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Zhang H, Yang Z. Research on dynamic comfort maintenance by measuring lower limb edema and seat pressure during simulated seated sleep in flight. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024; 30:72-83. [PMID: 37401853 DOI: 10.1080/10803548.2023.2232635] [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] [Indexed: 07/05/2023]
Abstract
Objectives. Seated sleep during flight can bring significant discomfort to passengers. The objective of this research was to study passengers' dynamic comfort maintenance strategies in lower limb postural shifting during seated sleep in flight. Methods. Studies on seated sleep postures and sitting comfort were conducted. First, 40 participants were recruited to the observational research for collecting typical leg postures during seated sleep. Then, an experiment was conducted with the participants simulating seated sleep in the aircraft seat. The changes in lower limb edema and seat pressure in different postures were measured with a bioelectrical impedance device, near-infrared spectroscopy device and pressure mapping device. Results. Six postures were selected through the observational research. The experiment showed that tissues of the thighs and buttocks suffer alternate higher compression by shifting between the six postures. Lower limb edema is higher when the shanks are forward, while the tissue under the ischial tuberosity suffers higher compression when the shanks are neutral. Conclusion. Six motivations for passengers to shift each sitting posture to achieve dynamic comfort were summarized, which helps obtain alternating rest in different body parts. The suggestion of a leg position adjustment system was also proposed.
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Affiliation(s)
- Huizhong Zhang
- School of Mechanical Engineering, Northwestern Polytechnical University, China
| | - Zhi Yang
- Department of Science and Technology, Beijing Institute of Fashion Technology, China
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Frange C, Elias RM, Siengsukon C, Coelho FMS. Physical activity for obstructive sleep apnea after stroke? A pilot study assessing the contribution of body fluids. Sleep Breath 2023; 27:1343-1350. [PMID: 36327028 DOI: 10.1007/s11325-022-02735-7] [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: 08/10/2022] [Revised: 10/10/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Obstructive sleep apnea (OSA) and physical inactivity are common after stroke. Physical inactivity can lead to/or exacerbate edema following stroke, and the resultant overnight fluid shift may increase the risk of OSA. We aimed to investigate the effect of physical activity on nocturnal rostral fluid shift, sleep pattern, and edematous state of hemiparetic patients. METHODS Neck circumference (tape measured) and arms, legs, and trunk fluid volume (bioelectrical impedance spectrum analyzer) were measured before and after 2 polysomnography (PSG) examinations. In the lab, a whole night PSG was performed after the intervention. The intervention consisted of inactivity (lying down and sitting) or activity (standing, performing calf muscle contractions while standing, walking, and climbing stairs) between 13 and 21 h, after the randomization of the participants. With a 7-day interval, participants crossed over to the other group. RESULTS From 126 eligible participants, 8 with hemiparetic post-first-ever ischemic stroke at the subacute phase were recruited (age: 53.2 ± 16.2; 6 women). Physical activity reduced AHI from 19 to 13 n°/h and wake after sleep onset from 76.5 to 60.3 min and increased fluid volume of paretic and non-paretic arms and trunk before sleep compared to inactivity. CONCLUSION An acute bout of physical activity reduced OSA classification based on AHI (from moderate to mild) and sleep fragmentation. Our results provide preliminary evidence of a possible link between physical activity in patients after stroke as an intervention to counteract OSA severity and improve sleep.
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Affiliation(s)
- Cristina Frange
- Neurology and Neurosurgery Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
| | - Rosilene Motta Elias
- Nephrology Division, Department of Medicine of the Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brazil
| | - Catherine Siengsukon
- Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kanasas, USA
| | - Fernando Morgadinho Santos Coelho
- Neurology and Neurosurgery Department, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Psychobiolgy Department, UNIFESP, São Paulo, Brazil
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Causal Association between Whole-Body Water Mass and Sleep Apnea: A Mendelian Randomization Study. Ann Am Thorac Soc 2022; 19:1913-1919. [PMID: 35727232 DOI: 10.1513/annalsats.202112-1331oc] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Rationale: Growing evidence has suggested that body water content plays a critical role in sleep apnea. However, the causal relationship has not been established. Objectives: This study aimed to investigate whether increased whole-body water mass is causally associated with a higher risk of sleep apnea using two-sample Mendelian randomization (MR) analysis. Methods: Body water mass (BWM)-associated genetic instruments were extracted from a genome-wide association study conducted by Neale Lab, which incorporates 331,315 individuals of European ancestry. Genetic variants for sleep apnea were derived from the FinnGen dataset. MR analysis was performed using inverse variance-weighted and weight median methods, respectively. MR-Egger regression and MR-Pleiotropy Residual Sum and Outlier tests were applied to evaluate the directional pleiotropy. In addition, we performed a multivariable MR analysis that includes body mass index, snoring, and waist-to-hip ratio as covariate exposures to address their confounding effects. To elucidate mechanisms of the association between BWM and sleep apnea, we further conducted MR analysis on common edematous diseases. Results: MR estimates showed that per standard deviation increase in BWM led to an increase in the risk of sleep apnea by 49% (odds ratio [OR], 1.490; 95% confidence interval [CI], 1.308-1.696; P = 1.75 × 10-9). The result after MR-Pleiotropy Residual Sum and Outlier correction further supports their causal association (OR, 1.414; 95% CI, 1.253-1.595; P = 1.76 × 10-8). In addition, the multivariable MR analysis indicates a significant causal association between a higher BWM and increased risk of sleep apnea (OR, 1.204; 95% CI, 1.031-1.377; P = 0.036). Genetic predisposition to a higher BWM was also causally related to increased risk of edematous diseases. Conclusions: Our results suggested that increased BWM is a potential risk factor for sleep apnea. Pathologic edema is a possible intermediate factor mediating this causal association.
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Prolonged Sitting Causes Leg Discomfort in Middle Aged Adults: Evaluation of Shear Wave Velocity, Calf Circumference, and Discomfort Questionaries. J Clin Med 2022; 11:jcm11144024. [PMID: 35887787 PMCID: PMC9320137 DOI: 10.3390/jcm11144024] [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: 05/05/2022] [Revised: 07/03/2022] [Accepted: 07/06/2022] [Indexed: 01/27/2023] Open
Abstract
Introduction: Prolonged sitting causes leg discomfort. We evaluated shear wave velocity (SWV) of leg muscles, leg circumference, and leg discomfort associated with 2 h sitting. Methods: Twenty-one middle-aged men and 19 middle-aged women participated in the study. SWV and leg circumference was measured just after sitting, 60 min, 120 min, and after 3 min of leg raising. Leg discomfort was assessed before sitting and 120 min. Results: SWV was significantly greater in men than women and increased over time, and decreased with leg raising. The percentage increase in lower leg circumference was significantly greater in women than in men, and it increased over time. Leg discomfort significantly increased after 120 min in both men and women. Discussions: Because SWV is proportional to an increase in intramuscular compartment pressure in the lower leg, intramuscular compartment pressure increased over time with sitting and decreased with leg raising. Considering the changes in SWV and leg circumference, it was inferred that prolonged sitting causes an increase in intramuscular compartment pressure and intravascular blood volume, as well as an increase in water content in the leg subcutaneous tissue. Leg discomfort was estimated to be due to increased intra-leg fluid. Brief leg raising may resolve leg edema and discomfort.
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da Silva RP, Martinez D, Uribe Ramos JM, Martins EF, Tedesco-Silva LM, Lopez P, Cadore EL. TheHE effectsEFFECTS ofOF resistanceRESISTANCE exerciseEXERCISE onON obstructiveOBSTRUCTIVE sleepSLEEP apneaAPNEA severitySEVERITY andAND bodyBODY waterWATER contentCONTENT inIN olderOLDER adultsADULTS: A randomizedRANDOMIZED controlledCONTROLLED trialTRIAL. Sleep Med 2022; 95:37-46. [DOI: 10.1016/j.sleep.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/08/2022] [Accepted: 04/18/2022] [Indexed: 11/15/2022]
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Rigby L, Frey M, Alexander KL, De Carvalho D. Monitoring calf circumference: changes during prolonged constrained sitting. ERGONOMICS 2022; 65:631-641. [PMID: 34590970 DOI: 10.1080/00140139.2021.1979660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 09/07/2021] [Indexed: 06/13/2023]
Abstract
Prolonged sitting has been associated with negative health effects; however, short-term time-varying exposure and response data is lacking. Twenty-two young and healthy participants were seated for 2 hours with the instruction to avoid the confounding effects of large leg movements while calf circumference, perceived discomfort, and lower limb muscle activity were collected. Calf circumference increased significantly (0.90 ± 0.32 cm) during sitting with no statistical differences between sexes. Perceived discomfort increased significantly over time in the low back and gluteal regions (p = 0.001-0.072, ηp2=0.080-0.360). On average, it took 20.31 ± 10.87 minutes of walking for calf measures to return to pre-sitting baseline. These results suggest that sitting for 2 hours without activity breaks may not be advisable and that recovery may take longer than expected. The exposure/response data from this study may be helpful in the design of future studies, with a larger and more general population, aiming to better define recommended duration/activity ratios for sitting-focused occupations. Practitioner summary: Leg swelling is a concern in prolonged sitting. In this study of young, healthy participants, we found a 2 hour constrained sitting exposure (controlling for large leg movements) induced significant increases in calf circumference that took an average of 20.31 ± 10.87 min of walking to return to baseline.Abbreviations: FMD: flow-mediated dilation, GSC: gastrocnemius; TA: tibialis anterior; EMG: electromyography; VAS: visual analog scale; MVC: maximum voluntary contractions.
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Affiliation(s)
- Laura Rigby
- School of Human Kinetics and Recreation, Memorial University, St. John's, Canada
| | - Mona Frey
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
| | - Kara-Lyn Alexander
- School of Human Kinetics and Recreation, Memorial University, St. John's, Canada
| | - Diana De Carvalho
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, Canada
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Okino K, Aoki M, Yamane M, Kohmura C. Effect of prolonged sitting immobility on shear wave velocity of the lower leg muscles in healthy adults: A proof-of-concept study. PLoS One 2021; 16:e0251532. [PMID: 33970970 PMCID: PMC8109794 DOI: 10.1371/journal.pone.0251532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 04/27/2021] [Indexed: 01/22/2023] Open
Abstract
Objective The purpose of this study is to investigate the physical changes of the lower leg muscles in the compartment by observing the changes in the shear wave velocity of the gastrocnemius, soleus and tibialis anterior muscles with time in the sitting position for 2 hours and after elevation of the lower leg. Materials and methods The subjects were 24 healthy adult males (average age 26.6 years). Shear wave velocity was measured by Aplio 500 in immobilized leg immediately after the start of sitting, 60 minutes and 120 minutes after the start of sitting. After 120 minutes the subjects raised the lower leg for 3 minutes, then measured again. Results In the lateral and medial gastrocnemius, there was a significant increase in the velocity at 60 (1.58 ± 0.06, 1.70 ± 0.09 m/s) and 120 minutes (1.70 ± 0.10, 1.83 ± 0.11 m/s) after the start of the test (1.52 ± 0.06, 1.66 ± 0.10 m/s), respectively (p<0.01). In the soleus and the tibialis anterior, there was a significant increase in the velocity at 120 minutes (1.89 ± 0.17, 2.30 ± 0.24 m/s) compared to after the start (1.60 ± 0.15, 2.15 ± 0.26 m/s), respectively (p<0.01). In all muscles, there was a significant decrease in the velocity after the raising compared to that of 120 minutes (p<0.01). Conclusions It has been reported that the change of shear wave velocity with time is proportional to the intramuscular pressure in the leg compartment, and it is assumed that the increase of shear wave velocity in the 2-hour seated leg is due to fluid retention in extra-cellular space of the compartment.
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Affiliation(s)
- Kumiko Okino
- Department of Clinical Laboratory Medicine, School of Medical Technology, Health Sciences University of Hokkaido, Kita-ku, Sapporo, Japan
| | - Mitsuhiro Aoki
- Department of Physical Therapy, Graduate School of Rehabilitation Science, Health Sciences University of Hokkaido, Tobetsu-cho, Ishikari-gun, Japan
- * E-mail:
| | - Masahiro Yamane
- Department of Physical Therapy, Health Science University Hospital, Kita-ku, Sapporo, Japan
| | - Chikashi Kohmura
- Department of Clinical Laboratory Medicine, School of Medical Technology, Health Sciences University of Hokkaido, Kita-ku, Sapporo, Japan
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Fiori CZ, Martinez D, Montanari CC, Lopez P, Camargo R, Sezerá L, Gonçalves SC, Fuchs FD. Diuretic or sodium-restricted diet for obstructive sleep apnea-a randomized trial. Sleep 2019; 41:4829728. [PMID: 29669139 DOI: 10.1093/sleep/zsy016] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 12/26/2017] [Indexed: 01/10/2023] Open
Abstract
Study Objectives Interventions that decrease leg fluid retention reduce obstructive sleep apnea (OSA) severity in nonrandomized experiments. We aimed to investigate in a randomized trial the effect of interventions that reduce fluid volume on OSA severity. Methods Men diagnosed with severe OSA were randomized to receive daily spironolactone 100 mg + furosemide 20 mg or nutritional counseling to sodium-restricted diet plus placebo pill or placebo pill. All participants underwent home sleep apnea testing at baseline and after 1 week follow-up. The change in apnea-hypopnea index (AHI) was the primary outcome. Results The study included 54 participants and all were assessed at follow-up. The average baseline value of the AHI was similar among groups and from baseline to follow-up the AHI reduced 14.4 per cent (δ value -7.3 events per hour; 95% confidence interval, -13.8 to -0.9) in the diuretic group, 22.3 per cent (-10.7; 95% CI, -15.6 to -5.7) in the diet group, and 0.8 per cent (0.4; 95% CI, -2.5 to 3.2) in the placebo group (p = .001 for time × group interaction). None of the patients had their AHI returned to normal. The reduction in the total body water was 2.2 ± 2.2 L in the diuretic group (p < .001) and 1.0 ± 1.6 l in the low salt diet group (p = .002). Sleepiness and neck circumference were significantly reduced only in the diet group (p = .007 and p < .001 for the time × group interactions, respectively). Conclusions Interventions to reduce bodily fluid content in men with severe OSA promoted a limited decrease of apnea frequency. This finding suggests that rostral fluid displacement affects only partially the OSA severity and/or that other factors prevail in determining pharyngeal collapsibility. Clinical Trial Sodium-Restricted Diet and Diuretic in the Treatment of Severe Sleep Apnea (DESALT), https://clinicaltrials.gov/ct2/show/NCT01945801 ClinicalTrials.gov number: NCT01945801.
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Affiliation(s)
- Cintia Zappe Fiori
- Graduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Interdisciplinary Sleep Research Laboratory, Hospital de Clínicas de Porto Alegre (LIPES-HCPA), Porto Alegre, RS, Brazil
| | - Denis Martinez
- Graduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Interdisciplinary Sleep Research Laboratory, Hospital de Clínicas de Porto Alegre (LIPES-HCPA), Porto Alegre, RS, Brazil.,Graduate Studies Program in Medical Sciences, School of Medicine, UFRGS, Brazil.,Division of Cardiology, HCPA, Porto Alegre, RS, Brazil
| | - Carolina Caruccio Montanari
- Interdisciplinary Sleep Research Laboratory, Hospital de Clínicas de Porto Alegre (LIPES-HCPA), Porto Alegre, RS, Brazil.,Graduate Studies Program in Medical Sciences, School of Medicine, UFRGS, Brazil
| | - Pedro Lopez
- Interdisciplinary Sleep Research Laboratory, Hospital de Clínicas de Porto Alegre (LIPES-HCPA), Porto Alegre, RS, Brazil.,Exercise Research Laboratory, UFRGS, Porto Alegre, RS, Brazil
| | - Rodrigo Camargo
- Interdisciplinary Sleep Research Laboratory, Hospital de Clínicas de Porto Alegre (LIPES-HCPA), Porto Alegre, RS, Brazil
| | - Lauren Sezerá
- Interdisciplinary Sleep Research Laboratory, Hospital de Clínicas de Porto Alegre (LIPES-HCPA), Porto Alegre, RS, Brazil
| | - Sandro Cadaval Gonçalves
- Graduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Division of Cardiology, HCPA, Porto Alegre, RS, Brazil
| | - Flavio Danni Fuchs
- Graduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Division of Cardiology, HCPA, Porto Alegre, RS, Brazil
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Dempsey PC, Larsen RN, Dunstan DW, Owen N, Kingwell BA. Sitting Less and Moving More: Implications for Hypertension. Hypertension 2019; 72:1037-1046. [PMID: 30354827 DOI: 10.1161/hypertensionaha.118.11190] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Paddy C Dempsey
- From the Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.C.D., R.N.L., D.W.D., N.O., B.A.K.).,MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, United Kingdom (P.C.D.).,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia (P.C.D., N.O.)
| | - Robyn N Larsen
- From the Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.C.D., R.N.L., D.W.D., N.O., B.A.K.)
| | - David W Dunstan
- From the Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.C.D., R.N.L., D.W.D., N.O., B.A.K.).,Mary MacKillop Institute of Health Research, Australian Catholic University, Melbourne, Victoria (D.W.D.)
| | - Neville Owen
- From the Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.C.D., R.N.L., D.W.D., N.O., B.A.K.).,Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia (P.C.D., N.O.)
| | - Bronwyn A Kingwell
- From the Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia (P.C.D., R.N.L., D.W.D., N.O., B.A.K.)
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Vena D, Lyons O, Fernie GR, Popovic MR, Malta D, Alshaer H, Yadollahi A. Effect of calf muscle electrical stimulation on rostral fluid shift, snoring and obstructive sleep apnea. Sleep Med 2019; 57:36-42. [PMID: 30897454 DOI: 10.1016/j.sleep.2019.01.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/17/2018] [Accepted: 01/27/2019] [Indexed: 11/19/2022]
Abstract
STUDY OBJECTIVES Overnight fluid shift from the legs into the neck may contribute to the pathogenesis of snoring and obstructive sleep apnea (OSA). The present study investigates the effects of calf muscle electrical stimulation (ES) on reducing leg fluid accumulation while seated, subsequent rostral fluid shift on lying down, and the impact on snoring and OSA. METHODS Sixteen non-obese, normotensive men with OSA participated in the study. On the first study day, participants sat for 150 min receiving either active or sham ES through random allocation, then lied supine for 60 min. While seated and supine, leg and neck fluid volumes were measured using bioelectrical impedance to determine the magnitude of fluid shift. On the night of the study day, participants wore a portable sleep apnea diagnostic device overnight to measure snoring and sleep apnea severity. One week later, participants crossed over to the other study condition. RESULTS Active calf muscle ES reduced leg fluid accumulation by 46% while seated. Upon lying supine, active ES reduced fluid shift out of the legs by 17% and reduced neck fluid accumulation by 31%. This led to a 15% reduction in snoring index, but did not alleviate OSA. CONCLUSIONS One session of calf muscle ES was effective at reducing leg fluid accumulation and rostral fluid shift, which led to a modest reduction in the snoring index, but not OSA. Despite this lack of effect of calf muscle ES in attenuating OSA severity, the reduction in the snoring index suggests that it did have an effect, albeit mild, on upper-airway mechanics.
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Affiliation(s)
- Daniel Vena
- KITE, Toronto Rehab - University Health Network, Toronto, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Owen Lyons
- KITE, Toronto Rehab - University Health Network, Toronto, Canada; Women's College Research Institute, Women's College Hospital, Toronto, Canada
| | - Geoff R Fernie
- KITE, Toronto Rehab - University Health Network, Toronto, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Milos R Popovic
- KITE, Toronto Rehab - University Health Network, Toronto, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - Daniela Malta
- Department of Nutritional Science, University of Toronto, Toronto, Canada; Division of Cardiology, Department of Medicine, Sinai Health System, Toronto, Canada
| | - Hisham Alshaer
- KITE, Toronto Rehab - University Health Network, Toronto, Canada
| | - Azadeh Yadollahi
- KITE, Toronto Rehab - University Health Network, Toronto, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada.
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Targeting volume overload and overnight rostral fluid shift: A new perspective to treat sleep apnea. Sleep Med Rev 2018; 42:160-170. [DOI: 10.1016/j.smrv.2018.07.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/25/2018] [Accepted: 07/31/2018] [Indexed: 01/15/2023]
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Effects of physical exercise training on nocturnal symptoms in asthma: Systematic review. PLoS One 2018; 13:e0204953. [PMID: 30346958 PMCID: PMC6197640 DOI: 10.1371/journal.pone.0204953] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 09/16/2018] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Nocturnal worsening of asthma symptoms is a common feature of asthma. Physical exercise training improves general asthma control; however, there is no evidence showing the effects of physical exercise on nocturnal asthma symptoms. Indeed, asthma patients with daytime and nighttime symptoms are physiologically different, and thus the effects of physical exercise on asthma may also be different in these two groups. The objective of this systematic review is to explore the effects of physical exercise on nocturnal asthma symptoms. METHODS Searches were conducted in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL and SPORTdiscus (last search on November 2017). Authors from studies that did not report nocturnal symptoms but used questionnaires and/or diaries were contacted for detailed information. Studies that provided results on nocturnal symptoms before and after physical activity intervention were included. Prevalence of nocturnal symptoms was calculated for each study from the percentage of study participants with nocturnal symptoms before and after intervention. RESULTS Eleven studies were included (5 with children and 6 with adults). The prevalence of nocturnal symptoms at baseline ranged from 0% to 63% among children and from 50-73% among adults. In children and adults with nocturnal asthma, aerobic physical exercise reduced the prevalence and frequency of nocturnal symptoms. CONCLUSIONS Aerobic physical exercise improves nocturnal asthma in children and adults by reducing the prevalence and frequency of nocturnal symptoms. Physical exercise training could be used with conventional treatments to improve quality of life and asthma control in patients with nocturnal worsening of asthma.
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McLeod KJ, Jain T. Postural Hypotension and Cognitive Function in Older Adults. Gerontol Geriatr Med 2017; 3:2333721417733216. [PMID: 28979924 PMCID: PMC5617084 DOI: 10.1177/2333721417733216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/09/2017] [Accepted: 08/24/2017] [Indexed: 11/18/2022] Open
Abstract
Background: Cognitive decline in the elderly is associated with chronic cerebral hypoperfusion. While many forms of exercise can slow or reverse cognitive decline, compliance in unsupervised exercise programs is poor. Objective: We address whether passive exercise, that is, muscle stimulation, is capable of reversing postural hypotension in an older adult population sufficiently to significantly improve cognitive function as measured by executive function tests. Subjects and Methods: In this study, 50- to 80-year-old women underwent cognitive testing, long-duration cardiac hemodynamic recordings during quiet sitting, and 60 min of soleus muscle stimulation with continued hemodynamic recording. Results: Two thirds of our subjects were hypotensive (diastolic blood pressure [DBP] < 70 mmHg) after 30 min of quiet sitting. Cognitive performance was significantly better in individuals with higher DBPs (0.79 s per 1-mmHg increase in DBP). Soleus muscle stimulation resulted in an average increase in DBP of 6.1 mmHg, which could translate into a 30% or greater improvement in cognitive performance. Conclusions: Incongruent Stroop testing provides high statistical power for distinguishing differential cognitive responses to resting DBP levels. These results set the stage to investigate whether regular use of calf muscle pump stimulation could effectively reverse age-related cognitive impairment.
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