Brett Gordon

Resistance training improves metabolic health in type 2 diabetes: a systematic review

This paper systematically reviews the effect of resistance training (RT) on glycemic control and insulin sensitivity in adults with type 2 diabetes. Twenty studies were included, with the volume, frequency and intensity of RT varying markedly. Supervised RT improved glycemic control and insulin sensitivity, however, when supervision was removed compliance and glycemic control decreased. Evidence indicates the mechanisms behind the improvements to glucose tolerance require further elucidation. Although research demonstrates apparent benefits of RT for individuals with diabetes, further research is required to elucidate the minimum effective dose by describing frequency, intensity and the duration of acute and chronic improvements.

A review of guidelines for cardiac rehabilitation exercise programmes: Is there an international consensus?:

Background Cardiac rehabilitation is an important component in the continuum of care for individuals with cardiovascular disease, providing a multidisciplinary education and exercise programme to improve morbidity and mortality risk. Internationally, cardiac rehabilitation programmes are implemented through various models. This review compared cardiac rehabilitation guidelines in order to identify any differences and/or consensus in exercise testing, prescription and monitoring. Methods Guidelines, position statements and policy documents for cardiac rehabilitation, available internationally in the English language, were identified through a search of electronic databases and government and cardiology society websites. Information about programme delivery, exercise testing, prescription and monitoring were extracted and compared. Results Leading cardiac rehabilitation societies in North America and Europe recommend that patients progress from moderate- to vigorous-intensity aerobic endurance exercise over the course of the programme, with resistance training included as an important adjunct, for maintaining independence and quality of life. North American and European guidelines also recommend electrocardiograph-monitored exercise stress tests. Guidelines for South America and individual European nations typically include similar recommendations; however, those in the United Kingdom, Australia and New Zealand specify lower-intensity exercise and less technical assessment of functional capacity. Conclusion Higher-intensity aerobic training programmes, supplemented by resistance training, have been recommended and deemed safe for cardiac rehabilitation patients by many authorities. Based on research evidence, this may also provide superior outcomes for patients and should therefore be considered when developing an international consensus for exercise prescription in cardiac rehabilitation.

Graduated exercise training and progressive resistance training in adolescents with chronic fatigue syndrome: a randomized controlled pilot study:

Objective: To investigate the differential effects of aerobic graded exercise and progressive resistance training on exercise tolerance, fatigue and quality of life in adolescent patients with chronic fatigue syndrome (CFS). Design: Single-blind, randomized controlled pilot trial. Setting: A major metropolitan hospital in Melbourne, Australia. Subjects: Twenty-two adolescents aged 13—18 years diagnosed with CFS and admitted to the inpatient chronic fatigue rehabilitation programme. Intervention: Patients were randomized to either graded aerobic exercise training or a progressive resistance training programme, for five days/week for four weeks. The graded aerobic training consisted of 20—40 minutes of stationary cycling and treadmill exercise. The progressive resistance training involved 16 exercises performed with single set, moderate load and high repetitions. Main measures: Exercise tolerance (time to fatigue) measured on a graded sub-maximal treadmill test, metabolic equivalents and quality of life, along with muscular strength (maximium push-ups) and endurance (sit-to-stand) and questionnaires evaluating depressive symptoms and fatigue severity. Results: No intervention was significantly better than the other for any outcome. However, physical capacity and quality of life significantly improved in both groups, while fatigue severity and symptoms of depression improved only with aerobic training. Conclusions: Resistance and aerobic training resulted in similar changes to physical capacity, quality of life and fatigue severity. Generally, patients who completed resistance training or aerobic training experienced significant improvements in outcomes from baseline when they entered the programme. Whether these improvements can be attributed to the treatment is unknown.

Promising outcomes of an adolescent chronic fatigue syndrome inpatient programme

Introduction:  Chronic fatigue syndrome (CFS) is a condition of prolonged and disabling fatigue, which is accompanied by characteristic constitutional and neuropsychiatric symptoms. In children and adolescents, this condition occurring at a developmentally vulnerable time adds to the disability affecting self‐concept, autonomy, body image, socialisation, sexuality and academic problems. This case series looks at the effects of a graded exercise programme on physical outcomes, fatigue and mental state in an adolescent population.

Reproducibility of multiple repeated oral glucose tolerance tests

We assessed the oral glucose tolerance tests (OGTT) ability to produce consistent results for estimating insulin sensitivity over four consecutive days. Individual coefficients of variation for OGIS and Stumvoll-ISI were 7.8% and 14.4% with no statistically significant difference between days. Thereby, indicating repeated OGTTs are reliable for estimating insulin sensitivity.

Identification of key performance parameters during off-spin bowling with a smart cricket ball

A smart cricket ball, instrumented with three high-speed MEMS gyroscopes, was used to measure performance parameters during off-spin bowling. The average spin rate and finger torque generated by the bowler were 22.7 rps and 0.28 N·m, respectively. The arm motion could be clearly identified on the spin-axis vector diagram. The spin-axis vector described a loop that closely followed the orientation of the bowlers forearm. The centre of pressure (COP) of the finger force was located between the ring and the middle finger. A set of performance parameters was identified in this study that can be used to quantify off-spin bowling performance in the future. These performance parameters are: the spin rate of the ball, the position of the spin axis with respect to the plane of the seam, the amount of torque applied to the ball by the bowler, the bowlers angular arm velocity, the fingers COP (where the force is applied to the ball) and the impact point on the ball.

Reliability and validity of a GPS-enabled iPhoneTM “app” to measure physical activity

Abstract This study assessed the validity and reliability of an iPhoneTM “app” and two sport-specific global positioning system (GPS) units to monitor distance, intensity and contextual physical activity. Forty (23 female, 17 male) 18–55-year-olds completed two trials of six laps around a 400-m athletics track wearing GPSports ProTM and WiSpiTM units (5 and 1 Hz) and an iPhoneTM with a Motion X GPSTM “app” that used the inbuilt iPhoneTM location services application programming interface to obtain its sampling rate (which is likely to be ≤1 Hz). Overall, the statistical agreement, assessed using t-tests and Bland–Altman plots, indicated an underestimation of the known track distance (2.400 km) and average speed by the Motion X GPSTM “app” and GPSports ProTM while the GPSports WiSpiTM device overestimated these outcomes. There was a ≤3% variation between trials for distance and average speed when measured by any of the GPS devices. Thus, the smartphone “app” trialled could be considered as an accessible alternative to provide high-quality contextualised data to enable ubiquitous monitoring and modification of programmes to ensure appropriate intensity and type of physical activity is prescribed and more importantly adhered to.

Implementing resistance training in the rehabilitation of coronary heart disease: A systematic review and meta-analysis.

BACKGROUND Resistance training has demonstrated efficacy in cardiac rehabilitation programs, but the optimal prescription of resistance training is unknown. This systematic review with meta-analysis compared the effectiveness of cardiac rehabilitation consisting of resistance training either alone (RT) or in combination with aerobic training (CT) with aerobic training only (AT) on outcomes of physical function. Further, resistance training intensity and intervention duration were examined to identify if these factors moderate efficacy. METHODS Six electronic databases were searched to identify studies investigating RT, coronary heart disease and physical function. The overall quality of evidence was assessed using the GRADE approach. Meta-analyses were performed when possible and qualitative analysis was performed for the remaining data. RESULTS Improvements in peak oxygen uptake (WMD: 0.61, 95% CI: 0.20-1.10), peak work capacity (SMD: 0.38, 95% CI: 0.11-0.64) and muscular strength (SMD: 0.65, 95% CI: 0.43-0.87) significantly favoured CT over AT with moderate quality evidence. There was no evidence of a difference in effect when comparing RT and AT. Shorter duration CT was superior to shorter duration AT for improving peak oxygen uptake and muscular strength (low quality evidence) while longer duration CT was only superior to longer duration AT in improving muscular strength (moderate quality evidence). CONCLUSIONS CT is more beneficial than AT alone for improving physical function. Although preliminary findings are promising, more high-quality evidence is required to determine the efficacy of high intensity resistance training. Shorter duration interventions that include resistance training might allow patients to return to their normal activities of daily living earlier.

Glycemic response varies between resistance and aerobic exercise in inactive males with long-term type 2 diabetes.

The glycemic response to aerobic exercise is well understood; however, the response to resistance exercise is not. Eight inactive males (61.0 ± 7.2 years) with insulin-treated type 2 diabetes randomly completed single sessions of whole-body resistance exercise or cycling, 7 days apart. There were different 24-h glucose responses (p < 0.001) between the resistance exercise and the aerobic exercise, with short-term (24-h) impairment of glycemic control following the resistance exercise (p = 0.004). Cycling did not reduce glucose concentrations (p > 0.05), which contrasts with previous findings.

Insulin sensitivity in response to a single resistance exercise session in apparently healthy individuals

Background: Regular resistance exercise completed for a number of weeks has been shown to increase insulin sensitivity and reduce the risk of diabetes-related complications. However, the acute responses to resistance exercise have not been adequately investigated in relation to training frequency. Aim: To investigate the changes to insulin sensitivity in apparently healthy individuals following a single session of unaccustomed resistance exercise. Subjects and methods: Ten sedentary, apparently healthy individuals performed a baseline oral glucose tolerance test and maximal strength testing. Participants then performed a single session of moderate-high intensity resistance exercise which was followed by 4 consecutive days of oral glucose tolerance testing, for which participants replicated their initial diet. Mean estimated insulin sensitivity change scores from baseline values and their 95% confidence intervals were compared to the previously determined values for a clinically meaningful change. Results: Two participants were identified as having hyperinsulinemia and their data were therefore removed from the main analysis. There was a clinically meaningful increase in insulin response (mean >7237 pmol·I−1·120 min−1) on all days following the exercise session and a clinically meaningful increase in glucose response (mean >81 mmol·I−1·120 min−1) on only the 3rd day following exercise. These changes suggest a potentially adverse short-term effect. Additionally, the 2 individuals with hyperinsulinemia displayed more extreme results. Conclusion: These results suggest that insulin sensitivity may be impaired following a single session of unaccustomed resistance exercise for approximately 4 days in healthy untrained, older individuals. Further research is required for individuals with hyperinsulinemia.