The association of innate and acquired aerobic capacity with resilience in healthy adults: Protocol for an eight-week randomized controlled web-based physical exercise intervention study (Preprint)

2021 ◽  
Author(s):  
David Tobias Ochmann ◽  
Keito F A Philippi ◽  
Peter Zeier ◽  
Magdalena Sandner ◽  
Barlo Hillen ◽  
...  

BACKGROUND Physical activity ameliorates chronic stress. Latest research suggests a relation between resilience and physical fitness. Beneficial adaptations of the hypothalamic-pituitary-adrenal axis, the sympathetic nervous system, the endocannabinoid system, and the tryptophan pathway, induced by an active lifestyle, are considered to be resilience conducive. However, detailed knowledge on the molecular link between the effects of acute and chronic physical exercise and an improved resilience is missing. OBJECTIVE Therefore, we implement a human exercise intervention trial addressing the main hypotheses: (1) web-based exercise training improves aerobic capacity of physically inactive adults, which (2) is accompanied by improved resilience. In this setting, we will analyze the relation of resilience parameters with innate and acquired aerobic capacity as well as circulating signaling molecules. METHODS 70 healthy physically inactive (<150min/week physical activity) adults (18-45y) will be randomly assigned to an intervention or control group. Participants in the intervention group receive weekly training utilizing progressive endurance and interval running individually adapted to their training performance via web-based physician support. A standardized incremental treadmill exercise test is performed before and after the intervention period of eight weeks to determine innate and acquired aerobic capacity. Before and after the intervention psychological tests and questionnaires that characterize parameters implicated in resilience (including impulse control, working memory, stress coping, emotion regulation) will be applied. Blood, and saliva will be sampled for analysis of lactate, cortisol, endocannabinoids, catecholamines, kynurenic acid, cell-free DNA and further circulating signal transducers. Statistical analysis will provide comprehensive knowledge on the relation of aerobic capacity and resilience, and furthermore, the capacity of peripheral factors to mediate the promoting effects of exercise on resilience. RESULTS The study was registered in October 2019. Enrollment began in September 2019. Out of 161 subjects, who were initially screened via telefon survey, 43 fulfilled the inclusion criteria and were included. Among the 17 participants in the intervention group, and 14 participants in the control group, who completed the study (total 31), no serious adverse event has been reported. Four participants withdrew during the programm (individual reasons), and 8 participants have not yet completed or begun the program due to the Covid-19 pandemic. Enrollment and data analysis are ongoing, and results are expected to be submitted for publication in October 2021. CONCLUSIONS Our study aims to demonstrate that an increase in physical activity with a simultaneous improvement in aerobic capacity is associated with an increase in resilience. This study design allows to investigate the effect of an active lifestyle on circulating molecular marker levels and their relationship to resilience factors. This will offer novel approaches for the diagnosis of depression and the therapy by exercise prescription. CLINICALTRIAL DRKS00018078, registered October 02, 2019, German Clinical Trials Register. Retrospectively registered: First participant September 10, 2019.

Author(s):  
Roxanne Gal ◽  
Evelyn M. Monninkhof ◽  
Carla H. van Gils ◽  
Rolf H. H. Groenwold ◽  
Sjoerd G. Elias ◽  
...  

Abstract Purpose The Trials within Cohorts (TwiCs) design aims to overcome problems faced in conventional RCTs. We evaluated the TwiCs design when estimating the effect of exercise on quality of life (QoL) and fatigue in inactive breast cancer survivors. Methods UMBRELLA Fit was conducted within the prospective UMBRELLA breast cancer cohort. Patients provided consent for future randomization at cohort entry. We randomized inactive patients 12–18 months after cohort enrollment. The intervention group (n = 130) was offered a 12-week supervised exercise intervention. The control group (n = 130) was not informed and received usual care. Six-month exercise effects on QoL and fatigue as measured in the cohort were analyzed with intention-to-treat (ITT), instrumental variable (IV), and propensity scores (PS) analyses. Results Fifty-two percent (n = 68) of inactive patients accepted the intervention. Physical activity increased in patients in the intervention group, but not in the control group. We found no benefit of exercise for dimensions of QoL (ITT difference global QoL: 0.8, 95% CI = − 2.2; 3.8) and fatigue, except for a small beneficial effect on physical fatigue (ITT difference: − 1.1, 95% CI = − 1.8; − 0.3; IV: − 1.9, 95% CI = − 3.3; − 0.5, PS: − 1.2, 95% CI = − 2.3; − 0.2). Conclusion TwiCs gave insight into exercise intervention acceptance: about half of inactive breast cancer survivors accepted the offer and increased physical activity levels. The offer resulted in no improvement on QoL, and a small beneficial effect on physical fatigue. Trial registration Netherlands Trial Register (NTR5482/NL.52062.041.15), date of registration: December 07, 2015.


2020 ◽  
Author(s):  
Claire F Trottier ◽  
Jessica RL Lieffers ◽  
Steven T Johnson ◽  
João F Mota ◽  
Roshni K Gill ◽  
...  

BACKGROUND First-year university students are at increased risk for presenting with anxiety, depression, suicidal thoughts and poor nutritional status. Self-care plays an essential role in optimizing mental health and can prevent/treat stress, anxiety and depression. Web-based self-monitoring of diet and physical activity can lead to similar or improved health outcomes compared to conventional methods. Such tools are also popular among university students. OBJECTIVE The primary objective of this 12-week randomized control trial was to assess the impact of a web-based wellness platform on perceived stress among first-year university students. The study’s secondary outcome was to assess the effects of the platform on diet quality and exploratory outcomes were body composition, health related quality of life, mindfulness, mental wellbeing and physical activity. METHODS Ninety-seven first-year undergraduate students were randomized to either the intervention (n=48) or control (n=49) group. The intervention consisted of access to a web-based platform called My Viva Plan® (MVP) which aims to support healthy living on the topics of mindfulness, nutrition, and fitness. The platform is fully automated and is guided by principals of cognitive behavior theory. Participants in the intervention group were instructed to use MVP as frequently as possible over 12 weeks. The control group did not receive access to MVP. Perceived stress was assessed using the Stress Indicators Questionnaire at baseline, week 6 and week 12. Three day food records were used to analyze dietary intake at baseline and week 12. Health related quality of life, mindfulness, mental wellbeing and physical activity questionnaires were completed at baseline, week 6 and week 12 and body composition was assessed at baseline and week 12. Study assessments were completed in-person at baseline and week 12 and electronically at week 6. RESULTS Study recruitment started in August 2018 with batch enrollment for students registered in the fall (September 2018 to December 2018) and winter (January 2019 to April 2019) academic terms at the University of Alberta, Edmonton, Alberta. Eighty participants completed the 12-week trial (n=35 in the intervention group; n=45 in the control group). All data collection ended in May 2019. CONCLUSIONS This project is the first to explore the impact of an online platform designed to promote health and wellness; it will also shed light into its applicability in first-year university students. If successful, this may become an important health care tool for preventative care in first year university students. CLINICALTRIAL ClinicalTrials.gov NCT03579264


2021 ◽  
pp. 105477382110176
Author(s):  
Esmail Shariati ◽  
Ali Dadgari ◽  
Seyedeh Solmaz Talebi ◽  
Gholam Reza Mahmoodi Shan ◽  
Hossein Ebrahimi

The aim of this study was to identify the effect of web-based communication between a nurse and a family member of a patient with COVID-19 on his/her perceived stress. In this multicenter parallel randomized controlled trial, 67 family members of COVID-19 patients admitted to the Intensive Care Unit (ICU) were investigated. In the intervention group, web-based communication was performed for four consecutive days for 10 to 15 minutes. The Perceived Stress Scale (PSS-14) were completed in both groups before and after the intervention. Mean and standard deviation of perceived stress scores in the two groups were not significantly different ( p = 0.26) before the intervention; however, after the intervention, the mean PSS-14 in the intervention group was significantly lower than that of the control group ( p < 0.001). Due to the need to follow the physical and social distancing to protect against Coronavirus disease, the use of web-based communication recommended in future studies.


10.2196/15448 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e15448
Author(s):  
Emily Staite ◽  
Adam Bayley ◽  
Ebaa Al-Ozairi ◽  
Kurtis Stewart ◽  
David Hopkins ◽  
...  

Background Intensive lifestyle interventions are effective in reducing the risk of type 2 diabetes, but the implementation of learnings from landmark studies is expensive and time consuming. The availability of digital lifestyle interventions is increasing, but evidence of their effectiveness is limited. Objective This randomized controlled trial (RCT) aimed to test the feasibility of a web-based diabetes prevention program (DPP) with step-dependent feedback messages versus a standard web-based DPP in people with prediabetes. Methods We employed a two-arm, parallel, single-blind RCT for people at high risk of developing diabetes. Patients with a hemoglobin A1c (HbA1c) level of 39-47 mmol/mol were recruited from 21 general practices in London. The intervention integrated a smartphone app delivering a web-based DPP course with SMS texts incorporating motivational interviewing techniques and step-dependent feedback messages delivered via a wearable device over 12 months. The control group received the wearable technology and access to the web-based DDP but not the SMS texts. As this was a feasibility study, the primary aim was to estimate potential sample size at different stages of the study, including the size of the target study population and the proportion of participants who consented, were randomized, and completed follow-up. We also measured the main outcomes for a full-scale RCT, namely, change in weight and physical activity at 6- and 12-month follow-ups, and secondary outcomes, including changes in the HbA1c level, blood pressure, waist circumference, waist-to-hip ratio, and lipid levels. Results We enrolled 200 participants: 98 were randomized to the intervention and 102 were randomized to the control group. The follow-up rate was higher in the control group (87/102, 85.3%) than in the intervention group (69/98, 70%) at 12 months. There was no treatment effect on weight at 6 months (mean difference 0.15; 95% CI −0.93 to 1.23) or 12 months (mean difference 0.07 kg; 95% CI −1.29 to 1.44) or for physical activity levels at 6 months (mean difference −382.90 steps; 95% CI −860.65 to 94.85) or 12 months (mean difference 92.64 steps; 95% CI −380.92 to 566.20). We did not observe a treatment effect on the secondary outcomes measured at the 6-month or 12-month follow-up. For the intervention group, the mean weight was 92.33 (SD 15.67) kg at baseline, 91.34 (SD 16.04) kg at 6 months, and 89.41 (SD 14.93) kg at 12 months. For the control group, the mean weight was 92.59 (SD 17.43) kg at baseline, 91.71 (SD 16.48) kg at 6 months, and 91.10 (SD 15.82) kg at 12 months. In the intervention group, the mean physical activity was 7308.40 (SD 4911.93) steps at baseline, 5008.76 (SD 2733.22) steps at 6 months, and 4814.66 (SD 3419.65) steps at 12 months. In the control group, the mean physical activity was 7599.28 (SD 3881.04) steps at baseline, 6148.83 (SD 3433.77) steps at 6 months, and 5006.30 (SD 3681.1) steps at 12 months. Conclusions This study demonstrates that it is feasible to successfully recruit and retain patients in an RCT of a web-based DPP. Trial Registration ClinicalTrials.gov NCT02919397; http://clinicaltrials.gov/ct2/show/NCT02919397


2019 ◽  
Vol 7 (3) ◽  
Author(s):  
Hesti Platini ◽  
Sandra Pebrianti ◽  
Indra Maulana

Hypertension is a cardiovascular disease globally. Hypertension is remains silent killer, the clinical strategy to focusing on new and improved treatments is exercise. Tera  gymnastics is a physical and mental exercise, combining the movement of body parts with breathing techniques and rhythms through the concentration of thought that is carried out regularly, harmoniously, correctly and continuously, Physical activity can reduce high blood pressure. Some study showed Regular physical activity is an effective intervention with respect to these factor, decreasing mortality rate for cardiovascular disease and all cause of disease in hypertensive patient. Gymnastic Tera exercise can help to control metabolic variable related to hypertension. The study was use quasy experimental design with one group pretest-posttest. The study was conducted in Puskesmas Pasundan Garut. Sampling in this study is subjects  that is criteria patients has hipertension with 8 weeks treatment so will take methode of  concecutive sampling with 15 respondents for intervention group and 15 for control group.  The sample were age 30-55 years. The Intervention was gymnastic tera exercise. The Blood pressure function was evaluated before and after the training period. The data were analyzed by using t-test paired. The result showed a significant difference before and after tera gymnastic exercise in patient with hypertension I (p=000.0). Result of systolic blood presure when in mean SD pretest is 146.00 higher than post test is 136.00 in intervention group. The tera gymnastic exercise conditioning program achieved effect in this population. The reduction of blood pressure after exercise is of great clinical relevance.  The increased riskof physical inactivity in controlling hypertension in our study suggest that general practitioners must be in the habit of prescribing practice of physical exercise. Physical activity has been shown to have beneficial effect on blood pressure. patients are followed up regularly to confirm that they are adhering to the management plan and the blood pressure targets.


2020 ◽  
Vol 24 (63) ◽  
pp. 1-106
Author(s):  
Adrian H Taylor ◽  
Rod S Taylor ◽  
Wendy M Ingram ◽  
Nana Anokye ◽  
Sarah Dean ◽  
...  

Background There is modest evidence that exercise referral schemes increase physical activity in inactive individuals with chronic health conditions. There is a need to identify additional ways to improve the effects of exercise referral schemes on long-term physical activity. Objectives To determine if adding the e-coachER intervention to exercise referral schemes is more clinically effective and cost-effective in increasing physical activity after 1 year than usual exercise referral schemes. Design A pragmatic, multicentre, two-arm randomised controlled trial, with a mixed-methods process evaluation and health economic analysis. Participants were allocated in a 1 : 1 ratio to either exercise referral schemes plus e-coachER (intervention) or exercise referral schemes alone (control). Setting Patients were referred to exercise referral schemes in Plymouth, Birmingham and Glasgow. Participants There were 450 participants aged 16–74 years, with a body mass index of 30–40 kg/m2, with hypertension, prediabetes, type 2 diabetes, lower limb osteoarthritis or a current/recent history of treatment for depression, who were also inactive, contactable via e-mail and internet users. Intervention e-coachER was designed to augment exercise referral schemes. Participants received a pedometer and fridge magnet with physical activity recording sheets, and a user guide to access the web-based support in the form of seven ‘steps to health’. e-coachER aimed to build the use of behavioural skills (e.g. self-monitoring) while strengthening favourable beliefs in the importance of physical activity, competence, autonomy in physical activity choices and relatedness. All participants were referred to a standard exercise referral scheme. Primary outcome measure Minutes of moderate and vigorous physical activity in ≥ 10-minute bouts measured by an accelerometer over 1 week at 12 months, worn ≥ 16 hours per day for ≥ 4 days including ≥ 1 weekend day. Secondary outcomes Other accelerometer-derived physical activity measures, self-reported physical activity, exercise referral scheme attendance and EuroQol-5 Dimensions, five-level version, and Hospital Anxiety and Depression Scale scores were collected at 4 and 12 months post randomisation. Results Participants had a mean body mass index of 32.6 (standard deviation) 4.4 kg/m2, were referred primarily for weight loss and were mostly confident self-rated information technology users. Primary outcome analysis involving those with usable data showed a weak indicative effect in favour of the intervention group (n = 108) compared with the control group (n = 124); 11.8 weekly minutes of moderate and vigorous physical activity (95% confidence interval –2.1 to 26.0 minutes; p = 0.10). Sixty-four per cent of intervention participants logged on at least once; they gave generally positive feedback on the web-based support. The intervention had no effect on other physical activity outcomes, exercise referral scheme attendance (78% in the control group vs. 75% in the intervention group) or EuroQol-5 Dimensions, five-level version, or Hospital Anxiety and Depression Scale scores, but did enhance a number of process outcomes (i.e. confidence, importance and competence) compared with the control group at 4 months, but not at 12 months. At 12 months, the intervention group incurred an additional mean cost of £439 (95% confidence interval –£182 to £1060) compared with the control group, but generated more quality-adjusted life-years (mean 0.026, 95% confidence interval 0.013 to 0.040), with an incremental cost-effectiveness ratio of an additional £16,885 per quality-adjusted life-year. Limitations A significant proportion (46%) of participants were not included in the primary analysis because of study withdrawal and insufficient device wear-time, so the results must be interpreted with caution. The regression model fit for the primary outcome was poor because of the considerable proportion of participants [142/243 (58%)] who recorded no instances of ≥ 10-minute bouts of moderate and vigorous physical activity at 12 months post randomisation. Future work The design and rigorous evaluation of cost-effective and scalable ways to increase exercise referral scheme uptake and maintenance of moderate and vigorous physical activity are needed among patients with chronic conditions. Conclusions Adding e-coachER to usual exercise referral schemes had only a weak indicative effect on long-term rigorously defined, objectively assessed moderate and vigorous physical activity. The provision of the e-coachER support package led to an additional cost and has a 63% probability of being cost-effective based on the UK threshold of £30,000 per quality-adjusted life-year. The intervention did improve some process outcomes as specified in our logic model. Trial registration Current Controlled Trials ISRCTN15644451. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 63. See the NIHR Journals Library website for further project information.


10.2196/13570 ◽  
2019 ◽  
Vol 5 (4) ◽  
pp. e13570 ◽  
Author(s):  
Teri Lindgren ◽  
Julie Hooper ◽  
Yoshimi Fukuoka

Background Despite the benefits of regular physical activity, women in every age group have lower activity levels than men, and few women meet the recommended levels of physical activity. Digital technologies have been useful in increasing physical activity during the course of an interventional study. However, sustaining that activity once the clinical trial was complete was a major challenge. Objective This study aimed to describe the experiences and perspectives of physically inactive women who completed the mobile phone–based physical activity education (mPED), a randomized controlled trial, at 12 months. Methods Of 210 women who were enrolled in the mPED trial, 203 completed a 12-month open-ended exit interview and survey through phone. The participants were asked about their physical activity levels; their digital technology use; what they learned from, liked, and would change about the trial; their motivations to keep active post-trial; and their advice for other women. Interviews were transcribed verbatim and thematically analyzed using the brief survey qualitative description. Descriptive statistics were used to describe the survey data with the significance level set at P<.05. Results In the 12-month survey, a greater proportion of the participants in the intervention group, compared with the control group, reported that they regularly wore a pedometer or physical activity tracker (49.3%, 66/143 vs 26.1%, 18/69; P=.002) and engaged in brisk walking (54.5%, 73/134 vs 30.4%, 21/69; P=.001). The experiences and perceptions of physical activity of physically inactive women over time were embedded in a complex interplay of internal and external factors. A total of 6 interactive themes emerged as critical in supporting continued engagement in physical activity postintervention: tracking, technology versus personal touch, accountability, resources and environment, motivation, and habit formation. Technology allowed for self-tracking, which supported internal accountability. However, tracking by another person (personal touch) was needed for external accountability. Resources and environment underpinned the relationship among the themes of tracking, technology versus personal touch, accountability, motivation, and habit formation. Conclusions Future research is needed to identify the best ways to harness this dynamic process in promoting and sustaining physical activity among inactive women. Digital technology is evolving at an exponential rate and provides new opportunities to transform research into new approaches to promote physical activity. Trial Registration ClinicalTrials.gov NCT01280812; https://clinicaltrials.gov/ct2/show/NCT01280812 International Registered Report Identifier (IRRID) RR2-10.1186/1471-2485-11-933


2020 ◽  
Author(s):  
Hongying Wang ◽  
Yi Xiao ◽  
Xiaoling Ren ◽  
Pei Zhang ◽  
MiaoMiao Lu ◽  
...  

Abstract Background:Working women in Shanghai are a special group with a high risk of suffering work stress and burnout. They were disturbed by the work-family conflicts, which resulted in lower health-related quality of life (HRQoL), higher job stress and burnout. This study evaluated the potential physical activity and counselling intervention effects on health outcomes of working women in Shanghai participating in a group- or an individual-based physical activity and counselling intervention compared to a control group.Methods:Participants were randomly recruited from eight communities of Shanghai using the stratified cluster sampling method. A sample of 121 female workers was used in this study. They were randomly divided into three groups: a control group and two intervention groups (individual-based and group-based intervention). The two intervention groups accepted 12-week moderate physical activity and counselling intervention. Subjective perceptions of work stress, burnout, and HRQoL were measured before and after the intervention. Results:In the control group, no significant difference was found between participants for stress (p = 0.752) and burnout (p = 0.622) before and after the experiment. However, the HRQoL value decreased after the experiment, with the mean value falling from 91.59 to 87.10. After the experiment, the values of stress and burnout decreased, and the value of HRQoL increased in the two intervention groups. At the intervention’s completion, there were significant differences compared the two intervention groups to the control group separately regarding changes in burnout and HRQoL (all p < 0.01). For stress, the group-based intervention group exhibited a significant difference compared to the control group (p < 0.01), while the individual-based intervention group did not exhibit a significant difference compared to the control group (p = 0.128).Conclusion: Physical activity and counselling intervention delivered either in a group or individual format could reduce burnout and improve HRQoL of working women in Shanghai, and the group interventions were more effective than those targeted at individuals.


2020 ◽  
Vol 16 (5) ◽  
pp. 439-446
Author(s):  
Renata RT Castro ◽  
Allan Robson Kluser Sales ◽  
Antonio CL Nóbrega

Aim: Variation of exercise ventilation confers poor prognosis in heart failure. Sedentary men have higher exercise ventilatory variability than athletes. However, the impact of lifestyle intervention on exercise ventilatory variability in sedentary people is unknown and this is the aim of this study. Materials & methods: Prospective controlled single-blinded interventional study that randomly assigned healthy sedentary individuals to diet and exercise (intervention group, n = 12) or no intervention (control group, n = 12) for 12 weeks. Exercise ventilatory variability was accessed before and after intervention. Results: Despite similar values at baseline, there was a 15% reduction in respiratory rate variability (root mean square of the successive differences/n) in intervention group. Conclusion: Diet and exercise training reduced exercise ventilatory variability.


Author(s):  
Holly Blake ◽  
Betsy Lai ◽  
Emil Coman ◽  
Jonathan Houdmont ◽  
Amanda Griffiths

We evaluate the outcomes and processes of a video and web-based worksite exercise intervention for sedentary office workers in China, in a 2-arm cluster-randomised wait-list control trial (n = 282: intervention (INT) n = 196 and wait-list control (WLC) n = 86). Eligible clusters were two sites of a major organisation in China randomly allocated to each group (INT: Guangzhou; WLC: Beijing); eligible participants were site employees (n = 690). A theoretically informed digital workplace intervention (Move-It) involving a 10 min Qigong exercise session (video demonstration via website) was delivered twice a day at set break times during the working day for 12 consecutive weeks. Individual-level outcomes were assessed. Participants’ physical activity increased significantly from baseline to post-intervention similarly in both the intervention and the control group. There was a significantly smaller increase in weekday sitting hours in intervention than controls (by 4.66 h/week), and work performance increased only in the control group. Process evaluation (including six focus groups) was conducted using the RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework. The intervention had wide reach and was successfully marketed to all employees with good uptake. The participatory approach increased perceived organisational support and enhanced adoption. The intervention was implemented broadly as planned. Qigong worksite exercise intervention can be successfully delivered to sedentary office workers in China using video and web-based platforms. It may increase physical activity and does not adversely affect perceived work performance. The study highlights the complexity of conducting health promotion research in real-world organisational settings.


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