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PubMed1987

The role of exercise therapy in patients with impaired ventricular function and chronic heart failure.

Physical training as a part of a comprehensive cardiac care program is accepted as an effective therapeutic modality. The physiological and psychological benefits of such a program have definitely been demonstrated in selected patients with coronary artery disease, but there is still some doubt about the influence of exercise therapy on morbidity and mortality. Recently, exercise training has also been instituted as part of the therapeutic regimen of groups of coronary patients who have impaired cardiac function or who suffer from chronic heart failure. If patients have been selected properly, taking into account absolute and relative contraindications, no deteriorating effect as a consequence of training has been observed in a follow-up period of 14 months. In some selected patients, an increased ejection fraction was found during the training. The results of our preliminary studies are reported and discussed, as is a special training method based on arm ergometry and applied to patients with impaired ventricular function. Clinicians are often concerned with the quality of life of their patients who have chronic cardiac conditions. In our experience, exercise therapy has beneficial effects on various psychological factors and determinants of the "quality of survival" in these patients. It still remains to be demonstrated whether a prolonged and effective exercise therapy can preserve or maintain patterns of an adaptive mechanism to exercise in patients with left ventricular dysfunction or chronic heart failure, or both.

Chronic Disease↗
PubMed2025

Exercise Therapy in Down Syndrome: A Systematic Review and Meta-Analysis Focused on Muscle Strength, Redox Balance, and Inflammatory Profile.

OBJECTIVE: This study systematically reviewed and meta-analyzed randomized and quasi-randomized controlled trials investigating the impact of exercise therapy on muscle strength, redox balance, and inflammatory profile in individuals with Down syndrome. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, SPORTDiscus, EMBASE, and PEDro. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomized and quasi-randomized controlled trials exploring exercise therapy effects on muscle strength and redox balance in individuals with Down syndrome. Although no initial restrictions on age, gender, or health condition were applied during the search process, all included studies focused on adult participants (>18 yr old). No language restrictions were applied, and the search covered the period from 1970 to 2021. RESULTS: We assessed the abstract of 1964 studies. Of the 46 studies meeting the inclusion criteria for the period 2004-2021, 32 focused on muscle strength, and 14 examined redox balance and inflammation. A total of 1611 participants with a mean age of 27 yr were included. This review confirmed that different exercise modalities are prone to improve muscle strength (random effect (95% confidence interval): 0.66, 0.54 to 0.78), redox balance and inflammatory profile (random effect (95% confidence interval): -1.04, -1.31 to -0.76) in this population. The multimodel inference suggested that the frequency of training (times per week) might play a significant role in the main effect. Unsupervised machine learning algorithms displayed a pattern-based graphic representation to assess heterogeneity. CONCLUSIONS: Exercise training demonstrated a positive impact on muscle strength in adults with Down syndrome. The review provides valuable insights into the effects of exercise therapy on individuals with Down syndrome, emphasizing the need for tailored training prescriptions.

Humans↗
PubMed2003

[Exercise therapy for chronic heart failure].

Increased mortality and impaired exercise tolerance is the two major clinical problems in patients with chronic heart failure(CHF). In addition, for many years, bed rest has been recommended for patients with CHF. However, in the last decade, exercise training has been shown to improve exercise capacity, quality of life, and event-free survival in patients with CHF. Furthermore, exercise training improves autonomic nerve function and vascular endothelial function in these patients. Based on these lines of evidence, clinical practice guidelines of exercise therapy for CHF have recently been published. More effort should be made to establish the optimal exercise prescription and to increase the implementation of exercise training as a non-pharmacologic therapy for CHF.

Autonomic Pathways↗
PubMed2000

Can exercise therapy improve the outcome of microdiscectomy?

STUDY DESIGN: A prospective randomized controlled trial of exercise therapy in patients who underwent microdiscectomy for prolapsed lumbar intervertebral disc. Results of a pilot study are presented. OBJECTIVE: To determine the effects of a postoperative exercise program on pain, disability, psychological status, and spinal function. SUMMARY OF BACKGROUND DATA: Microdiscectomy is often used successfully to treat prolapsed lumbar intervertebral disc. However, some patients do not have a good outcome and many continue to have low back pain. The reasons for this are unclear but impairment of back muscle function due to months of inactivity before surgery may be a contributing factor. A postoperative exercise program may improve outcome in such patients. METHODS: Twenty patients who underwent lumbar microdiscectomy were randomized into EXERCISE and CONTROL groups. After surgery, all patients received normal postoperative care that included advice from a physiotherapist about exercise and a return to normal activities. Six weeks after surgery, patients in the EXERCISE group undertook a 4-week exercise program that concentrated on improving strength and endurance of the back and abdominal muscles and mobility of the spine and hips. Assessments of spinal function were performed in all patients during the week before surgery and at 6, 10, 26, and 52 weeks after. The assessment included measures of posture, hip and lumbar mobility, back muscle endurance capacity and electromyographic measures of back muscle fatigue. On each occasion, patients completed questionnaires inquiring about pain, disability and psychological status. RESULTS: Surgery improved pain, disability, back muscle endurance capacity and hip and lumbar mobility in both groups of patients. After the exercise program, the EXERCISE group showed further improvements in these measures and also in electromyographic measures of back muscle fatigability. All these improvements were maintained 12 months after surgery. The only further improvement showed by the CONTROL group between 6 and 52 weeks was an increase in back muscle endurance capacity. CONCLUSION: A 4-week postoperative exercise program can improve pain, disability, and spinal function inpatients who undergo microdiscectomy. [Key words: electromyogram median frequency, exercise therapy, intervertebral disc prolapse, microdiscectomy, randomized controlled trial, spinal function.

Adolescent↗
PubMed1984

Guidelines for exercise therapy of the elderly after myocardial infarction.

We have previously demonstrated that elderly male cardiac patients benefit from participation in early exercise programmes through enhancement of functional capacity and improved psychological responses to exertion. Based on our experience, we present guidelines for early exercise therapy in elderly cardiac patients. It appears that no special considerations need be made to reduce risk beyond those precautions already present in a standard programme for younger patients. In general, it is recommended that exercise therapy in the elderly utilize 70-85% of maximal heart rate, 3 days per week for 40 min per session. Specific modifications include: decreasing intensity of work on certain modalities due to limitations of specific muscle groups, increasing frequency of exercise sessions for persons with particularly low functional capacity, and emphasizing flexibility exercises which should also be included in the regular exercise therapy sessions. Our experience has indicated that elderly cardiac patients have little problem with adherence and safety in the exercise programme and that standard methods of exercise prescription can be utilized with only minor modifications.

Aged↗
PubMed2002

Long-term effectiveness of bone-setting, light exercise therapy, and physiotherapy for prolonged back pain: a randomized controlled trial.

BACKGROUND: Chiropractic manipulation and strenuous exercise therapy have been shown effective in the treatment of nonspecific back pain. Bone-setting, the predecessor of modern manual therapies, still survives in some parts of Finland and was compared with a light exercise therapy and non-manipulative, pragmatic physiotherapy in a year-long randomized controlled trial on patients with long-term back pain. METHODS: One hundred fourteen ambulatory patients of working age with back pain for 7 weeks or more were randomly assigned to the therapies, which were offered in up to 10 sessions during a 6-week treatment period. The outcome was measured by the Oswestry Disability Questionnaire. Sick-leaves and visits to health centers were recorded for 1 year before and after the therapy. RESULTS: The Oswestry disability scores improved most in the bone-setting group (P =.02, Kruskall-Wallis test). Visits to health centers for back pain were reduced only in the physiotherapy group (P =.01, Wilcoxon test). Sick-leaves were not significantly different between groups. A secondary analysis based on the use of additional therapies after the intervention showed a possible subgroup with an enhanced effect from bone-setting. CONCLUSIONS: Traditional bone-setting seemed more effective than exercise or physiotherapy on back pain and disability, even 1 year after therapy.

Adult↗
PubMed1999

Physical therapy: exercises and the modalities: when, what, and Why?

This article reviews the evidence for using modalities and/or exercise treatment in patients with nonspecific low back pain. Poor evidence of efficacy exists for the use of modalities in this patient group. Exercises are beneficial for patients with subacute and chronic nonspecific low back pain. Further studies are needed for type, frequency, duration, and intensity of exercises.

Exercise Therapy↗
PubMed2001

Alleviation of myocardial ischemia after Kawasaki disease by heparin and exercise therapy.

BACKGROUND: Heparin promotes angiogenesis. We evaluated the effects of combined treatment with heparin and exercise on myocardial ischemia in the chronic stage of Kawasaki disease. METHODS AND RESULTS: This study was conducted in 7 patients (aged 6 to 19 years) who had a totally occluded coronary artery and stress-induced myocardial ischemia in the collateral-dependent areas. Twice-daily exercise using a bicycle ergometer was performed with increments of 0.5 W/kg every 3 minutes up to maximal exertion for 10 days. Heparin, which immediately increased circulating hepatocyte growth factor, was given intravenously 10 minutes before each exercise period. Newly developed myocardial infarction, ventricular tachyarrhythmia, anginal attack, or hemorrhagic complication was not observed in any patient. Dipyridamole-loading single photon emission computed tomography documented improved myocardial perfusion in the collateral-dependent areas and a significant reduction in total defect scores in all patients after the completion of 20 sessions (P=0.01). In control patients who did not receive the heparin-exercise therapy, however, stress defect scores remained unchanged (n=1) or increased (n=2) during follow-up. Computerized quantitative coronary angiography provided evidence that the heparin-exercise therapy increased the diameter of the occluded artery to which collaterals terminated (P=0.001) but not that of the reference artery with which collaterals were not connected (P=0.96). CONCLUSIONS: The findings suggest that a series of heparin and exercise treatments over 10 days may have a dramatic effect on the alleviation of myocardial ischemia in collateral-dependent regions. This may be a safe, noninvasive revascularization therapy for patients with coronary artery occlusion in the chronic stage of Kawasaki disease.

Adolescent↗
PubMed2007

Exercise therapy for elderly heart failure patients.

Exercise intolerance is one of the hallmark symptoms of heart failure (HF). Exercise training in this condition was not explored as a therapeutic modality until the past two decades. In fact, bed rest was promoted as a treatment for certain forms of HF in the 1970s. Over the past two decades, however, data have shown convincingly that exercise training can be implemented safely in patients who have HF, with significant improvement in functional capacity, various other physiologic variables, and quality of life. This article reviews the accumulated literature in this area, with specific emphasis on the effects of exercise training in older patients who have HF, a subset that may have the most to gain from such training.

Aged↗