Feasibility and Effects of a Postoperative Recovery Exercise Program Developed Specifically for Gastric Cancer Patients (PREP-GC) Undergoing Minimally Invasive Gastrectomy

PURPOSE: Exercise intervention after surgery has been found to improve physical fitness and quality of life (QOL). The purpose of this study was to investigate the feasibility and effects of a postoperative recovery exercise program developed specifically for gastric cancer patients (PREP-GC) undergoing minimally invasive gastrectomy. MATERIALS AND METHODS: Twenty-four patients treated surgically for early gastric cancer were enrolled in the PREP-GC. The exercise program comprised sessions of In-hospital Exercise (1 week), Home Exercise (1 week), and Fitness Improvement Exercise (8 weeks). Adherence and compliance to PREP-GC were evaluated. In addition, body composition, physical fitness, and QOL were assessed during the preoperative period, after the postoperative recovery (2 weeks after surgery), and upon completing the PREP-GC (10 weeks after surgery). RESULTS: Of the 24 enrolled patients, 20 completed the study without any adverse events related to the PREP-GC. Adherence and compliance rates to the Fitness Improvement Exercise were 79.4% and 99.4%, respectively. Upon completing the PREP-GC, patients also exhibited restored cardiopulmonary function and muscular strength, with improved muscular endurance and flexibility (P < 0.05). Compared to those in the preoperative period, no differences were found in symptom scale scores measured using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire (QLQ-C30) and Quality of Life Questionnaire-Stomach Cancer-Specific Module (QLQ-STO22); however, higher scores for global health status and emotional functioning were observed after completing the PREP-GC (P < 0.05). CONCLUSIONS: In gastric cancer patients undergoing minimally invasive gastrectomy, PREP-GC was found to be feasible and safe, with high adherence and compliance. Although randomized studies evaluating the benefits of exercise intervention during postoperative recovery are needed, surgeons should encourage patients to participate in systematic exercise intervention programs in the early postoperative period (Registered at the ClinicalTrials.gov NCT01751880).

Energy Expenditure on a User Sensitive Spontaneous Speed Control Treadmill

BACKGROUND: A conventional treadmill provides manually controlled constant speed during exercise. A fast interactive automatic speed control treadmill (FAST), which is highly sensitive to the position of the user on the belt and spontaneously adjusts its speed accordingly, was evaluated in terms of energy expenditure (EE) during exercise. METHODS: A total of 43 subjects were recruited and assigned to one of three exercise intensity groups-low (LIG; 40-50% of VO2max), moderate (MIG; 55-65% of VO2max), and high (HIG; 70-80% of VO2max). During the first test (Test-1), each subject performed an exercise bout on the FAST while spontaneously changing their locomotion speed within their assigned range of intensity. The average speed in Test-1 was calculated and applied to the second test (Test-2), in which the subjects exercised at a constant belt speed and matched the total travel distance of Test-1. During the tests, the oxygen uptake (VO2), heart rate (HR), respiratory quotient (RQ), oxygen pulse (OP), and EE of each subject were measured. RESULTS: The average VO2 in Test-1 was higher than that in Test-2 for both the LIG (22.95+/-2.55 vs. 21.72+/-2.90 ml/kg/min) and MIG (31.17+/-3.75 vs. 29.73+/-4.86 mL/kg/min) (P<.05) subjects. The EE in Test-1 was higher than that in Test-2 for both the LIG (7.09+/-1.67 vs. 6.71+/-1.73 kcal/min) and MIG (9.79+/-2.62 vs. 9.32+/-2.71 kcal/min) (P<.05) subjects. The HR, RQ, and OP in the LIG and the MIG were similar. There was no difference between Test-1 and Test-2 in any of the metabolic parameters for the HIG subjects. CONCLUSIONS: The results indicated that, low- to moderate-intensity treadmill exercise at varying speeds required higher energy expenditure than that at a constant speed. Thus, a treadmill with a spontaneous speed variation function may be an effective exercise modality that increases energy expenditure.

Effects of rehydration fluid temperature and composition on body weight retention upon voluntary drinking following exercise-induced dehydration

The purpose of this study was to determine the effects of beverage temperature and composition on weight retention and fluid balance upon voluntary drinking following exercise induced-dehydration. Eight men who were not acclimated to heat participated in four randomly ordered testing sessions. In each session, the subjects ran on a treadmill in a chamber maintained at 37degrees C without being supplied fluids until 2% body weight reduction was reached. After termination of exercise, they recovered for 90 min under ambient air conditions and received one of the following four test beverages: 10degrees C water (10W), 10degrees C sports drink (10S), 26degrees C water (26W), and 26degrees C sports drink (26S). They consumed the beverages ad libitum. The volume of beverage consumed and body weight were measured at 30, 60, and 90 min post-recovery. Blood samples were taken before and immediately after exercise as well as at the end of recovery in order to measure plasma parameters and electrolyte concentrations. We found that mean body weight decreased by 1.8-2.0% following exercise. No differences in mean arterial pressure, plasma volume, plasma osmolality, and blood electrolytes were observed among the conditions. Total beverage volumes consumed were 1,164 +/- 388, 1,505 +/- 614, 948 +/- 297, and 1,239 +/- 401 ml for 10W, 10S, 26W, and 26S respectively (P > 0.05). Weight retention at the end of recovery from dehydration was highest in 10S (1.3 +/- 0.7 kg) compared to 10W (0.4 +/- 0.5 kg), 26W (0.4 +/- 0.4 kg), and (0.6 +/- 0.4 kg) (P < 0.005). Based on these results, carbohydrate/electrolyte-containing beverages at cool temperature were the most favorable for consumption and weight retention compared to plain water and moderate temperature beverages.

Effects of caloric restriction with varying energy density and aerobic exercise on weight change and satiety in young female adults

This study examines the combined effects of caloric restriction on body composition, blood lipid, and satiety in slightly overweight women by varying food density and aerobic exercise. Twenty-three women were randomly assigned to one of two groups for a four-week weight management program: the high-energy density diet plus exercise (HDE: n = 12, 22 +/- 2 yrs, 65 +/- 7 kg, 164 +/- 5 cm, 35 +/- 4 % fat) and low-energy density diet plus exercise (LDE: n = 11, 22 +/- 1 yrs, 67 +/- 7 kg, 161 +/- 2 cm, 35 +/- 4 % fat) groups. Subjects maintained a low-calorie diet (1,500 kcal/day) during the program. Isocaloric (483 +/- 26 for HDE, 487 +/- 27 kcal for LDE) but different weight (365 +/- 68 for HDE, 814 +/- 202 g for LDE) of lunch was provided. After lunch, they biked at 60% of maximum capacity for 40 minutes, five times per week. The hunger level was scaled (1: extremely hungry; 9: extremely full) at 17:30 each day. Before and after the program, the subjects' physical characteristics were measured, and fasting blood samples were drawn. The daily energy intake was 1,551 +/- 259 for HDE and 1,404 +/- 150 kcal for LDE (P > 0.05). After four weeks, the subjects' weights and % fat decreased for both LDE (-1.9 kg and -1.5%, P < 0.05) and HDE (-1.6 kg and -1.4%, respectively, P < 0.05). The hunger level was significantly higher for HDE (2.46 +/- 0.28) than for LDE (3.10 +/- 0.26) (P < 0.05). The results suggest that a low-energy density diet is more likely to be tolerated than a high-energy density diet for a weight management program combining a low-calorie diet and exercise, mainly because of a reduced hunger sensation.

Molecular Mechanism of TNF-alpha and MMP-9 Production in Response to HIV-1 Core Antigen p24 in Human Monocytie THP-1 Cells

No abstract available.