Blunted responses of doppler-derived aortic flow parameters during whole-body heavy isometric exercise in heart transplant recipients

Improving Postoperative Care Through Mindfulness-Based Cognitive Therapy and Isometric Exercise Interventions: A Systematic Review (Preprint)

Background

Mindfulness-based cognitive therapy and isometric exercise training (IET) interventions are relatively new approaches to maintain physical functioning, alleviate pain, prevent joint stiffness and muscular atrophy, and positively influence other postoperative care outcomes.

Objective

The aim of this review was to identify the impacts of mindfulness-based interventions (MBIs) and IET and, more specifically, their combination, which have not previously been assessed to our knowledge.

Methods

Studies were identified by searching the PubMed and Cochrane databases within the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) algorithm format and using relevant keyword combinations, which resulted in 39 studies meeting the inclusion criteria.

Results

In general, MBI was shown to positively impact both pain relief and physical functioning, while IET positively impacted physical functioning. Numerous other benefits, including improved quality of life and decreased postoperative opioid use, were also described from both interventions; however, further research is needed to confirm these findings as well as to determine other possible benefits. No studies were found that combined MBI and IET.

Conclusions

Despite many positive results from each individual intervention, there is a lack of information about how the combination of MBI and IET might impact postoperative care. The combination of these two interventions might prove to be more effective than each individual intervention alone, and the findings from this review show that they could even be complementary. Going forward, research should be expanded to study the possible benefits of the combination of MBI and IET in postoperative care routines as well as other possible combinations.

Isometric handgrip does not elicit cardiovascular overload or post-exercise hypotension in hypertensive older women

BACKGROUND

Arterial hypertension is a serious health problem affecting mainly the elderly population. Recent studies have considered both aerobic and resistance exercises as a non-pharmacological aid for arterial hypertension treatment. However, the cardiovascular responses of the elderly to isometric resistance exercise (eg, isometric handgrip [IHG]) have not yet been documented.

OBJECTIVE

The purpose of this study was to investigate cardiovascular responses to different intensities of isometric exercise, as well as the occurrence of post-isometric exercise hypotension in hypertensive elderly people under antihypertensive medication treatment.

PATIENTS AND METHODS

Twelve women volunteered to participate in the study after a maximal voluntary contraction test (MVC) and standardization of the intervention workload consisting of two sessions of IHG exercise performed in four sets of five contractions of a 10-second duration. Sessions were performed both at 30% of the MVC and 50% of the MVC, using a unilateral IHG protocol. Both intensities were compared with a control session without exercise. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) at rest (R), during peak exercise (PE), and after 5, 10, 15, 30, 45, and 60 minutes of post-exercise recovery were evaluated.

RESULTS

No significant changes were observed after isometric exercise corresponding to 30% MVC for either SBP (R: 121 ± 10; PE: 127 ± 14; 5 min: 125 ± 13; 10 min: 123 ± 12; 15 min: 122 ± 11; 30 min: 124 ± 11; 45 min: 124 ± 10; 60 min: 121 ± 10 mmHg) or DBP (R: 74 ± 9; PE: 76 ± 6; 5 min: 74 ± 5; 10 min: 72 ± 8; 15 min: 72 ± 5; 30 min: 72 ± 8; 45 min: 73 ± 6; 60 min: 75 ± 7 mmHg). Similarly, the 50% MVC did not promote post-isometric exercise hypotension for either SBP (R: 120 ± 7; PE: 125 ± 11; 5 min: 120 ± 9; 10 min: 122 ± 9; 15 min: 121 ± 11; 30 min: 121 ± 9; 45 min: 121 ± 9; 60 min: 120 ± 7 mmHg) or DBP (R: 72 ± 8; PE: 78 ± 7; 5 min: 72 ± 7; 10 min: 72 ± 8; 15 min: 71 ± 7; 30 min: 72 ± 8; 45 min: 75 ± 10; 60 min: 75 ± 7 mmHg).

CONCLUSION

Our data reveal that cardiovascular overload or post-exercise hypotension did not occur in elderly women with controlled hypertension when they undertook an IHG session. Thus this type of resistance exercise, with mild to moderate intensity, with short time of contraction appears to be safe for this population.

Left ventricular contractility in response to upright isometric exercise in heart transplant recipients and healthy men

PURPOSE

We evaluated left ventricular contractility during upright isometric exercise, in heart transplant recipients (HTRs) and in healthy controls, using ejection fraction and end-systolic pressure/volume ratio indexes.

METHODS

Fifteen healthy men (40 +/- 13 years) and 10 HTRs (42 +/- 12 years) underwent dead lift (DL) test at 30% of maximal effort for 3 minutes. Echocardiographic variables were measured during the final 45 seconds.

RESULTS

During DL test, HTRs were significantly different (P < .01) from controls in all parameters except end-diastolic volume. DL test had lower mean values of ejection fraction (49.9% +/- 8.3% vs 67.0% +/- 4.3%, respectively) and left ventricular end-systolic pressure/volume ratio (3.5 +/- 0.7 vs 5.5 +/- 1.2, respectively) whereas higher values of end-systolic volume (51.0 +/- 9.4 mL vs 34.1 +/- 5.3 mL, respectively). Importantly, an intergroup effect was found in end-systolic pressure/volume ratio, further signifying differential response of HTRs. End-systolic pressure/volume ratio increased consistently (P < .001) in both groups, whereas the overall main effect of ejection fraction response was not significant.

CONCLUSIONS

Left ventricular function during upright isometric exercise displays differential pattern of response in HTRs in comparison with healthy controls. However, cardiac contractility in HTRs remained stable at peak systolic blood pressure produced by the isometric DL exercise. Results suggest that both ejection fraction and end-systolic pressure/volume ratio indexes can be used for assessment of ventricular function in patients after heart transplantation.

Blunt Circulatory Response to Exercise in Coronary High-Risk Subjects Among Apparently Healthy Japanese

BACKGROUND

Endothelial dysfunction leads to atherosclerosis and the hypothesis of the present study was that the systemic circulatory response during exercise would be a manifestation of endothelial dysfunction.

METHODS AND RESULTS

The circulatory response to exercise of 1,214 apparently healthy people (946 men, mean age 51.2 +/- 10.3; 268 women, mean age 52.7 +/- 10.1) was investigated, as well as the number of coronary risk factors. Systemic vascular resistance (SVR) was calculated from heart rate, blood pressure and oxygen uptake at rest and at maximal exercise during a ramp protocol using a bicycle ergometer. SVRs at rest (1,751-2,001 (dynes.s.cm(-5)) in women and 1,528-1,564 in men) did not significantly differ among the groups by number of coronary risk factors. At maximal exercise, however, they were lower in the group with fewer risk factors; that is, among women 929 (dynes.s.cm (-5)) with no risk factor to 1,305 with 5 risk factors; among men 793 with 1 risk factor to 1,170 with 6 risk factors.

CONCLUSIONS

Those with more coronary risk factors showed a lower but lengthier reduction in SVR during exercise. This weak circulatory response to exercise is a manifestation of deteriorated circulatory function in coronary high-risk subjects.