Exercise as a prescription for patients with various diseases

A growing understanding of the benefits of exercise over the past few decades has prompted researchers to take an interest in the possibilities of exercise therapy.Because each sport has its own set of characteristics and physiological complications that tend to occur during exercise training,the effects and underlying mechanisms of exercise remain unclear.Thus,the first step in probing the effects of exercise on different diseases is the selection of an optimal exercise protocol.This review summarizes the latest exercise prescription treatments for 26 different diseases:musculoskeletal system diseases(low back pain,tendon injury,osteoporosis,osteoarthritis,and hip fracture),metabolic system diseases(obesity,type 2 diabetes,type 1 diabetes,and nonalcoholic fatty liver disease),cardio-cerebral vascular system diseases(coronary artery disease,stroke,and chronic heart failure),nervous system diseases(Parkinson’s disease,Huntington’s disease,Alzheimer’s disease,depression,and anxiety disorders),respiratory system diseases(chronic obstructive pulmonary disease,interstitial lung disease,and after lung transplantation),urinary system diseases(chronic kidney disease and after kidney transplantation),and cancers(breast cancer,colon cancer,prostate cancer,and lung cancer).Each exercise prescription is displayed in a corresponding table.The recommended type,intensity,and frequency of exercise prescriptions are summarized,and the effects of exercise therapy on the prevention and rehabilitation of different diseases are discussed.

Physical exercise intensity prescription to improve health and fitness in overweight and obese subjects: A review of the literature

Obesity is one of the greatest public health challenges of the 21st century. Overweight and obesity drastically increase a person’s risk of developing chronic non-communicable diseases (NCDs), including cardiovascular disease, cancer and diabetes. Furthermore, obesity is already responsible for 2% -8% of health costs and 10% -13% of deaths in several industrialized countries. Lifestyle modifications involving changes in exercise, diet and psychological support are effective in reducing the incidence of overweight. Moreover, positive effects of physical activity (PA) for weight loss and prevention of weight regain are well documented. It was recognized that health benefits regarding both psychological and physiological aspects, such as improving cardiorespiratory and muscular fitness and/or decreasing depression symptoms, can be obtained from numerous activities. Public health institutions (American College of Sports Medicine, World Health Organization) provide recommendations for PA (volume, frequency, intensity and type of exercise) to achieve positive effects, at all ages and for many diseases and disorders situations. Although exercise under guidelines can be safely performed by obese subjects, several questions still need to be fully answered. In facts, the exercise program should be tailored according to an individual’s habitual physical activity, physical function, health status, exercise responses, and stated goals. Thus, this review analyzes the intensity of PA parameters. In the last years, research has been focused on the individualization of the right intensity in which different types of subjects’ condition must undergo to achieve the health goals. Aerobic exercise has been commonly used to reach weight loss goal. Prescription of aerobic exercise in clinical practice is frequently based on the percentage of maximum heart rate (%HRmax), heart rate reserve (%HRreserve), rating of perceived exertion (RPE), maximal oxygen consumption (%VO2max) and for unhealthy subjects, peak oxygen consumption (%VO2peak). It has been shown that unhealthy subjects, such as individuals affected by diabetes, obesity and cardiovascular diseases have a reduced maximal aerobic exercise capacity. For instance, using the formula based on percentage of HRmax or VO2max, it could be prescribed heavy exercises, which would result not appropriated and fully functional for the specific individual goal. To avoid this problem, another approach to individualize aerobic exercise could be to consider the gas exchange parameters such us aerobic gas exchange threshold (AerTGE). AerTGE corresponds to the first increase in blood lactate during incremental exercise. This review offers an overview of the different methods to assess exercise intensity, considering the different subjects health characteristics, in order to choose the right methods to achieve the health goals in obese and overweight subjects.

Aerobic Threshold for Exercise Prescription

The Aerobic Threshold (AerT), is an aged cardiovascular parameter not commonly used to evaluate the heart’s performance in athletes. It indirectly evaluated by ventilator parameters during Cardio Pulmonary Test (CPT). Considering that” exercise as prescription therapy “for the diseases, includes training normally established around at the 40% of the peak VO2, this parameter could be taken in care as initial level for the effort prescribed. The aim of the study was to estimate the behavior of the AerT and also Anaerobic Threshold (AT), VO2max in sedentary people. A group of athletes coming from different sports at the same and highest dynamic component were enrolled as control. A group of 41 athletes (16 soccer, 10 basket and 15 cyclists) and 9 healthy subjects were submitted to a CPT. The AerT, AT (assessed by Vslope method) and VO2max were evaluated. The statistical analysis was performed with T student test (P < 0.05 significant). As expected in sedentary all the values were lower than athletes, however for Aer T value appears to be not significantly inferior respect of this one, with the exclusion of the comparison with the cyclists. In sedentary the AerT measure seems to give additional information in evaluating the cardiovascular performance. The VO2max and AT remain the main parameters in defining the athletes performance. Therefore we cannot exclude any further utility of the AerT in normal subject but regularly trained.

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.

Reconsideration of Exercise Prescription in the Context of “Healthy China 2030” Blueprint

On the basis of “Healthy China 2030” Blueprint, this paper conducts an in-depth analysis of the current situation of insufficient physical activities on the background of China’s social development, explores the role of exercise prescription in improving the performance of the national’s functional quality during national fitness and physical medicine integration, provides reasonable exercise advice and programs for different populations, and analyzes and summarizes the development trend and direction of exercise prescriptions.

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.

Non-exhaustive double effort test is reliable and estimates the firs ventilatory threshold intensity in running exercise

Purpose: The present study aimed to investigate the reliability of the non-exhaustive double effort(NEDE) test in running exercise and its associations with the ventilatory thresholds(VT_1 and VT_2) and the maximal lactate steady state(MLSS).Methods: Ten healthy male adults(age: 23 ± 4 years, height: 176.6 ± 6.4 cm, body mass: 76.6 ± 10.7 kg) performed 4 procedures:(1) a ramp test for VT_1 and VT_2 determinations measured by ratio of expired ventilation to O_2 uptake(VE/VO_2) and expired ventilation to CO_2 output(VE/VCO_2) equivalents, respectively;(2) the NEDE test measured by blood lactate concentration(NEDE_(LAC)) and heart rate responses(NEDE_(HR));(3) a retest of NEDE for reliability analysis; and(4) continuous efforts to determine the MLSS intensity. The NEDE test consisted of4 sessions at different running intensities. Each session was characterized by double efforts at the same running velocity(E1 and E2, 180 s), separated by a passive recovery period(90 s rest). LAC and HR values after E1 and E2(in 4 sessions) were used to estimate the intensity equivalent to"null delta" by linear fit. This parameter represents, theoretically, the intensity equivalent to maximal aerobic capacity.Results: The intraclass correlation coefficient indicated significant reliability for NEDE_(LAC)(0.93) and NEDE_(HR)(0.79)(both p < 0.05). There were significant correlations, no differences, and strong agreement with the intensities predicted by NEDE_(LAC)(10.1 ± 1.9 km/h) and NEDE_(HR)(9.8 ± 2.0 km/h) to VT_1(10.2 ± 1.1 km/h). In addition, despite significantly lower MLSS intensity(12.2 ± 1.2 km/h), NEDE_(LAC) and NEDE_(HR) intensities were highly correlated with this parameter(0.90 and 0.88, respectively).Conclusion: The NEDE test applied to running exercise is reliable and estimates the VT_1 intensity. Additionally, NEDE intensities were lower but still correlated with VT_2 and MLSS.

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.

运动干预老年人的肌少性肥胖

背景:运动是老年人肌少性肥胖防治与管理的重要策略,但目前缺乏对于老年人肌少性肥胖的精准个性化运动处方的探索与研究。目的:综述老年人肌少性肥胖的串联机制以及不同运动方式对老年肌少性肥胖患者的干预效果,以期为老年人肌少性肥胖运动处方的制定提供理论与实践指导。方法:以英文检索词“sarcopenic obesity,sarcopenic adiposity,aging,sport,exercise,exercise intervention,exercise prescription,resistant training,aerobic training,combination training,muscle strength,muscle mass,physical activity”;中文检索词“肌少性肥胖,少肌性肥胖,肥胖性肌少症,老年人,运动,运动干预,运动处方,抗阻运动,有氧运动,联合运动,肌肉力量,肌肉质量,身体活动”,分别检索PubMed、Web of Science、中国知网、维普、万方数据库,严格按照纳入与排除标准,对纳入的85篇文献进行综述分析。结果与结论:①抗阻运动仍然是预防与缓解老年人肌少性肥胖的有效运动方式,抗阻运动在改善与提高骨骼肌质量、肌肉力量与耐力以及身体功能等方面效果更为显著,但在实际应用中应循序渐进,逐渐增加至中高强度。②有氧运动也是防治、减缓肌少性肥胖进程的重要干预方法,其在改善老年肌少性肥胖患者心肺耐力、降低体脂百分比以及减少内脏脂肪面积等方面更为有效。③有氧-抗阻联合运动将有氧运动与抗阻运动的优势相结合,可以更好地改善身体成分,同时在降低心血管疾病危险因素方面有更好的效果。联合运动在一定程度上优于单一的运动方式。

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.

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).

健康中国视域下传统功法处方库的设计与构建

文章运用文献资料法,对传统功法处方库进行设计与构建。处方库的功能模块设计既包括体检记录、健康规划及任务提醒等辅助功能,也包括传统功法云定制、处方库导航、饮食运动精准私人定制三项处方内容。处方库的构建列出了“针对经常跌倒或行动受限个体的神经肌肉(平衡)练习”处方推荐和“基于ACSM健康成年人传统功法抗阻训练”推荐两项内容,打造具体可行的实施程序,为社会公众的全面健康提供传统功法锻炼的科学依据与指导,助力全民健身。

智能运动处方助推全民健身发展的逻辑、困境与路径

人工智能在全民健身领域表现出广阔的应用前景,而融合人工智能的运动处方对推动全民健身高质量发展具有重要意义。该研究采用文献资料法、专家访谈法和逻辑分析法等研究方法,在回顾智能运动处方发展历史的基础上,探讨了智能运动处方助推我国全民健身发展的基本逻辑、现实困境与优化路径。研究认为:(1)智能运动处方主要经历了发展初期、发展上升期和全面发展期;(2)智能运动处方助推全民健身发展的过程中,政策法规提供了基本依据,学科交叉提供了创新驱动,健康升级提供了内生动力;(3)智能运动处方助推全民健身发展面临着政策法规跟进缓慢、科技自主创新不足、市场机制与用户需求脱节等现实困境。据此,提出了智能运动处方助推全民健身发展的优化路径:细化完善政策法规,切实发挥制度支撑导向作用;大力发展智能科技,持续强化技术创新驱动作用;始终紧盯用户需求,逐步激活市场调节作用。

肺癌化疗病人预康复理念下运动方案的构建

目的:基于预康复理念构建肺癌化疗病人的运动方案,以缓解病人癌性相关症状,改善病人呼吸功能,提高生存质量。方法:系统检索the Cochrane Library、PubMed、Web of Science、中国知网、中国生物医学文献数据库中有关预康复理念指导下,运动措施运用于肺癌病人的相关文献,检索时间为建库至2023年4月1日,对筛选后的文献进行质量评价并提炼内容,制定肺癌病人预康复理念下运动康复方案的初稿。于2023年4月—5月采用德尔菲法对24名专家进行两轮专家函询,修订并最终确定肺癌化疗病人预康复理念下运动方案。结果:两轮专家函询的问卷回收率分别为91.67%(22/24)和100.00%(22/22),专家权威系数为0.81,最终形成的肺癌病人运动康复方案包括筛查与评估、运动方案模式、辅助管理、运动效果评价4个一级指标、11个二级指标及40个三级指标。结论:基于循证和德尔菲法构建的运动康复方案具有一定的科学性和实用性,可用于指导肺癌化疗病人预康复理念下的运动管理。

补肺一号方联合呬字诀呼吸操治疗COPD患者的临床研究

目的探讨补肺一号方联合呬字诀呼吸操对慢性阻塞性肺疾病(COPD)患者的临床疗效。方法选取2022年2月至2023年2月福建中医药大学附属第二人民医院收治的COPD稳定期肺气虚证患者90例作为研究对象。按照“就诊时间顺序编号”将对象分为三组,每组30例,试验1组(补肺1号方汤剂治疗),试验2组(补肺1号方汤剂联合呬字诀操锻炼治疗),对照组(吸入硫酸沙丁胺醇气雾剂治疗)。对比外周血Th17、Treg细胞含量、慢性阻塞性肺疾病评估测试评分(CAT)、肺活量(VC)、呼气峰流速(PEF)以及第1秒用力呼气容积(FEV_(1))。结果治疗后,试验2组的外周血Th17细胞含量以及CAT评分低于试验1组与对照组,差异有统计学意义(P<0.05);试验2组比对照组、试验1组的VC、PEF、FEV_(1)数值以及外周血Treg细胞含量更高(P<0.05);试验1组的外周血Th17细胞含量以及CAT评分低于对照组,差异有统计学意义(P<0.05);对照组相比于试验1组,其VC、PEF、FEV_(1)数值以及外周血Treg细胞含量更低(P<0.05)。结论在COPD稳定期患者的治疗中,采用补肺一号方联合呬字诀呼吸操能够有效调节患者肺功能指标,改善外周血Th17、Treg细胞含量,同时改善患者咳嗽、气喘等症状,提升睡眠质量,调整患者精神状态,促进患者康复。

传统功法处方对公众免疫干预效果的研究综述

该文通过文献检索的方式,对与中国传统功法相关的运动处方进行综述,论述了中国传统功法处方作为干预手段对免疫系统、特定人群、特定疾病3个方面的干预效果。根据文献显示,目前很多研究已经证明中国传统功法处方对免疫系统的各项指标,如IgG、IgA、IgM、白细胞介素、NK细胞、T淋巴细胞等有着积极干预效果;对于特定人群如老年人、妇女、青少年、残疾人等群体的常见健康问题也有着较好的改善效果;对于国内常见疾病如糖尿病、高血压、呼吸系统疾病以及癌症等疾病在改善症状或调节情绪方面也有着不错的干预效果。

体医结合背景下高校女大学生异常身体姿态现状调查与运动处方的制定研究

文章从体医结合背景出发,结合运动处方的实施效果和现实意义,通过对高校女大学生异常身体姿态现状调查,了解当代女大学生的生活习惯等对体态的影响,根据大学生自身情况和锻炼需求,借鉴运动处方在全民健身中推广应用的经验与模式,以科学健身为原则,加强对女大学生身体姿态的重视程度,为女大学生提供运动处方的计划方案,有利于提高女大学生的体质健康水平。

福建省运动健康指导门诊建设的实践样态与治理路径研究

运动健康指导门诊是体医融合工作的重要突破口和具体抓手。采用问卷调查法、专家访谈法等,对福建省运动健康指导门诊的建设样态和治理路径进行系统分析。研究认为,目前福建省运动健康指导门诊尚处于探索阶段,存在的问题包括缺乏独立门诊部门、体适能评估用房不足、运动处方师队伍规模有限等。研究认为,应通过加强政策引导支持、推动门诊环境建设;扩大专业人才队伍,优化医生进修体系;明确分级诊疗职责,完善双向转诊机制;扩大医保支付范围,提升运动处方应用等路径推动福建省运动健康指导门诊的建设。

健康管理下不同体质人群运动处方的研究

当今社会,健康管理日益受到人们关注,而个体之间的生理差异导致了不同体质的存在。体质是中医学的核心概念之一,指个体在遗传、环境和生活方式等多方面因素的影响下所表现出来的身体特征和功能状态。因此,针对不同体质人群的个性化健康管理显得尤为重要。运动是一种重要的健康管理手段,不同体质人群在运动适应性和运动处方上存在差异,然而目前相关研究尚不充分。该研究基于健康管理的视角,旨在探讨为不同体质人群制定个性化运动处方的可行性与有效性。

传统体育养生融入社区慢病管理发展现状与动力考查

文章运用文献资料法和逻辑分析法,系统回顾和考察了传统体育养生在当代的发展情况及其融入社区慢病管理的动力因素,旨在为解决社区慢病管理面临的问题提供理论依据。研究发现:传统体育养生在学校体育和全民健身方面获得了稳定发展。作为一种非医疗健康干预手段,已逐渐成为社区、医疗、体育和养老等领域开展健康促进活动的重要途径。传统体育养生融入社区慢病管理具有国家政策扶持和自身技术内容的双重动力,展现出运动促进健康在居民健康管理和慢病防治方面的显著优势,并提出未来应加强与相关领域和部门的合作,深入探讨传统体育养生在社区慢病管理中的应用策略和效果评估,从而推动传统体育养生技术在体医、体卫融合领域的有效应用。