Measurement of subjective and objective indices after progressive resistance training compared with aerobic training in Patients with Haemophilia: a study protocol

Background: Bleeding episodes in mild haemophilia may occur after major injuries or surgical procedures with some people not experiencing bleeding episodes. People suffering from moderate haemophilia bleed once a month, however they rarely experience spontaneous bleeding. Those suffering from severe haemophilia bleed quite often into muscles or joints, and episodes can occur once to twice a week. Bleeding usually occurs spontaneously.Objective: To investigate the effects of progressive resistance training on quality of life, muscular strength and joint score in patients with haemophilia. Methodology: Sixty patients will be enrolled in the study. Thirty patients will be allocated to control group, and thirty to intervention group. Controls will be administered active muscle stretching and aerobic exercises. Intervention group will be given active muscle stretching, and resistance training. Patients will be randomly allocated to each group. Anthropometric data will be measured pre-test to establish a baseline. Study variables include muscular strength, and quality of life. All tests will be measured pre-test and post-test to compare effects of treatment.Results: Participant recruitment commenced in June 2021. The post intervention phase will be completed by August 2020. Data analysis will commence after this. A write-up for publication is expected to be completed after the follow-up phase is finalized in August 2021.Conclusions: If resistance training is found to be effective in improving quality of life and muscular strength in participants, it could reduce the frequency of factor therapy given prophylactically, or even as acute treatment, thus directing it towards more severe cases. It will also provide financial relief to organizations supporting the treatment of the hemophilic population.The registration number for this trial is NCT04892628.

Enhancement of Serum Myonectin Levels by Progressive Resistance Training in Rats Fed with High-Fat Diet and Sucrose Solution

Background: Myonectin (CTRP15) is a newly discovered myokine with important metabolic functions. It was shown that circulating myonectin levels decreased in obesity. Objectives: The present study investigated the effect of 8 weeks of progressive resistance training (PRT) on serum myonectin levels in rats following a high-fat diet plus sucrose solution. Methods: A total of 32 male Wistar rats were randomly divided into high-fat diet plus sucrose (HFDS) and standard diet (SD) groups. After 12 weeks, each group was divided into sedentary and training groups. The animals in training groups were subjected to a PRT program (3 days/week, for 8 weeks). Flexor hallucis longus (FHL) and gastrocnemius muscle weights, epididymal and retroperitoneal fat weights, serum glucose, insulin, myonectin, and homeostasis model assessment of insulin resistance (HOMA-IR) were measured in this study. Results: The results of the study revealed that HFDS increased weight gain, fat weight, serum glucose, and HOMA-IR levels and decreased muscle weights and serum myonectin levels. Eight weeks of PRT increased serum myonectin levels and FHL and gastrocnemius muscle weights and decreased retroperitoneal fat weight. Conclusions: The results suggest that PRT may be an efficient intervention to enhance serum myonectin levels, which is associated with the improvement of body composition.

Predictors of Treatment Response to Progressive Resistance Training for Adolescents with Cerebral Palsy

Objective The aim of the study was to examine the variability in plantar-flexor muscle strength changes after progressive resistance training for adolescents with cerebral palsy (CP) and to identify baseline variables associated with change in muscle strength. Methods Thirty-three adolescents with CP were randomized to a 10-week progressive resistance training program as part of a randomized controlled trial (STAR trial). The associations between muscle strength at 10 weeks (n = 30 adolescents) and 22 weeks (n = 28 adolescents) and biomechanical and neuromuscular baseline characteristics, motor function, and fidelity to the program were examined with multivariable linear regression. Conclusion Assessing levels of muscle activation may be able to identify responders to a progressive resistance training program for adolescents with CP. These findings are a first step toward developing tools that can inform decision making in the clinical setting. Impact Due to the heterogenous nature of CP, it is challenging to assess the efficacy of strength training programs in individuals with CP and to understand the variability in outcomes among participants. This study provides a better understanding of the factors that predict response to an exercise program so that resistance training can be directed to those who will potentially benefit from it. Lay Summary There is wide variability in how well young people with CP respond to resistance training. If you are a young person with CP, your physical therapist can measure the amount of your gastrocnemius muscle activity to get an indication of how well you will respond.

Effects of intradialytic progressive resistance training on muscle strength, physical capacity and quality of life in end-stage renal disease patients

Objective: This study aimed to investigate the effects of moderate- to high-intensity intradialytic progressive resistance training (IPRT) on muscle strength (MS), physical capacity (PC), and quality of life (QoL) in end-stage renal disease patients. Methods: Twenty-seven sedentary hemodialysis patients (55.5±10.6 years) were divided into a resistance training group (RTG, n=15) and a control group (CG, n=12). Patients of RTG were submitted to IPRT, three times per week for 12 weeks. The Borg’s scale was used for exercise prescription. Muscle strength was measured using hand grip dynamometry (MS). The sit-to-stand (STS) test and usual walking speed (UWS) test were performed to measure the physical capacity, and the SF-36 questionnaire to evaluate the quality of life (QoL). All patients were evaluated at baseline and after 12 weeks. Results: Moderate- to high-intensity IPRT significantly increased the MS (p=0.001, effect size (ES)=0.98), the physical capacity evaluated by the STS (p=0.002, ES=0.85) and UWS (p=0.014, ES=1.11), and all domains of SF-36 questionnaire (p<0.05). On the other hand, in the CG these variables did not change significantly. The protocol was well tolerated and was not associated with significant clinical complications. Conclusion: Twelve weeks of moderate- to high-intensity IPRT in HD patients was safe and improved MS, PC, and QoL.