Structured exercise training that consists of aerobic exercise, resistance training, or both combined is associated with HbA(1c) reduction in patients with type 2 diabetes. Structured exercise training of more than 150 minutes per week is associated with greater HbA(1c) declines than that of 150 minutes or less per week. Physical activity advice is associated with lower HbA(1c), but only when combined with dietary advice.

Background and Aim: The relationship between inspiratory muscle weakness and exercise intolerance in patients with heart failure has not been established, especially in elderly patients. The aim of this study was to investigate the relationship between inspiratory muscle strength and exercise tolerance according to age in elderly patients with heart failure. Methods: A total of 25 hospitalized patients were allocated to younger group (age<75) or older group (age>75). Medical records were reviewed with regard to echocardiograms (EF, LVDd/Ds), laboratory data (BNP), chest X-ray (CTR). We assessed inspiratory muscle strength (PImax), knee extensor muscle strength (KEMS), six-minute walk distance (6MWD) and normal / maximal gate speed. The correlation between 6MWD and other values was tested by Pearson's product-moment correlation coefficient in each group. Differences between 2 groups were compared with using stu-dent's t-test. A P-value of <.05 was considered to be statistically significant. Results: 6MWD was significantly correlated with PImax (r=0.74), KEMS (r=0.81), normal gate speed (r=0.71), maximal gate speed (r=0.68) in younger group. On the other hand, 6MWD was significantly correlated with only KEMS (r=0.57) and maximal gate speed (r=0.63) in older group. The value of 6MWD was shorter and the value of gate speed was slower in older group compared with those values in younger group (p<.05). Conclusion: These results suggested that inspiratory muscle weakness might be associated with exercise intolerance in younger patients with heart failure. Meanwhile, muscle strength and gate speed might be important as a determining factor of exercise tolerance in elderly patients with heart failure. Background: Although Chinese pulmonary function testing (PFT)

In patients with CHF and inspiratory muscle weakness, inspiratory muscle loading results in marked reduction of blood flow to resting and exercising limbs. Inspiratory muscle training improves limb blood flow under inspiratory loading in these patients.

The mechanism responsible for the attenuated heart rate (HR) response to exercise in patients with congestive heart failure (CHF) was investigated in 46 normal subjects and 59 patients with CHF stratified by peak exercise oxygen consumption (Vo2). The peak exercise HR and the increment in HR from rest to peak exercise were decreased in CHF patients, and both correlated strongly with peak Vo2 (r=0.810, p<0.0001; r=0.863, p <0.0001, respectively). Peak exercise norepinephrine level (NE) and the increment in NE from rest to peak exercise were not attenuated in CHF patients. Resting NE was elevated in CHF patients and correlated inversely with peak Vo2 (r=-0.595, p<0.001). However, no significant correlation occurred between peak Vo2 and either peak exercise NE or the exercise increment in NE. The ratio of the exercise increments in HR and NE, an indirect index of sinoatrial node sympathetic responsiveness, was markedly reduced in CHF patients and was inversely related to the severity of exercise impairment. Likewise, the HR response to a graded isoproterenol infusion was markedly reduced in CHF patients. Age-matching of normal subjects and CHF patients did not affect the foregoing observations. Infusion of CHF patients with the phosphodiesterase inhibitor milrinone caused a significant increase in the ratio of the exercise increments in HR and NE. These data strongly suggest that the attenuated HR response to exercise in CHF patients is due, at least in part, to postsynaptic desensitization of the 8-adrenergic receptor pathway. (Circulation 1989;80:314-323) P eak heart rate response to exercise is determined primarily by the magnitude of increase in sympathetic drive to the heart and the ability of f-adrenergic receptors in the sinoatrial node to respond to catecholamines. In patients with congestive heart failure (CHF), the chronotropic response to peak exercise is reduced and may contribute significantly to the impaired cardiac output response to exercise.1-4The mechanism responsible for a reduced chronotropic response to exercise in patients with CHF is not known. Although it is known that both the reflex stimulation of sympathetic nervous system

Aerobic training in overweight pregnant women substantially increases submaximal exercise capacity, overcoming the otherwise negative effects of pregnancy in this regard. Additional studies are required to evaluate its effect on major clinical outcomes.

This randomized trial demonstrates that the addition of IMT to AE results in improvement in cardiorespiratory responses to exercise in selected patients with CHF and IMW. The clinical significance of these findings should be addressed by larger randomized trials.

HIV-seropositive individuals with lipodystrophy and dyslipidemia submitted to a short-term intervention of low-lipid diet and aerobic exercise training are able to increase their functional capacity without any consistent changes in plasma lipid levels.

Pre- and postoperative cardiopulmonary rehabilitation in patients who await CABG in the hospital is superior to standard care and leads to a reduced rate of postoperative complications and shorter hospital stay.