Dataset Information

Maximal strength training as physical rehabilitation for patients with substance use disorder; a randomized controlled trial.

ABSTRACT:

Background

Patients with substance use disorder (SUD) suffer from multiple health and psychosocial problems. Because poor physical capacities following an inactive lifestyle may indeed contribute to these problems, physical training is often suggested as an attractive supplement to conventional SUD treatment. Strength training is shown to increase muscle strength and effectively improve health and longevity. Therefore we investigated the feasibility and effect of a maximal strength training intervention for SUD patients in clinical treatment.

Methods

16 males and 8 females were randomized into a training group (TG) and a control group (CG). The TG performed lower extremities maximal strength training (85-90 % of 1 repetition maximum (1RM)) 3 times a week for 8 weeks, while the CG participated in conventional clinical activities.

Results

The TG increased hack squat 1RM (88 ± 54 %), plantar flexion 1RM (26 ± 20 %), hack squat rate of force development (82 ± 29 %) and peak force (11 ± 5 %). Additionally, the TG improved neural function, expressed as voluntary V-wave (88 ± 83 %). The CG displayed no change in any physical parameters. The TG also reduced anxiety and insomnia, while the CG reduced anxiety.

Conclusion

Maximal strength training was feasible for SUD patients in treatment, and improved multiple risk factors for falls, fractures and lifestyle related diseases. As conventional treatment appears to have no effect on muscle strength, systematic strength training should be implemented as part of clinical practice.

Trial regestration

ClinicalTrials.gov Identifier: NCT02218970 (August 14, 2014).

SUBMITTER: Unhjem R

PROVIDER: S-EPMC4818502 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

Maximal strength training as physical rehabilitation for patients with substance use disorder; a randomized controlled trial.

Unhjem Runar R Flemmen Grete G Hoff Jan J Wang Eivind E

BMC sports science, medicine & rehabilitation 20160331

<h4>Background</h4>Patients with substance use disorder (SUD) suffer from multiple health and psychosocial problems. Because poor physical capacities following an inactive lifestyle may indeed contribute to these problems, physical training is often suggested as an attractive supplement to conventional SUD treatment. Strength training is shown to increase muscle strength and effectively improve health and longevity. Therefore we investigated the feasibility and effect of a maximal strength train ...[more]

PMID: 27042312

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Project description:BackgroundDrug use disorder has high potential for relapse and imposes an enormous burden on public health in China. Since the promulgation of the Anti-drug law in 2008, community-based rehabilitation has become the primary approach to treat drug addiction. However, multiple problems occurred in the implementation process, leading to a low detoxification rate in the community. Mobile health (mHealth) serves as a promising tool to improve the effectiveness and efficiency of community-based rehabilitation. Community-based addiction rehabilitation electronic system (CAREs) is an interactive system for drug users and their assigned social workers.ObjectiveThe study aimed to examine the feasibility and preliminary efficacy of CAREs in community-based rehabilitation from the perspective of drug users and social workers in Shanghai, China.MethodsIn this pilot randomized controlled trial, 40 participants were recruited from the community in Shanghai from January to May 2019. Participants randomized to the intervention group (n=20) received CAREs + community-based rehabilitation, while participants in the control group (n=20) received community-based rehabilitation only for 6 months. CAREs provided education, assessment, and SOS (support) functions for drug users. The assigned social workers provided service and monitored drug use behavior as usual except that the social workers in the intervention group could access the webpage end to obtain drug users' information and fit their routine workflow into CAREs. The primary outcome was the feasibility of CAREs, reflected in the overall proportion and frequency of CAREs features used in both app and webpage end. The secondary outcomes were the effectiveness of CAREs, including the percentage of drug-positive samples, longest period of abstinence, contact times with social workers, and the change of Addiction Severity Index (ASI) from baseline to the 6-month follow-up.ResultsThe number of participants logged in to the app ranged from 7 to 20 per week, and CAREs had relatively high levels of continued patient use. Drug users preferred assessment and education features in the app end while their social workers showed high levels of use in urine results record and viewing assessment results on the webpage end. After the 6-month intervention, 3.3% (17/520) of samples in the intervention group and 7.5% (39/520) in the control group were drug-positive (F=4.358, P=.04). No significant differences were noted between the control and intervention groups in terms of longest duration of abstinence, number of contact times and ASI composite scores.ConclusionsThe study preliminarily demonstrated that with relatively good feasibility and acceptability, CAREs may improve the effectiveness and efficiency of the community-based rehabilitation, which provided instruction for further improvement of the system.Trial registrationClinicalTrials.gov NCT03451344; https://clinicaltrials.gov/ct2/show/NCT03451344.International registered report identifier (irrid)RR2-10.3389/fpsyt.2018.00556.

Project description:BackgroundPersistent disability in chronic stroke survivors is often attributed to arm or leg weakness; however, respiratory muscle weakness also impedes poststroke rehabilitation, reduces quality of life, and increases the risk of health complications. Respiratory complications are common after stroke and place patients at risk for both prolonged functional disability and mortality. In addition, stroke survivors face ongoing cardiovascular disease that places them at risk for recurrent stroke.ObjectiveThe study aims to compare the effects of 2 respiratory training programs, paired with individualized flexibility, strengthening, and cardiovascular exercise programs, on physiologic, activity, and societal participation outcomes in chronic stroke survivors.MethodsThis study will be a randomized controlled trial. Participants are 80 community-dwelling adults with chronic stroke. In conjunction with a 24-session (3 times/week for 8 weeks), American Heart Association-informed, whole-body exercise program, participants will be randomized to receive either respiratory strength training or respiratory relaxation training. Study intervention will be directed by a physical therapist and take place in a community fitness center. Outcome assessments will occur in a clinical research center. The primary outcome measure is maximal respiratory pressure. Secondary outcome measures include airway clearance, walking endurance, spatial-temporal gait characteristics, community walking, functional strength and fatigue, depression, and societal participation measures. Longer-term societal participation is a complex domain that may be influenced by other factors beyond physical function. Participants' health status will be monitored for 1 year following the intervention for falls, respiratory illness, and hospitalizations. Additional subanalyses will evaluate the effect of smoke exposure on short- and long-term outcomes. Outcome assessors are blinded to group assignments. Respiratory relaxation training is an active comparator, but no pure control group is included.ResultsThis study was funded in March 2020 with enrollment commencing in November 2020. Completion of enrollment is projected for May 2025 with a study projected end date of April 2026. Published results are anticipated in Fall 2026.ConclusionsResults from this study will improve our understanding of the additive benefits of respiratory exercises on short- and long-term physiologic, functional, and societal gains for these individuals. These data will be instructive to meet a current unmet rehabilitative need to promote patient-centered care and contribute to decreasing morbidity and mortality in chronic stroke survivors.Trial registrationClinicalTrials.gov: NCT05819333; https://clinicaltrials.gov/study/NCT05819333.International registered report identifier (irrid)DERR1-10.2196/59749.

Project description:ObjectiveThe purpose of this systematic review and meta-analysis was to investigates whether transcranial direct current stimulation applied during physical training increases muscle strength in comparison with sham tDCS combined with physical training.MethodsRandomized controlled trials of the effects of tDCS combined physical training intervention on muscle strength and cortical excitability were collected by searching Web of Science, Pubmed, EBSCO, CNKI. The retrieval date ends in April 2024. 11 randomized controlled trials are finally included. The total sample size of the study is 338. The experimental group was subjected to tDCS combined with physical training intervention, and the control group was physical training combined with sham tDCS intervention.ResultsThere is a significant increase in maximal strength (SMD = 0.38; 95% CI: 0.09, 0.67; p = 0.01) and lower limb explosive strength (MD = 2.90; 95% CI: 1.06, 4.74; p = 0.002) when physical training was performed with tDCS, but not following physical training combined with sham tDCS. Subgroup analysis of the subject population showed an increase in muscle strength in those with training experience following tDCS combined with physical training (SMD = 0.39; 95% CI: 0.08, 0.70; p = 0.01), but not for those without training experience (SMD = 0.29; 95% CI: -0.06, 0.63; p = 0.10). Motor evoked potential (MEP) wave amplitude increased significantly following physical training with tDCS (SMD = 0.71; 95% CI: 0.18, 1.24; p = 0.008), but was not different between groups (SMD = 0.16; 95% CI: -0.33, 0.65; p = 0.52).ConclusionstDCS combined with physical training intervention can improve muscle strength, lower limb explosive strength and cerebral cortex excitability. Compared to tDCS combined with training of small muscle groups, tDCS combined with training of large muscle groups was more effective in improving muscle strength. Muscle strength was more likely to improve after tDCS combined with physical training in people with physical training experience compared with people without physical training experience. The combination of tDCS with physical training intervention and the sham-tDCS with physical training intervention both increased cortical excitability.Systematic review registrationhttps://www.crd.york.ac.uk/, PROSPERO, identifier (CRD42024550454).

Project description:BackgroundDespite the high rate of traumatic events in clients with substance use disorders, trauma exposure often remains undetected in a majority of treatment-seeking clients. Improving health professionals' knowledge and skills in the inquiry of traumatic events is therefore of utmost importance for appropriately addressing trauma-related treatment needs. However, professionals in substance use disorder treatment settings frequently report barriers to the inquiry about traumatic events, e.g., the fear of offending or harming the client. Such barriers should be addressed by trainings that aim to improve the systematic inquiry of traumatic events.MethodsUsing a cluster-randomized trial, we examined whether a one-day training in trauma inquiry ('Learning How to Ask') would reduce professionals' perceived barriers to trauma inquiry. One hundred forty-eight professionals working in outpatient substance use disorder treatment centers were randomized to an intervention (n = 72) or a control group (n = 76). The professionals in the intervention group received a one-day training plus a refresher session 3 months later, the professionals in the control group received no training. At baseline, and at 3-month and 6-month follow-up, professionals rated on a four-point Likert scale regarding how strongly they agreed with statements about six common barriers to trauma inquiry, namely 'Feeling uncomfortable when asking about traumatic events', 'Fear of offending the client', 'Fear of retraumatizing the client', 'Fear that client may terminate treatment', 'Unsure whether authorities have to be informed when perpetrator is known', and 'No trauma-specific treatment available in my local area'.ResultsThe trained group experienced significant greater decreases in five of the six perceived barriers to the inquiry of traumatic events from baseline to 6-month follow-up than the control group ('Feeling uncomfortable when asking about traumatic events': b = - 0.32, 95% CI [- 0.52, - 0.12]; 'Fear of offending the client': b = - 0.33, 95% CI [- 0.56, - 0.09]); 'Fear of retraumatizing the client': b = - 0.45, 95% CI [- 0.69, - 0.22]; 'Fear that client may terminate treatment': b = - 0.28, 95% CI [- 0.49, 0.07]; 'No trauma-specific treatment available in my local area': b = - 0.25, 95% CI [- 0.51, - 0.01]).ConclusionsOur findings provide first evidence that a one-day training in trauma inquiry is effective in reducing common barriers to trauma inquiry, which may in turn improve detection of traumatic events.

Dataset Information

Maximal strength training as physical rehabilitation for patients with substance use disorder; a randomized controlled trial.

Background

Methods

Results

Conclusion

Trial regestration

Publications

Maximal strength training as physical rehabilitation for patients with substance use disorder; a randomized controlled trial.

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