Efficacy of High Intensity Exercise on Disease Activity and Cardiovascular Risk in Active Axial Spondyloarthritis: A Randomized Controlled Pilot Study Web-based physiotherapy for people with axial spondyloarthritis (WEBPASS) – a study protocol Home-Based Exercise in Older Adults Recently Discharged From the Hospital for Cardiovascular Disease in China: Randomized Clinical Trial Intradialytic versus home based exercise training in hemodialysis patients: a randomised controlled trial Physical activity and physique anxiety in older adults: Fitness, and efficacy influences Effects of exercise training on physical impairment, arterial stiffness and health-related quality of life in patients with chronic kidney disease: a pilot study Efficacy and safety of infliximab plus naproxen versus naproxen alone in patients with early, active axial spondyloarthritis: results from the double-blind, placebo-controlled INFAST study, Part 1 Comparative effects of two physical activity programs on measured and perceived physical functioning and other health-related quality of life outcomes in older adults. A randomized controlled clinical trial of the Seattle Protocol for Activity in older adults. Older adults recently discharged from the hospital: effect of aerobic interval exercise on health-related quality of life, physical fitness, and physical activity. Improved Function and Reduced Pain after Swimming and Cycling Training in Patients with Osteoarthritis Effects of a Whatsapp-delivered physical activity intervention to enhance health-related physical fitness components and cardiovascular disease risk factors in older adults. Improvement in balance, strength, and flexibility after 12 weeks of Tai chi exercise in ethnic Chinese adults with cardiovascular disease risk factors. A cluster randomised school-based lifestyle intervention programme for the prevention of childhood obesity and related early cardiovascular disease (JuvenTUM 3) The effect of balneotherapy on patients with ankylosing spondylitis Randomized controlled trial of the effects of aerobic exercise on physical functioning and quality of life in lymphoma patients. The long-term effects of a randomized trial comparing aerobic interval versus continuous training in coronary artery disease patients: 1-year data from the SAINTEX-CAD study Physical activity and cardiovascular risk factors: effect of advice from an exercise specialist in Australian general practice. Anterior chest wall inflammation by whole-body magnetic resonance imaging in patients with spondyloarthritis: lack of association between clinical and imaging findings in a cross-sectional study Adolescent determinants of cardiovascular risk factors in adult men and women Long-term benefits of radon spa therapy in rheumatic diseases: results of the randomised, multi-centre IMuRa trial The Alberta moving beyond breast cancer (AMBER) cohort study: a prospective study of physical activity and health-related fitness in breast cancer survivors Exercise and well-being: a review of mental and physical health benefits associated with physical activity
Background Physical therapy is recommended for the management of axial spondyloarthritis ( axSpA ) and flexibility exercises have traditionally been the main focus . Cardiovascular ( CV ) diseases are considered as a major health concern in axSpA and there is strong evidence that endurance and strength exercise protects against CV diseases . Therefore , the aim of this study was to investigate the efficacy of high intensity endurance and strength exercise on disease activity and CV health in patients with active axSpA. Methods In a single blinded r and omized controlled pilot study the exercise group ( EG ) performed 12 weeks of endurance and strength exercise while the control group ( CG ) received treatment as usual . The primary outcome was the Ankylosing Spondylitis ( AS ) Disease Activity Score ( ASDAS ) . Secondary outcomes included patient reported disease activity ( Bath AS Disease Activity Index [ BASDAI ] ) , physical function ( Bath AS Functional Index [ BASFI ] ) , and CV risk factors measured by arterial stiffness ( Augmentation Index [ Alx ] ) and Pulse Wave Velocity [ PWV ] ) , cardiorespiratory fitness ( VO2 peak ) and body composition . ANCOVA on the post intervention values with baseline values as covariates was used to assess group differences , and Mann Whitney U-test was used for outcomes with skewed residuals . Results Twenty-eight patients were included and 24 ( EG , n = 10 , CG , n = 14 ) completed the study . A mean treatment effect of −0.7 ( 95%CI : −1.4 , 0.1 ) was seen in ASDAS score . Treatment effects were also observed in secondary outcomes ( mean group difference [ 95%CI ] ) : BASDAI : −2.0 ( −3.6 , −0.4 ) , BASFI : −1.4 ( −2.6 , −0.3 ) , arterial stiffness ( estimated median group differences [ 95 % CI ] ) : AIx ( % ) : −5.3 ( −11.0 , −0.5 ) , and for PVW ( m/s ) : −0.3 ( −0.7 , 0.0 ) , VO2 peak ( ml/kg/min ) ( mean group difference [ 95%CI ] : 3.7 ( 2.1 , 5.2 ) and trunk fat ( % ) : −1.8 ( −3.0 , −0.6 ) . No adverse events occurred . Conclusion High intensity exercise  improved disease activity and reduced CV risk factors in patients with active axSpA. These effects will be further explored in a larger trial . Trial Registration Clinical Trials.gov Background Evidence suggests people with axial spondyloarthritis ( axial SpA ) should exercise up to five times per week but lack of time , symptoms , cost and distance are barriers to regular exercise in axial SpA. Personalised exercise programmes delivered via the internet might support people with axial SpA to reach these exercise targets . The aim of this study is to investigate the effect of , and adherence to , a 12 month personalised web-based physiotherapy programme for people with axial SpA. Methods Fifty people with axial SpA will be recruited to this prospect i ve , interventional cohort study . Each participant will be assessed by a physiotherapist and an individualised exercise programme set up on www.webbasedphysio.com . Participants will be asked to complete their programme five times per week for 12 months . With the exception of adherence , data will be collected at baseline , 6 and 12 months . Discussion The primary outcome measure is adherence to the exercise programme over each four week cycle ( 20 sessions maximum per cycle ) and over the 12 months . Secondary measures include function ( BASFI ) , disease activity ( BASDAI ) , work impairment ( WPAI : SpA ) , quality of life ( ASQoL , EQ5D ) , attitude to exercise ( EMI-2 , EAQ ) , spinal mobility ( BASMI ) , physical activity and the six minute walk test . Participants will also be interviewed to explore their adherence , or otherwise , to the intervention . This study will determine the adherence and key clinical outcomes of a targeted web-based physiotherapy programme for axial SpA. This data will inform clinical practice and the development and implementation of similar programmes . Trial registration Clinical Trials.gov : NCT02666313 , 20th January Background Exercise is important for fitness and recovery of older adults after hospitalization for treatment of cardiovascular disease . Home-based , nurse-led exercise programs may be beneficial . Objective The aim of this study was to test the effects of a low-intensity , home-based exercise protocol led by an advanced practice nurse on health-related quality of life ( HRQOL ) , physical fitness , and left ventricular ejection fraction ( LVEF ) in older adults after hospital discharge with a cardiovascular disease diagnosis . Methods The study was r and omized and single blinded . Seventy-seven older adults ( ≥75 years old , mean = 80.68 years old ) were included ; 32 subjects in the intervention and 29 in the  control group completed the study . The low-intensity , home-based exercise protocol is composed of 14-type joint exercises and walking for 12 weeks . The main outcome measures were assessment s on the Medical Outcomes Study Short-Form-36 , the Senior Fitness Test , and LVEF at baseline and 12 weeks after hospital discharge . Results After 12 weeks , the intervention group showed significant improvements in HRQOL ( physical functioning , role-physical , bodily pain , and vitality ; p < .05 ) as well as on the Senior Fitness Test ( chair st and s , arm curls , Timed Up and Go , and 6-minute walk distance ; p < .05 ) ; there was no significant improvement in LVEF ( p = .56 ) . Conclusions The low-intensity , home-based exercise led by an advanced practice nurse was effective in improving HRQOL and physical fitness . Adherence was high , and there were no adverse events related to exercise Background Exercise training in hemodialysis patients improves fitness , physical function , quality of life and markers of cardiovascular disease such as arterial stiffness . The majority of trials investigating this area have used supervised exercise training during dialysis ( intradialytic ) , which may not be feasible for some renal units . The aim of this trial is to compare the effects of supervised intradialytic with unsupervised home-based exercise training on physical function and arterial stiffness . Methods and design This is a r and omised , controlled clinical trial . A total of 72 hemodialysis patients will be r and omised to receive either six months of  intradialytic exercise training , home-based exercise training or usual care . Intradialytic patients will undergo three training sessions per week on a cycle ergometer and home-based patients will be provided with a walking program to achieve the same weekly physical activity . Primary outcome measures are six-minute walk distance ( 6 MWD ) and aortic pulse wave velocity ( PWV ) . Secondary outcome measures include augmentation index , peripheral and central blood pressures , physical activity and self-reported health . Measures will be made at baseline , three and six months . Discussion The results of this study will help determine the efficacy of home-based exercise training in hemodialysis patients . This may assist in developing exercise guidelines specific for these patients .Trial Registration Employing a r and omized controlled trial , this study documents the effects of six months of physical activity and six month follow-up on reduction in social physique anxiety ( SPA ) in older adults . In addition , the role played by changes in behavioral , physiological , and psychological predictors of changes in SPA were examined . Participants ( n = 174 , mean age = 65 yrs ) were r and omly assigned to one of two activity groups and engaged in a six-month structured exercise program .  Measures of physique anxiety were taken at baseline , six and twelve months . Latent growth curve analyses revealed significant reductions in SPA over the course of the 12-month period . Structural analyses controlling for treatment condition indicated that improvements in self-efficacy and fitness were significant predictors of changes in SPA but that changes in body fat and exercise frequency did not contribute to variation in SPA . Overall this model accounted for 19 % of the variation in SPA changes . The extent to which changes in SPA may contribute to continued physical activity participation in older adults and how exercise programs might effectively influence predictors of SPA are discussed Background Patients with chronic kidney disease ( CKD ) have impaired performance in physical tasks , lower health-related quality of life and high cardiovascular morbidity and mortality . Moderate intensity exercise has been shown to provide cardiovascular and metabolic benefits in healthy individuals and patients without CKD . Long-term exercise training is recommended as a vital component in the management of a number of chronic diseases . This r and omized controlled pilot project examined the effects of exercise in predialysis CKD patients . Methods Ten patients were r and omized to 12 months of exercise ( EX ) and 10 to  st and ard care ( CT ) . We compared the difference between the two groups in physical impairment ( VO2peak and endurance time [ ET ] ) , arterial stiffness ( augmentation index [ AI ] ) and health-related quality of life ( EuroQol EQ-5D and Short Form-36 question naires ) ( all measured at baseline and 12 months ) . Results The difference between EX and CT was statistically significant for VO2peak ( 3.59 ml O2/kg/min ; 95 % CI 0.92 , 6.26 ; P = 0.01 ) , ET ( 10.97 min ; 95 % CI 4.34 , 17.59 ; P = 0.003 ) and AI ( −11.7 % ; 95 % CI −18.79 , −4.61 ; P = 0.003 ) . Clinical ly important changes were noted in EQ-5D and SF-36 . Conclusions This study suggests that long-term exercise training  improves physical impairment , arterial stiffness and health-related quality of life in patients with predialysis CKD . A larger r and omized trial is required to examine the impact of exercise on markers of cardiovascular risk and quality of life in predialysis CKD patients Objectives To assess whether combination therapy with infliximab ( IFX ) plus nonsteroidal anti-inflammatory drugs ( NSAIDs ) is superior to NSAID monotherapy for reaching Assessment of SpondyloArthritis international Society ( ASAS ) partial remission in patients with early , active axial spondyloarthritis ( SpA ) who were naïve to NSAIDs or received a submaximal dose of NSAIDs . Methods Patients were r and omised ( 2 : 1 ratio ) to receive naproxen ( NPX ) 1000 mg daily plus either IFX 5 mg/kg or placebo ( PBO ) at weeks 0 , 2 , 6 , 12 , 18 and 24 . The primary efficacy measure was the percentage of patients who met ASAS partial remission criteria at week 28 . Several other measures of disease activity , clinical symptoms and patient-rated outcomes were evaluated . Treatment group differences were analysed with Fisher exact tests or analysis of covariance . Results A greater percentage of patients achieved ASAS partial remission in the IFX+NPX group ( 61.9 % ; 65/105 ) than in the PBO+NPX group ( 35.3 % ; 18/51 ) at week 28 ( p=0.002 ) and at all other visits ( p<0.05 , all comparisons ) . Results of most other disease activity and patient-reported endpoints ( including Ankylosing Spondylitis Disease Activity Score , Bath Ankylosing Spondylitis Disease Activity Index , Bath Ankylosing Spondylitis Functional Index , multiple quality of life measures and pain measures ) showed greater improvement in the IFX+NPX group than the PBO+NPX group , with several measures demonstrating early and consistent improvement over 28 weeks of treatment . Conclusions Patients with early , active axial SpA who received IFX+NPX combination treatment were twice as likely to achieve clinical remission as patients who received NPX alone . NPX alone led to clinical remission in a third of patients BACKGROUND Although inactivity is an important contributor to impaired functioning and disability with age , little is known concerning how improvements in physical functioning and well-being in older adults vary with the type of physical activity undertaken . METHODS One hundred three adults age 65 years and older , recruited via population -based methods , were r and omized to 12 months of community-based , moderate-intensity endurance and strengthening exercises ( Fit & Firm ) or stretching and flexibility exercises ( Stretch & Flex ) . A combination of class- and home-based exercise formats was used . Measured and self-rated physical performance along with perceived functioning and well-being were assessed pre- and postintervention . RESULTS Fit & Firm subjects showed greater 12-month improvements in both measured and self-rated endurance and strength compared to Stretch & Flex subjects . Stretch & Flex subjects reported greater improvements in bodily pain , and Stretch & Flex men evidence d greater improvements in flexibility relative to Fit & Firm subjects . Although overall exercise adherence was high in both exercise conditions ( approximately 80 % ) , subjects in both conditions showed better adherence to the home- versus class-based portions of their exercise prescriptions . CONCLUSIONS Community-based programs focusing on moderate-intensity endurance and strengthening exercises or flexibility exercises can be delivered through a combination of formats that result in improvement in important functional and well-being outcomes . This represents one of the first studies to report significant improvements in an important quality of life outcome -bodily pain-with a regular regimen of stretching and flexibility exercises in a community-based sample of older adults OBJECTIVES To compare the efficacy of a physical activity program ( Seattle Protocol for Activity ( SPA ) ) for low-exercising older adults with that of an educational health promotion program ( HP ) , combination treatment ( SPA+HP ) , and routine medical care control conditions ( RMC ) . DESIGN Single-blind , r and omized controlled trial with two-by-two factorial design . SETTING Community centers in King County , Washington , from November 2001 to September 2004 . PARTICIPANTS Two hundred seventy-three community-residing , cognitively intact older adults ( mean age 79.2 ; 62 % women ) . INTERVENTIONS SPA ( in-class exercises with assistance setting weekly home exercise goals ) and HP ( information about age-appropriate topics relevant to enhancing health ) , with r and omization to four conditions : SPA only ( n=69 ) , HP only ( n=73 ) , SPA+HP ( n=67 ) , and RMC control ( n=64 ) . Active-treatment participants attended nine group classes over 3 months followed by five booster sessions over 1 year . MEASUREMENTS Self-rated health ( Medical Outcomes Study 36-item Short-Form Survey ) and depression ( Geriatric Depression Scale ) . Secondary ratings of physical performance , treatment adherence , and self-rated health and affective function were also collected . RESULTS At 3 months , participants in SPA exercised more and had significantly better self-reported health , strength , and general well-being ( P<.05 ) than participants in HP or RMC . Over 18 months , SPA participants maintained health and physical function benefits and had continued to exercise more than non-SPA participants . SPA+HP was not significantly better than SPA alone . Better adherence was associated with better outcomes . CONCLUSION Older adults participating in low levels of regular exercise can establish and maintain a home-based exercise program that yields immediate and long-term physical and affective benefits OBJECTIVES To compare the effect of high-intensity aerobic interval exercise ( HIA ) with home-based exercise ( HB ) in older adults with chronic disease soon after discharge from the hospital . DESIGN R and omized controlled trial . SETTING Hospital . PARTICIPANTS Community-dwelling older adults aged 70 to 92 ( N = 115 ) were recruited while in the hospital . After discharge , they were r and omized to HIA group ( n = 59 ) or HB ( n = 56 ) . INTERVENTION High-intensity aerobic interval exercise ( HIA ) consisted of endurance , strength , and balance exercises . The HB consisted of low-intensity exercises and telephone follow-up from a physical therapist . MEASUREMENTS Health-related quality of life ( HRQOL ) was assessed using the Medical Outcomes Study 36-item Short Form Survey , physical fitness was measured using the Senior Fitness Test , and physical activity was assessed using the Physical Activity Scale for the Elderly . RESULTS Intention-to-treat analysis showed that both groups improved their HRQOL and physical activity after 3 months . Improvements on the Senior Fitness Test ( chair st and , arm curl and 6-minute walk ( 6MWT ) ) were significantly greater in the HIA group than the HB group . The mean difference was 25.9 m on the 6MWT ( P = .001 , effect size d = 0.2 ) , 1.3 per 30 seconds on the chair st and s mean ( P = .001 , effect size d = 0.3 ) , and 1.6 per 30 seconds on the arm curl ( P = .001 , effect size d = 0.4 ) . CONCLUSION High-intensity aerobic interval exercise ( HIA ) participants significantly improved their physical fitness . Both groups increased their HRQOL and physical activity . The findings suggest that exercise therapy should be incorporated as a part of the treatment for older people at risk for functional decline Objective . Arthritis and its associated joint pain act as significant barriers for adults attempting to perform l and -based physical activity . Swimming can be an ideal form of exercise for patients with arthritis . Yet there is no information on the efficacy of regular swimming exercise involving patients with arthritis . The effect of a swimming exercise intervention on joint pain , stiffness , and physical function was evaluated in patients with osteoarthritis ( OA ) . Methods . Using a r and omized study design , 48 sedentary middle-aged and older adults with OA underwent 3 months of either swimming or cycling exercise training . Supervised exercise training was performed for 45 min/day , 3 days/week at 60–70 % heart rate reserve for 12 weeks . The Western Ontario and McMaster Universities Arthritis Index was used to measure joint pain , stiffness , and physical limitation . Results . After the exercise interventions , there were significant reductions in joint pain , stiffness , and physical limitation accompanied by increases in quality of life in both groups ( all p < 0.05 ) . Functional capacity as assessed by maximal h and grip strength , isokinetic knee extension and flexion power ( 15–30 % increases ) , and the distance covered in the 6-min walk test increased ( all p < 0.05 ) in both exercise groups . No differences were observed in the magnitude of improvements between swimming and cycling training . Conclusion . Regular swimming exercise reduced joint pain and stiffness associated with OA and improved muscle strength and functional capacity in middle-aged and older adults with OA . Additionally , the benefits of swimming exercise were similar to the more frequently prescribed l and -based cycling training . Trial registration : clinical trials.gov NCT01836380 BACKGROUND This pilot study evaluated the feasibility and preliminary effectiveness of a 10-week WhatsApp-based intervention aim ed at enhancing health-related physical fitness components and cardiovascular disease ( CVD ) risk factors compared with a face-to-face condition . METHODS Participants ( N.=32 ) were assigned to one of three groups : training group ( N.=16 ) , mobile group ( N.=7 ) and control group ( N.=9 ) . Training group and mobile group performed the same training program , based on strength training with elastics b and s and aerobic exercise , during 10 weeks ; only the delivery mode differed . RESULTS The mobile group increased h and grip strength , aerobic capacity and decreased systolic blood pressure and heart rate after exercise though there were no significant differences respect to control group . The training group decreased significantly systolic blood pressure ( P=0.038 ) , diastolic blood pressure ( P=0.005 ) , mean arterial pressure ( P=0.006 ) and heart rate after exercise ( P=0.002 ) , respect to control group . CONCLUSIONS Comparison between training and mobile group showed that WhatsApp-based physical activity intervention was less effective than face-to-face condition . The results indicate that the use of an online social network produced slight changes in some health-related physical fitness components and CVD risk factors CONTEXT Declines in physical performance are associated with aging and chronic health conditions . Appropriate physical activity interventions can reverse functional limitations and help maintain independent living . Tai chi is a popular form of exercise in China among older adults . OBJECTIVE To determine whether tai chi improves balance , muscular strength and endurance , and flexibility over time . DESIGN Repeated measures intervention ; data collected at baseline , 6 weeks , and 12 weeks . SETTING Community center in the San Francisco Bay Area . PARTICIPANTS Thirty-nine Chinese adults with at least 1 cardiovascular disease ( CVD ) risk factor . INTERVENTIONS A 60-minute tai chi exercise class 3 times per week for 12 weeks . MAIN OUTCOME MEASURES A battery of physical fitness measures specifically developed for older adults assessed balance , muscular strength and endurance , and flexibility . RESULTS Subjects were 65.7 ( + /- 8.3 ) years old , Cantonese-speaking ( 97 % ) immigrants , with 12 years or less of formal education ( 87 % ) and very low income ( 67 % ) . Reported CVD risk factors were hypertension ( 92 % ) , hypercholesteremia ( 49 % ) , diabetes ( 21 % ) , and 1 current smoker . Subjects were below the 50th percentile of fitness at baseline compared to age- and gender-specific normative US data . Statistically significant improvements were observed in all balance , muscular strength and endurance , and flexibility measures after 6 weeks , and they increased further after 12 weeks . CONCLUSIONS Tai chi is a potent intervention that improved balance , upper- and lower-body muscular strength and endurance , and upper- and lower-body flexibility in these older Chinese adults . These findings provide important information for future community-based tai chi exercise programs and support current public health initiatives to reduce disability from chronic health conditions and enhance physical function in older adults Background Childhood obesity is not only associated with adult obesity but also with increased risk of adult onset of type 2 diabetes and subsequent coronary heart disease . The potential effects of school-based health intervention programmes on cardiovascular risk and surrogate markers are unclear , as only few studies have attempted to investigate a complete risk profile including a detailed laboratory analysis or micro- and macrovascular function . In this study a comprehensive school-based r and omized intervention programme will be investigated in 10 - 14-year old children addressing the influence of lifestyle intervention on inactivity , cardiometabolic risk factors and early signs of vascular disease . Methods / Design 15 secondary schools in Southern Germany are r and omly assigned to intervention or control schools . Children in the fifth grade ( 10 - 11 years ) will be observed over four years . The study combines a school-based with a home-based approach , aim ing at children , teachers and parents . The main components are weekly lifestyle-lessons for children , taught by regular classroom teachers to increase physical activity in- and outside of school , to improve eating patterns at school and at home , to reduce media consumption and to amplify well-being . In 4 - 6 annual meetings , teachers receive information about health-related topics with worksheets for children and supporting equipment , accounting for school-specific needs and strategies . Parents ' trainings are provided on a regular basis . All examinations are performed at the beginning and at the end of every school year . Anthropometry includes measurements of BMI , waist and upper arm circumferences , skinfold thickness as well as peripheral blood pressure . Blood sampling includes lipid parameters , insulin , glucose , hsCRP , adiponectin , and IL-6 as well as testosteron and estrogen to determine maturation status . Vascular function is non-invasively assessed by measuring arterial stiffness in large arteries using a sphygmograph and by analysing arteriolar and venular diameters in the retinal microcirculation using a non-mydriatric vessel analyser . A question naire is filled out to determine daily physical activity , motivational factors , dietary habits , quality of life ( KINDL-R ) and socio-economic data . Physical fitness is assessed by a six-item test battery . Discussion Our study aims to provide a feasible long-term intervention strategy to re-establish childhood health and to prevent obesity-related cardiovascular dysfunction in children . Trial Registration Objective : To compare the effect of balneotherapy on physical activity and quality of life as well as the symptoms of pain and stiffness with exercise alone in ankylosing spondylitis ( AS ) patients . Methods : A total of 60 patients who had a diagnosis of AS according to the modified New York criteria were included in the study . The patients were r and omly assigned to two groups . In Group I ( n = 30 ) the patients received balneotherapy in a therapeutic pool for 30 min once a day for 3 weeks . All patients received instructions on the exercise programme , which they were requested to repeat once a day for 30 min during the study . The patients in this group continued the same exercise programme after the end of the balneotherapy protocol to complete a course of 6 months . In Group II the patients were given the same exercise protocol but did not receive balneotherapy . Patients were evaluated before the start of the study and at 3 weeks and 24 weeks . Evaluation parameters were daily and night pain , morning stiffness , the patient 's global evaluation and the physician 's global evaluation ( according to a scoring system of 1 to 5 ) , the Bath Ankylosing Spondilitis Disease Activity Index ( BASDAI ) , Bath Ankylosing Spondylitis Functional Index ( BASFI ) , Dougados Functional Index ( DFI ) , tragus – wall distance , chest expansion , modified Shober test ( MST ) , fingertip – fibula head distance , and Nottingham Health Profile ( NHP ) . Results : Evaluations were completed in 54 patients in the two groups . Comparison of the groups showed significantly superior results for Group I for parameters of BASDAI , NHP total , pain , physical activity , tiredness and sleep score , patient 's global evaluation and the physician 's global evaluation at 3 weeks , but only for the parameters of patient 's global evaluation and MST at 24 weeks . Conclusion : Balneotherapy has a supplementary effect on improvement in disease activity and functional parameters in AS patients immediately after the treatment period . However , in the light of our medium‐term evaluation results , we suggest that further research is needed to assess the role of balneotherapy applied for longer duration s in AS patients PURPOSE Lymphoma patients commonly experience declines in physical functioning and quality of life ( QoL )  that may be reversed with exercise training . PATIENTS AND METHODS We conducted a r and omized controlled trial in Edmonton , Alberta , Canada , between 2005 and 2008 that stratified 122 lymphoma patients by major disease type and current treatment status and r and omly assigned them to usual care ( UC ; n = 62 ) or 12 weeks of supervised aerobic exercise training ( AET ; n = 60 ) . Our primary end point was patient-rated physical functioning assessed by the Trial Outcome Index-Anemia . Secondary end points were overall QoL , psychosocial functioning , cardiovascular fitness , and body composition . RESULTS Follow-up assessment for our primary end point was 96 % ( 117 of 122 ) at postintervention and 90 % ( 110 of 122 ) at 6-month follow-up . Median adherence to the supervised exercise program was 92 % . At postintervention , AET was superior to UC for patient-rated physical functioning ( mean group difference , + 9.0 ; 95 % CI , 2.0 to 16.0 ; P = .012 ) , overall QoL ( P = .021 ) , fatigue ( P = .013 ) , happiness ( P = .004 ) , depression ( P = .005 ) , general health ( P < .001 ) , cardiovascular fitness ( P < .001 ) , and lean body mass ( P = .008 ) . Change in peak cardiovascular fitness mediated the change in patient-rated physical functioning . AET did not interfere with chemotherapy completion rate or treatment response . At 6-month follow-up , AET was still borderline or significantly superior to UC for overall QoL ( P = .054 ) , happiness ( P = .034 ) , and depression ( P = .009 ) without an increased risk of disease recurrence/progression . CONCLUSION AET significantly improved important patient-rated outcomes and objective physical functioning in lymphoma patients without interfering with medical treatments or response . Exercise training to improve cardiovascular fitness should be considered in the management of lymphoma patients Background Aerobic interval training ( AIT ) and aerobic continuous training ( ACT ) both improve physical fitness ( peak VO2 ) in coronary artery disease patients . However , little is known about the long-term effects of AIT and ACT on peak VO2 and exercise adherence . Design This study is a r and omized clinical multicenter trial . Methods In total , 163 patients were assessed after 12 weeks of AIT or ACT  and 12 months after their enrollment . Physical fitness and physical activity measures served as the primary outcomes , and peripheral endothelial function , cardiovascular risk factors and quality of life ( QoL ) served as the secondary outcomes . Results Twenty-six patients dropped out during the intervention ; 11 were lost during the follow-up period . Dropouts ( n = 37 ) consisted of more women ( p = 0.001 ) compared to completers ( n = 163 ) . Physical fitness ( VO2 , heart rate and workload at peak and at thresholds ) and physical activity ( steps , active energy expenditure [ kcal ] , physical activity duration [ minutes ] ) were preserved at the 1-year follow-up ( p-time > 0.05 ) after both AIT and ACT ( p-interaction > 0.05 ) . Forty percent of patients showed increased peak VO2 , 52 % showed increased active energy expenditure and 91.2 % met the recommended levels of 150 minutes/week of moderate physical activity ( p-group > 0.05 ) . Further , peripheral endothelial function , QoL and cardiovascular risk factors , except systolic blood pressure ( p-time < 0.05 ) , remained stable ( p-time > 0.05 ) after both AIT and ACT ( p-interaction > 0.05 ) . Conclusion The short-term improvements of center-based AIT and ACT on physical fitness , physical activity , peripheral endothelial function , cardiovascular risk factors and QoL are sustained after a 1-year follow-up period . The majority of patients ( > 90 % ) met the recommended physical activity levels of 150 minutes/week OBJECTIVE To determine whether provision of individualised physical activity advice by an exercise specialist in general practice is effective in modifying physical activity and cardiovascular risk factors  in older adults . DESIGN R and omised controlled trial of individualised physical activity advice , reinforced at three and six months ( intervention ) versus no advice ( control ) . SETTING Two general practice s in Adelaide , South Australia , 1996 . PARTICIPANTS 299 adults aged 60 years or more who were healthy , sedentary and living in the community . MAIN OUTCOME MEASURES Changes to physical activity ( frequency and duration of walking and vigorous exercise ) , selected cardiovascular risk factors ( blood pressure , body weight , serum lipid levels ) and quality of life over 12 months . RESULTS Self-reported physical activity increased over the 12 months in both groups ( P < 0.001 ) . The increase was greater for the intervention than the control group for all measures except time spent walking ( P < 0.05 ) . More intervention than control participants increased their intention to exercise ( P < 0.001 ) . Serum levels of total and low-density lipoprotein cholesterol and triglycerides fell significantly over the 12 months to a similar extent in the two groups . No other significant changes in cardiovascular risk factors were seen . Quality -of-life scores decreased over the 12 months . The decrease was significantly greater among intervention than control women , but not men , for emotional well-being ( P = 0.02 ) , physical well-being ( P = 0.04 ) and social functioning ( P = 0.04 ) . DISCUSSION Provision of general practice -based physical activity advice reinforced three-monthly produced a sustained increase in self-reported physical activity . However , there were no associated changes in clinical measures of cardiovascular risk factors and minimal changes in quality -of-life measures Introduction Inflammatory involvement of the anterior chest wall ( ACW ) affects the quality of life of patients with spondyloarthritis ( SpA ) , although involvement of the ACW is often neglected on clinical and imaging evaluation . Whole-body ( WB ) MRI is an imaging method used to assess the ACW in addition to the sacroiliac joints and spine without inconvenience for patients . Our goals in this study were to describe the distribution of ACW inflammation by WB MRI in both early and established SpA and associations between clinical and imaging findings indicative of inflammation . Methods The ACWs of 122 consecutive SpA patients ( 95 with ankylosing spondylitis ( AS ) and 27 with nonradiographic SpA ( nrSpA ) ) and 75 healthy controls were scanned by sagittal and coronal WB MRI . The MRI scans were scored independently in r and om order by seven readers blinded to patient identifiers . Active and structural inflammatory lesions of the ACW were recorded on a web-based data entry form . ACW pain by patient self-report , ACW tenderness on physical examination according to the Maastricht Ankylosing Spondylitis Enthesitis Score ( MASES ) and lesions detected by MRI  were analyzed descriptively . κ statistics served to assess the agreement between clinical and imaging findings . Results ACW pain or tenderness was present in 26 % of patients , with little difference between AS and nrSpA patients . Bone marrow edema ( BME ) , erosion and fat infiltration were recorded in 44.3 % , 34.4 % and 27.0 % of SpA patients and in 9.3 % , 12.0 % and 5.3 % of controls , respectively . Lesions found by MRI  occurred more frequently in AS patients ( BME , erosion and fat infiltration in 49.5 % , 36.8 % and 33.7 % , respectively ) than in nrSpA patients ( 25.9 % , 25.9 % and 3.7 % , respectively ) . The joint most frequently affected by lesions found on MRI scans was the manubriosternal joint . The κ values between clinical assessment s and MRI inflammation ranged from -0.10 to only 0.33 for both AS and nrSpA patients . Conclusions Among SpA patients , 26 % had clinical involvement of the ACW . WB MRI signs of ACW inflammation were found in a substantial proportion of patients with AS ( 49.5 % ) and nrSpA ( 25.9 % ) . There was no association between clinical assessment s of ACW , including the MASES , and  MRI features Aims : To investigate how physical activity , physical performance and sociodemographic characteristics at the age of 16 are related to adult health habits ( physical activity , dietary intake , smoking ) and biological risk factors for cardiovascular diseases ( being overweight , low aerobic fitness , unfavorable levels of serum lipids , high blood pressure ) . Methods : A r and omly selected group of 220 male and 205 female students at 16 years of age was tested in 1974 , and reinvestigated 18 years later . Results : The predictive health profiles for adult lifestyle and biological risk factors were different in men and women . Leisure sports activity along with high performance in the nine-minute run among the boys and in the two-h and lift test among the girls were significant predictors of adult physical activity . A positive attitude to aerobic exercise  and high performance in the nine-minute run test among the boys and high marks in physical education among the girls decreased the risk of smoking .  Leisure sports activities together with body mass index at young ages were the most powerful predictors of adult biological risk factors , but attitudes to sports and educational level were also significant determinants . Conclusion : These results contribute to the knowledge of which factors at young ages may promote adult healthy habits in particular physical activities In chronic rheumatic diseases , recent treatment regimens comprise multimodal concepts including pharmacologic , physical/exercise , occupational and psychological therapies . Rehabilitation programmes are used for long-term management of disease . Spa therapy is often integrated in various middle and south European and Asian countries . Here , we investigated radon spa therapy as applied in health resorts compared to a control intervention in rheumatic out- patients . R and omised , blinded trial enroling 681 patients [ mean age 58.3 ( st and ard deviation 11.1 ) ; female 59.7 % ] in 7 health resorts in Germany and Austria with chronic back pain ( n1 = 437 ) , osteoarthritis ( OA ) ( n2 = 230 ) , rheumatoid arthritis ( n3 = 98 ) , and /or ankylosing spondylitis ( n4 = 39 ) ; multiple nominations in 146 cases ) . Outcomes were pain ( primary ) , quality of life , functional capacity , and medication measured before start , after end of treatment , and 3 times thereafter in 3 monthly intervals . Adverse events were documented . To analyse between-group differences , repeated- measures analysis of covariance was performed in metric endpoints and Fisher ’s exact test in rates . Two-sided significance level of 5 % was chosen . Until end of follow-up , superiority of radon therapy was found regarding pain relief ( p = 0.032 ) and analgesic drug consumption ( p = 0.007 ) , but not regarding quality of life . Functional capacity was assessed specific to the underlying indication . Significant benefits were found in radon-treated OA patients until 6-month follow-up ( p = 0.05 ) , but not until end of study ( p = 0.096 ) . Neither the back pain sub- population nor the two smaller patient population s with inflammatory indications benefited significantly in functional capacity . Results suggest beneficial analgesic effects of radon spa therapy in rheumatic diseases until 9 months post-intervention Background Limited research has examined the association between physical activity , health-related fitness , and disease outcomes in breast cancer survivors . Here , we present the rationale and design of the Alberta Moving Beyond Breast Cancer ( AMBER ) Study , a prospect i ve cohort study design ed specifically to examine the role of physical activity and health-related fitness in breast cancer survivorship from the time of diagnosis and for the balance of life . The AMBER Study will examine the role of physical activity and health-related fitness in facilitating treatment completion , alleviating treatment side effects , hastening recovery after treatments , improving long term quality of life , and reducing the risks of disease recurrence , other chronic diseases , and premature death . Methods / Design The AMBER Study will enroll 1500 newly diagnosed , incident , stage I-IIIc breast cancer survivors in Alberta , Canada over a 5 year period . Assessment s will be made at baseline ( within 90 days of surgery ) , 1 year , and 3 years consisting of objective and self-reported measurements of physical activity , health-related fitness , blood collection , lymphedema , patient-reported outcomes , and determinants of physical activity . A final assessment at 5 years will measure patient-reported data only . The cohort members will be followed for an additional 5 years for disease outcomes . Discussion The AMBER cohort will answer key questions related to physical activity and health-related fitness in breast cancer survivors including : ( 1 ) the independent and interactive associations of physical activity and health-related fitness with disease outcomes ( e.g. , recurrence , breast cancer-specific mortality , overall survival ) , treatment completion rates , symptoms and side effects ( e.g. , pain , lymphedema , fatigue , neuropathy ) , quality of life , and psychosocial functioning ( e.g. , anxiety , depression , self-esteem , happiness ) , ( 2 ) the determinants of physical activity and health-related fitness including demographic , medical , social cognitive , and environmental variables , ( 3 ) the mediators of any observed associations between physical activity , health-related fitness , and health outcomes including biological , functional , and psychosocial , and ( 4 ) the moderators of any observed associations including demographic , medical , and biological/disease factors . Taken together , these data will provide a comprehensive inquiry into the outcomes , determinants , mechanisms , and moderators of physical activity and health-related fitness in breast cancer survivors Purpose of review This review highlights recent work evaluating the relationship between exercise , physical activity and physical and mental health . Both cross-sectional and longitudinal studies , as well as r and omized clinical trials , are included . Special attention is given to physical conditions , including obesity , cancer , cardiovascular disease and sexual dysfunction . Furthermore , studies relating physical activity to depression and other mood states are review ed . The studies include diverse ethnic population s , including men and women , as well as several age groups ( e.g. adolescents , middle-aged and older adults ) . Recent findings Results of the studies continue to support a growing literature suggesting that exercise , physical activity and physical-activity interventions have beneficial effects across several physical and mental-health outcomes . Generally , participants engaging in regular physical activity display more desirable health outcomes across a variety of physical conditions . Similarly , participants in r and omized clinical trials of physical-activity interventions show better health outcomes , including better general and health-related quality of life , better functional capacity and better mood states . Summary The studies have several implication s for clinical practice and research . Most work suggests that exercise and physical activity are associated with better quality of life and health outcomes . Therefore , assessment and promotion of exercise and physical activity may be beneficial in achieving desired benefits across several population s. Several limitations were noted , particularly in research involving r and omized clinical trials . These trials tend to involve limited sample sizes with short follow-up periods , thus limiting the clinical implication s of the benefits associated with physical activity . Abbreviations CAD : coronary artery disease ; COPD : chronic obstructive pulmonary disease ; CRP : cardiac rehabilitation program ; CVD : cardiovascular disease ; GMCB : group-mediated cognitive – behavioural ; HRQOL : health-related quality of life
Moderate evidence supports exercise interventions in improving physical function , disease activity and chest expansion compared to controls ; there is low-level evidence of improved pain , stiffness , spinal mobility and cardiorespiratory function .
Supervised group exercise yields better outcomes than unsupervised home exercise .
The addition of aerobic components to flexibility programmes  improves cardiorespiratory outcomes , but not cardiovascular risk factors .
The most effective exercise protocol remains unclear .
Current evidence suggests that therapeutic exercises are beneficial for adults with ankylosing spondylitis ; effects on other SpA subtypes are unknown
To evaluate the effects of therapeutic exercise on pain , stiffness , quality of life , physical function , disease activity , health-related fitness and cardiovascular risk factors in adults with spondyloarthritis ( SpA ) .