Organised exercise programmes are beneficial in the treatment of depression

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Dr David Veale (now Professor) was the psychiatrist working at the Royal Free Hospital, London responsible for this research. Professor Anthony Sargeant and Professor Anthony Mann were the consultants for these studies. The results indicate that many patients with depression benefited from organised programmes of exercise alongside normal treatment protocols.
Journal of The Royal Society of Medicine
J R Soc Med. 1992 Sep;85(9):541-4

Two clinical trials have been conducted in a sample of depressed patients to determine whether the addition of an aerobic exercise programme to their usual treatment improved outcome after 12 weeks. In the first trial, an aerobic exercise group had a superior outcome compared with a control group in terms of trait anxiety and a standard psychiatric interview. A second trial was then conducted to compare an aerobic exercise programme with low intensity exercise.

Both groups showed improvement but there were no significant differences between the groups. In neither trial was there any correlation between the extent of change in the subjects’ physical fitness due to aerobic exercise and the extent of the improvement of psychiatric scores.

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Strength training for athletes and in rehabilitation is very specific

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Professors Anthony J Sargeant and David A Jones were the PhD supervisors respectively for Carolyn A Greig and Olga M Rutherford who both held PhD studentships awarded by the UK Sports Council.
Journal of Sports Sciences
J Sports Sci. 1986 Autumn;4(2):101-7
Olga M Rutherford, Carolyn A Greig, Anthony J Sargeant, David A Jones.

 

The effects of strength training of the quadriceps on peak power output during isokinetic cycling has been investigated in group of 17 young healthy volunteers. Subjects trained by lifting near-maximal loads on a leg extension machine for 12 weeks. Measurements of maximal voluntary isometric force were made at 2-3 week intervals and a continual record was kept of the weights lifted in training.

Peak power output was measured at 110 rev min-1 and at either 70 or 80 rev min-1 before and after the 12 week training period. Measurements of maximum oxygen uptake (VO2max) were made on 12 subjects before and after training. The greatest change was in the weights lifted in training which increased by 160-200%. This was accompanied by a much smaller increase in maximum isometric force (3-20%). There was no significant change in peak power output at either speed. The VO2max remained unchanged with training. The role of task specificity in training is discussed in relation to training regimes for power athletes and for rehabilitation of patients with muscle weakness.

Rehabilitation following Myocardial Infarction

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This research was conducted at the the British Military’s Joint Services Medical Rehabilitation Unit based at Headley Court in Surrey. The work was carried out by Anthony J Sargeant (later Professor) under the clinical supervision of the Director of the Rehabilitation Unit’s Wing Commander Dr MA (Tony) Crawley.
Archives of Physical Medicine and Rehabilitation
Arch Phys Med Rehabil. 1979 Mar;60(3):121-5.

The physiological responses to exercise were studied in 16 men (33-52 years of age), 8–12 weeks after a first uncomplicated myocardial infarction and following a 3–4 week period of attendance at a residential rehabilitation center at which the patients were required to participate in a controlled program of exercise, sport and recreation. Data were also collected on an inactive, but otherwise healthy group of men of the same age and occupational status, and on an occupationally and recreationally active healthy group. The patient group were indistinguishable from the healthy inactive group in their response to submaximal exercise, although both of these groups showed differences when compared with the active group.

Symptom-limited maximal data were also collected and these are reported in relation to the energy requirements of some common leisure, occupational and domestic activities.

Prediction of Maximum Oxygen Uptake in patients with leg injury

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Anthony J Sargeant carried out this research in 1975 at the Joint Services Medical Rehabilitation Unit at Chessington in Surrey. It was aimed at quantifying the aerobic function of the young men undergoing residential rehabilitation following leg fracture. Given the difficulty in some patients of making direct maximal measurements this study sought to look at the reliability of predictions of maximum function based on submaximal measurements (this study formed part of the PhD research of Tony Sargeant who was solely responsible for the collection, analysis of the data, and drafting of the paper for publication).
Archives of Physical Medicine and Rehabilitation. 1975 Aug;56(8):340-5

Procedures for the prediction of one-leg and two-leg maximal aerobic power output (VO2 max) have been examined in a group of 15 young men having had fracture of one leg and consequent immobilization resulting in muscle atrophy. Extrapolation of the submaximal cardiac frequency (FH) and oxygen intake (VO2) responses to an assumed FH amx of 175 in one-leg and 195 in two-leg work resulted in a systematic overestimation of VO2 max. This overestimation could be removed by applying the appropriate regression equations, but the overall accuracy of the extrapolation method was limited to +/- 15% in the case of the injured leg and +/- 8% for either the uninjured leg or both legs combined.

Prediction of VO2 max from leg muscle (plus bone) volume gave the same order of accuracy. However, it was shown that the VO2 max of the injured leg could be predicted with an accuracy of +/- 5%, if the observed VO2 max data of the uninjured leg and two legs were combined and utilized in the following formula: VO2 max (injured leg) = (A X 2) – VO2 max (uninjured leg), where A is the mean one-leg VO2 max predicted from the two-leg VO2 max observed. It was concluded that wherever possible the one-leg and two-leg VO2 max of patients undergoing rehabilitation therapy should be measured directly. If the patient is unable to pedal the bicycle ergometer with his injured leg alone then the VO2 max of this limb may be predicted from leg volume measurements or from the observed uninjured and two-leg VO2 max with an accuracy of approximately 8%.

Muscle weakness in Post Polio Syndrome is due to loss of muscle mass plus reduced activation

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Abstract Quadriceps strength, maximal anatomical cross-sectional area (CSA), maximal voluntary activation (MVA), and maximal relaxation rate (MRR) were studied in 48 subjects with a past history of polio, 26 with and 22 without postpoliomyelitis syndrome (PPS), and in 13 control subjects. It was also investigated whether, apart from CSA, MVA and MRR were determinants of muscle strength. Polio subjects had significantly less strength, CSA, and MRR in the more-affected quadriceps than control subjects.

MVA was reduced in 18 polio subjects and normal in all controls. PPS subjects differed from non-PPS subjects only in that the MVA of the more-affected quadriceps was significantly lower. Both CSA and MVA were found to be associated with muscle strength. Quadriceps strength in polio subjects was dependent not only on muscle mass, but also on the ability to activate the muscles. Since impaired activation was more pronounced in PPS subjects, the new muscle weakness and functional decline in PPS may be due not only to a gradual loss of muscle fibers, but also to an increasing inability to activate the muscles.

Aerobic training improves muscle of renal patients undergoing rehabilitation

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Abstract

BACKGROUND: In the present study we investigated the effect of a 6-month aerobic exercise programme on the morphology of the gastrocnemius muscle of end-stage renal disease (ESRD) patients.

METHODS: Twenty-four ESRD patients volunteered to participate in the training programme and underwent muscle biopsy before training. Eighteen patients completed the training programme of whom nine agreed to a post-training biopsy (one woman and eight men, mean age 56 +/- 15 years).

Data are presented for the nine subjects who were biopsied before (PRE) and after training (POST) and separately for the 15 subjects for whom we only have a biopsy before training (cross-sectional group).

RESULTS: There were no significant differences (P > 0.05) in fibre type distribution or myosin heavy chain (MyHC) expression between the cross-sectional and PRE/POST groups. The mean cross-section fibre area after training (POST) increased by 46% compared with the PRE training status (P < 0.01). The proportion of atrophic fibres decreased significantly after training in type I, IIa and IIx fibre populations (from 51 to 15%, 58 to 21% and 62 to 32%, respectively). Significant differences were also found in capillary contact per fibre (CC/F), with the muscle having 24% (P < 0.05) more CC/F compared with the PRE training status. No significant differences in cytochrome c oxidase concentration were found between the groups.

CONCLUSIONS: In conclusion, exercise appeared to be beneficial in renal rehabilitation by correcting the fibre atrophy, increasing the cross-section fibre area and improving the capillarization in the skeletal muscle of renal failure patients

Obesity in young women and girls reduces aerobic performance by 25%

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This research was carried out at The Brompton Hospital in London in the paediatric department of Professor Simon Godfrey. It showed that the the aerobic performance measured as maximum oxygen uptake was surprisingly the same for obese and non-obese girls when expressed as an absolute value (litres/min). Thus they appeared to be just as fit as their non-obese age-matched peers.
However when the aerobic performance was expressed as the maximum oxygen uptake per kilogram of body weight that had to be moved when running or walking then the obese subjects show a reduced performance of nearly 25% because of the extra weight of fat that they had to move.
Journal of Applied Physiology. 1975 Mar;38(3):373-6

A study of exercise performance was carried out in 17 obese girls and young adults. During submaximal steady-state bicycle exercise oxygen intake (Vo2) for a given work output (W) was raised in obese subjects but minute ventilation at a fixed carbon dioxide output, gas exchange, blood gases, and cardiac output at a given VO2 were similar to the values previously found for normals. In obese subjects high levels of VO2 for fixed W were also obtained on the treadmill but when these were standardized for body weight (unlike the bicycle test) it was shown that the obese girls and women exercised within the normal (expected) range of aerobic energy expenditure.

During maximal performance the absolute VO2 max was the same in obese and nonobese subjects but for a given body weight, lean body mass, and leg muscle (plus) bone volume, VO2max was reduced by 23.8, 16.3, and 24.5% respectively, in the former group. It was concluded that obesity though having minimal affect on responses to submaximal exercise is nevertheless associated with a marked reduction in physiological performance at or near maximal effort.