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Results for “Exercise therapy”

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PubMed1997

Compliance to exercise therapy in older participants with knee osteoarthritis: implications for treating disability.

This investigation examined predictors of compliance with exercise therapy in a clinical trial involving older adults with knee osteoarthritis (OA). The study sample was partitioned into tertiles by level of compliance to determine its effect on several clinical outcome measures in the trial (i.e., knee pain, difficulty with activities of daily living, and performance-related disability). The participants (N = 439) first completed all baseline assessments and were then randomly assigned to one of three treatment conditions: health education control, aerobic exercise, or resistance exercise. The two exercise treatments involved a 3-month center-based phase and a 15-month home-based phase. Variables in five categories (i.e., demographic, fitness, health-related quality of life, performance-related disability, and prior exercise behavior) were entered as predictors of attendance and time spent exercising during each session for three different periods of time across the course of the study. Results of these analyses revealed that it was possible to explain more variance for time spent exercising (approximately 40%) during the first 3 months than for attendance (approximately 10%). Furthermore, once participants completed the first 3 months of their training, prior behavior was the strongest predictor of exercise compliance. In most cases, the regression models accounted anywhere from 26 to 46% of the variance in attendance or time spent exercising (7 of the 8 P values < 0.01). In general, demographic, fitness, psychosocial, and disability-related measures did not predict compliance with any consistency across the various phases of the trial. Analysis of the dose-response data suggest that, in the use of aerobic exercise to deter disability in older people with knee OA, consideration should be given to prescribing frequent bouts of activity (at least 3 times each week) of moderate duration (approximately 35 min).

Activities of Daily Living↗
PubMed2005

[Evaluation after four years of exercise therapy for chronic low back pain].

OBJECTIVE: To assess at four years follow-up the efficiency of exercise therapy for chronic low back pain in terms of pain, physical ability, quality of life and return to work. MATERIALS AND METHODS: Patients who graduated from a functional restoration program between April 1997 and June 1999, answered a questionnaire at one year follow-up. The patients who had answered this questionnaire were evaluated 48 months later: they first answered another questionnaire and then most underwent a clinical examination assessing pain on a visual analogue scale, flexibility by use of the Schöber index and the finger-ground distance test, endurance of abdominal and spinal muscles, and quality of life as assessed by the Dallas pain questionnaire. RESULTS: Thirty-four patients graduated from the program; 26 were studied at four-year follow-up. Pain intensity was significantly reduced. Improvement in flexibility after the program remained at four-year follow-up, whereas improvement in endurance did not. Scores on the Dallas pain questionnaire remained as improved as those at one-year follow-up. Initially, 23 of the 26 patients had a job; 19 were on sick leave for an average of 35 weeks. At four-year follow-up, 16 patients were still working, and 56% had changed jobs. Six patients pursued a regular activity before entering the program; at four-year follow-up, 17 were regularly active. No significant relationship was found between the pursuit of physical activity and return to work. Nevertheless, a significant relationship was found between having a regular physical activity and improvement of the finger-ground distance and endurance of spinal muscles. This observation was not true for the Dallas pain questionnaire scores. CONCLUSION: Despite the lack of a control group, this study seems to favour a benefit in the functional restoration program.

Adult↗
PubMed2000

[Chronic low back pain: exercise therapy, multidisciplinary programs, NSAID's, back schools and behavioral therapy effective; traction not effective; results of systematic reviews].

OBJECTIVE: To inventory the current state of the art regarding the effectiveness of conservative treatment of chronic low back pain. DESIGN: Systematic reviews. METHOD: The relevant literature from the period January 1966-September 1999 was retrieved via Medline, Embase, PsychLit and the Cochrane Library and via reference lists in the articles found. The methodological quality of the studies was assessed using criteria for internal validity. On the basis of the number of examinations, their quality and the consistency of the findings, conclusions were subdivided into four levels of strength of scientific evidence. RESULTS: There was strong evidence that exercise therapy and multidisciplinary treatment programmes were effective in chronic low back pain, and moderate evidence that non-steroidal anti-inflammatory drugs (NSAIDs), back schools and behavioural therapy were effective in chronic low back pain. There was also strong evidence that traction was not effective in chronic low back pain. Strong evidence for effectiveness of many other commonly used interventions was lacking.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

Exercise therapy for positional vertigo.

We present a common cause of vertigo, benign positional paroxysmal vertigo (BPPV), and its history, diagnosis, and therapy. BPPV is suggested by history, readily diagnosed by office examination, and cured by appropriate exercise therapy. Since the condition is so common and often unrecognized, physicians are encouraged to consider BPPV as a possible cause of treatable dizziness.

Exercise Therapy↗
PubMed2000

Exercise therapy effect on natural killer cell cytotoxic activity in stomach cancer patients after curative surgery.

OBJECTIVE: To evaluate the effect of early exercise therapy on the natural killer cell cytotoxic activity (NKCA) of patients who had undergone curative resection of stomach cancer. DESIGN: Prospective study. PATIENTS: Thirty-five stomach cancer patients who had undergone curative surgery were randomly divided into an exercise group (n = 17) and a control group (n = 18). INTERVENTION: From postoperative day 2, moderated exercise using arm and bicycle ergometers performed twice a day, 5 times a week, for 14 days. The intensity of exercise was 60% of maximal heart rate. Venous blood samples were obtained on postoperative days 1, 7, and 14. MAIN OUTCOME MEASURE: Mean sequential change of NKCA. RESULTS: The mean sequential change of NKCA decreased until postoperative day 7 and then increased. Mean NKCA of day 7 decreased in both groups, compared with that at postoperative day 1. At day 14, the mean NKCA of the exercise group demonstrated a significant increase compared with that of the control group (p < .05). CONCLUSION: This study suggests that early moderate exercise has a beneficial effect on the function of in vitro NK cells in stomach cancer patients after curative surgery.

Adult↗
PubMed2006

Cost-effectiveness of a graded exercise therapy program for patients with chronic shoulder complaints.

OBJECTIVES: The present study evaluated the cost-effectiveness of a behavioral graded exercise therapy (GET) program compared with usual care (UC) in terms of the performance of daily activities by patients with chronic shoulder complaints in primary care. METHODS: A total of 176 patients were randomly assigned either to GET (n=87) or to UC (n=89). Clinical outcomes (main complaints, shoulder disability [SDQ] and generic health-related quality of life [EQ-5D], and costs [intervention costs, direct health care costs, direct non-health-related costs, and indirect costs]) were assessed during the 12-week treatment period and at 52 weeks of follow-up. RESULTS: Results showed that GET was more effective than UC in restoring daily activities as assessed by the main complaints instrument after the 12-week treatment period (p = .049; mean difference, 7.5; confidence interval [CI], 0.0-15.0). These effects lasted for at least 52 weeks (p = .025; mean difference 9.2; CI, 1.2-17.3). No statistically significant differences were found on the SDQ or EQ5D. GET significantly reduced direct health care costs (p = .000) and direct non-health care costs (p = .029). Nevertheless, total costs during the 1-year follow-up period were significantly higher (p = .001; GET = Euro 530 versus UC = Euro 377) due to the higher costs of the intervention. Incremental cost-effectiveness ratios for the main complaints (0-100), SDQ (0-100), and EQ-5D (-1.0-1.0) were Euro 7, Euro 74, and Euro 5278 per unit of improvement, respectively. CONCLUSIONS: GET proved to be more effective in the short- and long-term and reduces direct health care costs and direct non-health care costs but is associated with higher costs of the intervention itself.

Chronic Disease↗
PubMed1993

A review of the clinical effectiveness of exercise therapy for intermittent claudication.

BACKGROUND: Intermittent claudication is both frequent and disabling. Conservative treatment consists of the elimination of risk factors, particularly smoking, drug treatment, and physical exercises. This review represents an attempt to define how effectively exercise prolongs the walking ability of claudicants. METHODS: A computerized literature search was done to identify all controlled trials on the subject. In addition, other studies were admitted if they were in accordance with certain quality criteria. RESULTS: Without exception, these studies showed that exercise can prolong the pain-free walking distance of claudicants. Even though this message seems uniform and convincing, one should point out that all trials are burdened with methodological flaws. The variability of increase in walking ability demonstrated in these studies is impressive and cannot be fully explained. A multitude of possible mechanisms could be involved in bringing about the clinical effect; at present it is impossible to define their relative importance. CONCLUSIONS: The optimal exercise program should be supervised, performed regularly for at least 2 months, and of high intensity. Appropriate steps to guarantee patients' compliance must be taken. Even though many fundamental questions remain unanswered, it is justified to prescribe exercise therapy for intermittent claudication more generally than is realized in today's practice.

Clinical Trials as Topic↗
PubMed1994

The effect of medical exercise therapy on a patient with chronic supraspinatus tendinitis. Diagnostic ultrasound--tissue regeneration: a case study.

There is an increased focus on the importance of using active exercise regimes for treating dysfunction in the musculoskeletal system. However, we have little exact knowledge on how to dose and grade exercises or the effect of exercise on the regeneration of low metabolic tissue structures in vivo. This case study deals with both topics and emphasizes the use of exercise only when treating a 73-year-old patient with a 1-year history of shoulder pain. His evaluation indicated chronic supraspinatus syndrome. Different treatment methods had no effect, and medical exercise therapy was tried as a last resort. The patient recovered after 21/2 months with four treatments per week. Diagnostic ultrasound taken before treatment and after a 51/2-month period showed that the supraspinatus tendon had regenerated. These findings are encouraging, supporting the possibility of tendon repair with biomechanical stresses from exercise. To our knowledge, it has never been shown in vivo that it is possible for a low metabolic structure to regenerate using exercise only. Instead of having surgery with an uncertain outcome, today the patient is free of symptoms and living a normal life enjoying his sporting activities nearly 4 years after he finished the treatment.

Aged↗
PubMed2004

Evidence for exercise therapy in the treatment of chronic disease based on at least three randomized controlled trials--summary of published systematic reviews.

Final evidence for the overall benefits of exercise therapy in the treatment/rehabilitation of specific chronic disease comes from randomized controlled trials (RCTs). This paper summarizes current evidence that is based on a systematic review including data from at least three RCTs with contrast for exercise only. The quality of specific RCTs as well as the quality of systematic reviews varies, the newest ones usually being of higher quality than the older ones. The most consistent finding of the studies is that aerobic capacity and muscular strength of patients can be improved without causing detrimental effects on disease progression. Severe complications during these carefully tailored programs were rare. The treatment periods and follow-up times of the majority of the RCTs are of a too short duration to document group differences in disease progression. However, exercise reduces disease-related symptoms in many diseases, such as osteoarthritis, asthma and chronic obstructive pulmonary disorder. Also, RCTs studying patients with coronary heart disease as well as patients with heart failure show that all-cause mortality is lower in exercisers than in controls.

Chronic Disease↗