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Structured Exercise, Lifestyle Physical Activity, and Cardiorespiratory Fitness in the Prevention and Treatment of Chronic Diseases
Published in Gia Merlo, Kathy Berra, Lifestyle Nursing, 2023
Barry A. Franklin, Thomas F. O’Connell
Cardiovascular exercise is one of the most effective lifestyle therapies in the prevention and treatment of coronary artery disease (CAD) (Quindry & Franklin, 2018). Typical cardiac rehabilitation exercise protocols incorporate moderate-intensity continuous training (MICT) where participants exercise at 50–75% of their peak or maximal attained heart rate (HRmax). Recently, there has been a heightened interest in high-intensity interval training (HIIT), which alternates high-intensity 30 to 240 second exercise bouts with periods of more moderate activity or passive recovery. An intensity of 85 to 100% HRmax is generally targeted during the most strenuous HIIT intervals (Gayda et al., 2016). In healthy individuals, HIIT has been shown to elicit similar improvements in body composition and aerobic capacity as compared with MICT but in an abbreviated training duration (Ross et al., 2016). HIIT has also been reported to increase post-exercise oxygen consumption, which has the potential to augment weight loss (Gibala et al., 2012). Despite some potential advantages of HIIT, questions remain regarding its safety and efficacy as compared with MICT in patients with CAD.
Participant pre-test preparation and evaluation
Published in R. C. Richard Davison, Paul M. Smith, James Hopker, Michael J. Price, Florentina Hettinga, Garry Tew, Lindsay Bottoms, Sport and Exercise Physiology Testing Guidelines: Volume II – Exercise and Clinical Testing, 2022
Maximal cardiopulmonary testing is the ‘gold standard’ assessment of the cardiovascular, ventilatory and metabolic responses to exercise and is a powerful diagnostic and prognostic tool. This method affords direct measurement of aerobic capacity (Taylor et al., 2015). However, maximal testing requires participants to perform vigorous-intensity exercise, which may be inappropriate or unnecessary for some individuals, or require additional monitoring during exercise testing to mitigate risk.
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 healthy adults, aerobic and resistance training is more effective when adequate dosages are used. Increased aerobic capacity and endurance are achieved with more efficient myocardial oxygen capacity and cardiac output. Muscle strength improvements are attained when maximal motor units are recruited. The same considerations apply to individuals with chronic disease. Observed training intensities of the evidence presented were mostly in the moderate to high intensity training ranges, with very few adverse events reported. These intensities were safe and well-tolerated in a wide spectrum of chronic diseases and severity, from early to end-stage disease. In fact, compliance was relatively high. However, low-intensity exercise is still beneficial for deconditioned individuals and still positively impacts physical and psychological function. Similarly, positive outcomes were generally observed even with heterogenous frequency and duration, suggesting that exercise recommendations can be flexible and tailored to individuals’ preferences and circumstances.
Aerobic capacity in persons with Parkinson’s disease: a systematic review
Published in Disability and Rehabilitation, 2023
Cecilie Thrue, Lars G. Hvid, Mads Gamborg, Helen Dawes, Ulrik Dalgas, Martin Langeskov-Christensen
Despite progress in pharmaceutical and surgical approaches in symptomatic treatment of PD, disease modifying therapies remain to be elucidated [4]. During the past decades, physical exercise has been recommended as a supplement to pharmaceutical treatment in order to improve symptom management [5]. Nonetheless, persons with PD (pwPD) are known to adopt a markedly more physically inactive lifestyle compared with healthy controls (HCs) [6–8]. Low levels of physical activity often lead to reduced aerobic capacity (maximal oxygen uptake: VO2max) [9] and subsequently cause a number of related health problems (e.g., increased risk of cardiovascular diseases, diabetes, osteoporosis, and depression [8,10]) as well as worsening of various non-motor symptoms (e.g., insomnia and constipation [8]). Importantly, aerobic capacity has been identified as a strong health and performance predictor in both healthy [11–14] and clinical [15] populations and is therefore also considered a highly relevant physiological outcome in PD [16]. In context thereof, an in-depth understanding of the exact levels of aerobic capacity in pwPD, with different medication states (i.e., on/off medication), compared to HC appears essential. So do the understanding of any potential associations between VO2max and clinical measures of motor and non-motor symptoms or functional outcomes in pwPD, as this could potentially identify new relevant targets that could be impacted in future (aerobic) exercise interventions. Yet, systematic reviews on these topics could not be identified.
Diastolic function and cardiovascular risk among patients with severe obesity referred to a lifestyle-program – a pilot study
Published in Scandinavian Cardiovascular Journal, 2023
Line M. Oldervoll, Rolf Gjestad, Christina Hilmarsen C, Anders Ose, Lisbeth Gullikstad, Ulrik Wisløff, Baard Kulseng, Jostein Grimsmo
Aerobic capacity was assessed by direct measurement of oxygen consumption walking or running on a treadmill. Prior to entering the treadmill (Woodway Inc., WI, USA), patients were equipped with a heart rate monitor (Polar WearLink; Polar Electro Oy, Kempele, Finland), and a fitted face mask (Hans Rudolph, Shawnee, KS, USA) or mouthpiece (Hans Rudolph, Shawnee, KS, USA) if having beard/moustache. Oxygen uptake and heart rate were measured continuously during an incremental, individualised protocol chosen by experienced test personal until exhaustion. All VO2 kinetics were measured using the Jaeger Masterscreen CPX (CareFusion, Hoechberg, Germany). A test was considered maximal (VO2max) if the VO2 did not increase more than 2 mL × 1/kg × 1/min despite increased workload, combined with a respiratory exchange ratio (RER) at or above 1.1. Since few patients reached both VO2max criteria, the term VO2peak was used. The VO2peak was registered as the mean of the three successively highest 30 s VO2 with simultaneous RER ≥ 1.05.
Comparison of Canadian firefighters and healthy controls based on submaximal fitness testing and strength considering age and gender
Published in International Journal of Occupational Safety and Ergonomics, 2019
Goris Nazari, Joy C. MacDermid, Kathryn E. Sinden, Tom J. Overend
Firefighters are set to respond to emergency situations to protect the health and well-being of their community as well as community property [1]. Of all civilian occupations, firefighting is often considered the most physiologically demanding profession, mainly due to its unpredictable nature, extreme levels of physical exertion – having to carry protective gear and equipment weighing over 34 kg – and need to work at maximal cardiovascular capacity for long periods, often in hostile environments [2,3]. Although it is difficult to quantify the actual physiological demands during real firefighting situations, it is believed that firefighters tend to have higher levels of fitness than the general/healthy population [4,5]. Two important parameters of fitness are aerobic capacity and muscle strength. Aerobic capacity is referred to as maximal oxygen consumption during vigorous exercise in a given period measured by VO2max (ml·kg−1·min−1), whereas muscle strength deals with exertion of maximal force in one effort by a muscle or groups of muscles to overcome maximal resistance [6]. Higher levels of aerobic capacity and muscle strength among firefighters have been shown to decrease injury risks and improve performance and task efficiency [7]. It has also been reported that firefighters’ aerobic capacities decrease with age whereas their static lifting performance (indicator of strength) remains unchanged [8].