1.
Cardiovascular phenotyping for personalized lifestyle treatments of chronic abdominal pain in Irritable Bowel Syndrome: A randomized pilot study.
Davydov, DM, Shahabi, L, Naliboff, B
Neurogastroenterology and motility. 2019;(12):e13710
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Abstract
BACKGROUND Different physical exercise interventions for pain and other related symptoms largely follow non-personalized guidelines and show a high degree of variability in outcome. These interventions are considered to have different pathways toward improvement in autonomic regulation of energy metabolism. The current pilot study was conducted to assess the predictive value of individual cardiovascular (CV) activity markers at rest to predict clinical outcomes for two popular exercise-based interventions (walking and yoga) in patients with Irritable Bowel Syndrome (IBS). METHODS Twenty-seven adult participants with IBS were randomly assigned to a 16-biweekly Iyengar yoga or walking program. They completed pre- and post-treatment assessments on IBS symptom severity, affective and somatic complaints, and various measures of resting autonomic function including blood pressure (BP), heart rate and its variability, baroreceptor sensitivity (BRS) to activations and inhibitions with gains of brady- and tachycardiac baro-responses, and BP start points for these spontaneous baroreflexes. RESULTS Pretreatment BRS was differentially related to clinical response for the treatment groups. Specifically, a significant decrease in pain severity was found in response to yoga for those participants who had lower resting BRS to activations, but decreased pain severity was associated with higher resting BRS for those in the walking group. The effect was not related to affective symptom relief. Other CV measures showed similar associations with clinical outcomes for both groups. CONCLUSIONS The data suggest therefore that CV based phenotypes may be useful in personalizing clinical interventions for IBS. They may also point to autonomic mechanisms that are targets for such interventions.
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[Effectiveness of two aerobic exercise programs in the treatment of metabolic syndrome: a preliminary study].
Salas-Romero, R, Sánchez-Muñoz, V, Franco-Sánchez, JG, Del Villar-Morales, A, Pegueros-Pérez, A
Gaceta medica de Mexico. 2014;(6):490-8
Abstract
The effectiveness of two aerobic exercise programs on the modification of the metabolic syndrome (MS) components and its influence in reducing cardiovascular risk was evaluated in 16 sedentary women (30-66 years old). Patients were randomly divided into two exercise groups: continuous training (CE: 45 minutes at 65-70% of heart rate reserve or HRR) or interval training (IE: 5 x 3 minute intervals at 80-85% HRR with two minutes of active recovery at 65-70% HRR), and each participant gave previous informed consent. The components of MS were assessed according to the criteria for women of the National Cholesterol Education/Third Treatment Adult Panel, and cardiovascular risk factors at baseline and 16 weeks later. Data analyses were performed with the Wilcoxon signed test and the Mann-Whitney U-test (SPSS v. 12.0 Windows: p < 0.05). Both exercise programs were effective in the modification of a number of MS components (triglycerides, systolic/diastolic blood pressure), however IE had a higher percentage of patients without MS diagnosis at the end of the study (62.5%). The CE improved the physical fitness by increasing the VO₂peak and METs and decreasing heart rate recovery, which is reflected on the reduction of cardiovascular risk.