A HOME-BASED MULTIDIMENSIONAL EXERCISE PROGRAM REDUCED PHYSICAL IMPAIRMENT AND FEAR OF FALLING Dynamic versus static training in patients with rheumatoid arthritis. The effectiveness of aerobic and muscle strength training in patients receiving hemodialysis and EPO: a randomized controlled trial. Older adults recently discharged from the hospital: effect of aerobic interval exercise on health-related quality of life, physical fitness, and physical activity. Rationale and design of the Exercise Intensity Trial (EXCITE): A randomized trial comparing the effects of moderate versus moderate to high-intensity aerobic training in women with operable breast cancer A Randomized Trial of an Intensive Physical Therapy Program for Patients with Acute Respiratory Failure. A dynamic exercise programme to improve patients' disability in rheumatoid arthritis: a prospective randomized controlled trial. Effectiveness of a group exercise program in a long-term care facility: a randomized pilot trial. Effect of supervised aerobic exercise rehabilitation on physical fitness and quality-of-life in survivors of critical illness: an exploratory minimized controlled trial (PIX study) Intensive aerobic and muscle endurance exercise in patients with systemic sclerosis: a pilot study The effect of aerobic training on rehabilitation outcomes after recent severe brain injury: a randomized controlled evaluation. Comparison of high and low intensity training in well controlled rheumatoid arthritis. Results of a randomised clinical trial. Effect of a preoperative protocol of aerobic physical therapy on the quality of life of patients with adolescent idiopathic scoliosis: a randomized clinical study. Short- and long-term effects of outpatient rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Supervised physical exercise improves VO2max, quality of life, and health in early stage breast cancer patients: a randomized controlled trial A Combined Aerobic and Resistance Exercise Program Improves Physical Functional Performance in Patients With Heart Failure: A Pilot Study Effectiveness of aquatic and non-aquatic lower limb muscle endurance training in the static and dynamic balance of elderly people.
Abstract Objective . To investigate the efficacy of a guided and grade d home-based exercise program for improving a range of physical outcomes in older people . Design . Controlled clinical trial of 16 weeks Setting . Two geographical areas in Gent , Belgium Participants . 66 independent-living older people ( age : 71 - 98 ) with a history of falls and moderate physical impairment Intervention . Twenty-four 30-minute training sessions were given by a trained physiotherapist over a period of 16 weeks in the participant ’s home . Different types of exercises on balance , aerobic performance , flexibility , and muscle strength were provided . Main outcome measures . Muscle strength , static and dynamic balance , aerobic performance , activities in daily living , fear of falling and avoidance of daily activities were assessed at baseline and after 16 weeks intervention . Results : At baseline , there were no significant differences in the measured variables between exercise and control groups . After 16 weeks , the exercise group showed significantly improved ankle muscle strength , balance performance and aerobic capacity , and decreased fear of falling , dependency in daily activities and avoidance of daily activities compared to the control group . The improvements in knee muscle strength , timed chair st and s , and functional reach were not significant . Conclusion : The home-based , individualized exercise program was effective in reducing several physical factors associated with falls in community-dwelling older people with moderate physical impairment . The decrease in fear of falling and other behavioural variables needs to be considered with care and needs further investigation Sixty-seven patients with classical or definite rheumatoid arthritis ( RA ) were studied concerning the effects of st and ardized physical training on muscle function in the lower extremities . The patients were r and omly assigned to four different training groups and were given 6 weeks of training supervised by a physiotherapist at a health care centre . The groups differed according to type ( dynamic or static ) and extent ( 12 or 4 times ) of training . During this training period as well as for an additional 3 months , the patients carried out programs of exercise at home ( either dynamic or static ) . A significantly greater increase in function during the 6-week period as regards muscle strength , endurance , aerobic capacity , and functional ability was found for the dynamic as compared with the static groups . The findings at follow-up 3 months later were similar . The effectiveness of the programs did not vary with the extent of training . In conclusion , in RA patients , dynamic training gives a greater increase in physical capacity than does static training BACKGROUND Individuals with end-stage renal disease on hemodialysis therapy have reduced aerobic exercise capacity and reduced muscle strength . METHODS This was a single-blind , r and omized , placebo-controlled trial of an exercise intervention in hemodialysis patients administered erythropoietin . The intervention consisted of progressive resisted isotonic quadriceps and hamstrings exercise and training on a cycle ergometer three times weekly for 12 weeks . Individuals in the control group underwent a nonprogressive program of range-of-motion exercises . Both groups were observed for an additional 5 months without intervention . Outcomes were assessed without knowledge of treatment assignment at baseline , 12 weeks , and 5 months . A healthy age- and sex-matched sample provided comparative data . RESULTS Our sample was relatively high functioning , with a mean score on the Physical Function subscale of the Short Form 36 ( SF-36 ) of 76 of 100 . At 12 weeks , there were large and statistically significant differences in favor of the experimental group on the submaximal exercise test ( 14 W ; 95 % confidence interval , 2 to 26 ) and muscle strength ( 45 lb ; 95 % confidence interval , 9 to 81 ) , but not in the 6-minute walk , symptoms question naire , or SF-36 . Differences between the intervention and control groups at 12 weeks were not evident on retesting 5 months after the end of the intervention . Compared with the healthy sample , patients were significantly lower functioning on the submaximal exercise test , muscle strength , and 6-minute walk test at baseline . CONCLUSION In this high-functioning sample , the exercise program improved physical impairment measures , but had no effect on symptoms or health-related quality of life . The impact on patients with a greater degree of physical dysfunction needs to be rigorously studied OBJECTIVES To compare the effect of high-intensity aerobic interval exercise ( HIA ) with home-based exercise ( HB ) in older adults with chronic disease soon after discharge from the hospital . DESIGN R and omized controlled trial . SETTING Hospital . PARTICIPANTS Community-dwelling older adults aged 70 to 92 ( N = 115 ) were recruited while in the hospital . After discharge , they were r and omized to HIA group ( n = 59 ) or HB ( n = 56 ) . INTERVENTION High-intensity aerobic interval exercise ( HIA ) consisted of endurance , strength , and balance exercises . The HB consisted of low-intensity exercises and telephone follow-up from a physical therapist . MEASUREMENTS Health-related quality of life ( HRQOL ) was assessed using the Medical Outcomes Study 36-item Short Form Survey , physical fitness was measured using the Senior Fitness Test , and physical activity was assessed using the Physical Activity Scale for the Elderly . RESULTS Intention-to-treat analysis showed that both groups improved their HRQOL and physical activity after 3 months . Improvements on the Senior Fitness Test ( chair st and , arm curl and 6-minute walk ( 6MWT ) ) were significantly greater in the HIA group than the HB group . The mean difference was 25.9 m on the 6MWT ( P = .001 , effect size d = 0.2 ) , 1.3 per 30 seconds on the chair st and s mean ( P = .001 , effect size d = 0.3 ) , and 1.6 per 30 seconds on the arm curl ( P = .001 , effect size d = 0.4 ) . CONCLUSION High-intensity aerobic interval exercise ( HIA ) participants significantly improved their physical fitness . Both groups increased their HRQOL and physical activity . The findings suggest that exercise therapy should be incorporated as a part of the treatment for older people at risk for functional decline Background The Exercise Intensity Trial ( EXcITe ) is a r and omized trial to compare the efficacy of supervised moderate-intensity aerobic training to moderate to high-intensity aerobic training , relative to attention control , on aerobic capacity , physiologic mechanisms , patient-reported outcomes , and biomarkers in women with operable breast cancer following the completion of definitive adjuvant therapy . Methods / Design Using a single-center , r and omized design , 174 postmenopausal women ( 58 patients / study arm ) with histologically confirmed , operable breast cancer presenting to Duke University Medical Center ( DUMC ) will be enrolled in this trial following completion of primary therapy ( including surgery , radiation therapy , and chemotherapy ) . After baseline assessment s , eligible participants will be r and omized to one of two supervised aerobic training interventions ( moderate-intensity or moderate/high-intensity aerobic training ) or an attention-control group ( progressive stretching ) . The aerobic training interventions will include 150 mins.wk-1 of supervised treadmill walking per week at an intensity of 60%-70 % ( moderate-intensity ) or 60 % to 100 % ( moderate to high-intensity ) of the individually determined peak oxygen consumption ( VO2peak ) between 20 - 45 minutes/session for 16 weeks . The progressive stretching program will be consistent with the exercise interventions in terms of program length ( 16 weeks ) , social interaction ( participants will receive one-on-one instruction ) , and duration ( 20 - 45 mins/session ) . The primary study endpoint is VO2peak , as measured by an incremental cardiopulmonary exercise test . Secondary endpoints include physiologic determinants that govern VO2peak , patient-reported outcomes , and biomarkers associated with breast cancer recurrence/mortality . All endpoints will be assessed at baseline and after the intervention ( 16 weeks ) . Discussion EXCITE is design ed to investigate the intensity of aerobic training required to induce optimal improvements in VO2peak and other pertinent outcomes in women who have completed definitive adjuvant therapy for operable breast cancer . Overall , this trial will inform and refine exercise guidelines to optimize recovery in breast and other cancer survivors following the completion of primary cytotoxic therapy . Trial Registration RATIONALE Early physical therapy ( PT ) interventions may benefit patients with acute respiratory failure by preventing or attenuating neuromuscular weakness . However , the optimal dosage of these interventions is currently unknown . OBJECTIVES To determine whether an intensive PT program significantly improves long-term physical functional performance compared with a st and ard-of-care PT program . METHODS Patients who required mechanical ventilation for at least 4 days were eligible . Enrolled patients were r and omized to receive PT for up to 4 weeks delivered in an intensive or st and ard-of-care manner . Physical functional performance was assessed at 1 , 3 , and 6 months in survivors who were not currently in an acute or long-term care facility . The primary outcome was the Continuous Scale Physical Functional Performance Test short form ( CS-PFP-10 ) score at 1 month . MEASUREMENTS AND MAIN RESULTS A total of 120 patients were enrolled from five hospitals . Patients in the intensive PT group received 12.4 ± 6.5 sessions for a total of 408 ± 261 minutes compared with only 6.1 ± 3.8 sessions for 86 ± 63 minutes in the st and ard-of-care group ( P < 0.001 for both analyses ) . Physical function assessment s were available for 86 % of patients at 1 month , for 76 % at 3 months , and for 60 % at 6 months . In both groups , physical function was reduced yet significantly improved over time between 1 , 3 , and 6 months . When we compared the two interventions , we found no differences in the total CS-PFP-10 scores at all three time points ( P = 0.73 , 0.29 , and 0.43 , respectively ) or in the total CS-PFP-10 score trajectory ( P = 0.71 ) . CONCLUSIONS An intensive PT program did not improve long-term physical functional performance  compared with a st and ard-of-care program . Clinical trial registered with www . clinical trials.gov ( NCT01058421 ) OBJECTIVE To evaluate the functional , clinical , radiological and quality of life outcomes of a 4-week dynamic exercise programme ( DEP ) in RA . METHODS Patients matched on the principal medico-social parameters were r and omly assigned to either the DEP or the conventional joint rehabilitation group . Primary end point for judging effectiveness was functional status assessed by HAQ . Secondary outcomes included Nottingham Health Profile ( NHP ) , Arthritis Impact Measurement Scale 2-Short Form ( AIMS 2-SF ) and radiological worsening measured by Simple Narrowing Erosion Score ( SENS ) . Clinical evaluation consisted of disease activity score ( DAS 28 ) , cycling aerobic fitness and dexterity . Dexterity was measured using Sequential Occupational Dexterity Assessment ( SODA ) and Duruoz H and Index ( DHI ) . Data were collected at baseline 1 , 6 and 12 months . RESULTS Fifty patients were enrolled .  HAQ improved throughout the length of the trial in the DEP group . This improvement was greater in DEP than in the st and ard joint rehabilitation group at 1 month ( -0.2 vs no variation from baseline , P = 0.04 ) , but not at 6 months ( -0.2 vs -0.1 in control group , P = 0.25 ) or 12 months ( -0.1 vs no variation in control group , P = 0.51 ) . DEP improved NHP ( -23 vs + 7 % in control group , P = 0.01 ) and aerobic fitness ( + 0.3 vs + 0.1 km per 5 min in control group , P = 0.02 ) at 1 month but the progress was not statistically significant thereafter . DEP also improved DHI , SODA , DAS 28 and AIMS 2-SF , although not significantly . CONCLUSION DEP was effective on functional status assessed by HAQ , quality of life and aerobic fitness at 1 month OBJECTIVE The purpose of this pilot was to determine whether a strength and flexibility program in frail long-term care facility ( LTC ) residents would result in improved function . DESIGN A prospect i ve , r and omized , controlled , semicrossover trial was design ed with participants assigned either to group exercise ( EX ) or recreational therapy ( C ) . In the EX group , the intervention continued for 1 year . In the C group , recreation continued for 6 months ; these controls were then crossed over to the same exercise intervention as the EX group and followed for an additional 6 months . Functional outcomes were measured at baseline and 3 , 6 , 9 , and 12 months for both groups . SETTING A LTC facility , which included both assisted living ( AL ) and nursing home ( NH ) residents . PARTICIPANTS Twenty frail residents ( 5 from NH , 15 from AL ) aged 75 to 99 years at one LTC facility . INTERVENTION After r and om group assignment , the EX group met 1 hour three times per week . An exercise physiologist and LTC staff conducted sessions which included seated range of motion ( ROM ) exercises and strength training using simple equipment such as elastic resistance b and s ( therab and s ) and soft weights . The C group met three times per week and participated in activities such as painting during the first 6 months , before crossing over to exercise . MEASUREMENTS AND METHODS Objective measures of physical and cognitive function were obtained at baseline and 3 , 6 , 9 , and 12 months using the timed get-up- and -go test ( TUG ) , Berg balance scale , physical performance test ( PPT ) , and mini-mental status exam ( MMSE ) . Because we were interested in the impact of exercise on multiple endpoints and to protect the type I error rate , a global hypothesis test was used . RESULTS There was a significant overall impact across the four measures of the exercise intervention ( P = 0.013 ) . Exercise benefit as indicated by the difference between exercise and control conditions showed exercise decreased TUG by 18 seconds , which represents an effect size ( in st and ard deviation units ) of 0.50 , increased PPT scores by 1.3 , with effect size = 0.40 , increased Berg scores by 4.8 , with effect size of 0.32 , and increased MMSE by 3.1 , with effect size = 0.54 . Except for the Berg , 90 % confidence intervals on these exercise effects excluded 0 . CONCLUSION Frail elderly in a LTC facility were able to participate and benefit from a strength training program . The program was delivered with low-cost equipment by an exercise physiologist and LTC staff . The advantage of such a program is that it provides recreational and therapeutic benefits Background Evidence is limited for the effectiveness of interventions for survivors of critical illness after hospital discharge . We explored the effect of an 8-week hospital-based exercise-training programme on physical fitness and quality -of-life . Methods In a parallel-group minimized controlled trial , patients were recruited before hospital discharge or in the intensive care follow-up clinic and enrolled 8–16 weeks after discharge . Each week , the intervention comprised two sessions of physiotherapist-led cycle ergometer exercise ( 30 min , moderate intensity ) plus one equivalent unsupervised exercise session . The control group received usual care . The primary outcomes were the anaerobic threshold ( in ml O2 kg−1 min−1 ) and physical function and mental health ( SF-36 question naire v.2 ) , measured at Weeks 9 ( primary time point ) and 26 . Outcome assessors were blinded to group assignment . Results Thirty patients were allocated to the control and 29 to the intervention . For the anaerobic threshold outcome at Week 9 , data were available for 17 control vs 13 intervention participants . There was a small benefit ( vs control ) for the anaerobic threshold of 1.8 ( 95 % confidence interval , 0.4–3.2 ) ml O2 kg−1 min−1 . This advantage was not sustained at Week 26 . There was evidence for a possible beneficial effect of the intervention on self-reported physical function at Week 9 ( 3.4 ; −1.4 to 8.2 units ) and on mental health at Week 26 ( 4.4 ; −2.4 to 11.2 units ) . These potential benefits should be examined robustly in any subsequent definitive trial . Conclusions The intervention appeared to accelerate the natural recovery process and seems feasible , but the fitness benefit was only short term . Clinical trial registration Current Controlled Trials IS RCT N65176374 ( http://www.controlled-trials.com/IS RCT N65176374 ) Background No previous studies have examined the effect of intensive exercise in systemic sclerosis patients with pulmonary impairment . The objective of this study was to examine the effect of an eight-week intensive aerobic exercise and muscle endurance training program for patients with systemic sclerosis with 50–100 % of forced vital capacity . Methods A single-subject experimental design with repeated systematic measures during a six week A-phase ( non-interventional baseline period ) and an eight week B-phase ( exercise intervention period ) was used . Three women and one man with median age 66 years and median disease duration of 3.5 years completed aerobic exercise corresponding to 15 on the Borg RPE scale ( strenuous ) and muscular endurance training three times/week . Physical capacity ( six-minute walk test ) , aerobic capacity ( submaximal treadmill test ) and muscle endurance in shoulder and hip flexion ( Functional Index 2 ) were assessed every other week throughout the 14-week study . Activity limitation ( Health Assessment Question naire ) , quality of life ( Short Form 36 ) , Raynaud , Fatigue and Global Health during the recent week ( Visual Analogue Scales ) were assessed at weeks 0 , 6 , 14 . Results Three participants improved significantly in muscular endurance , and two participants improved significantly or clinical ly relevant in aerobic capacity . All other variables remained unchanged , except for a trend towards reduced fatigue . Conclusions This eight week exercise program was largely successful with positive effects on aerobic capacity and muscle endurance . Trial registration Clinical trials.gov Identifier : OBJECTIVE To examine the impact of fitness training with recently brain-injured in patients on exercise capacity and functional and psychologic outcome measures . DESIGN A r and omized controlled trial of exercise versus relaxation training for 3 months . Blind assessment s were conducted before and after the end of a 12-week training program , as well as at follow-up assessment 12 weeks posttraining . SETTING Four regional neurologic inpatient rehabilitation units . PATIENTS Of 157 patients recruited 24 + /- 14 weeks after single-incident brain injury , 142 patients were assessed at week 12 , and 128 patients at follow-up . INTERVENTIONS Patients were r and omized between cycle ergometer aerobic training and a relaxation training control condition , which was theoretically inert with respect to cardiovascular fitness . MAIN OUTCOME MEASURES Validation of exercise training ( peak work rate , peak heart rate , body mass index ) ; mobility and physical function ( modified Ashworth scale , Berg balance scale , Rivermead Mobility Index , 10-m walk velocity ) ; disability and dependency ( Barthel index , FIMtrade mark instrument , Nottingham Extended Activities of Daily Living ) ; and psychologic function ( fatigue question naire , Hospital Anxiety and Depression Scale ) . RESULTS Significant improvements in exercise capacity ( p < .05 ) in the exercise training group ( n = 70 ) relative to the control group ( n = 72 ) were not matched by greater improvements in functional independence , mobility , or psychologic function , at either 12 weeks or follow-up . CONCLUSIONS The benefits of improved cardiovascular fitness did not appear to extend to measurable change in function or psychologic state OBJECTIVE : To investigate the benefit of intensive dynamic exercises in comparison to range of motion ( ROM ) and isometric exercises in rheumatoid arthritis . METHODS : 100 consecutive rheumatoid arthritis patients on stable medication were r and omly assigned to ( 1 ) intensive dynamic group exercises which included full weight bearing exercises and conditioning exercises on a stationary bicycle while the heart rate was maintained at 70 - 85 % of the age predicted maximum heart rate , ( 2 ) range of motion ( ROM ) exercises and isometric exercises in a group , ( 3 ) individual isometric and ROM exercises , and ( 4 ) home instructions for isometric and ROM exercises .  Variables of physical condition , muscle strength , joint mobility , daily functioning ( HAQ ) , and disease activity were assessed before and after the 12 week exercise course , and 12 weeks thereafter . An intention to treat analysis was performed . RESULTS : Increases in aerobic capacity ( n = 77 ) , muscle strength , and joint mobility in the high intensity exercise programme were respectively 17 % , 17 % and 16 % and differed significantly from the changes in aerobic capacity , muscle strength , and joint mobility in the other exercise groups . No deterioration of disease activity was observed . Twelve weeks after discontinuation of the exercise course the gain in physical capacity had disappeared . CONCLUSIONS : Intensive dynamic training is more effective in increasing aerobic capacity , joint mobility , and muscle strength than ROM exercises and isometric training in rheumatoid arthritis patients with well controlled disease Patients with adolescent idiopathic scoliosis ( AIS ) have lower potential for physical activity because of lung dysfunction and lower muscle strength , which can be reversed by the cardiorespiratory and musculoskeletal conditioning provided by st and ardized physical activities . We conducted a study to determine if a preoperative protocol of aerobic exercise would improve quality of life ( QoL ) both before and after training and if there would be any differences between patients who received the therapy and those who did not . Patients with the indication of surgical correction of AIS were r and omized to receive or not receive a 4-month preoperative course of aerobic physical training . At baseline and after 4 months , they were evaluated with the Short Form-36 question naire ( SF-36 ) . QoL scores improved for the study group but did not change for the control group . In all QoL domains , the study group 's mean score increased significantly between baseline and 4 months . We concluded that the proposed preoperative physical therapy protocol improved the QoL of patients with AIS PURPOSE Pulmonary rehabilitation programs are effective in patients with severe chronic obstructive pulmonary disease ( COPD ) in the short term , but their long-term effects are not known . We investigated the short- and long-term effects of a 6-month outpatient rehabilitation program in patients with severe COPD . SUBJECTS AND METHODS One hundred patients were r and omly assigned to receive either an exercise training program that included cycling , walking , and strength training ( n = 50 ) or usual medical care ( n = 50 ) . Thirty-four patients in the training group were evaluated after 6 months ( end of training ) , and 26 were evaluated after 18 months of follow-up . In the control group , 28 patients were evaluated at 6 months and 23 after 18 months . We measured pulmonary function , 6-minute walking distance , maximal exercise capacity , peripheral and respiratory muscle strength , and quality of life ( on a 20 to 140-point scale ) , and estimated the cost-effectiveness of the program . RESULTS At 6 months , the training group showed improvement in 6-minute walking distance [ mean difference ( training - control ) of 52 m ; 95 % confidence interval ( CI ) , 15 to 89 m ] , maximal work load ( 12 W ; 95 % CI , 6 to 19 W ) , maximal oxygen uptake ( 0.26 liters/min ; 95 % CI , 0.07 to 0.45 liters/min ) , quadriceps force ( 18 Nm ; 95 % CI , 7 to 29 Nm ) , inspiratory muscle force ( 11 cm H(2)O ; 95 % CI , 3 to 20 cm H(2)O ) , and quality of life ( 14 points ; 95 % CI , 6 to 21 points ; all P < 0.05 ) . At 18 months all these differences persisted ( P < 0.05 ) , except for inspiratory muscle strength . For 6-minute walking distance and quality of life , the differences between the training group and controls at 18 months exceeded the minimal clinical ly-important difference . CONCLUSION Among patients who completed the 6-month program , outpatient training result ed in significant and clinical ly relevant changes in 6-minute walking distance , maximal exercise performance , peripheral and respiratory muscle strength , and quality of life . Most of these effects persisted 18 months after starting the program Breast cancer patients suffer impairment in cardiorespiratory fitness after treatment for primary disease , affecting patients ’ health and survival . The aim of this study was to evaluate the ability of a pragmatic exercise intervention to improve cardiorespiratory fitness of breast cancer patients after primary treatment . Between February 2013 and December 2014 , 94 women with early stage ( I – III ) breast cancer , 1–36 months post-chemotherapy , and radiotherapy were r and omly assigned to an intervention program ( EX ) combining supervised aerobic and resistance exercise ( n = 44 ) or usual care ( CON ) ( n = 45 ) for 12 weeks . Primary study endpoint was VO2max . Secondary endpoints were muscle strength , shoulder range of motion , body composition , and quality of life ( QoL ) . Assessment s were undertaken at baseline , 12-week , and 6-month follow-ups . Eighty-nine patients aged 29–69 years were assessed at baseline and 12 weeks . The EX group showed significant improvements in VO2max , muscle strength , percent fat , and lean mass ( p ≤ 0.001 in all cases ) and QoL compared with usual care ( CON ) . Apart from body composition , improvements were maintained for the EX at 6-month follow-up . There were no adverse events during the testing or exercise intervention program . A combined exercise intervention produced considerable improvement in cardiorespiratory fitness , physical function , and quality of life in breast cancer patients previously treated with chemotherapy and radiation therapy . Importantly , most of these benefits were maintained 6 months after ceasing the supervised exercise intervention Background : Recent guidelines for exercise in patients with heart failure ( HF ) recommended aerobic and resistance exercise as being safe and effective ; however , the clinical and functional significance of these combined training modalities has not been established . In this pilot study , combined aerobic and resistance training was hypothesized to improve physical function , muscle strength , and health-related quality of life ( HRQOL ) compared with an attention control wait list ( ACWL ) . Methods : The 10-item Continuous Scale Physical Functional Performance Test ( CS-PFP10 ) , which simulates common household chores ; muscle strength ( h and grip and knee extension ) ; and HRQOL ( Kansas City Cardiomyopathy Question naire ) were evaluated at baseline ( T1 ) and at 12 weeks ( T2 ) . The home-based moderate-intensity walking and resistance training program was performed 5 days a week . Results : Twenty-four New York Heart Association class II to III HF patients ( mean [ SD ] age , 60 [ 10 ] years ; mean [ SD ] left ventricular ejection fraction , 25 % [ 9 % ] ) were r and omized to a combined aerobic and resistance exercise program or to an ACWL group . Of the total group , 58 % were New York Heart Association class III HF patients , 50 % were white , and 50 % were female . The CS-PFP10 total scores were significantly increased in the exercise group , from 45 ( 18 ) to 56 ( 16 ) . The Kansas City Cardiomyopathy Question naire overall summary score was significantly improved ( P < .001 ) at T2 in the exercise intervention group compared with the ACWL group . Conclusions : Participants provided the home-based , combined aerobic and resistance exercise program had significantly improved physical function , muscle strength , symptom severity , and HRQOL compared with the ACWL group . The findings of this study must be interpreted cautiously owing to the limitations of a small sample , data collection from a single center , and differences between control and interventions groups at baseline . A combined aerobic and resistance exercise approach may improve physical function in stable HF patients , but further study in a larger , more diverse population is recommended . However , in this study , the CS-PFP10 instrument demonstrated its ability to identify functional health status in HF patients and thus warrants further testing in a larger sample for possible use in clinical practice BACKGROUND Aging compromises the ability of the central nervous system to maintain body balance and reduces the capacity for adaptive reactions . To prevent falls , the reception conditions for sensory information need to be improved . OBJECTIVES To evaluate the impact of a structured aquatic and a non-aquatic exercise program for lower-limb muscle endurance on the static and dynamic balance of elderly people . METHODS This was a prospect i ve r and omized clinical study in which the variables were assessed before and after the training program . Thirty-six elderly people were evaluated using four tests : the Berg Balance Scale , Dynamic Gait Index , gait speed and t and em gait . The participants were r and omized into three groups : aquatic exercise group , non-aquatic exercise group and control group . The exercise groups underwent a program for lower-limb muscle endurance that consisted of 40-minute sessions twice a week for six weeks . The participants were reevaluated after six weeks . The data were analyzed statistically using the univariate ANOVA test for comparisons between the groups before and after the intervention . RESULTS The program for lower-limb muscle endurance significantly increased balance ( p<0.05 ) in the evaluation tests after the training program . CONCLUSION The muscle endurance program provided a significant improvement in static and dynamic balance among community-dwelling elderly people . It was also possible to infer that this improvement occurred regardless of the environment , i.e. aquatic or non-aquatic . Article registered in the Australian New Zeal and Clinical Trials Registry ( ANZCTR ) under the number ACTRN 12609000780257
3 ) short-term , water-based aerobic capacity training , which results show limited evidence for a positive effect on functional ability and aerobic capacity .
( 4 ) long-term , l and -based aerobic capacity and muscle strength training , which results show moderate evidence for a positive effect on aerobic capacity and muscle strength .
With respect to safety , no deleterious effects were found in any of the included studies .
Based on the evidence , aerobic capacity training combined with muscle strength training is recommended as routine practice in patients with RA
BACKGROUND An up-to- date overview of the effectiveness and safety of dynamic exercise therapy ( exercise therapy with a sufficient intensity , duration , and frequency to establish improvement in aerobic capacity and /or muscle strength ) is lacking .
OBJECTIVES To assess the effectiveness and safety of short-term ( < three months ) and long-term ( > three months ) dynamic exercise therapy programs ( aerobic capacity and /or muscle strength training ) , either l and or water-based , for people with RA .
To do this we up date d a previous Cochrane review ( van den Ende 1998 ) and made categories for the different forms of dynamic exercise programs .