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Advances in Personalized Exercise Prescription for Chronic Disease Prevention and Rehabilitation

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (31 August 2020) | Viewed by 27598

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Special Issue Editor

Prof. Dr. Lance Dalleck

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Guest Editor

Recreation, Exercise & Sport Science Department, Western Colorado University, Gunnison, CO 81231, USA
Interests: primary prevention; translational research
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is well-established that regular exercise training confers numerous health and wellness benefits. Accordingly, exercise remains a central feature of prevention, rehabilitation, and other public-health-related programs. However, not all individuals respond positively to exercise. Indeed, there is considerable individual variability in training adaptations, including the phenomenon of ‘responders’ and ‘non-responders’. This variability in training responsiveness is not well-understood and may be attributable to various factors, including the absence of set definitions in the literature for responders/non-responders and a one-size-fits-all approach to exercise prescription.

This Special Issue seeks original papers on advances in personalized exercise prescription for chronic disease prevention and rehabilitation. We also welcome high-quality systematic reviews related to these matters. I would be pleased if this Special Issue serves as a trigger for the provision of insightful data for the design of personalized exercise prescriptions that will optimize the training responsiveness of prevention and rehabilitation programs.

Prof. Lance Dalleck
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Primary prevention
Translational research
Exercise non-responders
Personalized medicine
Metabolic syndrome
Cardiovascular disease
Training responsiveness
Response heterogeneity
Cardiorespiratory fitness
Threshold-based training
Exercise training
Ventilatory threshold
Verification procedure

Published Papers (7 papers)

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Research

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14 pages, 1386 KiB

Open AccessArticle

Optimizing the Interaction of Exercise Volume and Metformin to Induce a Clinically Significant Reduction in Metabolic Syndrome Severity: A Randomised Trial

by Joyce S. Ramos, Lance C. Dalleck, Caitlin E. Keith, Mackenzie Fennell, Zoe Lee, Claire Drummond, Shelley E. Keating, Robert G. Fassett and Jeff S. Coombes

Int. J. Environ. Res. Public Health 2020, 17(10), 3695; https://doi.org/10.3390/ijerph17103695 - 24 May 2020

Cited by 2 | Viewed by 3371

Abstract

Insulin resistance is a central mediating factor of the metabolic syndrome (MetS), with exercise training and metformin proven antidotes to insulin resistance. However, when the two therapies are combined there is conflicting data regarding whether metformin blunts or improves exercise training-induced adaptations. The volume of exercise (duration, intensity, and frequency) on the interaction of exercise training and metformin has yet to be investigated. The aim of this study is therefore to explore the impact of a combination of different exercise volumes and metformin on MetS severity. This is a secondary analysis of data from one of the sites of the ‘Exercise in Prevention of Metabolic Syndrome’ (EX-MET) study. Ninety-nine adults with MetS were randomized into a 16-week exercise program completing either: (i) moderate-intensity continuous training (MICT) at 60–70% of peak heart rate (HRpeak) for 30 min/session (n = 34, 150 min/week); (ii) high-volume high-intensity interval training (HIIT) consisting of 4 × 4 min bouts at 85–95% HRpeak, interspersed with 3 min of active recovery at 50–70% HRpeak (n = 34, 38 min/session, 114 min/week); or (iii) low volume HIIT, 1 × 4 min bout of HIIT at 85–95% HRpeak (n = 31, 17 min/session, 51 min/week). Metformin intake was monitored and recorded throughout the trial. MetS severity was calculated as z-scores derived from MetS risk factors assessed at pre- and post-intervention. Sixty-five participants had complete pre- and post-intervention data for MetS z-score, of which 18 participants (28%) were taking metformin. Over the 16-week intervention, a similar proportion of participants clinically improved MetS severity (Δ ≥ −0.87) with metformin (8/18, 44%) or without metformin (23/47, 49%) (p = 0.75). While there were no between-group differences (p = 0.24), in those who did not take metformin low-volume HIIT had more likely responders (10/15, 67%) compared to MICT (6/16, 38%) and high-volume HIIT (7/16, 44%). In those taking metformin, there was a lower proportion of participants who clinically improved MetS severity following high-volume HIIT (1/6, 17%) compared to MICT (2/4, 50%) and low-volume HIIT (5/8, 63%), but with no between-group difference (p = 0.23). Moreover, in those who performed high-volume HIIT, there was a statistically significantly higher proportion (p = 0.03) of likely non-responders with improved MetS severity in participants taking metformin (4/6, 67%) compared to those not taking metformin (3/16, 19%). In individuals with MetS, the effect of high volume HIIT on MetS severity may be blunted in those taking metformin. These findings need to be confirmed in a larger study. Full article

(This article belongs to the Special Issue Advances in Personalized Exercise Prescription for Chronic Disease Prevention and Rehabilitation)

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13 pages, 904 KiB

Open AccessArticle

High-Intensity Interval Circuit Training Versus Moderate-Intensity Continuous Training on Cardiorespiratory Fitness in Middle-Aged and Older Women: A Randomized Controlled Trial

by Ismael Ballesta-García, Ignacio Martínez-González-Moro, Domingo J Ramos-Campo and María Carrasco-Poyatos

Int. J. Environ. Res. Public Health 2020, 17(5), 1805; https://doi.org/10.3390/ijerph17051805 - 10 Mar 2020

Cited by 12 | Viewed by 4675

Abstract

High-intensity interval training (HIIT) has similar or better effects than moderate-intensity continuous training (MICT) in increasing peak oxygen consumption (VO_2max), however, it has not been studied when HIIT is applied in a circuit (HIICT). The aim of this study was to compare the effects of a HIICT versus MICT on VO_2max estimated (VO_2max-ES), heart rate (HR) and blood pressure (BP) of middle-aged and older women. A quasi-experimental randomized controlled trial was used. Fifty-four women (67.8 ± 6.2 years) were randomized to either HIICT (n = 18), MICT (n = 18) or non-exercise control group (CG; n = 18) for 18 weeks. Participants in HIICT and MICT trained two days/week (one hour/session). Forty-one participants were assessed (HIICT; n = 17, MICT; n = 12, CG; n = 12). Five adverse events were reported. Cardiorespiratory fitness, HR and BP were measured. The tests were performed before and after the exercise intervention programs. VO_2max-ES showed significant training x group interaction, in which HIICT and MICT were statistically superior to CG. Moreover, HIICT and MICT were statistically better than CG in the diastolic blood pressure after exercise (DBP_ex) interaction. For the systolic blood pressure after exercise (SBP_ex), HIICT was statistically better than CG. In conclusion, both HIICT and MICT generated adaptations in VO_2max-ES and DBP_ex. Furthermore, only HIICT generated positive effects on the SBP_ex. Therefore, both training methods can be considered for use in exercise programs involving middle-aged and older women. Full article

(This article belongs to the Special Issue Advances in Personalized Exercise Prescription for Chronic Disease Prevention and Rehabilitation)

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9 pages, 6968 KiB

Open AccessArticle

Inter-Individual Variability in Metabolic Syndrome Severity Score and VO₂max Changes Following Personalized, Community-Based Exercise Programming

by Sophie Seward, Joyce Ramos, Claire Drummond, Angela Dalleck, Bryant Byrd, Mackenzie Kehmeier and Lance Dalleck

Int. J. Environ. Res. Public Health 2019, 16(23), 4855; https://doi.org/10.3390/ijerph16234855 - 3 Dec 2019

Cited by 8 | Viewed by 3334

Abstract

This study sought to examine the effectiveness of a personalized, community-based exercise program at reducing MetS severity and consequently Type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) risk. One-hundred and fifty physically inactive participants (aged 18–83 years) were randomized to a non-exercise control group (n = 75; instructed to continue their usual lifestyle habits) or treatment group (n = 75). Participants randomized to the treatment group completed a 12 week personalized exercise training program based on the American Council on Exercise (ACE) Integrated Fitness Training (IFT) model guidelines. Z-scores were derived from levels of metabolic syndrome risk factors to determine the severity of MetS (MetS z-score). After 12 weeks, the treatment group showed a significant favorable change in MetS z-score, whereas the control group demonstrated increased severity of the syndrome (between-group difference, p < 0.05). The proportion of MetS z-score responders (Δ > −0.48) was greater following the exercise intervention (71%, 50/70) compared to control (10%, 7/72) (between group difference, p < 0.001). The inter-individual variability in VO₂max change also showed a similar trend. These findings provide critical translational evidence demonstrating that personalized exercise programming based upon the ACE IFT model guidelines can be successfully implemented within the community setting to reduce T2DM and CVD risk. Full article

(This article belongs to the Special Issue Advances in Personalized Exercise Prescription for Chronic Disease Prevention and Rehabilitation)

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17 pages, 559 KiB

Open AccessArticle

High-Intensity Interval Circuit Training Versus Moderate-Intensity Continuous Training on Functional Ability and Body Mass Index in Middle-Aged and Older Women: A Randomized Controlled Trial

by Ismael Ballesta-García, Ignacio Martínez-González-Moro, Jacobo Á. Rubio-Arias and María Carrasco-Poyatos

Int. J. Environ. Res. Public Health 2019, 16(21), 4205; https://doi.org/10.3390/ijerph16214205 - 30 Oct 2019

Cited by 30 | Viewed by 6669

Abstract

The literature suggests that high-intensity interval training (HIIT) is more effective than moderate-intensity continuous training (MICT) to improve functional ability. However, there is no evidence on including HIIT in a circuit programme (HIICT). Our objective was to determine what type of training (HIICT or MICT) induces greater adaptations in the functional ability and body mass index of middle-aged and older women. The study used a quasi-experimental randomized controlled trial with 54 participants (age = 67.8 ± 6.2 years). Participants were randomly allocated to HIICT (n = 18), MICT (n = 18) or a non-exercise control group (CG; n = 18). The participants in the HIICT or MICT groups trained twice a week (1 h/session) for 18 weeks. Forty-one subjects were analysed (HIICT; n = 17, MICT; n = 12, CG; n = 12). Five subjects presented adverse events during the study. Strength, gait, cardiorespiratory fitness, balance and body mass index were measured. A significant training x group interaction was found in the arm curl test, where HIICT was statistically better than MICT and CG. Likewise, HIICT was statistically better than the CG in the BMI interaction. In lower limb strength, gait/dynamic balance and cardiorespiratory fitness, both HIICT and MICT were statistically better than the CG. In conclusion, HIICT generated better adaptations in upper limb strength than MICT. Likewise, HIICT generated better adaptations in body mass index than CG. Finally, both HIICT and MICT had a similar influence on strength, cardiorespiratory fitness and gait/dynamic balance. Full article

(This article belongs to the Special Issue Advances in Personalized Exercise Prescription for Chronic Disease Prevention and Rehabilitation)

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13 pages, 1092 KiB

Open AccessArticle

Evaluation of Power Production Asymmetry during Cycling in Persons with Multiple Sclerosis

by John W. Farrell III, Debra A. Bemben, Christopher D. Black, Daniel J. Larson, Gabriel Pardo, Cecilie Fjeldstad-Pardo and Rebecca D. Larson

Int. J. Environ. Res. Public Health 2019, 16(18), 3445; https://doi.org/10.3390/ijerph16183445 - 17 Sep 2019

Cited by 2 | Viewed by 2124

Abstract

Lower limb asymmetries have been observed in persons with multiple sclerosis (PwMS), and have been associated with mobility impairment. An incremental cycling test was performed on a cycle ergometer to determine peak power output (PPO) and peak oxygen consumption (VO₂peak). Then, participants cycled at 50%, 60%, and 70% of their PPO to assess the contribution of each lower limb to power production. Two-way repeated measures ANOVA was used to detect group × intensity differences in power production asymmetry. Eight PwMS and six healthy individuals (Non-MS) completed the study. No statistically significant (p > 0.05) group × intensity interactions or main effects were present when examining between-limb differences in power production. The current data do not indicate a statistically significant difference in power production asymmetry between groups and exercise intensities. Previous research has established a 10% difference between contralateral limbs as a threshold for asymmetry. The average asymmetry in power production in PwMS exceeded the 10% threshold at all measured outputs, suggesting the presence of asymmetry in power production. Full article

(This article belongs to the Special Issue Advances in Personalized Exercise Prescription for Chronic Disease Prevention and Rehabilitation)

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8 pages, 820 KiB

Open AccessArticle

Blood Lactate Concentration Is Not Related to the Increase in Cardiorespiratory Fitness Induced by High Intensity Interval Training

by Todd A. Astorino, Jamie L. DeRevere, Theodore Anderson, Erin Kellogg, Patrick Holstrom, Sebastian Ring and Nicholas Ghaseb

Int. J. Environ. Res. Public Health 2019, 16(16), 2845; https://doi.org/10.3390/ijerph16162845 - 9 Aug 2019

Cited by 7 | Viewed by 3431

Abstract

Background: There is individual responsiveness to exercise training as not all individuals experience increases in maximal oxygen uptake (VO₂max), which does not benefit health status considering the association between VO₂max and mortality. Approximately 50% of the training response is genetic, with the other 50% accounted for by variations in dietary intake, sleep, recovery, and the metabolic stress of training. This study examined if the blood lactate (BLa) response to high intensity interval training (HIIT) as well as habitual dietary intake and sleep duration are associated with the resultant change in VO₂max (ΔVO₂max). Methods: Fourteen individuals (age and VO₂max = 27 ± 8 years and 38 ± 4 mL/kg/min, respectively) performed nine sessions of HIIT at 130% ventilatory threshold. BLa was measured during the first and last session of training. In addition, sleep duration and energy intake were assessed. Results: Data showed that VO₂max increased with HIIT (p = 0.007). No associations occurred between ΔVO₂max and BLa (r = 0.44, p = 0.10), energy intake (r = 0.38, p = 0.18), or sleep duration (r = 0.14, p = 0.62). However, there was a significant association between training heart rate (HR) and ΔVO₂max (r = 0.62, p = 0.02). Conclusions: When HIIT is prescribed according to a metabolic threshold, energy intake, sleep status, and BLa do not predict ΔVO₂max, yet the HR response to training is associated with the ΔVO₂max. Full article

(This article belongs to the Special Issue Advances in Personalized Exercise Prescription for Chronic Disease Prevention and Rehabilitation)

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Review

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13 pages, 913 KiB

Open AccessReview

Responders to Exercise Therapy in Patients with Osteoarthritis of the Hip: A Systematic Review and Meta-Analysis

by Carolien H. Teirlinck, Arianne P. Verhagen, Elja A.E. Reijneveld, Jos Runhaar, Marienke van Middelkoop, Leontien M. van Ravesteyn, Lotte Hermsen, Ingrid B. de Groot and Sita M.A. Bierma-Zeinstra

Int. J. Environ. Res. Public Health 2020, 17(20), 7380; https://doi.org/10.3390/ijerph17207380 - 10 Oct 2020

Cited by 8 | Viewed by 3407

Abstract

The Outcome Measures in Rheumatology workgroup (OMERACT), together with the Osteoarthritis Research Society International (OARSI) developed the OMERACT-OARSI responder criteria. These criteria are used to determine if a patient with osteoarthritis (OA) ‘responds’ to therapy, meaning experiences a clinically relevant effect of therapy. Recently, more clinical OA trials report on this outcome and most OA trials have data to calculate the number of responders according to these criteria. A systematic review and meta-analysis were performed on the response to exercise therapy, compared to no or minimal intervention in patients with hip OA using the OMERACT-OARSI responder criteria. The literature was searched for relevant randomized trials. If a trial fit the inclusion criteria, but number of responders was not reported, the first author was contacted. This way the numbers of responders of 14 trials were collected and a meta-analysis on short term (directly after treatment, 12 trials n = 1178) and long term (6–8 months after treatment, six trials n = 519) outcomes was performed. At short term, the risk difference (RD) was 0.14 (95% confidence interval (CI) 0.06–0.22) and number needed to treat (NNT) 7.1 (95% CI 4.5–17); at long term RD was 0.14 (95% CI 0.07–0.20) and NNT 7.1 (95% CI 5.0–14.3). Quality of evidence was moderate for the short term and high for the long term. In conclusion, 14% more hip OA patients responded to exercise therapy than to no therapy. Full article

(This article belongs to the Special Issue Advances in Personalized Exercise Prescription for Chronic Disease Prevention and Rehabilitation)

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