Functional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis

Knee Osteoarthritis(KOA)is the most common type of knee joint injury and also a risk factor for multiple health consequences and is prevalent among older women.The updated clinical guidelines for KOA treatment by the American Rheumatism Association recommend Tai Chi exercise.However,a literature review outlined limitations in Tai Chi intervention implementations.This study aimed to address some of the gaps.This study selected thirty female patients to participate in Tai Chi exercises and undergo relevant tests.The subjects were randomly assigned to Tai Chi or education groups.Independent sample t-tests were conducted to compare the difference in health indicators between the two groups after the intervention.The difference-in-differences(DID)regression was performed to assess the difference in the health outcomes between the two groups at baseline and follow-up and the difference in the differences.After the completion of the intervention,the Tai Chi group reported significantly improved KOA symptoms,physical fitness,and health status indicators than the control group.Specifically,the group differences were significantly larger at the baseline than at the follow-up.Our findings provide compelling evidence of the effects of the innovative Tai Chi exercise prescription specifically designed for KOA patients.The empirical evidence on its effectiveness in alleviating KOA symptoms and improving the overall health of middle-aged and elderly women with KOA suggested that Tai Chi intervention exercise has huge prospects for integration in KOA rehabilitation therapy.

Immersible ergocycle prescription as a function of relative exercise intensity

Purpose: The purpose of this study was to establish the relationship between various expressions of relative exercise intensity percentage of maximal oxygen uptake(%VO_(2max)), percentage of maximal heart rate(%HR_(max)), %VO_2 reserve(%VO_2R), and %HR reserve(%HRR)) in order to obtain the more appropriate method for exercise intensity prescription when using an immersible ergocycle(IE) and to propose a prediction equation to estimate oxygen consumption(VO_2) based on IE pedaling rate(rpm) for an individualized exercise training prescription.Methods: Thirty-three healthy participants performed incremental exercise tests on IE and dryland ergocycle(DE) at equal external power output(Pext). Exercise on IE began at 40 rpm and was increased by 10 rpm until exhaustion. Exercise on DE began with an initial load of 25 W and increased by 25 W/min until exhaustion. VO_2 was measured with a portable gas analyzer(COSMED K4b^2) during both incremental tests. On IE and DE, %VO_2R, %HRmax, and %HRR at equal Pext did not differ(p > 0.05).Results: The %HRR vs. %VO_2R regression for both IE and DE did not differ from the identity line %VO_2R IE = 0.99 × HRR IE(%) + 0.01(r^2= 0.91, SEE = 11%); %VO_2R DE = 0.94 × HRR DE(%) + 0.01(r^2= 0.94, SEE = 8%). Similar mean values for %HRmax, %VO_2R, and %HRR at equal Pext were observed on IE and DE. Predicted VO_2 obtained according to rpm on IE is represented by: VO_2(L/min) = 0.000542 × rpm2-0.026 × rpm + 0.739(r = 0.91, SEE = 0.319 L/min).Conclusion: The %HRR–%VO_2R relationship appears to be the most accurate for exercise training prescription on IE. This study offers new tools to better prescribe, control, and individualize exercise intensity on IE.

Overview of Exercise Prescription for Diabetes Patients and Its Application in Japan

In recent years,the Westernization of dietary habits and increasingly sedentary lifestyle have contributed to a marked increase in the number of type 2 diabetes patients.Sedentary behavior may play a significant role in the development and aggravation of type 2 diabetes.The results of various follow-up studies have demonstrated that proper diet combined with physical exer-cise is useful in the prevention and treatment of type 2 diabetes.A nationwide survey regarding exercise therapy for diabetes patients in Japan revealed that relatively few physicians provide patients with exercise guidance because of time constraints,that the physicians do not receive additional consultation fee,and that there is a lack of specialized physical exercise educa-tors.Physical exercise promotes the utilization of glucose and free fatty acids in the muscles,and thus lowers blood glucose(BG)levels.Dietary restriction and physical exercise are effective in the prevention and treatment of type 2 diabetes by improving the in vivo sensitivity to insulin.Most adults with diabetes should engage in 150 min or more of moderate-to-vigorous intensity aerobic activity per week,spread out over at least 3 days/week,with no more than two consecutive days without activity.Mild-intensity resistance training such as half squat and calf raise is recommended for elderly individuals who have decreased muscle strength and mass(sarcopenia).Prolonged sitting should be interrupted every 30 min for BG benefits,particularly in adults with type 2 diabetes.Individuals with type 2 diabetes are also encouraged to increase their total daily unstructured physical activity(daily movement).

Increases in the incremental exercise mean response time across the steady state domain:Implications for exercise testing&prescription

We hypothesized that slowed oxygen uptake(VO_(2))kinetics for exercise transitions to higher power outputs(PO)within the steady state(SS)domain would increase the mean response time(MRT)with increasing exercise intensity during incremental exercise.Fourteen highly trained cyclists(mean±standard deviation[SD]);age(39±6)years[yr];and VO_(2) peak=(61±9)mL/kg/min performed a maximal,ramp incremental cycling test and on separate days,four 6-min bouts of cycling at 30%,45%,65%&75% of their incremental peak PO(Wpeak).SS trial data were used to calculate the MRT and verified by mono-exponential and linear curve fitting.When the ramp protocol attained the value from SS,the PO,in Watts(W),was converted to time(min)based on the ramp function W to quantify the incremental MRT(iMRT).Slope analyses for the VO_(2) responses of the SS versus incremental exercise data below the gas exchange threshold(GET)revealed a significant difference(p=0.003;[0.437±0.08]vs.[0.382±0.05]L·min^(-1)).There was a significant difference between the 45%Wpeak steady state VO_(2)(ss VO_(2))([3.08±0.30]L·min^(-1),respectively),and 30% Wpeak ss VO_(2)(2.26±0.24)(p<0.0001;[3.61±0.80]vs.[2.20±0.39]L·min^(-1))and between the iMRT for 45% and 30% Wpeak ss VO_(2) values([50.58±36.85]s vs.[32.20±43.28]s).These data indicate there is no single iMRT,which is consistent with slowed VO_(2) kinetics and an increasing VO_(2) deficit for higher exercise intensities within the SS domain.

Women and exercise in aging

Aging is associated with physiological declines, notably a decrease in bone mineral density （BMD） and lean body mass, with a concurrent increase in body fat and central adiposity. Interest in women and aging is of particular interest partly as a result of gender specific responses to aging, particularly as a result of menopause. It is possible that the onset of menopause may augment the physiological decline associated with aging and inactivity. More so, a higher incidence of metabolic syndrome （an accumulation of cardiovascular disease risk factors including obesity, low-density lipoprotein cholesterol, high blood pressure, and high fasting glucose） has been shown in middle-aged women during the postmenopausal period. This is due in part to the drastic changes in body composition, as previously discussed, but also a change in physical activity （PA） levels. Sarcopenia is an age related decrease in the cross-sectional area of skeletal muscle fibers that consequently leads to a decline in physical function, gait speed, balance, coordination, decreased BMD, and quality of life. PA plays an essential role in combating physiological decline associated with aging. Maintenance of adequate levels of PA can result in increased longevity and a reduced risk for metabolic disease along with other chronic diseases. The aim of this paper is to review relevant literature, examine current PA guidelines, and provide recom- mendations specific to women based on current research.

Muscle function, physical performance and body composition changes in men with prostate cancer undergoing androgen deprivation therapy

Prostate cancer （PCa） is the most common visceral malignancy in men with androgen deprivation therapy （ADT） the preferred therapy to suppress testosterone production and hence tumor growth. Despite its effectiveness in lowering testosterone, ADT is associated with side effects including loss of muscle mass, diminished muscle strength, decrements in physical performance, earlier fatigue and declining quality of life. This review reports a survey of the literature with a focus on changes in muscle strength, physical function and body composition, due to short-term and long-term ADT. Studies in these areas are sparse, especially well-controlled, prospective randomized trials. Cross-sectional and longitudinal data （up to 2 years） for men with PCa treated with ADT as well as patients with PCa not receiving ADT and age-matched healthy men are presented when available. Based on limited longitudinal data, the adverse effects of ADT on muscle function, physical performance and body composition occur shortly after the onset of ADT and tend to persist and worsen over time. Exercise training is a safe and effective intervention for mitigating these changes and initial guidelines for exercise program design for men with PCa have been published by the American College of Sports Medicine. Disparities in study duration, types of studies and other patient-specific variables such as time since diagnosis, cancer stage and comorbidities may all affect an understanding of the influence of ADT on health, physical performance and mortality.

Implementation and assessment of diverse strategies for physical activity promotion in Vietnam--A case report

Background: Regular physical activity(PA) has documented effects in prevention and treatment of many non-communicable diseases(NCDs).Physical inactivity is recognized as the fourth leading risk factor for premature death, worldwide. Despite these facts, physical inactivity is increasing,not only in high-income, but also in middle-and low-income countries. To address this negative trend, evidence-based methods to increase PA are needed. The purpose of this paper is to describe the implementation and assessment of 4 strategies designed to increase PA in Vietnam.Methods: Four strategies were used: i) introduction and evaluation of an education and training program on the Swedish method of Physical Activity on Prescription(PAP) among health care professionals, ii) translation of the PAP evidence-based handbook, Physical Activity in the Prevention and Treatment of Disease(called FYSS in Swedish) into Vietnamese, iii) launch of a mass-media campaign to promote PA, and iv)advocacy to support development of PA guidelines in Vietnam.Results: The evaluation indicated that the participating health care professionals had a positive attitude to PAP. However, they also reported uncertainty in prescribing PA. FYSS was translated and disseminated successfully to health care professionals. A mass-media campaign identified the beneficial effects of PA to health care professionals, journalists, policy makers, and the public. Last, the process of developing national guidelines on PA was initiated.Conclusion: This project led to enhanced awareness and appreciation of PA in the prevention and treatment of NCDs among health care professionals as well as initiation of national PA guidelines. Important lessons also were learned in the presentation of PAP, which will be considered when designing similar projects in the future.

Practical Use of Stairs to Assess Fitness, Prescribe and Perform Physical Activity Training

Aim: Evaluating climbing stairs for prescription and implementation of physical activity regimes. Methods: Healthy females (F, n = 14), and males (M, n = 15) participated. By climbing 100 steps of stairs with 0.173 m height, Heart rate (HR) and oxygen uptake were measured throughout the floors;Blood pressure (BP) was measured at ground and the 5th floors only. Results: Energy increased from 2 to 7.6 was metabolic equivalents (METs = 3.5 ml O2/min.kg) at 17.3 m elevation in 2 min. at the 5th floor, and percent Heart Rate Reserve (%HRR) was 66.17% in F and 48.7% in M, proportional to their aerobic efforts. Average climbing efficiency was 15.8 ± 2.3% (n = 29). Aerobic capacity estimated dividing the highest work rate (17.3 Kg.m/2min.Kg × 0.00239 = 0.0207 Kcal/min.Kg), by fractional effort (F = 0.6617, M = 0.487) and fractional efficiency (0.158), at 5 Kcal/L O2 was 0.040 in F and 0.054 L O2/Kg.min in M. Minimum training intensity reached at the 3rd floor by F. In M the highest %HRR reached was 48.7% at the 5th floor, insufficient for training. Conclusions: Stairs used for submaximal evaluation of aerobic capacity and for target intensity prescription. Training, levels climbed, repetitions per day (if 5, 100 Kcal per day, ascending) and number of days/week are adjusted. Full regime requires up to 7.6 METs, a total of 532 and 140 MET.min/week ascending and descending, respectively. Intensities >7.6 MET, climbing rate should be >8.65 m/min. Limiting ascent to 1 (3.5 METs) or 2 (5.5 METs) floors or only descents (2 - 3 METs) may be used for unfit subjects. This method is useful for those with no access to sophisticated facilities.

Research hotspots and trends of cardiopulmonary exercise test:Visualization analysis based on citespace

The study aims to grasp the hot spots and trends of global cardiopulmonary exercise research.Web of Science(WoS)core collection and Derwent Innovation Index database were retrieved to collect literature from 2002 to 2022 with Cardiopulmonary Exercise Test(CPET)as the retrieval theme.CiteSpace was used to conduct bibliometrics and visual analysis of 6679 pieces of literature in the web of science core collection database and 251 patent data in the Derwent Innovation Index database.The results show that:(1)the number of CPET theme research papers is increasing year by year,and the main research fields are cardiology,respiratory system,sports science,etc.;(2)The main research hot spots of CPET include exercise prescription,exercise and heart failure,COVID-19 cardiopulmonary rehabilitation and evaluation,etc.;(3)The development trend of CPET technology is majorly in the direction of intelligence,portability,individualization and the integration of Virtual Reality(VR)technology and evidence-based research of CPET guiding clinical decision-making.

Physically active primary care physicians consult more on physical activity and exercise for patients: A public teaching-hospital study

Physical activity and exercise(PAE)improve quality of life and reduce the effects of chronic diseases.Primary care physicians(PCPs)play an important role to encourage PAE in patients.We aim to assess PCPs'current PAE consultation practices and their enablers/barriers in daily clinical practice.We had 64 PCPs(age[35.3±4.7]y,47 women)that completed self-administered questionnaires on PAE consultation practices,training,and confidence levels.PCPs(n=42)also completed the International Physical Activity Questionnaire-Short Form to assess their physical activity(PA)levels.We conducted correlation,one-way analysis of variance and a linear regression to assess the associations between enablers,barriers and PA levels to PAE consultation practices.On average,PCPs consulted on PAE in 49.7%of their daily clinical appointments.Majority of PCPs(70%)strongly agreed that more PAE knowledge were needed to increase consultation practices.Top three barriers related(p<0.001)to practices were lack of PAE education(r=0.47),patients’preference of pharmaceutical interventions(r=0.45)and lack of continuing education in PAE for PCPs(r=0.37).Physically active PCPs(health-enhancing PA levels,n=6)gave significantly more daily consultations in PAE,73.2%±21.9%,compared to inactive PCPs(n=13),37.4%
22.8%(p=0.013).In our regression output,PCPs who had higher PA levels consulted more on PAE daily(R^(2)=0.38,p<0.001)while controlling for age.Conclusion,PCPs require more knowledge on PAE and need be physically active themselves to increase PAE consultation for patients in their daily practice.Medical education should consider including more PA and exercise topics that may benefit both physicians and their patients.

Backward Sled Pulling Load-Velocity Relationship in Youth: A Backward-Forward Comparison

Purpose To establish the load-velocity relationships during backward sled pulling and compare this to forward sled pulling and determine the reliability of running speeds and associated load-velocity regression slopes in youth athletes.Methods Twenty-one boys(age,13.6±0.28 years old;height,1.72±0.09 m;mass,66.1±8.2 kg;maturity,0.57±0.72 years from peak height velocity)performed backward and forward resisted running on three occasions.Load-velocity relationships were established using an un-resisted sprint and resisted sled pull with loads of 25%-81%body mass(BM)in both directions,and the reliability of sprint times at each load and the load-velocity regression slopes were examined.Results The load-velocity data was reliable across multiple testing occasions for backward(CV≤7.2%;ICC 0.67-0.91)and forward sled pulling(CV≤7.2%;ICC 0.66-0.91).From the regression lines(R2≥0.99;P≤0.01),it was observed that averaged loads across the sample of 31%,46% and 61% BM resulted in 27%,38% and 48% decrease in velocity during backward sled pulling and 23%,33% and 43% during forward sled pulling.Increasing backward and forward loads by∼13% and~15% BM respectively,reliably resulted in∼10% decreases in velocity.Conclusion If contractile overload of the lower limbs is a focus of training then practitioners should preferentially use back-ward sled pulling.Both backward and forward sled pulling can be used in a similar manner regarding loading,though back-ward velocity is more sensitive to load and therefore overloading backward motion should be prescribed with this in mind.