Allen E. Cornelius

Exercise training improves HR responses and V˙O2peak in predialysis kidney patients.

PURPOSE The current pilot and feasibility study was designed to examine the effect of 48 wk of moderate-intensity exercise training and dietary modification on kidney function and vascular parameters in chronic kidney disease (CKD) patients. METHODS Twenty-one stage 2-4 CKD patients (age, 18-70 yr) were randomly assigned to either the training group (TG, n = 10) or the usual care group (n = 11) for 48 wk. The TG received 48 wk of personal training (3 d·wk for up to 55 min per session at 50%-60% V˙O2peak) and dietary counseling, whereas individuals in the usual care group received standard of care and were instructed not to start a structured exercise program while in the study. V˙O2peak, estimated glomerular filtration rate (eGFR), resting and ambulatory HR, plasma lipids (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides), and inflammatory markers (high-sensitivity C-reactive protein and interleukin 6) were assessed at baseline and weeks 24 and 48. An independent groups t-test was used to compare glomerular filtration rate slopes between groups, whereas all other data were analyzed with ANCOVA using the baseline value as the covariate. RESULTS There were no statistically significant differences in any of the parameters at baseline. The 48-wk intervention led to a significant increase in V˙O2peak, reductions in both resting and ambulatory HR, and increases in LDL cholesterol and in TG, but it had no effect on the rate of change of eGFR over time. CONCLUSIONS A 48-wk exercise training program, primarily focused on aerobic exercise, increases V˙O2peak and favorably alters autonomic function as evidenced by reductions in HR in stages 2-4 CKD patients. The exercise intervention had no effect on kidney function as assessed by eGFR.

Predictors of Adherence to Home Rehabilitation Exercises Following Anterior Cruciate Ligament Reconstruction

OBJECTIVE Although home exercises are commonly prescribed following anterior cruciate ligament (ACL) reconstruction and are considered important in obtaining successful rehabilitation outcomes, little is known about factors associated with the completion of such exercises. Consequently, this study was designed to identify predictors of adherence to home rehabilitation exercises after ACL surgery. METHOD Participants (33 women, 58 men) completed indices of athletic identity, neuroticism, optimism, and pessimism before ACL surgery and measures of daily pain, negative mood, stress, and home exercise completion for 42 days postoperatively. RESULTS Participants reported a high level of adherence to the prescribed regimen. Home exercise completion increased significantly over time as the number of sets of prescribed home exercises declined. Personal factors were not predictive of home exercise completion. Participants completed fewer home exercises on days when they experienced more stress or negative mood. CONCLUSIONS Day-to-day variations in negative mood and stress may contribute to adherence to prescribed home exercises.

Blood pressure response to acute and chronic exercise in chronic kidney disease

The current study was designed to determine if a relationship exists between acute and chronic blood pressure responses to aerobic exercise in pre‐dialysis patients.

High-density lipoprotein particle pattern and overall lipid responses to a short-term moderate-intensity aerobic exercise training intervention in patients with chronic kidney disease

Abstract Background Chronic kidney disease (CKD) is associated with abnormal lipid profiles and altered high-density lipoprotein (HDL) particle size patterns. Lower levels of the larger, cardioprotective HDL particles found in CKD may play a role in the increased risk for cardiovascular disease in these patients. The current study was designed to assess the effects of short-term moderate-intensity aerobic exercise training on the HDL particle pattern and overall lipid profiles in stage 3 CKD patients. Methods Forty-six men and women with stage 3 CKD were randomized to either exercise (EX, n = 25) or control (CON, n = 21). Those in the EX group completed 16 weeks of supervised moderate-intensity aerobic exercise three times per week. Serum total cholesterol, HDL cholesterol (HDL-C), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), HDL particle size, estimated glomerular filtration rate (eGFR), body composition and peak oxygen uptake (VO2peak) were assessed at baseline and week 16. Results The rate of compliance in the EX group was 97 ± 7.2%. No change was observed in eGFR over time in either group. There was an 8.2% improvement in VO2peak in the EX group (P = 0.05), while VO2peak decreased in the CON group. HDL-C, TGs, HDL particle size and body composition remained unchanged in both groups. A trend was found for lower total cholesterol (TC) (P = 0.051) and LDL-C (P = 0.07) in the CON group. Conclusion Our findings indicate that a short-term aerobic exercise training intervention in stage 3 CKD patients does not induce changes in HDL particle size or favorable lipid profile modifications.