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The Prescription of Exercise to Improve Cardiovascular Health

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 18570

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Special Issue Editor

Dr. Brett Gordon

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Guest Editor

Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo 3550, Australia
Interests: exercise; exercise dosing; cardiometabolic health; resistance training

Special Issue Information

Dear Colleagues,

Exercise is medicine, and a critical component of the prevention and treatment of cardiometabolic diseases. However, cardiovascular conditions continue to affect large proportions of the global population, and prescription of the medicine known as exercise is far from being optimised. Within the changing physical environment and economic landscape, it is more important than ever to improve the cardiovascular health of communities and reduce the individual and societal cost of cardiometabolic diseases.

This Special Issue focuses on how exercise is associated with and can be used and prescribed to improve cardiovascular health. The minimum clinically effective dose of exercise is an important topic for exploration to discover more knowledge around typical components of exercise such as frequency, intensity, time, and type, but also how these components, individually and as a whole, interact with other interventions.

To further understand how exercise can be prescribed to improve cardiovascular health, we invite all researchers within the broad fields of exercise physiology and health to submit original manuscripts in the form of systematic reviews, meta-analysis, observational trials, randomised controlled trials, clinical trials, or health economy analyses for consideration.

Dr. Brett Gordon
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Exercise
Health
Cardiac
Metabolic
Cardiorespiratory fitness
Artery
Blood pressure
Obesity

Published Papers (6 papers)

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Research

Jump to: Review

13 pages, 1339 KiB

Open AccessArticle

Co-Production at Work: The Process of Breaking Up Sitting Time to Improve Cardiovascular Health. A Pilot Study

by Thomas D. Griffiths, Diane Crone, Mike Stembridge and Rachel N. Lord

Int. J. Environ. Res. Public Health 2022, 19(1), 361; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010361 - 30 Dec 2021

Cited by 1 | Viewed by 2108

Abstract

Prolonged sitting negatively affects several cardiovascular disease biomarkers. Current workplace physical activity interventions to reduce sitting result in inconsistent uptake and adherence rates. Co-production attempts to improve the translation of evidence to practice through engaging the participants within the intervention design, improving the context sensitivity and acceptability of the intervention. A needs analysis questionnaire was initially conducted (n = 157) to scope workplace behaviours and attitudes. A development group (n = 11) was consulted in focus groups around the needs analysis findings and asked to comment on the feasibility of a proposed intervention. A pilot intervention was then carried out (n = 5). The needs analysis indicated that only 1.8% (n = 4) engaged in occupational physical activity, and 68.7% (n = 103) sat for ≥6 h during their working day. Through the focus groups, an intervention breaking up sitting time hourly with five-minute walking breaks was co-produced. Cultural and pragmatic issues concerning the implementation of frequent physical activity breaks from sitting and the subsequent impact on work productivity were highlighted. The pilot intervention increased the number of breaks from sedentary behaviour from 2 to 11. The co-production methodology resulted in a research- and stakeholder-guided compromise. Large-scale intervention implementation is required before firm effectiveness conclusions can be made. Full article

(This article belongs to the Special Issue The Prescription of Exercise to Improve Cardiovascular Health)

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15 pages, 912 KiB

Open AccessArticle

Is the Clinical Delivery of Cardiac Rehabilitation in an Australian Setting Associated with Changes in Physical Capacity and Cardiovascular Risk and Are Any Changes Maintained for 12 Months?

by Kym Joanne Price, Brett Ashley Gordon, Stephen Richard Bird and Amanda Clare Benson

Int. J. Environ. Res. Public Health 2021, 18(17), 8950; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18178950 - 25 Aug 2021

Cited by 2 | Viewed by 2015

Abstract

Long-term maintenance of changes in cardiovascular risk factors and physical capacity once patients leave the supervised program environment have not previously been reported. This study investigated the changes in physical capacity outcomes and cardiovascular risk factors in an Australian cardiac rehabilitation setting, and the maintenance of changes in these outcomes in the 12 months following cardiac rehabilitation attendance. Improvements in mean (95% CI) cardiorespiratory fitness (16.4% (13.2–19.6%), p < 0.001) and handgrip strength (8.0% (5.4–10.6%), p < 0.001) were observed over the course of the cardiac rehabilitation program, and these improvements were maintained in the 12 months following completion. Waist circumference (p = 0.003) and high-density lipoprotein cholesterol (p < 0.001) were the only traditional cardiovascular risk factors to improve during the cardiac rehabilitation program. Vigorous-intensity aerobic exercise was associated with significantly greater improvements in cardiorespiratory fitness, Framingham risk score, and waist circumference in comparison to moderate-intensity exercise. An increase in the intensity of the exercise prescribed during cardiac rehabilitation in Australia is recommended to induce larger improvements in physical capacity outcomes and cardiovascular risk. A standardized exercise test at the beginning of the rehabilitation program is recommended to facilitate appropriate prescription of exercise intensity. Full article

(This article belongs to the Special Issue The Prescription of Exercise to Improve Cardiovascular Health)

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11 pages, 789 KiB

Open AccessArticle

Effects of Cardiopulmonary Rehabilitation on the Muscle Function of Children with Congenital Heart Disease: A Prospective Cohort Study

by Francisco José Ferrer-Sargues, Esteban Peiró-Molina, Maria Àngels Cebrià i Iranzo, José Ignacio Carrasco Moreno, Ana Cano-Sánchez, María Isabel Vázquez-Arce, Beatriz Insa Albert and Pablo Salvador-Coloma

Int. J. Environ. Res. Public Health 2021, 18(11), 5870; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115870 - 30 May 2021

Cited by 9 | Viewed by 3183

Abstract

Critical medical and surgical advances have led to a shift in the care and management of children with congenital heart disease (CHD). These patients present with muscle deconditioning, which negatively influences their response to exercise, functional capacities, and quality of life. This study evaluates the influence of a cardiopulmonary rehabilitation program (CPRP) on the function of peripheral musculature of children with CHD. A single-center prospective cohort study was designed. Fifteen CHD subjects, between 12 and 16 years of age, with reduced aerobic capacity on a cardiopulmonary exercise test, were included in a three-month, 24-session CPRP. Measurements of the subjects’ handgrip strength, biceps brachii and quadriceps femoris strength, and triceps surae fatigue process were collected at the beginning of the program, after completion, and six months after the end of the intervention. A substantial and statistically significant improvement was observed in the subjects’ handgrip strength (kg) (p < 0.001), biceps brachii and quadriceps femoris strength (N) (p < 0.001), as well as triceps surae fatigue process (repetitions) (p = 0.018), with a maintenance of the results six months after the intervention. These results suggest that a CPRP could potentially improve the peripheral muscle function of children with CHD. Additional research is needed to confirm and expand on this hypothesis. Full article

(This article belongs to the Special Issue The Prescription of Exercise to Improve Cardiovascular Health)

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14 pages, 3156 KiB

Open AccessArticle

Evaluating Exercise Progression in an Australian Cardiac Rehabilitation Program: Should Cardiac Intervention, Age, or Physical Capacity Be Considered?

by Kym Joanne Price, Brett Ashley Gordon, Stephen Richard Bird and Amanda Clare Benson

Int. J. Environ. Res. Public Health 2021, 18(11), 5826; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115826 - 28 May 2021

Cited by 2 | Viewed by 2533

Abstract

Progression of prescribed exercise is important to facilitate attainment of optimal physical capacity during cardiac rehabilitation. However, it is not clear how often exercise is progressed or to what extent. This study evaluated whether exercise progression during clinical cardiac rehabilitation was different between cardiovascular treatment, age, or initial physical capacity. The prescribed exercise of sixty patients who completed 12 sessions of outpatient cardiac rehabilitation at a major Australian metropolitan hospital was evaluated. The prescribed aerobic exercise dose was progressed using intensity rather than duration, while repetitions and weight lifted were utilised to progress resistance training dose. Cardiovascular treatment or age did not influence exercise progression, while initial physical capacity and strength did. Aerobic exercise intensity relative to initial physical capacity was progressed from the first session to the last session for those with high (from mean (95%CI) 44.6% (42.2–47.0) to 68.3% (63.5–73.1); p < 0.001) and moderate physical capacity at admission (from 53.0% (50.7–55.3) to 76.3% (71.2–81.4); p < 0.001), but not in those with low physical capacity (from 67.3% (63.7–70.9) to 85.0% (73.7–96.2); p = 0.336). The initial prescription for those with low physical capacity was proportionately higher than for those with high capacity (p < 0.001). Exercise testing should be recommended in guidelines to facilitate appropriate exercise prescription and progression. Full article

(This article belongs to the Special Issue The Prescription of Exercise to Improve Cardiovascular Health)

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11 pages, 1593 KiB

Open AccessArticle

A Comparison of the Gluco-Regulatory Responses to High-Intensity Interval Exercise and Resistance Exercise

by Brett A. Gordon, Caroline J. Taylor, Jarrod E. Church and Stephen D. Cousins

Int. J. Environ. Res. Public Health 2021, 18(1), 287; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010287 - 02 Jan 2021

Cited by 3 | Viewed by 3267

Abstract

High-intensity interval exercise and resistance exercise both effectively lower blood glucose; however, it is not clear whether different regulatory mechanisms exist. This randomised cross-over study compared the acute gluco-regulatory and the physiological responses of high-intensity interval exercise and resistance exercise. Sixteen (eight males and eight females) recreationally active individuals, aged (mean ± SD) 22 ± 7 years, participated with a seven-day period between interventions. The high-intensity interval exercise trial consisted of twelve, 30 s cycling intervals at 80% of peak power capacity and 90 s active recovery. The resistance exercise trial consisted of four sets of 10 repetitions for three lower-limb exercises at 80% 1-RM, matched for duration of high-intensity interval exercise. Exercise was performed after an overnight fast, with blood samples collected every 30 min, for two hours after exercise. There was a significant interaction between time and intervention for glucose (p = 0.02), which was, on average (mean ± SD), 0.7 ± 0.7 mmol∙L⁻¹ higher following high-intensity interval exercise, as compared to resistance exercise. Cortisol concentration over time was affected by intervention (p = 0.03), with cortisol 70 ± 103 ng∙mL⁻¹ higher (p = 0.015), on average, following high-intensity interval exercise. Resistance exercise did not induce the acute rise in glucose that was induced by high-intensity interval exercise and appears to be an appropriate alternative to positively regulate blood glucose. Full article

(This article belongs to the Special Issue The Prescription of Exercise to Improve Cardiovascular Health)

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Review

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14 pages, 3253 KiB

Open AccessReview

The Identification and Management of High Blood Pressure Using Exercise Blood Pressure: Current Evidence and Practical Guidance

by Martin G. Schultz, Katharine D. Currie, Kristofer Hedman, Rachel E. Climie, Andrew Maiorana, Jeff S. Coombes and James E. Sharman

Int. J. Environ. Res. Public Health 2022, 19(5), 2819; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19052819 - 28 Feb 2022

Cited by 4 | Viewed by 4159

Abstract

High blood pressure (BP) is a leading risk factor for cardiovascular disease (CVD). The identification of high BP is conventionally based on in-clinic (resting) BP measures, performed within primary health care settings. However, many cases of high BP go unrecognised or remain inadequately controlled. Thus, there is a need for complementary settings and methods for BP assessment to identify and control high BP more effectively. Exaggerated exercise BP is associated with increased CVD risk and may be a medium to improve identification and control of high BP because it is suggestive of high BP gone undetected on the basis of standard in-clinic BP measures at rest. This paper provides the evidence to support a pathway to aid identification and control of high BP in clinical exercise settings via the measurement of exercise BP. It is recommended that exercise professionals conducting exercise testing should measure BP at a fixed submaximal exercise workload at moderate intensity (e.g., ~70% age-predicted heart rate maximum, stage 1–2 of a standard Bruce treadmill protocol). If exercise systolic BP is raised (≥170 mmHg), uncontrolled high BP should be assumed and should trigger correspondence with a primary care physician to encourage follow-up care to ascertain true BP control (i.e., home, or ambulatory BP) alongside a hypertension-guided exercise and lifestyle intervention to lower CVD risk related to high BP. Full article

(This article belongs to the Special Issue The Prescription of Exercise to Improve Cardiovascular Health)

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