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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 "Exercise and Health".

Deadline for manuscript submissions: closed (15 June 2022) | Viewed by 21417

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Special Issue Editor

Dr. Stig Molsted

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1. Research Department, Nordsjællands Hospital, 3400 Hillerød, Denmark
2. Department of Clinical Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
Interests: exercise training; physical activity; diabetes; chronic kidney disease
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Special Issue Information

Dear Colleagues,

Physical activity is recognized as crucial in the prevention of chronic diseases including type 2 diabetes, heart diseases, and some cancers. In addition, it is also absolutely relevant as a rehabilitation strategy for the treatment of certain diseases, including acute conditions such as hip fracture. Decades of research have proven the positive effects of exercise training on physiological parameters in patients affected by various pathologies. Exercise training has also positive effects on physical function/performance, quality of life, pain, and mental health—parameters that are often impaired in patients with chronic diseases. In this context, exercise training can benefit patients indirectly by its positive effects on comorbidities and some patient’s outcomes, rather than on the primary disease, as it is observed for patients with type 1 diabetes, chronic obstructive pulmonary disease, arthritis, and chronic kidney disease.

Whilst aerobic training has great potential to positively impact several disease parameters, strength training can have positive effects on some disease outcomes. Some individuals may find it easier to perform resistance training compared to aerobic training, as the former does not increase the heart rate and can be carried out while seated. Though there is good evidence of the benefits of aerobic and resistance training in the treatment of many diseases, further investigation is necessary. In particular, it is important to understand 1) how to create attractive exercise training interventions to involve as many patients as possible and 2) how to improve adherence to exercise training interventions so to induce long-term changes in patients’ lifestyle. This Special Issue welcomes papers that present new research on physiological and/or patient-reported outcomes related to rehabilitation, especially studies that are based on clinically relevant interventions.

Dr. Stig Molsted
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 training
rehabilitation
aerobic training
strength training
chronic disease
acute disease
clinical trial
systematic review

Related Special Issue

2nd Edition of Exercise Training and Patients' Rehabilitation in International Journal of Environmental Research and Public Health (5 articles)

Published Papers (6 papers)

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Research

9 pages, 317 KiB

Open AccessArticle

Motives and Barriers to Exercise Training during Hospitalization in Patients with Type 2 Diabetes: A Cross-Sectional Study

by Stig Molsted, Lasse Kusk, Søren Mingon Esbensen, Thomas Martin Mohr, Malene Bang Vind, Camilla Hess, Thomas Bandholm, Morten Tange Kristensen, Cornelie Mølsted Flege and Peter Lommer Kristensen

Int. J. Environ. Res. Public Health 2022, 19(3), 1035; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031035 - 18 Jan 2022

Cited by 1 | Viewed by 1532

Abstract

Background: Exercise training during hospitalization may prevent loss of physical function and hyperglycemia in patients with type 2 diabetes. The aim of this study was to assess motives and barriers to exercise training in hospitalized patients with type 2 diabetes. Methods: Data were collected using a questionnaire about motives and barriers to exercise training during hospitalization. Additional data for clinical characteristics of the participants were collected from patient records. Results: 79 patients participated (mean ± SD age 72 ± 12 years; 42% women), of whom 25% had a low level of education and 46% lived alone. The median (IQR) length of the stay was 6 (4–10) days. A total of 67% of the participants wished to be more physically active. Walking as exercise was preferred by 51%. The most frequently reported barriers to exercise training were bodily pain (48%) and dizziness (42%). Low vs. high level of education, and living alone vs. being married/living with a partner were associated with reduced odds of a wish to be more physically active, odds ratio (OR) 0.15 [95% CI 0.03; 0.76], p = 0.022, and 0.21 [0.05; 0.82], p = 0.025, respectively. Conclusion: Two out of three hospitalized patients with type 2 diabetes wished to be more physically active during admission. Bodily pain was a barrier to exercise training and needs attention in training programs. As a low level of education was associated with reduced odds of a wish to be more active, a strategy to include all patients in training programs which considers social inequality is needed. Full article

(This article belongs to the Special Issue Exercise Training and Patients' Rehabilitation)

12 pages, 348 KiB

Open AccessArticle

Motivation, Barriers, and Suggestions for Intradialytic Exercise—A Qualitative Study among Patients and Nurses

by Pernille Maria Wodskou, Sasha Maria Reinhardt, Marie Borring Andersen, Stig Molsted and Lone Helle Schou

Int. J. Environ. Res. Public Health 2021, 18(19), 10494; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910494 - 06 Oct 2021

Cited by 6 | Viewed by 2566

Abstract

Background: Intradialytic exercise is an effective intervention to reduce morbidity and mortality and increase quality of life among patients with chronic kidney disease undergoing dialysis. However, implementing and sustaining it in clinical practice has proved challenging. To identify how to best design an effective and sustainable intervention in clinical practice, we aimed to explore hemodialysis patients’ and nurses’ attitudes towards intradialytic exercise, including their motivation, anticipated barriers, and suggestions for the design of a proposed exercise program. Methods: Data were collected through qualitative semistructured interviews with patients and focus group interviews with nurses and analyzed inductively with content analysis. Results: Overall, patients’ and nurses’ attitudes towards intradialytic exercise were positive. Patients were motivated by their expectations about perceived benefits, such as improved quality of life and reduced musculoskeletal pain. Their main concern was triggering dialysis machine alarms and disturbing nurses. Nurses were more skeptical of intradialytic exercise and concerned about patient safety. Patients and nurses had several ideas on how to design a safe and motivating intradialytic exercise intervention. Conclusion: The analysis of patients’ and nurses’ experiences and attitudes generated recommendations for an intradialytic exercise program. Recommendations include individually tailored programs that are safe and that patients can do independently, continuous collaboration between patients, nurses, physicians, and physiotherapists, and educating nurses about the benefits and safety of intradialytic exercise. Full article

(This article belongs to the Special Issue Exercise Training and Patients' Rehabilitation)

13 pages, 2103 KiB

Open AccessArticle

Scapular Retraction under Adduction Load: An Alternative to Overhead Exercises to Activate Infraspinatus, Upper, and Lower Trapezius in Subjects with and without Shoulder Pain

by Jefferson James dos Santos, Rebeca Orozco Nagy, Matheus Almeida Souza, Leonardo Intelangelo, Michelle Almeida Barbosa, Gabriela Silveira-Nunes and Alexandre Carvalho Barbosa

Int. J. Environ. Res. Public Health 2021, 18(17), 9251; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179251 - 02 Sep 2021

Cited by 2 | Viewed by 2814

Abstract

Exercises for lower trapezius (LT) often use overhead positions, causing compressive forces to the subacromial space. Scapular retraction would be an alternative to activate LT muscle. The present study aimed to assess the excitation levels of infraspinatus, upper trapezius, and lower trapezius muscles during a scapular retraction exercise under progressive adduction loads in subjects with and without painful shoulder. Electromyography of infraspinatus (IS), upper trapezius (UT), and LT was recorded during scapular retraction under progressive adduction loads of 42 participants, divided into two groups: with (SP, n = 26) and without shoulder pain (nSP, n = 16). The adduction loads of 20%, 30%, 40%, and 50% of the maximal voluntary contraction (MVC) were applied using a load cell. Normalized electromyography and the ratio between UT and LT (UT:LT) were used for statistical analysis. No differences were observed between groups, but a condition effect occurred for all muscles: UT showed higher values at 50% vs. 20% of MVC (p = 0.004); LT showed higher values on 40% and 50% of MVC (p = 0.001; 0.006). Higher values for IS were noted at 40% of MVC (vs. 20% of MVC; p = 0.04) and at 50% of MVC (vs. 20% of MVC; p = 0.001, vs. 30% of MVC, p = 0.001; vs. 40% of MVC; p = 0.001). UT:LT showed lower values at 50% of MVC (vs. 20% of MVC; p = 0.001 and vs. 30% of MVC; p = 0.016). Scapular retraction with adduction loads at 40–50% is an alternative to overhead exercises aiming to activate the LT and the IS muscles. The exercise ensures higher levels of LT and IS excitation without increasing UT excitation. Full article

(This article belongs to the Special Issue Exercise Training and Patients' Rehabilitation)

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10 pages, 365 KiB

Open AccessArticle

Sex Difference in the Association between Physical Activity and All-Cause Mortality in Ambulatory Patients with Chronic Kidney Disease

by Stig Molsted, Inge Eidemak and Mette Aadahl

Int. J. Environ. Res. Public Health 2021, 18(7), 3698; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073698 - 01 Apr 2021

Cited by 4 | Viewed by 2158

Abstract

(1) Background: The purpose of this article was to investigate the association between self-reported physical activity (PA) and all-cause mortality in ambulatory patients with chronic kidney disease (CKD), stage 4–5 including maintenance dialysis. (2) Methods: Ambulatory patients with CKD (eGFR < 30 mL/min/1.73 m²) with conservative treatment or chronic dialysis were included. PA was assessed using the Saltin–Grimby Physical Activity Level Scale. A Cox proportional hazards regression model––adjusted for age, sex, plasma–albumin, body mass index, socioeconomic status, and treatment––was applied. (3) Results: Participants (n = 374) were followed 39 ± 15 months from entry to death or censoring. Throughout the study period of 39 months, 156 deaths (42%) were registered. Regarding physical activity, 128 (34%) of the participants were inactive, 212 (57%) were moderately active, and 34 (9%) were highly or vigorously active. Moderate PA was associated with a decreased mortality risk in women (n = 150) compared to inactivity (HR 0.27 (0.15; 0.51), p < 0.001), whereas a high/vigorous level of PA was not significantly associated with mortality risk compared to inactivity. In men (n = 224), the associations between PA levels and mortality risk were not significant. (4) Conclusions: Moderate PA was associated with reduced all-cause mortality in ambulatory women with stage 4–5 CKD with or without maintenance dialysis treatment. Physical activity was not significantly associated with mortality in men. Full article

(This article belongs to the Special Issue Exercise Training and Patients' Rehabilitation)

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9 pages, 705 KiB

Open AccessArticle

Effect of Core Stabilizing Training on Young Individuals Presenting Different Stages of Degenerative Disc Disease—Preliminary Report

by Tomasz Kuligowski, Błażej Cieślik, Natalia Kuciel, Agnieszka Dębiec-Bąk and Anna Skrzek

Int. J. Environ. Res. Public Health 2021, 18(7), 3499; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073499 - 28 Mar 2021

Cited by 4 | Viewed by 3400

Abstract

The aim of this study was to assess the efficacy of stabilizing training for the deep core muscles of the lumbar spine in subjects with degenerative disc disease. This study was conducted on 38 participants. The participants were divided into two groups: the extrusion group (EXT, n = 17) and the protrusion group (PRO, n = 21). All the subjects underwent a four-week-long core stability exercise-based treatment (five sessions/week). Clinical outcome measures were assessed pre-intervention (pre), post-intervention (post) and four weeks after the intervention (follow-up). The primary outcome measures were the spinal range of motion (ROM; Spinal Mouse^® device) and the Oswestry Disability Index (ODI). In the PRO group, the ROM decreased from 88.52° pre-intervention to 83.33° post-intervention and to 82.82° at follow-up (p = 0.01), while the ODI decreased from 16.14 points pre-intervention to 6.57 points post-intervention, with 9.42 points at follow-up (p < 0.01). In the EXT group, the ROM decreased from 81.00° pre-intervention to 77.05° post-intervention, then increased to 77.94° at follow-up (p = 0.03), while the ODI decreased from 22.58 points pre-intervention to 15.41 points post-intervention and to 14.70 points at follow-up (p < 0.001). Although the stabilizing exercise sessions improved the clinical outcomes in each group, we cannot make conclusions as to whether the type of intervertebral disc damage significantly affects the results of stabilizing exercise-based treatment. Full article

(This article belongs to the Special Issue Exercise Training and Patients' Rehabilitation)

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11 pages, 1630 KiB

Open AccessArticle

Effect of 4 Weeks of Cervical Deep Muscle Flexion Exercise on Headache and Sleep Disorder in Patients with Tension Headache and Forward Head Posture

by Wonho Choi

Int. J. Environ. Res. Public Health 2021, 18(7), 3410; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18073410 - 25 Mar 2021

Cited by 7 | Viewed by 8137

Abstract

The purpose of this study was to investigate the effect of flexion exercise of the deep cervical muscles on headache and sleep disorders in patients with tension headaches and forward head posture. A total of 32 patients with tension headaches and forward head posture were randomly assigned to two groups: an experimental group (n = 16) and a control group (n = 16). The experimental group performed cervical deep muscle flexion exercises for 4 weeks, whereas the control group performed stretching exercises for the same period. The Henry Ford Hospital Headache Disability Inventory (HDI) was used for headache assessment, and the Korean version of the Pittsburgh Sleep Quality Index (PSQI-K) was used for sleep disorder assessment. The experimental group showed a significant reduction in both HDI and PSQI-K score after 4 weeks of intervention (p < 0.001), while no significant difference was found in the control group (p > 0.05). On comparing the experimental and control groups, we found a significant difference in changes in the HDI and PSQI-K between the groups (p < 0.05). The results indicate that flexion exercise of the deep cervical muscles in patients with tension headache and forward head posture will improve the quality of life and activities of daily life by mitigating headaches and sleep disorders. Full article

(This article belongs to the Special Issue Exercise Training and Patients' Rehabilitation)

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