Exercise Capacity and Acute Effect of Exercise on Affect in a Substance Use Disorder Population

ABSTRACT Background It is known that exercise is beneficial to people with substance use disorder, however little evidence exists regarding their exercise capacity. This pilot study investigates the exercise capacity of patients with substance use disorder and effects of an acute bout of exercise on affect. Methods Twenty-nine participants admitted to a withdrawal management facility were recruited to complete a health and exercise assessment (18 females, 11 males; 41 ± 11 years old). Mood was measured before and after exercise assessments using the subjective experience to exercise scale. Data was grouped by sex, and descriptive analyses were performed against age-matched normative data. Within group, before and after subjective experience to exercise scale measures were analyzed using 2-way ANOVA with sex as a between subject factor. Results Participants ranged from having 2 to 6 modifiable cardiovascular risk factors. Participants performed below average compared to age-matched and sex-matched normative data for the 6-minute walk test (females: 539 ± 54 m, males: 606 ± 89 m); and push-up test (females: 22% good, males: 36% good). Of the 29 participants, 29% failed to achieve the average range for sex-matched norms in the sit-to-stand test. However, all participants achieved above average for curl-ups, and 72% achieved an average or above score in the step-up test. Exercise significantly increased wellbeing (P < 0.001, effect size = 1.12) and decreased psychological distress (P = 0.045, effect size = 1.03) and fatigue (P < 0.001, effect size = 1.32). Conclusion Exercise is both feasible and beneficial in a withdrawal management setting. Capacity to perform exercise was generally poor with high individual variance. Design of future interventions will need tailored prescription for patients in this population.

A Primer on Systematic Reviews and Meta-Analyses: Part I

ABSTRACT The conduct of systematic reviews and meta-analyses are a cornerstone source of information required for evidence-based practice in all medical and allied health professions. Meta-analyses are important in the exercise sciences because, for instance, sometimes many small underpowered studies may suggest the optimal treatment deviates from the generic guidelines that suggest 30 minutes to 60 minutes of moderate intensity aerobic activity 3 to 5 times weekly, supplemented by 1 or more sessions of resistance exercise. A systematic review and meta-analysis can help by combining studies to increase power and provide an answer. The signature method of presenting results of meta-analyses is the forest plot, and an ability to interpret these data and the associated funnel plots are essential to the practice of evidence-based exercise programming. This work describes the processes of systematic review and meta-analysis and informs the reader on how these works may be presented, interpreted, and applied. Some examples from the field of kinesiology and exercise physiology are presented to illustrate how the results of a meta-analysis may influence evidence-based practice.

Effects of Acute and Chronic Stretching on Pain Control

ABSTRACT While muscle stretching has been commonly used to alleviate pain, reports of its effectiveness are conflicting. The objective of this review is to investigate the acute and chronic effects of stretching on pain, including delayed onset muscle soreness. The few studies implementing acute stretching protocols have reported small to large magnitude decreases in quadriceps and anterior knee pain as well as reductions in headache pain. Chronic stretching programs have demonstrated more consistent reductions in pain from a wide variety of joints and muscles, which has been ascribed to an increased sensory (pain) tolerance. Other mechanisms underlying acute and chronic pain reduction have been proposed to be related to gate control theory, diffuse noxious inhibitory control, myofascial meridians, and reflex-induced increases in parasympathetic nervous activity. By contrast, the acute effects of stretching on delayed onset muscle soreness are conflicting. Reports of stretch-induced reductions in delayed onset muscle soreness may be attributed to increased pain tolerance or alterations in the muscle's parallel elastic component or extracellular matrix properties providing protection against tissue damage. Further research evaluating the effect of various stretching protocols on different pain modalities is needed to clarify conflicts within the literature.

Rheumatology Practitioners' View of Exercise in Adults With Systemic Sclerosis or Systemic Lupus Erythematosus

ABSTRACT Background Exercise is part of the general recommendations for care of people with most arthropathies or connective tissue diseases, but it does not feature specifically in the clinical guidelines for management of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) by rheumatology practitioners. In this study, we sought to explore rheumatologists' (RHs') and rheumatology nurses' (RNs') perspectives and use of exercise interventions for adults with SLE or SSc. Methods Semistructured interviews were conducted with Australian RHs and RNs online using Zoom (video conferencing software). Interviews were transcribed verbatim, then coded and analyzed using NVivo for content analysis of themes. Results Seventeen participants completed the interviews (RHs n = 12, RNs n = 5). Five themes were identified: rheumatology practitioners perceive that (1) exercise is beneficial for adults with SLE or SSc, especially in managing fatigue, pain, and wellbeing; (2) exercise presents some general, structural, and disease-related barriers for adults with SLE or SSc; (3) rheumatology practitioners are confident in providing general exercise advice but lack time and confidence in prescribing exercise; (4) rheumatology practitioners' concerns about exercise are limited to those with heart and lung disease, inflamed joints, ulcerated fingertips, and severe contractures; and (5) to facilitate safe and attainable exercise, rheumatology practitioners recommend long-term, supervised, gradual, and affordable exercise options. There were no clear differences identified between the views of RNs and RHs. Conclusion Rheumatology practitioners require information and options for long-term and affordable exercise for adults with SLE or SSc that are supervised, individualized, and focus on a gradual progressive approach.

POINT: Is it Time to Rethink Aerobic Exercise Prescription Methods?

ABSTRACT Exercise prescription is complex and can vary greatly. As well, methods have their own advantages and disadvantages. The purpose of this discussion is to consider if some of these methods should be modified. We look at the concept of the heart rate and oxygen intake reserve because it is recommended by the American College of Sports Medicine.

Clinical Exercise Considerations for Opioid Addiction Recovery

ABSTRACT According to the American Psychiatric Association, in 2018, approximately 2 million Americans were suffering from a substance abuse disorder, defined as substance abuse and dependence (1), related to opioids that were prescribed for pain management (2), while worldwide, it is estimated this approaches 16 million (3). Consequently, exercise clinicians will be increasingly exposed to individuals who have been affected by opioids and should therefore know how these drugs affect physiological functioning and how exercise can play a role in opioid addiction recovery. This review article is intended to provide some of this information.