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Greendale GA, Jackson NJ, Shieh A, Cauley JA, Karvonen-Gutierrez C, Ylitalo KR, Gabriel KP, Sternfeld B, Karlamangla AS. Leisure time physical activity and bone mineral density preservation during the menopause transition and postmenopause: a longitudinal cohort analysis from the Study of Women's Health Across the Nation (SWAN). LANCET REGIONAL HEALTH. AMERICAS 2023; 21:100481. [PMID: 37008197 PMCID: PMC10060105 DOI: 10.1016/j.lana.2023.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 02/28/2023] [Accepted: 03/10/2023] [Indexed: 03/28/2023]
Abstract
Background Whether greater leisure time physical activity (LTPA) is associated with less bone mineral density (BMD) loss during the menopause transition (MT) remains an open question. We hypothesized that: 1) larger increases in LTPA from pre-/early perimenopause (period 1) to late perimenopause/postmenopause (period 2) would be associated with a slower period 2 BMD loss rate; and 2) greater entire-study LTPA levels would be associated with better final absolute BMD (g/cm2). Methods Data were from of the Study of Women's Health Across the Nation (1996-2017). Exclusions were: bone beneficial medications, inability to identify start of the MT, and extreme BMD change rates. LTPA measures were a validated ordinal scale and number of metabolic equivalents per hour per week (MET hr wk-1) from sport/exercise. Multiply adjusted, linear regression models estimated: 1) BMD decline rate (annualized %) as a function of LTPA change; and 2) final BMD as a function of entire-study LTPA. Findings Median [p25, p75] MET hr wk-1 were 4.2 [0.9, 10.1] and 4.9 [1.4, 11.2] in periods 1 and 2, respectively; walking was the commonest activity. In adjusted models (N = 875), greater increases in LTPA ordinal score and MET hr wk-1 were statistically significantly associated with a slower decline in femoral neck (FN) BMD. Larger entire-study averages of each LTPA measure were statistically significantly related to better final FN and lumbar spine BMD levels. Interpretation Findings suggest that LTPA, at modest levels, mitigate MT-related BMD decline and even small increases in intensity, duration or frequency of common activities may lessen bone loss at the population level. Funding US-NIH.
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Affiliation(s)
- Gail A. Greendale
- Department of Medicine, Division of Geriatrics, UCLA, Los Angeles, CA, USA
| | - Nicholas J. Jackson
- Department of Medicine, Division of General Internal Medicine, UCLA, Los Angeles, CA, USA
| | - Albert Shieh
- Department of Medicine, Division of Geriatrics, UCLA, Los Angeles, CA, USA
| | - Jane A. Cauley
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Kelly R. Ylitalo
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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Dule S, Barchetta I, Cimini FA, Passarella G, Dellanno A, Filardi T, Venditti V, Bleve E, Bailetti D, Romagnoli E, Morano S, Baroni MG, Cavallo MG. Reduced High-Density Lipoprotein Cholesterol Is an Independent Determinant of Altered Bone Quality in Women with Type 2 Diabetes. Int J Mol Sci 2023; 24:ijms24076474. [PMID: 37047445 PMCID: PMC10095189 DOI: 10.3390/ijms24076474] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Type 2 diabetes mellitus (T2DM) is associated with an increased fracture risk. Our study aimed to explore differences in bone alterations between T2DM women and controls and to assess clinical predictors of bone impairment in T2DM. For this observational case control study, we recruited 126 T2DM female patients and 117 non-diabetic, age- and BMI-comparable women, who underwent clinical examination, routine biochemistry and dual-energy X-ray absorptiometry (DXA) scans for bone mineral density (BMD) and trabecular bone score (TBS) assessment-derived indexes. These were correlated to metabolic parameters, such as glycemic control and lipid profile, by bivariate analyses, and significant variables were entered in multivariate adjusted models to detect independent determinants of altered bone status in diabetes. The T2DM patients were less represented in the normal bone category compared with controls (5% vs. 12%; p = 0.04); T2DM was associated with low TBS (OR: 2.47, C.I. 95%: 1.19–5.16, p = 0.016) in a regression model adjusted for age, menopausal status and BMI. In women with T2DM, TBS directly correlated with plasma high-density lipoprotein cholesterol (HDL-c) (p = 0.029) and vitamin D (p = 0.017) levels. An inverse association was observed with menopausal status (p < 0.001), metabolic syndrome (p = 0.014), BMI (p = 0.005), and waist circumference (p < 0.001). In the multivariate regression analysis, lower HDL-c represented the main predictor of altered bone quality in T2DM, regardless of age, menopausal status, BMI, waist circumference, statin treatment, physical activity, and vitamin D (p = 0.029; R2 = 0.47), which likely underlies common pathways between metabolic disease and bone health in diabetes.
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Affiliation(s)
- Sara Dule
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Ilaria Barchetta
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | | | - Giulia Passarella
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Arianna Dellanno
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Tiziana Filardi
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Vittorio Venditti
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Enrico Bleve
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Diego Bailetti
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L’Aquila, 67100 L’Aquila, Italy
| | | | - Susanna Morano
- Department of Experimental Medicine, Sapienza University, 00161 Rome, Italy
| | - Marco Giorgio Baroni
- Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L’Aquila, 67100 L’Aquila, Italy
- Neuroendocrinology and Metabolic Diseases, IRCCS Neuromed, 86077 Pozzilli, Italy
- Correspondence:
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Grili PPDF, Vidigal CV, da Cruz GF, Albergaria BH, Marques-Rocha JL, Pereira TSS, Guandalini VR. Nutrient Patterns and Risk of Osteopenia in Postmenopausal Women. Nutrients 2023; 15:1670. [PMID: 37049510 PMCID: PMC10096860 DOI: 10.3390/nu15071670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/21/2023] [Accepted: 03/26/2023] [Indexed: 04/14/2023] Open
Abstract
Nutrient patterns (NPs) and the synergistic effect between nutrients have been shown to be associated with changes in bone mineral density (BMD). This study aimed to identify NPs and to associate them with BMD categories in postmenopausal women. This cross-sectional, observational, analytical study was carried out with women in menopause for at least 12 months, aged ≥50 years. Sociodemographic, lifestyle, and clinical variables were investigated. BMD was assessed using dual energy X-ray absorptiometry. A dietary assessment was conducted using a food frequency questionnaire, and three nutrient patterns (NP1, NP2, and NP3) were extracted from the principal component analysis. Multivariate logistic regression was applied to investigate the association between BMD classifications and NP consumption. A total of 124 women, aged on average, 66.8 ± 6.1 years, were evaluated. Of these, 41.9% had osteopenia and 36.3% had osteoporosis. The NP1 (OR: 6.64, [CI95%: 1.56-28.16]; p = 0.010), characterized by vitamin B12, pantothenic acid, phosphorus, riboflavin, protein (total and animal), vitamin B6, potassium, vitamin D, vitamin E, calcium, cholesterol, β-carotene, omega 3, magnesium, zinc, niacin, and selenium; and the NP2 (OR: 5.03, [CI95%: 1.25-20.32]; p = 0.023), characterized by iron, vegetable protein, thiamine, folate, fibers (soluble and insoluble), PUFA, vitamin A, vitamin K, alpha-tocopherol, copper, sodium, and retinol, was inversely associated with osteopenia. The lower consumption of NP1 and NP2 by postmenopausal women was associated with a higher risk of osteopenia, but not osteoporosis.
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Affiliation(s)
- Patricia Paula da Fonseca Grili
- Postgraduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitória 29047-105, Brazil
| | - Camila Vilarinho Vidigal
- Postgraduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitória 29047-105, Brazil
| | - Geise Ferreira da Cruz
- Department of Integrated Education, Health Sciences Center, Federal University of Espirito Santo, Vitória 29047-105, Brazil
| | - Ben-Hur Albergaria
- Department of Social Medicine, Federal University of Espirito Santo, Vitória 29047-105, Brazil
| | - José Luiz Marques-Rocha
- Postgraduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitória 29047-105, Brazil
- Department of Integrated Education, Health Sciences Center, Federal University of Espirito Santo, Vitória 29047-105, Brazil
| | | | - Valdete Regina Guandalini
- Postgraduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espirito Santo, Vitória 29047-105, Brazil
- Department of Integrated Education, Health Sciences Center, Federal University of Espirito Santo, Vitória 29047-105, Brazil
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Bevilacqua G, Westbury LD, Bloom I, Zhang J, Ward KA, Cooper C, Dennison EM. Investigating the relationship between self-perception of fracture risk and prior fracture: findings from the Hertfordshire Cohort Study. Aging Clin Exp Res 2023; 35:599-606. [PMID: 36529804 PMCID: PMC9760539 DOI: 10.1007/s40520-022-02322-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Self-perceived risk of fracture (SPR) is associated with fracture independent of FRAX calculated risk. To understand this better we considered whether lifestyle factors not included in the FRAX algorithm and psychosocial factors (social isolation, self-efficacy, or mental health status) explain the relationship between SPR and fracture. METHODS We studied 146 UK community-dwelling older adults from the Hertfordshire Cohort Study. SPR ranked as 'lower', 'similar' and 'higher' relative to others of the same age, was assessed by questionnaire. Social isolation was assessed using the six-item Lubben Social Network Scale; self-efficacy was assessed using a shortened General Self-Efficacy Scale (GSE); mental health status was assessed using the anxiety/depression item from the EuroQoL questionnaire. SPR in relation to previous self-reported fracture was examined using logistic regression. RESULTS Among participants of median age 83.4 (IQR 81.5-85.5) years, SPR was lower for 54.1% of participants, similar for 30.8%, and higher for 15.1%; 74.7% reported no previous fractures. Greater SPR was associated with increased odds of previous fractures when adjusting for sex and age only (OR 1.72, 95% CI 1.03-2.87, per higher band of SPR). While further individual adjustment for social isolation (1.73, 1.04-2.89), self-efficacy (1.71, 1.02-2.85), or mental health (1.77, 1.06-2.97) did not attenuate the relationship, individual adjustment for diet quality and number of comorbidities did. CONCLUSIONS Adjustment for social isolation, self-efficacy or mental health status did not attenuate the relationship between SPR and fracture. By contrast, lifestyle factors not included in FRAX, such as diet quality, did attenuate relationships, suggesting a possible future area of investigation.
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Affiliation(s)
- Gregorio Bevilacqua
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Leo D Westbury
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Ilse Bloom
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- National Institute for Health and Care Research (NIHR), Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Jean Zhang
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- National Institute for Health and Care Research (NIHR), Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Kate A Ward
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Cyrus Cooper
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- National Institute for Health and Care Research (NIHR), Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
- National Institute for Health and Care Research (NIHR), Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Elaine M Dennison
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK.
- National Institute for Health and Care Research (NIHR), Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK.
- School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand.
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Azeez TA. Osteoporosis and cardiovascular disease: a review. Mol Biol Rep 2023; 50:1753-1763. [PMID: 36449152 DOI: 10.1007/s11033-022-08088-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/03/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Osteoporosis and cardiovascular disease are common diseases encountered globally, especially with advancing age. Osteoporosis occurs when there is a loss of bone mineral density leading to increased predisposition to fragility fracture. The conventional perception of osteoporosis is purely as a metabolic bone disease. However, there are mounting reports from recent studies that osteoporosis could be seen as a risk factor for cardiovascular disease just like other traditional risk factors such as hypertension, dyslipidaemia and diabetes. This is a paradigm shift with regards to the outlook of osteoporosis. Osteoporosis and cardiovascular disease have similar risk factors, including diabetes, smoking, excess alcohol, sedentary lifestyle, ageing and dyslipidaemia. This may partly explain the link between osteoporosis and cardiovascular disease. In addition, both osteoporosis and atherosclerosis, which underlies most cardiovascular disease, are both characterized by low grade chronic inflammation. Moreover, the processes involved in the calcification of atheroma are similar to what is seen in bone remodeling. Both processes also involve similar regulators such as osteoprotegerin and related proteins such as osteonectin, osteopontin and type 1 collagen are found in bone matrix and atheromatous plaques. CONCLUSION There is emerging evidence that individuals with osteoporosis are also at an increased risk of coronary artery disease and stroke even after controlling for other factors. The traditional risk factors for cardiovascular disease also predispose people to developing osteoporosis, suggesting that the same mechanism may be causing the two. Moreover, a number of anti-osteoporotic drugs have also been largely linked with cardiovascular disease. This calls for a change in the view of osteoporosis as a metabolic disease but as a cardio-metabolic disorder thereby emphasizing the need for intensified preventive strategies for the disease.
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Affiliation(s)
- Taoreed Adegoke Azeez
- Consultant Endocrinologist, Department of Medicine, Reddington Multi-Specialist Hospital, Lagos, Nigeria.
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Li J, Gu Q, Li R, Wang R, Cai Y, Huang Y, Wang S, Wang S, Liu X. Effect of Yi Jin Jing exercise plus Elastic Band Resistance exercise on overall bone mineral density in postmenopausal women. J Sci Med Sport 2023; 26:87-92. [PMID: 36707306 DOI: 10.1016/j.jsams.2023.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVES This work aimed to study the effects of Yi Jin Jing plus Elastic Band Resistance exercise on bone mineral density at all parts of the body and bone metabolism index levels in postmenopausal women. DESIGN Randomized controlled trial. METHODS Forty postmenopausal women were randomly assigned equally to the exercise or to the control group. The control group maintained their lifestyle behaviors unaltered, whereas the exercise group received Yi Jin Jing plus Elastic Band Resistance exercise. The primary outcome was overall bone mineral density at each part, and the secondary one was bone metabolism indicator levels and bone mineral density on both sides. RESULTS The results after six months showed increased bone mineral density at all parts of the body in the exercise group (spine, P = 0.002; thighs, lumbar, and whole body, P < 0.05) and decreased bone mineral density in the control group (trunk, pelvis, and spine, P < 0.01). In particular, the decrease and increase were greater on the non-preferred (left) side than on the right side. As for bone metabolism indexes, β-Crosslaps levels reduced (P = 0.016) and a significant increase in 1,25-(OH)2-D3 (P < 0.001) can be observed in the exercise group. CONCLUSIONS The results suggested that Yi Jin Jing plus Elastic Band Resistance exercise could delay the overall decrease of bone mineral density in postmenopausal women, especially on the non-preferred side. It also increased bone formation metabolite levels and inhibited bone resorption metabolite levels.
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Affiliation(s)
- Jingyuan Li
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Qing Gu
- Department of Endocrinology, Shidong Hospital, Yangpu District, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, China
| | - Ruixue Li
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Ru Wang
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Yanwei Cai
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Yunda Huang
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Shasha Wang
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China
| | - Suijun Wang
- Department of Endocrinology, Shidong Hospital, Yangpu District, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, China.
| | - Xiangyun Liu
- School of Exercise and health, Shanghai University of Sport, China; Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, China.
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Liao MC, Yen CC, Lin YT, Huang FD, Chang YT. Sarcopenia is associated with mortality in non-critical elderly patients visiting the emergency department. Front Med (Lausanne) 2023; 9:1027503. [PMID: 36714126 PMCID: PMC9874113 DOI: 10.3389/fmed.2022.1027503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/14/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Geriatric syndrome (GS) increases risk of disability and mortality in older adults. Sarcopenia is a predominant illness of GS and accelerate its progression. This study aimed to investigate associations between mortality, emergency department (ED) re-visits and GS-related illnesses among older adults who visited the ED. Method This retrospective observational study enrolled elderly patients who visited the ED in our hospital between January 2018 and October 2020. Patients were evaluated for potential sarcopenia, which was defined by both low handgrip strength and calf circumference. Follow-up was at least 6 months. Data of age, gender, mortality, ED re-visits, and GS-related illnesses were collected and analyzed for associations. Results A total of 273 older adults aged 74 years or older were included, of whom 194 were diagnosed with possible sarcopenia. Older adults with possible sarcopenia also had significantly lower body mass index (BMI); a higher proportion needed assistance with daily activities; more had malnutrition, frailty, and history of falls (all p < 0.001) and acute decline in activities of daily living (p = 0.027). Multivariate analysis showed that possible sarcopenia [adjusted hazard ratio, aHR): 9.89, 95% confidence interval (CI): 1.17-83.81, p = 0.036], living in residential institutions (aHR: 2.85, 95% CI: 1.08-7.50, p = 0.034), and frailty (aHR: 7.30, 95% CI: 1.20-44.62, p = 0.031) were associated with mortality. Aged over 85 years (adjusted odds ratio: 2.44, 95% CI: 1.25-4.80, p = 0.02) was associated with ED re-visits. Conclusion Sarcopenia is associated with mortality among older adults who visit ED. Initial screening for sarcopenia and relevant risk factors among older adults in the ED may help with early intervention for those at high-risk and may improve their prognosis.
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Affiliation(s)
- Mei-Chen Liao
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Cheng-Chang Yen
- Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Yuh-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan,Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Fong-Dee Huang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Yun-Te Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan,School of Medicine, National Yang-Ming University, Taipei City, Taiwan,Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung City, Taiwan,Department of Emergency & Critical Care Medicine, Pingtung Veterans General Hospital, Pingtung City, Taiwan,*Correspondence: Yun-Te Chang, ,
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Zhao X, Yang Y, Yue R, Su C. Potential causal association between leisure sedentary behaviors, physical activity and musculoskeletal health: A Mendelian randomization study. PLoS One 2023; 18:e0283014. [PMID: 36928028 PMCID: PMC10019723 DOI: 10.1371/journal.pone.0283014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Increasing evidence shows that leisure sedentary behaviors (LSB) and physical activity (PA) are associated with various musculoskeletal disorders. However, the causality between LSB/PA and musculoskeletal health remained unknown. In this study, we aimed to evaluate the causal relationships between LSB/PA and lower back pain (LBP), intervertebral disc disorder (IVDD), rheumatoid arthritis (RA), and bone mineral density (BMD) by using a two-sample Mendelian randomization method. METHODS The exposure data were obtained from large-scale genome-wide association studies (GWAS), including the PA dataset (self-reported PA, n = 377,234; accelerometer-assessed PA, n = 91,084) and LSB dataset (n = 422,218). The outcome data were derived from the FinnGen LBP dataset (n = 248,528), FinnGen IVDD dataset (n = 256,896), BMD GWAS dataset (n = 56,284), and RA GWAS dataset (n = 58,284). The causal relationships were estimated with inverse variance weighted (IVW), MR-Egger, and weighted median methods. Sensitivity analyses were performed with Cochran's Q test, MR-Egger intercept test, and leave-one-out analysis to estimate the robustness of our findings. RESULTS Genetically predicted leisure television watching increased the risk of LBP (OR = 1.68, 95% CI 1.41 to 2.01; P = 8.23×10-9) and IVDD (OR = 1.62, 95% CI 1.37 to 1.91; P = 2.13 × 10-8). In addition, this study revealed a potential causal relationship between computer use and a reduced risk of IVDD (OR = 0.60, 95% CI 0.42 to 0.86; P = 0.005) and RA (OR = 0.28, 95% CI 0.13 to 0.60; P = 0.001). CONCLUSIONS Our results suggest that leisure television watching is a risk factor for LBP and IVDD, whereas leisure computer use may act as a protective factor against IVDD and RA. These findings emphasized the importance of distinguishing between different sedentary behaviors in musculoskeletal disease studies.
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Affiliation(s)
- Xiaoyan Zhao
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Clinical Medical Department, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yan Yang
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Clinical Medical Department, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rensong Yue
- Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- * E-mail: (CS); (RY)
| | - Chengguo Su
- Acupuncture and Tuina Department, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- * E-mail: (CS); (RY)
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Kurt Z, Sice P, Krajewska K, Elvin G, Xie H, Ogwu S, Wang P, Turgut SS. A pilot study on the impacts of lung-strengthening Qigong on wellbeing. Complement Ther Med 2022; 71:102891. [PMID: 36179803 DOI: 10.1016/j.ctim.2022.102891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/19/2022] [Accepted: 09/26/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Qigong embraces a range of self-care exercises originating from China. Lung-Strengthening Qigong (LSQ) is a specific technique for maintaining and improving physical and mental wellbeing. METHODS We recruited 170 practitioners and 42 non-practitioner/control samples to investigate the impacts of LSQ practice on body, mind, thoughts, and feelings. This is a pilot study pursued to plan for an adequately powered, non-clinical randomized controlled trials (RCT) on overall wellbeing and health and to evaluate the adequacy of delivering the physical activity intervention with fidelity. Self-evaluation-based data collection schemes were developed by regularly requesting completion of a questionnaire from both practitioner and control group, and an online diary and end of study survey (EOS) completion only from the practitioners. Diverse types of analyses were conducted, including statistical tests, machine learning, and qualitative thematic models. RESULTS We evaluated all different data resources together and observed that (a)the impacts are diverse, including improvements in physical (e.g., elevated sleep quality, physical energy, reduced fatigue), mental (e.g., increased positivity, reduced stress), and relational (e.g., enhanced connections to self and nature) wellbeing, which were not observed in control group; (b)measured by the level-of-effectiveness, four distinct clusters were identified, from no-effect to a high-level of effect; (c)a majority (84 %) of the LSQ practitioners experienced an improvement in wellbeing; (d)qualitative and quantitative analyses of the diary entries, questionnaires, and EOS were all found to be consistent, (e)majority of the positively impacted practitioners had no or some little prior experience with LSQ. CONCLUSIONS Novel features of this study include (i)an increased sample size vis-à-vis other related studies; (ii)provision of weekly live-streamed LSQ sessions; (iii)integration of quantitative and qualitative type of analyses. The pilot study indicated that the proportion of practitioners who continued to engage in completing the regular-interval questionnaires over time was higher for practitioners compared to the control group. The engagement of practitioners may have been sustained by participation in the regular live LSQ sessions. To fully understand the impacts of LSQ on clinical/physiological outcomes, especially for specific patient groups, more objective biomarkers (e.g. respiratory rate, heart rate variation) could be tracked in future studies.
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Affiliation(s)
- Zeyneb Kurt
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK.
| | - Petia Sice
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK
| | - Krystyna Krajewska
- Confucius Institute, University of Wales Trinity Saint David, Lampeter, Ceredigion, UK
| | - Garry Elvin
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK
| | - Hailun Xie
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK; University of Exeter, Penryn Campus, Penryn, Cornwall, UK
| | - Suzannah Ogwu
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK; University of Wales Trinity Saint David, Sparkhill Centre, Birmingham, UK
| | - Pingfan Wang
- Department of Computer and Information Sciences, University of Northumbria, Newcastle Upon Tyne, UK
| | - Sultan Sevgi Turgut
- Department of Computer Engineering, Yildiz Technical University, Istanbul, Turkey
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Zemancová Z, Dubovská E, Tavel P. Older Adults’ Motivation to Exercise: Qualitative Insights from Czech Republic. ACTIVITIES, ADAPTATION & AGING 2022. [DOI: 10.1080/01924788.2022.2151807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Zuzana Zemancová
- Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
| | - Eva Dubovská
- Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University, Olomouc, Czech Republic
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Huggins CJ, Clarke R, Abasolo D, Gil-Rey E, Tobias JH, Deere K, Allison SJ. Machine Learning Models for Weight-Bearing Activity Type Recognition Based on Accelerometry in Postmenopausal Women. SENSORS (BASEL, SWITZERLAND) 2022; 22:9176. [PMID: 36501877 PMCID: PMC9740741 DOI: 10.3390/s22239176] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Hip-worn triaxial accelerometers are widely used to assess physical activity in terms of energy expenditure. Methods for classification in terms of different types of activity of relevance to the skeleton in populations at risk of osteoporosis are not currently available. This publication aims to assess the accuracy of four machine learning models on binary (standing and walking) and tertiary (standing, walking, and jogging) classification tasks in postmenopausal women. Eighty women performed a shuttle test on an indoor track, of which thirty performed the same test on an indoor treadmill. The raw accelerometer data were pre-processed, converted into eighteen different features and then combined into nine unique feature sets. The four machine learning models were evaluated using three different validation methods. Using the leave-one-out validation method, the highest average accuracy for the binary classification model, 99.61%, was produced by a k-NN Manhattan classifier using a basic statistical feature set. For the tertiary classification model, the highest average accuracy, 94.04%, was produced by a k-NN Manhattan classifier using a feature set that included all 18 features. The methods and classifiers within this study can be applied to accelerometer data to more accurately characterize weight-bearing activity which are important to skeletal health.
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Affiliation(s)
- Cameron J. Huggins
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Rebecca Clarke
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Daniel Abasolo
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Erreka Gil-Rey
- Faculty of Psychology and Education, University of Deusto, 20012 San Sebastián, Spain
| | - Jonathan H. Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS10 5NB, UK
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Kevin Deere
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS10 5NB, UK
| | - Sarah J. Allison
- School of Health and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
- School of Bioscience and Medicine, University of Surrey, Guildford GU2 7XH, UK
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Greenberg AL, Tolstykh IV, Van Loon K, Laffan A, Stanfield D, Steiding P, Kenfield SA, Chan JM, Atreya CE, Piawah S, Kidder W, Venook AP, Van Blarigan EL, Varma MG. Association between adherence to the American Cancer Society Nutrition and Physical Activity Guidelines and stool frequency among colon cancer survivors: a cohort study. J Cancer Surviv 2022; 17:836-847. [DOI: 10.1007/s11764-022-01288-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/27/2022] [Indexed: 11/08/2022]
Abstract
Abstract
Purpose
We sought to determine whether adherence to the American Cancer Society (ACS) Nutrition and Physical Activity Guidelines was associated with better bowel function among colon cancer survivors.
Methods
This prospective cohort study included patients surgically treated for stage I–IV colon cancer enrolled in the Lifestyle and Outcomes after Gastrointestinal Cancer (LOGIC) study between February 2017 and May 2021. Participants were assigned an ACS score (0–6 points) at enrollment. Stool frequency (SF) was assessed every 6 months using the EORTC QLQ-CR29. Higher SF is an indication of bowel function impairment. ACS score at enrollment was examined in relation to SF at enrollment and over a 3-year period. Secondarily, we examined associations between the ACS score components (body mass index, dietary factors, and physical activity) and SF. Multivariable models were adjusted for demographic and surgical characteristics.
Results
A total of 112 people with colon cancer (59% women, mean age 59.5 years) were included. Cross-sectionally, for every point increase in ACS score at enrollment, the odds of having frequent stools at enrollment decreased by 43% (CI 0.42–0.79; p < 0.01). Findings were similar when we examined SF as an ordinal variable and change in SF over a 3-year period. Lower consumption of red/processed meats and consuming a higher number of unique fruits and vegetables were associated with lower SF (better bowel function) at enrollment.
Conclusions
Colon cancer survivors who more closely followed the ACS nutrition and physical activity guidelines had lower SF, an indication of better bowel function.
Implications for Cancer Survivors
Our findings highlight the value of interventions that support health behavior modification as part of survivorship care for long-term colon cancer survivors.
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Artificial intelligence used to diagnose osteoporosis from risk factors in clinical data and proposing sports protocols. Sci Rep 2022; 12:18330. [PMID: 36316387 PMCID: PMC9622877 DOI: 10.1038/s41598-022-23184-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022] Open
Abstract
Osteoporosis (OP) is characterized by diminished bone mass and deteriorating bone structure that increases the chance of fractures in the spine, hips, and wrists. In this paper, a novel data processing method of artificial intelligence (AI) is used for evaluating, predicting, and classifying OP risk factors in clinical data of men and women separately. Additionally, artificial intelligence was used to suggest the most appropriate sports programs for treatment. Data was obtained from dual-energy x-ray absorption scanning center of Ayatollah Kashani, Milad, and Khatam al-Anbia hospitals in Tehran, Iran. The subjects included 1224 men and women. Models were developed using decision tree, random forest (RF), k-nearest neighbor, support vector machine, gradient boosting (GB), Extra trees, Ada Boost (AB), and artificial neural network multilayer perceptron analysis to predict osteoporosis and to recommend sports programs. Data was divided into training (80%) and test dataset (20%). The results were obtained on a 20% test dataset. Area under receiver operating characteristic curve (AUROC) was used to compare the performance of the models. To predict healthy individuals, osteopenia and osteoporosis, the FR algorithm with AUROC 0.91 performed best in men and the GB algorithm with AUROC 0.95 performed best in women compared to other classification algorithms. Prediction of RF algorithm in women and men with AUROC 0.96 and 0.99, respectively, showed the highest performance in diagnosing the type of exercise for healthy individuals and those with osteopenia and OP. Eight AI algorithms were developed and compared to accurately predict osteoporosis risk factors and classify individuals into three categories: healthy, osteopenia, and OP. In addition, the AI algorithms were developed to recommend the most appropriate sports programs as part of treatment. Applying the AI algorithms in a clinical setting could help primary care providers classify patients with osteoporosis and improve treatment by recommending appropriate exercise programs.
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64
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Phillips K, Stanley K, Fuller D. A theory-based model of cumulative activity. Sci Rep 2022; 12:15635. [PMID: 36115875 PMCID: PMC9482623 DOI: 10.1038/s41598-022-18982-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/23/2022] [Indexed: 11/24/2022] Open
Abstract
Energy expenditure can be used to examine the health of individuals and the impact of environmental factors on physical activity. One of the more common ways to quantify energy expenditure is to process accelerometer data into some unit of measurement for this expenditure, such as Actigraph activity counts, and bin those measures into physical activity levels. However, accepted thresholds can vary between demographics, and some units of energy measurements do not currently have agreed upon thresholds. We present an approach which computes unique thresholds for each individual, using piecewise exponential functions to model the characteristics of their overall physical activity patterns corresponding to well established sedentary, light, moderate and vigorous activity levels from the literature. Models are fit using existing piecewise fitting techniques and software. Most participants’ activity intensity profile is exceptionally well modeled as piecewise exponential decay. Using this model, we find emergent groupings of participant behavior and categorize individuals into non-vigorous, consistent, moderately active, or extremely active activity intensity profiles. In the supplemental materials, we demonstrate that the parameters of the model correlate with demographics of age, household size, and level of education, inform behavior change under COVID lockdown, and are reasonably robust to signal frequency.
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van Gameren M, Hoogendijk EO, van Schoor NM, Bossen D, Visser B, Bosmans JE, Pijnappels M. Physical activity as a risk or protective factor for falls and fall-related fractures in non-frail and frail older adults: a longitudinal study. BMC Geriatr 2022; 22:695. [PMID: 35996101 PMCID: PMC9396867 DOI: 10.1186/s12877-022-03383-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 08/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background Physical activity may be both a risk and protective factor for falls and fall-related fractures. Despite its positive effects on muscle and bone health, physical activity also increases exposure to situations where falls and fractures occur. This paradox could possibly be explained by frailty status. Therefore, the aim of this study was to investigate the associations between physical activity and both falls and fractures, and to determine whether frailty modifies the association of physical activity with falls, and fractures. Methods Data of 311 community-dwelling participants aged 75 years or older from the Longitudinal Aging Study Amsterdam, who participated in a three-year longitudinal study with five nine-monthly measurements between 2015/2016 and 2018/2019. Their mean age was 81.1 (SD 4.8) years and frailty was present in 30.9% of the participants. Physical activity in minutes per day was objectively assessed with an inertial sensor (Actigraph) for seven consecutive days. Falls and fractures were assessed every nine months using self-report during an interview over a follow-up period of three years. Frailty was determined at baseline using the frailty index. Associations were estimated using longitudinal logistic regression analyses based on generalized estimating equations. Results No association between physical activity and falls was found (OR = 1.00, 95% CI: 0.99–1.00). Fall risk was higher in frail compared to non-frail adults (OR = 2.21, 95% CI: 1.33–3.68), but no effect modification was seen of frailty on the association between physical activity and falls. Also no relation between physical activity and fractures was found (OR = 1.00, 95% CI: 0.99–1.01). Fracture risk was higher in frail compared to non-frail adults (OR = 2.81, 95% CI: 1.02–7.75), but also no effect modification of frailty was present in the association between physical activity and fractures. Conclusions No association between physical activity and neither falls nor fractures was found, and frailty appeared not to be an effect modifier. However, frailty was a risk factor for falls and fractures in this population of older adults. Our findings suggest that physical activity can be safely recommended in non-frail and frail populations for general health benefits, without increasing the risk of falls. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03383-y.
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Affiliation(s)
- Maaike van Gameren
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. .,Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | - Emiel O Hoogendijk
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Amsterdam Public Health, Amsterdam, the Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Data Science, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Amsterdam Public Health, Amsterdam, the Netherlands
| | - Daniël Bossen
- Faculty of Health, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Bart Visser
- Amsterdam Movement Sciences, Amsterdam, the Netherlands.,Faculty of Health, Centre of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Judith E Bosmans
- Amsterdam Public Health, Amsterdam, the Netherlands.,Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Mirjam Pijnappels
- Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Amsterdam, the Netherlands
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Adzhar MA, Manlapaz D, Singh DKA, Mesbah N. Exercise to Improve Postural Stability in Older Adults with Alzheimer's Disease: A Systematic Review of Randomized Control Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10350. [PMID: 36011984 PMCID: PMC9408145 DOI: 10.3390/ijerph191610350] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
In this systematic review, we aim to synthesize published evidence on the effects of exercise in improving postural stability among older adults with Alzheimer's Disease (AD). A systematic electronic literature search was undertaken in Pedro, Cochrane, MEDLINE, ProQuest, Science direct and Clinical trial databases involving human participants published from year 2000-2022. This search was updated in June 2022. The studies chosen were based on predetermined criteria. Data relating to the contents and parameters of exercise in persons with AD were gathered and analyzed. A total of 8 experimental studies met the inclusion criteria. Overall, the selected studies were of a medium quality. In these studies, information and physical exercises were used to improve postural stability in older adults with AD. The findings of the review suggest that performing combined strength, balance and executive function training can improve postural stability. However, we are unable to conclude the specific dose for specific type of exercise. More high-quality studies are required pertaining to exercise prescription for older adults with AD. Mostly, information and physical exercise were delivered via face-to-face sessions conducted by health professionals. The structure of exercises summarized in this review may be beneficial for older adults with AD to improve postural stability and as a result reduce falls.
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Affiliation(s)
- Mohamad Asyraf Adzhar
- Physiotherapy Program & Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Donald Manlapaz
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Santo Tomas, Manila 1008, Philippines
| | - Devinder Kaur Ajit Singh
- Physiotherapy Program & Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Normala Mesbah
- Physiotherapy Program & Centre for Healthy Ageing & Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
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Ji L, Zhang W, Zhong X, Zhao T, Sun X, Zhu S, Tong Y, Luo J, Xu Y, Yang D, Kang Y, Wang J, Bi Q. Osteoporosis, fracture and survival: Application of machine learning in breast cancer prediction models. Front Oncol 2022; 12:973307. [PMID: 36033513 PMCID: PMC9417646 DOI: 10.3389/fonc.2022.973307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022] Open
Abstract
The risk of osteoporosis in breast cancer patients is higher than that in healthy populations. The fracture and death rates increase after patients are diagnosed with osteoporosis. We aimed to develop machine learning-based models to predict the risk of osteoporosis as well as the relative fracture occurrence and prognosis. We selected 749 breast cancer patients from two independent Chinese centers and applied six different methods of machine learning to develop osteoporosis, fracture and survival risk assessment models. The performance of the models was compared with that of current models, such as FRAX, OSTA and TNM, by applying ROC, DCA curve analysis, and the calculation of accuracy and sensitivity in both internal and independent external cohorts. Three models were developed. The XGB model demonstrated the best discriminatory performance among the models. Internal and external validation revealed that the AUCs of the osteoporosis model were 0.86 and 0.87, compared with the FRAX model (0.84 and 0.72)/OSTA model (0.77 and 0.66), respectively. The fracture model had high AUCs in the internal and external cohorts of 0.93 and 0.92, which were higher than those of the FRAX model (0.89 and 0.86). The survival model was also assessed and showed high reliability via internal and external validation (AUC of 0.96 and 0.95), which was better than that of the TNM model (AUCs of 0.87 and 0.87). Our models offer a solid approach to help improve decision making.
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Impact of nutraceuticals and dietary supplements on mitochondria modifications in healthy aging: a systematic review of randomized controlled trials. Aging Clin Exp Res 2022; 34:2659-2674. [PMID: 35920994 DOI: 10.1007/s40520-022-02203-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/17/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND To date, the mitochondrial function has been related to several pathways involved in the cellular aging process. Dietary supplements might have reciprocal and multilevel interactions with mitochondria network; however, no systematic review assessed the role of different nutraceuticals in mitochondria modification of healthy older adults. AIM To assess the effects of different dietary supplements on mitochondria modifications in older adults. METHODS On February 22, 2022, PubMed, Scopus, Web of Science, and Cochrane were systematically searched from inception for randomized controlled trials (RCTs). According to PICO model, we considered healthy older adults as participants, nutraceutical treatment as intervention, any treatment as comparator, mitochondrial modifications as outcome. Jadad scale was used for the quality assessment. RESULTS Altogether, 8489 records were identified and screened until 6 studies were included. A total of 201 healthy older adults were included in the systematic review (mean age ranged from 67.0 ± 1.0 years to 76.0 ± 5.6 years). The dietary supplements assessed were sodium nitrite, N-3 polyunsaturated fatty acids, hydrogen-rich water, nicotinamide riboside, urolithin A, and whey protein powder. Positive effects were reported in terms of mitochondrial oxidative and antioxidant capacity, volume, bioenergetic capacity, and mitochondrial transcriptome based on the nutritional supplements. The quality assessment underlined that all the studies included were of good quality. DISCUSSION Although dietary supplements might provide positive effects on mitochondria modifications, few studies are currently available in this field. CONCLUSION Further studies are needed to better elucidate the reciprocal and multilevel interactions between nutraceuticals, mitochondria, and environmental stressors in healthy older adults.
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Diong J, Carden PC, O'Sullivan K, Sherrington C, Reed DS. Eccentric exercise improves joint flexibility in adults: A systematic review update and meta-analysis. Musculoskelet Sci Pract 2022; 60:102556. [PMID: 35390669 DOI: 10.1016/j.msksp.2022.102556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 02/27/2022] [Accepted: 03/11/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Eccentric exercise is thought to improve joint flexibility, but the size of the effect is not known. We aimed to quantify the overall effect of eccentric exercise on joint flexibility in adults. DESIGN Systematic review, meta-analysis. DATA SOURCES AMED, CINAHL, MEDLINE, EMBASE, SportDiscus. PARTICIPANTS Adults. INTERVENTION Eccentric exercise compared to no intervention or to a different intervention. OUTCOME MEASURES Joint range of motion or muscle fascicle length. DATA EXTRACTION AND SYNTHESIS Descriptive data of included trials and estimates of effect sizes were extracted. Standardised mean differences (SMD) of range of motion or fascicle length outcomes were meta-analysed using random effects models. Overall quality of evidence was assessed using the GRADE scale. RESULTS 32 trials (1122 participants, 108 lost to follow-up) were included in the systematic review. The mean (SD) PEDro score was 5.2 (1.3). Four trials reported insufficient data for meta-analysis. Data from 27 trials (911 participants, 82 lost to follow-up) were meta-analysed. Eccentric exercise improved joint flexibility in adults (pooled random effects Hedges' g SMD = 0.54, 95% CI 0.34 to 0.74). The true effect size is different across studies and 50% of the variance in observed effects is estimated to reflect variance in true effects rather than sampling error (I2 = 50%, Q = 67.6, d.f. = 34, p = 0.001). Overall quality of evidence ranged from 'low' to 'high'. CONCLUSION Eccentric exercise improves joint flexibility in adults. The overall standardised mean effect of eccentric exercise was moderately large, and the narrow width of the 95% confidence interval indicates the effect was estimated with good precision. REGISTRATION Open Science Foundation (https://osf.io/mkdqr); PROSPERO registration CRD42020151303.
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Affiliation(s)
- Joanna Diong
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
| | - Peter C Carden
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Kieran O'Sullivan
- Ageing Research Centre and Sports and Human Performance Centre, School of Allied Health, University of Limerick, Ireland
| | - Catherine Sherrington
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Institute of Musculoskeletal Health, The University of Sydney and Sydney Local Health District, NSW, Australia
| | - Darren S Reed
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
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Zhu R, Craciun I, Bernhards-Werge J, Jalo E, Poppitt SD, Silvestre MP, Huttunen-Lenz M, McNarry MA, Stratton G, Handjiev S, Handjieva-Darlenska T, Navas-Carretero S, Sundvall J, Adam TC, Drummen M, Simpson EJ, Macdonald IA, Brand-Miller J, Muirhead R, Lam T, Vestentoft PS, Færch K, Martinez JA, Fogelholm M, Raben A. Age- and sex-specific effects of a long-term lifestyle intervention on body weight and cardiometabolic health markers in adults with prediabetes: results from the diabetes prevention study PREVIEW. Diabetologia 2022; 65:1262-1277. [PMID: 35610522 PMCID: PMC9283166 DOI: 10.1007/s00125-022-05716-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/31/2022] [Indexed: 02/05/2023]
Abstract
AIMS/HYPOTHESIS Lifestyle interventions are the first-line treatment option for body weight and cardiometabolic health management. However, whether age groups or women and men respond differently to lifestyle interventions is under debate. We aimed to examine age- and sex-specific effects of a low-energy diet (LED) followed by a long-term lifestyle intervention on body weight, body composition and cardiometabolic health markers in adults with prediabetes (i.e. impaired fasting glucose and/or impaired glucose tolerance). METHODS This observational study used longitudinal data from 2223 overweight participants with prediabetes in the multicentre diabetes prevention study PREVIEW. The participants underwent a LED-induced rapid weight loss (WL) period followed by a 3 year lifestyle-based weight maintenance (WM) intervention. Changes in outcomes of interest in prespecified age (younger: 25-45 years; middle-aged: 46-54 years; older: 55-70 years) or sex (women and men) groups were compared. RESULTS In total, 783 younger, 319 middle-aged and 1121 older adults and 1503 women and 720 men were included in the analysis. In the available case and complete case analyses, multivariable-adjusted linear mixed models showed that younger and older adults had similar weight loss after the LED, whereas older adults had greater sustained weight loss after the WM intervention (adjusted difference for older vs younger adults -1.25% [95% CI -1.92, -0.58], p<0.001). After the WM intervention, older adults lost more fat-free mass and bone mass and had smaller improvements in 2 h plasma glucose (adjusted difference for older vs younger adults 0.65 mmol/l [95% CI 0.50, 0.80], p<0.001) and systolic blood pressure (adjusted difference for older vs younger adults 2.57 mmHg [95% CI 1.37, 3.77], p<0.001) than younger adults. Older adults had smaller decreases in fasting and 2 h glucose, HbA1c and systolic blood pressure after the WM intervention than middle-aged adults. In the complete case analysis, the above-mentioned differences between middle-aged and older adults disappeared, but the direction of the effect size did not change. After the WL period, compared with men, women had less weight loss (adjusted difference for women vs men 1.78% [95% CI 1.12, 2.43], p<0.001) with greater fat-free mass and bone mass loss and smaller improvements in HbA1c, LDL-cholesterol and diastolic blood pressure. After the WM intervention, women had greater fat-free mass and bone mass loss and smaller improvements in HbA1c and LDL-cholesterol, while they had greater improvements in fasting glucose, triacylglycerol (adjusted difference for women vs men -0.08 mmol/l [-0.11, -0.04], p<0.001) and HDL-cholesterol. CONCLUSIONS/INTERPRETATION Older adults benefited less from a lifestyle intervention in relation to body composition and cardiometabolic health markers than younger adults, despite greater sustained weight loss. Women benefited less from a LED followed by a lifestyle intervention in relation to body weight and body composition than men. Future interventions targeting older adults or women should take prevention of fat-free mass and bone mass loss into consideration. CLINICAL TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT01777893.
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Affiliation(s)
- Ruixin Zhu
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Ionut Craciun
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jan Bernhards-Werge
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Elli Jalo
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Sally D Poppitt
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Marta P Silvestre
- Human Nutrition Unit, School of Biological Sciences, Department of Medicine, University of Auckland, Auckland, New Zealand
- CINTESIS, NOVA Medical School (NMS), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Maija Huttunen-Lenz
- Institute for Nursing Science, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Melitta A McNarry
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
| | - Gareth Stratton
- Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, UK
| | - Svetoslav Handjiev
- Department of Pharmacology and Toxicology, Medical University of Sofia, Sofia, Bulgaria
| | | | - Santiago Navas-Carretero
- Centre for Nutrition Research, University of Navarra, Pamplona, Spain
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCII), Madrid, Spain
- IdisNA Instituto for Health Research, Pamplona, Spain
| | - Jouko Sundvall
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tanja C Adam
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Mathijs Drummen
- Department of Nutrition and Movement Sciences, NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Elizabeth J Simpson
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Ian A Macdonald
- MRC/ARUK Centre for Musculoskeletal Ageing Research, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - Jennie Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | | | - Pia S Vestentoft
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Kristine Færch
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Alfredo Martinez
- Centro de Investigacion Biomedica en Red Area de Fisiologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III (ISCII), Madrid, Spain
- Department of Nutrition and Physiology, University of Navarra, Pamplona, Spain
- Precision Nutrition and Cardiometabolic Health Program, IMDEA-Food Institute, Madrid Institute for Advanced Studies, CEI UAM + CSIC, Madrid, Spain
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark.
- Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark.
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Sargent B, Harbourne R, Moreau NG, Sukal-Moulton T, Tovin M, Cameron JL, Stevenson RD, Novak I, Heathcock J. Research Summit V: Optimizing Transitions From Infancy to Early Adulthood in Children With Neuromotor Conditions. Pediatr Phys Ther 2022; 34:411-417. [PMID: 35653258 PMCID: PMC9250600 DOI: 10.1097/pep.0000000000000912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE The purpose of this executive summary is to review the process and outcomes of the Academy of Pediatric Physical Therapy Research Summit V, "Optimizing transitions from infancy to young adulthood in children with neuromotor disabilities: biological and environmental factors to support functional independence." SUMMARY OF KEY POINTS An interdisciplinary group of researchers, representatives from funding agencies, and individuals with neuromotor disabilities and their parents participated in an intensive 2.5-day summit to determine research priorities to optimize life transitions for children with neuromotor disabilities. Recommended priorities for research included (1) promoting self-determination and self-efficacy of individuals with neuromotor disabilities and their families, (2) best care at the right time: evidence-based best practice care, led and navigated by families seamlessly across the lifespan, (3) strengthening connections between developmental domains to enhance function and participation, and (4) optimal dosing and timing to support adaptive bone, muscle, and brain plasticity across the lifespan.
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Affiliation(s)
- Barbara Sargent
- University of Southern California, Division of Biokinesiology and Physical Therapy, Herman Ostrow School of Dentistry, Los Angeles, California, USA
| | - Regina Harbourne
- Duquesne University, Rangos School of Health Sciences, Department of Physical Therapy, Pittsburgh, Pennsylvania, USA
| | - Noelle G. Moreau
- Louisiana State University Health Sciences Center – New Orleans, Department of Physical Therapy, School of Allied Health, New Orleans, Louisiana USA
| | - Theresa Sukal-Moulton
- Northwestern University, Departments of Physical Therapy and Human Movement Sciences and Pediatrics, Feinberg School of Medicine, Chicago, IL, USA
| | - Melissa Tovin
- Nova Southeastern University, Department of Physical Therapy, Fort Lauderdale, FL, USA
| | - Judy L. Cameron
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, Pennsylvania, USA
| | - Richard D. Stevenson
- University of Virginia School of Medicine, Department of Pediatrics, Charlottesville, VA, USA
| | - Iona Novak
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Cerebral Palsy Alliance Research Institute, Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jill Heathcock
- The Ohio State University, School of Health and Rehabilitation Sciences, Division of Physical Therapy, Columbus, OH, USA
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Chang CF, Lee JI, Huang SP, Geng JH, Chen SC. Regular Exercise Decreases the Risk of Osteoporosis in Postmenopausal Women. Front Public Health 2022; 10:897363. [PMID: 35784236 PMCID: PMC9240347 DOI: 10.3389/fpubh.2022.897363] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Regular exercise can regulate bone maintenance and improve bone health. However, large-scale epidemiological studies on the association between regular exercise and incident osteoporosis in menopausal women are still lacking. We aimed to examine the relationship between exercise and the risk of osteoporosis in menopausal women. In cross-sectional analysis, we enrolled 30,046 postmenopausal women with available information from the database of the Taiwan Biobank (TWB). We divided them into two groups according to their status of regular exercise, i.e., no exercise and regular exercise groups. A t-score of -2.5 or more standard deviations (SDs) below that of a young adult was defined as osteoporosis. Logistic regression after adjusting for confounding factors was used to analyze the association between regular exercise and the prevalence of osteoporosis. Furthermore, the risk of incident osteoporosis development was analyzed in a longitudinal cohort of 6,785 postmenopausal women without osteoporosis at baseline using a Kaplan-Meier analysis and a log-rank test. The mean age of subjects in the cross-sectional cohort was 59 years old. Fifty-six percent of them were exercising regularly. Osteoporosis was observed in 1,886 (14.2%) and 2,254 (13.4%) participants in the no exercise and regular exercise groups. Lower risk of osteoporosis was noted in postmenopausal women with regular exercise when compared with those without regular exercise [odds ratio (OR), 0.76; 95% confidence interval (95% CI), 0.71-0.81]. In the longitudinal cohort, incident osteoporosis was found in 430 (10.5%) women with regular exercise and 299 (11.2%) women without exercise during a mean follow-up of 45 months. Cox regression analysis revealed that the risk for incident osteoporosis was lower in postmenopausal women with regular exercise than those without exercise [hazard ratio (HR), 0.83; 95% CI, 0.71-0.97]. Our study suggests that regular exercise is associated with a reduced risk of osteoporosis in postmenopausal women and strengthens the importance of exercise for the prevention of osteoporosis.
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Affiliation(s)
- Chu-Fen Chang
- Department of Physical Therapy, Tzu Chi University, Hualien, Taiwan
| | - Jia-In Lee
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jiun-Hung Geng
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
| | - Szu-Chia Chen
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Brooke-Wavell K, Skelton DA, Barker KL, Clark EM, De Biase S, Arnold S, Paskins Z, Robinson KR, Lewis RM, Tobias JH, Ward KA, Whitney J, Leyland S. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. Br J Sports Med 2022; 56:bjsports-2021-104634. [PMID: 35577538 PMCID: PMC9304091 DOI: 10.1136/bjsports-2021-104634] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2022] [Indexed: 12/11/2022]
Abstract
Exercise and physical activity can improve bone strength and the risk of falls, which may offer benefits in the prevention and management of osteoporosis. However, uncertainty about the types of exercise that are safe and effective instigates lack of confidence in people with osteoporosis and health professionals. Existing guidelines leave some questions unresolved. This consensus statement aimed to determine the physical activity and exercise needed to optimise bone strength, reduce fall and fracture risk, improve posture and manage vertebral fracture symptoms, while minimising potential risks in people with osteoporosis. The scope of this statement was developed following stakeholder consultation. Meta-analyses were reviewed and where evidence was lacking, individual studies or expert opinion were used to develop recommendations. A multidisciplinary expert group reviewed evidence to make recommendations, by consensus when evidence was not available. Key recommendations are that people with osteoporosis should undertake (1) resistance and impact exercise to maximise bone strength; (2) activities to improve strength and balance to reduce falls; (3) spinal extension exercise to improve posture and potentially reduce risk of falls and vertebral fractures. For safety, we recommend avoiding postures involving a high degree of spinal flexion during exercise or daily life. People with vertebral fracture or multiple low trauma fractures should usually exercise only up to an impact equivalent to brisk walking. Those at risk of falls should start with targeted strength and balance training. Vertebral fracture symptoms may benefit from exercise to reduce pain, improve mobility and quality of life, ideally with specialist advice to encourage return to normal activities. Everyone with osteoporosis may benefit from guidance on adapting postures and movements. There is little evidence that physical activity is associated with significant harm, and the benefits, in general, outweigh the risks.
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Affiliation(s)
- Katherine Brooke-Wavell
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Karen L Barker
- Physiotherapy Department, Nuffield Orthopaedic Centre, University of Oxford, Oxford, UK
| | - Emma M Clark
- Bristol Medical School, University of Bristol, Bristol, UK
- North Bristol NHS Trust, Bristol, UK
| | - Sarah De Biase
- Older People's Mental Health Service, Bradford District Care NHS Foundation Trust, Bradford, UK
- AGILE, Chartered Society of Physiotherapy, London, UK
| | - Susanne Arnold
- AGILE, Chartered Society of Physiotherapy, London, UK
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
| | - Zoe Paskins
- Primary Care Versus Arthritis Centre, Keele University, Keele, UK
| | - Katie R Robinson
- Academic Unit of Injury, Inflammation and Recovery Sciences, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Jonathan H Tobias
- Bristol Medical School, University of Bristol, Bristol, UK
- North Bristol NHS Trust, Bristol, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Julie Whitney
- Department of Physiotherapy, King's College London, London, UK
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Bevilacqua G, D’Angelo S, Linaker C, Paul A, Bloom I, Zhang J, Laskou F, Cooper C, Ward KA, Walker-Bone K, Dennison EM. Physical Activity and Diet in a Global Pandemic: An Investigation of the Impact of COVID-19 on Factors Relevant for Musculoskeletal Health at Two Different Stages of the Lifecourse. Front Endocrinol (Lausanne) 2022; 13:882399. [PMID: 35592788 PMCID: PMC9110642 DOI: 10.3389/fendo.2022.882399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background Physical activity, nutrition and other lifestyle factors play important roles in maintaining musculoskeletal health. The coronavirus disease (COVID-19) originated in late 2019, spread globally to be declared a pandemic by the World Health Organisation in March 2020, and led to widespread behaviour change. The aim of this study was to use two existing cohorts, the Hertfordshire Cohort Study (HCS) and Health and Employment After Fifty Study (HEAF), to understand how wave one of the COVID-19 pandemic impacted lifestyle factors associated with musculoskeletal health in the UK. Methods 125 eligible participants, 65 males and 60 females (drawn from the HCS study, median (IQR) age 84.3 (82.4-86.6) years, all Caucasian, and community dwelling) were contacted by telephone and asked to complete a questionnaire administered by a trained researcher. Data collection occurred over the period July 2020 to February 2021. 2469 participants, 1086 men and 1383 women (drawn from the HEAF study, median age 65.7 (62.0-69.3) years, mostly Caucasian and community dwelling) completed an online questionnaire in March 2021. Results In HCS, 47% respondents reported being less physically active than before the pandemic (and only 5% more so), 27% said they consumed less alcohol compared to pre-pandemic times (and only 3% more so), and 18% reported eating less than before, although quality of diet was generally unchanged over this timeframe surveyed. In HEAF, 44% participants said they were less active than before the pandemic, while 17% reported being more active. The majority of participants reported no changes in alcohol consumption and diet; however, 19% said they drank more than before (32% of which was above recommended levels), 16% said their diet was less healthy, and 19% reported eating more than before. Conclusion We have reported the experience of the first wave of the COVID-19 pandemic among participants of two Caucasian community dwelling UK cohorts, highlighting the impact of the pandemic on lifestyle factors associated with musculoskeletal health. Changed physical activity levels were reported in a high proportion of respondents in both studies; an investigation of reversibility of these changes is required.
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Affiliation(s)
- Gregorio Bevilacqua
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- Medical Research Council (MRC) Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - Stefania D’Angelo
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- Medical Research Council (MRC) Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - Cathy Linaker
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- Medical Research Council (MRC) Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - Alice Paul
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Ilse Bloom
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, United Kingdom
| | - Jean Zhang
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, United Kingdom
| | - Faidra Laskou
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Cyrus Cooper
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, United Kingdom
- National Institute for Health and Care Research (NIHR) Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Kate A. Ward
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Karen Walker-Bone
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- Medical Research Council (MRC) Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, United Kingdom
| | - Elaine M. Dennison
- Medical Research Council (MRC) Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
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Tang Y, Liu Z, Wang S, Yi Q, Xia Y, Geng B. Development and validation of a novel screening tool for osteoporosis in older US adults: The NHANES cross-sectional study. Endocrine 2022; 76:446-456. [PMID: 35122626 DOI: 10.1007/s12020-022-03001-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/29/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Osteoporosis (OP) is a common disease among adults aged >50 years. At present, the main approach to screen or to diagnosis OP is mainly via bone mineral density (BMD) testing, which might not be optimal for OP screening. This study aimed to develop and validate a convenient and effective prediction model for screening OP based on the demographic information, medical history, and lifestyle habits in the elderly in the United States. METHODS All data were collected from the National Health and Nutrition Survey database. Participants aged ≥50 years with complete BMD data were included in this study. Twelve candidate predictors were initially selected to develop the prediction model. Final predictors screening and model development were based on multivariate logistic regression. Model discrimination (C statistic) and calibration (Brier scores) were calculated to evaluate the performance of the model. Internal validation was performed using the bootstrap resampling technique, and external validation was based on the validation cohort. RESULTS The screening tool was developed with individual patient data from 1941 patients and validated with data from 1947 patients after the development of the model. Seven predictors (patient age, sex, race, body mass index, physical activity, sleep duration, and history of fracture) were included in the final prediction model, and the final model had a C statistic of 0.849 [95% confidence interval (CI): 0.820-0.878] and Brier scores of 0.062 [95% CI: 0.054-0.070] on the development cohort. For the validation of the developed model, the results showed a C statistic >0.800 and Brier scores <0.070, irrespective of internal validation or external validation. CONCLUSIONS A novel screening tool for OP in the elderly, which has excellent discrimination and useful calibration, has been developed and externally validated. Considering its simplicity, generalizability, and accuracy, this tool has the potential to become a practical mean for the elderly to screen OP.
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Affiliation(s)
- Yuchen Tang
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China
- Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Zhongcheng Liu
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China
- Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Shenghong Wang
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China
- Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Qiong Yi
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China
- Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Yayi Xia
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China
- Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Bin Geng
- Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, Gansu, China.
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.
- Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China.
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Jamka M, Piotrowska-Brudnicka SE, Karolkiewicz J, Skrypnik D, Bogdański P, Cielecka-Piontek J, Sultanova G, Walkowiak J, Mądry E. The Effect of Endurance and Endurance-Strength Training on Bone Health and Body Composition in Centrally Obese Women-A Randomised Pilot Trial. Healthcare (Basel) 2022; 10:821. [PMID: 35627958 PMCID: PMC9140472 DOI: 10.3390/healthcare10050821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 12/04/2022] Open
Abstract
There is no consensus exercise programme to reduce body weight and improve body composition simultaneously preventing bone loss or stimulating osteogenesis. This pilot study compared the effect of endurance and endurance-strength training on body composition and bone metabolism in centrally obese women. Recruited subjects were randomly assigned to three-month endurance (n = 22) or endurance-strength training (n = 22). Body composition, bone mineral density (BMD) and content (BMC) were assessed before and after the intervention and markers of bone formation and resorption were measured. Both training significantly decreased fat mass; however, endurance-strength training had a more favourable effect on lean mass for the gynoid area (p = 0.0211) and legs (p = 0.0381). Endurance training significantly decreased total body BMC and BMD (p = 0.0440 and p = 0.0300), whereas endurance-strength training only reduced BMD (p = 0.0063). Changes in densitometric parameters did not differ between the groups but endurance training increased osteocalcin levels (p = 0.04845), while endurance-strength training increased tartrate-resistant acid phosphatase 5b concentrations (p = 0.00145). In conclusion, both training programmes were effective in the reduction of fat mass simultaneously negatively affecting bone health. However, endurance-strength training seemed to be more effective in increasing lean mass. The study protocol was registered in the ClinicalTrials.gov database under the number NCT03444207, date of registration: 23 February 2018 (retrospective registration).
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Affiliation(s)
- Małgorzata Jamka
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Szpitalna Str. 27/33, 60-572 Poznań, Poland; (M.J.); (J.W.)
| | - Sylwia E. Piotrowska-Brudnicka
- Department of Physiology, Poznan University of Medical Sciences, Święcickiego Str. 6, 61-781 Poznań, Poland;
- Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health Science, Wroclaw Medical University, Grunwaldzka Str. 2, 50-355 Wrocław, Poland
| | - Joanna Karolkiewicz
- Department of Food and Nutrition, Poznan University of Physical Education, Królowej Jadwigi Str. 27/39, 61-871 Poznań, Poland;
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Szamarzewskiego Str. 82, 60-569 Poznań, Poland; (D.S.); (P.B.)
| | - Paweł Bogdański
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Szamarzewskiego Str. 82, 60-569 Poznań, Poland; (D.S.); (P.B.)
| | - Judyta Cielecka-Piontek
- Department of Pharmacognosy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznań, Poland;
| | - Gulnara Sultanova
- West Kazakhstan Marat Ospanov Medical University, Maresyev Str. 68, Aktobe 030019, Kazakhstan;
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Szpitalna Str. 27/33, 60-572 Poznań, Poland; (M.J.); (J.W.)
| | - Edyta Mądry
- Department of Physiology, Poznan University of Medical Sciences, Święcickiego Str. 6, 61-781 Poznań, Poland;
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Dalal G, Bromiley PA, Kariki EP, Luetchens S, Cootes TF, Payne K. Understanding current UK practice for the incidental identification of vertebral fragility fractures from CT scans: an expert elicitation study. Aging Clin Exp Res 2022; 34:1909-1918. [PMID: 35435584 PMCID: PMC9283144 DOI: 10.1007/s40520-022-02124-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
Background There is an emerging interest in using automated approaches to enable the incidental identification of vertebral fragility fractures (VFFs) on existing medical images visualising the spine. Aim To quantify values, and the degree of uncertainty associated with them, for the incidental identification of VFFs from computed tomography (CT) scans in current practice. Methods An expert elicitation exercise was conducted to generate point estimates and measures of uncertainty for four values representing the probability of: VFF being correctly reported by the radiologist; the absence of VFF being correctly assessed by the radiologist; being referred for management when a VFF is identified; having a dual-energy X-ray absorptiometry (DXA) scan after general practitioner (GP) referral. Data from a sample of seven experts in the diagnosis and management of people with VFFs were pooled using mathematical aggregation. Results The estimated mean values for each probability parameter were: VFF being correctly reported by the radiologist = 0.25 (standard deviation (SD): 0.21); absence of VFF being correctly assessed by the radiologist = 0.89 (0.10); being referred for management when a VFF is identified by the radiologist = 0.15 (0.12); having a DXA scan after GP referral = 0.66 (0.28). Discussion These estimates could be used to facilitate the subsequent early economic evaluation of potential new approaches to improve the health outcomes of people with VFFs. Conclusion In the absence of epidemiological studies, this study produced point estimates and measures of uncertainty for key parameters needed to describe current pathways for the incidental diagnosis of VFFs. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-022-02124-w.
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Affiliation(s)
- Garima Dalal
- Manchester Centre for Health Economics, University of Manchester, Oxford Road, Manchester, UK
| | - Paul A Bromiley
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - Eleni P Kariki
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
- Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Timothy F Cootes
- Centre for Imaging Sciences, University of Manchester, Manchester, UK
| | - Katherine Payne
- Manchester Centre for Health Economics, University of Manchester, Oxford Road, Manchester, UK.
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Mair JL, Hayes LD, Campbell AK, Buchan DS, Easton C, Sculthorpe N. A Personalized Smartphone-Delivered Just-in-time Adaptive Intervention (JitaBug) to Increase Physical Activity in Older Adults: Mixed Methods Feasibility Study. JMIR Form Res 2022; 6:e34662. [PMID: 35389348 PMCID: PMC9030994 DOI: 10.2196/34662] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/20/2022] [Accepted: 02/11/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Just-in-time adaptive interventions (JITAIs) provide real time in-the-moment behavior change support to people when they need it most. JITAIs could be a viable way to provide personalized physical activity (PA) support to older adults in the community. However, it is unclear how feasible it is to remotely deliver a PA intervention through a smartphone to older adults or how acceptable they would find a JITAI targeting PA in everyday life. OBJECTIVE The aims of this study are to describe the development of JitaBug, a personalized smartphone-delivered JITAI designed to support older adults to increase or maintain their PA level, assess the feasibility of conducting an effectiveness trial of the JitaBug intervention, and explore the acceptability of JitaBug among older adults in a free-living setting. METHODS The intervention was developed using the Behavior Change Wheel and consisted of a wearable activity tracker (Fitbit) and a companion smartphone app (JitaBug) that delivered goal-setting, planning, reminders, and JITAI messages to encourage achievement of personalized PA goals. Message delivery was tailored based on time of day, real time PA tracker data, and weather conditions. We tested the feasibility of remotely delivering the intervention with older adults in a 6-week trial. Data collection involved assessment of PA through accelerometery and activity tracker, self-reported mood and mental well-being through ecological momentary assessment, and contextual information on PA through voice memos. Feasibility outcomes included recruitment capability and adherence to the intervention, intervention delivery in the wild, appropriateness of data collection methodology, adverse events, and participant satisfaction. RESULTS Of the 46 recruited older adults (aged 56-72 years), 31 (67%) completed the intervention. The intervention was successfully delivered as intended; 87% (27/31) of the participants completed the intervention independently; 94% (2247/2390) of the PA messages were successfully delivered; 99% (2239/2261) of the Fitbit and 100% (2261/2261) of the weather data calls were successful. Valid and usable wrist-worn accelerometer data were obtained from 90% (28/31) of the participants at baseline and follow-up. On average, the participants recorded 50% (7.9/16, SD 7.3) of the voice memos, 38% (3.3/8, SD 4.2) of the mood assessments, and 50% (2.1/4, SD 1.6) of the well-being assessments through the app. Overall acceptability of the intervention was very good (23/30, 77% expressed satisfaction). Participant feedback suggested that more diverse and tailored PA messages, app use reminders, technical refinements, and an improved user interface could improve the intervention and make it more appealing. CONCLUSIONS This study suggests that a smartphone-delivered JITAI is an acceptable way to support PA in older adults in the community. Overall, the intervention is feasible; however, based on user feedback, the JitaBug app requires further technical refinements that may enhance use, engagement, and user satisfaction before moving to effectiveness trials.
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Affiliation(s)
- Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Lawrence D Hayes
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, United Kingdom
| | - Amy K Campbell
- School of Science, Technology and Health, York St John University, York, United Kingdom
| | - Duncan S Buchan
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, United Kingdom
| | - Chris Easton
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, United Kingdom
| | - Nicholas Sculthorpe
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, South Lanarkshire, United Kingdom
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Acute effects of the resistance exercise associated with different blood flow restriction pressures on bone remodeling biomarkers. J Exerc Sci Fit 2022; 20:155-160. [PMID: 35356103 PMCID: PMC8928066 DOI: 10.1016/j.jesf.2022.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 02/10/2022] [Accepted: 02/26/2022] [Indexed: 12/18/2022] Open
Abstract
Background The present study analyzed the acute responses of parathyroid hormone (PTH) and bone-specific alkaline phosphatase (BSAP) to the low-intensity resistance exercise with blood flow restriction using different occlusion pressures. Methods Twelve women completed the three protocols of this crossover study: resistance exercise without blood flow restriction (RE), resistance exercise with blood flow restriction and occlusion pressure corresponding to 70% of systolic blood pressure (RE + BFR70), and resistance exercise with blood flow restriction and occlusion pressure corresponding 130% of systolic blood pressure (RE + BFR130). All exercises were performed in a guided squat apparatus with load corresponded to 30% of one-repetition maximum test. Results Relative to resting levels, PTH concentrations decreased significantly (p = .000) post-exercise in all groups and increased significantly (p = .000) 15 min post-exercise in RE + BFR70 and RE + BFR130 groups; PTH concentrations returned to resting levels after the 30-min recovery period in all groups. There was no significant difference (p >.05) between BSAP values at rest and 30 min post-exercise. Conclusion In conclusion, our results showed that protocols with blood flow restriction using occlusion pressures equivalent to 70% and 130% of systolic blood pressure were more effective than RE alone to induce PTH peaks, and to promote a metabolic condition favorable to bone anabolism.
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80
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Papp ME, Grahn-Kronhed AC, Rauch Lundin H, Salminen H. Changes in physical activity levels and relationship to balance performance, gait speed, and self-rated health in older Swedish women: a longitudinal study. Aging Clin Exp Res 2022; 34:775-783. [PMID: 34784017 PMCID: PMC9076716 DOI: 10.1007/s40520-021-02016-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 10/20/2021] [Indexed: 12/30/2022]
Abstract
Background and aim Physical activity levels in older people often decrease and may mean impaired physical functioning leading to an increased fall risk. The aim of this study was to investigate self-reported change in physical activity dose and deterioration in balance performance, gait speed, and self-rated health (SRH) in older women between two time points in a follow-up study. Methods A cohort of community-living women, aged 69–79 years (n = 351) were evaluated by questionnaire and clinical tests on balance, gait speed, and SRH at baseline. One hundred and eighty-six women were followed-up by these tests 8.5 years after inclusion. The non-parametric Wilcoxon signed-rank test and Mann–Whitney U test were used for the analysis. Results The greatest changes were seen in one-leg standing time (OLST) with eyes closed (− 60%) and eyes open (− 42%). The population was divided into high exercise (HE, n = 49) and low exercise (LE, n = 51) groups. At baseline the HE group had an OLST of 19 s with eyes open and 3 s with eyes closed. In the LE group, these values were 7.3 s and 2 s. At follow-up, differences between HE and LE concerning tandem walk forwards (steps) (HE = 8.5; LE = 2.5) and backwards (HE = 11; LE = 3.5) emerged. The HE group estimated SRH (VAS-scale) 30 mm higher at baseline and 17 mm higher at follow-up than the LE group. Conclusion Greater physical activity seems to be an important predictor for maintaining physical function and SRH in older women.
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Affiliation(s)
- Marian E Papp
- Division of Family Medicine and Primary Care, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Alfred Nobels alle 23, 141 83, Huddinge, Sweden.
- Division of Physical Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden.
| | - Ann Charlotte Grahn-Kronhed
- Rehab Väst, Local Health Care Services in the West of Östergötland, Motala, Sweden
- Division of Prevention, Rehabilitation, and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Hans Rauch Lundin
- Division of Family Medicine and Primary Care, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Alfred Nobels alle 23, 141 83, Huddinge, Sweden
- Academic Primary Healthcare Centre Stockholm, Stockholm, Sweden
| | - Helena Salminen
- Division of Family Medicine and Primary Care, Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Alfred Nobels alle 23, 141 83, Huddinge, Sweden
- Academic Primary Healthcare Centre Stockholm, Stockholm, Sweden
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81
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Aikawa Y, Yamashita T, Nakai N, Higashida K. Low-carbohydrate, high-fat diet and running exercise influence bone parameters in old mice. J Appl Physiol (1985) 2022; 132:1204-1212. [PMID: 35358401 DOI: 10.1152/japplphysiol.00789.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We examined the effects and interactions of a low-carbohydrate, high-fat (LCHF) diet and voluntary running exercise on bone in older mice. Male 19-month-old mice were divided into four groups by diet (control vs. LCHF) and exercise (sedentary vs. voluntary running). The control diet was 55% carbohydrate, 23% protein, and 22% fat, and the LCHF diet was 10% carbohydrate, 33% protein, and 57% fat as percentages of calories. The experiment ended when the mice reached 24 months old. Statistical analysis was conducted using two-way analysis of variance with diet and exercise. The LCHF diet decreased bone mineral content (BMC), bone mineral density, bone volume fraction, and trabecular number. There was no significant interaction between diet and exercise on many bone parameters. However, there were significant diet and exercise interactions on lumbar BMC and tibial trabecular total tissue volume and average cortical thickness. The LCHF diet attenuated the benefit of running exercise on lumbar BMC and caused running to have a negative effect on tibial trabecular total tissue volume. Our study suggests that the LCHF diet impairs bone mass and some trabecular microstructure and reduces the benefit of exercise on lumbar BMC in old mice.
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Affiliation(s)
- Yuki Aikawa
- Department of Food and Nutrition, Tsu City College, Tsu, Mie, Japan
| | - Takenori Yamashita
- Faculty of Health Science, Suzuka University of Medical Science, Suzuka, Mie, Japan
| | - Naoya Nakai
- Department of Nutrition, University of Shiga Prefecture, Hikone, Shiga, Japan
| | - Kazuhiko Higashida
- Department of Nutrition, University of Shiga Prefecture, Hikone, Shiga, Japan
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Lee Y, Kim DH. A preliminary study on the effects of an osteoporosis prevention program based on an Information-Motivation-Behavioral skill model in older adult women: A cluster randomized controlled trial. Geriatr Nurs 2022; 45:55-63. [PMID: 35334422 DOI: 10.1016/j.gerinurse.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 03/06/2022] [Accepted: 03/08/2022] [Indexed: 11/24/2022]
Abstract
We aimed to evaluate the feasibility and effects of an osteoporosis prevention program using the Information-Motivation-Behavioral skill (IMB) model in older adult women in this preliminary study. Korean women ≥65 years were randomly assigned to control (N=21) and intervention (N=23) groups. The intervention group participated in an IMB model-based, 12-week osteoporosis prevention program. The primary outcome was osteoporosis prevention behavior over time in both groups directly before, immediately after (post-test 1), and 4 weeks after (post-test 2) the intervention. Participants had a higher retention and attendance rate for the intervention, and the osteoporosis prevention behavior of the intervention group at post-test 1 and post-test 2 had significantly improved. The program based on the IMB model may be a feasible and effective intervention for osteoporosis prevention behavior in older adult women.
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Affiliation(s)
- Yeongsuk Lee
- College of Nursing, Catholic University of Pusan, 57 Oryundae-ro, Geumjeong-gu, Busan 46252, Republic of Korea.
| | - Dong-Hee Kim
- College of Nursing, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si 50612, Republic of Korea.
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83
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Bressi B, Iotti C, Cagliari M, Cavuto S, Fugazzaro S, Costi S. Feasibility and safety of physical exercise in men with prostate cancer receiving androgen deprivation therapy and radiotherapy: a study protocol. BMJ Open 2022; 12:e048854. [PMID: 35292485 PMCID: PMC8928322 DOI: 10.1136/bmjopen-2021-048854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Androgen deprivation therapy (ADT) and radiotherapy (RT) increase survival in selected patients with prostate cancer. Nevertheless, the side effects of these therapies are associated with an increased risk of accidental falls and fractures and a decreased quality of life. Preliminary evidence suggests that physical exercise can be a valid strategy to reduce the side effects of ADT and RT in men with prostate cancer. Despite this knowledge, most patients with prostate cancer are insufficiently active, and there is a lack of data on the safety and adherence to the recommended dose of physical exercise. This study protocol is designed to examine the feasibility and safety of a multicomponent experimental physical exercise intervention targeting psychophysical and cognitive functions and the quality of life in this population. METHODS AND ANALYSIS This is a pilot feasibility study. Twenty-five men currently treated with ADT and RT for prostate cancer will be invited to participate in a 20-week, multicomponent physical exercise intervention, including supervised and unsupervised exercise sessions and meeting the current recommendation for exercise in cancer. The primary outcomes are physical exercise feasibility (recruitment, adherence and drop-out rates) and safety (adverse events related and unrelated to the intervention). The secondary outcomes are muscle strength, balance, fatigue, symptoms of anxiety and depression, cognitive function, quality of life, and patient satisfaction. We will also record the number of accidental falls and fractures occurring during the intervention and at 1 year of follow-up. ETHICS AND DISSEMINATION The study has received ethics approval from The Area Vasta Nord Local Ethics Committee (Province of Reggio Emilia, 23 June 2020, Number 520/2020/SPER/IRCCSRE). Recruitment began in September 2020 and will be completed in September 2021. The results will be disseminated through scientific journals and conference presentations. TRIAL REGISTRATION NUMBER NCT04500080.
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Affiliation(s)
- Barbara Bressi
- Department of Neuromotor Physiopathology and Rehabilitation Medicine, Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy
| | - Cinzia Iotti
- Department of Oncology and Advanced Technologies, Radiotherapy Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maribel Cagliari
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvio Cavuto
- Research and Statistics Infrastructure, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Department of Neuromotor Physiopathology and Rehabilitation Medicine, Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Costi
- Department of Neuromotor Physiopathology and Rehabilitation Medicine, Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Ma R, Romano E, Davis K, Stewart R, Ashworth M, Vancampfort D, Gaughran F, Stubbs B, Mueller C. Osteoporosis referral and treatment among people with severe mental illness: A ten-year data linkage study. J Psychiatr Res 2022; 147:94-102. [PMID: 35030512 DOI: 10.1016/j.jpsychires.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/17/2021] [Accepted: 01/03/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION People with severe mental illness (SMI) are at increased risk of osteoporosis but minimal information is available on their treatment and referral. We investigated differences in these outcomes between patients with/without SMI in linked primary and specialist care data. METHODS People with SMI aged 18+ at diagnosis with both primary and mental healthcare records between 1st May 2009 and 31st May 2019 from a south London catchment were matched 1:4 to randomly selected controls on gender, age and duration of primary care follow-up. Outcomes included prescription of osteoporosis medications and referrals for osteoporosis, analysed using multivariable logistic regression analyses. RESULTS The study included 2269 people with SMI and 9069 matched non-SMI controls. People with SMI were more likely to have a recorded prescription of osteoporosis medications (odds ratio [OR] = 3.54, 95% confidence interval [CI] 2.87, 4.35) and be referred for osteoporosis (OR = 1.51, 95% CI 1.09, 2.08) within 2 years after the date of first SMI diagnosis after adjusting for ethnicity, deprivation and Charlson Comorbidity Index. Factors including older age (osteoporosis medications: OR = 1.04, 95% CI 1.03, 1.05; osteoporosis referral: OR = 1.05, 95% CI 1.04, 1.07) and being prescribed with Class A analgesics (osteoporosis medications: OR = 1.91, 95% CI 1.31, 2.77; osteoporosis referral: OR = 1.77, 95% CI 1.02, 3.07) are significant predictors for osteoporosis management pathways within SMI patients. CONCLUSION People with SMI are more frequently prescribed medications for osteoporosis and referred to osteoporosis screening than the general population. Given the many risk factors for osteoporosis in this group, this increased rate of referrals may well be warranted, and there is need to pay more attention to this at-risk group. Screening studies are needed to determine whether the rate of referral is proportional to the need.
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Affiliation(s)
- Ruimin Ma
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom.
| | - Eugenia Romano
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Katrina Davis
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Mark Ashworth
- School of Population Health and Environmental Sciences, King's College London, United Kingdom
| | - Davy Vancampfort
- KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Centre KU Leuven, Leuven, Kortenberg, Belgium
| | - Fiona Gaughran
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Christoph Mueller
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
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Sallehuddin H, Ong T, Md. Said S, Ahmad Tarmizi NA, Loh SP, Lim WC, Nadarajah R, Lim HT, Mohd Zambri NH, Ho YY, Shariff Ghazali S. Non-pharmacological interventions for bone health after stroke: A systematic review. PLoS One 2022; 17:e0263935. [PMID: 35196338 PMCID: PMC8865685 DOI: 10.1371/journal.pone.0263935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/30/2022] [Indexed: 11/26/2022] Open
Abstract
Objective To examine the effectiveness and safety of non-pharmacological interventions to reduce bone loss among post-stroke adult patients. Data sources Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database for Systematic Reviews, MEDLINE, CINAHL, ScienceDirect, Scopus, PubMed and PeDRO databases were searched from inception up to 31st August 2021. Methods A systematic review of randomized controlled trials, experimental studies without randomization and prospective cohort studies with concurrent control of non-pharmacological interventions for adult stroke patients compared with placebo or other stroke care. The review outcomes were bone loss, fall and fracture. The Cochrane Risk of Bias Tools were used to assess methodological quality, and Grading of Recommendations, Assessment, Development and Evaluations Framework to assess outcome quality. Synthesis Without Meta-Analysis (SWiM) was used for result synthesis. Results Seven studies (n = 453) were included. The methodological and outcome qualities varied from low to moderate. There were statistically significant changes between the intervention and parallel/placebo group in bone mineral density, bone mineral content, cortical thickness and bone turnover markers with specific physical and vibration therapies (p<0.05). Falls were higher in the intervention group, but no fracture was reported. Conclusion There was low to moderate evidence that physical and vibration therapies significantly reduced bone loss in post-stroke patients at the expense of a higher falls rate. The sample size was small, and the interventions were highly heterogeneous with different duration, intensities and frequencies. Despite osteoporosis occurring with ageing and accelerated by stroke, there were no studies on vitamin D or protein supplementation to curb the ongoing loss. Effective, high-quality non-pharmacological intervention to improve post-stroke bone health is required.
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Affiliation(s)
- Hakimah Sallehuddin
- Geriatric Medicine Unit, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Selangor, Malaysia
- * E-mail:
| | - Terence Ong
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Salmiah Md. Said
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | | | - Siew Ping Loh
- Department of Internal Medicine, Malacca Hospital, Malacca, Malaysia
| | - Wan Chieh Lim
- Department of Internal Medicine, Taiping Hospital, Perak, Malaysia
| | - Reena Nadarajah
- Department of Internal Medicine, Selayang Hospital, Selangor, Malaysia
| | - Hong Tak Lim
- Department of Internal Medicine, Tuanku Jaafar Hospital, Negeri Sembilan, Malaysia
| | | | - Yun Ying Ho
- Department of Internal Medicine, Tengku Ampuan Rahimah Hospital, Selangor, Malaysia
| | - Sazlina Shariff Ghazali
- Malaysian Research Institute on Ageing (MyAgeingTM), Universiti Putra Malaysia, Selangor, Malaysia
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
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Ahn H, Choi HY, Ki M. The association between levels of physical activity and low handgrip strength: Korea National Health and Nutrition Examination Survey 2014-2019. Epidemiol Health 2022; 44:e2022027. [PMID: 35209707 PMCID: PMC9117110 DOI: 10.4178/epih.e2022027] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/21/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the association between levels of physical activity (PA) and low handgrip strength in Korean adults. METHODS Our cross-sectional study design included 24,109 Korean adults older than 19 years of age who participated in the Korea National Health and Nutrition Examination Survey 2014–2019. Low handgrip strength is described as hand strength less than the cut-off value of the 20th percentile of handgrip strength from a healthy population in each gender and age group. PA was categorized into three levels (inactive, active, and highly active) according to the World Health Organization’s global recommendations on PA for health. Multivariable logistic regression analysis was used to examine the association between levels of PA and low handgrip strength. RESULTS Odds ratios (ORs) for low handgrip strength were significantly higher in middle-aged women who were active (adjusted odds ratio [aOR], 1.40; 95% confidence interval [CI], 1.15 to 1.69) and inactive (aOR, 1.47; 95% CI, 1.23 to 1.76) than in those highly active in walking exercise. Most of older people had significantly higher ORs for low handgrip strength in active compared to highly active in the context of aerobic, muscle strengthening, and walking exercise. CONCLUSIONS Walking exercise was associated with a lower risk of sarcopenia in middle-aged women and older individuals. However, further studies are necessary to confirm the causal relationship between levels of PA and low handgrip strength.
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Affiliation(s)
- Hyungsoon Ahn
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Hwa Young Choi
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Moran Ki
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
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Souto Braz RR, Campos SL, Villela DW, Antonino GB, Araújo Batista PK, Guerino MR, Rodrigues FTM, Pereira Alves KF, Duarte JVT, de Andrade Silva D, Lima DF, da Silva AFF, de Oliveira KCV, dos Santos EKD, Leite WS, de Lucena LC, de Lima Ferreira AP, Monte-Silva K, das Graças Rodrigues de Araújo M, Taiar R. Effectiveness of Whole-Body Vibration Combined with Multicomponent Training on the Risk of Falls and Quality of Life in Elderly Women with Osteoporosis: Study Protocol for a Randomized Controlled Clinical Trial. BIOLOGY 2022; 11:biology11020266. [PMID: 35205132 PMCID: PMC8869511 DOI: 10.3390/biology11020266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/16/2022]
Abstract
Osteoporosis and the risk of falls increase the risk of fractures and events of falls. Prescriptions and programs for different forms of exercise have different impacts on the risk of falls, and exercises from multiple categories of whole-body vibration can be effective. This study aims to evaluate the effectiveness of whole-body vibration (WBV) protocol combined with multicomponent training (MCT) in elderly women with osteoporosis and their history of falls. Our proposal is a protocol for a randomized clinical trial, divided into two stages: First, development of a protocol for WVB combined with MCT for elderly women with osteoporosis and a history of falls, under the Guidelines of the American College of Sports Medicine, and following the recommendations of the Standard Protocol Items Recommendations for Interventional Trials (SPIRIT), and second, a randomized controlled clinical trial following the Consolidated Standards of Reporting Trials (CONSORT). This trial will have implications for the effectiveness of a vibration protocol combined with multicomponent exercise on the risk of falls and quality of life for older women with osteoporosis. We expect that adding full-body vibration to an exercise protocol will decrease the risk of falls and improve participants’ quality of life, as well as their strength, balance, and functional capacity.
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Affiliation(s)
- Rúbia Rayanne Souto Braz
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
| | - Shirley Lima Campos
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
- Programa de Pós Graduação de Biologia Aplicada à Saúde, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil;
| | - Débora Wanderley Villela
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Gabriel Barreto Antonino
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
| | | | - Marcelo Renato Guerino
- Programa de Pós-Graduação em Saúde Translacional, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil;
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
| | - François Talles Medeiros Rodrigues
- Programa de Pós-Graduação em Ciências da Saúde, Instituto de Ciências Biológicas, Universidade de Pernambuco (UPE), Recife 50100-010, PE, Brazil;
| | - Kennedy Freitas Pereira Alves
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
| | - João Victor Torres Duarte
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Diana de Andrade Silva
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Daniel Florentino Lima
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Arthur Felipe Freire da Silva
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Karla Cybele Vieira de Oliveira
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
| | - Edy Kattarine Dias dos Santos
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
| | - Wagner Souza Leite
- Programa de Pós Graduação de Biologia Aplicada à Saúde, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil;
| | | | - Ana Paula de Lima Ferreira
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Kátia Monte-Silva
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
| | - Maria das Graças Rodrigues de Araújo
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
- Correspondence:
| | - Redha Taiar
- MATIM, Université de Reims Champagne-Ardenne, 51100 Reims, France;
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Zhao S, Mo X, Wen Z, Liu M, Chen Z, Lin W, Huang Z, Chen B. Declining serum bone turnover markers are associated with the short-term positive change of lumbar spine bone mineral density in postmenopausal women. Menopause 2022; 29:335-343. [PMID: 35102102 PMCID: PMC8862778 DOI: 10.1097/gme.0000000000001920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/20/2021] [Accepted: 10/20/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE While serum bone turnover markers (BTMs) and bone mineral density (BMD) have been confirmed as useable risk assessment tools for postmenopausal osteoporosis, the associations between BTMs and BMD changes are still ambiguous. The aim of this study was to explore the underlying associations between BTMs and BMD changes in postmenopausal women. METHODS Between January 2015 and October 2020, 135 postmenopausal women were retrospectively enrolled. They were divided into two groups according to lumbar spine (LS) 1-4 BMD change (1 y T-score minus baseline T-score, Group 1 [n = 36] < 0 and Group 2 [n = 99] ≥ 0). The changes of BTMs (N-terminal middle segment osteocalcin [N-MID], propeptide of type I procollagen [P1NP], and β-C-terminal telopeptide of type I collagen [β-CTX]) and their associations with LS 1-4 BMD change were analyzed. The biochemical indices and clinical parameters related with LS 1-4 BMD change were also evaluated. RESULTS The 1 year N-MID, P1NP, β-CTX and Phosphorus in Group 2 were lower than those in Group 1 (P < 0.05), their changes within 1 year were significantly negatively correlated with LS 1-4 BMD change (R2 = -0.200, P < 0.001; R2 = -0.230, P < 0.001; R2 = -0.186, P < 0.001; R2 = -0.044, P = 0.015; respectively). Except for the Phosphorus change (area under the curve [AUC] = 0.623), the changes of N-MID, P1NP, and β-CTX and their 1 year levels had similar AUC to diagnose the short-term LS 1-4 BMD change (AUC > 0.7 for all, with the AUC of 1 y P1NP being the largest at 0.803). Binary logistic regression analysis showed that the physical activity and drug intervention were the determinant factors for the LS 1-4 BMD change (odds ratio = 6.856, 95% confidence interval: 2.058-22.839, P = 0.002; odds ratio = 5.114, 95% confidence interval: 1.551-16.864, P = 0.007; respectively). CONCLUSIONS Declining N-MID, P1NP, β-CTX, and Phosphorus are associated with the short-term increase of LS 1-4 BMD within 1 year. Physical activity and drug intervention are factors significantly influencing the change of LS 1-4 BMD in postmenopausal women.
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Affiliation(s)
- Shengli Zhao
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Guangzhou, China
| | - Xiaoyi Mo
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Guangzhou, China
| | - Zhenxing Wen
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Guangzhou, China
| | - Ming Liu
- Institute of Precision Medicine, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhipeng Chen
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wei Lin
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Guangzhou, China
| | - Zifang Huang
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Guangzhou, China
| | - Bailing Chen
- Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Orthopaedics and Traumatology, Guangzhou, China
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89
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Wu CL, Nfor ON, Lu WY, Manli Tantoh D, Liaw YP. Relationship between Coffee Consumption and Osteoporosis Risk Determined by the ESR1 Polymorphism rs2982573. J Nutr Health Aging 2022; 26:558-563. [PMID: 35718863 DOI: 10.1007/s12603-022-1796-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The development of osteoporosis is partly explained by interactions between genetic and lifestyle or environmental factors. OBJECTIVES In the current study, we determined the relationship between coffee consumption and the risk of osteoporosis among individuals with ESR1 rs2982573 in Taiwan. DESIGN, PARTICIPANTS AND SETTING In this population-based cross-sectional study, we used genetic, demographic, and lifestyle data from participants recruited in Taiwan Biobank (TWB) between 2016 and 2019. We used multiple logistic regression analyses to determine the relationship between osteoporosis and variant rs2982573 genotypes (TT, TC, and CC). MAIN OUTCOME The primary outcome was osteoporosis. RESULTS Individuals with osteoporosis (n = 515) were older than those without the disease (mean age ±SE (year); 61.324±0.361 versus 53.068 ±0.130, p<0.001). There was no significant association between rs2982573 and osteoporosis (OR, 0.904; 95% CI, 0.706-1.157; p=0.422 for TC+CC when compared with the TT genotype). Coffee consumption was associated with a lower risk of osteoporosis (OR, 0.737; 95% CI, 0.592-0.918; p=0.006). The p-value for interaction between rs2982573 and coffee consumption was 0.0393. In our subgroup analyses, the adjusted ORs (95% CI) were 0.635 (0.410-0.985) in coffee drinking TC+CC individuals and 1.095 (0.809-1.482) in non-coffee drinking TC+CC individuals, respectively when compared with their TT genotype counterparts. CONCLUSION According to our study, participants in the TWB with the TC+CC genotype of ESR1 rs2982573 who consumed at least three cups of coffee per week were less likely to have osteoporosis.
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Affiliation(s)
- C-L Wu
- Yung-Po Liaw, No. 110 Sec. 1 Jianguo N. Road, Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City- 40201, Taiwan; Tel: +886436097722 ext. 11838; fax: +886423248179,
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90
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Stunes AK, Brobakken CL, Sujan MAJ, Aagård N, Brevig MS, Wang E, Syversen U, Mosti MP. Acute Effects of Strength and Endurance Training on Bone Turnover Markers in Young Adults and Elderly Men. Front Endocrinol (Lausanne) 2022; 13:915241. [PMID: 35846315 PMCID: PMC9279869 DOI: 10.3389/fendo.2022.915241] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Exercise is recognized as an important strategy to prevent bone loss, but its acute effects on bone turnover markers (BTMs) and related markers remain uncertain. OBJECTIVE To assess the acute effects of two different exercise modes on BTMs and related markers in young adults of both sexes and elderly men. DESIGN SETTING PARTICIPANTS This was a three-group crossover within-subjects design study with a total of 53 participants-19 young women (aged 22-30), 20 young men (aged 21-30 years), and 14 elderly men (aged 63-74 years)-performing two different exercise sessions [strength training (ST) and high-intensity interval training (HIIT)] separated by 2 weeks, in a supervised laboratory setting. MAIN OUTCOME MEASURES Plasma volume-corrected serum measurements of the BTMs C-terminal telopeptide of type 1 collagen (CTX-I) and procollagen of type 1 N-terminal propeptide (P1NP), total osteocalcin (OC), sclerostin, and lipocalin-2 (LCN2) at baseline, immediately after, and 3 and 24 h after each of the two exercise modes were performed. RESULTS AND CONCLUSION Analyses revealed sex- and age-dependent differences in BTMs and related bone markers at baseline and time-, sex-, and age-dependent differences in response to exercise. No differences between exercise modes were observed for BTM response except for sclerostin in young men and LCN2 in elderly men. An acute, transient, and uniform increase in P1NP/CTX-1 ratio was found in young participants, demonstrating that beneficial skeletal effects on bone metabolism can be attained through both aerobic endurance and resistance exercise, although this effect seems to be attenuated with age. The acute effects of exercise on bone-related biomarkers were generally blunted after 24 h, suggesting that persistent alterations following prolonged exercise interventions should be assessed at later time points.
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Affiliation(s)
- Astrid Kamilla Stunes
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Medical Clinic, St. Olavs University Hospital, Trondheim, Norway
- *Correspondence: Astrid Kamilla Stunes, orcid.org/0000-0003-1074-5199
| | - Cathrine Langlie Brobakken
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway
| | - Md Abu Jafar Sujan
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Norun Aagård
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway
| | - Martin Siksjø Brevig
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eivind Wang
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway
- Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Unni Syversen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, St. Olavs University Hospital, Trondheim, Norway
| | - Mats Peder Mosti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Medical Clinic, St. Olavs University Hospital, Trondheim, Norway
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
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Risk Factors Analysis of Bone Mineral Density Based on Lasso and Quantile Regression in America during 2015-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010355. [PMID: 35010615 PMCID: PMC8744920 DOI: 10.3390/ijerph19010355] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/24/2021] [Accepted: 12/27/2021] [Indexed: 02/07/2023]
Abstract
This study aimed to explore the risk factors of bone mineral density (BMD) in American residents and further analyse the extent of effects, to provide preventive guidance for maintenance of bone health. A cross-sectional study analysis was carried out in this study, of which data validity was identified and ethics approval was exempted based on the National Health and Nutrition Examination Survey (NHANES) database. Candidates' demographics, physical examination, laboratory indicators and part of questionnaire information were collected and merged from NHANES in 2015-2016 and 2017-2018. The least absolute shrinkage selection operator (lasso) was used to select initial variables with "glmnet" package of R, quantile regression model to analyze influence factors of BMD and their effects in different sites with "qreg" code in Stata. Among 2937 candidates, 17 covariates were selected by lasso regression (λ = 0.00032) in left arm BMD, with 16 covariates in left leg BMD (λ = 0.00052) and 14 covariates in total BMD (λ = 0.00065). Quantile regression results displayed several factors with different coefficients in separate sites and quantiles: gender, age, educational status, race, high-density lipoprotein (HDL), total cholesterol (TC), lead, manganese, ethyl mercury, smoking, alcohol use and body mass index (BMI) (p < 0.05). We constructed robust regression models to conclude that some demographic characteristics, nutritional factors (especially lipid levels, heavy metals) and unhealthy behaviors affected BMD in varying degrees. Gender and race differences, Low-fat food intake and low exposure to heavy metals (mostly lead, manganese and mercury) should be considered by both clinical doctors and people. There is still no consensus on the impact of smoking and alcohol use on bone mineral density in our study.
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Bonaccorsi G, Rizzati M, Salani L, Giganti M. Postmenopausal osteoporosis: risk evaluation and treatment options. Minerva Obstet Gynecol 2021; 73:714-729. [PMID: 34905877 DOI: 10.23736/s2724-606x.21.04896-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Postmenopausal osteoporosis is a chronic progressive condition characterized by reduced bone mass and impaired bone quality, leading to an increased risk of fragility fractures. Osteoporotic fractures reduce quality of life and are associated with high morbidity, mortality and economic burden. Primary and secondary prevention interventions are always recommended starting from the premenopausal age, in women after menopause, however, it is essential to develop a long-term intervention strategy that allows to identify patients at high risk of fracture and the choice of therapy based on the estimated risk. This narrative review described the tools for layering the management approach in relation to low, high and very high fracture risk. Several medications are now available for the treatment of osteoporosis and the prevention of fractures; the knowledge of the efficacy, safety and additional benefits profile of the individual preparations allows an appropriate choice between the different drugs available and the possibility of adapting the prescription to the lifetime fracture risk spectrum. From the literature it emerges that menopausal hormone therapy (MHT), TSEC combination and SERMs can be drugs of choice to counteract postmenopausal bone loss in younger women or at low risk of fracture, while bisphosphonates and denosumab are appropriate for women with high risk or at an older age. Therapy with denosumab and anabolic agents such as teriparatide and romosozumab is particularly indicated for subjects with very high risk of fracture.
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Affiliation(s)
- Gloria Bonaccorsi
- Department of Translational Medicine, Menopause and Osteoporosis Center, University of Ferrara, Ferrara, Italy - .,University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy -
| | - Monica Rizzati
- Department of Translational Medicine, Menopause and Osteoporosis Center, University of Ferrara, Ferrara, Italy
| | - Lara Salani
- Department of Translational Medicine, Menopause and Osteoporosis Center, University of Ferrara, Ferrara, Italy
| | - Melchiore Giganti
- Department of Translational Medicine and for Romagna, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Ferrara, Italy
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Schwartz AV, Pan Q, Aroda VR, Crandall JP, Kriska A, Piromalli C, Wallia A, Temprosa M, Florez H. Long-term effects of lifestyle and metformin interventions in DPP on bone density. Osteoporos Int 2021; 32:2279-2287. [PMID: 34086101 PMCID: PMC10088864 DOI: 10.1007/s00198-021-05989-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 05/03/2021] [Indexed: 12/19/2022]
Abstract
UNLABELLED In the Diabetes Prevention Program Outcome Study (DPPOS), a cohort at high risk of diabetes, randomization to intensive lifestyle intervention or metformin, both associated with weight loss, did not have long-term negative effects on BMD compared with the placebo group. Potential positive effects of metformin on bone warrant further investigation. INTRODUCTION Randomization to lifestyle intervention (ILS) or metformin in the Diabetes Prevention Program (DPP) resulted in weight loss and reduced progression to diabetes. Weight loss is associated with reduced bone mineral density (BMD), but the long-term effects of these interventions on BMD are unknown. In the DPP Outcome Study (DPPOS), we determined if randomization to ILS or metformin, compared with placebo, was associated with differences in BMD approximately 16 years later. METHODS Of 3234 DPP participants, 2779 continued in DPPOS and were offered ILS in group format. Those randomized to metformin were offered unmasked metformin. At DPPOS year 12, 1367 participants had dual-energy X-ray absorptiometry scans. BMD in metformin and ILS groups was compared to placebo using sex-specific linear regression models, adjusted for age, race/ethnicity, and weight and weight-bearing activity at DPP baseline. RESULTS At DPPOS year 12, mean age was 66.5 (±9.5) years. Femoral neck BMD was similar in the ILS and placebo groups in men (difference = -0.021 g/cm2, 95%CI (-0.063, 0.021)) and in women (+0.014 g/cm2, 95%CI (-0.014, 0.042)). Femoral neck BMD was higher in the metformin compared to placebo group although not statistically different in men (+0.017 g/cm2, 95% CI (-0.023, 0.058)) and in women (+0.019 g/cm2, 95% CI (-0.009, 0.047)). Prevalence of osteoporosis was low and similar across treatment groups in men (0.9%; p=0.745) and women (2.4%; p=0.466). CONCLUSION In a cohort at high risk of diabetes, lifestyle intervention or metformin did not appear to have long-term negative effects on BMD. Potential positive effects of metformin on bone warrant further research.
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Affiliation(s)
- A V Schwartz
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
| | - Q Pan
- Department of Statistics and The Biostatistics Center, George Washington University, Washington, D.C., USA
| | - V R Aroda
- MedStar Health Research Institute, Hyattsville, MD, USA
- Brigham Women's Hospital, Boston, MA, USA
| | - J P Crandall
- Albert Einstein College of Medicine, New York City, NY, USA
| | - A Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - A Wallia
- Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - M Temprosa
- Department of Biostatistics and Bioinformatics and The Biostatistics Center, George Washington University, Washington, D.C., USA
| | - H Florez
- Department of Public Health Sciences and Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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Effectiveness of Physical Activity and Finger Millet-Based Food Supplement on Biochemical Parameters and Bone Mineral Density among Premenopausal Women. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:4757991. [PMID: 34707668 PMCID: PMC8545543 DOI: 10.1155/2021/4757991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 11/17/2022]
Abstract
The effectiveness of physical activity and finger millet-based food supplement on biochemical parameters and bone mineral density (BMD) among premenopausal women were studied. Serum calcium, phosphorus, alkaline phosphatase, and BMD of 720 women (30-40 years) were analyzed. From them, 150 women with low BMD (t-score, -1 to -2.5) and low calcium (<9.0 mg/dL) were randomized to control and experimental groups, equally. The experimental group was given 5 days per week physical activity, for 3 months, and a diet supplement of finger millet-based sweet balls (ragi laddu), 3 days per week for 3 months. The above parameters were measured as the posttest. Physical activity was assessed by the General Practice Physical Activity Questionnaire. A 24 h recall assessment was carried out for the diet supplement, and self-reported activity checklist was maintained for physical activity. Among 720 women, 163 (22.6%) showed BMD, t-score < -1.0, and calcium <9.0 mg/dL (p < 0.001). The serum phosphorus and alkaline phosphatase were also low (p < 0.001). After the supplementation to the experimental group, all the biochemical parameters, BMD, and physical activity score showed significant improvement in the posttest (p < 0.001). This study showed significantly low BMD and calcium among premenopausal women. Physical activity and finger millet supplement improved the calcium level and BMD.
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Illario M, De Luca V, Cano A, Tramontano D. Go for it! Exercising makes you happy and strong. TRANSLATIONAL MEDICINE AT UNISA 2021; 23:92-105. [PMID: 34447722 PMCID: PMC8370514 DOI: 10.37825/2239-9747.1019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite it is generally recognized the beneficial role of physical activity, large portion of the population is physically inactive. Very alarmingly, the well-known gender gap in physical activity is constantly increasing. Several barriers obstacle women to perform physical activity although exercising would be of paramount importance for their health in particular during pregnancy and menopause. In addition to physical health benefits, physical activity may influence well-being and resilience, greatly impacting on quality of life. Here we explore the relationship between physical activity resilience and well-being in a group of 1107 female residents in the Metropolitan area of Naples.
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Affiliation(s)
- M Illario
- Department of Public Health; Research & Development Unit, Federico II University & Hospital, Naples, Italy
| | - V De Luca
- Department of Public Health; Research & Development Unit, Federico II University & Hospital, Naples, Italy
| | - A Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Spain
| | - D Tramontano
- Department of Molecular Medicine and Medical Biotechnology, Federico II University, Naples, Italy; Fondazione GENS, Naples Italy
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Wazzani R, Pallu S, Bourzac C, Ahmaïdi S, Portier H, Jaffré C. Physical Activity and Bone Vascularization: A Way to Explore in Bone Repair Context? Life (Basel) 2021; 11:life11080783. [PMID: 34440527 PMCID: PMC8399402 DOI: 10.3390/life11080783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/11/2021] [Accepted: 07/21/2021] [Indexed: 01/15/2023] Open
Abstract
Physical activity is widely recognized as a biotherapy by WHO in the fight and prevention of bone diseases such as osteoporosis. It reduces the risk of disabling fractures associated with many comorbidities, and whose repair is a major public health and economic issue. Bone tissue is a dynamic supportive tissue that reshapes itself according to the mechanical stresses to which it is exposed. Physical exercise is recognized as a key factor for bone health. However, the effects of exercise on bone quality depend on exercise protocols, duration, intensity, and frequency. Today, the effects of different exercise modalities on capillary bone vascularization, bone blood flow, and bone angiogenesis remain poorly understood and unclear. As vascularization is an integral part of bone repair process, the analysis of the preventive and/or curative effects of physical exercise is currently very undeveloped. Angiogenesis–osteogenesis coupling may constitute a new way for understanding the role of physical activity, especially in fracturing or in the integration of bone biomaterials. Thus, this review aimed to clarify the link between physical activities, vascularization, and bone repair.
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Affiliation(s)
- Rkia Wazzani
- Laboratoire APERE, Université de Picardie Jules Verne, CEDEX, F-80000 Amiens, France; (R.W.); (S.A.)
| | - Stéphane Pallu
- Laboratoire B3OA, Université de Paris, CEDEX, F-75010 Paris, France; (S.P.); (C.B.); (H.P.)
- UFR Science & Technique, Université d’Orléans, CEDEX, F-45100 Orléans, France
| | - Céline Bourzac
- Laboratoire B3OA, Université de Paris, CEDEX, F-75010 Paris, France; (S.P.); (C.B.); (H.P.)
| | - Saïd Ahmaïdi
- Laboratoire APERE, Université de Picardie Jules Verne, CEDEX, F-80000 Amiens, France; (R.W.); (S.A.)
| | - Hugues Portier
- Laboratoire B3OA, Université de Paris, CEDEX, F-75010 Paris, France; (S.P.); (C.B.); (H.P.)
- UFR Science & Technique, Université d’Orléans, CEDEX, F-45100 Orléans, France
| | - Christelle Jaffré
- Laboratoire APERE, Université de Picardie Jules Verne, CEDEX, F-80000 Amiens, France; (R.W.); (S.A.)
- Laboratoire B3OA, Université de Paris, CEDEX, F-75010 Paris, France; (S.P.); (C.B.); (H.P.)
- Correspondence:
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97
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Daly RM, Dalla Via J, Fyfe JJ, Nikander R, Kukuljan S. Effects of exercise frequency and training volume on bone changes following a multi-component exercise intervention in middle aged and older men: Secondary analysis of an 18-month randomized controlled trial. Bone 2021; 148:115944. [PMID: 33836310 DOI: 10.1016/j.bone.2021.115944] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/01/2021] [Accepted: 03/30/2021] [Indexed: 01/09/2023]
Abstract
Progressive resistance training (PRT) combined with weight-bearing impact exercise are recommended to optimize bone health, but the optimal frequency and dose of training remains uncertain. This study, which is a secondary analysis of an 18-month intervention in men aged 50-79 years, examined the association between exercise frequency and the volume of training with changes in DXA and QCT-derived femoral neck (FN) and lumbar spine (LS) bone outcomes, respectively. Men were allocated to either thrice-weekly PRT plus impact exercise training (n = 87) or a non-exercising (n = 85) group. Average weekly exercise frequency (ExFreq) and training volume per session [PRT volume (weight lifted, kg), number of weight-bearing impacts (jumps completed) and total training volume] over the 18-months were calculated from the participants' exercise cards. Regression analysis showed that average weekly ExFreq and training volume per session were positively associated with the 18-month changes in FN BMD and LS trabecular volumetric BMD. Men completing on average 1 to <2 and ≥2 sessions/week had a 1.6 to 2.2% greater net gain in FN BMD relative to non-exercising men, while those completing ≥2 sessions/week had 3.9 to 5.2% net gain in LS trabecular vBMD compared to non-exercising men and those completing <1 session/week. Further analysis showed that the average number of impact loads per session, but not the average PRT weight-lifted, was positively associated with changes in BMD. Every 10 impact loads per session over 18 months was associated with a 0.3% and 1.3% increase in FN BMD and LS trabecular vBMD, respectively. In conclusion, this study indicates that exercise frequency and training volume were predictors of the changes in hip and spine BMD following a multi-component exercise program, and that the number of impact loads rather than PRT weight lifted per session was more important for eliciting positive skeletal responses in middle-aged and older men.
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Affiliation(s)
- Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Jack Dalla Via
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Jackson J Fyfe
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Riku Nikander
- Faculty of Sports Science, Gerontology Research Centre (Gerec), University of Jyväskylä, Finland; Central Hospital of Central Finland, Jyväskylä, Finland; GeroCenter Foundation for Aging Research & Development, Jyväskylä, Finland.
| | - Sonja Kukuljan
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
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98
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Baldelli G, De Santi M, De Felice F, Brandi G. Physical activity interventions to improve the quality of life of older adults living in residential care facilities: a systematic review. Geriatr Nurs 2021; 42:806-815. [PMID: 34090224 DOI: 10.1016/j.gerinurse.2021.04.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Pursuing active aging and maintaining the quality of life (QoL) is essential, particularly in older people living in residential care facilities (RCFs). We evaluated physical activity (PA) as an intervention to improve the QoL in this population, trying to hypothesize future perspectives in this field. METHODS A systematic search was performed on Pubmed. Only randomized control trials or quasi-experimental control group trials were considered. RESULTS Results showed that a high-frequency PA can be effective in older people, allowing them to improve their functional mobility, autonomy, anxiety level, balance, and social interactions. Moreover, a moderate-intensity PA showed the most interesting results, improving all the QoL-related aspects considered. CONCLUSION Results highlight the beneficial effects of multidisciplinary intervention strategies in increasing QoL and QoL-related aspects of RCFs older residents, contemplating PA as the main instrument. However, structured PA is necessary to fully understand which protocol could be the most effective.
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Affiliation(s)
- Giulia Baldelli
- Biomolecular Sciences Department, Public Health Unit, University of Urbino Carlo Bo, Urbino, Italy.
| | - Mauro De Santi
- Biomolecular Sciences Department, Public Health Unit, University of Urbino Carlo Bo, Urbino, Italy
| | | | - Giorgio Brandi
- Biomolecular Sciences Department, Public Health Unit, University of Urbino Carlo Bo, Urbino, Italy
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99
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Pina I, Mendham AE, Tomaz SA, Goedecke JH, Micklesfield LK, Brooks NE, Gallagher IJ, Crockett R, Dudchenko P, Hunter AM. Intensity Matters for Musculoskeletal Health: A Cross-Sectional Study on Movement Behaviors of Older Adults from High-Income Scottish and Low-Income South African Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4310. [PMID: 33921644 PMCID: PMC8072994 DOI: 10.3390/ijerph18084310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 04/15/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to investigate differences in physical activity (PA) patterns and the associations between objectively measured 24-h movement behaviors and musculoskeletal measures (muscle strength, muscle mass, physical performance, and bone mineral density) in a high-income and a low-income community. This cross-sectional study recruited independent living older adults aged 60-85 years from high-income Scottish (n = 150) and low-income South African (n = 138) settings. Participants completed demographic and health questionnaires, and testing included body composition and bone mineral density (dual energy X-ray absorptiometry), physical performance (grip strength, gait speed), and PA (accelerometry). Participants accumulated similar amounts of weekly total PA, however, the Scottish cohort engaged in more moderate-to-vigorous intensity PA (MVPA) and sedentary behavior (SB), while the South African cohort spent more time sleeping and in light intensity PA (LPA). From compositional data analysis, more time spent in MVPA relative to the other movement behaviors was positively associated with higher muscle mass (p < 0.001) and strength (p = 0.001) in the Scottish cohort. Conversely, more time spent in MVPA was associated with faster gait speed (p < 0.001) and greater hip bone mineral density (p = 0.011) in the South African cohort. Our findings confirm the beneficial role of MVPA in both high- and low-income cohorts, however, the relationship MVPA had with components of musculoskeletal health in older adults differed between settings.
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Affiliation(s)
- Ilaria Pina
- Department of Psychology, University of Stirling, Stirling FK9 4LA, UK; (R.C.); (P.D.)
| | - Amy E. Mendham
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa; (A.E.M.); (J.H.G.); (L.K.M.)
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa
| | - Simone A. Tomaz
- Faculty of Health Science and Sport, University of Stirling, Stirling FK9 4LA, UK; (S.A.T.); (N.E.B.); (I.J.G.); (A.M.H.)
| | - Julia H. Goedecke
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa; (A.E.M.); (J.H.G.); (L.K.M.)
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa
| | - Lisa K. Micklesfield
- MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa; (A.E.M.); (J.H.G.); (L.K.M.)
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town 7700, South Africa
| | - Naomi E. Brooks
- Faculty of Health Science and Sport, University of Stirling, Stirling FK9 4LA, UK; (S.A.T.); (N.E.B.); (I.J.G.); (A.M.H.)
| | - Iain J. Gallagher
- Faculty of Health Science and Sport, University of Stirling, Stirling FK9 4LA, UK; (S.A.T.); (N.E.B.); (I.J.G.); (A.M.H.)
| | - Rachel Crockett
- Department of Psychology, University of Stirling, Stirling FK9 4LA, UK; (R.C.); (P.D.)
| | - Paul Dudchenko
- Department of Psychology, University of Stirling, Stirling FK9 4LA, UK; (R.C.); (P.D.)
| | - Angus M. Hunter
- Faculty of Health Science and Sport, University of Stirling, Stirling FK9 4LA, UK; (S.A.T.); (N.E.B.); (I.J.G.); (A.M.H.)
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100
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Pinelli E, Barone G, Marini S, Benvenuti F, Murphy MH, Julin M, Kemmler W, Von Stengel S, Di Paolo S, Dallolio L, Maietta Latessa P, Zinno R, Bragonzoni L. Effects of COVID-19 Lockdown on Adherence to Individual Home- or Gym-Based Exercise Training among Women with Postmenopausal Osteoporosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2441. [PMID: 33801389 PMCID: PMC7967569 DOI: 10.3390/ijerph18052441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 12/02/2022]
Abstract
Adherence is important for an exercise program's efficacy. This study aims at investigating whether the COVID-19 lockdown had different consequences on the adherence to an exercise program specifically designed for women with postmenopausal osteoporosis when administered as individual home training (IHT) or gym group training (GGT). At the start of the lockdown, which imposed the temporary closure of any gym activities, GGT participants were invited to continue to exercise at home. IHT participants continued to exercise at home as usual. Adherence was recorded via logs and measured as the percentage of exercise sessions actually performed out of the total number of scheduled sessions in three 1-month periods: one before (PRE) and two after (M1 and M2) the beginning of lockdown. Before lockdown, IHT (66.8% ± 26.6) and GGT (76.3% ± 26.6) adherence were similar. During lockdown, IHT participation increased (M1: 81.5% ± 31.0; M2: 88.0% ± 28.3), while that of GGT showed no statistical differences (M1: 79.4% ± 34.2; M2: 80.6% ± 36.4). Exercise protocols based on supervised gym practice must consider the possibility of disruptive events, which could cause a sudden interruption of gym activity and include educational initiatives to instruct participants to exercise effectively and safely without a trainer's direct supervision.
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Affiliation(s)
- Erika Pinelli
- Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d’Augusto 237, 47921 Rimini, Italy; (E.P.); (G.B.); (F.B.); (S.D.P.); (P.M.L.); (R.Z.); (L.B.)
| | - Giuseppe Barone
- Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d’Augusto 237, 47921 Rimini, Italy; (E.P.); (G.B.); (F.B.); (S.D.P.); (P.M.L.); (R.Z.); (L.B.)
| | - Sofia Marini
- Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d’Augusto 237, 47921 Rimini, Italy; (E.P.); (G.B.); (F.B.); (S.D.P.); (P.M.L.); (R.Z.); (L.B.)
| | - Francesco Benvenuti
- Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d’Augusto 237, 47921 Rimini, Italy; (E.P.); (G.B.); (F.B.); (S.D.P.); (P.M.L.); (R.Z.); (L.B.)
| | - Marie H. Murphy
- Centre for Exercise Medicine Physical Activity and Health, Ulster University, Newtownabbey, Co Antrim BT37 0QB, UK;
| | - Mikko Julin
- Department of Physiotherapy, Laurea University of Applied Sciences, 02650 Espoo, Finland;
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander-University Erlangen-Nürnberg, 91052 Erlangen, Germany; (W.K.); (S.V.S.)
| | - Simon Von Stengel
- Institute of Medical Physics, Friedrich-Alexander-University Erlangen-Nürnberg, 91052 Erlangen, Germany; (W.K.); (S.V.S.)
| | - Stefano Di Paolo
- Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d’Augusto 237, 47921 Rimini, Italy; (E.P.); (G.B.); (F.B.); (S.D.P.); (P.M.L.); (R.Z.); (L.B.)
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Science, University of Bologna, Via San Giacomo 12, 40126 Bologna, Italy;
| | - Pasqualino Maietta Latessa
- Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d’Augusto 237, 47921 Rimini, Italy; (E.P.); (G.B.); (F.B.); (S.D.P.); (P.M.L.); (R.Z.); (L.B.)
| | - Raffaele Zinno
- Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d’Augusto 237, 47921 Rimini, Italy; (E.P.); (G.B.); (F.B.); (S.D.P.); (P.M.L.); (R.Z.); (L.B.)
| | - Laura Bragonzoni
- Department for Life Quality Studies, Campus of Rimini, University of Bologna, Corso d’Augusto 237, 47921 Rimini, Italy; (E.P.); (G.B.); (F.B.); (S.D.P.); (P.M.L.); (R.Z.); (L.B.)
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