Background: Sleep disturbances are common in pregnancy and have negative implications for the health of the mother and offspring. We aimed to test the effect of prenatal exercise on sleep quantity and quality. Methods: This study was a retrospective, secondary analysis of pooled data from 2 blinded, prospective, randomized controlled trials (control n = 15; exercise n = 71). Sleep quality and quantity were assessed via self-report at 16 (baseline) and 36 weeks’ gestation in women assigned to exercise (aerobic, resistance, or combination) or an attention-control group. Sleep metrics were compared between exercise and control groups using independent-samples t tests. Tests for exercise mode and sleep characteristics were completed using mixed models, and the influence of exercise dose on sleep was assessed via Pearson correlations and independent-samples t tests. Results: Women exercised for an average of 21.8 weeks during pregnancy (range = 13–28 weeks). Exercising women slept 15–30 min longer per night than controls at 16 weeks’ ( P = 0.049) but not 36 weeks’ gestation (control 7.27 h, exercise 7.52 h; P = 0.26). Whereas the aerobic and resistance exercise groups showed an increased probability of reporting good sleep quality at 36 weeks ( P < .05), combination exercisers had no decrease in sleep quantity compared with decreases in the other groups ( P = 0.19). Conclusion: Whereas exercise benefits sleep quantity during pregnancy, our results show an exercise mode–dependent influence on sleep quantity and quality at 36 weeks’ gestation.
Background: Heart failure with preserved ejection fraction (HFpEF) is a progressive condition associated with high hospitalization and mortality rates. Exercise intolerance, chronotropic incompetence, elevated resting heart rate, and diastolic dysfunction are key prognostic markers. This systematic review and meta-analysis evaluated the effects of pharmaceutical and physical therapies on exercise capacity, chronotropic response, and left ventricular filling pressure (LVFP) in individuals with HFpEF. Methods: We conducted a systematic search of PubMed, Medline, the Clinical Trials Register, and Cochrane Central from inception to June 8, 2024. We included randomized controlled trials (RCTs) involving adults with HFpEF that reported peak oxygen consumption (VO 2 peak) as the primary outcome, with secondary outcomes including resting and peak heart rate and rest E/e′. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool for pharmaceutical studies and the Tool for the Assessment of Study Quality and Reporting in Exercise scale for physical therapy studies. Data were synthesized using a random-effects model in Review Manager 5.4.1. Results: Twenty-one studies (N = 2,491 participants) met inclusion criteria; 14 were included in the meta-analysis (pharmaceutical [n = 10], physical [n = 4]). Physical therapy significantly improved VO 2 peak (mean difference [MD] 2.33 mL·kg −1 ·min −1 ; 95% confidence interval [95% CI], 1.71–2.95 mL·kg −1 ·min −1 ; P < 0.00001; I 2 = 0%) and increased peak heart rate [HR] (MD, 9.78 b·min −1 ; 95% CI, 3.93–15.63 b·min −1 ; P = 0.001; I 2 = 39%). Pharmaceutical therapies showed no significant pooled effects overall. Subgroup analyses showed β-blockers and phosphodiesterase inhibitors reduced peak HR; mineralocorticoid receptor antagonists increased peak HR and reduced rest E/e′. The evidence base is limited by small sample sizes and heterogeneity across interventions and study populations. Sparse data prevented broader comparisons. Conclusion: Current evidence suggests that exercise-based physical therapies may improve exercise capacity and chronotropic response in HFpEF, and mineralocorticoid receptor antagonists may reduce LVFP. Heart rate–lowering therapies do not appear to impair exercise capacity. However, because of generally low to moderate certainty of evidence, these findings should be interpreted cautiously. Further high-quality, standardized RCTs are needed to confirm these effects and guide clinical practice. Registration: Registered with PROSPERO (CRD42024556709).
Background: Evidence-based, accessible, and cost-effective solutions to address health and social challenges for older adults are urgently required. Social isolation, a key contributor to frailty, multimorbidity, and psychological distress in older adults, underscores the importance of interventions that foster connectivity and engagement. Therefore, this study assessed the impact of a pilot implementation of the codesigned EngAGE Community program aimed to improve social, psychological, and quality-of-life outcomes in community-dwelling older adults. Methods: EngAGE Community was a 15-week telehealth-based group exercise and social engagement program, delivered by student practitioners under professional supervision. EngAGE Community consisted of a 3-week preparation phase and a 12-week delivery phase with 2-h sessions once a week. Results: This pilot study enrolled 73 older adults aged 65 years and older, with 45 participants meeting attendance criteria for analysis. Statistically significant improvements were observed in loneliness (UCLA Loneliness Scale, P = 0.002), social anxiety (Social Anxiety and Phobia Scales, P = 0.007), psychological distress (Kessler-10, P = 0.03), and overall quality of life (SF-12, P = 0.02). Participants provided highly positive feedback, highlighting the program’s accessibility, enjoyment, and perceived lasting impact. The student-led delivery model effectively increased participant contact time while offering meaningful educational experiences for student practitioners. Conclusion: These findings demonstrate the feasibility and potential effectiveness of student-led telehealth interventions in addressing the social and psychological burdens of aging. This pilot study highlights the EngAGE Community program as a scalable and sustainable model for promoting healthy aging, with valuable insights to guide future iterations and broader implementation.
INTRODUCTION: Postmenopausal women are at risk of sarcopenic obesity and metabolic dysfunction. While exercise has been proven to offer benefits to counter these risks, the efficacy of concurrent training (CT) in this population remains unclear. This study investigated the effects of a 10-week supervised CT program incorporating HIIT and resistance exercise training on body composition, muscular strength and glucose regulation in overweight postmenopausal women. METHODS: 12 postmenopausal women (age 58.4 ± 4.5 y; BMI 29.3 ± 2.3 kg/m²) completed a 10-week CT program with a frequency of 2 sessions per week. Sessions included progressive resistance training with 6 exercises targeting major muscle groups with 1-3 reps in reserve followed by stationary cycling with high-intensity interval training (HIIT) (10 x 60s at 70-90% peak power output interspersed with 60s active recovery). Pre- and post-intervention testing included whole body DEXA scans (lean mass, fat mass), 3-repetition maximum (3RM) strength tests (chest press and leg press) and 2-hour oral glucose tolerance test (OGTT). RESULTS: Adherence rate to the training program was 99%. There were significant increases in upper-body strength (51.0% ± 7.1%; p < 0.05) and lower-body strength (97.6% ± 9.7%; p < 0.05). Total lean mass increased significantly by 2.4% ± 0.5% (p < 0.05) while total fat mass did not change significantly (- 0.4% ± 1.2%; p = 0.6). Glucose AUC increased by 12.2% ± 5.1% after the intervention (p < 0.05). CONCLUSION: A 10-week, twice-weekly CT program incorporating HIIT is effective for improving muscular strength and lean mass in overweight postmenopausal women. However, as fat mass and glucose tolerance did not improve, the training program may be insufficient for metabolic changes without dietary changes. These findings support the utility of time-efficient CT as a viable intervention to mitigate menopause-related physiological decline.
A multidisciplinary prehabilitation approach may help to counter the negative physical, psychological and social impacts experienced during an allogeneic hematopoietic stem cell transplant (allo-HSCT) among Acute Myeloid Leukaemia (AML) and Myelodysplastic Syndrome (MDS) patients. This study investigated the feasibility, safety and preliminary efficacy of multidisciplinary prehabilitation in adults offered allo-HSCT. This single-group pilot study recruited patients (≥ 18 years) with AML or MDS scheduled for allo-HSCT between June 2023 and July 2024. The intervention integrated exercise physiology, physiotherapy, dietetics, occupational therapy, psychology, and social work. Feasibility outcomes included uptake, retention, adherence, and acceptability. Safety was evaluated by monitoring adverse events. Preliminary efficacy was assessed across functional (30-s sit-to-stand, grip strength, 2-min step test, Timed Up and Go), nutritional (PG-SGA), and patient-reported outcomes (EORTC QLQ-C30, HADS, NCCN Distress Thermometer). Of 27 patients approached, 19 (70.4%) enrolled; one withdrew due to medical deterioration. Eleven participants completed the full 8 weeks, and seven completed 3–7 weeks before transplant. Adherence was high (79.3%), and acceptability was positive across disciplines. No deaths or serious (grade ≥ 3) adverse events occurred. Four intervention-related adverse events were observed (three mild, one moderate), and 34 sessions were cancelled for safety reasons (haemodynamic abnormalities or cytopenias). Preliminary efficacy analyses showed moderate effect size improvements in lower body strength (sit-to-stand, d = 0.49), mobility (Timed Up and Go, d = 0.63), aerobic capacity (2-min step test, d = 0.60), and nutritional status (PG-SGA, d = 0.41). Small-to-moderate effects were observed for several QOL domains, with improvements in constipation but increases in nausea, dyspnoea, and financial concerns. Based on this study’s favourable safety, feasibility and preliminary efficacy results, future, larger-scale research is warranted to evaluate the efficacy of multidisciplinary prehabilitation more rigorously in this setting. The preliminary efficacy results provided by this study may be helpful to inform sample size calculations.
