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PubMed1975

Effects of mode of training on cardiovascular function and body composition of adult men.

The purpose of this investigation was to determine the comparative effects on middle-aged men of training by running, walking, and bicycling. Sedentary men (X age = 38 yrs), who volunteered to participate, were assigned randomly to one of the following training groups: I, running (n = 9); II, walking (n = 9); and III, bicycling (n = 8). All groups trained for 30 min, 3 times/week for 20 weeks at 85 to 90% of maximal heart rate. A control group of seven men of similar qualifications also were evaluated. Training heart rates averaged 90%, 87%, and 87% of maximum for groups I, II, and III, respectively. All experimental groups improved significantly in cardiovascular and body composition measures. The former was shown by significant increases in Vo2max, VEmax, and O2 pulse and a significant decrease in resting heart rate. Body composition results showed that the experimental groups had a significant reduction in body weight, skinfold fat, and abdominal girth measurements. The control group showed no significant changes for any of the variables. It was concluded that improvement in the experimental groups was independent of mode of training.

Adult↗
PubMed1993

Brisk walking and serum lipoprotein variables in formerly sedentary men aged 42-59 years.

1. The purpose of this study was to examine the influence of brisk walking on serum lipoprotein variables. 2. Seventy-two apparently healthy but physically inactive men (aged 42-59 years) were recruited. These men were normotensive non-smokers without a history of dyslipidaemia. Subjects were randomly allocated on a 2 to 1 basis into either a walking group (n = 48) or a control group (n = 24). Walkers followed a self-monitored programme of brisk walking for 1 year, whereas control subjects maintained their habitual lifestyle. 3. Treadmill walking tests were conducted to examine changes in fitness. Concentrations of serum lipids and lipoproteins were determined in fasting subjects. The amount of body fat was measured by body density. Circumferences at the waist and hip and skinfold thicknesses were used to determine the distribution of body fat. Dietary intakes were assessed by weighed food inventories. 4. Seven subjects (six walkers and one control subject) dropped out during the study. Walkers did an average of 28 (SEM 1.4; n = 42) min of brisk walking/day. This improved endurance fitness but did not influence serum concentrations of total cholesterol, high-density lipoprotein cholesterol, triacylglycerol, apolipoprotein A-1, apolipoprotein B or lipoprotein (a). Neither body mass nor the amount of body fat changed, relative to control subjects. 5. These data suggest that brisk walking does not modify lipoprotein metabolism in normolipidaemic middle-aged men.

Adult↗
PubMed2005

Functional status in rate- versus rhythm-control strategies for atrial fibrillation: results of the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Functional Status Substudy.

OBJECTIVES: The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) functional status substudy aimed to test the hypothesis that functional status is similar in rate-control and rhythm-control strategies. BACKGROUND: Randomized studies, including the AFFIRM study, have failed to demonstrate survival benefits between rate-control and rhythm-control strategies for atrial fibrillation (AF). However, AF may cause functional capacity or cognitive impairment that might justify maintenance of sinus rhythm. METHODS: Investigators of the AFFIRM study enrolled 4,060 patients with AF who required long-term therapy and who were 65 years of age or older or who had another risk factor for stroke or death. New York Heart Association functional class (NYHA-FC) and Canadian Cardiovascular Society Angina Classification were assessed at initial and each follow-up visit. From 22 randomly chosen functional status substudy sites, 245 participants underwent 6-min walk tests and Mini-Mental State Examination (MMSE) at initial, two-month, and yearly visits. Patients were assigned randomly to rate-controlling drugs, allowing AF to persist, or rhythm-controlling antiarrhythmic drugs, to maintain sinus rhythm. RESULTS: The NYHA-FC worsened with time in both rate-control and rhythm-control groups, with no differences between groups. Presence of AF was associated with worse NYHA-FC (p < 0.0001). No differences were observed in Canadian Cardiovascular Society Angina Classification or MMSE scores. Six-minute walk distance improved over time in both study arms. On average, walk distance was 94 feet greater in the rhythm-control group (adjusted p = 0.049). CONCLUSIONS: Modest improvement in 6-min walk distance was noted in the rhythm-control arm. Presence of AF was associated with worse NYHA-FC. No difference in cognitive function was detected.

Aged↗
PubMed2005

Total and leisure-time walking among U.S. adults should every step count?

BACKGROUND: Although walking is a popular leisure-time activity, a substantial amount of total daily walking occurs in non-leisure contexts (i.e., occupation, transportation, and household work). Because non-leisure walking is not assessed by traditional leisure-time activity surveys, total walking among U.S. adults may be underestimated. This study describes walking estimates obtained from a measure of leisure-time activity and a specific measure of total walking in all contexts. METHODS: A national sample of adults (n=6626), selected by random-digit dialing, was surveyed between May 1999 and November 2000. Estimates of walking prevalence and of weekly time spent walking were examined from two separate modules: (1) an assessment restricted to leisure-time activity, and (2) an assessment of total walking. RESULTS: Walking prevalence based on the total walking module was nearly double that based on the leisure-time module (81% vs 43%, respectively). The median weekly minutes of walking also nearly doubled using the total walking module (239 vs 130 minutes, respectively). Among those with jobs involving substantial walking, median weekly walking minutes were more than three times greater with the total walking module (476 vs 130 minutes, respectively). CONCLUSIONS: U.S. adults, particularly those with jobs involving walking, do a substantial amount of walking not captured by traditional leisure-time activity surveys. This may affect the appropriate targeting of physical activity interventions, as well as the evaluation of the effectiveness of physical activity promotions and policies. However, further characterization of non-leisure walking is needed to determine its contribution to health and meeting physical activity guidelines.

Adolescent↗
PubMed2004

Assessment of mobility, activities and pain in different subtypes of epidermolysis bullosa.

A standardized questionnaire was used to assess mobility, activity and pain in 140 randomly chosen children, who were representative of all major types and subtypes of inherited epidermolysis bullosa (EB). Pain status in these children was compared with 374 randomly selected adults with EB. The level of independence for each of six activities of daily living (ADL) (toileting; feeding; bathing; dressing; grooming; walking) was assessed in these EB children using conventional criteria for scoring. Whereas more than 90% of all EB simplex (EBS) and dominant dystrophic EB (DDEB) children were totally independent for each function (excluding walking), the frequency of similarly totally independent patients with junctional EB (JEB) and recessive dystrophic EB (RDEB) ranged from only 39% to 73%. No DDEB children and only 2% of EBS patients were totally dependent in their individual ADL, in comparison to 8-27% of JEB and 2-27% of RDEB children. Totally independent walking was reported in only 31%, 31%, 67%, and 24% of EBS, JEB, DDEB, and RDEB children, respectively. A daily level of EB-related pain was assessed in children by their parents using a linear scale of 0 (no pain) to 10 (unbearable pain). Whereas 14-19% of all children with EBS, JEB, and DDEB were graded with pain levels of more than 5, 32% of all RDEB children reportedly suffered this much pain. Increased frequencies of pain with scores more than 5 were most often noted in those patients having more clinically extensive or severe EB subtypes. These included JEB-Herlitz (20% vs. 14% in JEB-non-Herlitz) and RDEB-Hallopeau-Siemens (47% vs. 20% in all other RDEB subtypes). Only 5% of all RDEB children reportedly were pain-free, compared to 12-14% of those with EBS, JEB, and DDEB. Collectively, these data provide the first report of the specific impact different forms of EB have on daily living and coping with this genodermatosis.

Activities of Daily Living↗
PubMedDate not supplied

Stage of motivational readiness: predictive ability for exercise behavior.

OBJECTIVE: To determine if stage of motivational readiness for exercise predicted adherence to a 9-month exercise intervention. METHODS: Three hundred forty-two individuals were randomized into a diet and physical activity trial. The exercise goal was to complete or add at least 10 miles of weekly brisk walking or jogging. Adherence was determined from logs. RESULTS: Sixty-four percent of men and 34% of women reported an increase of at least 10 miles per week. Adherence did not differ by baseline exercise motivational readiness stage. CONCLUSIONS: Future work should determine in what contexts stage-targeted interventions are most successful for adoption and maintenance of physical activity.

Adult↗
PubMed2006

Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial.

OBJECTIVES: To determine the effects of moderate intensity group-exercise programs on falls, functional performance, and disability in older adults; and to investigate the influence of frailty on these effects. DESIGN: A 20-week, multicenter randomized controlled trial, with 52-week follow-up. SETTING: Fifteen homes for the elderly. PARTICIPANTS: Two hundred seventy-eight men and women (mean age +/- standard deviation, 85+/-6y). INTERVENTIONS: Two exercise programs were randomly distributed across 15 homes. The first program, functional walking (FW), consisted of exercises related to daily mobility activities. In the second program, in balance (IB), exercises were inspired by the principles of Tai Chi. Within each home participants were randomly assigned to an intervention or a control group. Participants in the control groups were asked not to change their usual pattern of activities. The intervention groups followed a 20-week exercise program with 1 meeting a week during the first 4 weeks and 2 meetings a week during the remaining weeks. MAIN OUTCOME MEASURES: Falls, Performance Oriented Mobility Assessment (POMA), physical performance score, and the Groningen Activity Restriction Scale (GARS) (measuring self-reported disability). RESULTS: Fall incidence rate was higher in the FW group (3.3 falls/y) compared with the IB (2.4 falls/y) and control (2.5 falls/y) groups, but this difference was not statistically significant. The risk of becoming a faller in the exercise groups increased significantly in the subgroup of participants who were classified as being frail (hazard ratio [HR] = 2.95; 95% confidence interval [CI], 1.64-5.32). For participants who were classified as being pre-frail, the risk of becoming a faller decreased; this effect became significant after 11 weeks of training (HR = .39; 95% CI, .18-.88). Participants in both exercise groups showed a small, but significant improvement in their POMA and physical performance scores. In the FW group, this held true for the GARS score as well. Post hoc analyses revealed that only the pre-frail participants improved their POMA and physical performance scores. CONCLUSIONS: Fall-preventive moderate intensity group-exercise programs have positive effects on falling and physical performance in pre-frail, but not in frail elderly.

Accidental Falls↗
PubMed2005

Perceptions and practice of concordance in nurses' prescribing consultations: findings from a national questionnaire survey and case studies of practice in England.

BACKGROUND: The number of nurses able to independently prescribe medicines in England is increasing. Patient adherence to prescribed medicines remains a significant problem [Department of Health, 2000. Pharmacy in the Future: Implementing the NHS Plan. A Programme for Pharmacy in the NHS. Stationary Office, London]. Concordance-a partnership approach to medicine consultations-is advocated as an effective solution [Medicines Partnership, 2003. Project Evaluation Toolkit. Medicines Partnership, London]. OBJECTIVES: To investigate whether nurses were practising the principles of concordance within their prescribing interactions. DESIGN: Phase (i) postal questionnaire survey. Phase (ii): case studies of practice. SETTINGS: Phase (i) primary and secondary care trusts throughout England in which nurse prescribers were practicing. Phase (ii) six general practice settings; one community midwifery service; one specialist community palliative care service; one secondary care ophthalmology unit; one NHS walk-in centre. PARTICIPANTS: Phase (i) a random sample of 246 nurses registered as independent nurse prescribers with the Nursing and Midwifery Council in 2002/2003. Phase (ii) purposively selected sample of 14 nurse prescribers who participated in Phase (i) of the study; a total of 208 purposively selected patients completed self-administered questionnaires. METHODS: Phase (i) postal questionnaires. Phase (ii) structured non-participant observation of 118 nurse prescribing consultations; 115 post-consultation patient questionnaires; 93-patient postal questionnaires. RESULTS: 99% of the nurses in the national survey stated they were practising the principles of concordance. The majority of patients surveyed also reported experiencing concordance in practice. Observation of practice revealed that although some principles of concordance were regularly integrated into nurses' practice, other principles were less often in evidence. Some evidence from both observation of practice and patient questionnaires suggested that a professionally determined 'compliance' agenda may still be partially operating in practice. CONCLUSIONS: Most nurses believe they are practicing concordance in their prescribing consultations. The majority of patients also reported that they had experienced some of the principles of concordance in practice. Observation of practice highlighted that the shift from a professionally determined compliance agenda to the integration of concordance into nurses' prescribing consultations had not yet taken place.

Attitude of Health Personnel↗
PubMed2002

Floor-rise strategy training in older adults.

OBJECTIVES: To determine the effect of a 2-week (six-session) training intervention to improve the ability of disabled older adults to rise from the floor. DESIGN: Prospective intervention trial. SETTING: Congregate housing in Michigan. PARTICIPANTS: Subjects aged 65 and older who admitted to requiring assistance (such as from a person, equipment, or device) in performing at least one of the following mobility-related activities of daily living: transferring, walking, bathing, and toileting. INTERVENTION: Participants were randomly allocated to individual training (n = 17, mean age 81) in strategies to rise from the floor (using for example, certain key intermediate body positions) or a control chair-based flexibility intervention (n = 18, mean age 80). MEASUREMENTS: At baseline and postintervention, residents were queried regarding their rise difficulty (difficulty scale) and symptoms (symptoms scale) associated with the rise and were tested in their ability to perform timed floor-rise tasks. These tasks varied in starting position (supine vs all fours) and in use of a support to assist in rising (no support, use of an end table, use of a chair). RESULTS: Using baseline performance as the covariate, by analysis of covariance (ANCOVA), the training group showed a significant (P <.05) improvement in mean number of rise tasks completed (baseline mean 6.6, postintervention mean 7.3) versus essentially no improvement in the controls. Similarly, by ANCOVA, the training group (compared with controls) showed a significant (P <.05) improvement on the difficulty and symptoms scales. There was no intervention effect for rise time. CONCLUSIONS: A short-term, strategy-based intervention improved floor-rise ability and perceived difficulty and symptoms associated with the rise. This approach, focusing on key intermediate body positions, may be useful in training floor-rise skills, particularly in older adults at risk for falls.

Activities of Daily Living↗
PubMed1998

How effective is exercise training for the treatment of hypertension?

OBJECTIVE: Exercise is often recommended as therapy for hypertension, yet its use is not widespread among clinicians. Reasons include uncertainty regarding its efficacy, the relative importance of the exercise prescription determinants (intensity and frequency), or confounding variables including patient characteristics such as age and gender. This review will present the evidence for exercise as a treatment for hypertension using a search of the English language literature from January 1966 to January 1998. DATA SOURCES: A search of MEDLINE articles using the MESH headings and textwords of blood pressure, hypertension, exercise, and exertion as well as hand searches in related articles and cross-referencing. DATA EXTRACTION AND SYNTHESIS: Identified articles were reviewed for their design characteristics, and specific attention was made of the subject characteristics, the exercise training protocol, the magnitude of the blood pressure-lowering response, and the influence of pharmacologic treatment on blood pressure lowering. RESULTS: A total of 39 studies representing random and nonrandom designs using predominantly walking-jogging exercise were identified. These studies showed reductions in blood pressure (systolic blood pressure/diastolic blood pressure) of -13/ -18 mm Hg in hypertensive patients. Most of the antihypertensive effect of exercise training was observed after 10 weeks, whereas training more than three times per week or for more than 50 minutes did not confer added benefit. Lower intensity exercise resulted in greater blood pressure reduction than did high intensity exercise. No gender differences in the antihypertensive effect of exercise were observed although most studies were performed in men. Although few studies were performed in older patients, there did not appear to be an age-dependent antihypertensive effect of exercise. There was a paucity of literature regarding the interaction of pharmacologic therapy and exercise in hypertensive patients. CONCLUSIONS: The results support the use of exercise as an effective therapy in hypertension. Studies were generally lacking in adequate control groups. Future research opportunities are many and should include studies using ambulatory monitoring and stratification of patients with different degrees of hypertension, undergoing different pharmacologic regimens.

Clinical Trials as Topic↗
PubMed2005

The effect of spirometry and exercise on exhaled nitric oxide in asthmatic children.

American Thoracic Society (ATS) guidelines recommend to refrain from spirometry or exercise before measuring fractional exhaled nitric oxide (FENO) because forced breathing maneuvers might influence FENO values. However the few studies already reported in children have given conflicting results. The aim of the study was to observe to what extent spirometry or exercise could affect FENO in asthmatic children. Twenty-four asthmatic children (mean age 12.8 yr) were enrolled. Measurements of FENO were performed before and 5, 15, 30, 45 and 60 min after spirometry or a 6-min walk test, on two separate days in random order. Geometric mean FENO at baseline was 25.6 parts per billion (ppb) before spirometry and 23.5 ppb before exercise. A small drop of FENO to 24.2 and 23.7 ppb was found 5 and 15 min after spirometry (both p = 0.04). After exercise, FENO values showed a larger drop to 18.5 ppb after 5 min and 20.7 ppb after 15 min (p < 0.001; p = 0.004 respectively). Changes in FENO occurred after exercise irrespective of baseline FENO and values returned to baseline within 30 min. We conclude that both spirometry and exercise affect FENO in asthmatic children. As the changes after exercise may lead to erroneous interpretations, children should refrain from physical exercise during at least 30 min before FENO measurements.

Adolescent↗
PubMed1987

Stumbling reactions in man: significance of proprioceptive and pre-programmed mechanisms.

1. Electromyogram (e.m.g.) responses of the leg musculature and the corresponding joint movements were studied following a perturbation of the limb during walking on a treadmill, produced by a randomly timed treadmill acceleration impulse, either predictable, or unpredictable in its amplitude and rate of acceleration. 2. The rate of rise of ipsilateral gastrocnemius e.m.g. response following a perturbation was dependent on the rate of treadmill acceleration. For a given acceleration rate the amplitude of the e.m.g. response and the timing of its peak was dependent on the amplitude of the impulse and the rate of rise of the gastrocnemius response was the same for impulses of both small and large amplitude. The onset latency was shorter (65 ms) for high accelerations and longer (85 ms) for lower ones. 3. The amplitude of the ipsilateral biceps femoris response was much smaller than the gastrocnemius response but was larger following unpredictable than predictable impulses. 4. The initial gastrocnemius response was followed by a tibialis anterior activation associated with a gastrocnemius depression and sometimes with a second, weak gastrocnemius activation. The gastrocnemius depression ended within a fixed time range relative to the onset of the response. The tibialis anterior activation was most pronounced when unpredictable impulses with high acceleration but a small amplitude were induced. 5. It is concluded that generation of the first gastrocnemius response is obviously under continuous control by muscle proprioceptive information and can be best described in terms of a stretch reflex response. It is suggested that, on the evidence of the diphasic or triphasic e.m.g. pattern, a close interaction occurs between a central programme and muscle proprioceptive input in order to generate the appropriate e.m.g. pattern. 6. On the basis of earlier work (Berger, Dietz & Quintern, 1984a) and on the present results it is suggested that the e.m.g. responses may be mediated mainly by muscle proprioceptive input from group II afferents. This input is modulated and processed by spinal interneuronal circuits, closely connected with spinal locomotor centres. The mode of processing depends on various factors, such as the predictability of the nature of the impulse.

Adolescent↗
PubMedDate not supplied

Cooling the foot to prevent diabetic foot wounds: a proof-of-concept trial.

The etiology of neuropathic diabetic foot wounds can be summarized by the following formula: pressure x cycles of repetitive stress = ulceration. The final pathway to ulceration consists of an inflammatory response, leading to tissue breakdown. Mitigation of this response might reduce the risk of ulceration. This proof-of-concept trial evaluates whether simple cooling of the foot can safely reduce the time to thermal equilibrium after activity. After a 15-min brisk walk, the six nondiabetic volunteers enrolled were randomly assigned to receive either air cooling or a 10-min 55 degrees F cool water bath followed by air cooling. The process was then repeated with the intervention reversed, allowing subjects to serve as their own controls. There was a rise in mean +/- SD skin temperature after 15 min of activity versus preactivity levels (87.8 degrees +/- 3.9 degrees versus 79 degrees +/- 2.2 degrees F; P = .0001). Water cooling immediately brought the foot to a point cooler than preactivity levels for all subjects, whereas air cooling required an average of nearly 17 min to do so. Ten minutes of cooling required a mean +/- SD of 26.2 +/- 5.9 min to warm to preactivity levels. No adverse effects resulted from the intervention. We conclude that cooling the foot may be a safe and effective method of reducing inflammation and may serve as a prophylactic or interventional tool to reduce skin breakdown risk.

Adult↗
PubMed2005

Can mental practice increase ankle dorsiflexor torque?

BACKGROUND AND PURPOSE: Mental practice has been shown to be effective in increasing the force production of the abductor digiti minimi muscle in the hand. The aim of this study was to determine whether mental practice could produce strength gains in the larger ankle dorsiflexor muscles, which are important during walking. SUBJECTS: Twenty-four subjects were randomly assigned to a physical practice group, a mental practice group, or a control group (8 subjects per group). METHODS: In the practice groups, subjects either physically or mentally practiced producing maximal isometric contractions for 3 sets of 10 repetitions, 3 times per week for 4 weeks. Changes in mean peak isometric torque normalized to body weight and the resulting percentage of improvement were analyzed across the 3 groups. RESULTS: Differences in raw torque production after training in the 2 practice groups resulted in significant percentages of improvement for the physical practice group (25.28%) and the mental practice group (17.13%), but not for the control group (-1.77%). The 2 practice groups were not statistically different in their maximal torque-generating capacity after training. DISCUSSION AND CONCLUSION: These findings show that mental practice in people without impairments can lead to an increase in torque production similar to that produced by physical practice. Such a technique may prove to be a useful adjunct to traditional treatment options aimed at increasing muscle strength.

Adult↗
PubMed1994

Physical activity training for weight loss in Latinas: a controlled trial.

This study tested the effects of an exercise and diet modification training program for weight loss among Latinas. Forty four obese women were assigned to an experimental training group (n = 22) or a control (n = 22), at random. One session per week for eight weeks included instruction for diet modification and walking for exercise, and all women were led in 20 min of walking during each session. Instruction was provided by a bi-cultural Spanish-speaking physician. Statistically significant (P < 0.05) decreases, relative to controls, were obtained for Body Mass Index, waist to hip ratio, and serum cholesterol. Significant increases were obtained for fitness, exercise rate and frequency, and diet/exercise knowledge. Results suggest that the training was effective for decreasing obesity and increasing fitness among Low SES, Mexican-American women. Implications for weight control and disease prevention among under-served populations are discussed.

Adult↗
PubMed1997

Randomized trial of a hospital-based exercise training program after acute myocardial infarction: cardiac autonomic effects.

OBJECTIVES: This study sought to determine whether a moderate intensity supervised exercise training program, performed immediately after an uncomplicated acute myocardial infarction, improves recovery in cardiac autonomic function compared with standard advice about activity at home. BACKGROUND: Exercise training has beneficial effects on cardiac autonomic function and may improve prognosis after acute myocardial infarction. METHODS: Thirty-nine male and 10 female patients, mean (+/-SE) age 57 +/- 1 years, with an uncomplicated acute myocardial infarction were randomized to either a 6-week moderate intensity supervised hospital-based exercise training program (exercise group) or to an unsupervised low intensity home walking program (control group). Outcome measures included changes in baroreflex sensitivity (phenylephrine bolus method) and heart rate variability (24-h Holter monitoring) and the endurance time at 85% of peak oxygen consumption. RESULTS: At baseline, there were no significant differences in left ventricular ejection fraction (57 +/- 2% vs. 53 +/- 2%), frequency of anterior infarction (27% vs. 18%) and peak creatine kinase (1,256 +/- 170 vs. 2,599 +/- 295 IU) between the exercise and control groups. Baroreflex sensitivity (10.5 +/- 1.0 vs. 8.4 +/- 1.2 ms/mm Hg) and time domain measures of heart rate variability were also similar. After completion of the program, the exercise group exercised for a median of 15 min (interquartile range 12 to 25) at a workload of 104 +/- 7 W compared with 7 min (interquartile range 3.5 to 12) at a workload of 89 +/- 8 W in the control group (p < 0.01). There were significant (p < 0.001) improvements in baroreflex sensitivity and heart rate variability for the 49 patients combined but no differences between the exercise and control groups. Baroreflex sensitivity improved by 3.4 +/- 1.0 and 1.7 +/- 1.0 ms/mm Hg and the standard deviation of 24-h RR intervals by 36 +/- 6 and 40 +/- 10 ms, respectively (p > 0.1). CONCLUSIONS: A hospital-based exercise training program increased endurance capacity but did not improve recovery of cardiovascular antonomic function after uncomplicated acute myocardial infarction.

Ambulatory Care↗
PubMed2000

Effects of two types of training on pulmonary and cardiac responses to moderate exercise in patients with COPD.

The effects of two 8-week programmes of exercise reconditioning on the time constants (tau) of the pulmonary gas exchange, ventilatory and heart rate responses to moderate intensity exercise in patients with chronic obstructive pulmonary disease (COPD) were studied. Thirty-five subjects (mean+/-SD 64+/-5 yrs; forced expiratory volume in one second (FEV1) 1.09+/-0.17 L; 41+/-6.2% predicted) were randomly assigned either to supervised (s) training on a treadmill, 4 days x week(-1) (group S; n=21) or self-monitored (SM) walking 3 or 4 km in 1 h 4 days x week(-l) (group SM; n=20). The different levels of supervision resulted in a different estimated intensity of training (35+/-10 W in the SM group and 70+/-22 W in the S group). The kinetics were evaluated with a constant-load exercise test on a cycle-ergometer at a work rate corresponding to 80% the highest oxygen consumption (V'O2) that can be achieved without blood lactic acidosis (V'O2,LAT) or 50% of V'O2,max, if maximum oxygen consumption V'O2,LAT was not found. Mean endurance time at a work rate equivalent to 70% of the pretraining V'O2,max increased by 493+/-281 s in the S group and 254+/-283 s in the SM group (p<0.001). Mean tauV'O2 decreased from 83+/-17 s to 67+/-11 s (p<0.0001) in the S group and from 84+/-12 to 79+/-16 (p=0.04) in the SM group. Mean tau for carbon dioxide output minute ventilation and heart rate were also speeded after training, again more markedly in the S group. In the S group there was a significant correlation between the decrease in tauV'O2 and the increase in endurance time (r=-0.56, SEM=0.21). It is concluded that training speeds the kinetic response of oxygen consumption, carbon dioxide production, minute ventilation and heart rate to moderate exercise and that the effect is greater after supervised, more intense training.

Aged↗
PubMed2004

Effects of multicomponent training on functional fitness in older adults.

The purpose of this study was to evaluate the effects of a 9-week supervised multicomponent exercise program on functional fitness and body composition in independent older adults. Forty-two adults age 60-86 years were randomly assigned to an exercise or a control group and were evaluated before and after training. The training program consisted of 3 sessions of walking, strengthening, and flexibility exercises per week. The multicomponent training program resulted in significant (p < .005) improvements on the chair stand, arm curl, 6-min walk, and up-and-go tests. The findings of this study indicate that a 9-week training program increased upper and lower body strength, aerobic endurance, and agility/dynamic balance in older adults. The most affected components of functional fitness were lower body strength and aerobic endurance. There was no effect of the 9-week training on body composition.

Activities of Daily Living↗