The lung cancer exercise training study: a randomized trial of aerobic training, resistance training, or both in postsurgical lung cancer patients: rationale and design.

BACKGROUND: The Lung Cancer Exercise Training Study (LUNGEVITY) is a randomized trial to investigate the efficacy of different types of exercise training on cardiorespiratory fitness (VO2peak), patient-reported outcomes, and the organ components that govern VO2peak in post-operative non-small cell lung cancer (NSCLC) patients. METHODS/DESIGN: Using a single-center, randomized design, 160 subjects (40 patients/study arm) with histologically confirmed stage I-IIIA NSCLC following curative-intent complete surgical resection at Duke University Medical Center (DUMC) will be potentially eligible for this trial. Following baseline assessments, eligible participants will be randomly assigned to one of four conditions: (1) aerobic training alone, (2) resistance training alone, (3) the combination of aerobic and resistance training, or (4) attention-control (progressive stretching). The ultimate goal for all exercise training groups will be 3 supervised exercise sessions per week an intensity above 70% of the individually determined VO2peak for aerobic training and an intensity between 60 and 80% of one-repetition maximum for resistance training, for 30-45 minutes/session. Progressive stretching will be matched to the exercise groups in terms of program length (i.e., 16 weeks), social interaction (participants will receive one-on-one instruction), and duration (30-45 mins/session). The primary study endpoint is VO2peak. Secondary endpoints include: patient-reported outcomes (PROs) (e.g., quality of life, fatigue, depression, etc.) and organ components of the oxygen cascade (i.e., pulmonary function, cardiac function, skeletal muscle function). All endpoints will be assessed at baseline and postintervention (16 weeks). Substudies will include genetic studies regarding individual responses to an exercise stimulus, theoretical determinants of exercise adherence, examination of the psychological mediators of the exercise - PRO relationship, and exercise-induced changes in gene expression. DISCUSSION: VO2peak is becoming increasingly recognized as an outcome of major importance in NSCLC. LUNGEVITY will identify the optimal form of exercise training for NSCLC survivors as well as provide insight into the physiological mechanisms underlying this effect. Overall, this study will contribute to the establishment of clinical exercise therapy rehabilitation guidelines for patients across the entire NSCLC continuum. TRIAL REGISTRATION: NCT00018255.

Evaluation of Corrosion Fatigue Behaviour of Laser-welded NiTi Alloys using Bending Rotation Fatigue Test in Simulated Body Fluid

Shape memory NiTi alloys have been used extensively for medical device applications such as orthopedic, dental, vascular and cardiovascular devices on account of their unique shape memory effect (SME) and super-elasticity (SE). Laser welding is found to be the most suitable method used to fabricate NiTi-based medical components. However, the performance of laser-welded NiTi alloys under corrosive environments is not fully understood and a specific focus on understanding the corrosion fatigue behaviour is not evident in the literature. This study reveals a comparison of corrosion fatigue behaviour of laser-welded and bare NiTi alloys using bending rotation fatigue (BRF) test which was integrated with a specifically designed corrosion cell. The testing environment was Hanks’ solution (simulated body fluid) at 37.5oC. Electrochemical impedance spectroscopic (EIS) measurement was carried out to monitor the change of corrosion resistance at different periods during the BRF test. Experiments indicate that the laser-welded NiTi alloy would be more susceptible to the corrosion fatigue attack than the bare NiTi alloy. This finding can serve as a benchmark for the product designers and engineers to determine the factor of safety of NiTi medical devices fabricated using laser welding.

Low cycle fatigue properties of CLAM steel at room temperature

The low cycle fatigue (LCF) properties and the fracture behavior of China Low Activation Martensitic (CLAM) steel have been studied over a range of total strain amplitudes from 0.2 to 2.0%. The specimens were cycled using tension-compression loading under total strain amplitude control. The CLAM steel displayed initial hardening followed by continuous softening to failure at room temperature in air. The relationship between strain and fatigue life was predicted using the parameters obtained from fatigue test. The factors effecting on low cycle fatigue of CLAM steel consisted of initial state of matrix dislocation arrangement, magnitude of cyclic stress, magnitude of total strain amplitude and microstructure. The potential mechanisms controlling the stress response, cyclic strain resistance and low cycle fatigue life have been evaluated.

Corrosion Fatigue Behaviour of Laser-welded Shape Memory NiTi Wires in a Simulated Body Fluid

Corrosion fatigue is a fracture process as a consequence of synergistic interactions between the material structure, corrosive environment and cyclic loads/strains. It is difficult to be detected and can cause unexpected failure of engineering components in use. This study reveals a comparison of corrosion fatigue behaviour of laser-welded and bare NiTi wires using bending rotation fatigue (BRF) test coupled with a specifically-designed corrosion cell. The testing medium was Hanks’ solution (simulated body fluid) at 37.5 oC. Electrochemical impedance spectroscopic (EIS) measurement was carried out to monitor the change of corrosion resistance of sample during the BRF test at different periods of time. Experiments indicate that the laser-welded NiTi wire would be more susceptible to the corrosion fatigue attack than the bare NiTi wire. This study can serve as a benchmark for the product designers and engineers to understand the corrosion fatigue behaviour of the NiTi laser weld joint and determine the fatigue life safety factor for NiTi medical devices/implants involving laser welding in the fabrication process.

Fracture and fatigue of natural fiber-reinforced cementitious composites

This paper presents the results of an experimental study of resistance-curve behavior and fatigue crack growth in cementitious matrices reinforced with eco-friendly natural fibers obtained from agricultural by-products. The composites include: blast furnace slag cement reinforced with pulped fibers of sisal, banana and bleached eucalyptus pulp, and ordinary Portland cement composites reinforced with bleached eucalyptus pulp. Fracture resistance (R-curve) and fatigue crack growth behavior were studied using single-edge notched bend specimens. The observed stable crack growth behavior was then related to crack/microstructure interactions that were elucidated via scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). Fracture mechanics models were used to quantify the observed crack-tip shielding due to crack-bridging. The implications of the results are also discussed for the design of natural fiber-reinforced composite materials for affordable housing. (C) 2009 Elsevier Ltd. All rights reserved.

Effects of Low-Level Laser Therapy (LLLT) in the Development of Exercise-Induced Skeletal Muscle Fatigue and Changes in Biochemical Markers Related to Postexercise Recovery

STUDY DESIGN: Randomized crossover double-blinded placebo-controlled trial. OBJECTIVE: To investigate if low-level laser therapy (LLLT) can affect biceps muscle performance, fatigue development, and biochemical markers of postexercise recovery. BACKGROUND: Cell and animal studies have suggested that LLLT can reduce oxidative stress and inflammatory responses in muscle tissue. But it remains uncertain whether these findings can translate into humans in sport and exercise situations. METHODS: Nine healthy male volleyball players participated in the study. They received either active LLLT (cluster probe with 5 laser diodes; A = 810 nm; 200 mW power output; 30 seconds of irradiation, applied in 2 locations over the biceps of the nondominant arm; 60 J of total energy) or placebo LLLT using an identical cluster probe. The intervention or placebo were applied 3 minutes before the performance of exercise. All subjects performed voluntary elbow flexion repetitions with a workload of 75% of their maximal voluntary contraction force until exhaustion. RESULTS: Active LLLT increased the number of repetitions by 14.5% (mean +/- SD, 39.6 +/- 4.3 versus 34.6 +/- 5.6; P = .037) and the elapsed time before exhaustion by 8.0% (P = .034), when compared to the placebo treatment. The biochemical markers also indicated that recovery may be positively affected by LLLT, as indicated by postexercise blood lactate levels (P<.01), creatine kinase activity (P = .017), and C-reactive protein levels (P = .047), showing a faster recovery with LLLT application prior to the exercise. CONCLUSION: We conclude that pre-exercise irradiation of the biceps with an LLLT dose of 6 J per application location, applied in 2 locations, increased endurance for repeated elbow flexion against resistance and decreased postexercise levels of blood lactate, creatine kinase, and C-reactive protein. LEVEL OF EVIDENCE: Performance enhancement, level 1b. J Orthop Sports Phys Ther 2010;40(8):524-532. doi:10.2519/jospt.2010.3294

Psychological responses to acute resistance exercise in men and women who are obese

The purpose of the study was to investigate the psychological response to the very first session of resistance exercise on positive well-being (PWB), psychological distress (PD), and perception of fatigue in untrained men and women who are obese. Forty-five (male = 22, female = 23) untrained, middle-aged volunteers (mean ± SEM, 51.0 ± 1.0; range, 40-69 years) participated in the study. Participants were divided into 4 groups according to sex and obesity level (i.e., men who are obese, men who are nonobese, women who are obese, women who are nonobese). The threshold for obesity was defined as waist circumference ≥94 cm for men and 80 cm for women. Measures included body composition, aerobic power, muscle strength, and quality of life (Short Form 36, SF-36). Before and after resistance exercise, participants completed the Subjective Exercise Experience Scale (SEES). Paired sample t-tests were used to assess changes in SEES scores within group pre- and post-exercise and repeated-measures analysis of variance were used to assess changes in SEES scores between groups. Exercise increased the perception of PWB in both women who are obese and nonobese, without changes in PD or fatigue. In women, the change in PWB after exercise was negatively correlated with most scales of the SF-36, particularly with the mental health dimension (r = -0.55, p < 0.01). No significant changes in PWB, PD, or fatigue were found in men who are obese. Acute resistance exercise improved PWB in women who are obese and nonobese and those with lower self-perceived quality of life scores at the start improved the most. In addition, resistance exercise did not increase feelings of distress in either women or men who are obese.

Fatigue depresses maximal in vitro skeletal muscle Na+-K+-ATPase activity in untrained and trained individuals

This study investigated whether fatiguing dynamic exercise depresses maximal in vitro Na+-K+-ATPase activity and whether any depression is attenuated with chronic training. Eight untrained (UT), eight resistance-trained (RT), and eight endurance-trained (ET) subjects performed a quadriceps fatigue test, comprising 50 maximal isokinetic contractions (180°/s, 0.5 Hz). Muscle biopsies (vastus lateralis) were taken before and immediately after exercise and were analyzed for maximal in vitro Na+-K+-ATPase (K+-stimulated 3-O-methylfluoroscein phosphatase) activity. Resting samples were analyzed for [3H]ouabain binding site content, which was 16.6 and 18.3% higher (P < 0.05) in ET than RT and UT, respectively (UT 311 ± 41, RT 302 ± 52, ET 357 ± 29 pmol/g wet wt). 3-O-methylfluoroscein phosphatase activity was depressed at fatigue by −13.8 ± 4.1% (P < 0.05), with no differences between groups (UT −13 ± 4, RT −9 ± 6, ET −22 ± 6%). During incremental exercise, ET had a lower ratio of rise in plasma K+ concentration to work than UT (P < 0.05) and tended (P = 0.09) to be lower than RT (UT 18.5 ± 2.3, RT 16.2 ± 2.2, ET 11.8 ± 0.4 nmol · l−1 · J−1). In conclusion, maximal in vitro Na+-K+-ATPase activity was depressed with fatigue, regardless of training state, suggesting that this may be an important determinant of fatigue.

Understanding in-vivo abrasion fatigue or common suture materials used in arthroscopic and open shoulder surgery

In orthopaedic surgery the reattachment of tendon to bone requires suture materials that have stable and durable properties to allow healing at the tendon-bone interface. Failure rates of this type of surgery can be as high as 25%. While the tissue suture interface is a weak link, proportions of these failures are caused by in-vivo abrasion of the suture with bone and suture anchor materials. Abrasion of the suture material results from the movement of the suture through the eyelet by the surgeon during surgery, or with limb movement after surgery as the suture is not rigidly restrained within the eyelet. During movement the suture is subjected to bending and frictional forces that can lead to fatigue induced failure. This paper investigates the mechanism of bending abrasion fatigue induced failure of number two grade braided sheath only and braided sheath/multifilament core sutures. Sutures were oscillated over a stainless steel wire at low frequency under load in a dry state to simulate the bending and frictional forces between suture and eyelet. Failure mechanism was determined by video microscopy of the suture during abrasion combined with optical microscopy analysis of partially and fully abraded sutures. Braided only structures had high friction loading on the small number of fibres at the abrasion interface. This caused rapid single fibre breakages that accumulate to cause suture failure. The addition of ultra-high molecular weight polyethylene core fibres to a braided suture distributed the applied load across multiple fibres at the abrasion interface. This improved abrasion resistance by 15-20 times that of braided sheath alone.

Influence of shot peening and hard chromium electroplating on the fatigue strength of 7050-T7451 aluminum alloy

Chromium electrodeposition is a technique for the production of functional coatings on engineering components. These coatings are extensively micro-cracked and present high level of hardness, resistance to corrosion and wear and low coefficient of friction. In this paper the shot peening influence on the fatigue strength of aluminum 7050-T7451 alloy chromium electroplated, was investigated.The shot peening process was carried out to create residual stresses using ceramic and glass shots. A hard chromium electroplated coating of 100 mu m thickness was performed on the base material and the shot peened base material surfaces. S-N curves were obtained in axial and bending fatigue tests and compared with the 7050-T7451 aluminum alloy. In order to study the influence of residual stresses on fatigue life, the behavior of compressive residual stress field was measured by an X-ray tensometry.An increase in the axial fatigue strength of 25% and 50% of ceramic and glass shots, respectively, was observed. The lower performance in fatigue life for ceramic-shot peening may be attributed to higher surface damage, as a consequence of the overpeening intensity performed. However, in bending fatigue the behavior was practically equivalent for both processes. Fracture surface analysis by scanning electron microscopy was used to observe crack origin sites from shot peened and chromium electroplated samples. (C) 2006 Elsevier Ltd. All rights reserved.

Influence of anodization on the fatigue strength of 7050-T7451 aluminium alloy

In recent years, with higher demand for improved quality and corrosion resistance, recovered substrates have been extensively used. Consequently residual stresses originated from these coatings reduce the fatigue strength of a component. Due to this negative influence occasioned by corrosion resistance protective coatings, an effective process like shot peening must be considered to improve the fatigue strength. The shot peening treatment pushes the crack sources beneath the surface in most of medium and high cycle cases due to the compressive residual stress field (CRSF) induced. The aim of this study was to evaluate the influence on the fatigue life of anodic films grown on 7050-T7451 aluminium alloy by sulphuric acid anodizing, chromic acid anodizing and hard anodizing. The influence on the rotating and reverse bending fatigue strength of anodic films grown on the aluminium alloy is to degrade the stress life fatigue performance of the base material.A consistent gain in fatigue life in relation to the base material was obtained through the shot peening process in coated specimens, associated to a residual stress field compressive near the surface, useful to avoid fatigue crack nucleation and delay or even stop crack propagation.

Effect of electroless nickel interlayer on the fatigue strength of chromium electroplated AISI 4340 steel

Deposition of wear-resistant hard chromium plating leads to a decrease in the fatigue strength of the base material. Despite the effective protection against wear and corrosion, fatigue life and environmental requirements result in pressure to identify alternatives or to improve conventional chromium electroplating mechanical characteristics. An interesting, environmentally safer and cleaner alternative for the replacement of hard chronic plating is tungsten carbide thermal spray coating, applied by high velocity oxyfuel (HVOF) process.To improve the fatigue strength of aeronautical steel chromium electroplated, shot peening is a successfully used method. Multiple lacer systems of coatings are considered to have larger resistance to crack propagation in comparison with simple layer.The aim of this study was to analyze the effect of nickel underplate on the fatigue strength of hard chromium plated AISI 4340 steel in two mechanical conditions: HRc 39 and HRc 52.Rotating bending fatigue tests results indicate that the clectroless nickel plating underlayer is responsible for the increase in fatigue strength of AISI 4340 steel chromium electroplated. This behavior may be attributed to the largest toughness/ductility and compressive residual stresses which, probably, arrested or delayed the inicrocrack propagation from the hard chromium external layer. The compressive residual stress field (CRSF) induced by the electroplating process was determined by X-ray diffraction method. The evolution of fatigue strength compressive residual stress field CRSF and crack sources are discussed and analyzed by SEM. (c) 2006 Elsevier Ltd. All rights reserved.

Evaluation of WC-17Co and WC-10Co-4Cr thermal spray coatings by HVOF on the fatigue and corrosion strength of AISI 4340 steel

It is known that chromium electroplating is related to the reduction in the fatigue strength of base metal. However, chromium results in protection against wear and corrosion combined with chemical resistance and good lubricity. Environmental requirements are an important point to be considered in the search for possible alternatives to hard chrome plating. Aircraft landing gear manufactures are considering WC thermal spray coating applied by the high-velocity oxygen-fuel (HVOF) process an alternative candidate, which shows performance at least comparable to results, obtained for hard chrome plating. The aim of this study is to compare the influence of WC-17Co and WC-10Co-4Cr coatings applied by HVOF process and hard chromium electroplating on the fatigue strength of AISI 4340 steel, with and without shot peening. S-N curves were obtained in axial fatigue test for base material, chromium plated and tungsten carbide coated specimens. Tungsten carbide thermal spray coating results in higher fatigue strength when compared to hard chromium electroplated. Shot peening prior to thermal spraying showed to be an excellent alternative to increase fatigue strength of AISI 4340 steel. Experimental data showed higher axial fatigue and corrosion resistance in salt fog exposure for samples WC-10Co-4Cr HVOF coated when compared with WC-17Co. Fracture surface analysis by scanning electron microscopy (SEM) indicated the existence of a uniform coverage of nearly all substrates. (C) 2004 Elsevier B.V. All rights reserved.

Residual stress influence on fatigue lifetimes of electroplated AISI 4340 high strength steel

Residual stresses play an important role in the fatigue lives of structural engineering components. In the case of near surface tensile residual stresses, the initiation and propagation phases of fatigue process are accelerated; on the other hand, compressive residual stresses close to the surface may increase fatigue life. In both decorative and functional applications, chromium electroplating results in excellent wear and corrosion resistance. However, it is well known that it reduces the fatigue strength of a component. This is due to high tensile internal stresses and microcrack density. Efforts to improve hard chromium properties have increased in recent years. In this study, the effect of a nickel layer sulphamate process, as simple layer and interlayer, on fatigue strength of hard chromium electroplated AISI 4340 steel hardness - HRc 53, was analysed. The analysis was performed by rotating bending fatigue tests on AISI 4340 steel specimens with the following experimental groups: base material, hard chromium electroplated, sulphamate nickel electroplated, sulphamate nickel interlayer on hard chromium electroplated and electroless nickel interlayer on hard chromium electroplated. Results showed a decrease in fatigue strength in coated specimens and that both nickel plating interlayers were responsible for the increase in fatigue life of AISI 4340 chromium electroplated steel. The shot peening pre-treatment was efficient in reducing fatigue loss in the alternatives studied.