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Prescription of home exercise therapy for cardiovascular fitness.

The importance of regular exercise activity in health maintenance has been continually emphasized. Family physicians, as the primary health care providers to many individuals, need a protocol for exercise prescription that is both practical for the physician to administer and reasonable for the patient to understand and follow. A practical protocol applicable to individuals of varying cardiac states is presented.

Angina Pectoris↗

[Cardiac exercise tolerance of infarct patients in exercise therapy].

UNLABELLED: 92 female patients with myocardial infarction were divided into three exercise groups of 25 W, 50 W and 75 W according to their symptom-limited working capacity and examined during bicycle ergometer training. Exercise tolerance, training heart rate and arterial lactic acid were analyzed. RESULTS: 1. Increase in maximal working capacity corresponds to a decrease in limiting cardiac symptoms, or an increase of limiting symptoms, e.g., in tired leg muscles. 2. Intensity of training (as a percentage of maximal symptom-limited work capacity) is 55 +/- 21%, 73 +/- 15%, and 90 +/- 8% for groups of 25, 50 and 75 W (p less than 0.05) respectively. 3. Training heart rate and lactic acid increase significantly proportional to the increase of work capacity. 4. In all three exercise groups, training heart rate corresponds to about 84% maximal heart rate measured at maximal working capacity. 5. Mean maximal lactic acid level is at 3.18 +/- 0.97 mmol/l for the whole exercise group on 75 W. Within this group, only a small subgroup of seven women, who were limited in maximal working capacity by tired leg muscles, reached the so-called anaerobic threshold of 4 mmol/l lactic acid. 6. Female patients greater than or equal to 60 years have partially significant higher mean lactic acid levels for the same exercise load as women less than or equal to 59 years. CONCLUSION: Gender specific differences in performance in women and the cardiac situation in female patients were considered on the basis of symptom-limited performance and body-weight-related physical training, regulated by individual training heart rate.

Angina Pectoris↗

Six- and 24-month follow-up of pool exercise therapy and education for patients with fibromyalgia.

OBJECTIVE: To follow patients with fibromyalgia six and 24 months after they finished a six-month treatment programme. The programme comprised pool exercise therapy, adjusted to the patients' limitations, and education based on their health problems. METHODS: Twenty-six patients were examined six and 24 months after the completion of the treatment programme with the Fibromyalgia Impact Questionnaire (FIQ), SF-36, the 6-minute walk test, and the Grippit measure. The values obtained at the follow-up examinations were compared with the baseline and post-treatment values. RESULTS: As compared with baseline, symptom severity (FIQ, SF-36), physical function (FIQ, SF-36, 6-minute walk test) and quality of life (SF-36) still showed improvements six months after the completion of treatment (p <0.05). Pain (FIQ, SF-36), fatigue (FIQ, SF-36), walking ability, and social function (SF-36) still showed improvements 2 years after the completion of the programme as compared with the baseline values (p < 0.05). No significant changes were found for these variables, when the values obtained at the two follow-up examinations were compared with those of the post-treatment examination. CONCLUSIONS: Improvements in symptom severity, physical function and social function were still found six and 24 months after the completed treatment programme.

Female↗

Osteoporosis: exercise therapy, pre- and postdiagnosis.

The idiopathic, accelerated phase of bone loss associated with postmenopausal and surgically induced menopausal women is rapidly becoming a large public health problem due to the great expense involved in caring for those with vertebral, hip and distal radial fractures. The method of therapy with the least incidence of ill effects is physical exercise. This is a valid, appropriate alternative, but is, however, the most overlooked and unappreciated form of treatment. Studies have shown that bone mineral content can be increased, not just maintained as with the other forms of therapy. The question may then be asked: what about exercise therapy for women already clinically diagnosed? Would exercise increase their risk of fracture, and if not, what forms of exercise would be the most effective? Although osteoporosis prevention and treatment is a multifactorial process, it appears that extension exercises are one form of physical activity necessary to prevent further fracture once it has occurred. A review of the literature will address this conservative noninvasive approach to preventive and ongoing treatment of involutional osteoporosis.

Chiropractic↗