Has the fear of being unable to exercise for a longer duration prevented you from working out and being active? Just 15-20 minutes of exercise or exercising just 2-3 days a week feels worthless or not worth trying? Let’s see what the data says while discussing the methodology of the papers to unveil the intervention followed.
In this study, 20 male patients 70 years old were included with CHF as a result of dilated cardiomyopathy or ischemic heart disease. All patients had clinical, radiologic, and echocardiographic signs of CHF and a left ventricular ejection fraction of 40% ( normal value: 50-70%).
The initial phase of the exercise program was performed on an in-patient basis. Patients exercised four to six times daily for 10 min on a bicycle ergometer during the first two weeks. Upon discharge, patients were given bicycle ergometers for daily home exercise training. They were asked to exercise close to their target heart rate daily for just 20 min per day. In addition, they were expected to participate in one group training session (walking, calisthenics, and non-competitive ball games) of 60 min each week.
Patients assigned to the control group continued their sedentary lifestyle and remained on their individually tailored cardiac medication supervised by their private physicians. Results indicate that long-term aerobic endurance training in CHF patients has anti-inflammatory effects on the skeletal muscle. The reduction of local cytokine expression by exercise may represent a potential anti-catabolic intervention in CHF.
The authors of the paper conclude, “The present study confirms that training interventions do not only reverse changes associated with disuse but may interfere with the inflammation-induced CHF myopathy, that may in the long run result in muscle catabolism, wasting, and cardiac cachexia. Thus, regular exercise in CHF patients should be considered not only as a symptomatic intervention aimed at maintaining exercise capacity but also as a therapeutic strategy with local anti-inflammatory effects,” showing that some exercise is better than none.
Another hindrance to movement that arises is, “Is it too late to start now?”
In this study, Twenty-four elderly (85 years or older that met Fried's criteria for frailty, which was determined by the presence of three or more of the following components: slowness, weakness, weight loss, exhaustion, and low physical activity) were randomized into intervention or control group.
Participants underwent a twice-weekly, 12-week multicomponent exercise program that lasted for approx 40 mins composed of upper and lower body resistance training with progressively increased loads that optimized the muscle power output in this population (8–10 repetitions, 40–60 % of 1RM) using resistance variable machines combined with balance and gait retraining exercises that progressed in difficulty (semi-tandem foot standing, line walking, stepping practice, walking with small obstacles, altering the base of support and weight transfer from one leg to the other) and functional exercises, such as rises from a chair. A minimum of 2 days elapsed between consecutive training sessions. The resistance exercises focused on the major upper and lower limb muscles. Each resistance training session included (just) two exercises for the leg extensor muscles and (just) one exercise for the upper limbs.
Subjects in the control group performed mobility exercises 30 minutes per day,
4 days per week, which consisted of small active and passive movements applied as a series of stretches in a rhythmic fashion to the individual joints.
The result of the study showed enhancements in the functional outcomes (i.e., TUG, rise from a chair, changes in BI, and balance) and a reduction in the incidence of falls in the elderly participants after 12 weeks of multicomponent exercise.
Surprisingly, not only can exercise be beneficial when done for a short period (40 minutes, twice a week, here) but it’s also better to act smart than hard with an exercise plan that delivers desired outcomes.
Furthermore, more is not always better depending on the goal (this is in no way a message to discourage you if you are quite active, only an optimistic statement to get you started!). Though the recommended amount of physical activity as advised by WHO is 150-300 minutes of moderate physical activity or 75-150 mins of vigorous physical activity or a combination of both per week, recent studies show that vigorous physical activity as little as 15-20 mins/week can also have significant benefits.
The authors of the study state, “We observed a consistent non-linear inverse association between VPA and all-cause and cancer mortality and a linear dose-response association for CVD mortality.”
In simpler terms, the researchers found that when it comes to the risk of dying from any cause or cancer, doing more vigorous physical activity lowered the risk, but the decrease wasn't always the same for every additional minute or hour of exercise. However, when it came to dying from cardiovascular disease, the risk went down steadily with each additional unit of vigorous physical activity.
Lastly, let’s talk about the elephant in the room, what is considered as “vigorous” physical activity?
Vigorous physical activity sounds daunting but just refers to exercise that requires a significant amount of effort and noticeably increases your heart rate. This can include activities like walking at a fast pace, walking uphill, cycling, HIIT workouts, climbing stairs at a relatively faster pace, playing any sport, jumping a rope, etc.
To quantify vigorous physical activity, researchers often use standardized measures such as METs (metabolic equivalents) or scales like Borg’s rate of perceived exertion. METs are a way of expressing the energy cost of physical activities relative to resting metabolism. For example, running at 6 miles per hour has a MET value of around 9, indicating that it requires nine times as much energy as sitting quietly. A MET of 6-9 above is considered to be vigorous or can be explained as an intensity that cannot be maintained without compromising speech and conversation which would be relative and can vary depending on the person, their age, previous activity levels, etc.
To sum it up, just get moving, start with whatever you can, be it good old walking, taking a slightly longer route to work, skipping the lift, working out just on the weekends, or doing something you enjoy like dancing. Everything counts!
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