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"Training Methods"
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Combined endurance and resistance exercise training in heart failure with preserved ejection fraction: a randomized controlled trial
Endurance exercise training (ET) is an effective treatment in heart failure with preserved ejection fraction (HFpEF), but the efficacy of resistance training in this patient population has been only scarcely evaluated. In this multicenter, randomized trial, we evaluated the effects of combined endurance and resistance training over 12 months in patients with HFpEF. The primary endpoint was a modified Packer score, including all-cause mortality, hospitalizations classified as potentially related to heart failure or exercise and changes in peak oxygen consumption (
V
̇
O
2
), diastolic function (E/e′), New York Heart Association (NYHA) class and global self-assessment (GSA). In total, 322 patients (mean age, 70 years; 192 females (59.6%) and 130 males (40.4%)) were randomized (1:1) to ET or usual care (UC). At 12 months, the modified Packer score showed an improvement in 33 ET patients (20.5%) and in 13 UC patients (8.1%) and showed a worsening in 69 ET patients (42.9%) and in 71 UC patients (44.1%) (Kendall’s tau-b = −0.073,
P
= 0.17). Although the primary endpoint was not met, clinically relevant differences favoring the ET group as compared to the UC group were observed for the following secondary endpoints: changes in peak
V
̇
O
2
(mean difference, 1.3 ml kg
−1
min
−1
(95% confidence interval (CI): 0.4–2.1)) and NYHA class (odds ratio = 7.77 (95% CI: 3.73–16.21)). No significant between-group differences were observed for other secondary endpoints, including change in E/e′, change in GSA, time to cardiovascular hospitalization or all-cause mortality. In conclusion, 1 year of combined endurance and resistance ET did not result in a significantly better modified Packer score, but it did result in improvements in important clinical parameters, such as peak
V
̇
O
2
and NYHA class, as compared to UC. ISRCTN registration:
ISRCTN86879094
.
In a multicenter, randomized trial, patients with heart failure with preserved ejection fraction who underwent a regimen of combined endurance and resistance exercise training over the course of 1 year did not show a statistically significant improvement in the modified Packer score—the primary efficacy endpoint—as compared to patients who received usual care, but they did show improvements in secondary endpoints for maximal oxygen consumption and NYHA heart failure class.
Journal Article
Effects of resistance training vs high intensity interval training on body composition, muscle strength, cardiorespiratory fitness, and quality of life in survivors of breast cancer: a randomized trial
Purpose
Breast cancer treatments often lead to unfavourable changes in body composition, physical fitness, and quality of life (QoL). We compared the effects of resistance training (RT) and high-intensity interval training (HIIT) on these outcomes in survivors of breast cancer.
Methods
Twenty-eight survivors of breast cancer, post-treatment (Stage I–III), aged 55.5 ± 8.8 years and body mass index 27.9 ± 5 kg/m
2
were randomly allocated to a 12-week supervised RT (
n
= 14) or HIIT (
n
= 14) intervention, 3 days per week. Body composition (dual energy x-ray absorptiometry), upper and lower body muscle strength (1-repetition maximum), cardiorespiratory fitness (CRF) (Ekblom Bak Cycle Test), and QoL domains (EORTC QLQ-C30 and EORTC QLQ-BR45) were assessed at baseline and 12 weeks.
Results
There were no significant differences between groups at baseline. Exercise attendance ranged from 81 to 85%. Between groups, there were significant differences (
p
≤ 0.001) after 12 weeks in chest press strength for RT (mean difference [MD] = 4.7 kg) and CRF for HIIT (MD = 1.9 ml/min/kg). Within groups, there were significant improvements (
p
< 0.05) for % lean mass and % fat mass in both RT and HIIT, as well as for upper and lower body muscle strength, CRF, and QoL domains. No major adverse events were noted.
Conclusion
Both exercise groups improved body composition, physical fitness, and QoL domains over 12 weeks of RT or HIIT, although mode-specific benefits were apparent with more substantial improvements in lean mass and muscle strength with RT and reductions in % fat mass and improved CRF with HIIT. Tailored exercise programs should address the specific health needs of each patient.
Journal Article
The impact of individualised versus standardised endurance and resistance training on the fitness–fatness index in inactive adults
The aim of the current study was to investigate the impact of individualised versus standardised combined endurance and resistance training on the fitness–fatness index in physically inactive adults.
Randomised controlled trial.
Fifty-four participants aged 21–55 years were randomised into three groups; 1) non-exercise control (n = 18), 2) standardised moderate-intensity continuous training (n = 18), or 3) individualised moderate-intensity continuous training + high-intensity interval training (n = 18). The fitness–fatness index was calculated by dividing cardiorespiratory fitness (expressed as metabolic equivalents) by the waist-to-height ratio. Participants were classified as likely responders to the intervention if a change of ≥1 fitness–fatness index unit was achieved.
The individualised group showed the greatest fitness–fatness index improvement (between group difference p < 0.001), with 100 % of this group classified as likely responders, compared to the standardised (68 %) and non-exercise control (0 %) groups.
An individualised, threshold-based exercise programme may produce more favourable changes in the fitness–fatness index than a standardised exercise programme.
Journal Article
High-intensity interval training improves cardiovascular and physical health in patients with rheumatoid arthritis: a multicentre randomised controlled trial
ObjectivesPatients with rheumatoid arthritis (RA) have substantially elevated risk for cardiovascular diseases, and low cardiorespiratory fitness (VO2max) is a major mediator. The aim of this assessor-blinded, two-armed multicentre randomised controlled trial was to evaluate the effects of high-intensity interval training (HIIT) and strength exercise on cardiovascular health, physical fitness and overall health in patients with RA.MethodsIn total, 87 patients (86% female; aged 20–60 years) were randomly assigned to an intervention group (IG) or a control group (CG). The IG performed HIIT and strength exercise for 12 weeks. The CG was instructed to be physically active on a moderately intensive level, ≥150 min/week. Primary outcome was change in VO2max. Secondary outcomes were changes in anthropometry measures, muscle strength, overall health (Visual Analogue Scale (VAS)-Global), Patient Global Impression of Change (PGIC), pain and disease activity (Disease Activity Score in 28 joints (DAS28)).ResultsThere was a significant mean group difference of change on VO2max (3.71 mL/kg/min; 95% CI 2.16, 5.25) in favour of the IG. Significant mean group differences of change were also seen for O2-pulse (1.38; 95% CI 0.85 to 1.91), waist circumference (−2.6; 95% CI −5.09 to –0.18), 1-minute sit-to-stand (5.0; 95% CI 3.35 to 6.72), handgrip strength (28.5; 95% CI 3.80 to 52.8), overall health (−14.7; 95% CI –23.8 to –5.50) and PGIC (p<0.0001) in favour of the IG. No significant mean group differences of change were found for pain (−4.0; 95% CI −13.07 to 5.06), DAS28 (−0.25; 95% CI −0.60 to 0.10) and erythrocyte sedimentation rate (−0.64; 95% CI −3.23 to 1.90).ConclusionSupervised HIIT and strength exercise improved cardiovascular health, physical fitness and overall health without a deterioration in pain and disease activity and should be considered in patients with well-controlled RA.Trial registration numberNCT05768165.
Journal Article
Piano by ear : learn to play by ear, improvise and accompany songs in simple steps
This book teaches people how to play the piano by ear. Suitable for beginners through to experienced pianists, you will learn to: Pick out tunes and harmonise them Improvise with an array of keys and chord patterns Accompany songs in a range of styles Understand how music works from the inside out Work through timeless favourites, folk, film, Christmas and contemporary songs.
Book
Effect of short-term exercise with different programs on prevention of sarcopenia in postmenopausal women: A Quasi-Randomized Controlled Trial
Physical exercise is an effective measure to prevent sarcopenia. However, the effects of Nordic walking based on high-intensity interval training (HIIT NW) and conventional strength training (ST) on the parameters related to sarcopenia in postmenopausal women remain unclear. Therefore, this study aims to evaluate the effects of 12-week HIIT NW and ST on body composition and physical function performance in postmenopausal women.
The participants were 71 women aged between 60 and 79 years old without sarcopenia. Participants were randomly assigned to the HIIT NW group (12-week Nordic walking training, 3 × /week), the ST group (12-week strength training, 3 × /week), and the control group. The body composition was determined by using Otupole InBody 720. Test the hand grip strength with a digital hand force gauge. The strength of the extensor and flexor muscles of the knee joint was measured using Biodex System 4 Pro™. This study also employed common methods for measuring functional performance and conducted two measurements of blood creatinine and creatine kinase.
Compared with the control group, significant improvements were observed in parameters such as Time Up and Go (TUG) and knee joint flexor strength (KFS) in both the HIIT NW group and the ST group. In the ST group alone, significant enhancements were noted in parameters including walking speed (GS) and hand strength on the left side (HS-L). Following the intervention, the HIIT NW group exhibited a marked increase in limb lean mass, which led to a significant rise in the skeletal muscle index (SMI) (p < 0.001). However, the body fat mass (BFM) and body mass index (BMI) decreased significantly in the ST group (p < 0.001 and p = 0.005, respectively). No significant changes were observed in the control group.
Both HIIT NW and ST interventions can effectively prevent sarcopenia in postmenopausal women. The former focuses on improving lower limb strength, while the latter focuses on improving upper limb strength. In the short term, the HIIT NW intervention model is more beneficial for postmenopausal women with normal weight, while the conventional ST intervention model is more conducive to the overweight population.
Journal Article