Comparison of the effects of two resistance training regimens on muscular and bone responses in premenopausal women Physical activity and weight loss: does prescribing higher physical activity goals improve outcome? Sample size slippages in randomised trials: exclusions and the lost and wayward Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain? High Intensity Resistance Training: Effects on Bone in Older Men and Women Effect of moderate intensity resistance training during weight loss on body composition and physical performance in overweight older adults Effect of exercise duration and intensity on weight loss in overweight, sedentary women: a randomized trial. Melanocortin receptor expression is associated with reduced CRP in response to resistance training. Implementation of neck/shoulder exercises for pain relief among industrial workers: A randomized controlled trial The Response of Persons With Chronic Nonspecific Low Back Pain to Three Different Volumes of Periodized Musculoskeletal Rehabilitation Effect of a Lifestyle Intervention on Change in Cardiorespiratory Fitness in Adults with Type 2 Diabetes: Results from the Look AHEAD Study Flexible Nonlinear Periodization in a Beginner College Weight Training Class A periodized model for exercise improves the intra-hospital evolution of patients after myocardial revascularization: a pilot randomized controlled trial Nonlinear exercise training in advanced chronic obstructive pulmonary disease is superior to traditional exercise training. A randomized trial. A Comparison of Two Forms of Periodized Exercise Rehabilitation Programs in the Management of Chronic Nonspecific Low-Back Pain Effects of resistance training on resistin, leptin, cytokines, and muscle force in elderly post-menopausal women Effect of Concurrent Training, Flexible Nonlinear Periodization, and Maximal-Effort Cycling on Strength and Power Effect of block-periodized exercise training on bone and coronary heart disease risk factors in early post-menopausal women: a randomized controlled study. Effects of resistance training and dietary changes on physical function and body composition in overweight and obese older adults. Acute Affective Response to a Moderate-intensity Exercise Stimulus Predicts Physical Activity Participation 6 and 12 Months Later. The periodized resistance training promotes similar changes in lipid profile in middle-aged men and women. Effect of exercise and Cimicifuga racemosa (CR BNO 1055) on bone mineral density, 10-year coronary heart disease risk, and menopausal complaints: the randomized controlled Training and Cimicifuga racemosa Erlangen (TRACE) study Effects of aerobic vs. resistance training on visceral and liver fat stores, liver enzymes, and insulin resistance by HOMA in overweight adults from STRRIDE AT/RT. Physical activity in the treatment of the adulthood overweight and obesity: current evidence and research issues. Linear and daily undulating resistance training periodizations have differential beneficial effects in young sedentary women. An Intensive, Progressive Exercise Program Reduces Disability and Improves Functional Performance in Patients After Single-Level Lumbar Microdiskectomy
Summary A 28-week resistance training with linear periodization was compared with an undulating model in 27 premenopausal women . In both groups , bone mineral density ( BMD ) was not changed but muscle strength increased , and there were changes in anthropometrical and muscle damage parameters , indicating that in this population , these models are similar concerning these variables . Introduction This study seeks to compare the effects of resistance training with undulating versus linear periodization on BMD , muscle strength , anthropometrical variables , and muscle damage parameters in premenopausal women . Methods Twenty-seven females ( 39.6 ± 0.41 years , mean ± st and ard error ) , without osteopenia or osteoporosis and without calcium supplementation , were r and omly assigned either to a linear periodization group ( LPG , n = 14 ) or to an undulating periodization group ( UPG , n = 13 ) . The subjects were trained three times a week for 28 weeks . Lumbar spine and femoral neck BMDs were measured through dual-energy X-ray absorptiometry . Maximal and submaximal dynamic muscle strengths were measured through the 1-RM and 20-RM tests , respectively . Anthropometrical ( body mass , skinfolds , and perimeters ) and muscle damage parameters were assessed through serum creatine kinase ( CK ) and delayed-onset muscle soreness ( DOMS ) . Results BMD remained unchanged in both groups , despite significant increases in maximal ( LPG , 37–73 % ; UPG , 40–70 % ) and submaximal ( LPG , 82–114 % ; UPG , 70–102 % ) muscle strength . The perimeter of the distal thigh was increased ( about 1.7 cm ) in both groups . CK and DOMS were greater in the first mesocycle than in the subsequent ones . After the 1st training session in each mesocycle , 24 and 48 h CK was increased as compared to pretraining values . Conclusions The resistance training of 28 weeks increased muscle strength in both training groups with no difference in BMD or in the occurrence of muscle damage BACKGROUND Recommending increased physical activity facilitates long-term weight loss , but the optimal level of physical activity to recommend is unknown . OBJECTIVE The objective of the study was to evaluate the efficacy for long-term weight loss of recommendations for much higher physical activity than those normally used in behavioral treatments . DESIGN Overweight men and women ( n = 202 ) were r and omly assigned to either a st and ard behavior therapy ( SBT ) for obesity , incorporating an energy expenditure ( EE ) goal of 1000 kcal/wk , or to a high physical activity ( HPA ) treatment , in which the goal was an EE of 2500 kcal/wk . To help HPA treatment group participants achieve this high exercise goal , their treatment included encouragement to recruit 1 - 3 exercise partners into the study , personal counseling from an exercise coach , and small monetary incentives . RESULTS The HPA treatment group reported achieving higher mean ( + /- SD ) physical activity levels than did the SBT group at 6 mo ( EE of 2399 + /- 1571 kcal/wk compared with 1837 + /- 1431 kcal/wk ) , 12 mo ( EE of 2249 + /- 1751 kcal/wk compared with 1565 + /- 1309 kcal/wk ) , and 18 mo ( EE of 2317 + /- 1854 kcal/wk compared with 1629 + /- 1483 kcal/wk ) ( all P < 0.01 ) . Mean ( + /- SEM ) cumulative weight losses at 6 , 12 , and 18 mo in the HPA treatment group were 9.0 + /- 7.1 , 8.5 + /- 7.9 , and 6.7 + /- 8.1 kg , respectively . In the SBT group , the corresponding weight losses were 8.1 + /- 7.4 , 6.1 + /- 8.8 , and 4.1 + /- 7.3 kg , respectively . Between-group differences in weight loss were significant at 12 and 18 mo . CONCLUSION These results suggest that recommendations of higher levels of physical activity ( EE of 2500 kcal/wk ) promote long-term weight loss better than do conventional recommendations Proper r and omisation means little if investigators can not include all r and omised participants in the primary analysis . Participants might ignore follow-up , leave town , or take aspartame when instructed to take aspirin . Exclusions before r and omisation do not bias the treatment comparison , but they can hurt generalisability . Eligibility criteria for a trial should be clear , specific , and applied before r and omisation . Readers should assess whether any of the criteria make the trial sample atypical or unrepresentative of the people in which they are interested . In principle , assessment of exclusions after r and omisation is simple : none are allowed . For the primary analysis , all participants enrolled should be included and analysed as part of the original group assigned ( an intent-to-treat analysis ) . In reality , however , losses frequently occur . Investigators should , therefore , commit adequate re sources to develop and implement procedures to maximise retention of participants . Moreover , research ers should provide clear , explicit information on the progress of all r and omised participants through the trial by use of , for instance , a trial profile . Investigators can also do secondary analyses on , for instance , per- protocol or as-treated participants . Such analyses should be described as secondary and non-r and omised comparisons . Mish and ling of exclusions causes serious method ological difficulties . Unfortunately , some explanations for mish and ling exclusions intuitively appeal to readers , disguising the seriousness of the issues . Creative mismanagement of exclusions can undermine trial validity BACKGROUND High levels of exercise may be necessary for long-term maintenance of weight loss . OBJECTIVE We aim ed to determine in a r and omized prospect i ve design whether encouraging 2500 kcal physical activity/wk produced greater 30-mo weight losses than did the st and ard 1000 kcal physical activity/wk prescription . DESIGN Overweight adults ( n = 202 ) were r and omly assigned to either 18 mo of st and ard behavioral treatment ( SBT ) with an exercise goal of 1000 kcal/wk or a high physical activity ( HPA ) treatment with a goal of 2500 kcal/wk . The HPA treatment included all procedures in the SBT plus encouragement to recruit 1 - 3 exercise partners and small-group counseling with an exercise coach . Participants were followed for 30 mo . RESULTS The HPA group achieved significantly greater exercise levels and weight losses than did the SBT group at 12 and 18 mo ( P < 0.01 ) . Weight losses did not differ significantly at 30 mo : 0.90 + /- 8.9 and 2.86 + /- 8.6 kg for the SBT and HPA groups , respectively ( P = 0.16 ) . At 30 mo , average exercise levels no longer differed significantly between groups ( 1390 and 1696 kcal/wk , respectively ; P > 0.10 ) . Participants sustaining high exercise levels ( > 2500 kcal/wk ) for 30 mo had significantly ( P < 0.001 ) greater 30-mo weight loss than did those exercising less ( 12 + /- 8.8 and 0.8 + /- 8.1 kg , respectively ) . CONCLUSIONS Although participants in the HPA group sustained the 2500-kcal activity goal during the 18-mo treatment , activity declined once treatment ended , which result ed in no between-group differences in activity or weight loss at 2.5 y. Participants who reported continuing to engage in high levels of exercise maintained a significantly larger weight loss Abstract . There is evidence that high intensity resistance training promotes bone maintenance in older women , however , the effect of high intensity free weight training has not been investigated in older men or women . Furthermore , little is known about the chronic effect of weight training on serum insulin growth factor-I ( IGF-I ) in this population . We compared the effects of a moderate intensity seated resistance-training program with a high intensity st and ing free weight exercise program on bone mass and serum levels of IGF-I and IGFBP3 in healthy older men and women . Twenty-eight men ( 54.6 ± 3.2 years ) and 26 nonestrogen-replaced women ( 52.8 ± 3.3 years ) served as their own controls for 12 weeks , then were r and omly assigned to a moderate or high intensity training group and trained three times/week for 24 weeks . Prior to and after the control period and at the end of training , bone mass and body composition were assessed by dual energy X-ray absorptiometry ( DXA ) , muscle strength by isokinetic dynamometry , muscular power by Wingate Anaerobic Power Test , and IGF-I by radioimmunoassay ( RIA ) . A repeated measures analysis of covariance ( ANCOVA ) revealed that high intensity training result ed in a gain in spine BMD in men ( 1.9 % ) , P < 0.05 , but not in women , whereas moderate intensity training produced no changes in either gender at this site . Increases were observed at the greater trochanter , P < 0.03 , in men regardless of training intensity , but not in women at any hip site . However , when compared with zero , both men and women in the high intensity group demonstrated significant increases in trochanteric BMD ( 1.3 % and 2.0 % , respectively ) and a decrease in femoral BMD ( −1.8 % ) . Neither circulating serum IGF-I nor IGFBP3 were altered by either training regimen , but both training programs result ed in improvements in total body strength ( 37.62 % ) and lean mass ( males 4.1 % , females 3.1 % ) . We conclude that although resistance training of moderate to high intensity produced similar muscle changes in older adults , a higher magnitude is necessary to stimulate osteogenesis at the spine . However , at the spine , intensity was not sufficient to offset low levels of estrogen in early postmenopausal women . Furthermore , bone changes were not accompanied by changes in circulating serum levels of IGF-I or IGFBP3 The impact of resistance training has not been thoroughly examined in overweight older adults undergoing weight loss . Subjects ( n = 27 ) were overweight and obese ( BMI 31.7 ± 3.6 kg/m2 ) older ( age 67 ± 4 years ) adults and were r and omized into either a 10-week Dietary Approaches to Stop Hypertension for weight loss diet ( DASH , n = 12 ) or DASH plus moderate intensity resistance training ( DASH-RT , n = 15 ) . Outcomes included weight loss , total body and mid-thigh composition , muscle and physical function . There were no significant weight loss differences between the DASH-RT and DASH groups ( −3.6 ± 0.8 vs. −2.0 ± 0.9 % , p = 0.137 ) . The DASH-RT group had a greater reduction in body fat than the DASH group ( −4.1 ± 0.9 vs. −0.2 ± 1.0 kg , p = 0.005 ) . The DASH-RT group had greater changes in lean mass ( + 0.8 ± 0.4 vs. −1.4 ± 0.4 kg , p = 0.002 ) and strength ( + 60 ± 18 vs. −5 ± 9 N , p = 0.008 ) than the DASH group . There were favorable changes in mid-thigh composition variables in the DASH-RT group that were different than the lack of changes observed in the DASH group , except for intermuscular adipose tissue . Both groups experienced decreases in 400-m walk times showed ( DASH −36 ± 11 s , DASH-RT −40 ± 7 s ) with no differences between groups . Moderate intensity resistance training  during weight loss appears to improve fat mass and thigh composition , but weight loss only does not . However , global measures of physical functioning may improve with a weight loss-only program CONTEXT A higher duration and intensity of exercise may improve long-term weight loss . OBJECTIVE To compare the effects of different duration s and intensities of exercise on 12-month weight loss and cardiorespiratory fitness . DESIGN , SETTING , AND PARTICIPANTS R and omized trial conducted from January 2000 through December 2001 involving 201 sedentary women ( mean [ SD ] age , 37.0 [ 5.7 ] years ; mean [ SD ] body mass index , 32.6 [ 4.2 ] ) in a university-based weight control program . INTERVENTION Participants were r and omly assigned to 1 of 4 exercise groups ( vigorous intensity/high duration ; moderate intensity/high duration ; moderate intensity/moderate duration ; or vigorous intensity/moderate duration ) based on estimated energy expenditure ( 1000 kcal/wk vs 2000 kcal/wk ) and exercise intensity ( moderate vs vigorous ) . All women were instructed to reduce intake of energy to between 1200 and 1500 kcal/d and dietary fat to between 20 % and 30 % of total energy intake . MAIN OUTCOME MEASURES Body weight , cardiorespiratory fitness , and exercise participation . RESULTS After exclusions , 184 of 196 r and omized participants completed 12 months of treatment ( 94 % ) . In intention-to-treat analysis , mean ( SD ) weight loss following 12 months of treatment was statistically significant ( P < .001 ) in all exercise groups ( vigorous intensity/high duration = 8.9 [ 7.3 ] kg ; moderate intensity/high duration = 8.2 [ 7.6 ] kg ; moderate intensity/moderate duration = 6.3 [ 5.6 ] kg ; vigorous intensity/moderate duration = 7.0 [ 6.4 ] kg ) , with no significant difference between groups . Mean ( SD ) cardiorespiratory fitness levels also increased significantly ( P = .04 ) in all groups ( vigorous intensity/high duration = 22.0 % [ 19.9 % ] ; moderate intensity/high duration = 14.9 % [ 18.6 % ] ; moderate intensity/moderate duration = 13.5 % [ 16.9 % ] ; vigorous intensity/moderate duration = 18.9 % [ 16.9 % ] ) , with no difference between groups . Post hoc analysis revealed that percentage weight loss at 12 months was associated with the level of physical activity performed at 6 and 12 months . Women reporting less than 150 min/wk had a mean ( SD ) weight loss of 4.7 % [ 6.0 % ] ; inconsistent ( other ) pattern of physical activity , 7.0 % [ 6.9 % ] ; 150 min/wk or more , 9.5 % [ 7.9 % ] ; and 200 min/wk or more of exercise , 13.6 % [ 7.8 % ] . CONCLUSIONS Significant weight loss and improved cardiorespiratory fitness were achieved through the combination of exercise and diet during 12 months , although no differences were found based on different exercise duration s and intensities in this group of sedentary , overweight women The existing paradigm of exercise-induced decreases in chronic inflammation focuses on the expression of inflammatory receptors on systemic monocytes in response to exercise training , with the role of anti-inflammatory receptors largely ignored . Our recent preliminary studies indicate that the anti-inflammatory melanocortin receptors ( MCRs ) may play a role in modulating exercise-induced decreases in chronic inflammation . Here , we present a study design ed to determine the effect of intense , resistance exercise training on systemic monocyte MCR expression . Because low- grade chronic inflammation is associated with elevated cardiometabolic risk in healthy population s and exercise decreases chronic inflammation , we investigated the associations between systemic monocyte cell surface expression of MCRs and inflammatory markers as a possible mechanism for the beneficial anti-inflammatory effects of resistance training . To this end , the present study includes 40 adults ( aged 19 - 27 yr ) and implements a 12-wk periodized , intensive resistance training intervention . Melanocortin 1 and 3 receptor expression on systemic monocytes and inflammatory markers , including C-reactive protein ( CRP ) , interleukin (IL)-6 , IL-1β , and IL-10 , were measured before and after the intervention . Resistance training significantly altered MCR systemic monocyte cell surface expression , had no chronic effects on IL-6 , IL-1β , or IL-10 expression , but significantly decreased CRP levels from a moderate to a low cardiovascular disease risk category . More specifically , decreased melanocortin 3 receptor expression significantly correlated with decreased CRP , independent of changes in adiposity . These data suggest that the observed responses in MCR expression and decreases in cardiovascular disease risk in response to resistance training represent an important anti-inflammatory mechanism in regulating exercise-induced decreases in chronic inflammation that occur independent of chronic changes in systemic cytokines Background Although leisure-time physical activity is important for health , adherence to regular exercise is challenging for many adults . The workplace may provide an optimal setting to reach a large proportion of the adult population needing regular physical exercise . This study evaluates the effect of implementing strength training at the workplace on non-specific neck and shoulder pain among industrial workers . Methods Cluster-r and omized controlled trial involving 537 adults from occupations with high prevalence of neck and shoulder pain ( industrial production units ) . Participants were r and omized to 20 weeks of high-intensity strength training for the neck and shoulders three times a week ( n = 282 ) or a control group receiving advice to stay physically active ( n = 255 ) . The strength training program followed principles of progressive overload and periodization . The primary outcome was changes in self-reported neck and shoulder pain intensity ( scale 0 - 9 ) . Results 85 % of the participants followed the strength training program on a weekly basis . In the training group compared with the control group , neck pain intensity decreased significantly ( -0.6 , 95 % CI -1.0 to -0.1 ) and shoulder pain intensity tended to decrease ( -0.2 , 95 % CI -0.5 to 0.1 , P = 0.07 ) . For pain-cases at baseline ( pain intensity > = 3 ) the odds ratio - in the training group compared with the control group - for being a non-case at follow-up ( pain intensity < 3 ) was 2.0 ( 95 % CI 1.0 to 4.2 ) for the neck and 3.9 ( 95 % CI 1.7 to 9.4 ) for the shoulders . Conclusion High-intensity strength training relying on principles of progressive overload can be successfully implemented at industrial workplaces , and results in significant reductions of neck and shoulder pain . Trial registration NCT01071980 Kell , RT , Risi , AD , and Barden , JM . The response of persons with chronic nonspecific low back pain to three different volumes of periodized musculoskeletal rehabilitation . J Strength Cond Res 25(4 ) : 1052 - 1064 , 2011-Chronic nonspecific low back pain ( CLBP ) is a common musculoskeletal health issue associated with pain and disability reduced quality of life ( QoL ) . Pain initiates a fear-avoidance cycle , which needs to be broken if rehabilitation is to work . To break this cycle , exercise must be gradual and focused on strengthening the weakened musculature . Recently , periodized resistance training was effectively used as a musculoskeletal rehabilitation for adults with CLBP . The purpose of this study was to determine if the volume of periodized musculoskeletal rehabilitation ( PMR ) influences strength , pain , disability , and QoL in untrained persons . Subjects ( n = 240 ) were age and sex matched , with attempts made to match on strength and pain , and r and omly assigned to groups after baseline testing : ( a ) 4 days per week ( 4D ; n = 60 ) , ( b ) 3 days per week ( 3D ; n = 60 ) ( c ) , 2 days per week ( 2D ; n = 60 ) training volume or control ( C ; n = 60 ) with no training . The PMR program progressively overloaded muscle groups , with mean training volumes of 4D ( 1,563 repetitions [ reps ] per week ) , 3D ( 1,344 reps per week ) , and 2D ( 564 reps per week ) . Three weeks of familiarization and 13 weeks of PMR were employed . The 4D training volume significantly ( p ≤ 0.05 ) outperformed all other training volumes by weeks 9 and 13 . However , all training volumes made significant ( p ≤ 0.05 ) improvements in strength , pain , disability , and QoL across time . The effect sizes ( ESs ) associated with the group means of the outcome measures ranged from moderate to strong , with the 4D training volume consistently demonstrating the largest ESs . The 4D training volume is most effective at treating CLBP . Periodization can not only be applied to athlete training but also to the rehabilitation setting Objective : To examine the effect of an intensive lifestyle weight loss intervention ( ILI ) compared to diabetes support and education ( DSE ) on changes in fitness and physical activity in the Look AHEAD trial . Design : R and omized clinical trial to compare a lifestyle intervention for weight loss with a DSE condition in individuals with type 2 diabetes . Subjects : Data from 4376 overweight or obese adults with type 2 diabetes ( age=58.7±6.8 years , body mass index ( BMI ) = 35.8±5.8 kg/m2 ) who completed 1 year of the Look AHEAD trial and had available fitness data were analyzed . Intervention : Subjects were r and omly assigned to DSE or ILI . DSE received st and ard care plus three education sessions over the 1-year period . ILI included individual and group contact throughout the year , restriction in energy intake and 175 min per week of prescribed physical activity . Measurements : Fitness was assessed using a submaximal grade d exercise test . Physical activity was assessed by question naire in a subset of 2221 subjects . Results : Change in fitness was statistically greater in ILI vs DSE after adjustment for baseline fitness ( 20.9 vs 5.7 % ; P<0.0001 ) . Multivariate analysis showed that change in fitness was greater in overweight vs obese Class II and III ( P<0.05 ) . Physical activity increased by 892±1694 kcal per week in ILI vs 108±1254 kcal per week in DSE ( P<0.01 ) . Changes in fitness ( r=0.41 ) and physical activity ( r=0.42 ) were significantly correlated with weight loss ( P<0.0001 ) . Conclusions : The ILI was effective in increasing physical activity and improving cardiorespiratory fitness in overweight and obese individuals with type 2 diabetes . This effect may add to weight loss in improving metabolic control in patients in lifestyle intervention programs McNamara , JM and Stearne , DJ . Flexible Nonlinear Periodization in a Beginner College Weight Training Class . J Strength Cond Res 24(8 ) : 2012 - 2017 , 2010-The purpose of this study was to determine the effect of a flexible nonlinear ( FNL ) periodized weight training program compared to a nonlinear ( NL ) periodized weight training program on strength and power .  Sixteen beginner weight training students were r and omly assigned to an FNL group ( n = 8) or an NL group ( n = 8) . The exercise program included a combination of machines and free weights completed in 30 minutes , twice per week , for 12 consecutive weeks . Both groups were assigned the same total training volume of 3,680 repetitions and the same total training repetition maximum assignments of 10 , 15 , and 20 . The FNL group , however , was allowed to choose which day they completed the 10 , 15 , or 20 repetition workout . This was the only difference between the groups . Pre- and post-test measures included chest press , leg press , and st and ing long jump . The FNL group significantly improved by an average increase of 62 kg ( p < 0.05 ) , whereas the NL group only increased by an average of 16 kg in the leg press . The FNL group did not significantly differ in chest press or st and ing long jump performance when compared to the NL group . The conclusion from this study is that an FNL periodization program may be a highly effective method of training for improving leg strength . Coaches can immediately implement an FNL program by evaluating the readiness of an athlete immediately before his or her training session , then adjusting the assigned exercise intensity accordingly Objective : To compare models of the postoperative hospital treatment phase after myocardial revascularization . Design : A pilot r and omized controlled trial . Setting : Hospital patients in a hospital setting . Subjects : Thirty-two patients with indications for myocardial revascularization were included between January 2008 and December 2009 , with a left ventricular ejection fraction ( LVEF ) ≥50 % , 1-second forced expiratory volume ( FEV1 ) ≥60 and forced vital capacity ( FVC ) ≥60 % of predicted value . Interventions : Patients were r and omly placed into two groups : one performed prescribed exercises according to the model proposed by the American College of Sports Medicine ( ACSM ) and the other according to a periodized model . Main measures : Partial pressure of O2 ( Po2 ) and arterial O2 saturation ( Sao2 ) , percentage of predicted FVC and total distance on the six-minute walking test ( 6MWT ) . Results : Twenty-seven patients were re-evaluated upon release from the hospital ( ACSM = 14 and PP = 13 ) . Five patients extubated for more than 6 hours in the postoperative period were excluded from the sample . In the preoperative period the variables Po2 , Sao2 , % FVC and 6MWT were similar . In the postoperative period , a reduction was observed for all parameters in both groups . Upon comparison of the groups , a difference was observed in Po2 ( ACSM = 68.0 ± 4.3 vs. PP = 75.9 ± 4.8 mmHg ; P < 0.001 ) , Sao2 ( ACSM = 93.5 ± 1.4 vs. PP = 94.8 ± 1.2 % ; P = 0.018 ) and 6MWT ( ACSM = 339.3 ± 41.7 vs. PP = 393.8 ± 25.7 m ; P < 0.001 ) . There was no difference in % FVC . Conclusion : Patients after myocardial revascularization following a periodized model of exercise presented a better intra-hospital evolution when compared to those using the ACSM model RATIONALE The optimal exercise training intensity and strategy for individualized exercise training in chronic obstructive pulmonary disease ( COPD ) is not clear . OBJECTIVES This study compares the effects of nonlinear periodized exercise ( NLPE ) training used in athletes to traditional endurance and progressive resistance ( EPR ) training in patients with severe COPD . METHODS A total of 110 patients with severe COPD ( FEV1 32 % predicted ) were r and omized to EPR or NLPE . Exercise training was performed three times per week for 10 weeks . The primary outcomes were cycling endurance time and health-related quality of life using the Chronic Respiratory Question naire . The difference in change between EPR and NLPE was assessed using linear mixed-effects modeling . MEASUREMENTS AND MAIN RESULTS NLPE result ed in significantly greater improvements in cycling endurance time compared with EPR . The difference in change was + 300.6 seconds ( 95 % confidence interval [ CI ] = 197.2 - 404.2 s ; P < 0.001 ) . NLPE also result ed in significantly greater improvements in all domains of the Chronic Respiratory Question naire compared with EPR , ranging from + 0.48 ( 95 % CI = 0.19 - 0.78 ) for the domain , emotions , to + 0.96 ( 95 % CI = 0.57 - 1.35 ) for dyspnea . CONCLUSIONS NLPE results in greater improvements in cycle endurance and health-related quality of life in patients with severe COPD than traditional training methods . Clinical trial registered with www.trialregister.nl ( The Netherl and s Trial Register ; NTR 1045 ) Kell , RT , and Asmundson , GJG . A comparison of two forms of periodized exercise rehabilitation programs in the management of chronic nonspecific low-back pain . J Strength Cond Res 23(2 ) : 513 - 523 , 2009-The purpose of this study was to determine the influence of 2 different periodized exercise rehabilitation programs ( resistance training [ RT ] and aerobic training [ AT ] ) on musculoskeletal health , body composition , pain , disability , and quality of life ( QOL ) in chronic ( ≥3 months ; ≥3 d·wk−1 ) nonspecific low-back pain ( CLBP ) persons . Twenty-seven CLBP subjects were r and omly assigned to 1 of 3 groups , 1 ) RT ( n = 9 ) , 2 ) AT ( n = 9 ) , or 3 ) control ( C ; n = 9 ) . Subjects were tested at baseline and at weeks 8 and 16 of training . Intensity and volume were periodized in the training groups . Significance was set at p ≤ 0.05 . No significant differences were noted among the groups at baseline . The RT group significantly decreased body fat percent from baseline to week 8 and from baseline to week 16 , whereas the AT group significantly decreased body fat percent and body mass from baseline to week 16 . The RT group significantly improved most musculoskeletal fitness , pain , disability , and QOL outcomes from baseline to week 8 , baseline to week 16 , and weeks 8 to 16 . However , the AT group showed significant improvements in flexibility from baseline to week 8 and in cardiorespiratory and peak leg power from baseline to week 8 and baseline to week 16 . The AT groups showed no significant improvements in pain , disability , or QOL . The primary finding was that periodized RT was successful at improving many fitness , pain , disability , and QOL outcome measures , whereas AT was not . This study indicates that whole-body periodized RT can be used by training and conditioning personnel in the rehabilitation of those clients suffering with CLBP Abstract It may be that resistance exercise can be used to prevent the degenerative processes and inflammation associated with ageing . Thus , the aim of the present study was to evaluate the effects of resistance training on cytokines , leptin , resistin , and muscle strength in post-menopausal women . Thirty-five sedentary women ( mean age 63.18 years , s = 4.8 ; height 1.64 m , s = 0.07 ; body mass 57.84 kg , s = 7.70 ) were recruited . The 16 weeks of periodized resistance training consisted of two weekly sessions of three sets of 6–14 repetition maximum . Maximal strength was tested in bench press , 45 ° leg press , and arm curl . Plasma tumour necrosis factor-α , interleukin-6 , interleukin-15 , leptin , and resistin were determined by enzyme-linked immunosorbent assay . Maximal strength on all measures was increased after 16 weeks . There were minor or no modifications in tumour necrosis factor-α and interleukin-15 . Interleukin-6 was decreased 48 h after compared with baseline and declined after 16 weeks . Leptin decreased 24 h after compared with baseline and was reduced at baseline and 48 h after compared with pre-training . There was a decrease in resistin after 24 and 48 h compared with baseline and a decline in baseline and immediately after levels compared with pre-training . A possible explanation of the results of the present study is a lower production of pro-inflammatory cytokines by the innate immune system . Periodized resistance training seems to be an important intervention to reduce systemic inflammation in this population Abstract McNamara , JM and Stearne , DJ . Effect of concurrent training , flexible nonlinear periodization , and maximal-effort cycling on strength and power . J Strength Cond Res 27(6 ) : 1463–1470 , 2013—Although there is considerable research on concurrent training , none has integrated flexible nonlinear periodization and maximal-effort cycling in the same design . The purpose of this investigation was to test outcome measures of strength and power using a pretest-posttest r and omized groups design . A strength and endurance ( SE ) group was compared with a strength , endurance , and maximal-effort cycling ( SEC ) group . Both groups used a flexible nonlinear periodization design . Thirteen male and 7 female students ( mean ± SD : age , 22.5 ± 4.1 years ; height , 173.5 ± 12.4 cm ; weight , 79.4 ± 20.2 kg ; strength training experience , 2.4 ± 2.2 years ) participated in this study . Groups were not matched for age , height , weight , strength training experience , or sex , but were r and omly assigned to an SE ( n = 10 ) or SEC ( n = 10 ) group . All training was completed within 45 minutes , twice per week ( Monday and Wednesday ) , over 12 consecutive weeks . Both groups were assigned 6.75 total hours of aerobic conditioning , and 13.5 hours of free weight and machine exercises totaling 3,188 repetitions ranging from 5 to 20 repetition maximums . The SEC group performed 2 cycling intervals per workout ranging from 10 to 45 seconds . Pretest and posttest measures included chest press and st and ing broad jump . Analysis of variance showed that there were no significant differences between the SE and SEC groups on measures of chest press or st and ing broad jump performance ( p , not significant ) . Paired sample t-tests ( p = 0.05 ) showed significant improvement in strength and power in all groups ( pretest to posttest ) , except for SE jump performance ( p , not significant ) . In conclusion , adding maximal-effort cycling does not provide additional strength or power benefits to a concurrent flexible nonlinear training program . However , an exercise professional can take confidence that a concurrent flexible nonlinear training program can increase strength and power in healthy individuals The purpose of this 12 month r and omized exercise intervention was to determine the effect of a block-periodized multi purpose exercise program on bone mineral density ( BMD ) and parameters of the metabolic syndrome ( MetS ) in early post-menopausal women . Eighty-five subjects ( 52.3 ± 2.4 years ) living in the area of Erlangen ( Germany ) were r and omly assigned into an exercise ( EG , n=43 ) or a wellness-control group ( CG : n=42 ) . The EG performed a periodized multi purpose exercise program with 4 - 6-week blocks of high-intensity bone-specific exercise intermitted by 10 - 12 weeks of exercise dedicated to increase endurance and reduce cardiac and metabolic risk factors . The CG performed a low-volume/low-intensity " wellness " program to increase well-being . After 12 months , significant exercise effects were observed for the lumbar spine ( LS ) BMD as assessed by quantitative computed tomography [ total BMD ( EG : -0.3 ± 2.1 % vs CG : -2.1 ± 2.2 % , P=0.015 ) ; trabecular BMD ( EG : -0.7 ± 3.4 % vs CG : -4.7 ± 4.9 % , P=0.001 ) and dual-energy x-ray absorptiometry ( DXA ) ( EG : -0.1 ± 2.2 % vs CG : -2.0 ± 2.0 % , P=0.002 ) ] . However , no significant effects were observed for total hip BMD as assessed by DXA ( P=0.152 ) . Although all MetS parameters were favorably affected among the EG , only the effect for waist circumference was significant . In summary , short periods of bone-specific intervention embedded in longer periods of exercises dedicated to improve cardiovascular and metabolic risk factors positively affected BMD at the LS BACKGROUND Community-based interventions that incorporate resistance training ( RT ) and dietary changes have not been extensively studied in overweight and obese older adults . The purpose of this investigation was to determine the effects of a community-based RT and dietary intervention on physical function and body composition in overweight and obese older adults . METHODS Ninety-five overweight and obese ( BMI = 33.4±4.0 kg/m2 ) older adults aged 55 - 80 years completed an 8-week RT and dietary intervention at 4 Rhode Isl and senior centers . Participants performed RT twice-weekly using resistance tubing , dumbbells , and ankle weights . Participants also attended 1 weekly dietary counseling session on a modified Dietary Approaches to Stop Hypertension diet . Outcome measurements included anthropometrics , body composition , and physical function . RESULTS There were small changes in body mass ( -1.0±1.8 kg , P<.001 ) , waist circumference ( -5.2±3.8 cm , P<.001 ) , and percent body fat ( -0.5±1.4 % , P<.001 ) . In addition , significant improvements were observed in knee extensor torque ( + 7.9±19.1 N-m , P<.001 ) , h and grip strength ( + 1.2±2.5 kg , P<.001 ) , and 8-foot up- and -go test time ( -0.56±0.89 s , P<.001 ) . CONCLUSION Community-based RT and dietary modifications can improve body composition , muscle strength , and physical function in overweight and obese older adults . Future investigations should determine if this intervention is effective for long-term changes Abstract Objective Examine the relationship between acute affective responses during a moderate-intensity exercise stimulus and future physical activity participation . Design Longitudinal , observational study in the context of a r and omized controlled trial . Methods Healthy , sedentary adults ( n=37 ) reported their basic affective response ( i.e. , feel good versus bad ) prior to and during an acute , moderate-intensity exercise stimulus presented prior to r and omization in a controlled physical activity promotion trial . At 6 and 12 months , 31 of the 37 participants reported their total weekly minutes of physical activity . Results As hypothesized , basic affective response to the moderate-intensity stimulus predicted 6-month physical activity ( β=.51 , p=.013 ) when controlling for baseline physical activity and self-reported affect prior to the initial exercise stimulus , and 12-month physical activity ( β=.45 , p=.047 ) when also controlling for 6-month physical activity . Conclusions Affective response to an acute moderate-intensity exercise stimulus  predicted self-reported physical activity 6 and 12 months later . The findings could have implication s for prescription of exercise intensity , as exercising at an intensity that yields a positive affective response may lead to greater participation in physical activity programs among previously sedentary adults AIM The aim of the present study was to evaluate the effects of 16 weeks of periodized resistance training in lipid profile in sedentary middle-aged men and women . METHODS Healthy subjects ( N.=50 ) , middle-aged men and postmenopausal women ( > 12 months amenorrhea ) , were r and omized into resistance training men ( RTM ) , resistance training women ( RTW ) , control group men ( CGM ) and control group women ( CGW ) . They performed three weekly sessions for 16 weeks ( 9 exercises with 3 x 8 - 10 RM and with a 60 - 90 seconds rest period ) . RESULTS Trained groups showed significant decrease in total cholesterol ( TC ) ( RTM -23.61 % ; RTW -21.08 % ; P=0.0001 ) and LDL-C ( RTM -35.68 % ; RTW -38.53 % ; P=0.0001 ) . No significant changes were observed in HDL-C and triglycerides ( TG ) . No significant changes were found in plasma levels of LDL-C , HDL-C and TG for control groups , though there were significant differences between CGM and CGW for TC . CONCLUSION The present results indicate that 16 weeks of periodized RT contribute to decrease of cardiovascular risk factors , such as LDL-C and TC in middle-aged men and women , even without changes in body mass and body mass index Objective : The aim of this study was to determine the effect of periodized exercise training with and without Cimicifuga racemosa ( CR ) on bone mineral density ( BMD ) and 10-year coronary heart disease ( CHD ) risk in early postmenopausal women . Methods : A total of 128 women were r and omly assigned to three subgroups : exercise ( EG , n = 43 ) , exercise and CR supplementation ( EGCR , n = 43 ) , and wellness control ( control group [ CG ] , n = 42 ) . Both exercise groups performed a periodized exercise program with high-intensity-resistance/high-impact exercise dedicated to bone parameters interspersed by blocks of 10 weeks of training focusing on CHD parameters . In addition to the exercise program , the EGCR was supplemented with 40 mg/day of CR according to the specification of the manufacturer . A low-intensity exercise program of 60 minutes per week for a period of 10 weeks interspersed with 10-week blocks without exercise was performed in the CG . Primary endpoints were BMD and 10-year CHD risk proposed by Wilson . Secondary endpoints were body composition and menopausal symptoms . Results : BMD at the lumbar spine was maintained in both exercise groups ( EG , −0.1 % ± 2.2 % , P = 0.74 ; EGCR , −0.4 % ± 2.4 % , P = 0.40 ) and significantly decreased ( P < 0.001 ) in the CG ( 2.0 % ± 2.0 % ) . Both exercise groups significantly differed from the CG ( P = 0.001 and 0.005 for the EG and EGCR , respectively ) ; however , no differences between the exercise groups with and without CR was determined . Although slight increases in femoral neck BMD were determined in both exercise groups ( EG , 0.5 % ± 3.0 % , P = 0.36 ; EGCR , 0.4 % ± 3.1 % , P = 0.52 ) , a reduction was assessed in the CG ( −0.6 % ± 2.7 % , P = 0.29 ) . No significant differences were determined between the groups . The 10-year CHD risk significantly increased in the EGCR ( 12.9 % ± 25.1 % , P = 0.018 ) and in the CG ( 16.5 % ± 27.8 % , P = 0.007 ) . The EG did not show corresponding changes ( −2.7 % ± 21.9 % , P = 0.60 ) . However , no significant between-group differences were observed . Conclusions : In conclusion our exercise program favorably affected bone , menopausal symptoms , lean body mass , and , to a smaller extent , 10-year CHD risk in early postmenopausal women . Adjuvant supplementation of CR did not enhance these positive effects While the benefits of exercise are clear , many unresolved issues surround the optimal exercise prescription . Many organizations recommend aerobic training ( AT ) and resistance training ( RT ) , yet few studies have compared their effects alone or in combination . The purpose of this study , part of Studies Targeting Risk Reduction Interventions Through Defined Exercise-Aerobic Training and /or Resistance Training ( STRRIDE/AT/RT ) , was to compare the effects of AT , RT , and the full combination ( AT/RT ) on central ectopic fat , liver enzymes , and fasting insulin resistance [ homeostatic model assessment ( HOMA ) ] . In a r and omized trial , 249 subjects [ 18 - 70 yr old , overweight , sedentary , with moderate dyslipidemia ( LDL cholesterol 130 - 190 mg/dl or HDL cholesterol ≤ 40 mg/dl for men or ≤ 45 mg/dl for women ) ] performed an initial 4-mo run-in period . Of these , 196 finished the run-in and were r and omized into one of the following 8-mo exercise-training groups : 1 ) RT , which comprised 3 days/wk , 8 exercises , 3 sets/exercise , 8 - 12 repetitions/set , 2 ) AT , which was equivalent to ∼19.2 km/wk ( 12 miles/wk ) at 75 % peak O(2 ) uptake , and 3 ) full AT + full RT ( AT/RT ) , with 155 subjects completing the intervention . The primary outcome variables were as follows : visceral and liver fat via CT , plasma liver enzymes , and HOMA . AT led to significant reductions in liver fat , visceral fat , alanine aminotransferase , HOMA , and total and subcutaneous abdominal fat ( all P < 0.05 ) . RT result ed in a decrease in subcutaneous abdominal fat ( P < 0.05 ) but did not significantly improve the other variables . AT was more effective than RT at improving visceral fat , liver-to-spleen ratio , and total abdominal fat ( all P < 0.05 ) and trended toward a greater reduction in liver fat score ( P < 0.10 ) . The effects of AT/RT were statistically indistinguishable from the effects of AT . These data show that , for overweight and obese individuals who want to reduce measures of visceral fat and fatty liver infiltration and improve HOMA and alanine aminotransferase , a moderate amount of aerobic exercise is the most time-efficient and effective exercise mode PURPOSE The purpose of this paper is to review the evidence on the role of physical activity in the treatment of adult overweight and obesity . Three specific questions are addressed : ( 1 ) Does exercise alone produce weight loss ? ( 2 ) Does exercise in combination with diet produce greater weight loss than diet only ? and ( 3 ) Does exercise in combination with diet produce better maintenance of weight loss than diet alone ? METHODS The literature initially identified by the Expert Panel on Clinical Guidelines for the Treatment of Obesity , three key meta analyses , and additional literature search es were used to identify r and omized trials related to the three aforementioned topics . These articles were review ed and tabulated . RESULTS Six of 10 r and omized studies found significantly greater weight loss in exercise alone versus no treatment controls . The magnitude of the effect averaged 1 - 2 kg . Only 2 of 13 studies found significant differences in initial weight loss for diet plus exercise versus diet only , although almost all studies pointed in this direction . Six studies were identified with maintenance periods of at least 1 yr . In two of the six there were significant long term differences favoring diet plus exercise , but in every study considered the direction of the difference favored diet plus exercise . Other strong evidence showing benefits of exercise for long-term weight loss comes from correlational analyses which consistently find that those individuals who report the greatest exercise have the best maintenance of weight loss . CONCLUSIONS R and omized trials consistently show benefits of exercise for weight loss , but the effects are often modest . This may result from small sample sizes , short study duration , and poor adherence to the exercise prescriptions . To better define the doses and types of exercise that will promote long-term weight loss , it is necessary to develop better ways to measure exercise and promote adherence to exercise The aim of this r and omized controlled study was to verify the impact of a 12-weeks muscular endurance ( ME ) training of high repetitions ( i. e. , 15 - 30 ) with 2 different periodization models on body composition , maximal strength , muscular endurance and cardiorespiratory fitness .  Twenty eight sedentary women aged 20 - 35 years were r and omly assigned to : control ( CON ) ( n=8 ) , linear periodization ( LP ) ( n=10 ) and daily undulating periodization ( DUP ) ( n=10 ) . LP and DUP models significantly improved body composition , maximal strength and ME . However , no significant changes were detected for cardiorespiratory fitness . LP showed a higher body fat loss ( - 12.73 % ) compared to DUP ( - 9.93 % ) ( p=0.049 ) , and systematic ally higher effect sizes ( ES ) when compared with DUP for maximal strength and cardiorespiratory fitness parameters ( e. g. ES=0.53 for ventilatory threshold ) . In contrast , DUP exhibited a significantly ( p=0.002 ) greater ME gain ( 129.43 % ) compared to LP ( 70.72 % ) in bench press , and greater ES in all exercises . It may be suggested that LP performed with a high number of repetitions may be considered an appropriate periodization model for untrained young women that would likely lead to the improvement of body composition and maximum strength performance , whereas DUP is more effective for the development of ME Background Restoration of physical function following lumbar microdiskectomy may be influenced by the postoperative care provided . Objective The purpose of this study was to examine the effectiveness of a new interventional protocol to improve functional performance in patients who have undergone a single-level lumbar microdiskectomy . Setting The study was conducted in physical therapy outpatient clinics . Design and Participants Ninety-eight participants ( 53 male , 45 female ) who had undergone a single-level lumbar microdiskectomy were r and omly allocated to receive education only or exercise and education . Intervention and Measurements The exercise intervention consisted of a 12-week periodized program of back extensor strength ( force-generating capacity ) and endurance training and mat and upright therapeutic exercises . The Oswestry Disability Index ( ODI ) and physical measures of functional performance were tested 4 to 6 weeks postsurgery and 12 weeks later , following completion of the intervention program . Because some participants sought physical therapy outside of the study , postintervention scores were analyzed for both an as-r and omized ( 2-group ) design and an as-treated ( 3-group ) design . Results In the 2-group analyses , exercise and education result ed in a greater reduction in ODI scores and a greater improvement in distance walked . In the 3-group analyses , post hoc comparisons showed a significantly greater reduction in ODI scores following exercise and education compared with the education-only and usual physical therapy groups . Limitations The limitations of this study include a lack of adherence to group assignment , disproportionate therapist contact time among treatment groups , and multiple use of univariate analyses . Conclusions An intensive , progressive exercise program combined with education reduces disability and improves function in patients who have undergone a single-level lumbar microdiskectomy
Background Periodization of exercise is a method typically used in sports training , but the impact of periodized exercise on health outcomes in untrained adults is unclear .
Purpose This review aims to summarize existing research wherein aerobic or resistance exercise was prescribed to inactive adults using a recognized periodization method .