Changes in cardiorespiratory fitness, psychological wellbeing, quality of life, and vocational status following a 12 month cardiac exercise rehabilitation programme. The effect of aerobic training on rehabilitation outcomes after recent severe brain injury: a randomized controlled evaluation. Inspiratory muscular training in chronic stroke survivors: a randomized controlled trial. Benefits and problems of a physical training programme for asthmatic patients. Effects of frequency and duration of training on attrition and incidence of injury. Combined aerobic and resistance training in breast cancer survivors: A randomized, controlled pilot trial. Randomised controlled trial of rehabilitation in chronic respiratory disability. Comprehensive local muscle training increases aerobic working capacity and quality of life and decreases neurohormonal activation in patients with chronic heart failure. Short- and long-term effects of outpatient rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial.
To examine and evaluate improvements in cardiorespiratory fitness, psychological wellbeing, quality of life, and vocational status in postmyocardial infarction patients during and after a comprehensive 12 month exercise rehabilitation programme.
                The sample population comprised 124 patients with a clinical diagnosis of myocardial infarction (122 men and two women).
                62 patients were randomly allocated to a regular weekly aerobic training programme, three times a week for 12 months, and compared with 62 matched controls who did not receive any formal exercise training. A five year follow up questionnaire/interview was subsequently conducted on this population to determine selected vocational/lifestyle changes.
                Significant improvements in cardiorespiratory fitness (p < 0.01-0.001), psychological profiles (p < 0.05-0.001), and quality of life scores (p < 0.001) were recorded in the treatment population when compared with their matched controls. Although there were no significant differences in mortality, a larger percentage of the regular exercisers resumed full time employment and they returned to work earlier than the controls. Controls took lighter jobs, lost more time from work, and suffered more non-fatal reinfarctions (p < 0.05-0.01).
                Regularly supervised and prolonged aerobic exercise training improves cardiorespiratory fitness, psychological status, and quality of life. The trained population also had a reduction in morbidity following myocardial infarction, and significant improvement in vocational status over a five year follow up period. To examine the impact of fitness training with recently brain-injured inpatients on exercise capacity and functional and psychologic outcome measures.
                A randomized controlled trial of exercise versus relaxation training for 3 months. Blind assessments were conducted before and after the end of a 12-week training program, as well as at follow-up assessment 12 weeks posttraining.
                Four regional neurologic inpatient rehabilitation units.
                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.
                Patients were randomized between cycle ergometer aerobic training and a relaxation training control condition, which was theoretically inert with respect to cardiovascular fitness.
                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 questionnaire, Hospital Anxiety and Depression Scale).
                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.
                The benefits of improved cardiovascular fitness did not appear to extend to measurable change in function or psychologic state. To assess the effectiveness of inspiratory muscular training (IMT) on measures of strength, resistance, functional performance, and quality of life (QOL) for chronic stroke survivors.
                Double-blinded randomized controlled trial.
                Research laboratory.
                Subjects (N=21) with stroke (11 men, 10 women; maximal inspiratory pressure [MIP] <90% of predicted values) were randomly assigned to the experimental (n=11) and control groups (n=10); 18 participants completed all testing and training.
                Interventions were based on home-based training, with resistance adjusted biweekly to 30% of MIP for the experimental group. The control group underwent the same protocol without the threshold resistance valve. Both groups received home training 30 minutes a day 5 times a week for 8 weeks.
                MIP, inspiratory muscular endurance (IME), functional performance, and QOL.
                There were significant between-group differences for the MIP and IME measures. Significant changes were observed for only the experimental group for MIP (67.8±14.6 at baseline to 102.2±26.0cmH(2)O at posttraining) and IME (31.8±19.3 to 49.2±21.1cmH(2)O). No statistically significant differences were observed for measures of functional performance and QOL.
                Significant short-term effects of the IMT program for inspiratory strength and endurance were observed in chronic stroke survivors. These findings gave some indications that IMT may benefit people with stroke, and it is feasible to be included in rehabilitation interventions with this population.
                Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved. The clinical and physiological effects of a medically supervised, indoor physical training programme were investigated in 36 asthmatic subjects aged 16-40 years. After clinical evaluation, lung function assessment, and progressive incremental exercise testing subjects were randomly allocated to control and training groups. The measurements were repeated after a six week run in period and after a further three months in which those in the training group underwent an indoor training programme. The measurements made at three months were compared with those at the end of the run in period. There was no significant change in anthropometric characteristics, blood lipid profiles, or the provocative concentration of histamine causing a 20% fall in FEV1 (histamine PC20) in the group who underwent training. After training there were significant increases in mean maximal oxygen uptake (ml kg-1 min-1) from 23 (5) to 28 (6), oxygen pulse (ml/beat) from 8.8 (2.3) to 10.8 (2.4), and anaerobic threshold (1/min) from 1.11 (0.27) to 1.38 (0.33). These changes were significantly greater in the group undergoing training than in the control group. There was also a significant fall in breathlessness scores (Borg ratings), blood lactate, carbon dioxide output, and minute ventilation during submaximal exercise in the training group, with no change in the control group. The subject's motivation, the initial level of fitness, and the symptom score at the time of training were the most important factors influencing improvements in cardiorespiratory fitness. Thus submaximal physical exercise of controlled intensity, sustained for three months, produced significant improvements in fitness and cardiorespiratory performance that should be advantageous to the exercising asthmatic patient. The availability of medical supervision throughout the exercise programme appears to have contributed to the successful outcome. Eighty-seven male inmates from a state prison and 70 inmates from a county jail volunteered as subjects. The subjects, age 20 to 35 yrs, were assigned randomly into a control or exercise group. Their Vo2max and treadmill performance values were determined before and after a 20 week jogging program. Training intensity was between 85 and 90 percent of maximum heart rate and involved workouts 3 days/week for 15, 30, or 45-min duration at the state prison and for 30-min 1, 3, or 5 days/week at the country jail. Cardiorespiratory fitness improved in direct proportion to frequency and duration of training. Injury, occurred in 22%, 24% and 54% of the 15, 30, and 45-min duration groups and in 0%, 12%, and 39% of the 1, 3, and 5-day/week groups, respectively. Attrition resulting from injury occurred in 0%, 0%, and 17% and in 0%, 4%, and 6% of the same respective groups. Attrition due to lack of interest was similar for all training groups (25%), but was significantly lower in the control groups (10%). Although the results showed a greater increase in cardiorespiratory fitness for the 45-min duration and 5-day/week groups, these programs are not recommened for beginning joggers because of the significantly greater percent of injuries. The purpose of this pilot study was to examine the effects of a combined cardiorespiratory and resistance exercise training program of short duration on the cardiorespiratory fitness, strength endurance, task specific functional muscle capacity, body composition and quality of life (QOL) in women breast cancer survivors. Sixteen subjects were randomly assigned to either a training (n = 8; age: 50 +/- 5 yrs) or control non-exercising group (n = 8; age: 51 +/- 10 yrs). The training group followed an 8-week exercise program consisting of 3 weekly sessions of 90-min duration, supervised by an experienced investigator and divided into resistance exercises and aerobic training. Before and after the intervention period, all of the subjects performed a cardiorespiratory test to measure peak oxygen uptake (VO2peak), a dynamic strength endurance test (maximum number of repetitions for chest and leg press exercise at 30 - 35 % and 100 - 110 % of body mass, respectively) and a sit-stand test. Quality of life was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC-C30) questionnaire. In response to training, QOL, VO2peak (mean 3.9 ml/kg/min; 95 % CI, 0.93, 6.90) performance in leg press (17.9 kg; 95 % CI, 12.8, 22.4) and sit-stand test (- 0.67 s; 95 % CI, - 0.52, - 1.2) improved (p < or = 0.05). We observed no significant changes in the control group. Combined cardiorespiratory and resistance training, even of very brief duration, improves the QOL and the overall physical fitness of women breast cancer survivors. A randomised controlled study of the effects of exercise training in 39 patients with chronic respiratory disability was performed. Exercise training began with six weeks in a rehabilitation centre and was continued at home. The original control group attended the rehabilitation centre after the controlled part of the study. The treated group experienced subjective benefit from rehabilitation. The 12-minute walking distance increased on average from 523 m to 643 m in the treatment group and from 564 m to 607 m in the control group. The treatment effect of 77 m (SE 33 m) was significant at the 5% level. Treadmill exercise performance changed little and resting lung function was unaltered after rehabilitation. The treatment group maintained most of their improvement seven months later and the original control subjects improved after their rehabilitation. The study confirms the beneficial effects of exercise training in the chronically breathless and it suggests that the 12-minute walking distance is a useful index of changes in everyday exercise tolerance. Beneficial training outcomes have been reported in patients with chronic heart failure (CHF) following leg exercise training. However, data from more comprehensive training programs are limited. The aim of this study was to test the hypothesis that exercise training applying the concept of comprehensive local muscle training can improve aerobic and functional working capacity as well as quality of life in patients with CHF.
                Twenty-four men and women [age 63+/-9 years (mean+/-S.D.)] with stable, moderate chronic heart failure (left ventricular ejection fraction 30+/-10%), were investigated in a randomized controlled study with a training group of 16 patients and a control group of 8 patients. The training was performed as an aerobic resistance training by activating all the main muscle groups, one at a time. The patients exercised for 1 h, three times per week for 8 weeks.
                Patient groups did not differ at baseline. Peak oxygen uptake (8%, P<0.03), the distance walked in a 6-min walking test (11%, P<0.002), the health-related quality of life (P<0.001) and plasma norepinephrine levels at rest (32%, P<0.003) and at submaximal intensities (P<0.03) improved after training. No changes were found in the control group, except for decreased peak oxygen uptake (P<0.02) and quality of life scores (P<0.03).
                Since comprehensive physical training activating a minor muscle mass at a time markedly improves exercise capacity and quality of life and reduces catecholamine levels, it can be recommended for the rehabilitation of patients with CHF under supervision of a physical therapist. 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.
                One hundred patients were randomly 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.
                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 clinically-important difference.
                Among patients who completed the 6-month program, outpatient training resulted in significant and clinically 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.
There is insufficient evidence to draw any definitive conclusions about the effects of fitness training on cardiorespiratory fitness. Whilst it appears to be a safe and accepted intervention for people with TBI, more adequately powered and well-designed studies are required to determine the effects across a range of outcome measures.