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Exercise as it relates to Disease/Can strength training preserve bone mineral density in postmenopausal women?

This is a critique of the journal article titled "Strength training preserves the bone mineral density of postmenopausal women without hormone replacement therapy" by Danilo Sales Bocalini, Andrey Jorge Serra, Leonardo dos Santos, Neif Murad and Rozeli Ferreira Levy published in 2009 in the Journal of Aging and Health

What is the background to this research?

Bone mineral density (BMD) decreases as we age which can lead to a lot of health implications with osteoporosis being one of the most common in postmenopausal women. One in three women agreed fifty years and older will suffer from osteoporosis in their lifetime. The result of this is linked to a decrease in quality of life for many individuals due to fractures in hips, wrists and forearms which can cause them to struggle with walking, lifting, bending over, cooking, cleaning, personal care and cause mobility issues. The loss of bone mineral density and osteoporosis is commonly linked with older women who have a hormone deficiency.

Hormone replacement therapy is commonly prescribed to postmenopausal women to offset bone loss, however, there is evidence to suggest that resistance training on its own can stimulate bone formation and reduce the risk of osteoporosis. Most studies in this area look at a combination of hormone therapy and strength training, however, in the study being reviewed today, we are looking at bone mineral density and strength training without hormone therapy. This is important as not all individuals are willing to undergo hormone therapy.

Where is the research from?
This research was conducted in Sȃo Paulo in Brazil and was published in the Journal of Aging and Health. The primary author in this study was Danilo Sales Bocalini who is from the Federal University of Sȃo Paulo and Heart Institute and Medical School. Danilo has a PhD and specialises in resistance training, physical fitness, blood pressure, physiology, molecular biology and atherosclerosis. He has published around two hundred articles and is currently undergoing more studies in the area of ageing. There were no sponsorship links that may form a bias or conflict of interest to the study.

What kind of research was this?
The research was a randomised control trial (RCT). RCT studies are known as the gold standard in epidemiology study design and are classified as a level two study as it had a small number of participants in the RCT. RCT are designed to be unbiased and have less room for any systemic error that may occur in the research study. It involves splitting up the participants into two groups, one control and one intervention group. In this particular research article, the intervention group were known as the ‘trained’ participants and the control group were known as the ‘untrained’ participants. The trained group performed the tasks/activity required in the study whilst also continuing their normal daily activity routines whereas the untrained group had no form of intervention and continued with their normal daily activity routines. Both groups maintained a normal dietary intake.

There are many other forms of studies and all have their limitations, however, in epidemiology, RCT is the gold standard.

What did the research involve?
Thirty-five women aged fifty-seven to seventy-five years of age were recruited to participate in this study. All women underwent a medical and clinical examination before the study to check that they were the right candidates. The participants followed a twenty-four-week strength program completing three resistive sessions (one-hour in duration each) per week and focused on eccentric muscle action.

There were three major parameters directly tested before and after the twenty-four weeks which looked at:
 * 1) Bone mineral density;
 * 2) Muscular strength;
 * 3) and body composition.

To test the participant's muscular strength, this was completed via a one-rep max (1RM). To test their bone mineral density, they used a dual-energy x-ray absorptiometry (DEXA) and their body composition was measured via body mass index (BMI) and body fat percentage.

Study Limitations

 * A limited number of final participants (final data based on twenty-five participants);
 * No prescribed advice or referral post-study for participants to continue with strength/resistance training;
 * There was a no follow-up post-study (i.e. 6 months, 1 year or 2 years later) to see how clients may have progressed or regressed depending on whether they did or didn't continue strength training;
 * No mention of what type of training the untrained participants were doing for exercise.

Study Strengths

 * Thorough clinical examination and questionnaire looking at the medical history of the participant before participating in the study;
 * Strict inclusion and exclusion criteria had to be met to be a participant;
 * All training sessions were guided by trained fitness instructors and supervised by the researchers;

What were the basic results?
After the 24-week training program, the results showed us that:
 * Bone mineral density in the lumbar spine and femoral neck stayed the same for the trained group and decreased significantly in the untrained group (see table 1);
 * Muscle strength increased in the trained group and stayed the same for the untrained group;
 * BMI and body fat percentage decreased slightly in the trained group and increased slightly in the untrained group.

What conclusions can we take from this research?
Although this study ended up with a small final participant size, the data shows us that there is quite strong evidence that strength training does keep BMD consistent and could be implemented as a form of training to maintain BMD and therefore reducing the risk of osteoporosis. However, it is to be noted that individuals should invest in an exercise professional. Further research can be conducted looking at the biomechanical mechanisms of bone adaptation to strength training. The findings in this paper align well with other studies which suggest that strength training does help maintain and increase bone mineral density

Practical advice
Before a postmenopausal woman participates in exercise including strength training, they should consult a health professional (general practitioner) to discuss if there may be any risks of potential injury from any form of exercise or to get the all-clear to strength train (if necessary). If given the all-clear, I would recommend investing in a coach/personal trainer or exercise physiologist who will be able to program appropriately for you based on your history and capabilities. The health professional will program all exercises and will make sure that they are monitoring you closely and progressing exercises appropriately.

Further information/resources
If you are interested in further information about osteoporosis, how you can incorporate exercise postmenopause and access to more support, please see the links below:

 * Health Benefits of Resistance/Strength Training
 * Exercising with osteoporosis
 * What is osteoporosis
 * Why is physical activity important?
 * Ways to incorporate more physical activity into your day
 * Physical Activity Recommendations for Adults 18-64 years of age
 * Exercise tips for postmenopausal women
 * Menopause support/more information


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Exercise as it relates to Disease/Can physical activity improve cognitive and motor function in patients with Dementia?

This is a critique of a 2015 article A 9-Week Aerobic and Strength Training Program Improves Cognitive and Motor Function in Patients with Dementia: A Randomized, Controlled Trial, published in the American Journal of Geriatric Psychiatry.

What is the background to this research?
Dementia is associated with a decline in cognitive and motor function, which results in the need for daily assistance and care. Dementia is on the rise, and is expected to elicit an ever increasing burden on social and fiscal systems, making it a public health priority.

Currently, there is no cure for dementia. Medications exist to slow the key elements of cognitive decline. The cost-effective nature of these medicines however, is highly controversial, as are the associated side effects. Moreover, these medications fail to combat the decline in motor skills associated with dementia, including the continued loss of endurance, muscle strength, mobility and balance. Therefore, there is an urgent need for affordable alternative treatments to counteract the cognitive and motor decline of patients suffering from dementia.

Previous studies have provided results which are highly inconsistent. Some studies have found a moderate association between aerobic exercise and cognitive improvements, whilst others have found there to be no significant effect. Of these studies, those which investigated the effects of both aerobic and strength training on cognitive function in healthy, older adults found the strongest benefits. Therefore, the study in question hypothesised a combination of aerobic and strength training would elict greater benefits than single-compartment exercise (aerobic only) vis-à-vis cognitive and motor function in patients with dementia.

Where is the research from?
This study was conducted in the Netherlands, and published in The American Journal of Geriatric Psychiatry. The paper was attributed to a collaboration of several reputable authors. The majority of these authors are based at the Center for Human Movement Sciences at the University of Groningen. Others were based in areas such as rehabilitation, elderly care medicine and neuropsychology. Many of these authors have published articles investigating the relationship between exercise, cognitive function and dementia- both before and after publishing this article. The research was financially supported by Fonds NutsOhra (FNO), a Netherlands based health and disability research fund. The authors state FNO had no role in study design, data collection, analysis, decision to publish, or manuscript preparation. In addition, the authors declared no conflicts of interest.

What kind of research was this?
This research was a randomised control trial with three intervention groups. Randomised control trials are highly effective in evaluating the effectiveness of interventions and are considered the gold standard in data collection.

What did the research involve?
The research compared the effects of a 9-week intervention on cognitive and motor functions in institutionalised patients with dementia over the age of 70. Participants were assigned to one of three intervention groups: combined aerobic and strength exercise (combined group) (n = 37), aerobic-only exercise (aerobic group) (n = 36), and social support visits (social groups) (n = 36). The sample size of 109 participants is sufficient to generate meaningful data. Post tests were conducted after the 9-week intervention and follow-up tests 9 weeks thereafter. Participants also had to meet various eligibility criteria.

Each group participated in 36 individualised, 30 minute sessions. The combined group participated in two strength sessions and two walking sessions per week. These sessions were alternated. The aerobic group participated in four walking sessions per week and the social group participated in four social visits per week.

Strength exercises for the combined group focused on lower-limb strengthening and consisted of seated knee extension, plantar flexion through toe raises while holding both hands of the trainer, hip abduction by moving the straight leg sideways while holding onto a surface and hip extension by moving the straight leg backwards while holding onto a surface. The combined and aerobic group performed moderate to high intensity walking sessions.

As a follow-up assessment of cognitive function, a neurophysiological battery test was conducted. Both short and long term visual and verbal memory were assessed, as were executive function. To assess motor function, a physical battery test was conducted focusing on walking endurance, leg strength, mobility and balance.

There are several limitations which this study has. Primarily, the sample of dementia patients is limited to those who are able and willing, hence there would be less or no severe cases. This is problematic because, when determining the effectiveness of the intervention, it does not account for cases which are more severe. Hence, it is difficult to know if the intervention would improve patients symptoms, slow down the decline of their illness, or do nothing at all for patients with more severe symptoms. Finally, while 9 weeks may be sufficient to comment on the shorter term effects, it by no means provides the scope or scale to comment on the medium to longer term effects of a degenerative condition such as dementia.

What were the basic results?
Relative to the social group, the combined group improved on cognitive function, visual memory, verbal memory and executive function. The aerobic group varied only from the social group in relation to improved executive function. In the motor domain, intervention showed significant effects in the walking endurance, leg muscle strength and balance of participants. The combined group improved relative to the social group on walking endurance, leg muscle strength and balance. Moreover, comparisons revealed that the combined group scored higher than the aerobic group in walking endurance and leg muscle strength. After the 9-week follow up test no significant improvements in cognitive or motor function remained.

What conclusions can we take from this research?
The study provides evidence which suggests the effectiveness of a combined aerobic and strength training program to improve cognitive and motor function in patients with dementia. Furthermore, a combination of aerobic and strength training is more effective than aerobic only training.

Dementia is associated with global cognitive decline and is assessed using a Mini-Mental State Exam (MMSE). Compared with the aerobic only and social groups, the combined group significantly improved their MMSE scores, indicating a combination of aerobic and strength training reduces global cognitive decline in patients with dementia.

In addition, a combination of aerobic and strength training can improve verbal memory, visual memory and executive function. These conclusions are consistent with those of a 6-week pilot study investigating the effects of exercise on cognitive function. The study found only a moderately significant intervention effect on visual memory, whereas the current study found greater improvements in all domains of cognitive function. These more meaningful findings can be explained by the longer training period, indicating the importance of ongoing engagement in exercise in improving cognitive function.

Practical advice
Older adults suffering from dementia are likely to experience cognitive and motor benefits from engaging in a combination aerobic and strength training.

Two 30 minute aerobic and two 30 minute strength sessions per week is a strong starting position. Aerobic activities should be physically undemanding and may include walking or stationary cycling. Strength training exercises should focus primarily on lower limb strengthening. Progression and monitoring of exercise engagement among this population should be managed by health professionals.

A well structured and ongoing training plan is an important consideration when seeking to slow disease progression, as well as maintain the positive effects of exercise in patients with dementia.

Further information/resources
Dementia Australia

The Dementia Centre

Clearing house for Sport: Sport and Mature Age Physical Activity

[https://www.healthdirect.gov.au/physical-activity-guidelines-for-older-adults#:~:text=It's%20recommended%20that%20adults%20aged,weight%2C%20health%20problems%20or%20abilities. Physical activity guidelines for older adults]

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/


text:
User talk:49.145.8.14

--Synoman Barris (discuss • contribs) 06:49, 12 September 2020 (UTC)

title: User talk:49.145.8.14


text:
User talk:98.206.246.110

--Synoman Barris (discuss • contribs) 06:49, 12 September 2020 (UTC)

title: User talk:98.206.246.110


text:
User:LaureneAbrams54

Hi there! :) My name is Ariel, I'm a student studying Anthropology and Sociology from Peterborough, Canada.

title: User:LaureneAbrams54


text:
User:TheaODonnell

My name is Thea O"Donnell and I am a student at the university of Canberra. I am studying sport and exercise science with the ambition to change in to exercise physiology and rehabilitation.

title: User:TheaODonnell


text:
User talk:Brett Stockton

--Synoman Barris (discuss • contribs) 08:57, 12 September 2020 (UTC)

title: User talk:Brett Stockton


text:
Scribbling On Regardless/Making a Shrinkie

Make a shrinkie!

Materials you'll need

 * Shrinkie sheet - can be bought from most art shops
 * Pens or pencils
 * Scissors
 * Hole punch (optional)
 * Oven

Instructions
Watch our video for a step-by-step guide
 * 1) Decide what design you want to make.  In our video, we're making a key, but you can make anything you like.  A flower?  A tree?  A character?
 * 2) Using a dark pen, sketch out the design of shrinkie you want to make, and colour it in.  The colour will intensify when you shrink it!
 * 3) If you're making a keyring, or would like to attach your shrinkie on to something, make sure to punch a hole.
 * 4) Now to the oven bit - make sure you have adult supervision for this bit!
 * 5) Preheat the oven to 160 Celsius, and bake your shrinkie on a tray for 1-3 minutes.
 * 6) At first the shrinkie will curl up, but then it will flatten out.
 * 7) Once it flattens back out, bake for 30 seconds more
 * 8) Remember it will be hot when it comes out of the oven - use an oven glove, and don't peel it off straight away, mind your fingers!
 * 9) Once it's cool, you can thread a string or keyring through your shrinkie :)

Previous Project
Making Stickers


text:
Exercise as it relates to Disease/The effects exercise has on individuals diagnosed with chronic primary insomnia

This is a critique of the journal article titled “Effects of moderate aerobic exercise training on chronic primary insomnia”

What is the background to this research?

 * Chronic Primary Insomnia (CPI) is defined as prolonged difficulty with initiation and maintenance of sleep. Characteristics of CPI include non-restorative sleep, hyperarousal, and impaired mental and physical function such as; inferior working memory, impaired concentration, and an overall poor quality of life. Literature has hypothesised CPI as a collective pathway via interchangeable imbalances between hyperarousal and sleep inducing brain activity, encouraged through psychosocial stressors causing irregular sleeping patterns and decreased cognitive behaviour. Epidemiological literature associated CPI with other mental disorders, the most common being depression. This is evident in longitudinal studies as 40% of the depressed population have CPI symptoms. Previous literature has concluded that CPI is the most common sleeping disorder with its prevalence worldwide being 10-15%, if accounting for acute insomnia the prevalence rises to 50% of the population. Literature has also found that CPI is predominant in individuals over the age of 45 years, along with an increasing risk in Females.
 * Although CPI is the most common sleeping disorder and can work in conjunction with other disorders it is predominantly left untreated, resulting in a problematic issue at large on quality of life. Those whom do seek treatment are commonly prescribed drug therapy through sleep medication. Sleep medication is not recommended for long-term usage as there is a likelihood of potential side effects and is often expensive.
 * Using exercise as a non-pharmacological way to treat CPI along with other psychosocial diseases is becoming more prevalent as a cost effective and easily accessed treatment for antidepressant effects. Specification on type of diseases and exercise needs addressing further.

Where is the research from?

 * The research was conducted in São Paulo, Brazil. It is based on 19 sedentary individuals with CPI. The mean age of individuals being 45 ± 1.9 years.
 * The data for this study was collected over six months in 2011.
 * The authors of this study are derived from a large pool of professors and physicians. All whom have been involved in numerous publications, Marco Tûlio De Mello himself having over 400. Giselle Soares Passos specialises in medicine, sport and exercise, and psycho-neuroendocrinology. She has many years of experience in nonpharmacologic treatment for chronic insomnia.
 * The participants of this study did not include those with CPI whom are physically active, limiting generalisation of findings towards CPI as whole.

What kind of research was this?

 * This research was a randomized trial, as participants were randomised into either a morning or late afternoon exercise group.
 * The aim of the study was to determine the influence long-term aerobic training has on sedentary individuals with CPI, specifically on their subjective sleep, quality of life and mood. Secondarily assessing whether exercising in the morning or afternoon influenced the effects of the exercise and whether changes in sleep were accompanied with changes in mood.
 * The research data relied heavily on self-reports such as questionaries and sleep dairies, this influencing the validity of results due to response bias.

What did the research involve?

 * The participants whom met the selection criteria were required to keep record of their sleep every morning when they woke in a sleep dairy for 1-week. They also completed a SF-60 and POMS questionnaire prior commencing the intervention. The intervention consisted of a 6-week aerobic exercise training protocol of three days a week for 50-minutes on a treadmill as well as 5-minute warm up and cool down, this was implemented to both groups. Completion resulted in another 1-week sleep diary and both questionaries.
 * Intensity and environment were both controlled and monitored enhancing reliability of the study.
 * Limitations include the exercise protocol itself. Exercise was only completed on a treadmill, in a lab and only for 60minutes questioning the generalisation of results outside of these variables. Sleep diaries and questionaries were also only conducted before and after exercise none during, this effecting the reliability and variability of results. Although participants were randomised into two different groups there was no control group for further reliability and variability. The use of only sedentary participants concludes that generalisations cannot be made to those with CPI whom are already physically active.

What were the basic results?

 * The main results of the study indicated that there was a significant improvement in latency sleep quality, sleep onset and the feeling of ‘well-rested’ in the morning following both exercise conditions.
 * The questionaries revealed a significant decrease in tension-anxiety, depression and overall mood disturbance, as well as a significant increase in numerous quality of life characteristics.
 * There was no significant difference between either morning or night conditions.
 * Overall the 6-week exercise intervention had a positive effect on individuals with CPI assisting with both improvements in sleep and other psychological factors.

What conclusions can we take from this research?

 * The conclusion the authors suggested in this study was that long-term aerobic exercise is positively associated with individuals with CPI in numerous psychological aspects and fields in their life.
 * The conclusion I drew from this study agrees with the authors conclusion however, less generalised. Initially I concluded that 60-minutes of aerobic exercise three times a week has a significant positive impact on previously sedentary individuals with CPI in all aspects of their lifestyle not just their sleeping patterns. Although there are limitations towards generalising these findings to other types of exercise and individuals with CPI as a whole, results are consistent with other research, displaying that people with disturbed sleep significantly benefit from exercise training. Whilst it is clear that there are limitations within this study towards generalisations of results the authors conclusions can be supported by previous evidence, altering my conclusion to be the same.
 * Further research into specificity of individuals with CPI characteristics and lifestyles is needed, to determine if exercise is beneficial for everyone with CPI.

Practical advice

 * Individuals with CPI should understand the important of exercise daily and the associated benefits that come with it. This study demonstrated its positive effect towards treatment of individuals with CPI and opens a pathway for treating other disorders/ problematic lifestyle challenges.
 * Exercise as an applaudable treatment for CPI is inexpensive, easily accessible and more importantly provides further benefits in all aspects of quality of life, both physically and psychologically.
 * This research concluded with positive findings, yet limited control over validity and reliability. Researchers interested in expanding in this area of research need to address exercises suitable for the individual’s interest/lifestyle, increasing adherence of the intervention being maintained over a longer period of time. This would also assist on identifying whether other fields of exercise produce the same affect towards CPI symptoms such as; resistance training, sports, yoga, outdoor walking etc. Studies on broader individuals with CPI need addressing such as; advance fitness levels, younger cohorts, or individuals whom are injured or have long term impaired mobility to assist in generalisation of exercise as a profound treatment.

Further information/ resources

 * Kalmbach DA, Cuamatzi-Castelan AS, Tonnu CV, Tran KM, Anderson JR, Roth T, et al. Journal of Nat Sci Sleep, 10 (2018), pp. 193–201 Retrieved via Pubmed
 * Riemann D, Spiegelhalder K, Feige B, Voderholzer U, Berger M, Perlis M, et al. Journal of Sleep Medicine, 14 (2010), pp. 19–31 Retrieved via Pubmed
 * Fact sheet on insomnia: https://sleepaustralia.com.au/docs/Insomnia-Fact-Sheet-Sleep-Australia.pdf
 * https://www.beyondblue.org.au/
 * https://au.reachout.com/articles/insomnia
 * https://www.sleepoz.org.au/


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User:Pocathasaigh/sandbox

Confusion. In Section Linear Systems I.3 (Problem 7 e.g.)we were taught that to determine whether a given vector is in a given set one tries to find c's that satisfy. Now in Vector Spaces I.2 (Problem 24.2) we're told that Vector (1 1) is not in the set (1 0), (0 1)when clearly c1=c2=1 would satisfy.

title: User:Pocathasaigh/sandbox


text: Template:User Wikidata

title: Template:User Wikidata


text:
User talk:42.111.200.72

--Synoman Barris (discuss • contribs) 18:21, 12 September 2020 (UTC)

title: User talk:42.111.200.72


text:
User:JoonasD6

Hi there! Do contact me @JoonasD6 (everywhere on the net), if necessary. You deem it necessary, not me, so keep the bar low.

I teach maths, physics, chemistry, biology, music... gladly mixing all of them together.

title: User:JoonasD6


text:
Chess Opening Theory/1. d4/1...d5/2. Nc3/2...Bf5

=Queen's Pawn Game: Chigorin Variation, Alburt Defense= The Alburt Defense is a rare line of the Queen's Pawn Game. This line has only appeared 32 times in 365chess.com's Master Database of over 500,000 games (as of September 13, 2020).

Theory table
.

'''1. d4 d5 2. Nc3 Bf5'''


text:
Exercise as it relates to Disease/The effect of aerobic exercise in overweight chronic kidney disease patients

This page is a critical analysis of the research article “A Randomized controlled trial to evaluate the impact of aerobic exercise on visceral fat in overweight chronic kidney disease patients” by Flavia Baria, Maria Ayako Kamimura, Danilo Takashi Aoike, Adriano Ammirati, Mariana Leister Rocha, Marco Túlio de Mello and Lilian Cuppar. This analysis was completed for the unit Health, Disease and Exercise at the University of Canberra.

What is the background to this research?
Obesity rates are becoming a global issue spanning through all age groups with the frequency of being diagnosed with chronic obesity being more prevalent in individuals who also have chronic kidney disease. This is due to obesity being a known risk factor of hypertension and high visceral fat levels, which are two main causes for chronic kidney disease. This study aimed to investigate the effect that aerobic exercise, performed in either an exercise centre or at home, has on overall visceral fat in the targeted over weight population with chronic kidney disease.

Where is the research from?
This study was conducted by the Nutrition Graduation Program of the Federal University of São Paulo in Brazil and was published within the Nephrology Dialysis Transplantation, a medical journal produced by Oxford University. This article mentions other studies with similar parameters that were used to improve and adapt for a specific focus on visceral fat and chronic kidney disease. The American college of sports medicine recommendations were used to create and conduct the training programs.

What kind of research was this?
This article was a prospective, randomised, controlled interventional trial that covered twelve weeks.

What did the research involve?
The research consisted of the observation of twenty-seven sedentary men, aged between eighteen and seventy, who had been diagnosed with chronic kidney disease stages three and four but where non-dialysed. The eligibility criteria for these participants included: Each participant was randomly assigned to either an exercise center-based or at home-based workout program. Both assigned groups were advised to participate in a light to moderate aerobic based exercise routine three times per week. The participants where monitored weekly through telephone calls checking compliance rates, had mandatory monthly progress assessments and the participants physical capacities, body composition and blood pressure where assessed at baseline and at the end of the twelfth week.
 * Male
 * Sedentary behaviour patterns
 * BMI >30 kg/m2
 * No use of heart medication
 * Cleared to exercise by medical professional
 * No presence of:
 * Pulmonary disease
 * Congestive heart failure
 * Coronary disease

The main outcome of the study was to measure the presence of visceral fat with results being obtained by the use of computed tomography. Anthropometric markers where also taken such as BMI, body composition using a Dual-energy X-ray absorptiometry (DEXA) scan, waist circumference and blood pressure to further clarify the observations seen relating to visceral fat presence.

Limitations:

The use of BMI is not recommended in a research environment due to the inaccurate measurement given resulting from the lack of inclusion of any body composition besides height and weight. This is a large limitation of the study as this is one of the main criteria for being chosen to be included in the study. When implementing a trial such as this there are many limiting factors to the participants compliance such as lack of knowledge with both exercise and the benefits, lack of time and limited place and equipment required. It was mentioned that participants had the option to seek advice about their movements through exercise center employees or supervised session at home to insure they correctly performed each exercise given. This leaves the question of how many participants chose not to seek advice and either performed the exercises incorrectly effecting their results or not at all due to worry of injury and embarrassment.

Whilst this study had a large range of ages from eighteen to seventy, there are many questions in relation to the exercise capacity and general normative physical activity data that the results found can relate to. This large sample group may affect the final results of this study due to the circumstance that an eighteen-year-old is expected to have a greater aerobic capacity to begin with, despite their disease, when compared to a seventy-year-old. Whilst results may be further affected if the randomised groups had a different average age leading possibility of the results to be skewed.

What were the basic results?
This study showed that overall visceral fat and waist circumference decreased in the individuals who participated in the exercise center based routines, with an increase of lean leg mass also seen. There was also a decrease in mean blood pressure, due to the known result aerobic exercise has on reducing peripheral vascular resistance. The decrease in general hypertension is beneficial due to the reduction of the known risk factor but also has a positive influence on kidney function within these obese chronic kidney disease participants.

There were no significant changes in the home-based group when compared to the center based-group due to once standardise, the home based-group had a higher average age, but it was highlighted that this form of exercise helped to prevent the increase of visceral fat.

Group: Center-Based

Group: Home-Based

What conclusions can we take from this research?
The implementation of exercise center-based routines are an effective approach in relation to the reduction of visceral fat within overweight chronic kidney diseased males. Light to moderate aerobic exercise has a positive impact on visceral fat reduction and prevention, high blood pressure and lean muscle mass within the body. These results although cannot provide evidence to revert the disease but they do suggest that aerobic exercise can aid in the prevention of progression for further stages of chronic kidney disease.

Practical advice
As previously mentioned, aerobic exercise at low to moderate intensity has positive health results in relation to visceral fat levels and blood pressure within chronic kidney disease participants. Although no significant results where seen through the home-based group, it is to note that this form of program prevented an increase in visceral fat. Individuals with chronic kidney disease should at a minimum participate in these forms of activity, recommended at an exercise centre but if not at their home in order to prevent further deterioration with their disease.

Information found from studies conducted subsequently to this found that exercise generating between 6 to 10 METS, otherwise moderate to vigorous intensity, had a significant relationship to the reduction of visceral fat levels.

Further information/resources
Below are both, websites and articles with further information relating to the topics and information previously mentioned.

Information about Chronic kidney Disease: https://www.kidney.org/atoz/content/about-chronic-kidney-disease

An informative article about visceral fat: https://www.healthline.com/health/visceral-fat#rating-and-measurements

Systemic review of similar studies on aerobic exercise and visceral fat: https://www.nature.com/articles/0803683/


text:
User talk:112.141.174.214

Creting inappropriate books/pages
Hello and welcome to Wikibooks,please don’t create inappropriate pages which you don’t plan to expand or work on. This may be considered vandalism and you may be blocked from editing. Best regards --Synoman Barris (discuss • contribs) 06:59, 13 September 2020 (UTC)

title: User talk:112.141.174.214


text:
User talk:HumbleBeauty

Wikibooks Information Team
Dear [Mars Turner],

You need to provide the evidence. For example, something that links the email account you are using to the author or to the website where the work is published. Say the work was published on a site called "mysite.com". Sending us an email from "admin@mysite.com" might demonstrate you were the owner of the site.

Yours sincerely,

Marc Garver

 * test

title: User talk:HumbleBeauty


text:
User talk:24.188.207.15

--Synoman Barris (discuss • contribs) 07:03, 13 September 2020 (UTC)

title: User talk:24.188.207.15


text:
User talk:Goldy3116

--Synoman Barris (discuss • contribs) 08:34, 13 September 2020 (UTC)

title: User talk:Goldy3116