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At least 1,081 records · Page 60Linked to original sources
PubMed2000

The effect of exercise on percentile rank aerobic capacity, pain, and self-rated disability in patients with chronic low-back pain: a retrospective chart review.

OBJECTIVE: To determine the effect of 6 weeks of exercise on aerobic capacity and on measures of pain and disability in patients with chronic low-back pain (LBP). DESIGN: Retrospective chart survey. SETTING: A fitness facility in Saskatoon, Saskatchewan. PATIENTS: Patients with chronic LBP with an average duration of pain of 10 months. INTERVENTIONS: Six-week exercise program to improve aerobic capacity, muscular endurance, and flexibility. MAIN OUTCOME MEASURES: Data were collected from 258 charts of patients with chronic LBP treated from 1991 to 1994, including age, sex, and aerobic capacity. Patients completed the numeric ratings scale-101 (pain scale) and Oswestry LBP disability questionnaire. Pre- and postexercise data were compared for patients with LBP who completed the exercise prescription. Comparative data from the same time period were also collected from the records of individuals not treated for chronic pain (controls) and who had volunteered for a test of general fitness at the same facility. RESULTS: Both the control groups and the patients with LBP groups had statistically significant lower levels of aerobic capacity than a large group of Canadians tested in the early 1980s, the benchmark on which the age- and sex-matched standardized scores are based. The percentile rank of aerobic capacity for the patients with LBP was statistically significant and lower than those measures for the controls. Patients with LBP who completed the exercise therapy showed statistically significant improvement in percentile rank aerobic capacity, as well as statistically significant decreases in pain and disability scores. Aerobic capacity improved to a level above the norm. CONCLUSIONS: This study supports the hypothesis that exercise may be helpful in the management of chronic LBP.

Adult↗
PubMed1999

Immune responses to exercise in children treated for cancer.

BACKGROUND: Children treated for cancer commonly benefit physiologically from moderate aerobic training, but it is less clear if impairment of the immune system secondary to chemotherapy reduces the immunological tolerance of exercise relative to normal children. METHODS EXPERIMENTAL DESIGN: a case series. SETTING: hospital laboratory. PARTICIPANTS: six children aged 13-14 yr, successfully treated for acute lymphoblastic leukaemia and other types of neoplasms, were compared with 11 normal volunteer children. INTERVENTIONS: three of the sample underwent 12 weeks training at 70-85% of maximal heart rate; the remaining three provided initial and final test data only. MEASURES: mood state (Piers-Harris test), anthropometric data, maximal oxygen intake, response to 30 min exercise challenges at anaerobic threshold, and standard immune measures (differential count, cytolytic activity, and mitogen-induced lymphocyte proliferation) at rest, during and following submaximal exercise. RESULTS: A low maximal oxygen intake, excess of body fat, and high anxiety scores all improved with training. Children who were still receiving chemotherapy showed low resting CD3+, CD4+, CD8+, CD19+ and CD25+ counts and reduced PHA-induced proliferation. Acute exercise and training caused further impairment of immune responses, although changes remained insufficient to cause concern for health. CONCLUSIONS: Exercise therapy is beneficial following treatment of cancer, but should be prescribed individually, with a careful monitoring of immune responses.

Adolescent↗
PubMed1993

Benefits of a structured peripheral arterial vascular rehabilitation program.

A structured vascular rehabilitation program is effective in relieving pain, improving function, and promoting optimal wellness. The rehabilitation program at the Vascular Institute of Florida uses supervised in-house exercise as well as a home maintenance program with follow-up. Extensive education and information on life-style factors are provided to the patient to normalize blood fats, control high blood pressure, stabilize blood glucose levels, reduce adverse stress, prevent progression of illness, and potentially prevent the progression of atherosclerosis to the arterial periphery. Ongoing research of structured exercise therapy and atherosclerotic risk factor behavior modification practices is crucial to the continued growth of vascular nursing.

Aged↗
PubMedDate not supplied

Effects of resistive exercise on skeletal muscle in marrow transplant recipients receiving total parenteral nutrition.

Skeletal muscle protein loss occurs during marrow transplantation despite total parenteral nutrition. To determine if muscle atrophy could be minimized with exercise therapy, 30 patients undergoing marrow transplantation for acute leukemia completed a prospective randomized trial to receive: (1) no therapy (controls), (2) physical therapy thrice weekly (PT3), or (3) physical therapy five times weekly (PT5). Patients were studied through 35 days posttransplant. Muscle protein status and turnover was assessed by weekly nitrogen balance, and creatinine and 3-methylhistidine excretion. Results favored a muscle protein-sparing effect of exercise, as a significant decrease in creatinine excretion in controls only suggested muscle protein loss associated with inactivity. Changes in arm muscle area correlated with energy, but not protein intake. Large individual variation, inadequate nutritional support and differences in admission arm muscle area may have clouded these results.

Acute Disease↗
PubMed2003

Feasibility of exercise during treatment for multiple myeloma.

Fatigue and insomnia are problems for patients with cancer. Research findings show that aerobic exercise decreases cancer-related fatigue. Because patients with cancer who have skeletal muscle wasting may not obtain maximum benefit from aerobic exercise training, exercise programs may need to include resistance training. Thus far, testing exercise as an intervention for fatigue has focused on patients with breast cancer and excluded patients with bone metastasis. There is a need to test the feasibility and effectiveness of exercise for patients with other types of cancer and with bone involvement. The effect of aerobic and strength resistance training on the sleep of patients with cancer has not been tested. A pilot/feasibility study with a randomized controlled design was conducted to investigate home-based exercise therapy for 24 patients receiving high-dose chemotherapy and autologous peripheral blood stem cell transplantation as treatment for multiple myeloma. None of the patients injured themselves. Because of the small sample size in the feasibility study, the effect of exercise on lean body weight was the only end point that obtained statistical significance. However, the results suggest that an individualized exercise program for patients receiving aggressive treatment for multiple myeloma is feasible and may be effective for decreasing fatigue and mood disturbance, and for improving sleep.

Depression↗
PubMed2002

Efficacy of a short-course intensive rehabilitation program in patients with moderate-to-severe intermittent claudication.

BACKGROUND: Many rehabilitation programs for intermittent claudication include physical training for several months, since the outcome of short-course protocols is still unclear. The aim of this study was to evaluate the efficacy of a short course of exercise therapy in patients with moderate-to-severe intermittent claudication in terms of walking distance variations. METHODS: Twenty-six patients (males 88%, mean age 59 +/- 8 years, ankle-brachial index < or = 0.8 and < or = 0.5 before and after exercise respectively) were evaluated. Moderate-to-severe stenoses or occlusions were localized at color Doppler scanning of the abdominal aorta/iliac arteries and femoral/popliteal/tibial arteries in 15 and 31% of patients respectively, while in 54% of cases both the proximal and distal sites were involved. The initial and absolute claudication distances were recorded by means of the constant treadmill test (3 km/hour speed, 0% grade) at the time of presentation and after a short-course comprehensive rehabilitation program (4 week duration) including physical training, educational intervention, psychological support, and cardiovascular risk management. RESULTS: At the end of the program, 1 patient (4%) became asymptomatic (walked > 1000 m without pain). In 25 patients who still developed pain, the average increase in the initial claudication distance was 132% (from 75 to 174 m). Among these, 20 patients (77%) were still unable to complete the treadmill test due to maximal claudication pain, but the absolute claudication distance increased by 87% from 204 to 381 m (p < 0.05). No cardiovascular complication occurred during the study period. Major clinical variables failed to predict an unsatisfactory increase in walking capacity. CONCLUSIONS: Short-course training programs enhance the walking ability even in patients with moderate-to-severe intermittent claudication and seem to be well tolerated, supporting their widespread use in rehabilitation centers.

Aged↗
PubMed2004

[Exercise and nicotinic acid delayed action drug Enduracin: application in outpatient rehabilitation of patients with ischemic heart disease].

AIM: To evaluate efficacy of combined use of moderate exercise and nicotinic acid drug enduracin in patients with coronary heart disease (CHD) with moderate dyslipidemia (DE). MATERIAL AND METHODS: The effects of exercise therapy alone, enduracin alone and their combination on physical performance (PP), hemodynamics, blood lipid spectrum and clinical course of CHD were studied in 93 CHD patients with moderate DE. The results were evaluated clinically after 1-year treatment. RESULTS: Combined used of exercise and enduracin in CHD patients showed its efficacy manifesting in improvement of PP, hemodynamics at rest and exercise test, left ventricular systolic function, clinical course, reduction of DE. Enduracin + exercise appeared more efficient than their use in monotherapy. Enduracin monotherapy had a positive action on PP, arterial pressure and anginal attacks frequency. CONCLUSION: Enduracin is recommended as monotherapy and in combination with moderate exercise in outpatient rehabilitation and secondary prophylaxis of CHD patients with moderate dyslipidemia and angina pectoris to relieve myocardial ischemia under exercise, to raise PP, improve lipid composition of blood and prevent maladaptive left ventricular remodeling.

Ambulatory Care↗
PubMed1993

Diet and exercise and gemfibrozil therapy for the management of dyslipidemia: a CEN study. Clinical Experience Network.

BACKGROUND: Dyslipidemia constitutes a serious health problem that should be diagnosed and treated by the family physician. Little is known about the efficacy of typical dietary therapy for patients with abnormal cholesterol levels. This study was the first large prospective family practice evaluation of the effectiveness of diet-and-exercise therapy followed by a pharmacologic intervention for those patients who remained dyslipidemic. METHODS: Patients who met standard criteria for cardiovascular disease risk based on lipid analysis were enrolled in a typical 6-week physician-directed diet-and-exercise program. Those patients who were still dyslipidemic after that period were started on 12 weeks of pharmacologic treatment with gemfibrozil. RESULTS: Of the 2992 patients screened, 1193 were eligible for participation in the study. The diet-and-exercise program led to a modest change in lipid values (average decrease in total cholesterol of 4.1%). Only 2% of the patients achieved desirable levels of all lipid values. Seven hundred thirty-nine subjects qualified for further therapy and were treated with gemfibrozil. Seventy patients discontinued drug therapy because of adverse effects. Those who completed 12 weeks of pharmacologic therapy had an additional 5.4% reduction in total cholesterol, 3.9% reduction in low-density lipoprotein cholesterol, 30.6% reduction in triglycerides, and a 17.2% increase in high-density lipoprotein cholesterol. CONCLUSIONS: These findings suggest that in a typical clinical setting, a nonpharmacologic intervention of diet and exercise may not produce the desired overall lipid changes in the majority of dyslipidemic patients.

Cholesterol↗
PubMedDate not supplied

Hemodynamic responses during aerobic and resistance exercise.

PURPOSE: Resistance training has become an accepted part of cardiac rehabilitation programs. Because of the potential for a high afterload to have a negative impact on left ventricular function, there has been concern regarding the safety of resistance training for patients with congestive heart failure. METHODS: This study addressed this concern by studying 12 healthy volunteers, 12 patients with stable coronary artery disease, and 12 patients with stable congestive heart failure during upright cycling at 90% of ventilatory threshold, and during one set of 10 repeated leg presses, shoulder presses, and biceps curls at 60% to 70% of 1-repetition maximum. Left ventricular function was measured by echocardiography. RESULTS: The pattern of changes in heart rate, blood pressure, left ventricular ejection fraction, wall thickness, and left ventricular internal diameters was similar across all three groups of subjects, although there were large differences in absolute values. Despite elevations in diastolic and mean arterial pressures during resistance exercise, there was no evidence of significant rest-to-exercise deterioration in left ventricular function during leg press (ejection fraction, 60%-59%, 56%-55%, and 38%-37%), shoulder press (66%-65%, 59%-53%, and 38%-35%), or biceps curls (63%-58%, 53%-54%, and 35%-36%), as compared with cycle ergometry (63%-69%, 51%-57%, and 35%-42%) in the healthy control subjects, the patients with coronary artery disease, and the patients with congestive heart failure, respectively. CONCLUSIONS: Left ventricular function remains stable during moderate-intensity resistance exercise, even in patients with congestive heart failure, suggesting that this form of exercise therapy can be used safely in rehabilitation programs.

Aged↗
PubMed1994

[Scientific activity in the physical medicine and rehabilitation specialty in Germany, Austria and Switzerland].

On the background of similar analyses (American and European), this analysis was aimed at investigating the scientific activity in physical medicine and rehabilitation in Germany, Austria and Switzerland. A medline search covering 1 year was performed, all relevant publications were identified and evaluated according to the following criteria: address and speciality of author, subject (diagnostic or therapeutic), journal, and study design. The results show that the majority of publications does not originate from institutions of physical medicine and rehabilitation. Therapeutic subjects dominate with a predominance of exercise therapy. Their study design leaves room for improvement. This investigation might stimulate consequent and rigorous research in our field.

Austria↗
PubMed1978

[Indices of the sympathetic-adrenal and hypophyseal-adrenocortical system reactions in myocardial infarct patients during physical rehabilitation].

Changes in the content of hormones of the cortical and medullary layers of the adrenals in 40 patients with myocardial infarction were studied during physical rehabilitation. Increased activity of the sympathetico-adrenal and hypophyseal-adrenocortical systems after therapeutical gymnastics was revealed. The greatest shifts in all indices were noted in the first and fourth movement regimens. Changes in the blood hormone content were most obvious. The importance of studying hormones during rehabilitation of patients by means of exercise therapy is discussed. Fluorometry was employed in tests for adrenal hormones in blood and urine and for determining their concentration.

Adrenal Glands↗
PubMed2004

[The practice guideline 'Peripheral vascular disease' (first revision) from the Dutch College of General Practitioners: a response from the perspective of general practice].

The practice guideline 'Peripheral vascular disease' (PVD) from the Dutch College of General Practitioners will certainly be of benefit to the Dutch general practitioner. Its limited set of simple diagnostic steps can help the general practitioner to assess or exclude PVD in patients with intermittent claudication. The inclusion of a pretest-posttest probability scheme enhances a clear diagnostic process. This guideline differs from the previous one in one important aspect. This guideline deals not only with the specific management of peripheral arterial disease but also with the management of cardiovascular risk in general. In this way the guideline follows the recently changed international attitude reflected in the European Guidelines on cardiovascular disease prevention. Smoking cessation and exercise therapy continues to be the cornerstone as well as the stumbling block of management of most cases of PVD in general practice; a challenge for every general practitioner.

Exercise Therapy↗
PubMed2005

Therapeutic exercise for knee osteoarthritis: considering factors that may influence outcome.

While exercise has been shown to be beneficial for reducing pain and improving physical function in individuals with knee osteoarthritis (OA), there are still individuals who do not always respond well to this treatment approach. There are a number of factors that have been shown to influence either the degree of disability and/or the progression of disease in individuals with knee OA. These factors include quadriceps inhibition or activation failure, obesity, passive knee laxity, knee alignment, fear of physical activity and self efficacy. It may be possible that varying levels of these factors might also interfere with an individual's ability to participate in an exercise or physical activity program or minimize the benefits that can be achieved by such programs. This paper examines the influence of these factors on physical function and their potential for altering the outcome of exercise therapy programs for individuals with knee OA. Implications and suggestions for potential adjunctive interventions to address these factors in future research and clinical practice are also discussed.

Disease Progression↗
PubMed1987

[The role of aerobic capacity and efficiency in determining the intensity of training therapy and physical rehabilitation in chronic ischemic heart disease].

A number of values based on ergospirography results determining and limiting physical aerobic working capacity were studied by way of comparison in 35 patients with angina of effort with different threshold oxygen consumption. It was first established that aerobic capacities in chronic CHD were characterized not only by the power or cardiorespiratory productivity but also by the efficacy of the oxygen mechanism of energy production and realization of aerobic potentialities unrelated to one another. The informative value and usefulness of values of the threshold of anaerobic metabolism for determination of the optimum intensity of exercise therapy were revealed for expanding the aerobic capacities of patients with chronic CHD.

Adult↗
PubMed2001

The effects of physical therapy in Parkinson's disease: a research synthesis.

OBJECTIVE: To present a critical review and meta-analysis of studies evaluating the effects of physical therapy in patients suffering from Parkinson's disease (PD), in terms of neurologic signs, activities of daily living (ADLs), and walking ability. DATA SOURCES: Articles published from 1966 to May 1999 were compiled by means of MEDLINE, Cochrane register of controlled trials, and CINAHL using combinations of the key words Parkinson's disease, exercise, exercise therapy, physical therapy, and group training. References presented in relevant publications were also examined. Articles written in English, German, or Dutch were included. STUDY SELECTION: Studies had to meet the following selection criteria: (1) patients with PD were included in the intervention study, (2) the effects of physical therapy (PT) were evaluated, (3) the study could be classified as true or quasi-experiment, and (4) the study was published in a journal or book. DATA EXTRACTION: Two reviewers assessed independently the methodologic quality of the data of each included study. One reviewer extracted relevant meta-analysis data. DATA SYNTHESIS: For each outcome measure the estimated effect size and the summary effect size (SES) were calculated, using fixed (ie, Hedges's g) and random effects models. The meta-analysis resulted in a significant homogeneous SES with regard to ADLs (.40; confidence interval [CI] = .17-.64) and stride length (.46; CI = .12-.82). The SES with regard to walking speed showed a significant heterogeneous SES, which remained significant after applying a random effects model (.49; CI = .21-.77). The SES with regard to neurologic signs was not significant (.22; CI = -.08 to .52). The small number of studies included and the shortcomings of the methodologic quality of these studies, however, bias the results of the present study. CONCLUSIONS: The results of the present research synthesis support the hypothesis that Parkinson patients benefit from PT added to their standard medication.

Activities of Daily Living↗
PubMed1997

Effect of training program based on anaerobic threshold in the early phase after acute myocardial infarction.

We devised a new physical training program on the basis of anaerobic threshold for rehabilitation in the early phase of acute myocardial infarction. Forty-four patients were divided into two groups, control and training. We measured the left ventricular ejection fraction using nuclear stethoscopy during the treadmill test and calculating radioactive cardiac output. In the training group, anaerobic threshold and exercise time to the anaerobic threshold point were significantly increased, and stroke volume at rest measured by the dye dilution method increased significantly. Radioactive cardiac output during exercise also increased after the exercise therapy. These results indicate that the rehabilitation program consisting of physical training based on the anaerobic threshold is effective.

Adult↗
PubMed1981

Exercise training in post-myocardial infarction patients: comparison of results with high risk coronary and post-bypass patients.

Measurements were made before and following 3 to 6 months of exercise therapy in 24 patients who had had myocardial infarction (group MI), in 16 patients having positive test and/or multiple risk factors for coronary heart disease (Group CHD), and in 10 patients who had undergone coronary artery bypass surgery (Group CAB). All patients were men and had a mean age of 51.6 years. Exercise training was conducted 3 times per week for a duration of 20 to 40 minutes per session. Walking and jogging both on a treadmill and a track and stationary cycling were used as training modalities. A paired t test was used to determine significance of differences between pre- and post-treatment results for each group. Percent body fat decreased in each group and aerobic capacity increased significantly (p less than 0.01) in all 3 groups (6.2 ml/kg . min-1 in MI, 7.0 ml/kg . min-1) in CHD, and 8.0 ml/kg . min-1 in CAB). Changes in other exercise related variables were found not to be statistically significant. Analysis of variance yielded no difference among the 3 groups for any of the variables evaluated. The results clearly indicate that the trainability of the MI patient is equivalent to that of the cardiac patient who has not suffered an infarct and to that of the post-CAB patient.

Adult↗