Effects of a Combined Intradialytic Exercise Training Program and Music on Cardiac Autonomic Nervous System Activity in Hemodialysis Patients

This study aimed to examine the effect of an intradialytic exercise program in combination with music on heart rate variability (HRV) indices and functional capacity in patients on maintenance hemodialysis (HD). Methods: Forty HD patients were randomized to four training groups for six months: the combined music and exercise group (Group A), the exercise group (Group B), the music group (Group C), and the control group (Group D). At baseline and after 6 months, all participants underwent both short- (for 30 min) and long- (for 24 h) term measurements of HRV and functional capacity assessment with a 6 min walking test (6MWT). Patients of groups A and C listened to preferred music. Results: Long-term HRV analysis showed that standard deviation of all normal-to-normal RR intervals (SDNN) and the square root of the mean squared differences of successive RR intervals (rMSSD) were significantly higher at the end of the study in groups A (by 13.2% and 47.3%), B (by 15.1% and 50%), and C (by 9.0% and 30.1%), compared to group D (p < 0.05). Values of rMSSD and percentage of RR intervals differing by more than 50 ms from the preceding RR interval (pNN50) were elevated in groups A (by 35.6% and 142.9%), B (by 36.1% and 75%), and C (by 15.2% and 28.6%), compared to baseline measurements (p < 0.05). Also, pNN50 was increased in group A compared to groups B (by 21.4%), C (by 88.9%), and D (by 142.9%) (p < 0.05). Similar results were noted by short-term HRV analysis. Functional capacity was improved at the end of the 6-month study in groups A (by 20.3% and 25.7%) and B (by 15.8% and 21.1%) compared to groups C and D (p < 0.05). Conclusions: Intradialytic exercise combined with music-listening can improve the functional capacity and cardiac autonomic nervous system activity in hemodialysis patients.

Impact of traditional Greek dancing on jumping ability, muscular strength and lower limb endurance in cardiac rehabilitation programmes

AIMS

The objective of this study was to evaluate the effect of a training programme based on traditional Greek dance on the jumping ability, muscle strength and lower limb endurance in patients with chronic heart failure (CHF).

PATIENTS AND METHODS

Forty Greek patients with CHF graded as NYHA ⩽ II and aged 73.2±4.7 years were randomly divided into two groups. Group A ( n=20) participated in a three-month physical rehabilitation programme based on Greek traditional dances, whereas group B ( n=20) remained untrained and served as the control group. All patients were studied before and after the 12-week exercise training programme. At baseline and follow-up the exercise capacity of the patients was evaluated by the six-minute walking test, their lower extremity muscle strength was evaluated by an isokinetic dynamometer and their jumping ability by the Myotest-Pro test, which includes three types of jumps (plyometric, countermovement and squat jumps).

RESULTS

No significant difference was observed between the two groups at the baseline evaluation. At follow-up, group A showed significant improvements in walking distance calculated from the six-minute walking test (10.0% improvement; p<0.05), in lower limb strength (10.32% improvement; p<0.05), and in countermovement jump speed (6.9%; p<0.05) and squat jump speed (5.8%; p<0.05). Group A also increased their jump plyometry height by 13.86% ( p<0.05), their counter jump height by 10.68% ( p<0.05) and their squat jump height by 10.45% ( p<0.05). Group A had a 6.85% ( p<0.05) increased force of counter jump compared with group B.

CONCLUSION

The design and implementation of cardiac rehabilitation programmes using Greek traditional dances in patients with CHF are both safe and effective in improving lower limb function.

Indirect estimation of VO2max in athletes by ACSM's equation: valid or not?

AIM

The purpose of this study was to assess the indirect calculation of VO2max using ACSM's equation for Bruce protocol in athletes of different sports and to compare with the directly measured; secondly to develop regression models predicting VO2 max in athletes.

METHODS

Fifty five male athletes of national and international level (mean age 28.3 ± 5.6 yrs) performed graded exercise test with direct measurement of VO2 through ergospirometric device. Moreover, 3 equations were used for the indirect calculation of VO2max: a) VO2max= (0.2 · Speed) + (0.9 · Speed · Grade) + 3.5 (ACSM running equation), b) regression analysis model using enter method and c) stepwise method based on the measured data of VO2. Age, BMI, speed, grade and exercise time were used as independent variables.

RESULTS

Regression analysis using enter method yielded the equation (R=.64, standard error of estimation [SEE] = 6.11): VO2max (ml·kg(-1)·min(-1)) = 58.443 - (0.215 · age) - (0.632 · BMI) - (68.639 · grade) + (1.579 · time) while stepwise method (R = .61, SEE = 6.18) led to: VO2max (ml·kg(-1)·min(-1)) = 33.971 - (0.291 · age) + (1.481 · time). The calculated values of VO2max from these regression models did not differ significantly from the measured VO2max (p>.05). On the contrary, VO2max calculated from the ACSM's running equation was significantly higher from the actually measured value by 14.6% (p <.05).

CONCLUSIONS

In conclusion, it seems that ACSM's equation is not capable of accurately predicting VO2max in athletes aged 18-37 years using Bruce protocol. Only the regression models were correlated moderately with the actually measured values of VO2max.