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Theodorakis Y, Hassandra M, Panagiotounis F. Enhancing Substance Use Disorder Recovery through Integrated Physical Activity and Behavioral Interventions: A Comprehensive Approach to Treatment and Prevention. Brain Sci 2024; 14:534. [PMID: 38928533 PMCID: PMC11201577 DOI: 10.3390/brainsci14060534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024] Open
Abstract
The global issue of substance abuse demands ongoing initiatives aligned with the United Nations Sustainable Development Goals. With drug use remaining prevalent worldwide, interventions are critical to addressing the associated health challenges and societal implications. Exercise and physical activities have emerged as integral components of substance use disorder (SUD) treatment, offering promising avenues for prevention, intervention, and recovery. Recent research underscores the efficacy of exercise in reducing substance cravings, promoting abstinence, and improving overall well-being. However, integrating exercise into SUD recovery programs presents challenges such as dropout rates and cultural considerations. This paper synthesizes existing literature on exercise integration into SUD recovery, highlighting strategies for enhancing treatment outcomes and addressing barriers to exercise adherence. Drawing on cognitive-behavioral therapy, experiential learning, motivational interviewing, and goal-setting techniques, the holistic approach outlined in this paper aims to empower individuals both mentally and physically, fostering resilience and supporting long-term recovery. In conclusion, new initiatives need to be taken by advocating for inclusive policies, promoting community engagement, and fostering collaborations across sectors. By doing so, stakeholders can optimize the effectiveness of exercise programs and contribute to sustainable rehabilitation efforts for individuals with SUD.
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Affiliation(s)
- Yannis Theodorakis
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece;
| | - Mary Hassandra
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece;
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Tøien T, Nielsen JL, Berg OK, Brobakken MF, Nyberg SK, Espedal L, Malmo T, Frandsen U, Aagaard P, Wang E. The impact of life-long strength versus endurance training on muscle fiber morphology and phenotype composition in older men. J Appl Physiol (1985) 2023; 135:1360-1371. [PMID: 37881849 PMCID: PMC10979801 DOI: 10.1152/japplphysiol.00208.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 10/11/2023] [Accepted: 10/25/2023] [Indexed: 10/27/2023] Open
Abstract
Aging is typically associated with decreased muscle strength and rate of force development (RFD), partly explained by motor unit remodeling due to denervation, and subsequent loss of fast-twitch type II myofibers. Exercise is commonly advocated to counteract this detrimental loss. However, it is unclear how life-long strength versus endurance training may differentially affect markers of denervation and reinnervation of skeletal myofibers and, in turn, affect the proportion and morphology of fast-twitch type II musculature. Thus, we compared fiber type distribution, fiber type grouping, and the prevalence of atrophic myofibers (≤1,494 µm2) in strength-trained (OS) versus endurance-trained (OE) master athletes and compared the results to recreationally active older adults (all >70 yr, OC) and young habitually active references (<30 yr, YC). Immunofluorescent stainings were performed on biopsy samples from vastus lateralis, along with leg press maximal strength and RFD measurements. OS demonstrated similar type II fiber distribution (OS: 52.0 ± 16.4%; YC: 51.1 ± 14.4%), fiber type grouping, maximal strength (OS: 170.0 ± 18.9 kg, YC: 151.0 ± 24.4 kg), and RFD (OS: 3,993 ± 894 N·s-1, YC: 3,470 ± 1,394 N·s-1) as young, and absence of atrophic myofibers (OS: 0.2 ± 0.7%; YC: 0.1 ± 0.4%). In contrast, OE and OC exhibited more atrophic fibers (OE: 1.2 ± 1.0%; OC: 1.1 ± 1.4%), more grouped fibers, and smaller proportion of type II fibers (OE: 39.3 ± 11.9%; OC: 35.0 ± 12.4%) than OS and YC (all P < 0.05). In conclusion, strength-trained master athletes were characterized by similar muscle morphology as young, which was not the case for recreationally active or endurance-trained old. These results indicate that strength training may preserve type II fibers with advancing age in older men, likely as a result of chronic use of high contractile force generation.NEW & NOTEWORTHY Aging is associated with loss of fast-twitch type II myofibers, motor unit remodeling, and grouping of myofibers. This study reveals, for the first time, that strength training preserves neural innervation of type II fibers, resulting in similar myofiber type distribution and grouping in life-long strength-trained master athletes as young moderately active adults. In contrast, life-long endurance-trained master athletes and recreationally active old adults demonstrated higher proportion of type I fibers accompanied by more marked grouping of type I myofibers, and more atrophic fibers compared with strength-trained master athletes and young individuals. Thus, strength training should be utilized as a training modality for preservation of fast-twitch musculature, maximal muscle strength, and rapid force capacity (RFD) with advancing age.
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Affiliation(s)
- Tiril Tøien
- Department of Health and Social Sciences, Molde University College, Molde, Norway
| | - Jakob Lindberg Nielsen
- Department of Sports Science and Clinical Biomechanics, Research Unit for Muscle Physiology and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ole Kristian Berg
- Department of Health and Social Sciences, Molde University College, Molde, Norway
| | - Mathias Forsberg Brobakken
- Department of Health and Social Sciences, Molde University College, Molde, Norway
- Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Stian Kwak Nyberg
- Department of Anesthesiology and Intensive Care, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
| | - Lars Espedal
- Department of Health and Social Sciences, Molde University College, Molde, Norway
| | - Thomas Malmo
- Norwegian Defence University College, Norwegian Armed Forces, Oslo, Norway
| | - Ulrik Frandsen
- Department of Sports Science and Clinical Biomechanics, Research Unit for Muscle Physiology and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, Research Unit for Muscle Physiology and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Eivind Wang
- Department of Health and Social Sciences, Molde University College, Molde, Norway
- Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
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Brobakken MF, Krogsæter I, Helgerud J, Wang E, Hoff J. Abdominal aerobic endurance exercise reveals spot reduction exists: A randomized controlled trial. Physiol Rep 2023; 11:e15853. [PMID: 38010201 PMCID: PMC10680576 DOI: 10.14814/phy2.15853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/26/2023] [Accepted: 10/22/2023] [Indexed: 11/29/2023] Open
Abstract
The existence of spot reduction, exercise-induced local body fat reduction, has been debated for half a century. Although the evidence is equivocal, no study has applied aerobic endurance training closely matching interventions for energy expenditure. Sixteen overweight (BMI: 29.8 ± 3.3(SD) kg m-2 ) males (43 ± 9 years) were randomized to: (1) abdominal endurance exercise (AG), combining treadmill running at 70% HRmax (27 min) with 4 × 4 min (30%-40% maximal strength, 1RM) of torso rotation and abdominal crunches (57 min), 4 days⋅week-1 for 10 weeks; or (2) control group (CG) performing only treadmill running (45 min) at 70% HRmax . Local fat mass was measured by dual-energy x-ray absorptiometry (DEXA), along with 1RM, and pulmonary oxygen uptake (to control energy expenditure during training). Trunk fat mass decreased more (697 g, 3%, p < 0.05) in AG (1170 ± 1093 g, 7%; p < 0.05) than in CG (no change). Total fat mass (AG: 1705 ± 1179 g, 6%; CG: 1134 ± 731 g, 5%; both p < 0.01) and body weight (AG: 1.2 ± 1.2 kg, 1%, p < 0.05; CG: 2.3 ± 0.9 kg, 3%, p < 0.01) decreased similarly in AG/CG. Torso rotation (AG: 32 ± 16 kg, 39%, p < 0.01; CG: no change) and abdominal crunch 1RM (AG: 35 ± 16 kg, 36%, p < 0.01; CG: 13 ± 12 kg, 17%, p < 0.05) increased more (p < 0.05/0.01) in AG than CG. Abdominal endurance exercise utilized more local fat than treadmill running, indicating that spot reduction exists in adult males.
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Affiliation(s)
- Mathias Forsberg Brobakken
- Faculty of Health Sciences and Social CareMolde University CollegeMoldeNorway
- Department of Psychosis and Rehabilitation, Psychiatry ClinicSt. Olavs University HospitalTrondheimNorway
| | - Iben Krogsæter
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
| | - Jan Helgerud
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
- Myworkout, Medical Rehabilitation ClinicTrondheimNorway
| | - Eivind Wang
- Faculty of Health Sciences and Social CareMolde University CollegeMoldeNorway
- Department of Psychosis and Rehabilitation, Psychiatry ClinicSt. Olavs University HospitalTrondheimNorway
| | - Jan Hoff
- Myworkout, Medical Rehabilitation ClinicTrondheimNorway
- Department of Physical Medicine and RehabilitationSt. Olavs University HospitalTrondheimNorway
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Nygård M, Brobakken MF, Lydersen S, Güzey IC, Morken G, Heggelund J, Wang E. Strength training integrated in long term collaborative care of patients with schizophrenia. Schizophr Res 2023; 260:67-75. [PMID: 37625226 DOI: 10.1016/j.schres.2023.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 06/26/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
INTRODUCTION Skeletal muscle strength is reduced in patients with schizophrenia, contributing to their impaired physical health, functional performance, and potentially mental health challenges. Although short-term training programs have shown promising results, improving muscle strength and functional performance, it is unknown how exercise can be successfully integrated into the long-term clinical care of outpatients with schizophrenia. OBJECTIVE To investigate effects of strength training with adherence support in a collaborative care model. METHODS We randomized 28 men and 20 women (mean ± SD, 35 ± 11 years) to leg press maximal strength training (MST) with 4 sets at 90 % of one repetition maximum (1RM) 2 × week, facilitated by municipal service and professional supervision (TG), or a control group (CG). RESULTS The TG increased scaled leg press 1RM (0-3 months: 19 %; 0-6 months: 31 %, 0-12 months: 40 %, all p < .001, and 3-12 months: 18 %, p < .05) and power (0-3 months, 11 %; 0-6 months: 22 %, 0-12 months: 26 %, all p < .001, and 3-12 months: 13 %, p < .05) throughout the 1-year period compared to the CG. The increased muscle strength was accompanied by improved sit-to-stand performance (20 %) after 12 months (p < .001). Both groups also exhibited within-group improvements in walking work efficiency after 6 months (TG: 13 %; CG: 23 %) and 1 year (TG: 11 %; CG: 21 %, p < .01-0.05), but with no evident differences between the groups. Stair climbing performance remained unchanged. CONCLUSION Our results reveal that strength training can successfully be integrated as a part of long-term clinical care of outpatients with schizophrenia, contributing to improved functional performance.
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Affiliation(s)
- Mona Nygård
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Mathias Forsberg Brobakken
- Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Faculty of Health and Social Sciences, Molde University College, Molde, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ismail Cüneyt Güzey
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Gunnar Morken
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Psychiatry, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jørn Heggelund
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Regional Centre for Healthcare Improvement, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eivind Wang
- Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Faculty of Health and Social Sciences, Molde University College, Molde, Norway
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Vigue D, Rooney M, Nowakowski-Sims E, Woods S. Trauma informed weight lifting: considerations for coaches, trainers and gym environments. Front Psychol 2023; 14:1224594. [PMID: 37546487 PMCID: PMC10400004 DOI: 10.3389/fpsyg.2023.1224594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
A growing body of research supports weight lifting as an effective adjunct intervention in the treatment of psychological trauma and trauma-related disorders. However, studies indicate that numerous barriers exist to participation in weight lifting, especially among populations disproportionately impacted by trauma. Trauma-informed care offers a paradigm for service delivery that aims to empower clients to access healing resources by attending to six domains of experience: safety, trustworthiness and transparency, peer support, collaboration and mutuality, empowerment, voice and choice, and cultural, historical, and gender issues. This mixed-methods study utilizes semi-structured, one-on-one interviews and surveys to inform the design of an evidence-based trauma-informed weight lifting program for trauma survivors. The contributions of this paper are twofold. First, the salient experiential categories for conceptualizing psychological healing in the gym environment are presented, informed by the lived experiences and recommendations of a national sample of trauma-impacted weight lifters. Second, based on the findings of this study, guidelines are proposed for the development of trauma-informed weight lifting programming that may be incorporated into the practice habits of personal trainers. The results of this study aid in the reduction in barriers that currently limit the adoption of weight lifting as an adjunct intervention for trauma and contribute to the professionalization of personal trainers in trauma-related competencies.
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Affiliation(s)
- Dana Vigue
- Department of Anthropology, Harvard Graduate School of Arts and Sciences, Harvard University, Cambridge, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Mariah Rooney
- Center for Trauma and Embodiment, Justice Resource Institute, Needham, MA, United States
| | | | - Savannah Woods
- The New School for Social Research, New York, NY, United States
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Piché F, Daneau C, Plourde C, Girard S, Romain AJ. Characteristics and impact of physical activity interventions during substance use disorder treatment excluding tobacco: A systematic review. PLoS One 2023; 18:e0283861. [PMID: 37099488 PMCID: PMC10132651 DOI: 10.1371/journal.pone.0283861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/19/2023] [Indexed: 04/27/2023] Open
Abstract
Substance use disorder is a worldwide issue that entails negative health and physical activity is a promising complementary therapy for alleviating the consequences. The objective of this reviews is to characterize physical activity interventions offered in the literature and explore their effects during treatment for people with substance use disorders with excluding studies focusing only on tobacco use. A systematic search of seven databases on articles including a physical activity intervention during a treatment for substance use disorder was done and an examination of the presence of bias was performed. A total of 43 articles including 3135 participants were identified. Most studies were randomized controlled trial (81%), followed by pre-post design (14%) and cohort studies (5%). The most common physical activity intervention identified was of moderate intensity, 3 times per week (≈ 1 hour) for 13 weeks. Cessation/reduction of substance use was the most studied outcome (21 studies, 49%), and 75% showed a decrease in substance use following physical activity intervention. Aerobic capacity was the second most studied effect (14 studies, 33%), with more than 71% of studies showing improvement. Twelve studies (28%) reported a decrease of depressive symptoms. Physical activity interventions in a treatment for substance use disorder seem to be a promising, but more methodologically rigorous scientific studies are needed.
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Affiliation(s)
- Florence Piché
- Department of Human Kinetics, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
- Faculty of Medicine, University of Montreal, Montreal, Québec, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Québec, Canada
| | - Catherine Daneau
- Department of Human Kinetics, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Chantal Plourde
- Department of Psychoeducation, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Stéphanie Girard
- Department of Human Kinetics, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Ahmed Jérôme Romain
- Faculty of Medicine, University of Montreal, Montreal, Québec, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Québec, Canada
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Tøien T, Unhjem R, Berg OK, Aagaard P, Wang E. Strength versus endurance trained master athletes: Contrasting neurophysiological adaptations. Exp Gerontol 2023; 171:112038. [PMID: 36442699 DOI: 10.1016/j.exger.2022.112038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/11/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
Neural factors play a critical role in the age-related decline in maximal strength and rate of force development (RFD). However, it is uncertain how the age-related attenuation in neuromuscular function may be mitigated in strength or endurance trained master athletes. In this study we applied evoked spinal motoneuron recordings to examine descending motor drive, i.e., efferent drive from supraspinal and spinal centres during maximal voluntary contraction (MVC; V-wave) and H-reflex excitability measured at 10 % MVC in older (>65 yrs) and younger (<35 yrs) strength athletes (n = 21), endurance athletes (n = 17) and untrained control participants (n = 30). Both strength (b = 0.09 [0.01-0.18], p = 0.038) and endurance training (b = 0.14 [0.04-0.23], p = 0.006) were associated with a high V-wave amplitude. This was likely explained by an elevated H-reflex excitability (b = 0.23 [0.11-0.35], p < 0.001) in endurance trained participants, which failed to be seen in strength trained participants. These contrasting neurophysiological properties were accompanied by different physiological traits; strength training was associated with high maximal strength (b = 107.5 [84.6 to 130.4] kg, p < 0.001) and RFD (b = 3171 [2248 to 4094] N‧s-1, p < 0.001), whereas endurance training was associated with elevated maximal oxygen uptake (V̇O2max; b = 13.6 [8.0-19.2] ml‧kg-1‧min-1, p < 0.001). This pattern was apparent irrespective of age, although all traits were negatively associated with advanced age (p < 0.05). In conclusion, strength trained individuals demonstrate higher descending motor drive (elevated V-wave responses), compared to age-matched untrained individuals. Endurance trained individuals also showed elevated V-wave responses, uniquely accompanied by enhanced α-motoneuron excitability and/or reduced pre/postsynaptic inhibition (elevated H-reflex responses). Since a high descending motor drive is a key component of strong muscle contractions, strength training should be emphasized to sustain the ability to carry out force-dependent tasks at older age.
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Affiliation(s)
- Tiril Tøien
- Department of Health and Social Sciences, Molde University College, Norway.
| | - Runar Unhjem
- Faculty of Education and Arts, Nord University, Bodø, Norway
| | - Ole Kristian Berg
- Department of Health and Social Sciences, Molde University College, Norway
| | - Per Aagaard
- Department of Sports Science and Clinical Biomechanics, Research Unit for Muscle Physiology and Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Eivind Wang
- Department of Health and Social Sciences, Molde University College, Norway; Department of Østmarka, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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Loe H, Mosti MP, Wisløff U, Haberstroh C, Flemmen G. Cardiopulmonary and muscular effects of different doses of high-intensity physical training in substance use disorder patients: study protocol for a block allocated controlled endurance and strength training trial in an inpatient setting. BMJ Open 2022; 12:e061014. [PMID: 36167363 PMCID: PMC9516060 DOI: 10.1136/bmjopen-2022-061014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Patients with substance use disorder (SUD) have high prevalence of lifestyle-related comorbidities. Physical exercise is known to yield substantial prophylactic impact on disease and premature mortality, and there seems to be an inverse association between physical fitness and adverse health outcomes. High-intensity training is regarded as most effective for improving physical fitness, but less is known concerning the ideal training dose necessary to achieve clinically relevant effects in these patients. The aim of this study is to compare the effect of low-dose and high-dose, high-intensity training, on physical fitness in patients diagnosed with SUD. METHODS AND ANALYSIS This study will recruit 40 in-patients of mixed genders, aged 18-70 years. Participants will be block allocated to low-dose or high-dose training, encompassing 24 high-intensity interval and maximal strength training sessions (3/week × 8 weeks). After a 10 min warm-up, the low-dose group will perform 1×4 min intervals at ⁓90% of maximal heart rate and 2×4 repetitions strength training at ⁓90% of 1 repetition maximum. The high-dose group will perform 4×4 min intervals at ⁓90% of maximal heart rate and 4×4 repetitions strength training at ⁓90% of 1 repetition maximum. Clinical measurements and physical tests will be conducted at baseline, midway and on completion and a questionnaire on physical activity will be administered at baseline. ETHICS AND DISSEMINATION This protocol is in accordance with the Standard Protocol Items: Recommendations for Interventional Trials statement. All participants will sign a written informed consent. The Regional Committee of Medical Research Ethics, Norway has approved the study. A study of this kind is warranted, and the results will be published in an open access journal to ensure public access, and presented at national and international conferences. TRIAL REGISTRATION NUMBER NCT04065334.
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Affiliation(s)
- Henrik Loe
- Department of Research and Development, Clinic of Substance use and Addicition Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway
| | - Mats Peder Mosti
- Department of Research and Development, Clinic of Substance use and Addicition Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Carolin Haberstroh
- Department of Research and Development, Clinic of Substance use and Addicition Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway
| | - Grete Flemmen
- Department of Research and Development, Clinic of Substance use and Addicition Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway
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Brobakken MF, Nygård M, Wang E. Physical Health Impairment and Exercise as Medicine in Severe Mental Disorders: A Narrative Review. SPORTS MEDICINE - OPEN 2022; 8:115. [PMID: 36107334 PMCID: PMC9478018 DOI: 10.1186/s40798-022-00490-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/17/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Individuals with severe mental disorders (SMDs; schizophrenia spectrum disorders, bipolar disorder, and major depressive disorder) are not only suffering from their mental conditions; they also have an attenuated physical health, augmenting their overall critical condition. OBJECTIVES We review and critically appraise the evidence based on (1) key physiological factors relating to aerobic endurance and skeletal muscle strength; (2) implications for physical function and health; and (3) effects of training interventions with different intensities evaluated in individuals with SMDs. FINDINGS Reductions in aerobic endurance factors, peak oxygen uptake (VO2peak) and walking work efficiency, are paralleled by reductions in maximal skeletal muscle strength and power. In turn, the poor aerobic endurance and muscle strength lead to impaired physical function, increased risk of lifestyle-related diseases, and ultimately early death. Exercise has the potential to counteract the attenuated physical health in people with SMDs. While aerobic endurance training is shown to increase VO2peak due to plasticity of the oxygen transport system, strength training is documented to improve maximal muscle strength, power, and walking work efficiency as a result of adaptations in neuromuscular force developing factors. CONCLUSIONS In conclusion, improvements in these key determinants for physical health appear to be achievable in people with SMDs despite many being challenged by motivational difficulties with attending regular exercise and have beneficial implications for physical function during activities of daily living, lifestyle-related diseases, and early death.
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Affiliation(s)
- Mathias Forsberg Brobakken
- grid.411834.b0000 0004 0434 9525Faculty of Health and Social Sciences, Molde University College, Molde, Norway ,grid.52522.320000 0004 0627 3560Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Mona Nygård
- grid.52522.320000 0004 0627 3560Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Eivind Wang
- grid.411834.b0000 0004 0434 9525Faculty of Health and Social Sciences, Molde University College, Molde, Norway ,grid.52522.320000 0004 0627 3560Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
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10
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Zuo C, Bo S, Wang T, Zhang W. Functional and Traditional Resistance Training Are Equally Effective in Increasing Upper and Lower Limb Muscular Endurance and Performance Variables in Untrained Young Men. Front Physiol 2022; 13:868195. [PMID: 36117686 PMCID: PMC9471151 DOI: 10.3389/fphys.2022.868195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Functional resistance training (FRT) has been proposed as a safe alternative to traditional resistance training (TRT) for developing neuromuscular adaptation capacity and improving muscular strength and competitive performance. This study sought to compare the effects of 6 weeks of FRT and TRT on upper and lower limb muscular endurance and performance variables in untrained young men.Methods: Twenty-nine untrained healthy young males aged 18–29 years were randomly given 6 weeks of FRT [40% of 1repetition maximum (RM), 4,5 sets of 20 repetitions, 3 times/week] or TRT (70% of 1RM, 4,5 sets of 12 repetitions, 3 times/week). All participants underwent numerous tests before and after the 6-week training, such as muscular endurance (reps of bench press and leg flexion) and physical performance tests (sprint performance, pull-ups, throwing ability, and jumping ability).Results: After the 6 weeks of training, the TRT and FRT groups showed an equally significant increase in muscular endurance (p < 0.01), while the throwing and jumping abilities, 30-m sprint, and pull-ups performances in both the groups (p < 0.01) also improved significantly. However, no differences were observed between the groups (p > 0.05).Conclusion: These findings indicate that both functional resistance training and traditional resistance training are effective training methods for improving the upper and lower limb muscular endurance and performance in untrained young men.
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Affiliation(s)
- Chongwen Zuo
- Graduate Department of Capital University of Physical Education and Sports, Beijing, China
- *Correspondence: Chongwen Zuo,
| | - Shumin Bo
- School of Kinesiology and Health of Capital University of Physical Education and Sports, Beijing, China
| | - Tao Wang
- Graduate Department of Capital University of Physical Education and Sports, Beijing, China
- School of Physical Education, Liaocheng University, Liaocheng, China
| | - Wei Zhang
- Graduate Department of Capital University of Physical Education and Sports, Beijing, China
- College of Basic Medical, Jining Medical University, Jining, China
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11
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Huhn AS, Ellis JD, Dunn KE, Sholler DJ, Tabaschek P, Burns R, Strain EC. Patient-reported sleep outcomes in randomized-controlled trials in persons with substance use disorders: A systematic review. Drug Alcohol Depend 2022; 237:109508. [PMID: 35660223 DOI: 10.1016/j.drugalcdep.2022.109508] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sleep disturbances and disorders are a common and sometimes recalcitrant problem in persons recovering from substance use disorders (SUDs). As such, several randomized-controlled trials (RCTs) have been conducted to address sleep disturbances in a variety of SUD subpopulations and clinical scenarios. The goal of this systematic review was to collate patient-reported sleep outcomes used in past SUD-related RCTs to provide guidance for future sleep research in persons with SUDs. METHODS This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on May 7th, 2020 (CRD42020182004). Studies were included if they were peer-reviewed manuscripts describing RCTs in an SUD population. RESULTS The initial search yielded 13,403 candidate articles, and 76 met a priori criteria and were included in this review. Thirty-five (46.1%) assessed sleep as a primary outcome (i.e., sleep improvement was the primary goal of the research) and 41 (53.9%) assessed sleep as a secondary outcome (i.e., sleep improvement was an important outcome, but not the primary outcome). The most commonly used measures included the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and sleep diaries. However, multiple additional sleep assessments were also used, including visual analogue and Likert scales. CONCLUSIONS The field of addiction medicine would benefit from a streamlined approach in assessing patient-reported sleep in RCTs, including commonly used and validated assessments of sleep quality, inserting daily or repeated measures into RCTs, and including questionnaires that assess clinically relevant insomnia or other sleep disorders.
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Affiliation(s)
- Andrew S Huhn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA.
| | - Jennifer D Ellis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Kelly E Dunn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Dennis J Sholler
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Paula Tabaschek
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Rachel Burns
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Eric C Strain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
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12
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Dowla R, Sinmaz H, Mavros Y, Murnion B, Cayanan E, Rooney K. The Effectiveness of Exercise as an Adjunct Intervention to Improve Quality of Life and Mood in Substance Use Disorder: A Systematic Review. Subst Use Misuse 2022; 57:911-928. [PMID: 35354366 DOI: 10.1080/10826084.2022.2052098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Introduction: Quality of life and affective outcomes offer a perspective of the burden of disease experienced by people with substance use disorder. This can be considered an alternative measure of substance use disorder severity. This review aims to evaluate the impact of exercise as a novel intervention on quality of life and affect in substance use disorder. Method: Medline, CINAHL, Amed, Web of Science core collections, Embase, PsychINFO and SportDISCUS databases were searched from inception to August 2021 for studies that assessed the impact of exercise on mood, depression, anxiety and quality of life outcomes in substance use disorder. Exercise interventions of any duration were included. Results: Forty-two studies met the inclusion criteria. Quality of life scores improved with larger effects seen in studies with two or more sessions per week. Depression and anxiety scores decreased, with 19 of the 25 data sets reporting a reduction in depression (effect size 0.2-1.86) and 13 of the 17 data sets reporting a reduction in anxiety (effect sizes 0.2-1.42). Mood improved in six of the seven data sets reviewed with effect sizes ranging from 0.34 to 1.13. Discussion: Included studies had numerous methodological flaws therefore results need to be interpreted with caution. Further research needs to be completed with more rigorous methodologies to support these results. Conclusions: Results indicate promising responses to exercise as a novel intervention for quality of life and mood in substance use disorder, however further research of high methodological quality is needed to confirm.
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Affiliation(s)
- Rhiannon Dowla
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia.,Missenden Mental Health Service, Sydney Local Health District, Sydney, Australia
| | - Hulya Sinmaz
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia
| | - Yorgi Mavros
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia
| | - Bridin Murnion
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia.,Central Coast Local Health District, Gosford, Australia
| | - Elizabeth Cayanan
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia.,The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Kieron Rooney
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia
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13
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Fitzgerald C, Barley R, Hunt J, Klasto SP, West R. A Mixed-Method Investigation into Therapeutic Yoga as an Adjunctive Treatment for People Recovering from Substance Use Disorders. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-020-00228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
AbstractMind Body Connect (MBC) is a charity which uses therapeutic yoga as a vehicle of change for marginalized populations. Alongside MBC, Sheffield Hallam University’s SHU Strength researchers carried out this study aiming to: (1) Gauge the impact of therapeutic yoga classes upon the mood state of people with a Substance Use Disorder (SUD) and (2) Explore the perceived benefits of therapeutic yoga class participation. An adapted shortened Profile of Mood States (POMS) was completed before and after each yoga class. A comparison of means with paired sample T-Test and Cohen’s D was then carried out. Participants who attended 6+ classes were interviewed. Findings were then converged. Before and after measurements of anger, sadness, tiredness, worry, confusion, energy and relaxation were taken, Classes were held at SHU for service users from a Phoenix Future’s (PF) rehabilitation centre. A single yoga class significantly relaxed participants and reduced negative mood states. Interview data covered a range of perceived benefits including the use of yogic down-regulation techniques as daily coping strategies. The MBC yoga programme appears beneficial as an adjunctive therapy for PF residents. Future SHU Strength research shall focus on the mid-long-term exercise habits of the recovery community and the impact of the MBC yoga programme upon the early recovery period of detoxification.
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14
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Application of Nanosystems Synergized by Optics and Chemotherapy in the Treatment of Sports Rehabilitation Diseases. J CHEM-NY 2020. [DOI: 10.1155/2020/7124512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
With the rapid development of sports in my country, many athletes will have mild or severe diseases. Physical rehabilitation can improve their physical pain, and some more serious diseases require optical and chemotherapy treatments. This article mainly studies the application of nanosystems that cooperate with optical and chemotherapy in the treatment of sports rehabilitation diseases. In the experiment, the bacteria-infected mice in the wound were divided into 5 groups (n = 4), and the mouse wound model was made. After that, the number of bacteria remaining in the wound was determined by the plate count method. At the same time, a cytotoxicity test was performed, and a control experiment was performed on the cell culture of the polymer at a concentration below the VCR and CMC values. The final sections were used for tissue analysis of serine and epoxy staining. It was found from the experimental data that the cumulative release of free CLB molecules within 3 hours almost reached 100%, and its rapid release was attributed to its small molecular size. In contrast, the release of CLB-HDH micelles in 3 h is 62%, which has a certain relaxation effect. The results showed that CLB-HDH micelles significantly inhibited tumor growth, had good safety in vivo, and had low systemic toxicity. CLB-HDH micelles provide new ideas for efficient CLB tumor treatment.
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15
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Unhjem R, Tøien T, Kvellestad ACG, Øren TS, Wang E. External Resistance Is Imperative for Training-Induced Efferent Neural Drive Enhancement in Older Adults. J Gerontol A Biol Sci Med Sci 2020; 76:224-232. [DOI: 10.1093/gerona/glaa160] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Strength training performed with heavy loads and maximal intended velocity is documented to enhance efferent neural drive to maximally contracting musculature in older adults. However, it remains unclear whether the neural plasticity following training result from motor skill learning or if external resistance is a prerequisite. To investigate this, we assessed electrically evoked potentials (H-reflex and V-waves normalized to maximal M-wave) and voluntary activation (VA) in 36 older adults (73 ± 4 years) randomized to 3 weeks of plantar flexion strength training, with (maximal strength training [MST]) or without (unloaded ballistic training [UBT]) heavy external loading (90% of one repetition maximum), or a control group. Both training groups aimed to execute the concentric phase of movement as fast and forcefully as possible. The MST group improved maximal voluntary contraction (MVC) and rate of force development (RFD) by 18% ± 13% (p = .001; Hedges g = 0.66) and 35% ± 17% (p < .001; g = 0.94), respectively, and this was different (MVC: p = .013; RFD: p = .001) from the UBT group which exhibited a 7% ± 8% (p = .033; g = 0.32) increase in MVC and a tendency to increase RFD (p = .119; g = 0.22). Concomitant improvements in efferent neural drive (Vmax/Msup ratio: 0.14 ± 0.08 to 0.24 ± 0.20; p = .010) and a tendency towards increased VA (79% ± 9% to 84% ± 5%; p = .098), were only apparent after MST. No changes were observed in Hmax/Mmax ratio for the groups. In conclusion, external loading during exercise training appears to be a prerequisite for efferent neural drive enhancement in older adults. Thus, strength training with heavy loads should be recommended to counteract the typically observed age-related decline in motoneuron firing frequency and recruitment.
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Affiliation(s)
- Runar Unhjem
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Tiril Tøien
- Department of Health and Social Sciences, Molde University College, Norway
| | - Ann Charlotte Gjertsen Kvellestad
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thomas Storehaug Øren
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eivind Wang
- Department of Health and Social Sciences, Molde University College, Norway
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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16
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Andreassen Ø, Brønnick K, Njå AL, Furulund E, Nesvåg S. The Effect of High-Intensity Interval/Circuit Training on Cognitive Functioning and Quality of Life During Recovery From Substance Abuse Disorder. A Study Protocol. Front Psychol 2019; 10:2564. [PMID: 31803108 PMCID: PMC6873325 DOI: 10.3389/fpsyg.2019.02564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/30/2019] [Indexed: 01/07/2023] Open
Abstract
This proposed study will examine whether structured physical activity reduces the recovery time of cognitive functioning during the early phase of substance use disorder treatment. Addiction or substance dependence is associated with neurobiological changes and cognitive impairment that can affect quality of life and the efficacy of therapy for up to a year after clinical detoxification. The biological, psychological, and social effects of physical exercise have the potential to be a therapeutic approach to increase quality of life and relieve symptoms associated with substance abuse, such as psychosis, depression, and anxiety. There is a dearth of research on physical activity and exercise in clinical substance use disorder patients. This protocol describes a clinical study that will examine cognitive recovery after substance abuse using physical exercise as a treatment intervention. We will use a quasi-experimental longitudinal clinical trial, with a pretest and multiple posttests, on naturally randomized sequential groups. Patients will be consecutively be recruited into the study groups, with a control group that is completed, before its followed by an intervention group, each with 30 patients. Patients will be enrolled 2 weeks after the start of detoxification, at which time all subjects will be inpatients at the Stavanger Salvation Army Treatment Center in the Norwegian specialized healthcare system. Cognition will be evaluated with a comprehensive battery of cognitive tests, including several tests of executive function. Physical fitness will be tested with the Rockport 1-Mile Walk Test, the 30-S Chair Stand Test, the 1-Min Burpee Test at baseline (within the first 2 weeks of admittance) and after 4 weeks. The intervention will be a 30-min workout at 70–90% of maximum heart rate (134–170 bpm), recorded and calculated by a Polar heart rate monitor. The intervention treatment will be administered four times a week for 4 weeks and will consist of high-intensity circuit training, high-intensity interval training, functional movement, and primitive reflex training. We anticipate improvement in both the control and intervention groups, with the exercise intervention group having the greatest increase in recovery of cognitive function because of the combination of functional full body movements and primitive movement training in an intense interval training program. Clinical Trial Registration ID: ISRCTN74750479, Retrospectively Registered.
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Affiliation(s)
- Øyvind Andreassen
- Salvation Army Treatment Center Stavanger, Stavanger, Norway.,Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Kolbjørn Brønnick
- Department of Public Health, Faculty of Health Sciences, Stavanger, Norway.,Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
| | - Anne-Lill Njå
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Einar Furulund
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Sverre Nesvåg
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, Stavanger, Norway
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17
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Unhjem R, van den Hoven LT, Nygård M, Hoff J, Wang E. Functional Performance With Age: The Role of Long-Term Strength Training. J Geriatr Phys Ther 2019; 42:115-122. [DOI: 10.1519/jpt.0000000000000141] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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18
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Colledge F, Gerber M, Pühse U, Ludyga S. Anaerobic Exercise Training in the Therapy of Substance Use Disorders: A Systematic Review. Front Psychiatry 2018; 9:644. [PMID: 30564150 PMCID: PMC6288373 DOI: 10.3389/fpsyt.2018.00644] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 11/15/2018] [Indexed: 12/15/2022] Open
Abstract
Background: In the past 3 decades, there has been an increase in the number of studies assessing exercise as a form of treatment for substance use disorders (SUDs). While a variety of substance types and outcomes have been assessed, exercise intensities have never been systematically examined. Consequently, it remains unclear whether particular forms of exercise are better suited to the treatment of these populations. Anaerobic exercise has been shown to have positive effects in populations with psychiatric disorders, but its effectiveness in the treatment of SUDs has to date not been reviewed. Methods: The aim of this systematic review is to identify and evaluate studies which have employed either an acute or chronic anaerobic exercise component as a therapy modality for SUDs. The primary outcomes are abstinence, craving, withdrawal, consumption, quality of life, and the following psychological symptoms and disorders: depression, anxiety, stress, and mood. A secondary objective is to assess whether the type of training described in the study protocol can be reliably categorized as anaerobic training. Results: Twenty-six studies are included in this review. Twelve studies addressed nicotine dependence, one addressed alcohol dependence, and 13 addressed dependence on various illicit drugs. Thirteen studies reported the intensity at which participants actually exercised, but only one employed a test to determine whether training was carried out above the anaerobic threshold (AT). The risk of bias in the included studies was generally high. Results of the studies were mixed, with the most positive effects being found for abstinence in nicotine dependence. Conclusion: The evidence for the effects of anaerobic exercise in SUDs is weak, although a tendency toward positive effects on abstinence in nicotine dependent individuals was observable. The majority of studies do not report data on exercise intensity, making a categorization of anaerobic exercise impossible in all but one case. This means that the effects of this form of exercise cannot be determined, and therefore not evaluated or compared with other forms. In order to improve the quality of evidence for exercise in SUD treatment, clearly defined and objectively assessed evaluations of anaerobic and anaerobic exercise are necessary.
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Affiliation(s)
- Flora Colledge
- Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel, Switzerland
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19
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Tøien T, Pedersen Haglo H, Unhjem R, Hoff J, Wang E. Maximal strength training: the impact of eccentric overload. J Neurophysiol 2018; 120:2868-2876. [PMID: 30332319 DOI: 10.1152/jn.00609.2018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
The search for the most potent strength training intervention is continuous. Maximal strength training (MST) yields large improvements in force-generating capacity (FGC), largely attributed to efferent neural drive enhancement. However, it remains elusive whether eccentric overload, before the concentric phase, may augment training-induced neuromuscular adaptations. A total of 53 23 ± 3 (SD)-yr-old untrained males were randomized to either a nontraining control group (CG) or one of two training groups performing leg press strength training with linear progression, three times per week for 8 wk. The first training group carried out MST with four sets of four repetitions at ~90% one-repetition maximum (1RM) in both action phases. The second group performed MST with an augmented eccentric load of 150% 1RM (eMST). Measurements were taken of 1RM and rate of force development (RFD), countermovement jump (CMJ) performance, and evoked potentials recordings [V-wave (V) and H-reflex (H) normalized to M-wave (M) in musculus soleus]. 1RM increased from 133 ± 16 to 157 ± 23 kg and 123 ± 18 to 149 ± 22 kg and CMJ by 2.3 ± 3.6 and 2.2 ± 3.7cm for MST and eMST, respectively (all P < 0.05). Early, late, and maximal RFD increased in both groups [634-1,501 N/s (MST); 644-2,111 N/s (eMST); P < 0.05]. These functional improvements were accompanied by increased V/M-ratio (MST: 0.34 ± 0.11 to 0.42 ± 14; eMST: .36 ± 0.14 to 0.43 ± 13; P < 0.05). Resting H/M-ratio remained unchanged. Training-induced improvements did not differ. All increases, except for CMJ, were different from the CG. MST is an enterprise for large gains in FGC and functional performance. Eccentric overload did not induce additional improvements, suggesting firing frequency and motor unit recruitment during MST may be maximal. NEW & NOTEWORTHY This is the first study to apply evoked potential recordings to investigate effects on efferent neural drive following high-intensity strength training with and without eccentric overload in a functionally relevant lower extremity exercise. We document that eccentric overload does not augment improvements in efferent neural drive or muscle force-generating capacity, suggesting that high-intensity concentric loads may maximally tax firing frequency and motor unit recruitment.
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Affiliation(s)
- Tiril Tøien
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology , Trondheim , Norway
| | - Håvard Pedersen Haglo
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology , Trondheim , Norway
| | - Runar Unhjem
- Faculty of Professional Studies, Nord University , Bodø , Norway
| | - Jan Hoff
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology , Trondheim , Norway.,Department of Physical Medicine and Rehabilitation, St. Olav's University Hospital , Trondheim , Norway
| | - Eivind Wang
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology , Trondheim , Norway.,Department of Health and Social Sciences, Molde University College , Norway.,Department of Medicine, University of Utah , Salt Lake City, Utah
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20
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Nygård M, Mosti MP, Brose L, Flemmen G, Stunes AK, Sørskår-Venæs A, Heggelund J, Wang E. Maximal strength training improves musculoskeletal health in amphetamine users in clinical treatment. Osteoporos Int 2018; 29:2289-2298. [PMID: 29978257 DOI: 10.1007/s00198-018-4623-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/26/2018] [Indexed: 12/01/2022]
Abstract
UNLABELLED Amphetamine use leads to impaired skeletal health and elevated risk of osteoporosis. In the current study, we document that maximal strength training (MST), as a part of clinical treatment, works as a countermeasure, improving muscle force generating capacity, body composition, and skeletal health at sites particularly prone to osteoporotic fractures. INTRODUCTION Amphetamine users have attenuated musculoskeletal health. MST with heavy loads, few repetitions, and emphasis on maximal mobilization in the concentric phase may increase muscle force generating capacity and skeletal health. This study investigated if MST-induced improvements in force generating capacity improved bone mineral density (BMD), trabecular bone score, and body composition in amphetamine users participating in 3-months clinical treatment. METHODS Of 40 randomized patients, 23 completed the study: 11 in the supervised training group (TG; 8 men, 3 women, 34 ± 10 years) and 12 in the control group (CG; 9 men, 3 women, 32 ± 8 years). The TG performed hack-squat MST three times a week for 12 weeks with an intensity of ~90% of one repetition maximum (1RM). Both groups attended conventional clinical treatment. Pre-training and post-training, we assessed hack-squat 1RM and rate of force development (RFD), BMD, body composition and trabecular bone score by dual X-ray absorptiometry, and serum bone metabolism markers. RESULTS MST induced increases in 1RM (70%) and RFD (86%), and resulted in BMD improvements at lumbar spine (3.6%) and total hip (2.4%); all improvements were different from CG (p < 0.05). Both the 1RM and RFD increases were associated with BMD improvements (lumbar spine: r = 0.73 (1RM), r = 0.60 (RFD); total hip: r = 0.61 (1RM); all p < 0.05). No differences were observed in trabecular bone score or bone metabolism markers. CONCLUSIONS MST improved force generating capacity and skeletal health at sites prone to bone loss in amphetamine users, and advocate that MST should be implemented as a clinical strategy to restore the patients' musculoskeletal health.
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Affiliation(s)
- M Nygård
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
- Department of Mental Health, St. Olav's University Hospital, Trondheim, Norway.
| | - M P Mosti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav's University Hospital, Trondheim, Norway
| | - L Brose
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - G Flemmen
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - A K Stunes
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav's University Hospital, Trondheim, Norway
| | - A Sørskår-Venæs
- Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - J Heggelund
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Mental Health, St. Olav's University Hospital, Trondheim, Norway
| | - E Wang
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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21
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Aune AAG, Bishop C, Turner AN, Papadopoulos K, Budd S, Richardson M, Maloney SJ. Acute and chronic effects of foam rolling vs eccentric exercise on ROM and force output of the plantar flexors. J Sports Sci 2018; 37:138-145. [PMID: 29893193 DOI: 10.1080/02640414.2018.1486000] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Foam rolling and eccentric exercise interventions have been demonstrated to improve range of motion (ROM). However, these two modalities have not been directly compared. Twenty-three academy soccer players (age: 18 ± 1; height: 1.74 ± 0.08 m; body mass: 69.3 ± 7.5 kg) were randomly allocated to either a foam rolling (FR) or eccentric exercise intervention designed to improve dorsiflexion ROM. Participants performed the intervention daily for a duration of four weeks. Measurements of dorsiflexion ROM, isometric plantar flexion torque and drop jump reactive strength index were taken at baseline (pre-intervention) and at three subsequent time-points (30-min post, 24-hours post and 4-weeks post). A significant time x group interaction effect was observed for dorsiflexion (P = 0.036), but not for torque or reactive strength index. For dorsiflexion, there was a significant increase in both acute (30-min; P < 0.001) and chronic (4-week; P < 0.001) ROM for the eccentric group, whilst FR exhibited only an acute improvement (P < 0.001). Eccentric training would appear a more efficacious modality than foam rolling for improving dorsiflexion ROM in elite academy soccer players.
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Affiliation(s)
- Anne A G Aune
- a London Sport Institute, Middlesex University , London , United Kingdom
| | - Chris Bishop
- a London Sport Institute, Middlesex University , London , United Kingdom
| | - Anthony N Turner
- a London Sport Institute, Middlesex University , London , United Kingdom
| | | | - Sarah Budd
- a London Sport Institute, Middlesex University , London , United Kingdom
| | - Mark Richardson
- a London Sport Institute, Middlesex University , London , United Kingdom
| | - Sean J Maloney
- b Department of Sports Science and Physical Activity , University of Bedfordshire , Bedford , United Kingdom
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