Purpose This study sought to investigate the electromyographic activity of the vastus lateralis (... more Purpose This study sought to investigate the electromyographic activity of the vastus lateralis (VL) muscle during concentric-eccentric exercise using a new concept leg press machine enabling a preset overloading in the eccentric phase. Methods Ten young males familiar with resistive exercise were recruited for this study. Tests were performed on a Leg-press Biostrength® (Technogym S.p.A., Italy). The load was set to 70% and 80% of one-repetition maximum (1-RM). The participants performed 2 sets of 6 repetitions at each relative load with (ECC +) and without (ISOW) an eccentric overload equivalent to 150% of the concentric load. A metronome was employed to maintain the selected cadence. Sets were separated by a 5-min rest. Surface electromyography (EMG) of VL was recorded and integrated (iEMG). Results Results showed a higher iEMG in ECC + with respect to ISOW at both intensities (+ 29% for 70% 1-RM, p < 0.01 and + 31% for 80% 1-RM, p < 0.001). No statistically significant differences were detected between concentric and eccentric phase in both ECC + conditions. Conclusions Training with a 150% eccentric overload provides a ~ 30% greater motor unit recruitment of the VL muscle in leg press exercise. Moreover, the results show that the eccentric overloading provided by the Biostrength® machine enables training at the same level of neural activation of the concentric phase. Hence, the derecruitment of motor units, normally observed during the eccentric phase when using conventional training machines, was overcome using the Biostrength® machine; this observation seems particularly important for maximizing neuromuscular responses to strength training.
In recent years, different companies have developed devices that estimate "running power&quo... more In recent years, different companies have developed devices that estimate "running power". The main objective of this paper is to evaluate the effect of running speed on aerobic and running powers measured using force plates and by different devices. The second objective is to evaluate the relationship between aerobic power and running powers measured using force plates and by different devices. We enrolled 11 subjects in the study, they performed 5-min running trials at 2.22, 2.78, 3.33, 3.89 and 4.44 m/s respectively on a force-measuring treadmill while we collected metabolic data. We calculated running power as the dot product of ground reaction force and velocity of the centre of mass and compared it to the running power estimates of three devices: Skillrun (Technogym), Stryd Summit Powermeter (Stryd) and Garmin HRM-Run (Garmin). We found statistically significant linear correlations with running powers measured by all devices and running speed. Although absolute running power measurements were different among devices, an increase of 1 m/s in running speed translated to an increase of 0.944 W/kg in running power (p < 0.001). We found statistically significant linear correlations with running powers measured by all devices and aerobic power, in particular: as aerobic power increases by 1 W/kg, running power increases by 0.218 W/kg for all devices (p < 0.001). For level treadmill running, across speeds, running power measured by commercially available devices reflects force-based measurements and it can be a valuable metric, providing quasi real-time feedback during training sessions and competitions. HighlightsWe evaluated the effect of running speed on aerobic and running powers measured using force plates and by different devices.We also compared the relationship between aerobic power and running powers measured using force plates and by different devices.We found statistically significant linear correlations with running powers measured by all devices and aerobic power, in particular: as aerobic power increases by 1 W/kg, running power increases by 0.218 W/kg for all devices.For level treadmill running, across speeds, running power measured by commercially available devices reflects force-based measurements and it can be a valuable metric, providing quasi real-time feedback during training sessions and competitions.
Introduction Recent theoretical studies indicate that during leg extension exercises the tibiofem... more Introduction Recent theoretical studies indicate that during leg extension exercises the tibiofemoral shear forces and the ACL strain-forces can be externally modulated. These modulations can be obtained by a controlled displacement of the application point of the resistance force along the lower-leg during the knee flexion/extension (Biscarini, 2008), or through an external compressive force applied on the knee joint (Fleming et al., 2007). Methods We have designed and developed two innovative leg extension prototypes which integrate these functions. In the first prototype, the resistance lever of a standard leg-extension equipment was replaced by a linear guide along with the resistance pad can slide. The pad movement along the guide is generated by an electric motor controlled by an angular encoder placed on the rotation axis of the equipment, and a linear encoder installed along the linear guide. A feedback control algorithm was developed to provide an accurate and fast dynamic control of the pad positioning. In the second prototype, a foot platform was inserted at the distal side of the resistance lever to exert a controlled axial compression on the lower limb during the exercise. Two protocols for surface EMG and imaging techniques measurement were designed to assess and compare the levels of hamstring co-contraction (which is known to represent a protective factor for the ACL) and the anterior tibial translation (which is proportional to the ACL strain-force), during the exercise with these two new prototypes and the standard equipment, at different levels of external resistances. Each trial was also repeated encouraging the subjects to intentionally enhance hamstring co-activation during the exercise. Results EMG data collected on seventeen healthy subjects indicate that hamstring co-activation is not influenced by pad movement and axial compression. However, the hamstring co-activation was increased from two to four times when the subjects were encouraged to intentionally co-contract the knee flexor muscles during the leg extension exercise. Discussion Intentional hamstring co-contraction in leg extension exercises can be an effective strategy for ACL protection and tibiofemoral joint stability in ACL deficient patients, and in rehabilitation programs after cruciate ligament reconstruction. Further investigations with imaging techniques will definitely asses the effectiveness of the two prototypes. References Biscarini (2008). Medical Engineering & Physics 30(8), 1032-1041 Fleming et al. (2003). Am J Sports Med 31(5), 701-70
Introduction: Metabolic equivalents (METs) are typically used to measure the caloric cost of aero... more Introduction: Metabolic equivalents (METs) are typically used to measure the caloric cost of aerobic exercises, rarely that of resistance exercises. Aim of this study was to investigate the metabolic equivalents of resistance training executed at light-moderate or vigorous effort respectively in type 2 diabetic patients and young subjects. Methods: Twenty type 2 diabetic patients (62.9 \ub1 6.1 years) and twenty-two young subjects (22.6 \ub1 1.9 years) performed two training sessions with 2-day recovery between each other: one at vigorous intensity (80% of 1-RM) and one at moderate intensity (60% of 1-RM) at Leg Press, Chest Press and Lat Pull Down. Oxygen consumption was continuously measured from fifteen minutes before the session, during the actual resistance training and for fifteen minutes after the session. Results: In both diabetic patients and young subjects no differences on METs intensities were found between vigorous and moderate intensities. A statistical difference was detected in between groups analysis, with young subject showing a statistical higher METs intensities in both 60% and 80% of 1-RM training sessions when compared with diabetic subject (+66.33%, P<0.01; +60.01%, P<0.01). METs values at rest at the end of the study were significantly higher than baseline values in both groups at both intensities: +0.30\ub10.25 METs at 60% of 1RM (P<0.01) and +0.19\ub10.19 METs at 80% of 1RM in type 2 diabetes group, and +0.59\ub10.34 METs at 60% of 1RM (P<0.01) and +0.50\ub10.34 METs at 80% of 1RM in young subject group. After 15 minutes of quite rest, both diabetic patients and young subjects revealed no significant differences on METs in within group analysis. However in the between group comparison, at both intensities, data analysis indicated a post-exercise METs significantly higher in young subjects than type 2 diabetes patients (+22.43%, P<0.01; 34.31%, P<0.01). Discussions: In both diabetic patients and young subjects there are no differences in executing a resistance-training program at 60 or 80% of 1-RM. The METs value that best represent training intensities is 5 METs for young subjects and 3 METs for diabetic patients
... Zanuso, Silvano and Jimenez, Alfonso (2011) Promoting wellbeing in long-term conditions. In: ... more ... Zanuso, Silvano and Jimenez, Alfonso (2011) Promoting wellbeing in long-term conditions. In: Understanding Wellbeing: An Introduction for Students and Practicioners of Health and Social Care. ... URI: http://gala.gre.ac.uk/id/eprint/7155. Actions (login required). View Item. ...
Nutrition, Metabolism and Cardiovascular Diseases, 2010
We investigated the effect of different exercise modalities on high sensitivity-C reactive protei... more We investigated the effect of different exercise modalities on high sensitivity-C reactive protein (hs-CRP) and other inflammatory markers in patients with type 2 diabetes and the metabolic syndrome. Eighty-two patients were randomized into 4 groups: sedentary control (A); receiving counseling to perform low-intensity physical activity (B); performing prescribed and supervised high-intensity aerobic (C) or aerobic+resistance (D) exercise (with the same caloric expenditure) for 12 months. Evaluation of leisure-time physical activity and assessment of physical fitness, cardiovascular risk factors and inflammatory biomarkers was performed at baseline and every 3 months. Volume of physical activity increased and HbA(1c) decreased in Groups B-D. VO(2max), HOMA-IR index, HDL-cholesterol, waist circumference and albuminuria improved in Groups C and D, whereas strength and flexibility improved only in Group D. Levels of hs-CRP decreased in all three exercising groups, but the reduction was significant only in Groups C and D, and particularly in Group D. Changes in VO(2max) and the exercise modalities were strong predictors of hs-CRP reduction, independent of body weight. Leptin, resistin and interleukin-6 decreased, whereas adiponectin increased in Groups C and D. Interleukin-1β, tumor necrosis factor-α and interferon-γ decreased, whereas anti-inflammatory interleukin-4 and 10 increased only in Group D. Physical exercise in type 2 diabetic patients with the metabolic syndrome is associated with a significant reduction of hs-CRP and other inflammatory and insulin resistance biomarkers, independent of weight loss. Long-term high-intensity (preferably mixed) training, in addition to daytime physical activity, is required to obtain a significant anti-inflammatory effect.
European Review of Aging and Physical Activity, 2012
The research on the effects of aquatic exercise is a field that has grown rapidly in the last dec... more The research on the effects of aquatic exercise is a field that has grown rapidly in the last decade. The majority of the available literature is focused on the benefits of water-based exercise programs for people with rheumatologic disease and back pain; however, there is a lack of evidence reporting the effects of exercise performed in an aquatic medium for healthy elderly adults. The purpose of this study was to critically review the existing evidence of a potential relationship between water-based exercise and improvement of physical fitness in healthy elderly subjects. A systematic database search for manuscripts and a quality control were performed. A system of rating was defined. Aerobic, muscular strength, flexibility and body composition outcomes were then extracted. Nine studies were analyzed after the screening for eligibility: five randomized controlled trials (RCT), three randomized uncontrolled trials (UT) and one controlled trial (CT). Four RCT and two randomized UT w...
OBJECTIVE To examine the effect of supervised exercise on traditional and nontraditional cardiova... more OBJECTIVE To examine the effect of supervised exercise on traditional and nontraditional cardiovascular risk factors in sedentary, overweight/obese insulin-treated subjects with type 2 diabetes from the Italian Diabetes Exercise Study (IDES). RESEARCH DESIGN AND METHODS The study randomized 73 insulin-treated patients to twice weekly supervised aerobic and resistance training plus structured exercise counseling (EXE) or to counseling alone (CON) for 12 months. Clinical and laboratory parameters were assessed at baseline and at the end of the study. RESULTS The volume of physical activity was significantly higher in the EXE versus the CON group. Values for hemoglobin A1c, BMI, waist circumference, high-sensitivity C-reactive protein, blood pressure, LDL cholesterol, and the coronary heart disease risk score were significantly reduced only in the EXE group. No major adverse events were observed. CONCLUSIONS In insulin-treated subjects with type 2 diabetes, supervised exercise is safe ...
OBJECTIVE Physical fitness is inversely related to mortality in the general population and in sub... more OBJECTIVE Physical fitness is inversely related to mortality in the general population and in subjects with type 2 diabetes. Here, we present data concerning the relationship between changes in physical fitness and modifiable cardiovascular risk factors in subjects with type 2 diabetes from the Italian Diabetes and Exercise Study. RESEARCH DESIGN AND METHODS Sedentary patients with type 2 diabetes (n = 606) were enrolled in 22 outpatient diabetes clinics and randomized to twice-a-week supervised aerobic and resistance training plus exercise counseling versus counseling alone for 12 months. Baseline to end-of-study changes in cardiorespiratory fitness, strength, and flexibility, as assessed by Vo2max estimation, a 5–8 maximal repetition test, and a hip/trunk flexibility test, respectively, were calculated in the whole cohort, and multiple regression analyses were applied to assess the relationship with cardiovascular risk factors. RESULTS Changes in Vo2max, upper and lower body stren...
Exercise as a public health tool has largely been built around its plausible impact on physical h... more Exercise as a public health tool has largely been built around its plausible impact on physical health, including a positive impact on the prevention and management of type 2 diabetes. There is a growing interest in its potential to influence other aspects of quality of life such as mental health and general well-being. The effects of physical activity on overall quality of life are well established in the general population and have been analyzed on various dimensions of the Health-Related Quality of Life (HRQL) including physical and social functioning; subjective well-being, emotion and mood; self esteem and self-perception; cognitive performance; and sleep quality. Even though the effectiveness of physical activity and exercise on physical health has been shown in numerous studies, less evidence is available to show if similar positive improvements in well-being can be seen in subjects with type 2 diabetes. The purpose of this manuscript is to summarize the efficacy of structured exercise counseling on the well-being of type 2 diabetic patients and make some general recommendations. As such, although there is more to be learned about effective strategies in clinical practice, it seems clear that the intervention needs to incorporate individualization and long-term interaction with trained facilitators.
Purpose This study sought to investigate the electromyographic activity of the vastus lateralis (... more Purpose This study sought to investigate the electromyographic activity of the vastus lateralis (VL) muscle during concentric-eccentric exercise using a new concept leg press machine enabling a preset overloading in the eccentric phase. Methods Ten young males familiar with resistive exercise were recruited for this study. Tests were performed on a Leg-press Biostrength® (Technogym S.p.A., Italy). The load was set to 70% and 80% of one-repetition maximum (1-RM). The participants performed 2 sets of 6 repetitions at each relative load with (ECC +) and without (ISOW) an eccentric overload equivalent to 150% of the concentric load. A metronome was employed to maintain the selected cadence. Sets were separated by a 5-min rest. Surface electromyography (EMG) of VL was recorded and integrated (iEMG). Results Results showed a higher iEMG in ECC + with respect to ISOW at both intensities (+ 29% for 70% 1-RM, p < 0.01 and + 31% for 80% 1-RM, p < 0.001). No statistically significant differences were detected between concentric and eccentric phase in both ECC + conditions. Conclusions Training with a 150% eccentric overload provides a ~ 30% greater motor unit recruitment of the VL muscle in leg press exercise. Moreover, the results show that the eccentric overloading provided by the Biostrength® machine enables training at the same level of neural activation of the concentric phase. Hence, the derecruitment of motor units, normally observed during the eccentric phase when using conventional training machines, was overcome using the Biostrength® machine; this observation seems particularly important for maximizing neuromuscular responses to strength training.
In recent years, different companies have developed devices that estimate "running power&quo... more In recent years, different companies have developed devices that estimate "running power". The main objective of this paper is to evaluate the effect of running speed on aerobic and running powers measured using force plates and by different devices. The second objective is to evaluate the relationship between aerobic power and running powers measured using force plates and by different devices. We enrolled 11 subjects in the study, they performed 5-min running trials at 2.22, 2.78, 3.33, 3.89 and 4.44 m/s respectively on a force-measuring treadmill while we collected metabolic data. We calculated running power as the dot product of ground reaction force and velocity of the centre of mass and compared it to the running power estimates of three devices: Skillrun (Technogym), Stryd Summit Powermeter (Stryd) and Garmin HRM-Run (Garmin). We found statistically significant linear correlations with running powers measured by all devices and running speed. Although absolute running power measurements were different among devices, an increase of 1 m/s in running speed translated to an increase of 0.944 W/kg in running power (p < 0.001). We found statistically significant linear correlations with running powers measured by all devices and aerobic power, in particular: as aerobic power increases by 1 W/kg, running power increases by 0.218 W/kg for all devices (p < 0.001). For level treadmill running, across speeds, running power measured by commercially available devices reflects force-based measurements and it can be a valuable metric, providing quasi real-time feedback during training sessions and competitions. HighlightsWe evaluated the effect of running speed on aerobic and running powers measured using force plates and by different devices.We also compared the relationship between aerobic power and running powers measured using force plates and by different devices.We found statistically significant linear correlations with running powers measured by all devices and aerobic power, in particular: as aerobic power increases by 1 W/kg, running power increases by 0.218 W/kg for all devices.For level treadmill running, across speeds, running power measured by commercially available devices reflects force-based measurements and it can be a valuable metric, providing quasi real-time feedback during training sessions and competitions.
Introduction Recent theoretical studies indicate that during leg extension exercises the tibiofem... more Introduction Recent theoretical studies indicate that during leg extension exercises the tibiofemoral shear forces and the ACL strain-forces can be externally modulated. These modulations can be obtained by a controlled displacement of the application point of the resistance force along the lower-leg during the knee flexion/extension (Biscarini, 2008), or through an external compressive force applied on the knee joint (Fleming et al., 2007). Methods We have designed and developed two innovative leg extension prototypes which integrate these functions. In the first prototype, the resistance lever of a standard leg-extension equipment was replaced by a linear guide along with the resistance pad can slide. The pad movement along the guide is generated by an electric motor controlled by an angular encoder placed on the rotation axis of the equipment, and a linear encoder installed along the linear guide. A feedback control algorithm was developed to provide an accurate and fast dynamic control of the pad positioning. In the second prototype, a foot platform was inserted at the distal side of the resistance lever to exert a controlled axial compression on the lower limb during the exercise. Two protocols for surface EMG and imaging techniques measurement were designed to assess and compare the levels of hamstring co-contraction (which is known to represent a protective factor for the ACL) and the anterior tibial translation (which is proportional to the ACL strain-force), during the exercise with these two new prototypes and the standard equipment, at different levels of external resistances. Each trial was also repeated encouraging the subjects to intentionally enhance hamstring co-activation during the exercise. Results EMG data collected on seventeen healthy subjects indicate that hamstring co-activation is not influenced by pad movement and axial compression. However, the hamstring co-activation was increased from two to four times when the subjects were encouraged to intentionally co-contract the knee flexor muscles during the leg extension exercise. Discussion Intentional hamstring co-contraction in leg extension exercises can be an effective strategy for ACL protection and tibiofemoral joint stability in ACL deficient patients, and in rehabilitation programs after cruciate ligament reconstruction. Further investigations with imaging techniques will definitely asses the effectiveness of the two prototypes. References Biscarini (2008). Medical Engineering & Physics 30(8), 1032-1041 Fleming et al. (2003). Am J Sports Med 31(5), 701-70
Introduction: Metabolic equivalents (METs) are typically used to measure the caloric cost of aero... more Introduction: Metabolic equivalents (METs) are typically used to measure the caloric cost of aerobic exercises, rarely that of resistance exercises. Aim of this study was to investigate the metabolic equivalents of resistance training executed at light-moderate or vigorous effort respectively in type 2 diabetic patients and young subjects. Methods: Twenty type 2 diabetic patients (62.9 \ub1 6.1 years) and twenty-two young subjects (22.6 \ub1 1.9 years) performed two training sessions with 2-day recovery between each other: one at vigorous intensity (80% of 1-RM) and one at moderate intensity (60% of 1-RM) at Leg Press, Chest Press and Lat Pull Down. Oxygen consumption was continuously measured from fifteen minutes before the session, during the actual resistance training and for fifteen minutes after the session. Results: In both diabetic patients and young subjects no differences on METs intensities were found between vigorous and moderate intensities. A statistical difference was detected in between groups analysis, with young subject showing a statistical higher METs intensities in both 60% and 80% of 1-RM training sessions when compared with diabetic subject (+66.33%, P<0.01; +60.01%, P<0.01). METs values at rest at the end of the study were significantly higher than baseline values in both groups at both intensities: +0.30\ub10.25 METs at 60% of 1RM (P<0.01) and +0.19\ub10.19 METs at 80% of 1RM in type 2 diabetes group, and +0.59\ub10.34 METs at 60% of 1RM (P<0.01) and +0.50\ub10.34 METs at 80% of 1RM in young subject group. After 15 minutes of quite rest, both diabetic patients and young subjects revealed no significant differences on METs in within group analysis. However in the between group comparison, at both intensities, data analysis indicated a post-exercise METs significantly higher in young subjects than type 2 diabetes patients (+22.43%, P<0.01; 34.31%, P<0.01). Discussions: In both diabetic patients and young subjects there are no differences in executing a resistance-training program at 60 or 80% of 1-RM. The METs value that best represent training intensities is 5 METs for young subjects and 3 METs for diabetic patients
... Zanuso, Silvano and Jimenez, Alfonso (2011) Promoting wellbeing in long-term conditions. In: ... more ... Zanuso, Silvano and Jimenez, Alfonso (2011) Promoting wellbeing in long-term conditions. In: Understanding Wellbeing: An Introduction for Students and Practicioners of Health and Social Care. ... URI: http://gala.gre.ac.uk/id/eprint/7155. Actions (login required). View Item. ...
Nutrition, Metabolism and Cardiovascular Diseases, 2010
We investigated the effect of different exercise modalities on high sensitivity-C reactive protei... more We investigated the effect of different exercise modalities on high sensitivity-C reactive protein (hs-CRP) and other inflammatory markers in patients with type 2 diabetes and the metabolic syndrome. Eighty-two patients were randomized into 4 groups: sedentary control (A); receiving counseling to perform low-intensity physical activity (B); performing prescribed and supervised high-intensity aerobic (C) or aerobic+resistance (D) exercise (with the same caloric expenditure) for 12 months. Evaluation of leisure-time physical activity and assessment of physical fitness, cardiovascular risk factors and inflammatory biomarkers was performed at baseline and every 3 months. Volume of physical activity increased and HbA(1c) decreased in Groups B-D. VO(2max), HOMA-IR index, HDL-cholesterol, waist circumference and albuminuria improved in Groups C and D, whereas strength and flexibility improved only in Group D. Levels of hs-CRP decreased in all three exercising groups, but the reduction was significant only in Groups C and D, and particularly in Group D. Changes in VO(2max) and the exercise modalities were strong predictors of hs-CRP reduction, independent of body weight. Leptin, resistin and interleukin-6 decreased, whereas adiponectin increased in Groups C and D. Interleukin-1β, tumor necrosis factor-α and interferon-γ decreased, whereas anti-inflammatory interleukin-4 and 10 increased only in Group D. Physical exercise in type 2 diabetic patients with the metabolic syndrome is associated with a significant reduction of hs-CRP and other inflammatory and insulin resistance biomarkers, independent of weight loss. Long-term high-intensity (preferably mixed) training, in addition to daytime physical activity, is required to obtain a significant anti-inflammatory effect.
European Review of Aging and Physical Activity, 2012
The research on the effects of aquatic exercise is a field that has grown rapidly in the last dec... more The research on the effects of aquatic exercise is a field that has grown rapidly in the last decade. The majority of the available literature is focused on the benefits of water-based exercise programs for people with rheumatologic disease and back pain; however, there is a lack of evidence reporting the effects of exercise performed in an aquatic medium for healthy elderly adults. The purpose of this study was to critically review the existing evidence of a potential relationship between water-based exercise and improvement of physical fitness in healthy elderly subjects. A systematic database search for manuscripts and a quality control were performed. A system of rating was defined. Aerobic, muscular strength, flexibility and body composition outcomes were then extracted. Nine studies were analyzed after the screening for eligibility: five randomized controlled trials (RCT), three randomized uncontrolled trials (UT) and one controlled trial (CT). Four RCT and two randomized UT w...
OBJECTIVE To examine the effect of supervised exercise on traditional and nontraditional cardiova... more OBJECTIVE To examine the effect of supervised exercise on traditional and nontraditional cardiovascular risk factors in sedentary, overweight/obese insulin-treated subjects with type 2 diabetes from the Italian Diabetes Exercise Study (IDES). RESEARCH DESIGN AND METHODS The study randomized 73 insulin-treated patients to twice weekly supervised aerobic and resistance training plus structured exercise counseling (EXE) or to counseling alone (CON) for 12 months. Clinical and laboratory parameters were assessed at baseline and at the end of the study. RESULTS The volume of physical activity was significantly higher in the EXE versus the CON group. Values for hemoglobin A1c, BMI, waist circumference, high-sensitivity C-reactive protein, blood pressure, LDL cholesterol, and the coronary heart disease risk score were significantly reduced only in the EXE group. No major adverse events were observed. CONCLUSIONS In insulin-treated subjects with type 2 diabetes, supervised exercise is safe ...
OBJECTIVE Physical fitness is inversely related to mortality in the general population and in sub... more OBJECTIVE Physical fitness is inversely related to mortality in the general population and in subjects with type 2 diabetes. Here, we present data concerning the relationship between changes in physical fitness and modifiable cardiovascular risk factors in subjects with type 2 diabetes from the Italian Diabetes and Exercise Study. RESEARCH DESIGN AND METHODS Sedentary patients with type 2 diabetes (n = 606) were enrolled in 22 outpatient diabetes clinics and randomized to twice-a-week supervised aerobic and resistance training plus exercise counseling versus counseling alone for 12 months. Baseline to end-of-study changes in cardiorespiratory fitness, strength, and flexibility, as assessed by Vo2max estimation, a 5–8 maximal repetition test, and a hip/trunk flexibility test, respectively, were calculated in the whole cohort, and multiple regression analyses were applied to assess the relationship with cardiovascular risk factors. RESULTS Changes in Vo2max, upper and lower body stren...
Exercise as a public health tool has largely been built around its plausible impact on physical h... more Exercise as a public health tool has largely been built around its plausible impact on physical health, including a positive impact on the prevention and management of type 2 diabetes. There is a growing interest in its potential to influence other aspects of quality of life such as mental health and general well-being. The effects of physical activity on overall quality of life are well established in the general population and have been analyzed on various dimensions of the Health-Related Quality of Life (HRQL) including physical and social functioning; subjective well-being, emotion and mood; self esteem and self-perception; cognitive performance; and sleep quality. Even though the effectiveness of physical activity and exercise on physical health has been shown in numerous studies, less evidence is available to show if similar positive improvements in well-being can be seen in subjects with type 2 diabetes. The purpose of this manuscript is to summarize the efficacy of structured exercise counseling on the well-being of type 2 diabetic patients and make some general recommendations. As such, although there is more to be learned about effective strategies in clinical practice, it seems clear that the intervention needs to incorporate individualization and long-term interaction with trained facilitators.
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Papers by S. Zanuso