Exercise intervention in pediatric patients with solid tumors: The PAPEC trial

The randomized controlled trial ‘Physical Activity in Pediatric Cancer’ (PAPEC) determined the effects of an in-hospital exercise intervention combining aerobic and muscle strength training on pediatric cancer patients with solid tumors undergoing neoadjuvant chemotherapy. Methods. Participants were allocated to an exercise (n=24, 17 boys; mean±SEM age 10±1y) or control group (n=25, 18 boys; 11±1y). Training included three sessions/week for 19±2 weeks. Participants were assessed at treatment initiation, termination, and two months after end-treatment. The primary endpoint was muscle strength (as assessed by upper and lower-body five-repetition-maximum (5RM) tests). Secondary endpoints included cardiorespiratory fitness, functional capacity during daily life activities, physical activity, body mass and body mass index, and quality of life. Results. Most sessions were performed in the hospital’s gymnasium. Adherence to the program averaged 68±4% and no major adverse events or health issues were noted. A significant interaction (group*time) effect was found for all 5RM tests. Performance significantly increased after training (leg press: 40% (95% CI=15–41 kg); bench press: 24% (95% CI=6–14 kg); lateral row 25% (95%CI=6–15 kg)), whereas an opposite trend was found in controls. Two-month post values tended to be higher than baseline for leg (P=0.017) and bench press (P=0.014). In contrast, no significant interaction effect was found for any of the secondary endpoints. Conclusion. An in-hospital exercise program for pediatric cancer patients with solid tumors undergoing neoadjuvant treatment increases muscle strength despite the aggressiveness of such therapy. Key words: Cancer, exercise, muscle strength, fitness, quality of life.

Comparación entre los efectos de un programa de entrenamiento de fuerza explosiva mediante bandas elásticas y un programa de entrenamiento con electro-estimulación de cuerpo completo

El objetivo del presente estudio fue analizar los cambios en el rendimiento en función de dos métodos de entrenamiento, el desarrollado mediante electro-estimulación muscular integral (EMI) frente a otro en el que se utilizaron bandas elásticas y que denominamos entrenamiento funcional con elásticos (EFE). La muestra estuvo compuesta por un grupo de diez (N=10) personas físicamente activas (23,04 ± 2,5 años). Se utilizó un diseño cuasi-experimental con medidas pre-post. Y fueron analizados los resultados de las pruebas: salto vertical con ayuda de brazos; y velocidad de desplazamiento en una carrera de ida y vuelta de 12 metros de distancia (6+6). Se realizó un análisis descriptivo de casos y medias. Y dado el tamaño de la muestra se calculó el tamaño del efecto, el cual fue bajo o moderado (d<0,5). Por último se compararon las diferencias de las medias de los grupos mediante la U de Mann Whitney, y las diferencias de las medias en función del tiempo (pre-post) mediante Friedman; en ambos casos los resultados no fueron significativos (p<0,5). En cuanto a los valores descriptivos del pre-post en ambos grupos: el grupo que entrenó con bandas elásticas obtuvo mejores resultados en ambas pruebas que el grupo que entrenó con EMI. En conclusión, el entrenamiento con bandas elásticas, a pesar de no ser significativo, parece mostrarse más efectivo que el entrenamiento con electro-estimulación muscular integral. Si bien, dadas las limitaciones del estudio estos datos hay que tomarlos con la pertinente cautela.

Efectos del tipo de recuperación sobre la oxigenación muscular durante el ejercicio de sentadilla

El objetivo de esta investigación es comprobar los cambios en la oxigenación muscular del recto anterior durante la realización del ejercicio de sentadilla según el tipo de recuperación. Para ello, 11 sujetos varones bien entrenados fueron distribuidos aleatoriamente a tres grupos experimentales: grupo que realiza recuperación pasiva con 2 minutos de descanso (GC), grupo que realiza recuperación activa hasta la estabilización de oxígeno (GA), grupo que realiza recuperación pasiva hasta la estabilización de oxígeno (GP). Todos realizaron la sentadilla hasta los 90º al 65% del 1RM con un 80% del carácter del esfuerzo (CE) (4x10). Los resultados muestran que el tiempo de reoxigenación (TrecSmO2) fue inferior significativamente en GA (77,94 ± 11,08) que en GC (p<0.001). En las inclinaciones medias de ejecución y reoxigenación el GA obtuvo los menores y mayores valores respectivamente y de forma significativa respecto a GC (p<0.001). Estas dos variables obtuvieron una relación inversamente proporcional con una r=-0.9585 (p<0.001). Estos resultados muestran una mejor reoxigenación en el grupo que realizó descanso de forma activa. Se muestra una relación inversamente proporcional entre la inclinaciones de ejecución y recuperación por lo que cuanto más rápida y completa sea la desoxigenación más lenta resultará la reoxigenación. Además, la saturación de oxígeno puede ser un factor de la fatiga neuromuscular y su control durante el entrenamiento de fuerza podría facilitar los objetivos de entrenamiento. Estos resultados muestran, a priori, una mejor recuperación entre series a nivel oxidativo cuando los sujetos realizan una recuperación de forma activa, en comparación con la pasiva.

Muscle function and body composition profile in adolescents withrestrictive anorexia nervosa: Does resistance training help?

The aim of this study was to analyze the effects of short-term resistance training on the body composition profile and muscle function in a group of Anorexia Nervosa restricting type (AN-R) patients. The sample consisted of AN-R female adolescents (12.8 ± 0.6 years) allocated into the control and intervention groups (n¼18 each). Body composition and relative strength were assessed at baseline, after 8 weeks and 4 weeks following the intervention. Body mass index (BMI) increased throughout the study (p = 0.011). Significant skeletal muscle mass (SMM) gains were found in the intervention group (p = 0.045, d = 0.6) that correlated to the change in BMI (r = 0.51, p < 0.031). Meanwhile, fat mass (FM) gains were significant in the control group (p = 0.047, d = 0.6) and correlated (r > 0.60) with change in BMI in both the groups. Significant relative strength increases (p < 0.001) were found in the intervention group and were sustained over time.

Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss

We investigated the effect of different exercise modalities on high sensitivity-C reactive protein (hs-CRP) and other inflammatory markers in patients with type 2 diabetes and the metabolic syndrome. Eighty-two patients were randomized into 4 groups: sedentary control (A); receiving counseling to perform low-intensity physical activity (B); performing prescribed and supervised high-intensity aerobic (C) or aerobic + resistance (D) exercise (with the same caloric expenditure) for 12 months. Evaluation of leisure-time physical activity and assessment of physical fitness, cardiovascular risk factors and inflammatory biomarkers was performed at baseline and every 3 months. Volume of physical activity increased and HbA1c decreased in Groups B–D. VO2max, HOMA-IR index, HDL-cholesterol, waist circumference and albuminuria improved in Groups C and D, whereas strength and flexibility improved only in Group D. Levels of hs-CRP decreased in all three exercising groups, but the reduction was significant only in Groups C and D, and particularly in Group D. Changes in VO2max and the exercise modalities were strong predictors of hs-CRP reduction, independent of body weight. Leptin, resistin and interleukin-6 decreased, whereas adiponectin increased in Groups C and D. Interleukin-1β, tumor necrosis factor-α and interferon-γ decreased, whereas anti-inflammatory interleukin-4 and 10 increased only in Group D. In conclusion, physical exercise in type 2 diabetic patients with the metabolic syndrome is associated with a significant reduction of hs-CRP and other inflammatory and insulin resistance biomarkers, independent of weight loss. Long-term high-intensity (preferably mixed) training, in addition to daytime physical activity, is required to obtain a significant anti-inflammatory effect.

Novel resistance training-specific rating of perceived exertion scale measuring repetitions in reserve

The primary aim of this study was to compare rating of perceived exertion (RPE) values measuring repetitions in reserve (RIR) at particular intensities of 1 repetition maximum (RM) in experienced (ES) and novice squatters (NS). Furthermore, this investigation compared average velocity between ES and NS at the same intensities. Twenty-nine individuals (24.0 ± 3.4 years) performed a 1RM squat followed by a single repetition with loads corresponding to 60, 75, and 90% of 1RM and an 8-repetition set at 70% 1RM. Average velocity was recorded at 60, 75, and 90% 1RM and on the first and last repetitions of the 8-repetition set. Subjects reported an RPE value that corresponded to an RIR value (RPE-10 = 0-RIR, RPE-9 = 1-RIR, and so forth). Subjects were assigned to one of the 2 groups: (a) ES (n = 15, training age: 5.2 ± 3.5 years) and (b) NS (n = 14, training age: 0.4 ± 0.6 years). The mean of the average velocities for ES was slower (p ≤ 0.05) than NS at 100% and 90% 1RM. However, there were no differences (p > 0.05) between groups at 60, 75%, or for the first and eighth repetitions at 70% 1RM. In addition, ES recorded greater RPE at 1RM than NS (p = 0.023). In ES, there was a strong inverse relationship between average velocity and RPE at all percentages (r = −0.88, p < 0.001), and a strong inverse correlation in NS between average velocity and RPE at all intensities (r = −0.77, p = 0.001). Our findings demonstrate an inverse relationship between average velocity and RPE/RIR. Experienced squatter group exhibited slower average velocity and higher RPE at 1RM than NS, signaling greater efficiency at high intensities. The RIR-based RPE scale is a practical method to regulate daily training load and provide feedback during a 1RM test.