Effects of low-impact, moderate-intensity exercise training with and without wrist weights on functional capacities and mood states in older adults.

This study examined the effects of low-impact, moderate-intensity exercise training with and without wrist weights (0.68 kg.wrist-1) on functional capacities and mood states in older adults (age 68.6 +/- 5.6, mean +/- SD). Twenty-three senior citizens residing in the community were randomly assigned to wrist weight (WW; n = 12) and no-wrist weight (NW; n = 11) exercise groups while 11 matched subjects served as non-exercise controls (NE). Exercise training was performed for 10 weeks, 3 days/week, for 60 min/session and consisted of low-impact aerobic dance (50-70% of maximal heart rate) combined with exercises to promote muscular fitness, flexibility, and balance. Before and after the intervention, each participant's aerobic fitness, muscular strength, flexibility, static and dynamic balance, skinfold thickness, and psychological mood states were assessed under standardized testing conditions. Exercise training resulted in significant improvements in peak oxygen uptake, lower extremity muscle strength, and psychological vigor (p < 0.05) but did not affect other fitness components (p > 0.05). There were no differences between the WW and NW exercise groups for any of the same variables studied (p > 0.05). No significant pre- to post-test changes were found for the NE control group (p > 0.05). It is concluded that 10 weeks of low-impact, moderate-intensity exercise training of the type that can be considered well-rounded in nature provides a sufficient stimulus to augment aerobic fitness, beneficially affects leg strength, and increases feelings of vigor in older adults. The present observations indicate that the use of light wrist weights has no beneficial or adverse effects on the measured training outcomes.

Evolution of early TIMI 2 flow after thrombolysis for acute myocardial infarction. GUSTO-1 Angiographic Investigators.

BACKGROUND: Patients with early Thrombolysis in Myocardial Infarction (TIMI) grade 2 flow after thrombolysis appear to have outcomes similar to thrombolytic failures. To evaluate the origin and evolution of early TIMI 2 flow, we examined early and late angiographic and ventriculographic data from the Global Utilization of Streptokinase and TPA for Occluded Arteries (GUSTO-1) angiographic study. METHODS AND RESULTS: Of the 914 patients with both 90-minute and 5- to 7-day catheterizations, 278 patients had TIMI grade 2 flow at 90 minutes. At follow-up, 188 (67%) had improved to TIMI grade 3 flow. At 90 minutes, patients with TIMI grade 2 flow had greater infarct vessel narrowing and a significantly greater incidence of thrombus than patients with TIMI grade 3 flow. At the 5- to 7-day follow-up, patients whose flow had improved from TIMI grade 2 at 90 minutes to grade 3 flow at follow-up had larger-caliber vessels (minimum luminal diameter, 0.99 +/- 0.47 versus 0.84 +/- 0.48 mm; P = .03) and a lower incidence of visible thrombus (26% versus 38%, P = .04) than those with persistent TIMI grade 2 flow. These patients also had a higher mean ejection fraction (57.5 +/- 14.1% versus 52.8 +/- 12.9%, P = .02) and better infarct zone wall motion (-2.1 +/- 1.5 versus -2.6 +/- 1.3 SD per chord, P = .01) at the 5- to 7-day follow-up. Patients in whom flow improved from TIMI grade 2 at 90 minutes to TIMI grade 3 by 5 to 7 days had significantly better left ventricular function than patients with persistent TIMI grade 0, 1, or 2 flow and constituted a group whose left ventricular function was intermediate between those who had no reperfusion (TIMI grades 0 and 1) and those whose reperfusion was complete (TIMI grade 3). CONCLUSIONS: These data suggest that incomplete clot lysis plays a significant role in the pathogenesis of TIMI grade 2 flow. Furthermore, early TIMI grade 2 flow may be sufficient to provide prolonged myocyte viability, which will further recover if flow normalizes.