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PubMedDate not supplied

[Exercise training of lower limbs in pulmonary rehabilitation of COPD patients].

Pulmonary rehabilitation is an efficient treatment method of COPD patients, recommended by GOLD programme, beginning with stage II. We followed the role of exercise training of lower limbs in improving exercise capacity and quality of life in medium and severe forms of COPD. Depending on COPD stadium, patients were included in an endurance or interval programme. We performed six-minute walking test and a QOL test before and after the programme. We observed a significant improvement of distance covered in six-minute walking test and of quality of life in these patients. Exercise training elicits important clinic benefits: improves exercise performance, quality of life and relieves symptoms in COPD.

Exercise Therapy↗

PubMed2006

Excessive breathlessness in patients with diastolic heart failure.

OBJECTIVES: To establish the prevalence of preserved left ventricular (LV) systolic function (PSF) in 435 consecutive symptomatic patients referred to a heart failure clinic and to examine their ventilatory response to exercise when compared with 134 control volunteers. METHODS: 216 (50%) patients had systolic heart failure (SHF) (ejection fraction < 45%). 51 (11%) had an immediately apparent alternative causes of breathlessness and 168 (39%), with no obvious other cause of breathlessness, were divided into those with PSF and diastolic dysfunction (DD) (PSF(DD); n = 113 or 26% of referrals) and those without DD (PSF(N); n = 55 or 13% of referrals). The controls were divided into those with (C(DD); n = 32) and those without (C(N); n = 102) echocardiographic evidence of DD. RESULTS: Patients with SHF had lower peak oxygen consumption (pVo(2)), steeper slope of minute ventilation (Ve) to carbon dioxide production, lower exercise time and shorter 6 min walk test than PSF patients and controls. PSF(DD) patients had lower pVo(2), exercise time and 6 min walk test than C(DD), although their echocardiograms were not different. Exercise capacity did not differ between PSF(DD) and PSF(N) patients. The slope relating Ve to symptoms (Borg/Ve slope) was less steep in those with SHF than in PSF(DD) (0.17 (0.04) v 0.20 (0.08), p < 0.05) and in PSF(N) (0.19 (0.10), p < 0.05), implying greater symptoms of breathlessness for a given level of Ve. Both PSF groups had a steeper slope than C(DD) (0.14 (0.09), p < 0.05 for both comparisons). CONCLUSIONS: Patients with PSF have exercise tolerance intermediate between that of patients with SHF and controls. Exercise tolerance is similar in PSF(DD) and PSF(N). Both groups have worse exercise tolerance than C(DD). PSF(DD) and PSF(N) patients seem to experience a greater awareness of Ve than C(DD) and patients with SHF.

Aged↗

PubMed1998

A step in the right direction: assessing exercise tolerance in cystic fibrosis.

Exercise tolerance may be reduced in patients with cystic fibrosis, but it is not always possible to predict this from standard lung function measurements. Formal exercise testing may, therefore, be necessary, and the test should be simple and readily available. We have developed a "3-minute step test" and compared it with the standard 6-minute walking test. Subjects stepped up and down a 15-cm-high single step at a rate of 30 steps per minute for 3 minutes. The effect of the step test on spirometry was tested first in 31 children with CF (mean age, 12.0 years), who had a mean (range) baseline forced expired volume in 1 second (FEV1) of 64% (18-94%) of predicted values. The step test was then compared with the standard 6-minute walk in a further 54 patients with cystic fibrosis (mean age, 12.5 years), with mean (range) baseline FEV1 of 61% (14-103%) of predicted values. Outcome measures were minimum arterial oxygen saturation (SaO2), maximum pulse rate, and the modified Borg dyspnea score. Post-step test spirometry showed mean (95% CI) changes of -1.1% (-6.0 + 3.9%) for forced vital capacity, of -1.6% (-4.2 + 1.1%) for FEV1, and +0.25% (-2.8 + 3.3%) for peak expiratory flow, although 5/31 children showed >15% drop in one or more parameters. The step and walk tests both produced significant changes (P < 0.0001) in all outcomes, with a mean (range) minimum SaO2 of 92% (75-98%) versus 92% (75-97%), a maximum pulse rate of 145 b.p.m. (116-189) versus 132 (100-161), and a Borg score of 2.5 (0-9) versus 1.0 (0-5), respectively. Comparison of the two tests showed that the step test increased breathlessness (mean change Borg score, 2.3 vs. 0.8; P < 0.0001) and pulse rate (mean change, 38% vs. 24%, P < 0.0001) significantly more than the walk, whereas the decrease in SaO2 was similar (mean change, -2.9% vs. -2.6%; P = 0.12). Some patients with a significant drop in SaO2 (>4%) would not have the decrease predicted from their baseline lung function. Reproducibility for the two tests was similar. The step test is quick, simple and portable, and is not dependent on patient motivation. Although the step test is more tiring, its effect on SaO2 is similar to the 6-minute walking test. It is a safe test that may prove to be a valuable measure of exercise tolerance in children with pulmonary disease, although longitudinal studies are now needed.

Adolescent↗

PubMed2000

Measuring physical strain during ambulation with accelerometry.

PURPOSE: To study the feasibility of ambulatory accelerometry in the evaluation of physical strain in walking at different speeds and different levels of economy. METHODS: Twelve able-bodied subjects performed a walking test on a treadmill with increasing walking speed. After a 6-wk period, these measurements were repeated, with an additional test of perturbed walking. Motility (the intensity of body segment movements, measured with accelerometry), heart rate, and oxygen uptake were simultaneously recorded. Feasibility was determined by comparing motility with percentage heart rate reserve (%HRR), using oxygen uptake (VO2) as reference. The relation with oxygen uptake, the sensitivity to change when walking speed increased and gait was perturbed, and intrasubject and intersubject variability were studied. RESULTS: Walking with increasing walking speed resulted in a higher pooled r2 value (0.91) and a lower residual standard deviation (1.44 mL x kg(-1) x min(-1)) for the motility-VO2 relation than for the %HRR-VO2 relation (0.84 and 1.92 mL x kg(-1) x min(-1), respectively). Furthermore, the motility-VO2 relation for this part of the protocol showed lowest interindividual differences. The sensitivity to changes due to an increase in walking speed, and the test-retest reliability were the highest for motility. Walking with a brace resulted in a lower pooled r2 value for the motility-VO2 relation than for the %HRR-VO2 relation (0.31 and 0.67, respectively); the sensitivity to changes due to walking with a brace was lower for motility than for %HRR. CONCLUSION: Compared with heart rate, accelerometry allows accurate measurement with little error in any able-bodied individual, without the need for individual calibration. The response of motility to changes and differences in economy in patients requires further study.

Acceleration↗

PubMed2007

Assessment of physical fitness in adults by field testing supported by the specific software for personal computer based use.

Physical inactivity is the second most important risk factor for development of cardiovascular diseases. Various field tests were developed for assessment of the fitness in general population. We aimed to assess the applicability and effectiveness of the specific software for UKK 2-km walking test data management. Descriptive results and statistical analysis on physical fitness of 383 adults are presented. The UKK 2-km walking test could be used as a feasible alternative for measurement of cardiovascular fitness. The test was integrated to exercise related health promotion programme, and widely available information technologies will be used for data management.

Adult↗

PubMed2003

[Validation of the chronic respiratory questionnaire in Chilean patients with chronic airflow limitation].

BACKGROUND: Chronic respiratory diseases are an important problem in Chile, causing disability and worsening the quality of life. AIM: To validate the Spanish version of the Chronic Respiratory Questionnaire (CRQ) to be used in Chilean population. MATERIAL AND METHODS: The CRQ was applied to 38 patients with chronic respiratory diseases. At the same time the functional and physiologic status of patients (the 6 Minute Walking Test and spirometry) was assessed in an independent and blinded fashion. RESULTS: CRQ scores were associated with 6 Minute Walking Test and forced expiratory volume results (p < 0.01 adjusted by age, sex and smoking). The Internal Consistency analysis showed a Cronbach alpha between 0.60 and 0.89. CONCLUSIONS: Considering the construct validation as an on-going process, the present results give additional evidence supporting the use of the CRQ in Chilean population to evaluate the health-related quality of life of patients with chronic respiratory diseases.

Adult↗

PubMed2002

[Physical training as treatment of reduced functional ability in frail 75+ year-olds living at home. A randomized intervention study in general practice with technological assessment elements].

INTRODUCTION: The aim of this study was to establish the value of physical training as a treatment of reduced physical ability in frail, elderly patients living at home. MATERIAL AND METHODS: 46 community-dwelling frail elderly patients (> 74 years) participated in a randomised, controlled intervention study. The intervention group was transported to training, whilst the control group was not activated. All had their physical functional ability determined using SF-36, Berg's Balance Scale, 10 m walking test and muscle strength test. RESULTS: The intervention group had a significant improvement in functional ability measured by means of Berg's Balance Scale, walking test, muscle strength test and SF-36 (p < 0.01) compared with the control group. The average cost per patient was estimated at 121 DKK per training session, equivalent to 1452 DKK for a 12-week training period. DISCUSSION: The establishing of a "multi-component-training" as a treatment offer, to which general practitioners could refer their patients, would involve some costs, but savings due to reduced nursing care can be expected.

Activities of Daily Living↗

PubMed1997

The effect of reduced gravity on the kinematics of human walking: a test of the dynamic similarity hypothesis for locomotion.

To gain insight into the basic principles that govern the biomechanics of locomotion, we investigated the effect of reduced gravity on walking kinematics. We hypothesized that humans walk in a dynamically similar fashion at combinations of speed and simulated gravity that provide equal values of the Froude number, v2/gLleg, where v is forward speed, g is gravitational acceleration and Lleg is leg length. The Froude number has been used to predict the kinematics and kinetics of legged locomotion over a wide range of animal sizes and speeds, and thus provides a potentially unifying theory for the combined effects of speed, size and gravity on locomotion biomechanics. The occurrence of dynamic similarity at equal Froude numbers has been attributed previously to the importance of gravitational forces in determining locomotion mechanics. We simulated reduced gravity using a device that applies a nearly constant upward force to the torso while subjects walked on a treadmill. We found that at equal Froude numbers, under different levels of gravity (0.25g-1.0g), the subjects walked with nearly the same duty factor (ratio of contact time to stride time), but with relative stride lengths (Ls/Lleg, where Ls is stride length) that differed by as much as 67 %, resulting in the rejection of our hypothesis. To understand the separate effects of speed and gravity further, we compared the mechanics of walking at the same absolute speed at different levels of gravity (0.25g-1.0g). In lower gravity, subjects walked with lower duty factors (10 %) and shorter relative stride lengths (16 %). These modest changes in response to the fourfold change in gravity indicate that factors other than gravitational forces are the primary determinants of walking biomechanics.

Biomechanical Phenomena↗

PubMed2001

Exercise tolerance in children with cystic fibrosis undergoing lung transplantation assessment.

The aim of this study was to compare the 6-min walk test against the recently developed 3-min step test, as measures of exercise tolerance in children with moderate to severe cystic fibrosis (CF) lung disease referred for lung transplantation assessment. Twenty-eight children with CF (16 girls, 12 boys), with a mean age of 13.7 yrs (range 7.2-17.8 yrs) and mean forced expiratory volume in one second of 34% predicted (range 17%-67%) were recruited. All subjects performed both the 6-min walk and 3-min step-tests. Outcome measures were maximum rise in heart rate (HR), and maximum fall in arterial oxygen saturation (Sa,O2). There was no significant difference in resting HR or Sa,O2 prior to starting the two tests. Both step and walk tests produced significant rises in median HR (from 114-149 min(-1), p<0.0005, and 119-138 min(-1), p<0.0005, respectively) and significant falls in Sa,O2 (both from 94-92%, p<0.0005). The step test produced a significantly greater percentage rise in HR (30% versus 18%, p<0.0005) and a significantly greater percentage fall in Sa,O2 (4% versus 2%, p=0.002). Bland-Altman analysis gave wide 95% limits of agreement (10.7-29.3% for rise in HR, -2.14.6% for fall in Sa,O2). The step test was well tolerated. The 3-min step test produced a greater fall in Sa,O2 and a greater rise in HR than the 6-min walk test in children with moderate to severe CF lung disease. It may be of value when assessing a child's suitability for lung transplantation.

Adolescent↗

PubMed1995

An approach in the assessment of pacing hemodynamics: a comparison of VVI and DDD.

Previous methods for assessment of pacemaker hemodynamics have been limited to a rigid hospital environment. An alternative is the ambulatory ventricular function monitor (C-VEST) that, with a single injection of technetium-99m, permits the continuous measurement of relative ejection fraction (EF) and cardiac output (CO) during the activities of daily living. A study of reproducibility and a comparison of dual chamber (DDD) and fixed rate ventricular (VVI) pacing are presented. Reproducibility was assessed in six patients (4 males; mean age 58, range 27-78 years) with a mean EF of 48.5% (range 34%-62%) and DDD pacemakers, implanted for conduction abnormalities. In addition, 11 patients (7 males; mean age 55.5, range 34-75 years) with a mean EF of 48.5% (range 34%-65%), chronic complete heart block, and DDD pacemakers were used for the comparative study. After an initial multigated scan, the monitor was positioned over the left ventricle and kept in place with the plastic C-VEST. The patients undergoing the reproducibility study performed three shuttle walking tests with 20 minutes of rest in between. The patients in the comparative study were randomized to either VVI or DDD mode and performed one shuttle walking test in each pacing mode. The results confirmed that the C-VEST produces reproducible results with no significant difference in peak CO between the three shuttle walks. In addition, it confirmed previous hemodynamic studies showing that DDD pacing was superior to VVI pacing both at rest (P < 0.004) and at exercise (P < 0.002). These findings show the C-VEST to be an extremely useful tool for the hemodynamic assessment of pacemaker patients.

Adult↗

PubMed2006

Six-minute walk distance in healthy Singaporean adults cannot be predicted using reference equations derived from Caucasian populations.

OBJECTIVES: The 6-min walk test (6MWT) is commonly used to assess the functional exercise capacity of individuals with cardiopulmonary disease. Recent studies have established regression equations to predict the 6-min walk distance (6MWD) in healthy Caucasian populations; however, regression equations have yet to be established for the Singaporean population. The aim of this study was to determine 6MWD in healthy Singaporeans and identify contributors to 6MWD in this population. We also compared measured 6MWD with predicted 6MWD from two regression equations derived in Caucasian subjects. METHODOLOGY: Thirty-five healthy subjects (32 Chinese, 16 men) aged between 45 and 85 years performed three walking tests using a standardized protocol. 6MWD was defined as the greatest distance achieved from the three tests. Heart rate (HR) was recorded each minute during the 6MWT. Other measurements included age, height, leg length, smoking history and self-reported physical activity. RESULTS: 6MWD was 560 +/- 105 m and was not significantly different between men and women (P = 0.19). 6MWD was related to age (r = -0.36, P = 0.03), height (r = 0.35, P = 0.04), leg length (r = 0.38, P = 0.02) and the maximum HR achieved on the 6MWT when expressed as a percentage of the predicted maximum HR (%predHRmax, r = 0.73, P < 0.001). Stepwise multiple regression analysis showed that age, height, weight and %predHRmax were independent contributors (P < 0.01) to 6MWD, explaining 78% of the variance. Predicted 6MWD using regression equations derived from Caucasian subjects exceeded measured 6MWD by more than 75 m (P < 0.001). CONCLUSIONS: This is the first study to report 6MWD for healthy Singaporeans aged 45-85 years. The regression equation developed in this study explained 78% of the variance in 6MWD. Published equations derived from Caucasian subjects overestimate 6MWD in Singaporean Chinese.

Aged↗

PubMed2006

Creatine supplementation improves muscle strength in patients with congestive heart failure.

BACKGROUND: Both, cardiac and skeletal muscle creatine levels are depressed in patients with congestive heart failure (CHF). Oral supplementation of creatine (Cr) could increase physical performance in healthy volunteers. We therefore hypothesized that oral creatine supplementation improves skeletal muscle strength, quality of live and symptom-limited performance in patients with CHF. METHODS: In a double-blind, placebo-controlled and crossover-designed study, 20 patients suffering from congestive heart failure more than 6 months and a peak oxygen uptake (peak VO2) below 20 ml/min/kg received 4 x 5 g Cr daily vs. placebo for 6 weeks and were crossed over for the following 6 weeks. Peak VO2, VO2 at the anaerobic threshold (VO2AT), ejection fraction (EF), distance in 6-minute-walk-test (6 min W), and muscle strength (Modified Sphygmomanometer (MS)) were determined at baseline, after 6, and after 12 weeks. Dyspnoea after 6-minute-walk-test was measured using the Borg Scale. Quality of live was assessed with the Minnesota Living with Heart Failure Questionnaire (MLHFQ). RESULTS: 13 of 20 Patients finished the study. After 6 weeks of creatine supplementation there was a significant increase in body weight and muscle strength compared to baseline and placebo (p < 0.05). However, there was no significant change in peak VO2, VO2AT, walking distance, quality of life assessment and EF. CONCLUSION: Short-term creatine supplementation inaddition to standard medication in patients with CHF leads to an increase in body weight and an improvement of muscle strength. This effect is restricted to the time of supplementation.

Aged↗

PubMed1975

Physiological parameters related to running performance in college trackmen.

Submaximal and maximal oxygen consumption (VO2) and heart rate (HR) were correlated with running performance in events ranging from 100 yards to 2 miles, using as subjects 20 members of a college track team. In the first of two studies (n=11) a multi-stage walking test was used to determine VO2 and HR. Max VO2 expressed in ml/kg/min, was significantly related to 1 mile run performance but not to any of the other runs. Submaximal HR was significantly related to performance in both the 1 mile and 2 mile runs. Correlations between these physiological parameters and performance in the 220, 440, and 880 yard runs were nonsignificant. Multiple R's using max VO2 (ml/kg/min) and submaximal H were .758 and 9671, respectively, for the 1 and 2 mile runs. In study two (n=9) a running test for VO2 and HR was used, which resulted in a mean max VO2 about 7 ml higher than than elicited in the walking test, implying that for trained runners a running test was a more valid test of aerobic power. Marked relationships were found between body weight and performance, positive for the 100 yard dash and negative for the 2 mile run. Submaximal HR was again significantly related to performance in the 1 and 2 mile runs. Max VO2 was positively related to 2 mile performance and negatively related to 100 yard dash performance. Multiple R's using max VO2 and submaximal HR were .799 and .925 for the 1 and 2 mile runs, respectively. Using submaximal HR and weight the multiple R's were .777 and .945, showing that these two can account for a large amount of the variance in distance running performance. In neither study was submaximal VO2 significantly related to running performance.

Body Weight↗

PubMed2006

Home respiratory muscle training in patients with chronic obstructive pulmonary disease.

OBJECTIVE AND BACKGROUND: The benefits of inspiratory muscle strength training in decreasing symptoms, disability or handicap of patients affected by COPD are not well established. The objective of this study was to assess the efficacy of the constant use of a new flow-volumetric inspiratory exerciser, named Respivol, in improving respiratory functional parameters in COPD patients. METHODS: Twenty consecutive ambulatory patients affected by COPD were enrolled. Each patient was assessed, before and after 3 and 6 months inspiratory exercise with Respivol, for the following clinical parameters: maximal inspiratory pressure, maximal expiratory pressure, dyspnoea grade, quality of life by a self-administered St George questionnaire and a 6-min walking test. After a brief progressive ambulatory training programme, inspiratory exercise with Respivol was performed at home for 6 months. All patients used Respivol together with medical treatment. RESULTS: Maximal inspiratory pressure and maximal expiratory pressure values were significantly increased after 3 and 6 months of exercise. Dyspnoea grade was significantly reduced and the 6-min walking test showed an increase in effort tolerance, after 6 months of home training. Quality of life assessment showed an improvement, associated with a decrease of respiratory disease symptoms. CONCLUSIONS: Inspiratory muscle strength training with Respivol seems to be efficient in reducing symptoms and improving quality of life in adults with COPD.

Aged↗

PubMed1986

Two modes of analgesic action of aspirin, and the site of analgesic action of salicylic acid.

The analgesic activities of aspirin and salicylic acid were investigated by means of the lame-walking test in adjuvant-induced hind-paw-oedematous rats. Aspirin showed ca. 4 times more potent analgesic activity than did salicylic acid in the lame-walking test. The analgesic activity of aspirin was decreased to the level of that of salicylic acid by injection of prostaglandin E2 into the inflamed tissue. The analgesic activity of salicylic acid was not decreased by the same treatment. Salicylic acid inhibited the lame-walking reaction when given intracerebroventricularly. On the other hand, salicylic acid did not inhibit the lame-walking reaction by topical administration on the inflamed hind paw. However, with topical administration, salicylic acid inhibited the carrageenin-induced hind-paw oedema. These results suggest that aspirin has two analgesic effects on the inflammatory pain; one may be the inhibition of prostaglandin biosynthesis by acetylation of cyclo-oxygenase, and the other may be an action due to salicylic acid. Salicylic acid may produce its analgesic action mainly via a central mechanism.

Analgesia↗

PubMed1998

The effect of walking aids on exercise capacity and oxygenation in elderly patients with chronic obstructive pulmonary disease.

BACKGROUND: high walking frames may improve exercise capacity in young patients with chronic obstructive pulmonary disease (COPD). We have assessed the effect of Zimmer, rollator and gutter frames on 6-min walking distance and on arterial oxygenation during exercise in elderly patients with COPD. METHODS: 27 out-patients (15 men) aged 70-82 (mean 75) years were recruited. Exclusions comprised: COPD exacerbation or oral steroid use within 6 weeks, confusional state, participation in a pulmonary rehabilitation programme and exercise limitation by other diseases. Subjects completed 6-min walk tests unaided and with the three frames on four separate days in random order 30 min after nebulized salbutamol (5 mg) and ipratropium (0.5 mg) and were accompanied by an investigator blinded to results of all other walk tests undertaken. Oxygen saturation (SaO2) was monitored by finger probe during exercise. Grouped t-tests were used to compare distances and reductions in SaO2. RESULTS: Unaided, the mean (SEM) 6-min walk distance was 210 (16) m and fall in oxygen saturation was 6.0 (1.1)%. Use of a rollator frame did not significantly affect either of these values. Using the Zimmer frame reduced the mean distance to 165 (13) m (t=5.2, P < 0.001 vs unaided walk) with an SaO2 fall similar to that recorded during the unaided walk. Using the gutter frame increased the mean distance to 234 (150) m (t=3. 1, P=0.004 vs unaided walk) and reduced the fall in SaO2 to 3.7 (0.8)% (t=2.3, P=0.03 vs unaided walk). CONCLUSIONS: gutter frames improve exercise capacity and SaO2 during exercise in elderly COPD patients who remain symptomatic on optimal therapy, whereas unwheeled Zimmer frames have a deleterious effect in such patients.

Aged↗

PubMedDate not supplied

The effects of a pulmonary rehabilitation program on pulmonary function tests and exercise tolerance in patients with Parkinson's disease.

The effects of exercise training, as a part of a pulmonary rehabilitation program, on pulmonary function tests and exercise tolerance have not been clarified in patients with Parkinson's disease (PD). This study compares the results of pulmonary function test parameters and exercise tolerance in individuals with and without PD. It also compares the results of pulmonary function test parameters, exercise tolerance and subjective ratings of perceived exertion (RPE) between entry to and the end of exercise training program in patients with PD. Nine patients with PD and 9 age-matched healthy controls participated in the study. Pulmonary function tests and a six-minute walk test were performed in subjects with and without PD, and the Borg RPE scale was applied to patients with PD at the beginning of the study. After the exercise training program, all parameters were recorded again in patients with PD. Statistically significant differences were observed between the groups in some of the pulmonary function test parameters and in exercise tolerance. After the training program, we observed improvement in some of the pulmonary function test parameters, exercise tolerance, and RPE in patients with PD.

Adult↗

PubMedDate not supplied

Student-led exercise sessions yield significant fitness gains for Alzheimer's patients.

At a time when they are losing skills in virtually all arenas of life, persons with Alzheimer's disease can experience significant, esteem-building achievements in physical fitness and mood through supervised participation in an exercise program. The effects of physical exercise plus cognitive and social stimulation on persons with early stage Alzheimer's disease were assessed in a longitudinal study. Twenty-four such individuals, aged 54 to 88 at program entry, participated in 16 to 20 exercise sessions and 10 community activity sessions per semester for two to eight semesters. Half of the weekly exercise sessions included memory and language stimulation activities. Students, supplemented by family caregivers, supervised the sessions. Exercise sessions consisted of flexibility, balance, aerobic, and weight resistance activities. Preparticipation and semiannual post-testing of aerobic fitness and duration and upper and lower body strength was done. Highly significant fitness gains (p < .001) were achieved in the six-minute walk test, upper and lower body strength, and duration of aerobic exercise. Five participants, aged 86 to 91, completed six to eight semesters and were doing 27 to 45 minutes of aerobics per session at program's end. Five participants scored within the normal range for age-matched healthy active adults on the six-minute walk test at baseline. Nine others achieved and three exceeded the normal range during treatment. Cognitive decline was slowed and mood improved. First-year cognitive outcomes have been published elsewhere. An article reporting final cognitive outcomes is in preparation; Outcome data is summarized on the project website: www.u.arizona.edu/ ~sarkin/elderrehab.html. The benefits of physical exercise can be made available at nominal cost to Alzheimer's patients and other elderly persons by using students to provide transportation, supervision, and the motivational support that is key to exercise adherence. Further research is needed to determine the relative contributions of each program component to the positive outcomes.

Affect↗