Clinical (BMI and MRI) and Biochemical (Adiponectin, Leptin, TNF-α, and IL-6) Effects of High-Intensity Aerobic Training with High-Protein Diet in Children with Obesity Following COVID-19 Infection.

Objective: To find the clinical and biochemical effects of high-intensity aerobic training with a high-protein diet in children with obesity following COVID-19 infection. Methods: By using the block randomization method, the eligible participants were randomized into two groups. The first group received high-intensity aerobic training with a high-protein diet (Group A; n = 38) and the second group were allowed to do regular physical activities and eat a regular diet (Group B; n = 38) for 8 weeks. Clinical (basal metabolic index (BMI) and muscle-mass-cross-sectional area (CSA)) and biochemical (Adiponectin, leptin, TNF-α, and IL-6) measures were measured at baseline, on the 8th week, and at 6-months follow-up. Results: Baseline demographic and clinical attributes show homogenous presentation among the study groups (p > 0.05). After eight weeks of intervention, and at the end of 6-months follow-up, the basal metabolic index (BMI) (6.3) (CI 95% 4.71 to 7.88), mid-arm CSA (17) (CI 95% 14.70 to 19.29), mid-thigh CSA (13.10) (CI 95% 10.60 to 15.59), mid-calf CSA (11.3) (CI 95% 9.30 to 13.29), adiponectin (−1.9) (CI 95% −2.13 to −1.66), leptin (5.64) (CI 95% 5.50 to 5.77), TNF-α (0.5) (CI 95% 0.42 to 0.57), and IL-6 (0.21) (CI 95% 0.18 to 0.23) showed more improvement (p < 0.001) in Group A than Group B (p > 0.05). Conclusion: Overall, this trial found that high-intensity aerobic training with a high-protein diet decreased the BMI percentile and muscle mass (arm, thigh, and calf), and positively altered the biochemical variables in children with obesity.

Pulmonary Function and Aerobic Capacity Responses to Equine Assisted Therapy in Adolescents with Idiopathic Scoliosis: A Randomized Controlled Trial.

BACKGROUND: Idiopathic scoliosis is a common spinal malalignment that negatively impacts the respiratory system and physical conditioning in adolescents. Equine-assisted therapy comprises therapeutic horseback riding that optimizes physical performance and mobility in a range of contexts. However, the influence of equine-assisted therapy on pulmonary function remains unclear. OBJECTIVE: To examine the impact of 10 weeks of hippotherapy combined with Schroth exercises on pulmonary function and aerobic capacity in adolescents with idiopathic scoliosis. METHODS: A randomized controlled trial including 45 patients, randomly assigned to experimental and control groups, was performed. Patients in the experimental group received 15 30-min sessions of hippotherapy over a period of 10 weeks. The 2 groups attended a 60-min session of Schroth exercises 3 times/week for 10 weeks. Pulmonary function and functional capacity were assessed before and after the intervention. RESULTS: Pre- and post-intervention variables (FVC, FEV1, FEV1/FVC, MVV and 6MWT) revealed significant improvement in both groups (p < 0.05). The improvement in the experimental group was significantly higher than in the control group (p < 0.05). CONCLUSION: The addition of hippotherapy to Schroth exercises resulted in improved pulmonary function and aerobic capacity in adolescents with idiopathic scoliosis.

Effects of isokinetic knee muscle training on bone morphogenetic proteins and inflammatory biomarkers in post-traumatic osteoarthritis after anterior cruciate ligament injury: A randomized trial.

OBJECTIVE: To determine the effects of isokinetic training of the knee muscles on bone morphogenetic proteins and inflammatory biomarkers in post-traumatic osteoarthritis after anterior cruciate ligament injury in university football players. METHODS: A total of 60 participants with post-traumatic osteoarthritis after anterior cruciate ligament injury were randomly allocated into 3 groups: isokinetic training (n = 20), sensory motor training (n = 20) and control (n = 20) groups. The groups underwent different training programmes for 4 weeks. Clinical and biochemical values were measured at baseline, 4-week, 8-week and 6-month follow-ups. RESULTS: Four weeks after training the isokinetic group showed more significant changes in pain intensity and functional disability than the sensory motor training or control groups (p < 0.001). There was no significant improvement in bone morphogenic protein measures, (e.g. bone morphogenic proteins 2, 4, 6, and 7) in any of the groups. There was an improvement in inflammatory markers (CRP, TNF-α, IL-2, IL-4, IL-6) in the isokinetic training group compared with the other 2 groups (p < 0.001). CONCLUSION: Isokinetic training results in greater improvements in pain and functional disability than sensory motor training in post-traumatic osteoarthritis after anterior cruciate ligament injury in university football players. The isokinetic training programme had a beneficial effect on levels of inflammatory biomarkers and negligible effect on bone morphogenic proteins.

Comparative Effects of Isokinetic Training and Virtual Reality Training on Sports Performances in University Football Players with Chronic Low Back Pain-Randomized Controlled Study.

OBJECTIVE: The objective of this study is to find and compare the effects of isokinetic training and virtual reality training on sports performances in university football players with chronic low back pain. DESIGN: This is a randomized, double-blinded controlled study. METHODS: The study was conducted on 45LBP participants at university hospital. First group (n = 15) received isokinetic training, second group (n = 15) received virtual reality training, and the control group (n = 15) received conventional training exercises for four weeks. Clinical (pain intensity and player wellness) and sports performance (40 m sprint, 4 × 5 m sprint, submaximal shuttle running, countermovement jump, and squat jump) scores were measured at baseline, after 4 weeks, 8 weeks, and 6 months. RESULTS: Four weeks following training VRT group shows more significant changes in pain intensity and player wellness scores than IKT and control groups (p ≤ 0.001). Sports performance variables (such as 40 m sprint, 4 × 5 m sprint, submaximal shuttle running, countermovement jump, and squat jump) scores also show significant improvement in VRT group than the other two groups (p ≤ 0.001). CONCLUSION: Overall, our study suggests that strength training through virtual reality training protocol improves pain and sports performances than isokinetic training and other conventional trainings in university football players with chronic low back pain.

Effect of Moderate-Intensity Aerobic Exercise on Hepatic Fat Content and Visceral Lipids in Hepatic Patients with Diabesity: A Single-Blinded Randomised Controlled Trial.

OBJECTIVE: Limited studies have assessed the effect of moderate-intensity continuous aerobic exercise on hepatic fat content and visceral lipids in hepatic patients with diabesity. This study was designed to evaluate hepatic fat content and visceral lipids following moderate-intensity continuous aerobic exercise in hepatic patients with diabesity. DESIGN: A single-blinded randomised controlled trial. METHODS: Thirty-one diabetic obese patients with nonalcoholic fatty liver disease were recruited into this study. The patients were randomly classified into exercise and control groups, fifteen patients in the exercise group and sixteen patients in the control group. The exercise group received an 8-week moderate-intensity continuous aerobic exercise program with standard medical treatment, while the control group received standard medical treatment without any exercise program. Hepatic fat content and visceral lipids were assessed before and after intervention at the end of the study. RESULTS: Baseline and clinical characteristics showed a nonsignificant difference between the two groups (p > 0.05). At the end of the intervention, the aerobic exercise showed significant improvements (serum triglycerides and low-density lipoproteins (LDLs), p ≤ 0.002, total cholesterol, p=0.004, visceral fats, p=0.016, glycated hemoglobin (HbA1C), p=0.022, high-density lipoproteins (HDLs), p=0.038, alanine transaminases (AL), p=0.044, intrahepatic triglyceride and HOMA-IR, p=0.046, and body mass index (BMI), p=0.047), while the control group showed a nonsignificant difference (p > 0.05). The postintervention analysis showed significant differences in favor of the aerobic exercise group (p < 0.05). CONCLUSIONS: Moderate-intensity continuous aerobic exercise reduces the hepatic fat content and visceral lipids in hepatic patients with diabesity. Recommendations should be prescribed for encouraging moderate-intensity aerobic exercise training, particularly hepatic patients with diabesity.

Effects of high-intensity interval and moderate-intensity continuous aerobic exercise on diabetic obese patients with nonalcoholic fatty liver disease: A comparative randomized controlled trial.

BACKGROUND: Some studies assessed the effect of aerobic exercise on diabetic obese patients with hepatic disease, while very limited studies compared high-intensity interval (HII) versus moderate-intensity continuous (MIC) on diabetic obese patients with non-alcoholic fatty liver disease (NAFLD). OBJECTIVES: This study was designed to assess the effects of HII versus MIC on intrahepatic triglycerides (IHTG) and visceral lipids in diabetic obese patients with NAFLD. DESIGN: Randomized controlled trial. METHODS: Forty-seven diabetic obese individuals with NAFLD were enrolled in this study. The individuals were randomly divided into 16 in HII group, 15 in MIC group, and 16 in the controls. HII group received HII exercise, MIC group received 8-week MIC exercise while the control group did not receive any exercise intervention. IHTG and visceral lipids were assessed pre- and post-intervention. RESULTS: Baseline and clinical characteristics showed nonsignificant difference among the 3 groups (P > .05). Both HII and MIC groups showed a significant reduction in hepatic fat and visceral lipids (P < .05), while the controls showed nonsignificant difference (P > .05) after completing the study intervention. Postintervention analysis showed nonsignificant changes between the HII and MIC groups (P > .05). CONCLUSIONS: Exercise training wither HII or MIC aerobic exercise reduces IHGT and visceral lipids in diabetic obese patients with NAFLD. No differences were observed between the effects of both exercise programs on diabetic obese patients with NAFLD.

Examining the impacts of 12 weeks of low to moderate-intensity aerobic exercise on depression status in patients with systolic congestive heart failure - A randomized controlled study.

OBJECTIVES: Psychiatric depression disorder is common in patients with systolic congestive heart failure (HF), and both conditions share underlying pathophysiological mechanisms. The incidence rate of depression disorder has clearly increased with the increase in HF manifestations in recent decades. Depression disorder is considered an independent predisposing factor for hospitalization, disturbed functional performance, and high rates of morbidity and mortality in HF patients. This randomized controlled study was designed to examine the impacts of low- to moderate-intensity aerobic exercise training on depression status in patients with systolic congestive HF. METHODS: A total of 46 systolic congestive HF patients with depression (40-60 years of age) were randomized to receive twelve weeks of mild- to moderate-intensity aerobic exercise plus standard medical treatment (exercise group) or standard medical treatment without any exercise intervention (control group). Depression status was examined using the validated Patient Health Questionnaire-9 (PHQ9) pre- and post-intervention at the end of the study program. RESULTS: No significant differences were observed between the exercise and control groups in demographic data or clinical characteristics (p>0.05). Both study groups showed a significant reduction in depression status at the end of the 12-week intervention (p<0.05). The comparison between the mean values of the depression scores showed significant differences between the two groups after 6 and 12 weeks of the intervention, indicating a greater reduction in depression scores in the exercise group than in the control group (p<0.05). CONCLUSIONS: Twelve weeks of a low- to moderate-intensity aerobic exercise program was safe and effective for reducing depression severity in patients with systolic congestive HF. Low- to moderate-intensity aerobic training should be recommended for cardiac patients, particularly those with HF-related depression.

Similar effects of low to moderate-intensity exercise program vs moderate-intensity continuous exercise program on depressive disorder in heart failure patients: A 12-week randomized controlled trial.

BACKGROUND: Heart failure related depression is recently increased worldwide. Heart failure (HF) disease is identified as a critical cause of increasing morbidity, hospital readmission, and mortality. The most important purpose of treatment of HF disease is to relief disease problems, improve functional performance, and achieve better quality of life. OBJECTIVES: This study was proposed to evaluate the effects of low to moderate-intensity exercise program vs moderate-intensity continuous exercise program on the level of depressive disorder in heart failure patients. STUDY DESIGN: 12-week randomized controlled trial. METHODS: Sixty nine HF patients with mild to moderate level of depression and ejection fraction <40% were examined before and after 12-week intervention. Their age was ranged from 40 to 60 years. Patients were randomly classified into 3 groups. Group I (n = 23) received low to moderate intensity exercise program (LMIEP), group II (n = 23) received moderate-intensity exercise program (MICEP), and group III (n = 23) did not receive any exercise program (Non-exercised group). All patients were instructed to conduct home-based exercise with their pharmacological therapy. The level of depression was evaluated before and after 12 weeks of the intervention program. RESULTS: The 3 study groups were associated with significant decrease of depression level (P < .05). Significant differences were exhibited between the 3 groups in favor to both exercise programs (P < .05) with non-significant differences between the 2 exercise programs (P > .05). CONCLUSIONS: Both exercise programs had positive effects in reducing the severity of depression in HF patients. Low to moderate and moderate-intensity exercise programs should be proposed for depression illness specially patients with heart failure.

Examining the impacts of 12 weeks of low to moderate-intensity aerobic exercise on depression status in patients with systolic congestive heart failure - A randomized controlled study

OBJECTIVES: Psychiatric depression disorder is common in patients with systolic congestive heart failure (HF), and both conditions share underlying pathophysiological mechanisms. The incidence rate of depression disorder has clearly increased with the increase in HF manifestations in recent decades. Depression disorder is considered an independent predisposing factor for hospitalization, disturbed functional performance, and high rates of morbidity and mortality in HF patients. This randomized controlled study was designed to examine the impacts of low- to moderate-intensity aerobic exercise training on depression status in patients with systolic congestive HF. METHODS: A total of 46 systolic congestive HF patients with depression (40-60 years of age) were randomized to receive twelve weeks of mild- to moderate-intensity aerobic exercise plus standard medical treatment (exercise group) or standard medical treatment without any exercise intervention (control group). Depression status was examined using the validated Patient Health Questionnaire-9 (PHQ9) pre- and post-intervention at the end of the study program. RESULTS: No significant differences were observed between the exercise and control groups in demographic data or clinical characteristics (p>0.05). Both study groups showed a significant reduction in depression status at the end of the 12-week intervention (p<0.05). The comparison between the mean values of the depression scores showed significant differences between the two groups after 6 and 12 weeks of the intervention, indicating a greater reduction in depression scores in the exercise group than in the control group (p<0.05). CONCLUSIONS: Twelve weeks of a low- to moderate-intensity aerobic exercise program was safe and effective for reducing depression severity in patients with systolic congestive HF. Low- to moderate-intensity aerobic training should be recommended for cardiac patients, particularly those with HF-related depression.