◽

Exercise During Pregnancy

Abstract Background There are limited data on long-term outcomes of children whose mothers have followed exercise interventions during pregnancy. The aim of this paper was to investigate whether regular moderate intensity exercise during pregnancy affected the children’s body mass index (BMI) and physical activity (PA) at 7 years of age, and determine the relationship between children’s and mothers’ BMI and PA. Methods This was a follow-up of a multicentre randomised controlled trial, carried out at St. Olavs Hospital, Trondheim University Hospital, and Stavanger University Hospital, Norway (2007–2009 and 2014–2016). Women were randomised to follow a 12-week structured exercise protocol or standard antenatal care during pregnancy. At the 7-year follow-up, parents reported their child’s height, weight, and PA. The mothers also reported their own weight and PA. Main outcome variables were BMI, frequency and duration of moderate to vigorous PA (MVPA), and intensity of PA. Results A total of 855 women were randomised to exercise (n = 429) or standard antenatal care (n = 426) during pregnancy. At follow-up, 164 (38.2%) children and mothers in the intervention group and 117 (27.5%) in the control group participated. We found no group differences in the children’s iso-BMI or PA. Findings were similar when we performed stratified analyses by sex, except boys in the control group spent more time on electrical devices than boys in the intervention group. Subgroup analyses of children of mothers who adhered to the exercise protocol and sensitivity analyses excluding children born preterm, children admitted to the neonatal intensive care unit, and children with diseases or health problems at the 7-year follow-up, did not change the results. Children’s BMI, weekly leisure time MVPA and intensity of PA correlated with mothers’ BMI, daily exercise, and intensity of exercise. Conclusions Regular moderate intensity exercise during pregnancy did not affect BMI or PA of the children at 7 years. Good maternal health should be encouraged as it may influence the health of the next generation. Trial registration The initial RCT study was registered in ClinicalTrials.govNCT00476567.

Download Full-text