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391 Effects of exercise training on arterial stiffness in haemodialysis patients
Effects of exercise training on arterial stiffness in haemodialysis patients
391
K. Koh1*, A. Williams1, J. Coombes2 & R. Fassett3 School of Human Life Sciences, University Of Tasmania 2 School of Human Movement Studies, University of Queensland 3 Renal Research Tasmania, Launceston General Hospital
1
We compared the effects of a supervised versus a home based aerobic exercise training program on physical fitness, functional capacity, pulse wave velocity, self-reported health and physical activity in end stage kidney disease patients on haemodialysis. Forty maintenance haemodialysis patients were randomized to receive six months of either supervised cycle training during dialysis (S), a home based walking program (H) or usual care (C). The goals of the training programs were to complete three sessions per week and eventually be exercising for 45 minutes per session at an RPE of 13. After six months, twenty six patients (males=13, mean±SD, age=52±13yrs, BMI=29±7) remained in the study (S=7, H=10, C=9). Training compliance over the six months was S=83±8% and H=71±22% in the remaining patients. There were no significant (P>0.05) time or group differences in pre to post changes in six minute walk distance (S=Ĺ13%, H=Ĺ11%, C=Ĺ8%), get-up-and-go time (S=Ļ 2%, H= Ļ6%, C=Ļ11%), pulse wave velocity (S=Ļ8%, H=Ĺ15%, C=Ĺ3%), self reported mental (S=Ļ6%, H=Ĺ4, C=Ļ6%) and physical health (S=Ļ14%, H=Ĺ 8%, C=ĹĻ1%). Of interest was the finding that increases in health enhancing physical activity levels (including time spent training) were not different between groups (S=Ĺ198%, H=Ĺ18%, C=Ĺ196%). After six months, there were no differences in functional capacity, physical functioning, pulse wave velocity and self-reported health in haemodialysis patients randomised to supervised cycle training; home based walking or usual care. An increase in physical activity levels in the usual care patients may explain the unexpected lack of differences between these and the exercising patients.
Exercise after stroke in the North East Melbourne Stroke Incidence Study (NEMESIS)
392
S. Paul1,2,3* & A. Thrift2,3,4 1 Menzies Research Institute, Hobart 2 National Stroke Research Institute, Heidelberg Heights 3 University of Melbourne, Parkville 4 Baker Heart Research Institute, Melbourne
Tuesday 16 October
Although exercise may improve outcome for stroke survivors by controlling cardiovascular risk factors, and improving mobility and mood, little is known about the prevalence of exercise after stroke. Five-year stroke survivors, from a population-based stroke incidence study, were administered a questionnaire about exercise habits before and after stroke, and about exercise advice received from a doctor. Exercise was defined as sessions of activity lasting ≥ 20 minutes that caused ‘huffing and puffing’. We calculated the proportion of survivors who a) exercised, b) exercised ≥ three times per week, c) exercised prior to stroke, and d) recalled receiving exercise advice. Forty-five percent (n = 441) of 978 incident stroke patients were alive at 5 years (49% female, mean age 74 ± 15 (SD) years). Of these, 349 (79%) completed this questionnaire: completers were older and more often Australian-born than noncompleters (p < 0.05). Sixty-nine survivors (20%) exercised and 52 (15%) exercised ≥ three times per week. Of those exercising ≥ three times per week, 42 (80%) had exercised before their stroke. Only 51 survivors (15%) recalled receiving exercise advice. Those who recalled advice more often reported exercising than those who did not recall advice (27% versus 13%, p = 0.01). In summary, few stroke survivors exercise after stroke. Although this may be partly attributable to disability, more stroke survivors could engage in exercise. Only 15% of survivors recalled receiving exercise advice. Improving this figure may increase exercise after stroke, as a greater proportion of those who recalled advice were exercising.
Design of the Internet Heart Health Project: A randomized trial of online outpatient cardiac rehabilitation
393
K. Mummery1*, T. Dwyer1, R. Steele2 & A. Hinchliffe1 Central Queensland University, Rockhampton, Australia 2 Medical Research Council, Cambridge, U.K.
1
Where Phase II cardiac rehabilitation programs have been shown to reduce coronary risk factors, increase psychosocial well-being and physical activity, attendance and adherence to such programs is poor. The Internet Heart Health project is a randomized controlled trial that will test the efficacy and efficiency of a tailored, interactive internet-based phase II outpatient cardiac rehabilitation program based on the Best Practice Guidelines established by Queensland Health. The project is comprised of two distinct stages, the first being the formative evaluation and useability testing of the program. The second stage involves the completion of a randomized control trial of the developed internet resource in a sample of regional/rural cardiac rehabilitation patients to assess the efficacy of the approach. Program success will be evaluated by assessing (i) the prevalence of rehabilitation program exposure/completion for participants in the Internet Heart Health arm compared with the control arm; (ii) the proportion of participants in the Internet Heart Health intervention arm compared with a non-intervention or standard care control arm who adopt goal behaviors in risk factors at a 3 month follow-up; and (iii) change in levels of physical activity, improved lipid measures, weight reduction, blood pressure and smoking behaviors in the Internet Heart Health intervention arm compared with the control arm at the 3 month follow-up. The presentation will cover the establishment of the two phases of the project in collaboration with a regional health service provider.
A six week repeated measures comparison of lung function in people diagnosed with Chronic Fatigue Syndrome
394
R. Coutts1*, A. Davie1, A. Silk1 & R. Weatherby1 Southern Cross University
1
Chronic Fatigue Syndrome (CFS) is a complex illness encompassing the effects of reduced energy. The etiology for the onset of CFS remains unknown whilst treatment and management regimes are still unclear. Medically diagnosed CFS participants (n = 23) performed a lung function test (FVC, VC and MVV) once weekly during a six week time period. With the exception of MVV (from Week 1 to Week 2) the lung function measures were consistent over time. Repeated measures comparisons with the normal population based on age, body mass and height revealed that MVV (F (1.0, 14.0) = 29.14, p < 0.001, partial n2 = 0.68), FEF25 (F (1.0, 15.0) = 32.62, p < 0.01, partial n2 = 0.69), FEF75 (F (1.0,15.0) = 4.42, p = 0.05, partial n2 = 0.23) and PEF (F (1.0,16.0) = 10.72, p = 0.005, partial n2 = 0.40) were below predicted values. The progression of the FEF25 (below predicted), FEF50 (within predicted) and FEF75 (below predicted) and the combined measure FEF2575 (within predicted) is suggestive of over-compensation in the middle of the breathing maneuver. The reduced PEF values may arise from resistance and/or decrease in elastic recoil. Possible contributors to the lung function changes may be due to previous or existing infection and/or the effects of reduced activity. Of interest were the linear positive changes in the MVV that the participants were able to produce themselves. The use of biofeedback techniques to encourage physiological adaptation towards improved health in CFS may be worthy of further investigation. 129
391
K. Koh1*, A. Williams1, J. Coombes2 & R. Fassett3 School of Human Life Sciences, University Of Tasmania 2 School of Human Movement Studies, University of Queensland 3 Renal Research Tasmania, Launceston General Hospital
1
We compared the effects of a supervised versus a home based aerobic exercise training program on physical fitness, functional capacity, pulse wave velocity, self-reported health and physical activity in end stage kidney disease patients on haemodialysis. Forty maintenance haemodialysis patients were randomized to receive six months of either supervised cycle training during dialysis (S), a home based walking program (H) or usual care (C). The goals of the training programs were to complete three sessions per week and eventually be exercising for 45 minutes per session at an RPE of 13. After six months, twenty six patients (males=13, mean±SD, age=52±13yrs, BMI=29±7) remained in the study (S=7, H=10, C=9). Training compliance over the six months was S=83±8% and H=71±22% in the remaining patients. There were no significant (P>0.05) time or group differences in pre to post changes in six minute walk distance (S=Ĺ13%, H=Ĺ11%, C=Ĺ8%), get-up-and-go time (S=Ļ 2%, H= Ļ6%, C=Ļ11%), pulse wave velocity (S=Ļ8%, H=Ĺ15%, C=Ĺ3%), self reported mental (S=Ļ6%, H=Ĺ4, C=Ļ6%) and physical health (S=Ļ14%, H=Ĺ 8%, C=ĹĻ1%). Of interest was the finding that increases in health enhancing physical activity levels (including time spent training) were not different between groups (S=Ĺ198%, H=Ĺ18%, C=Ĺ196%). After six months, there were no differences in functional capacity, physical functioning, pulse wave velocity and self-reported health in haemodialysis patients randomised to supervised cycle training; home based walking or usual care. An increase in physical activity levels in the usual care patients may explain the unexpected lack of differences between these and the exercising patients.
Exercise after stroke in the North East Melbourne Stroke Incidence Study (NEMESIS)
392
S. Paul1,2,3* & A. Thrift2,3,4 1 Menzies Research Institute, Hobart 2 National Stroke Research Institute, Heidelberg Heights 3 University of Melbourne, Parkville 4 Baker Heart Research Institute, Melbourne
Tuesday 16 October
Although exercise may improve outcome for stroke survivors by controlling cardiovascular risk factors, and improving mobility and mood, little is known about the prevalence of exercise after stroke. Five-year stroke survivors, from a population-based stroke incidence study, were administered a questionnaire about exercise habits before and after stroke, and about exercise advice received from a doctor. Exercise was defined as sessions of activity lasting ≥ 20 minutes that caused ‘huffing and puffing’. We calculated the proportion of survivors who a) exercised, b) exercised ≥ three times per week, c) exercised prior to stroke, and d) recalled receiving exercise advice. Forty-five percent (n = 441) of 978 incident stroke patients were alive at 5 years (49% female, mean age 74 ± 15 (SD) years). Of these, 349 (79%) completed this questionnaire: completers were older and more often Australian-born than noncompleters (p < 0.05). Sixty-nine survivors (20%) exercised and 52 (15%) exercised ≥ three times per week. Of those exercising ≥ three times per week, 42 (80%) had exercised before their stroke. Only 51 survivors (15%) recalled receiving exercise advice. Those who recalled advice more often reported exercising than those who did not recall advice (27% versus 13%, p = 0.01). In summary, few stroke survivors exercise after stroke. Although this may be partly attributable to disability, more stroke survivors could engage in exercise. Only 15% of survivors recalled receiving exercise advice. Improving this figure may increase exercise after stroke, as a greater proportion of those who recalled advice were exercising.
Design of the Internet Heart Health Project: A randomized trial of online outpatient cardiac rehabilitation
393
K. Mummery1*, T. Dwyer1, R. Steele2 & A. Hinchliffe1 Central Queensland University, Rockhampton, Australia 2 Medical Research Council, Cambridge, U.K.
1
Where Phase II cardiac rehabilitation programs have been shown to reduce coronary risk factors, increase psychosocial well-being and physical activity, attendance and adherence to such programs is poor. The Internet Heart Health project is a randomized controlled trial that will test the efficacy and efficiency of a tailored, interactive internet-based phase II outpatient cardiac rehabilitation program based on the Best Practice Guidelines established by Queensland Health. The project is comprised of two distinct stages, the first being the formative evaluation and useability testing of the program. The second stage involves the completion of a randomized control trial of the developed internet resource in a sample of regional/rural cardiac rehabilitation patients to assess the efficacy of the approach. Program success will be evaluated by assessing (i) the prevalence of rehabilitation program exposure/completion for participants in the Internet Heart Health arm compared with the control arm; (ii) the proportion of participants in the Internet Heart Health intervention arm compared with a non-intervention or standard care control arm who adopt goal behaviors in risk factors at a 3 month follow-up; and (iii) change in levels of physical activity, improved lipid measures, weight reduction, blood pressure and smoking behaviors in the Internet Heart Health intervention arm compared with the control arm at the 3 month follow-up. The presentation will cover the establishment of the two phases of the project in collaboration with a regional health service provider.
A six week repeated measures comparison of lung function in people diagnosed with Chronic Fatigue Syndrome
394
R. Coutts1*, A. Davie1, A. Silk1 & R. Weatherby1 Southern Cross University
1
Chronic Fatigue Syndrome (CFS) is a complex illness encompassing the effects of reduced energy. The etiology for the onset of CFS remains unknown whilst treatment and management regimes are still unclear. Medically diagnosed CFS participants (n = 23) performed a lung function test (FVC, VC and MVV) once weekly during a six week time period. With the exception of MVV (from Week 1 to Week 2) the lung function measures were consistent over time. Repeated measures comparisons with the normal population based on age, body mass and height revealed that MVV (F (1.0, 14.0) = 29.14, p < 0.001, partial n2 = 0.68), FEF25 (F (1.0, 15.0) = 32.62, p < 0.01, partial n2 = 0.69), FEF75 (F (1.0,15.0) = 4.42, p = 0.05, partial n2 = 0.23) and PEF (F (1.0,16.0) = 10.72, p = 0.005, partial n2 = 0.40) were below predicted values. The progression of the FEF25 (below predicted), FEF50 (within predicted) and FEF75 (below predicted) and the combined measure FEF2575 (within predicted) is suggestive of over-compensation in the middle of the breathing maneuver. The reduced PEF values may arise from resistance and/or decrease in elastic recoil. Possible contributors to the lung function changes may be due to previous or existing infection and/or the effects of reduced activity. Of interest were the linear positive changes in the MVV that the participants were able to produce themselves. The use of biofeedback techniques to encourage physiological adaptation towards improved health in CFS may be worthy of further investigation. 129