1.
Effects of Lifestyle Modification on an Exaggerated Blood Pressure Response to Exercise in Normotensive Females.
Michishita, R, Ohta, M, Ikeda, M, Jiang, Y, Yamato, H
American journal of hypertension. 2017;(10):999-1007
Abstract
BACKGROUND This study was designed to examine the effects of a lifestyle modification on the improvement in an exaggerated systolic blood pressure (SBP) response to exercise in normotensive females. METHODS The subjects were 78 normotensive females with (n = 25) and without (n = 53) an exaggerated SBP response to exercise who were not taking any medications. An exaggerated SBP response to exercise was defined according to the criteria of the Framingham Study (peak SBP: ≥190 mm Hg). A lifestyle modification program consisting of aerobic exercise and diet counseling was conducted for 12 weeks. The brachial-ankle pulse wave velocity (baPWV), plasma nitrate/nitrite (NOx), plasma thiobarbituric acid-reactive substances (TBARS), high-sensitivity C-reactive protein, fibrinogen levels, and the white blood cell (WBC) counts were measured before and after 12-week intervention. RESULTS After 12-week intervention, the exercise-induced SBP elevation decreased in an exaggerated SBP response group (P < 0.05). In addition, the plasma NOx significantly increased, and the WBC counts and plasma TBARS decreased in an exaggerated SBP response group (P < 0.05). In an exaggerated SBP response group, a stepwise multiple regression analysis showed that the percent change in exercise-induced SBP elevation was independently associated with the percent changes in the plasma NOx level and baPWV (r2 = 0.647, P < 0.0001). CONCLUSIONS These results suggest that a lifestyle modification is considered to be important for reducing an exaggerated SBP response to exercise by improving the arterial stiffness and nitric oxide bioavailability.
2.
HEART: heart exercise and remote technologies: a randomized controlled trial study protocol.
Maddison, R, Whittaker, R, Stewart, R, Kerr, A, Jiang, Y, Kira, G, Carter, KH, Pfaeffli, L
BMC cardiovascular disorders. 2011;:26
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death worldwide. Cardiac rehabilitation (CR) is aimed at improving health behaviors to slow or reverse the progression of CVD disease. Exercise is a central element of CR. Technologies such as mobile phones and the Internet (mHealth) offer potential to overcome many of the psychological, physical, and geographical barriers that have been associated with lack of participation in exercise-based CR. We aim to trial the effectiveness of a mobile phone delivered exercise-based CR program to increase exercise capacity and functional outcomes compared with usual CR care in adults with CVD. This paper outlines the rationale and methods of the trial. METHODS A single-blinded parallel two-arm randomized controlled trial is being conducted. A total of 170 people will be randomized at 1:1 ratio either to receive a mHealth CR program or usual care. Participants are identified by CR nurses from two metropolitan hospitals in Auckland, New Zealand through outpatient clinics and existing databases. Consenting participants are contacted to attend a baseline assessment. The intervention consists of a theory-based, personalized, automated package of text and video message components via participants' mobile phones and the Internet to increase exercise behavior, delivered over six months. The control group will continue with usual CR. Data collection occurs at baseline and 24 weeks (post-intervention). The primary outcome is change in maximal oxygen uptake from baseline to 24 weeks. Secondary outcomes include post-intervention measures on self-reported physical activity (IPAQ), cardiovascular risk factors (systolic blood pressure, weight, and waist to hip ratio), health related quality of life (SF-36), and cost-effectiveness. DISCUSSION This manuscript presents the protocol for a randomized controlled trial of a mHealth exercise-based CR program. Results of this trial will provide much needed information about physical and psychological well-being, and cost-effectiveness of an automated telecommunication intervention. If effective, this intervention has enormous potential to improve the delivery of CR and could easily be scaled up to be delivered nationally (and internationally) in a very short time, enhancing the translational aspect of this research. It also has potential to extend to comprehensive CR (nutrition advice, smoking cessation, medication adherence). TRIAL REGISTRATION ACTRN12611000117910.
3.
Feasibility, design and conduct of a pragmatic randomized controlled trial to reduce overweight and obesity in children: The electronic games to aid motivation to exercise (eGAME) study.
Maddison, R, Foley, L, Mhurchu, CN, Jull, A, Jiang, Y, Prapavessis, H, Rodgers, A, Vander Hoorn, S, Hohepa, M, Schaaf, D
BMC public health. 2009;:146
Abstract
BACKGROUND Childhood obesity has reached epidemic proportions in developed countries. Sedentary screen-based activities such as video gaming are thought to displace active behaviors and are independently associated with obesity. Active video games, where players physically interact with images onscreen, may have utility as a novel intervention to increase physical activity and improve body composition in children. The aim of the Electronic Games to Aid Motivation to Exercise (eGAME) study is to determine the effects of an active video game intervention over 6 months on: body mass index (BMI), percent body fat, waist circumference, cardio-respiratory fitness, and physical activity levels in overweight children. METHODS/DESIGN Three hundred and thirty participants aged 10-14 years will be randomized to receive either an active video game upgrade package or to a control group (no intervention). DISCUSSION An overview of the eGAME study is presented, providing an example of a large, pragmatic randomized controlled trial in a community setting. Reflection is offered on key issues encountered during the course of the study. In particular, investigation into the feasibility of the proposed intervention, as well as robust testing of proposed study procedures is a critical step prior to implementation of a large-scale trial.