[show abstract][hide abstract] ABSTRACT: Few studies have investigated changes in autonomic function after training in patients with cardiovascular diseases, particularly patients with congestive heart failure (CHF). Heart rate recovery (HRR) is a strong predictor of mortality in coronary artery disease (CAD) patients. The aim of this study was to determine the effect of 8 weeks of supervised exercise training on autonomic function, which were assessed by heart rate, systolic blood pressure (SBP), and rate-pressure product (RPP) in CHF patients.
65 patients aged 57-82 years with CHF were assigned to two groups randomly. The first group received a supervised 8-week aerobic training program of 30-45 min sessions, 3 days per week on alternate days, while controls received standard medical care and were followed up. Body weight, body mass index, functional capacity, resting heart rate, HRR, resting systolic blood pressure, peak heart rate, peak systolic blood pressure, and RPP were measured before and after the study period. Medications and diet recommendations remained unchanged in both groups during the study period.
The exercise group consisted of 33 patients with mean age of 61.54 ± 5.89 years and the controls were 32 patients with mean age of 60.94 ± 5.03 years. One-way analysis of variance (ANOVA) with repeated measures revealed a statistically significant difference in the exercise group compared to the control group regarding body mass index, resting heart rate, heart rate recover, functional capacity, peak heart rate, peak systolic blood pressure, peak RPP after 8 weeks (P ≤ 0.05).
In conclusion, a multidisciplinary CR program with supervised exercise training support significantly improves functional capacity and autonomic function in CHF patients. Therefore, a supervised and guided exercise training program is safe and beneficial for patients with CHF with different etiologies.
[show abstract][hide abstract] ABSTRACT: This study was to evaluate the effect of a period of aquatic exercise therapy on muscle strength and joints range of motion in hemophilia patients.
This was a semiexperimental, pretest, post-test study with a control group. This semi-experimental study comprised twenty men suffering moderate hemophilia were selected by convenience sampling method from patients of a referral hospital. They were randomly assigned to intervention and control groups of equal number. The hemophilia patients who were referred to Sayedo-Shohada Hospital enrolled in this study. Twenty men suffering moderate hemophilia were selected using convenience sampling method and then divided randomly into intervention and control groups (10 patients in each group). Subjects of aquatic exercise therapy group underwent activity in water in three sessions (45-60 minutes) per week for 8 weeks, while the control group was only under follow-up and during this period did not experience any effective physical activity. The patients' muscle strength and joint range of motion were evaluated through standard laboratory tools, using an isokinetic dynamometer (Biodex, Systems III) and a standard goniometer in the beginning and at end of the study. Finally, data was analyzed using analysis of covariance (ANCOVA).
The strength of the muscles around the knee joint (to perform extension and flexion movements) increased significantly in the case group while the control group experienced a significant reduction of strength in left leg, but in right leg remarkable change was observed. Range of motion in all joints was improved in the case group, while the control group did not improve significantly.
The results showed that aquatic exercise therapy can be a useful method to improve joints' strength and range of motion in hemophilia patients in order to improve their daily functioning and quality of life.
International journal of preventive medicine 01/2013; 4(1):50-6.
[show abstract][hide abstract] ABSTRACT: Kargarfard M, Etemadifar M, Baker P, Mehrabi M, Hayatbakhsh R. Effect of aquatic exercise training on fatigue and health-related quality of life in patients with multiple sclerosis.
To examine the effectiveness of aquatic exercise training on fatigue and health-related quality of life (HRQOL) in women with multiple sclerosis (MS).
Randomized controlled trial, 4-week and 8-week follow-up.
Referral center of a multiple sclerosis society.
Women (N=32) diagnosed with relapsing-remitting MS (mean age ± SD, 32.6±8.0y) were recruited into this study. After undergoing baseline testing by a neurologist, participants were randomly assigned to either an intervention (aquatic exercise) or a control group.
The intervention consisted of 8 weeks supervised aquatic exercise in a swimming pool (3 times a week, each session lasting 60min).
At baseline, 4 weeks, and 8 weeks, fatigue and HRQOL were assessed by a blind assessor using the Modified Fatigue Impact Scale and the Multiple Sclerosis Quality of Life-54 questionnaire, respectively. A mixed-model approach to repeated-measures analysis of variance was used to detect within- and between-subject effects.
Findings are based on 21 patients (10 from the exercise group and 11 from the control group) who had data available on outcomes. There was no significant difference between the 2 groups at the baseline. Patients in the aquatic exercise group showed significant improvements in fatigue and subscores of HRQOL after 4 and 8 weeks compared with the control group. Results obtained from the intention-to-treat analysis were consistent with those of per-protocol analysis.
The findings suggest that aquatic exercise training can effectively improve fatigue and HRQOL of patients with MS and should be considered in the management of this relatively common public health problem.
Archives of physical medicine and rehabilitation 05/2012; 93(10):1701-8. · 2.18 Impact Factor
[show abstract][hide abstract] ABSTRACT: To examine the effectiveness of parental support and involvement in a low-cost intervention for the improvement of health-related fitness of high school girls through an after-school physical activity (PA) program.
This multi-site study was conducted in 2006-2007 in 7 provinces in Iran. The study population comprised of two groups of children. The first group consisted of 206 children who were randomly selected from female students (7th-10th grade) and their mothers (n=204). Another 60 children (without their mothers) were randomly selected as the control group. Overall, during 12 weeks, 24 sessions of after-school aerobic exercise were held. Health-related fitness data were collected pre- and post-intervention.
The findings are based on 470 participants. The after-school PA significantly improved body mass index, resting heart rate, cardiorespiratory fitness, flexibility and muscle strength and endurance in children in both groups, and in mothers. Improvement in the physiological measures of the children in the mother/daughter group was significantly better than the control group.
The findings suggest that after-school PA may provide an effective model for improving the health-related fitness of high school girls and their mothers. Our data show that family support, including mother's participation, contributes to enhanced health-related achievements in adolescent girls.
Preventive Medicine 01/2012; 54(3-4):219-23. · 3.50 Impact Factor
[show abstract][hide abstract] ABSTRACT: Current guidelines recommend cardiac rehabilitation programs (CRP) as a means to improve functional status of patients after coronary revascularization. However, research supporting this recommendation has been limited and positive effects of CRP on diastolic function are controversial. The aim of this study was to examine the effects of an 8-week CRP on left ventricular diastolic function.
This randomized, clinical trial included 29 men with ST elevation myocardial infarction (MI) who had received reperfusion therapy, i.e. coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). They were randomized to a training group (n = 15; mean age: 54.2 ± 9.04 years old) and a control group (n = 14; mean age: 51.71 ± 6.98 years old). Patients in the training group performed an 8-week CRP with an intensity of 60-85% of maximum heart rate. Exercise sessions lasted 60-90 minutes and were held three times a week. At the start and end of the study, all patients performed symptom-limited exercise test based on Naughton treadmill protocol. Pulsed-wave Doppler echocardiography was also used to determine peak velocity of early (E) and late (A) waves, E/A ratios, and the deceleration time of E (DT).
Left ventricular diastolic indices (E, A, E/A ratio, DT) did not change significantly after the CRP. Compared to baseline, patients in the training group had significant improvements in functional capacity (8.30 ± 1.30 vs. 9.7 ± 1.7) and maximum heart rate (118.50 ± 24.48 vs. 126.85 ± 22.75). Moreover, resting heart rate of the training group was significantly better than the control group at the end of the study (75.36 ± 7.94 vs. 79.80 ± 7.67; P < 0.001).
An 8-week CRP in post-MI patients revascularized with PCI or CABG led to improved exercise capacity. However, the CRP failed to enhance diastolic function.
[show abstract][hide abstract] ABSTRACT: Quality of life (QoL) of patients with multiple sclerosis (MS) is worse than that of other chronic diseases. There is a need to examine the impact of fatigue and depression on the QoL independent of level of physical disability in MS. The aim of this study is to explore physical, psychological, and social aspects of health-related QoL (HRQoL) of MS patients in association with physical disability, fatigue, and depression.
In a cross-sectional study, 281 (63.4% women, 36.6% men) patients with MS participated in the study. The HRQoL was assessed by the Persian version of the multiple sclerosis quality of life (MSQoL-54) questionnaires. Other covariates included in the study were disease type, physical disability, fatigue, disease impact, and depression.
In univariate analysis disease type, physical disability, fatigue, disease impact, and depression were significantly associated with both physical and mental health composite summaries of MSQoL-54. In multivariate regression analysis, patients' physical disability remained significantly associated with both components of MSQoL-54, whilst fatigue and depression were associated with physical and mental composite summaries, respectively.
Our findings suggest that MS-related physical disability, fatigue, and depression affect the HRQoL of MS patients, independently of each other and other potential confounding factors. Effective interventions that target fatigue and depression may help improve the QoL of patients, regardless of their disease type and level of disability.
European Journal of Neurology 10/2011; 19(3):431-7. · 4.16 Impact Factor
[show abstract][hide abstract] ABSTRACT: The purpose of this study was to assess the effects of exercise on the aerobic power, serum lactate level, and cell blood count among active individuals in the environments with similar climatic characteristics differing in their level of air pollution.
This trial comprised 20 volunteer students of Physical education in The University of Isfahan, Iran. Two places with the same climate (altitude, temperature, and humidity), but low and high level of air pollutants air were selected in Isfahan, Iran. Participants underwent a field Cooper test with a 12-minute run for fitness assessment. Then the aerobic power, serum lactate, and cell blood counts were measured and compared between the two areas.
The study participants had a mean (SD) age of 21.70 (2.10) years and body mass index (BMI) of 24.44 (2.32) Kg/m2. We found a significant decrease in mean Vo2 max, red blood cell count, hemoglobin, hematocrit, and mean corpuscular hemoglobin, as well as significant increase in mean lactate level, white blood cell count and mean corpuscular volume in the higher-polluted than in the lower-polluted area. No significant difference was documented for other parameters as platelet counts or maximum heart rate.
Exercise in high-polluted air resulted in a significant reduction in the performance at submaximal levels of physical exertion. Therefore, the acute exposure to polluted air may cause a significant reduction in the performance of active individuals. The clinical importance of these findings should be assessed in longitudinal studies.
International journal of preventive medicine 07/2011; 2(3):145-50.
[show abstract][hide abstract] ABSTRACT: Supervised exercise cardiac rehabilitation programs have been suggested to all patients specially patients with post-myocardial infarction (MI) for many years. However, limited information is available on the usefulness of exercise rehabilitation programs in chronic MI. The aim of this study was to evaluate the outcome of supervised exercise training on MI patients by measuring both physical and physiological factors.
This was a semi-experimental randomized study. It included seventy two (35 cases, 37 controls) post-MI patients aged 40 to 67 years. They were randomly selected from those with MI based on WHO criteria who were referred to cardiac rehabilitation unit of Isfahan Shahid Chamran cardiovascular research center. After initial measurements including weight, height, functional capacity, diastolic blood pressure (DBP) and systolic blood pressure (SBP) in both resting and exercise states, patients were randomized into either the training group (n=35) or the control group (n =37). The training group had supervised aerobic training program, three times a week, with 60-70% of the maximal heart rate (HR) reserve for two months. After the training program was completed, all measurements were repeated in both groups. Data were analyzed using one-way analysis of variance (ANOVA) with repeated measures.
Patients in exercise group showed statistically significant improvement in resting HR (81.27±7.75 bpm vs. 74.17±10.11bpm, p≤0.001), resting SBP (125.92±9.30 mmHg vs. 123.54±6.82 mmHg, p≤0.01), SBP peak (150.22±7.12 mmHg vs. 133.54±6.82 mmHg, p≤0.001), HR peak (132.51±3.06 bpm vs. 142.00±3.14bpm, p≤0.001), and exercise capacity (8.49±1.18 METs vs. 9.42±1.19 METs, p≤0.01).
The results from the study showed that a 2-month exercise rehabilitation program in post-MI patients is useful for improving both blood pressure and exercise capacity and should be encouraged more commonly.
International journal of preventive medicine 01/2010; 1(2):124-30.