Tailored Exercise in Patients with Chronic Diseases

A special issue of Journal of Functional Morphology and Kinesiology (ISSN 2411-5142).

Deadline for manuscript submissions: closed (30 November 2016) | Viewed by 48161

Special Issue Editor


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Guest Editor
Sport Medicine Center, Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy
Interests: physical exercise; training; non-communicable chronic diseases; sedentary time; cardio-metabolic and inflammatory risk biomarkers; nutritional integration; functional evaluation; long-term efficacy of physical exercise; exercise prescription in non-communicable chronic disease and in solid organ transplantations; cardiotoxicity; echocardiographic deformation parameters
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Special Issue Information

Dear Colleagues,

Physical Exercise is usually suggested to reduce cardiovascular risks factors and prevent chronic metabolic diseases as a consequence of the effects on the body weight and structure, overall fitness, muscle strength, flexibility and quality of life. Regular physical training has been more recently promoted for the evidence of the “anti-inflammatory effectiveness”. A positive impact has been shown in the most common “non-communicable diseases”, such as hypertension, diabetes, metabolic syndrome, cardio-vascular diseases, elderly age, post-transplant syndrome, and also in cancer, where the inflammatory process is globally represented. The American College of Sports Medicine (ACSM) guidelines actually support “exercise as therapy” at moderate level of Energy Expenditure. The importance to establish the individual level of physical exercise, like a drug’s dose, has induced the literature in investigating this aspect in diverse context varied by sex, age, and/or race/ethnicity and especially in different clinical fields associated to an incorrect life style habits. To reach this goal a bench to bedside research strategy is needed. The Special Issue, “Tailored Exercise in Patients with Chronic Diseases”, is dedicated to collect the experience in this field and authors are invited to submit original research papers and current review articles.

Dr. Laura Stefani
Guest Editor

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Keywords

  • exercise
  • training
  • quality of life
  • sedentarism
  • metabolic syndrome
  • cancer
  • elderly
  • diabetes
  • hypertension
  • nutrition

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Published Papers (7 papers)

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Research

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870 KiB  
Communication
Mental Health and Quality of Life Perception of Surviving Cancer Patients: A Pilot Study
by Laura Stefani, Mattia Rotelli, Angelica Frulli, Luca Amoroso, Laura Belloni and Giorgio Galanti
J. Funct. Morphol. Kinesiol. 2016, 1(3), 322-327; https://doi.org/10.3390/jfmk1030322 - 1 Sep 2016
Viewed by 4089
Abstract
Quality of life (QoL) is one of the most important factors for cancer patients related to survival. Literature supports the role of physical exercise as therapy for improving QoL in this category. This study aims to verify the impact of an unsupervised physical [...] Read more.
Quality of life (QoL) is one of the most important factors for cancer patients related to survival. Literature supports the role of physical exercise as therapy for improving QoL in this category. This study aims to verify the impact of an unsupervised physical activity program at moderate intensity in this field. Fourteen breast and colon cancer patients, aged 63 ± 15, were prescribed a program of unsupervised exercise for at least six months. They were administered the SF36 questionnaire at the beginning of the program and after six months, to evaluate QoL parameters. Significant improvements in PF (physical functioning) and RP (role physical) (T0: 78.9; T6: 79.2; T0: 53.6; T6: 73.3), mental health role (T0: 54.6 ± 19.53; T6: 55.7) and RE (role emotional) (T0: 54.7; T6: 73.8), with a decrease particularly in pain perception (T0: 21.8; T6: 17.1), were found. A significant decrease in the intake of calories was also evident. In this study unsupervised exercise programs were seen to significantly improve QoL perception in a short time, considerably decreasing metabolic risk factors. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases)
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495 KiB  
Article
Cardiovascular Outcomes in Renal Transplant Recipients: Feasibility and Clinical Role of 2D Speckle Tracking to Assess Myocardial Function
by Laura Stefani, Gianni Pedrizzetti, Stefano Pedri, Enrico Minetti, Marco Mandoli, Benedetta Tosi and Giorgio Galanti
J. Funct. Morphol. Kinesiol. 2016, 1(1), 109-117; https://doi.org/10.3390/jfmk1010109 - 2 Mar 2016
Cited by 3 | Viewed by 4229
Abstract
Left ventricular (LV) function is normally improved after renal transplant; however, cardiovascular mortality remains elevated. Moderate physical activity has a positive impact on myocardial function; however, few data are available about the role of 2D echocardiography (2DE) and 2D speckle tracking echocardiography (2DSTE) [...] Read more.
Left ventricular (LV) function is normally improved after renal transplant; however, cardiovascular mortality remains elevated. Moderate physical activity has a positive impact on myocardial function; however, few data are available about the role of 2D echocardiography (2DE) and 2D speckle tracking echocardiography (2DSTE) on renal transplant recipients (RTR). From a large cohort of RTR submitted to a supervised exercise as the prescription program, 10 subjects who were regularly trained were studied for sixth months. They underwent periodically an echo evaluation (ESAOTE MyLab 50), cardiopulmonary test (CPT) and strength test for the lower and upper limbs. The LV function study was completed with the speckle tracking longitudinal strain (Lo Strain) measure calculated by dedicated software (XStrain–Esaote) at the end of the protocol. All of the cardiovascular parameters were normal: the ejection fraction (EF) increased significantly (from 62.7 ± 4 to 67.2 ± 2.3 with p < 0.05), as well as the anaerobic threshold (15.3 ± 6.8 to 20.5 ± 10.1 with p < 0.05). Particularly, the global longitudinal strain (GLS) values were within the normal range (−19.2% ± 5.1), maintaining the physiological gradient from the basal (−13.2 ± 4.1; −16.5 ± 5.21) to the apex level (−21 ± 2.3; −25.7 ± −7.0). 2D speckle tracking echocardiography (2DSTE) can be effectively used to confirm the presence of preserved physiological myocardial function in post-renal transplantation subjects submitted to a physical training. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases)
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182 KiB  
Article
Lifestyle Intervention in Surviving Cancer Patients
by Laura Stefani, Cristian Petri, Gabriele Mascherini and Giorgio Galanti
J. Funct. Morphol. Kinesiol. 2016, 1(1), 48-53; https://doi.org/10.3390/jfmk1010048 - 18 Jan 2016
Cited by 14 | Viewed by 3859
Abstract
Supervised physical exercise and diet are normally suggested for preventing eventual weight gain, especially in cancer patients. However, little data is available on the effects of “unsupervised” mixed exercises associated with simple correct nutritional advice. This study aims to assess the impact of [...] Read more.
Supervised physical exercise and diet are normally suggested for preventing eventual weight gain, especially in cancer patients. However, little data is available on the effects of “unsupervised” mixed exercises associated with simple correct nutritional advice. This study aims to assess the impact of these two aspects in reducing major risk factors. 37 surviving cancer patients including breast (20 females) and colon cancer patients (10 males and seven females), aged 55.51 ± 10.94, were enrolled in this study on the correction of lifestyle habits. After six months from the onset of the study, the anthropometric parameters of Body Mass Index (BMI), circumference of waist/hip and also cardiovascular parameters (heart rate, blood pressure and respiratory rate during the 6 Minute Walking Test (6MWT) were measured. The resistance program was established using the Sit and Reach, Hand Grip and Chair Test. The anthropometric data showed significant modifications of the main parameters (body density T0: 1013.54 ± 10.48 g/cm3, T6: 1015 ± 10.45 g/cm3, p < 0.03; Fat Mass (FM%) T0: 38.44% ± 5.04%, T6: 37.65% ± 5.00%, p < 0.03; FFM% (Free Fat Mass) T0: 61.56% ± 5.04%, T6: 62.35% ± 5.00%, p < 0.03; TBW% (Total Body Water) T0: 49.26% ± 7.22%, T6: 47.94% ± 5.97%, p < 0.05). The respiratory rate decreased significantly (T0: 31.15 ± 4.61 bpm, T6: 29.42 ± 3.34 bpm, p < 0.04). The functional parameters, evaluated by the number of repetitions of the Chair Test, showed significant improvement (Chair Test T0: 13.20 ± 4.84 at rest, T6: 15.31 ± 3.54 at rest, p < 0.01). Moderate aerobic resistance unsupervised exercises, associated with correct nutritional habits, allow a significant improvement of the principal cardiovascular risk factors in cancer. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases)

Review

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812 KiB  
Review
The Role of Compensatory Adaptations and Individual Variability in Exercise Prescription
by Clemens Drenowatz
J. Funct. Morphol. Kinesiol. 2016, 1(2), 230-239; https://doi.org/10.3390/jfmk1020230 - 11 May 2016
Cited by 3 | Viewed by 6139
Abstract
Physical inactivity is a major risk factor for public health. Due to the decline in physical demands of daily living exercise becomes an increasingly important contributor to an active lifestyle. The evidence on health benefits of exercise, particularly regarding weight loss, however, remains [...] Read more.
Physical inactivity is a major risk factor for public health. Due to the decline in physical demands of daily living exercise becomes an increasingly important contributor to an active lifestyle. The evidence on health benefits of exercise, particularly regarding weight loss, however, remains equivocal. In addition to lack of adherence to an exercise program, participants display behavioral and physiological adaptations that potentially mitigate exercise-induced health benefits. Specifically, a reduction in non-exercise physical activity (PA) and/or an increase in energy intake along with metabolic adaptations have been suggested to affect exercise-induced health benefits. There is also a large inter-individual variability, which makes some participants more receptive to exercise-induced weight loss than others. Even in the absence of weight loss exercise, however, provides various health benefits such as an increase in cardiorespiratory fitness, beneficial changes in blood lipids and blood pressure. In fact, some of these benefits have been more pronounced in participants who did not experience weight loss. In order to enhance the understanding of the role of exercise in health promotion a better understanding of compensatory adaptations is needed along with an identification of characteristics that contribute to inter-individual variability in response to exercise interventions. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases)
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839 KiB  
Review
The Role of Physical Activity and Nutrition in the Sarcopenia of Cirrhosis
by Francesca Maria Trovato, Flavia Concetta Aiello, Licia Larocca and Simon D. Taylor-Robinson
J. Funct. Morphol. Kinesiol. 2016, 1(1), 118-125; https://doi.org/10.3390/jfmk1010118 - 3 Mar 2016
Cited by 13 | Viewed by 6704
Abstract
The aim of this review is to understand how physical activity and nutrition are involved in the improvement of sarcopenia in patients affected by liver cirrhosis. The pathogenesis of sarcopenia in cirrhosis involves three major factors: inadequate dietary intake, metabolic disturbances, and malabsorption. [...] Read more.
The aim of this review is to understand how physical activity and nutrition are involved in the improvement of sarcopenia in patients affected by liver cirrhosis. The pathogenesis of sarcopenia in cirrhosis involves three major factors: inadequate dietary intake, metabolic disturbances, and malabsorption. Although in the early stages muscles appear to be spared, sarcopenia progressively leads to mobility limitations and its consequences, such as propensity to falls and drastically reducing life quality. Several studies confirm the important role played by physical activity and balanced nutrition in this chronic condition. Exercise and nutritional intervention should be recommended in these patients in order to improve quality of life. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases)
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Other

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555 KiB  
Concept Paper
Clinical Implementation of Exercise Guidelines for Cancer Patients: Adaptation of ACSM’s Guidelines to the Italian Model
by Laura Stefani, Giorgio Galanti and Riggs Klika
J. Funct. Morphol. Kinesiol. 2017, 2(1), 4; https://doi.org/10.3390/jfmk2010004 - 13 Jan 2017
Cited by 41 | Viewed by 16888
Abstract
The goal of cancer treatment is to arrest or eradicate the tumor while minimizing the often toxic effects of treatment. While oncologic diagnostics and treatments are improving and survival rates are increasing, it is critical to provide additional patient management that appears to [...] Read more.
The goal of cancer treatment is to arrest or eradicate the tumor while minimizing the often toxic effects of treatment. While oncologic diagnostics and treatments are improving and survival rates are increasing, it is critical to provide additional patient management that appears to affect long-term survival. Epidemiologic evidence suggests patients diagnosed with cancer tend to fair better after treatment when following a comprehensive rehabilitation program aimed at achieving an ideal body weight through dietary and exercise interventions while also increasing cardiorespiratory fitness, strength, mobility, neuromuscular integrity and psycho-social wellbeing. Additionally, it is now being tested whether exercise during cancer treatment and possibly prior to the start of treatment may increase post treatment outcomes by altering body weight, having direct effects on tumorigenesis, reducing oxidative stress and inflammation, and perhaps increasing chemotherapy delivery efficacy. The purpose of this review is to outline an evidence based model to evaluate cancer patients and provide guidelines for post-cancer treatment rehabilitation programs. Additionally, strategies aimed at changing lifestyle habits such as smoking and poor dietary habits will be addressed. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases)
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2447 KiB  
Concept Paper
Clinical Application of 2D Speckle Tracking Strain for Assessing Cardio-Toxicity in Oncology
by Laura Stefani, Gianni Pedrizzetti and Giorgio Galanti
J. Funct. Morphol. Kinesiol. 2016, 1(4), 343-354; https://doi.org/10.3390/jfmk1040343 - 11 Oct 2016
Cited by 9 | Viewed by 5556
Abstract
Echocardiography has recently undergone innovations due to the availability of deformation parameters as strain, strain rate, torsion and rotation that allow an accurate assessment of myocardial function. Because of this general progress, the importance of myocardial deformation parameters has been highlighted, and some [...] Read more.
Echocardiography has recently undergone innovations due to the availability of deformation parameters as strain, strain rate, torsion and rotation that allow an accurate assessment of myocardial function. Because of this general progress, the importance of myocardial deformation parameters has been highlighted, and some aspects of their clinical and research applications have recently been considered for the daily management of many acute and chronic metabolic diseases. The deformation parameters are largely proposed for the early detection of myocardial dysfunction, especially in the case of patients being completely asymptomatic. Strain analysis is extensively applied to cardiomyopathies, to coronary artery disease, or to the evaluation of the “forgotten chambers”, such as the right ventricles and atria. More recently, several other clinical contexts, like non-communicable chronic diseases (NCCD), have actually been benefitting from specific evaluation by strain analysis. Lately, some specific aspects of strain evaluation, particularly Global Longitudinal Strain (GLS) have been shown to provide useful information of clinical relevance in the case of cancer patients. This paper presents an initial review of the recent applications of strain analysis in cardio-oncology, in order to share the recent experience in this field and to support the role of these parameters in cardio-oncology. Full article
(This article belongs to the Special Issue Tailored Exercise in Patients with Chronic Diseases)
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