Effects of exercise programs on cardiorespiratory fitness and arterial stiffness on postmenopausal women: A systematic review study

BACKGROUND

Arterial stiffness is an important marker of cardiovascular disease, with a considerable increase in menopause. The impact of exercise, as a preventive measure, on controlling the progression of cardiovascular disease and arterial dysfunction in middle age remains under investigation.

OBJECTIVE

This systematic review aims to present the results of studies that examined the effects of different exercise programs (isolated, aerobic, and resistance or combined) on arterial stiffness and cardiorespiratory fitness in postmenopausal women.

METHODS

Based on PRISMA guidelines, B-On, BioMed, EBSCOhost, MEDLINE, ScienceOpen, PubMed, Science Direct, Scopus, Web of Science, Cochrane library and LILACS databases were searched using specific keywords.

RESULTS

A final total of 13 manuscripts were included in the qualitative synthesis, involving 700 participants. Four studies used only cardiorespiratory exercise, three only resistance, taekwondo class or flexibility exercise, and six combined exercise programs. Most interventions ranged from 3 to 5 days per week. Carotid-femoral pulse wave velocity showed improvements between 0.22 m/s and 1.56 m/s. In addition, one study showed an improvement of 4.4 ml/kg/min in maximal oxygen consumption. In 7 studies, participation in exercise programs improved arterial stiffness.

CONCLUSIONS

Combined exercise (aerobic and resistance exercise) and aerobic exercise alone (swimming) improve cardiorespiratory fitness and arterial stiffness in postmenopausal women, particularly pulse wave velocity. The combined exercise program is the most effective, promoting improvements of up to -2.6 m/s in pulse wave velocity in this climacteric phase.

Correlates and participation in community-based exercise programming for cancer patients before and during COVID-19

PURPOSE

COVID-19 pandemic restrictions ceased the opportunity for face-to-face group exercise classes with at risk populations, such as cancer patients, forcing an adaptation to online exercise programming. The purpose of this study was to compare the attendance rates and correlates of face-to-face exercise programming pre-COVID-19 to online programming delivered during the first year of pandemic restrictions.

METHOD

The sample was comprised from 1189 patient records between 2018 and 2021. Data analysis was based around the three primary research questions: (i) whether the volume of attendance in online exercise programming differed from the previous face-to-face programming; (ii) whether there were any differences in attendee demographics between online and face-to-face classes; and (iii) whether there were specific correlates of online attendance that can inform future exercise programming.

RESULTS

Class attendance increased significantly when online exercise classes were introduced during the first year of the pandemic when compared to face-to-face attendance the prior years (p < .01). Multiple demographic findings were also observed including age, gender, and geographic differences.

CONCLUSION

While COVID-19 has effected the ability to deliver face-to-face exercise programs for cancer patients, online programming has proved a promising delivery model with greater geographical reach. The approach, however, has gender and age differences in program attendance so targeted programming to reach specific cancer patient demographics may need attention. These results add to the continuing research in the area of online exercise and online programming strategies offering an effective option for cancer patients to achieve targeted exercise prescription.

A systematic review of exercise studies for individuals hospitalized with an acute exacerbation of chronic obstructive pulmonary disease: Focus on the principles of exercise training

BACKGROUND

For exercise interventions to be effectively reproduced or applied in a "real world" clinical setting, clinical trials must thoroughly document all components of the exercise prescription and ensure that participants adhere to each component. However, previous reviews have not critically examined the quality of exercise prescription of inpatient Pulmonary Rehabilitation (PR) programs.

OBJECTIVE

The objectives of this review were to evaluate the (a) application of the principles of exercise training, (b) reporting of the frequency, intensity, time and type (FITT) components of exercise prescription, and (c) reporting of patient's adherence to the FITT components in intervention studies for patients admitted to hospital for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

METHODS

Relevant scientific databases were searched for randomized controlled trials (RCTs) that compared in-hospital PR with usual care for people hospitalized with AECOPD. Title and abstract followed by full-text screening were conducted independently by two reviewers. Data were extracted and synthesized to evaluate the application of the principles of exercise training and the reporting/adherence of the FITT components.

RESULTS

Twenty-seven RCTs were included. Only two applied all principles of exercise training. Specificity was applied by 70%, progression by 48%, overload by 37%, initial values by 89% and diminishing returns and reversibility by 37% of trials. Ten trials adequately reported all FITT components. Frequency and type were the components most reported (85% and 81%, respectively), while intensity was less frequently reported (52%). Only three trials reported on the patient's adherence to all four components.

CONCLUSIONS

Studies have not adequately reported the exercise prescription in accordance with the principles of exercise training nor reported all the FITT components of the exercise prescription and patient's adherence to them. Therefore, interpretation of the current literature is limited and information for developing exercise prescriptions to individuals hospitalized with an AECOPD is lacking.

Change in Daily Steps and Self-efficacy of Online Interactive Exercise Classes for Community-dwelling Older Adults in Japan: A Preliminary Study

Aims

This study aimed to (1) examine the feasibility of an online interactive exercise class for community-dwelling older adults and (2) preliminarily examine changes in physical activity and self-efficacy.

Methods

Participants were 25 community-dwelling older adults aged 65 years or older, but due to 5 dropouts, the final number of participants for analysis was 20 (mean age 76.9 ± 5.7 years). The intervention program was conducted for 40 minutes each session, twice a week for four consecutive weeks, using the LINE group call (LINE Corporation, Japan). An online questionnaire was used to assess participant characteristics, modified Fall Efficacy Scale score, modified Gait Efficacy Scale (m-GES) score, self-rated health, and daily steps, which were compared pre- and post-intervention using the Wilcoxon signed-rank sum and chi-square tests.

Results

The Wilcoxon signed-rank sum test showed significant improvement in the m-GES score and daily steps. The chi-square test showed that self-rated health was significantly greater in the maintenance/increase group.

Conclusions

Online interactive exercise classes are feasible for community-dwelling older individuals. These results also suggest the possibility of using telehealth to improve physical activity and self-efficacy.

Rehabilitation of Individuals With Cancer

The survival rate of cancer is increasing as treatment improves. As patients with cancer now live longer, impairments may arise that impact quality of life (QOL) and function. Therefore, a focus on QOL is often as important as survival. An interdisciplinary team can achieve goal-oriented and patient-centered rehabilitation, which can optimize function and QOL, and minimize impairments, restrictions, and activity limitations. In most cases, cancer patients must be active participants in therapy and exhibit carryover. Patients with cancer often have impairments that include fatigue, pain, brain fog, impaired cognition, paresis, mood disorders, difficulty with activities of daily living (ADL), bowel/bladder/sexual dysfunction, and bone and soft tissue involvement. Adaptive equipment, exercise, and ADL training can mitigate restrictions on activity. The trajectory and phase of the disease along the continuum of cancer care may influence the goals of rehabilitation in that time window. QOL is often influenced by participation in vocational, recreational, and home-based activities. A holistic perspective should include an analysis of distress, socioeconomic barriers, and transportation limitations when addressing issues.

Improving access to exercise training programs for patients with serious mental illness

In a recent issue of this journal, Pratt et al report on an important new position statement by the Society of Behavioral Medicine and the American College of Sports Medicine to improve access to exercise programming as a treatment for patients treated in community mental health settings. If implemented, these recommendations could greatly expand access to these services and improve outcomes for patients treated in community mental health settings.

Multiple levels of influence on older adults' attendance and adherence to community exercise classes

Purpose: To examine the influence of individual participant, instructor, and group factors on participants’ attendance and adherence to community exercise classes for older adults. Design and Methods: Longitudinal data from 16 instructors, 26 classes, and 193 older participants within those classes (aged 60–100 years) were examined. Data were collected using questionnaires on individual participants’ demographics, attitudes, health perceptions and conditions, and group cohesion. Instructors’ demographics, training, background, experience, attitudes, and personality were collected. Group factors included class type, cost, transport, and whether the class was held in an area of deprivation. Outcomes (attendance/adherence) were collected through attendance records. Results: Multilevel modelling (MLwiN) revealed both instructor and individual participant variables were important in understanding attendance and adherence. Individuals’ housing, education, mental well-being, group cohesion, and attitudes were important predictors of attendance at 3 and 6 months. Instructors’ age, gender, experience, and motivational training were important at 3 months, whereas instructor personality was important at both 3 and 6 months. Having attended longer than 6 months at baseline, participants’ attitudes, weeks offered, instructors’ personality, and experience were associated with adherence at 6 months. Implications: Results suggest that instructors’ characteristics alongside individual participant factors play a role in influencing participants’ attendance to exercise classes. These factors should be considered when setting up new programs.