scholarly journals Benefits of home-based exercise training following critical SARS-CoV-2 infection: a case study

2021 ◽  
Author(s):  
Igor Longobardi ◽  
Danilo Marcelo Leite do Prado ◽  
Karla Fabiana Goessler ◽  
Gersiel Nascimento de Oliveira Júnior ◽  
Danieli Castro Oliveira de Andrade ◽  
...  
Keyword(s):  
Exercise Training ◽  
Handgrip Strength ◽  
Post Intervention ◽  
Exertional Dyspnea ◽  
Persistent Symptoms ◽  
Home Based ◽  
Exercise Training Program ◽  
Before And After ◽  
Severe Impairment ◽  
Fatigue Severity

Abstract Purpose: We report for the first time the effect of exercise training in a survivor patient from critical COVID-19 illness. Methods: A 67-yr-old woman who had critical COVID-19 disease underwent a 10-wk home-based exercise training aimed at recovering her overall physical condition. Before and after the intervention, we assessed cardiopulmonary parameters, skeletal muscle strength and functionality, fatigue severity and self-reported persistent symptoms. Results: The patient was hospitalized for 71 days, being admitted in the intensive care unit (ICU) due to respiratory failure. At baseline (3 months after discharge), she presented with severe impairment in cardiorespiratory functional capacity (<50% age predicted VO2peak). After the intervention, remarkable improvements in VO2peak (∆: 45.9%), oxygen uptake efficiency slope (OUES; ∆: 30.1%), HR/VO2 slope (∆: -43.5%), the lowest VE/VCO2 ratio (∆: -7.1%), and exertional dyspnea were observed. In addition, handgrip strength (∆: 22.7%), 30-second Sit-to-Stand (30-STS; ∆:14.3%), Timed-Up-&-Go (TUG; ∆: -15%) performance and Post-COVID Functional Status (PCFS) score (4 vs. 2) were also improved from baseline to post-intervention. Self-reported persistent symptoms were also improved and Fatigue Severity Scale (FSS) score decreased (4 vs. 2.7) from baseline to post-intervention.Conclusions: This is the first evidence that a semi-supervised, home-based exercise training program may be safe and potentially effective in improving cardiorespiratory and physical functionality in COVID-19 survivors. Controlled studies are warranted to confirm these findings.

scholarly journals Benefits of Home-Based Exercise Training Following Critical SARS-CoV-2 Infection: A Case Report

2022 ◽  
Vol 3 ◽  
Author(s):  
Igor Longobardi ◽  
Danilo Marcelo Leite do Prado ◽  
Karla Fabiana Goessler ◽  
Gersiel Nascimento de Oliveira Júnior ◽  
Danieli Castro Oliveira de Andrade ◽  
...  
Keyword(s):  
Exercise Training ◽  
Handgrip Strength ◽  
Invasive Mechanical Ventilation ◽  
Exercise Intolerance ◽  
Post Intervention ◽  
Timed Up And Go ◽  
Exertional Dyspnea ◽  
Persistent Symptoms ◽  
Home Based ◽  
Fatigue Severity

In the current scenario, in which an elevated number of COVID-19 survivors present with severe physical deconditioning, exercise intolerance, persistent symptoms, and other post-acute consequences, effective rehabilitation strategies are of utmost relevance. In this study, we report for the first time the effect of home-based exercise training (HBET) in a survivor patient from critical COVID-19 illness. A 67-year-old woman who had critical COVID-19 disease [71 days of hospitalization, of which 49 days were in the intensive care unit (ICU) with invasive mechanical ventilation due to respiratory failure] underwent a 10-week HBET aiming to recovering overall physical condition. Before and after the intervention, we assessed cardiopulmonary parameters, skeletal muscle strength and functionality, fatigue severity, and self-reported persistent symptoms. At baseline (3 months after discharge), she presented with severe impairment in cardiorespiratory functional capacity (&lt;50% age predicted VO2peak). After the intervention, remarkable improvements in VO2peak (from 10.61 to 15.48 mL·kg−1·min−1, Δ: 45.9%), oxygen uptake efficiency slope (OUES; from 1.0 to 1.3 L·min−1, Δ: 30.1%), HR/VO2 slope (from 92 to 52 bpm·L−1, Δ: −43.5%), the lowest VE/VCO2 ratio (from 35.4 to 32.9 L·min−1, Δ: −7.1%), and exertional dyspnea were observed. In addition, handgrip strength (from 22 to 27 kg, Δ: 22.7%), 30-s Sit-to-Stand (30-STS; from 14 to 16 repetitions, Δ:14.3%), Timed-Up-and-Go (TUG; from 8.25 to 7.01 s, Δ: −15%) performance and post-COVID functional status (PCFS) score (from 4 to 2) were also improved from baseline to post-intervention. Self-reported persistent symptoms were also improved, and Fatigue Severity Scale (FSS) score decreased (from 4 to 2.7) from baseline to post-intervention. This is the first evidence that a semi-supervised, HBET program may be safe and potentially effective in improving cardiorespiratory and physical functionality in COVID-19 survivors. Controlled studies are warranted to confirm these findings.

Regional vascular resistance during exercise: role of cardiac afferents and exercise training

1990 ◽  
Vol 258 (3) ◽  
pp. H842-H847 ◽  
Author(s):  
S. E. DiCarlo ◽  
V. S. Bishop
Keyword(s):  
Exercise Training ◽  
Vascular Resistance ◽  
Endurance Exercise ◽  
Vagal Afferents ◽  
Inhibitory Influence ◽  
Endurance Exercise Training ◽  
Exercise Training Program ◽  
Before And After ◽  
Regional Vascular Resistance ◽  
Cardiac Afferents

This study was designed to determine whether cardiac vagal afferents exert an inhibitory influence on increases in regional vascular resistance during exercise and to determine whether endurance exercise training enhances the inhibitory influence of cardiac vagal afferents. We measured changes in regional vascular resistance in 12 rabbits at rest and during running at 12.6 m/min, 20% grade, before and after reversible denervation of cardiac afferents (intrapericardial procainamide HCl, 2%). In addition, these procedures were repeated in five of these rabbits following an 8-wk endurance exercise training program. Because intrapericardial injections of procainamide anesthetize both the efferent as well as the afferent innervation to the heart, it was necessary to determine the effects of blocking the efferent innervation on the regulation of regional vascular resistance during exercise. Rabbits were instrumented with Doppler ultrasonic flow probes around the renal (R), mesenteric (M), ascending, and terminal aortic (TA) arteries. Catheters were positioned in the central ear artery and vein and pericardial sac. Mean arterial pressure, heart rate, cardiac output, R, M, TA, and systemic (S) resistances were determined. Exercise changed R (+37 +/- 4%), M (+88 +/- 9%), TA (-62 +/- 6%), and S (-34 +/- 3) resistances. Subsequent cardiac efferent blockade alone had no significant effect on regional vascular resistance during exercise. Combined efferent and afferent blockade resulted in significant increases in R (+62 +/- 6%) and M resistance (+134 +/- 13%) but did not alter TA (-51 +/- 4%) or S (-27 +/- 2%) resistance during exercise. Exercise training significantly enhanced the inhibitory influence of cardiac afferents on R and M regional vascular resistance.(ABSTRACT TRUNCATED AT 250 WORDS)

P753Exercise has similar beneficial effect in the mobilization of endothelial progenitor cells in patients with chronic heart failure of different severity

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Kourek ◽  
E Karatzanos ◽  
K Psarra ◽  
G Mitsiou ◽  
D Delis ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Exercise Training ◽  
Training Program ◽  
Progenitor Cells ◽  
Endothelial Progenitor Cells ◽  
Endothelial Progenitor ◽  
Peak Vo2 ◽  
Exercise Training Program ◽  
Before And After

Abstract Introduction Vascular endothelial dysfunction is an underlying pathophysiological feature of chronic heart failure (CHF). Exercise has been shown to stimulate the mobilization of endothelial progenitor cells (EPC) in healthy populations. EPC contribute to the regeneration of the inflammatory endothelium and promote neovascularization. Purpose The purpose of the present study was to investigate the mobilization of EPC between CHF patients with different severity after a 36-session exercise training program. Methods Thirty eight consecutive patients (32 ♂, 6 ♀) with stable CHF [mean±SD, age (years): 56±10, EF (%): 32±9, peak VO2 (ml/kg/min): 18.1±4.1] enrolled a 36-session exercise training program. All patients underwent a symptom limited maximal cardiopulmonary exercise testing (CPET) on a cycle ergometer before and after the training program. Venous blood was sampled before and after each CPET. Five endothelial circulating populations were quantified by flow cytometry (Table 1). Patients were divided in severity groups according to the median values of peak VO2, predicted peak VO2, VE/VCO2 slope and EF. EPC values are expressed as “cells/million enucleated cells” in medians (25th, 75th percentiles). Results In all patients, rehabilitation showed a statistical significant effect as well as a significant acute effect in all endothelial circulating populations (p<0.001). Although there was statistical significant mobilization of endothelial circulating populations within each severity group (groups separated by peak VO2), no differences were observed between groups (p>0.05, Table 1). Similar results were also shown for the rest of CPET parameters and EF. Cellular populations in severity groups Endothelial cellular populations Peak VO2 <18 ml/kg/min Peak VO2 ≥18 ml/kg/min Before rehabilitation After rehabilitation Before rehabilitation After rehabilitation Before CPET After CPET Before CPET After CPET Before CPET After CPET Before CPET After CPET CD34+/CD45–/CD133+ 54 (24–74) 90 (40–104)* 96 (54–120) 154 (100–169)* 37 (16–66) 60 (33–93)* 79 (46–106) 122 (96–159)* CD34+/CD45–/CD133+/VEGFR2 1 (1–3) 3 (2–8)* 8 (4–9) 14 (10–19)* 2 (1–3) 4 (3–8)* 5 (4–7) 13 (9–16)* CD34+/CD133+/VEGFR2 13 (8–18) 13 (9–25) 22 (16–31) 27 (14–38) 10 (7–19) 14 (9–20)** 16 (13–37) 22 (15–62)** CD34+/CD45–/CD133– 186 (131–368) 494 (202–640)* 431 (301–564) 738 (590–921)* 214 (150–270) 306 (233–575)* 434 (277–835) 740 (524–1588)* CD34+/CD45–/CD133–/VEGFR2 2 (1–2) 3 (2–5)* 4 (3–5) 10 (9–14)* 1 (1–1) 3 (2–5)* 4 (2–8) 9 (7–12)* Differences within groups *p<0.001, **p<0.05. Conclusion A 36-session training program stimulates the long term mobilization of EPC in CHF patients. This mobilization seems to be similar in all patients irrespective of their severity. The clinical relevance of these findings and the potential mechanisms need further investigation. Acknowledgement/Funding Greece and the European Union (European Social Fund-ESF) through the Operational Programme “Human Resources Development, Education, Lifelong Learning”

Effectiveness of a Home-Based Telehealth Exercise Training Program for Patients With Cardiometabolic Multimorbidity

2020 ◽  
Vol 35 (5) ◽  
pp. 491-501
Author(s):  
Shang-Lin Chiang ◽  
Chien-Lung Shen ◽  
Liang-Cheng Chen ◽  
Yi-Pang Lo ◽  
Chueh-Ho Lin ◽  
...  
Keyword(s):  
Exercise Training ◽  
Training Program ◽  
Home Based ◽  
Exercise Training Program

Lifestyle Modification Decreases Arterial Stiffness in Overweight and Obese Men: Dietary Modification vs. Exercise Training

2015 ◽  
Vol 25 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Seiji Maeda ◽  
Asako Zempo-Miyaki ◽  
Hiroyuki Sasai ◽  
Takehiko Tsujimoto ◽  
Rina So ◽  
...  
Keyword(s):  
Weight Loss ◽  
Exercise Training ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Lifestyle Modification ◽  
Arterial Compliance ◽  
Aerobic Exercise Training ◽  
Dietary Modification ◽  
Exercise Training Program ◽  
Before And After

Obesity and increased arterial stiffness are independent risk factors for cardiovascular disease. Arterial stiffness is increased in obese individuals than in age-matched nonobese individuals. We demonstrated that dietary modification and exercise training are effective in reducing arterial stiffness in obese persons. However, the differences in the effect on arterial stiffness between dietary modification and exercise training are unknown. The purpose of the current study was to compare the effect of dietary modification and aerobic exercise training on arterial stiffness and endothelial function in overweight and obese persons. Forty-five overweight and obese men (48 ± 1 year) completed either a dietary modification (well-balanced nutrient, 1680 kcal/day) or an exercise-training program (walking, 40–60 min/day, 3 days/week) for 12 weeks. Before and after the intervention, all participants underwent anthropometric measurements. Arterial stiffness was measured based on carotid arterial compliance, brachial-ankle pulse wave velocity (baPWV), and endothelial function was determined by circulating level of endothelin-1 (ET-1) and nitric oxide metabolite (nitrites/nitrate as metabolite: NOx). Body mass and waist circumference significantly decreased after both intervention programs. Weight loss was greater after dietary modification than after exercise training (-10.1 ± 0.6 kg vs. -3.6 ± 0.5 kg, p < .01). Although arterial stiffness and the plasma levels of ET-1 and NOx were improved after dietary modification or exercise training, there were no differences in those improvements between the 2 types of interventions. Exercise training improves arterial function in obese men without as much weight loss as after dietary modification.

Effects of structured home-based exercise training on circulating endothelial progenitor cells and endothelial function in patients with intermittent claudication

2021 ◽  
pp. 1358863X2110208
Author(s):  
Leonella Pasqualini ◽  
Francesco Bagaglia ◽  
Stefano Ministrini ◽  
Maria Rosaria Frangione ◽  
Christian Leli ◽  
...  
Keyword(s):  
Exercise Training ◽  
Endothelial Function ◽  
Training Program ◽  
Progenitor Cells ◽  
Intermittent Claudication ◽  
Treadmill Test ◽  
Home Based ◽  
Exercise Training Program ◽  
Walking Capacity ◽  
Walking Time

Introduction: Exercise training improves walking capacity in patients with intermittent claudication (IC). Endothelial progenitor cells (EPCs), endothelial microparticles (EMPs), and endothelial dysfunction could play a role in this process. Methods: We measured EPCs and EMPs in a group of 60 patients with IC, and in a control group of 20 individuals without IC, before a treadmill test and 2, 24, and 48 hours after the test. Thirty patients with IC were randomly assigned to perform a 12-week home-based exercise training program. The EPC count, flow-mediated dilation (FMD) of the brachial artery, pain-free walking time (PFWT), and maximum walking time (MWT) were measured at the baseline and after the exercise training program. Results: In patients with IC, EMPs significantly increased 2 hours after the treadmill test, whereas EPCs significantly increased after 24 hours. Among the subjects assigned to complete the training program, we observed a significant increase in the number of EPCs after 12 weeks, as well as an improvement in FMD, PFWT, and MWT. A significant correlation between the variation of EPCs, FMD, and MWT was found. The increase of EPCs and FMD were independent determinants of the walking capacity improvement, without significant interaction. Conclusion: Our results suggest that EPCs mobilization contributes to the improvement of walking capacity in patients with IC undergoing structured physical training. A number of different, partly independent, mechanisms are involved in this process, and our results highlight the potential role of EMPs release and endothelial function improvement. ClinicalTrials.gov Identifier: NCT04302571

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