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Discovery Medicine Mar 2012A decline in maximal aerobic exercise capacity occurs across the adult age-span, accelerating in later years. This age-associated decline in aerobic capacity is... (Review)
Review
A decline in maximal aerobic exercise capacity occurs across the adult age-span, accelerating in later years. This age-associated decline in aerobic capacity is accentuated by superimposed comorbidities common to the elderly such as cardiac, pulmonary, and peripheral artery disease. However, observational and training studies demonstrate significant improvement in peak oxygen consumption in both health and disease settings. In addition, exercise training exerts beneficial effects on blood pressure, lipids, glucose tolerance, bone density, depression, and quality of life. A major challenge to physicians and society is to increase the low participation rates of older adults in both home-based exercise and supervised exercise rehabilitation programs.
Topics: Aged; Aging; Cardiovascular Diseases; Exercise; Exercise Therapy; Humans; Time Factors
PubMed: 22463798
DOI: No ID Found -
The Journal of Headache and Pain Oct 2022Multiple clinical trials with different exercise protocols have demonstrated efficacy in the management of migraine. However, there is no head-to-head comparison of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Multiple clinical trials with different exercise protocols have demonstrated efficacy in the management of migraine. However, there is no head-to-head comparison of efficacy between the different exercise interventions.
METHODS
A systematic review and network meta-analysis was performed involving all clinical trials which determined the efficacy of exercise interventions in reducing the frequency of monthly migraine. Medical journal search engines included Web of Science, PubMed, and Scopus spanning all previous years up to July 30, 2022. Both aerobic and strength/resistance training protocols were included. The mean difference (MD, 95% confidence interval) in monthly migraine frequency from baseline to end-of-intervention between the active and control arms was used as an outcome measure. Efficacy evidence from direct and indirect comparisons was combined by conducting a random effects model network meta-analysis. The efficacy of the three exercise protocols was compared, i.e., moderate-intensity aerobic exercise, high-intensity aerobic exercise, and strength/resistance training. Studies that compared the efficacy of migraine medications (topiramate, amitriptyline) to exercise were included. Additionally, the risk of bias in all included studies was assessed by using the Cochrane Risk of Bias version 2 (RoB2).
RESULTS
There were 21 published clinical trials that involved a total of 1195 migraine patients with a mean age of 35 years and a female-to-male ratio of 6.7. There were 27 pairwise comparisons and 8 indirect comparisons. The rank of the interventions was as follows: strength training (MD = -3.55 [- 6.15, - 0.95]), high-intensity aerobic exercise (-3.13 [-5.28, -0.97]), moderate-intensity aerobic exercise (-2.18 [-3.25, -1.11]), topiramate (-0.98 [-4.16, 2.20]), placebo, amitriptyline (3.82 [- 1.03, 8.68]). The RoB2 assessment showed that 85% of the included studies demonstrated low risk of bias, while 15% indicated high risk of bias for intention-to-treat analysis. Sources of high risk of bias include randomization process and handling of missing outcome data.
CONCLUSION
Strength training exercise regimens demonstrated the highest efficacy in reducing migraine burden, followed by high-intensity aerobic exercise.
Topics: Adult; Amitriptyline; Exercise; Female; Humans; Male; Migraine Disorders; Network Meta-Analysis; Resistance Training; Topiramate
PubMed: 36229774
DOI: 10.1186/s10194-022-01503-y -
The Journal of Physiology Oct 2019Cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality in both men and women in developed societies. Age is the greatest risk factor for CVD... (Review)
Review
Cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality in both men and women in developed societies. Age is the greatest risk factor for CVD due largely to adverse changes to arteries that include stiffening of the large elastic arteries (aortic and carotid arteries) and endothelial dysfunction. Vascular ageing is driven by oxidative stress, which reduces nitric oxide (NO) bioavailability and stimulates changes in the extracellular matrix. In women, reductions in circulating oestrogens with menopause interact with ageing processes to induce vascular dysfunction. Regular aerobic exercise is the most evidence-based strategy for reducing CVD risk with ageing in both men and women. Much of this cardiovascular-protective effect of aerobic exercise is likely due to its vascular health-enhancing influence. Large elastic artery stiffening with advancing age is attenuated in healthy adults engaged in aerobic exercise training, and aerobic exercise interventions improve arterial stiffness in previously sedentary middle-aged and older men and postmenopausal women. Regular aerobic exercise also enhances endothelial function with ageing in men (by reducing oxidative stress and preserving NO bioavailability), but not consistently in oestrogen-deficient postmenopausal women. In postmenopausal women, treatment with oestradiol appears to restore the ability of aerobic exercise to improve NO-mediated endothelial function by reducing oxidative stress. Several research gaps exist in our understanding of potential sex differences in the vascular adaptations to regular aerobic exercise. More information is needed on the factors that are responsible for sex differences, including the role of circulating oestrogens in transducing the aerobic exercise training 'stimulus'.
Topics: Aging; Cardiovascular Physiological Phenomena; Exercise; Female; Humans; Male; Oxidative Stress
PubMed: 31077372
DOI: 10.1113/JP277764 -
International Journal of Environmental... Aug 2022Exercise is often recommended in addition to diet and medication in the management of gestational diabetes mellitus (GDM). Our aim was to determine if strength training... (Review)
Review
Exercise is often recommended in addition to diet and medication in the management of gestational diabetes mellitus (GDM). Our aim was to determine if strength training compared with aerobic exercise had an impact on glycaemic control, maternal and neonatal outcomes. The Cochrane library, Embase, PubMed, CINAHL, Medline, Google Scholar, and OpenGrey were searched. Over 758 pregnant women (mother-baby pairs) from 14 studies are included in this systematic review. Interventions ranged from cycling, aerobic exercises, walking, yoga, or combined aerobic and resistance exercises. Of the studies identified, none directly compared aerobic exercise with strength training. Half of the studies showed benefit in glycaemic control with additional exercise compared with usual physical activity. There was largely no impact on obstetric or neonatal outcomes. Studies on exercise in GDM have reiterated the safety of exercise in pregnancy and shown mixed effects on maternal glycaemic control, with no apparent impact on pregnancy outcomes. The heterogenicity of reported studies make it difficult to make specific recommendations on the optimum exercise modality for the management of GDM. The use of a core outcome set for GDM may improve reporting of studies on the role of exercise in its management.
Topics: Diabetes, Gestational; Exercise; Female; Glycemic Control; Humans; Infant, Newborn; Pregnancy; Pregnancy Outcome; Resistance Training
PubMed: 36078508
DOI: 10.3390/ijerph191710791 -
Exercise and Sport Sciences Reviews Apr 2014Current dogma suggests that aerobic exercise training has minimal effects on skeletal muscle size. We and others have demonstrated that aerobic exercise acutely and... (Review)
Review
Current dogma suggests that aerobic exercise training has minimal effects on skeletal muscle size. We and others have demonstrated that aerobic exercise acutely and chronically alters protein metabolism and induces skeletal muscle hypertrophy. These findings promote an antithesis to the status quo by providing novel perspective on skeletal muscle mass regulation and insight into exercise countermeasures for populations prone to muscle loss.
Topics: Adaptation, Physiological; Aging; Exercise; Humans; Mitochondria, Muscle; Muscle Fibers, Skeletal; Muscle Proteins; Muscle, Skeletal; Resistance Training
PubMed: 24508740
DOI: 10.1249/JES.0000000000000007 -
Neurotherapeutics : the Journal of the... Oct 2020Parkinson's disease (PD) is a progressive neurological disorder characterized by motor and non-motor symptoms for which only symptomatic treatments exist. Exercise is a... (Review)
Review
Parkinson's disease (PD) is a progressive neurological disorder characterized by motor and non-motor symptoms for which only symptomatic treatments exist. Exercise is a widely studied complementary treatment option. Aerobic exercise, defined as continuous movement of the body's large muscles in a rhythmic manner for a sustained period that increases caloric requirements and aims at maintaining or improving physical fitness, appears promising. We performed both a scoping review and a systematic review on the generic and disease-specific health benefits of aerobic exercise for people with PD. We support this by a meta-analysis on the effects on physical fitness (VOmax), motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor section), and health-related quality of life (39-item Parkinson's disease Questionnaire (PDQ-39)). Aerobic exercise has generic health benefits for people with PD, including a reduced incidence of cardiovascular disease, a lower mortality, and an improved bone health. Additionally, there is level 1 evidence that aerobic exercise improves physical fitness (VOmax) and attenuates motor symptoms (MDS-UPDRS motor section) in the off-medication state, although the long-term effects (beyond 6 months) remain unclear. Dosing the exercise matters: improvements appear to be greater after training at higher intensities compared with moderate intensities. We found insufficient evidence for a beneficial effect of aerobic exercise on health-related quality of life (PDQ-39) and conflicting results regarding non-motor symptoms. Compliance to exercise regimes is challenging for PD patients but may be improved by adding exergaming elements to the training program. Aerobic exercise seems a safe intervention for people with PD, although care must be taken to avoid falls in at-risk individuals. Further studies are needed to establish the long term of aerobic exercise, including a focus on non-motor symptoms and health-related quality of life.
Topics: Exercise; Exercise Therapy; Humans; Parkinson Disease; Physical Fitness; Quality of Life
PubMed: 32808252
DOI: 10.1007/s13311-020-00904-8 -
Journal of Applied Physiology... Apr 2021Short-term blood pressure (BP) variability (BPV), measured by 24-h ambulatory BP monitoring (ABPM), has been independently related to a higher risk of cardiovascular... (Randomized Controlled Trial)
Randomized Controlled Trial
Short-term blood pressure (BP) variability (BPV), measured by 24-h ambulatory BP monitoring (ABPM), has been independently related to a higher risk of cardiovascular events and target organ in hypertensive patients. The aim of this study was to compare the effects of two different exercise modalities on BPV in hypertensive patients enrolled in a cardiac rehabilitation program. This study is a randomized trial, with two intervention arms: ) aerobic training (AT) and ) combined aerobic and resistance training (CT). We studied 55 male patients with hypertension. They were randomly assigned either to AT or CT group. The training program lasted 12 wk for each group. Short-term BP variability was evaluated by means of average real variability (ARV), at baseline and after 12 wk, by ABPM. Systolic and diastolic 24-h BP values decreased significantly ( < 0.01) in both groups, without between-groups differences ( = 0.11). The 24-h systolic BP variability decreased in both groups (AT: from 8.4 ± 1.2 to 7.6 ± 0.8; CT: from 8.8 ± 1.5 to 7.1 ± 1.1), with a greater decrease in CT ( = 0.02). Night-time systolic BPV decreased in CT (from 9.4 ± 1.3 to 8.3 ± 1.2, = 0.03) and remained unchanged in AT (from 9.5 ± 1.2 to 9.4 ± 1.4). Day-time BPV decreased in both groups without between-groups differences ( = 0.07). CT was more effective than AT in reducing short-term BPV in hypertensive patients, and both exercise modalities reduced BP to a same extent. CT appears to be a more appropriate exercise modality if the objective is to reduce BPV in addition to BP levels. Combined exercise training (CT) including aerobic plus resistance exercises could be more effective in comparison with aerobic exercise (AT) alone in reducing blood pressure variability (BPV) in hypertensive patients. We report that CT was indeed more effective than AT in reducing short-term BPV, and both exercise modalities reduced BP levels to the same extent. CT appears to be a more appropriate exercise modality if the objective is to reduce BPV in addition to BP levels.
Topics: Blood Pressure; Blood Pressure Monitoring, Ambulatory; Exercise; Humans; Hypertension; Male; Resistance Training
PubMed: 33630677
DOI: 10.1152/japplphysiol.00910.2020 -
Journal of Hepatology Jan 2017Exercise is a first-line therapy for patients with non-alcoholic fatty liver disease (NAFLD). We sought to: 1) summarize effective aerobic and resistance exercise... (Review)
Review
BACKGROUND & AIMS
Exercise is a first-line therapy for patients with non-alcoholic fatty liver disease (NAFLD). We sought to: 1) summarize effective aerobic and resistance exercise protocols for NAFLD; and 2) compare the effects and energy consumption of aerobic and resistance exercises.
METHODS
A literature search was performed using PubMed, Web of Science, and Scopas to January 28, 2016. From a total of 95 articles, 23 studies including 24 aerobic and 7 resistance exercise protocols were selected for the summary of exercise protocols. Twelve articles including 13 aerobic and 4 resistance exercise protocols were selected for the comparative analysis.
RESULTS
For aerobic exercise, the median effective protocol was 4.8 metabolic equivalents (METs) for 40min/session, 3times/week for 12weeks. For resistance exercise, the median effective protocol was 3.5 METs for 45min/session, 3times/week for 12weeks. Aerobic and resistance exercise improved hepatic steatosis. No significant difference was seen in the duration, frequency, or period of exercise between the two exercise groups; however, %VOmax and energy consumption were significantly lower in the resistance than in the aerobic group (50% [45-98] vs. 28% [28-28], p=0.0034; 11,064 [6394-21,087] vs. 6470 [4104-12,310] kcal/total period, p=0.0475).
CONCLUSIONS
Resistance exercise improves NAFLD with less energy consumption. Thus, resistance exercise may be more feasible than aerobic exercise for NAFLD patients with poor cardiorespiratory fitness or for those who cannot tolerate or participate in aerobic exercise. These data may indicate a possible link between resistance exercise and lipid metabolism in the liver.
LAY SUMMARY
Both aerobic and resistance exercise reduce hepatic steatosis in non-alcoholic fatty liver disease (NAFLD) with similar frequency, duration, and period of exercise (40-45min/session 3times/week for 12weeks); however, the two forms of exercise have different characteristics. Intensity and energy consumption were significantly lower for resistance than for aerobic exercise. Resistance exercise may be more feasible than aerobic exercise for NAFLD patients with poor cardiorespiratory fitness or for those who cannot tolerate or participate in aerobic exercise.
Topics: Exercise; Humans; Non-alcoholic Fatty Liver Disease; Patient Selection; Resistance Training
PubMed: 27639843
DOI: 10.1016/j.jhep.2016.08.023 -
Psychosomatic Medicine Apr 2010To assess the effects of aerobic exercise training on neurocognitive performance. Although the effects of exercise on neurocognition have been the subject of several... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess the effects of aerobic exercise training on neurocognitive performance. Although the effects of exercise on neurocognition have been the subject of several previous reviews and meta-analyses, they have been hampered by methodological shortcomings and are now outdated as a result of the recent publication of several large-scale, randomized, controlled trials (RCTs).
METHODS
We conducted a systematic literature review of RCTs examining the association between aerobic exercise training on neurocognitive performance between January 1966 and July 2009. Suitable studies were selected for inclusion according to the following criteria: randomized treatment allocation; mean age > or =18 years of age; duration of treatment >1 month; incorporated aerobic exercise components; supervised exercise training; the presence of a nonaerobic-exercise control group; and sufficient information to derive effect size data.
RESULTS
Twenty-nine studies met inclusion criteria and were included in our analyses, representing data from 2049 participants and 234 effect sizes. Individuals randomly assigned to receive aerobic exercise training demonstrated modest improvements in attention and processing speed (g = 0.158; 95% confidence interval [CI]; 0.055-0.260; p = .003), executive function (g = 0.123; 95% CI, 0.021-0.225; p = .018), and memory (g = 0.128; 95% CI, 0.015-0.241; p = .026).
CONCLUSIONS
Aerobic exercise training is associated with modest improvements in attention and processing speed, executive function, and memory, although the effects of exercise on working memory are less consistent. Rigorous RCTs are needed with larger samples, appropriate controls, and longer follow-up periods.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Attention; Cognition; Cognition Disorders; Executive Function; Exercise; Exercise Therapy; Humans; Memory; Middle Aged; Neuropsychological Tests; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 20223924
DOI: 10.1097/PSY.0b013e3181d14633 -
Reviews in Cardiovascular Medicine Dec 2021This study examines the effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors, to identify the most... (Meta-Analysis)
Meta-Analysis
This study examines the effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors, to identify the most effective way of improving metabolic syndrome and preventing cardiovascular disease. We searched EMBASE, the Cochrane Library, PubMed, MEDLINE, Ovid, the Chinese Biological Medicine Database (CBM), the Wanfang Database, the China National Knowledge Infrastructure (CNKI) database, and the Chinese Scientific Journal Database (VIP), for randomized controlled trials (RCTs), identifying 15 comparing the effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors (e.g., glucose, triglyceride, blood pressure, body mass index, etc.). We assessed the quality of the articles and performed a network meta-analysis with a Bayesian random effects model to synthesize direct and indirect evidence. Combined exercise was most effective at controlling glucose and total triglyceride (TG) levels. Aerobic, resistance, and combined exercise groups achieved significant effects regarding body fat. Aerobic exercise was superior to resistance exercise regarding body mass index (BMI). There was no statistically significant difference in weight, waist circumference (WC), levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), insulin, systolic blood pressure (SBP), and diastolic blood pressure (DBP) among the exercise groups. Combined exercise was the best exercise scheme for improving weight, WC, DBP, TG, TC, glucose, and insulin levels. Resistance exercise was most effective at ameliorating body fat, LDL-C levels, and SBP. Aerobic exercise was the optimal way of improving BMI and HDL-C levels. This network meta-analysis suggests combined exercise is the most effective choice in improving the metabolic syndrome and cardiovascular risk parameters, whereas aerobic exercise reveals the minimum effect. Further studies should certify the role resistance exercises play in metabolic syndrome and cardiac rehabilitation.
Topics: Cholesterol, HDL; Exercise; Humans; Metabolic Syndrome; Network Meta-Analysis; Risk Factors; Waist Circumference
PubMed: 34957791
DOI: 10.31083/j.rcm2204156