Evaluation of Community Exercise Classes for Cardiovascular Diseases

ABSTRACT Background: Community-based exercise classes have the potential to sustain the benefits of cardiac rehabilitation for the prevention of future cardiovascular events. Such classes can be designed to address this need; however, whether such classes meet these objectives is rarely evaluated. Methods: Facility managers, instructors, and class participants completed questionnaires. Two assessors observed exercise classes called “Heartmoves.” A maximum of 10 participants per class wore heart rate (HR) monitors. Mean and highest HR as percentage of age-predicted maximum were recorded for class components. At the end of classes, participants completed a 10-point rating of perceived exertion (RPE) scale. Data were compared with international guidelines for community exercise classes for individuals with cardiovascular disease (CVD). Results: Twelve classes were observed with 82 participants. All classes included guideline-recommended components of warm-up, cooldown, strength, and aerobic conditioning; 58% of classes (n = 7) incorporated strength and aerobic conditioning in a circuit. Class participants exercised at low to moderate intensities as indicated by mean ± SD: HR (warm-up 55% ± 11% age-predicted maximum HR; cooldown 52 ± 11; strength 59 ± 11; aerobic conditioning 58 ± 12); and overall RPE (6 ± 2). Class participants' mean age was 70 ± 8 years; 27% (n = 24) were referred by health professionals; 73% (n = 61) attended for fitness; 61% (n = 50) had CVD risk factors; and 21% (n = 17) reported diagnosed CVD. Conclusion: Community exercise classes for individuals with CVD, specifically those aligned with Heartmoves, may comply with international guidelines, although few class participants have diagnosed CVD.

A MULTI-COMPONENT HOME-BASED PHYSICAL THERAPY INTERVENTION FOR IMPROVING COMMUNITY AMBULATION AFTER HIP FRACTURE

Presented is a two-group RCT evaluating a multi-component exercise program for hip fracture patients to determine if it is effective in improving the ability to walk independently in the community. Hip fracture patients age ≥60 years (N=210) were assessed and randomized within 26 weeks of hospitalization, and reassessed 16 and 40 weeks later. The primary outcome was ability to walk 300m in six minutes. PUSH (active treatment) included aerobic conditioning, strengthening, balance and functional training. PULSE (attention control) included transcutaneous electrical nerve stimulation, flexibility and active range of motion exercises. Both groups received 2-3 visits per week for 16 weeks in their residences from a physical therapist. 22/96 in PUSH (22.9%) and 18/101 in PULSE (17.8%) (difference 5.1%; 95% CI: -6.1%, 16.3%; P=.37) became community ambulators. We conclude that advancing substantial proportions of hip fracture patients to community ambulation will require more than the intervention evaluated in this study.

Physical and Physiological Characteristics of Various-Sided Games in Elite Women’s Soccer

Purpose:To investigate the physical and physiological response to different formats of various-sided games.Methods:Eighteen elite women’s soccer players wore 15-Hz global positioning system devices and heart-rate (HR) monitors during various-sided games (small, 4 vs 4 and 5 vs 5; medium, 6 vs 6 and 7 vs 7; large, 8 vs 8 and 9 vs 9).Results:Players covered more relative sprinting distance during large-sided games than in small-sided (P < .001, d = 0.69) and medium-sided (P < .001, d = 0.54) games. In addition, a greater proportion of total acceleration efforts that had a commencement velocity <1 m/s were observed in small-sided games (44.7% ± 5.5%) than in large-sided games (36.7% ± 10.6%) (P = .018, d = 0.94). This was accompanied by a greater proportion of acceleration efforts with a final velocity equivalent to the sprint threshold in large-sided games (15.4% ± 7.7%) than in small-sided games (5.2% ± 2.5%) (P < .001, d = 1.78). The proportion of time spent in HR zone 4 (>85% maximum HR) was greater during small-sided games (69.8% ± 2.5%) than in medium- (62.1% ± 2.8%, d = 2.90) and large-sided games (54.9% ± 3.1%) (P < .001, d = 5.29).Conclusions:The results from this study demonstrate that coaches can use small-sided games as an aerobic conditioning stimulus and to develop players’ explosiveness and repeat-sprint ability over short durations. Large-sided games can be used to maintain aerobic capacity and develop maximum speed over longer distances.