BACKGROUND: Physical activity is pivotal in managing heart failure with reduced ejection fraction, and walking integrated into daily life is an especially suitable form of physical activity. This study aimed to determine whether a 6-month lifestyle walking intervention combining self-monitoring and regular telephone counseling improves functional capacity assessed by the 6-minute walk test (6MWT) in patients with stable heart failure with reduced ejection fraction compared with usual care. METHODS: The WATCHFUL trial (Pedometer-Based Walking Intervention in Patients With Chronic Heart Failure With Reduced Ejection Fraction) was a 6-month multicenter, parallel-group randomized controlled trial recruiting patients with heart failure with reduced ejection fraction from 6 cardiovascular centers in the Czech Republic. Eligible participants were ≥18 years of age, had left ventricular ejection fraction <40%, and had New York Heart Association class II or III symptoms on guidelines-recommended medication. Individuals exceeding 450 meters on the baseline 6MWT were excluded. Patients in the intervention group were equipped with a Garmin vívofit activity tracker and received monthly telephone counseling from research nurses who encouraged them to use behavior change techniques such as self-monitoring, goal-setting, and action planning to increase their daily step count. The patients in the control group continued usual care. The primary outcome was the between-group difference in the distance walked during the 6MWT at 6 months. Secondary outcomes included daily step count and minutes of moderate to vigorous physical activity as measured by the hip-worn Actigraph wGT3X-BT accelerometer, NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity C-reactive protein biomarkers, ejection fraction, anthropometric measures, depression score, self-efficacy, quality of life, and survival risk score. The primary analysis was conducted by intention to treat. RESULTS: Of 218 screened patients, 202 were randomized (mean age, 65 years; 22.8% female; 90.6% New York Heart Association class II; median left ventricular ejection fraction, 32.5%; median 6MWT, 385 meters; average 5071 steps/day; average 10.9 minutes of moderate to vigorous physical activity per day). At 6 months, no between-group differences were detected in the 6MWT (mean 7.4 meters [95% CI, -8.0 to 22.7]; P=0.345, n=186). The intervention group increased their average daily step count by 1420 (95% CI, 749 to 2091) and daily minutes of moderate to vigorous physical activity by 8.2 (95% CI, 3.0 to 13.3) over the control group. No between-group differences were detected for any other secondary outcomes. CONCLUSIONS: Whereas the lifestyle intervention in patients with heart failure with reduced ejection fraction improved daily steps by about 25%, it failed to demonstrate a corresponding improvement in functional capacity. Further research is needed to understand the lack of association between increased physical activity and functional outcomes. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03041610.
- MeSH
- chůze MeSH
- dysfunkce levé srdeční komory * MeSH
- funkce levé komory srdeční MeSH
- kvalita života MeSH
- lidé MeSH
- senioři MeSH
- srdeční selhání * terapie farmakoterapie MeSH
- tepový objem MeSH
- životní styl MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
Závěrečná zpráva o řešení grantu Agentury pro zdravotnický výzkum MZ ČR
nestr.
Chronické srdeční selhání (CHSS) je spojeno s vysokou mortalitou i morbiditou, významně ovlivňuje kvalitu života pacientů a péče o pacienty s CHSS je nákladná. Pravidelné cvičení je všeobecně spojováno se zlepšením zdravotního stavu u širokého spektra chronicky nemocných. Přiměřeně navržený cvičební program může být hodnotnou součástí komplexní péče o dospělé pacienty s CHSS a v tomto smyslu je pravidelná chůze považována za vhodný typ fyzické aktivity. Krokoměry jsou levné, jednoduché přístroje, které poskytují informaci o úrovni fyzické aktivity, která je snadno srozumitelná a hodnotitelná. Navíc je používání krokoměrů spojeno s významným zvýšením fyzické aktivity u řady různých skupin nemocných. Projekt je navržen jako multicentrická, randomizovaná studie, která by měla zhodnotit, zda šestiměsíční chodecká intervence s využitím krokoměru v kombinaci s osobními návštěvami a telefonickými kontakty ve srovnání s běžnou péčí zlepšuje fyzickou zdatnost (hodnocenou šestiminutovým testem chůze) a neurohumorální modulaci u pacientů s CHSS.; Chronic heart failure (CHF) is associated with high mortality and morbidity, significantly affects patient ́s quality of life and is resource demanding. Regular exercise training is generally associated with improved health outcomes in a wide spectrum of chronically ill individuals. Adequately designed exercise rehabilitation may be an effective part of complex care for adults with CHF. Regular walking is considered to be a suitable mode of physical activity for patients with CHF. Pedometers are low-cost, simple devices that provide information regarding physical activity level that is easy to understand and evaluate. Moreover, pedometer use is associated with significant increases in physical activity in different populations. The project is designed as a multicenter randomized trial to determine whether a 6-month pedometer-based intervention combinig regular face-to-face appointments and telephone contacts improves functional tolerance, as measured by 6-minute walk test (6MWT) and neurohumoral regulation in patients with chronic heart failure compared to usual care.
- Klíčová slova
- chronické srdeční selhání, chůze, krokoměr, chronic heart failure, walking, pedometer,
- NLK Publikační typ
- závěrečné zprávy o řešení grantu AZV MZ ČR
BACKGROUND: Many authors consider running to be a protective physical activity (PA) in bone health. However, many studies also show inconsistencies in their results. The objective of the study is to analyze the effect of cumulative loading rate (TCL) on the bone mass of middle-aged runners and non-runners is assessed. METHODS: This cross-sectional study included 322 individuals. There were 212 runners (109 male, 103 female) and those were individuals who did >10 km of running per week. There were 110 non-runners (54 male, 56 female). This group included individuals who did not adhere to the WHO (2020) recommendations for PA. The average age in the individual groups ranged from 40.9±4.1 to 42.3±4.8 years. Bone parameters were measured on the lower extremities and vertebral spine using the DXA method (Hologic QDR Horizon A). Multi-regression dependencies analysis was used to assess the results. RESULTS: The results of the multi-regression dependencies analysis showed that the bone mineral content (BMC) and bone mineral density (BMD) are significantly influenced by the TCL and gender. CONCLUSIONS: Therefore, we can conclude that running could be a suitable PA for preventing the reduction of BMD in the middle-aged population, especially in the lower limbs.
- MeSH
- absorpční fotometrie * MeSH
- běh * fyziologie MeSH
- dolní končetina fyziologie MeSH
- dospělí MeSH
- kostní denzita * fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- průřezové studie MeSH
- sexuální faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Age and reduction in performed physical activity cause physiological changes that include an increase in body fat (BF) and visceral fat (VF) during aging. These parameters, together with increased body mass (BM), are some of the risk factors of several noninfectious diseases. However, changes in body composition can be influenced by regular physical activity. Running is a suitable, accessible, and the most effective physical activity cultivating people. The objective of this study is to investigate the effects of long-term, regular PA, specifically recreational running, on changes in body composition among recreational adult runners covering a weekly distance of at least 10 km, compared with inactive adult individuals within the same age bracket. METHODS: The study included 1296 runners and inactive individuals (691 male and 605 female), divided into 5 age groups: 18-25, 26-35, 36-45, 46-55, and 56-65 years. Runners are as follows: ran ≥ 10 km/week, and inactive is as follows: did not follow the WHO 2020 physical activity recommendations. The measured parameters included BM, BF, and VF. To check statistical significance, the Mann-Whitney U-test was used. Practical significance was assessed using the effect of size. RESULTS: All age groups of runners were selected to include individuals who run at least 10 km per week. In fact, they ran, on average, from 21.6 to 31.4 km per week in relation to age and showed significantly lower values of BM, BMI, BF, and VF (p < 0.05) than inactive individuals. Exceptions included insignificant differences (p > 0.05) in BM and BMI in males in the age category of 18-25 and in females in the age category of 18-25 and 26-35. CONCLUSION: The selected runners had to run at least 10 km per week. Their actual average volume was significantly higher (from 21.6 to 31.4 km/week), and the results showed that it could lead to significantly better body composition values. It may lead to significant changes in body mass, body fat, and visceral fat. It may meet the contemporary societal expectations for physical activities that are both achievable and effective at the lowest possible volume.
- MeSH
- běh * fyziologie MeSH
- cvičení MeSH
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- složení těla MeSH
- tělesná hmotnost MeSH
- tuková tkáň MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
(1) Background: Breathing economy during endurance sports plays a major role in performance. Poor breathing economy is mainly characterized by excessive breathing frequency (BF) and low tidal volume (VT) due to shallow breathing. The purpose of this study was to evaluate whether a 4 week intervention based on the Wim Hof breathing method (WHBM) would improve breathing economy during exercise in adolescent runners. (2) Methods: 19 adolescent (16.6 ± 1.53 years) middle- and long-distance runners (11 boys and 8 girls) participated in the study. Participants were randomly divided into experimental (n = 11) and control groups (n = 8). The study was set in the transition period between competitive race seasons and both groups had a similar training program in terms of running volume and intensity over the course of the study. The experimental group performed breathing exercises every day (~20 min/day) for 4 weeks. The control group did not perform any kind of breathing exercise. The breathing exercises consisted of three sets of controlled hyperventilation and consecutive maximum breath holds. Before and after the intervention, participants performed incremental cycle ergometer testing sessions consisting of two minute stages at 1, 2, 3, and 4 W·kg-1 with breath-by-breath metabolic analysis. During the testing sessions, BF, VT, and minute ventilation (VE) were assessed and compared. (3) Results: There were no statistically significant differences (p > 0.05) in BF, VT, or VE between experimental and control groups before or after the intervention. A nonsignificant small-to-large effect for an increase in VE and BF in both groups following the 4 week intervention period was observed, possibly due to a reduction in training volume and intensity owing to the down period between competitive seasons. (4) Conclusions: The 4 week intervention of WHBM did not appear to alter parameters of breathing economy during a maximal graded exercise test in adolescent runners.
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: The structural and functional changes of the hands and face in systemic sclerosis (SSc) can be severely disabling. We aimed to assess the effect of a 24-week supervised physiotherapy and occupational therapy program (POTp) combined with home exercise on the function of hands/mouth of SSc patients, compared to a daily home exercise program in typical outpatient care. METHODS: Fifty-nine patients with SSc were consecutively and non-selectively enrolled in an intervention (IG, n=27) or control (CG, n=32) group. Only the IG underwent the POTp twice a week for 1.5 hours. At baseline, 12, 24, and 48 weeks, all patients were assessed by a blinded physiotherapist for the hands/mouth function (delta finger-to-palm, handgrip strength, Hand and Mobility in Scleroderma, interincisal/interlabial distance), and self-evaluated their hand (Cochin Hand Function Scale) and mouth function (Mouth Handicap in Systemic Sclerosis scale), disability (Health Assessment Questionnaire [HAQ], SSc HAQ), and quality of life (Short Form-36). RESULTS: At week 24, compared to the significant deterioration in the CG, we found a significant improvement in the IG in the objectively assessed hands/mouth function and in the subjectively evaluated hand function and disability. The improvement was clinically meaningful (by >20%) in a substantial proportion of patients. Although the improvement in most outcomes was still present at week 48, the maximum effect was not sustained. CONCLUSIONS: This 24-week POTp not only attenuated the progressive deterioration, but also significantly improved the function of the hands/mouth, which was clinically meaningful in a substantial proportion of patients with SSc.
BACKGROUND: Breathing technique may influence endurance exercise performance by reducing overall breathing work and delaying respiratory muscle fatigue. We investigated whether a two-month yoga-based breathing intervention could affect breathing characteristics during exercise. METHODS: Forty-six endurance runners (age = 16.6 ± 1.2 years) were randomized to either a breathing intervention or control group. The contribution of abdominal, thoracic, and subclavian musculature to respiration and ventilation parameters during three different intensities on a cycle ergometer was assessed pre- and post-intervention. RESULTS: Post-intervention, abdominal, thoracic, and subclavian ventilatory contributions were altered at 2 W·kg-1 (27:23:50 to 31:28:41), 3 W·kg-1 (26:22:52 to 28:31:41), and 4 W·kg-1 (24:24:52 to 27:30:43), whereas minimal changes were observed in the control group. More specifically, a significant (p < 0.05) increase in abdominal contribution was observed at rest and during low intensity work (i.e., 2 and 3 W·kg-1), and a decrease in respiratory rate and increase of tidal volume were observed in the experimental group. CONCLUSIONS: These data highlight an increased reliance on more efficient abdominal and thoracic musculature, and less recruitment of subclavian musculature, in young endurance athletes during exercise following a two-month yoga-based breathing intervention. More efficient ventilatory muscular recruitment may benefit endurance performance by reducing energy demand and thus optimize energy requirements for mechanical work.
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The structural and functional changes of the skeletal muscles in idiopathic inflammatory myopathies (IIM) caused by inflammation and immune changes can be severely disabling. The objective of this study was to assess the effect of a 24-week program combining a supervised training of activities of daily living (ADL), resistance, and stability with home exercise for improving muscle function, compared to a daily home-based exercise representing the regular outpatient care. METHODS: Fifty-seven patients with IIM were consecutively and non-selectively enrolled in an intervention (IG, n = 30) or control (CG, n = 27) group. Both groups were provided a standard-of-care pharmacological treatment and follow-up. Only the IG underwent the supervised intervention twice a week for 1 h per session. At baseline, 12, 24, and 48 weeks, all patients were assessed by an assessor blinded to the intervention for primary outcomes: muscle strength (Manual Muscle Testing of eight muscle groups [MMT-8]) and endurance (Functional Index-2 [FI-2]), and secondary outcomes: stability and body composition. Secondary outcomes also included questionnaires evaluating disability (Health Assessment Questionnaire [HAQ]), quality of life (Short Form 36 [SF-36]), depression (Beck's Depression Inventory-II [BDI-II]), and fatigue (Fatigue Impact Scale [FIS]), and analysis of the systemic and local inflammatory response and perceived exertion to assess the safety of the intervention. RESULTS: Twenty-seven patients in the IG and 23 in the CG completed the entire program and follow-up. At week 24, compared to deterioration in the CG, we found a significant improvement in the IG in muscle strength (mean % improvement compared to baseline by 26%), endurance (135%), disability (39%), depression (26%), stability (11%), and basal metabolism (2%) and a stabilization of fitness for physical exercise. The improvement was clinically meaningful (a 24-week change by >20%) in most outcomes in a substantial proportion of patients. Although the improvement was still present at 48 weeks, the effect was not sustained during follow-up. No significant increase in the systemic or local expression of inflammatory markers was found throughout the intervention. CONCLUSIONS: This 24-week supervised intervention focused on ADL training proved to be safe and effective. It not only prevented the progressive deterioration, but also resulted in a significant improvement in muscle strength, endurance, stability, and disability, which was clinically meaningful in a substantial proportion of patients. TRIAL REGISTRATION: ISRCTN35925199 (retrospectively registered on 22 May 2020).
- MeSH
- činnosti denního života * MeSH
- kosterní svaly MeSH
- kvalita života MeSH
- lidé MeSH
- myozitida * MeSH
- následné studie MeSH
- svalová síla MeSH
- terapie cvičením MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Background and objectives: Body mass index (BMI) is commonly used to assess the proportionality of body mass; however, there are currently no standards for assessing the weight status of the child population for the needs of epidemiological studies. This study aims to establish bioelectric impedance analysis (BIA) standards for assessing the body weight of children (body fat, visceral fat) using BMI percentile growth charts. Materials and Methods: The study was implemented in a group of 1674 children (816 boys and 858 girls), ages 6 to 11. To classify the subjects at a percentile level, the percentile growth charts from the 6th national anthropological study in the Czech Republic were used. Body composition parameters were ascertained by BIA. Results: Body fat (%) and visceral fat standard values were determined for all age categories. The standards were in three-stages, enabling the determination of underweight, normal weight and overweight children aged 6-11 years. For boys with proportionate body mass, standard body fat values ranging from 14.3-16.0% to 15.5-18.0% were determined, while for girls' values ranging from 16.7-19.4% to 18.3-20.5% were determined, depending on age. As far as visceral fat is concerned, standard values in boys ranging from 30.3-36.9 cm2 to 36.1-44.9 cm2 and in girls 30.3-36.9 cm2 to 36.1-44.9 cm2 were determined, depending on age. Conclusions: Standards for assessing weight status are applicable to children aged 6-11 years, while it can be confirmed that BMI can be considered as an objective tool in assessing body mass and body composition in children.
- MeSH
- dítě MeSH
- elektrická impedance MeSH
- index tělesné hmotnosti MeSH
- lidé MeSH
- školy * MeSH
- tělesná hmotnost MeSH
- tuková tkáň * MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Volleyball is an exceedingly popular physical activity in the adolescent population, especially with females. The study objective was to assess the effect of volleyball training and natural ontogenetic development on the somatic parameters of adolescent girls. The study was implemented in a group of 130 female volleyball players (aged 12.3 ± 0.5 - 18.1 ± 0.6 years) along with 283 females from the general population (aged 12.3 ± 0.5 - 18.2 ± 0.5 years). The measured parameters included: body height (cm), body mass (kg), body fat (kg, %), visceral fat (cm2), body water (l), fat free mass (kg) and skeletal muscle mass (kg, %). Starting at the age of 13, the volleyball players had significantly lower body fat ratio and visceral fat values than those in the general population (p < 0.001 in body fat % and p < 0.01 in visceral fat). In volleyball players, the mean body fat (%) values were 17.7 ± 6.6 in 12-year-old players, 16.7 ± 4.9 in 13-year-old players, 18.5 ± 3.9 in 16-year-old players, and 19.3 ± 3.1 in 18-year-old players. In the general population, the mean body fat (%) values were 19.6 ± 6.3 in 12-year-old girls, 21.7 ± 6.4 in 13-year-old girls, 23.4 ± 6.1 in 16-year-old girls, and 25.8 ± 7.0 in 18-year-old girls. The visceral fat (cm2) mean values were 36.4 ± 19.3 in 12-year-old players, 39.2 ± 16.3 in 13-year-old players, 45.7 ± 14.7 in 16-year-old players, and 47.2 ± 12.4 in 18-year-old players. In the general population, the mean visceral fat (cm2) values were 41.4 ± 21.1 in 12-year-old girls, 48.4 ± 21.5 in 13-year-old girls, 58.0 ± 24.7 in 16-year-old girls, and 69.1 ± 43.7 in 18-year-old girls. In volleyball players, lower body fat ratio corresponded with a higher skeletal muscle mass ratio. The differences found in skeletal muscle mass ratio were also significant starting at the age of 13 (p < 0.001). The mean skeletal muscle mass (%) values were 44.1 ± 3.4 in 12-year-old volleyball players, 45.4 ± 2.5 in 13-year-old players, 45.0 ± 2.2 in 16-year-old players, and 44.7 ± 1.8 in 18-year-old players. In the general population, the mean skeletal muscle mass (%) values were 42.8 ± 3.2 in 12-year-old girls, 42. ± 4.1 in 13-year-old girls, 41.9 ± 3.3 in 16-year-old girls, and 40.6 ± 3.7 in 18-year-old girls. Differences in body composition between the individual age groups were similar between the volleyball players and girls in the general population. The results indicate that regular volleyball training influences the body composition of young females however the development of body composition parameters is subject to their ontogenetic development.
- Publikační typ
- časopisecké články MeSH