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Lifestyle Medicine Clinical Processes
Published in James M. Rippe, Lifestyle Medicine, 2019
The equipment needed for this test can include a treadmill, elliptical trainer, or cycle ergometer, allowing for this testing to be included in some clinical facilities. Using HR telemetry, and increasing exercise in small increments to increase steady state HR by approximately five beats per minute (bpm) per stage, the end-point is identified based on monitoring changes in breathing rate that are determined by the ability to recite a predetermined combination of phrases. At this point, breathing rate and ability to talk is not compromised. Above VT1, the demand for carbon dioxide removal is met by an increasing breathing rate, so the ability to talk continuously during expiration becomes compromised, resulting in a noticeable increase in breathing rate where the ability to string five to 10 words together becomes challenging or difficult. The test should be completed within eight to 16 minutes, after a steady state of heart rate is achieved at each stage.
Exercise, Activity in Cancer and Chronic Disease
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
In individuals with cancer, predominantly aerobic type interventions that were at a moderate to vigorous level of intensity seemed to show more favorable responses in fatigue, health-related quality of life, physical function, and immune responses compared to those who exercised at a lower intensity, or not at all.17–20 These exercise parameters and resultant findings seem to be consistent in individuals with advanced stage cancer, where Borg’s RPE scale ratings ranging from 10 to 1521–23 were reported, with resulting statistically significant improvements in gait speed, six-minute walk distance, and fatigue severity.24 For individuals with chronic heart failure, engaging in physical exercise has been theorized to increase systemic arterial compliance, improve stroke volume, counteract muscle atrophy, and inhibit catabolic processes that occur in heart failure.7,25 Moderate continuous aerobic training is the recommended exercise modality from the Heart Failure Association Guidelines,26 although interval aerobic training has been posited as a potentially more effective way to build up exercise tolerance in these individuals.27 For those with Parkinson’s disease, where the disease progression can result in quite debilitating sequelae, physical activity may facilitate motor unit recruitment and more efficient energy utilization if used with medication.28 Several studies have used treadmill training or other aerobic means like a bike or elliptical trainer for individuals with Parkinson’s disease as an aerobic modality with significant improvements in walking economy, speed, and distance. Training duration ranged from 3 to 21 weeks.29,30 Necessary adaptations to the treadmill or elliptical trainer set-up, such as less resistance or shorter initial duration, can be implemented if indicated by the person’s health status.7
Metabolic syndrome components response to the conducted 16-week randomised-controlled training trial on an elliptical trainer
Published in European Journal of Physiotherapy, 2023
In these modern days, another different popular cardiorespiratory fitness device, the elliptical trainer (ET), is widely used in cardiovascular rehabilitation settings/centres instead of treadmills. Similar production of maximal oxygen uptake (VO2 max) and maximal heart rate (HRmax), low-workload impact nature [5], during-training comfortable configuration for people with obesity, lower-limb joints and muscles disorders [6], low risk of falls, during-training fixed balance due to feet contact, low during-training stress on lower-body parts and simultaneous stepped motion of upper and lower limb that produce more energy expenditure due to concurrent contraction of upper and lower muscles [7] are the main reported advantages that qualify ET devices to be superior than a treadmill for long-timed exercise interventions [8].
Adjuvant physical exercise for the management of painful polyneuropathy
Published in Postgraduate Medicine, 2022
Andreas Liampas, Loizos Hadjigeorgiou, Antonios Nteveros, Christiana Ioannou, Giustino Varrassi, Panagiotis Zis
Aerobic exercise (AE) is the most tested physical activity for the adjuvant management of painful PN. In an open-label interventional pilot study, Kluding et al. [26] examined the role of a supervised aerobic and resistance exercise program of moderate intensity for the management of pain in 10 patients with diabetic peripheral neuropathy (DPN). The program consisted of a 10-week program, during which subjects could use a variety of cardiovascular and strength training equipments, such as total body recumbent steppers, upright cycle, recumbent cycle, elliptical trainer, and treadmill. During each exercise session, blood glucose levels, blood pressure, heart rate, and rate of perceived exertion (RPE) were monitored. The moderate intensity of aerobic exercise was calculated at 50–70% of VO2 reserve during a pretest procedure, where individuals were tested using a cycle ergometer with a metabolic cart and integrated ECG. During the strengthening session, which included abdominal curls, biceps curls, chest presses, lat pulldowns, leg extensions, seated leg curls, seated rows, shoulder presses, squats, and triceps presses, the RPE levels were gradually increased to a moderate range (7–8 out of 10) for each participant. The authors found statistically significant improvements in the context of pain intensity, overall neuropathic symptoms, and cutaneous fiber branching in subjects with painful DPN. Additionally, HbA1c was significantly reduced following the exercise program.
The need for mapping personal goals to exercise dosage in community-based exercise programs for people with Parkinson’s disease
Published in Physiotherapy Theory and Practice, 2019
Allison L. Amateis, Chelsea L. Boesel, Bryan P. Ehnert, Abby S. Evans, Katheryn E. Hurst, Katie L. Marek, Amanda C. Sullivan, Kathryn R. Zalewski, Wendy E. Huddleston
We also wanted to determine the Instructor’s perceptions regarding program goals to determine alignment between participants and instructors. Instructors identified treadmill training as a primary goal of the exercise session, however, were flexible in meeting the needs of the participants for aerobic activity. Four of six instructors mentioned that if a participant was not comfortable with the treadmill, they would modify the exercise to include other types of equipment (e.g., stationary cycle ergometer or recumbent elliptical trainer). Instructors appeared aware of the need for aerobic exercise to support self-management of PD symptoms as exemplified by the following statements: “I try to keep them going at the highest intensity they can sustain for at least 20+ minutes overall on the treadmill.” And“Evidence-based application of the guidelines that have been created for use of walking on treadmills and a land based program that focuses on extension exercises is our focus.”