Are flexibility and muscle-strengthening activities associated with functional limitation?

Cardiorespiratory dynamics of type 2 diabetes mellitus: An extensive view of breathing and fitness challenges in a diabetes prevalent population

BACKGROUND

Diabetes mellitus (DM) is well known for related micro and macrovascular complications. Uncontrolled hyperglycemia in diabetes mellitus leads to endothelial dysfunction, inflammation, microvascular impairment, myocardial dysfunction, and skeletal muscle changes which affect multiple organ systems. This study was designed to take an extensive view of cardiorespiratory dynamics in patients with type 2 DM.

METHODS

One hundred healthy controls (HC) and 100 DM patients were enrolled. We measured and compared the breathing patterns (spirometry), VO2 max levels (heart rate ratio method) and self-reported fitness level (international fitness scale) of individuals with and without diabetes. Data was analyzed in SPSS v.22 and GraphPad Prism v8.0.

RESULTS

We observed restrictive spirometry patterns (FVC <80%) in 22% of DM as compared to 2% in HC (p = 0.021). There was low mean VO2 max in DM as compared to HC(32.03 ± 5.36 vs 41.91 ± 7.98 ml/kg/min; p value <0.001). When evaluating physical fitness on self-reported IFiS scale, 90% of the HC report average, good, or very good fitness levels. In contrast, only 45% of the DM shared this pattern, with a 53% proportion perceiving their fitness as poor or very poor (p = <0.05). Restrictive respiratory pattern, low VO2 max and fitness level were significantly associated with HbA1c and long-standing DM.

CONCLUSION

This study shows decreased pulmonary functions, decreased cardiorespiratory fitness (VO2 max) and IFiS scale variables in diabetic population as compared to healthy controls which are also associated with glycemic levels and long-standing DM. Screening for pulmonary functions can aid optimum management in this population.

Flexibility: A Hidden But Trainable Morbidity in Pediatric Patients with Congenital Heart Disease

Flexibility is important for range of motion, muscular performance, and injury prevention with exercise. Promoting exercise is important for patients with congenital and pediatric acquired heart disease (CHD), yet there are a paucity of data addressing flexibility in this population. We hypothesized that flexibility was worse in pediatric patients with CHD than the general population but could be improved with directed training. Patients at Boston Children's Hospital who participated in the pediatric Cardiac Fitness Program between 09/2016 and 11/2022 were retrospectively analyzed. Flexibility was assessed via sit-and-reach (SaR) box. Data from baseline and 60 days into the fitness program intervention were compared to age-matched population norms, and changes over time were assessed. Analyses were also stratified by sex and history of sternotomy. Patients with paired baseline and 60-day data were analyzed (n = 46, age 8-23 years old, 52% male). The mean SaR at baseline for CHD patients was 24.3 cm, significantly lower than the population norm (p = 0.002). The mean for male (n = 24, 21.2 cm) and female (n = 22, 27.2 cm) CHD patients was significantly lower than their respective population norms (p = 0.017 and p = 0.026, respectively). After the fitness intervention, flexibility in CHD patients significantly improved to normal, including patients with a history of sternotomy. Flexibility was significantly lower in CHD patients than the general population, but normalized with training. Further research is warranted to investigate associations of flexibility with other measures of fitness, cardiovascular status, and quality of life, as well as benefits gained with training.

A health behaviour pandemic: The COVID-19 pandemic has impacted the physical activity, sleep, and sedentary behaviour of already-struggling Canadians

Objectives

The Canadian 24-Hour Movement Guidelines (24HMG) provide evidence-based recommendations for health behaviours, including light physical activity, moderate-to-vigorous physical activity (MVPA), sedentary behaviour (SB), sleep, and muscle strengthening activities. These behaviours likely changed as a result of public health measures implemented throughout the COVID-19 pandemic. We aimed to understand how Canadians' health behaviours changed during the pandemic.

Methods

We conducted a nationwide survey asking Canadians aged 18-64 to report their health behaviours according to the 24HMG at three timepoints: 1) immediately prior to the pandemic, 2) the most restricted timepoint of the pandemic, and 3) more recently, in March 2022.

Results

We received 494 eligible responses from across Canada. Prior to the pandemic, only 7.7% of respondents were able to meet all 24HMG, which reduced to 3.8% during the most restricted phase of the pandemic (p < 0.01). During this timepoint, self-reported MVPA decreased by -21.9 ± 55.6 weekly minutes, muscle strengthening decreased by -0.34 ± 0.94 weekly sessions, and SB increased by 0.88 ± 2.04 daily hours (p < 0.00001 for all), with nonsignificant increases in nightly sleep. At the more recent March 2022 timepoint, mild recoveries were observed in all health behaviours, however remained significantly lower than baseline levels, with the exception of sleep, which decreased significantly (-0.18 ± 1.42 nightly hours, p = 0.005).

Conclusions

Unfavourable health behaviour changes among Canadians were observed throughout the COVID-19 pandemic, which increases the risk for acute and long-term health conditions. Improved education, infrastructure, and support from public and private sectors can reverse the negative risk factors that arise from these health behaviour changes, and can improve the culture of proactive health behaviours in Canada.

Effects of a Single Session of Systemic Vibratory Therapy on Flexibility, Perception of Exertion and Handgrip Strength in Chronic Obstructive Pulmonary Disease Individuals: A Quasi-Experimental Clinical Trial

BACKGROUND

Whole-body vibration exercises (WBVE), that are generated in systemic vibratory therapy (SVT), may benefit individuals with chronic obstructive pulmonary disease (COPD). This study evaluated acute effects of SVT on the flexibility, on the perception of exertion to perform the anterior trunk flexion (ATF), and on the handgrip strength (HG).

METHODS

Thirty-eight individuals, separated into two groups, performed a single session of SVT (five bouts, 25 Hz, 2.5 of amplitude) on a side-alternating vibrating platform (SAVP), in two postures: sitting (Sitting group-SitG, n = 21) or standing (Stand group-StandG, n = 17). In both positions, the feet were on the base of the SAVP. The HG and the AFT were performed before and after the session, and the perception of effort (RPE) was measured during the ATF.

RESULTS

The ATF in the SitG (p ≤ 0.05) and in the StandG (p ≤ 0.05) was significantly improved, but in the comparison between both groups, no significant reduction was found (p = 0.14). The RPE was not influenced by the session. A significant increase of the HG in StandG post session (33.49 ± 10.30 kgf) p = 0.03 was found, but not in the SitG (p = 0.12) or between the two groups (p = 0.55).

CONCLUSIONS

SVT, in a single acute session, would be capable of promoting some functional benefits for the COPD individuals without altering the perception of exertion to perform the ATF.

TRIAL REGISTRATION

49219115.3.0000.5259, RBR-72dqtm.

Cross-cultural adaptation and validation of the rapid assessment of physical activity questionnaire (RAPA) in Hungarian elderly over 50 years

Background

Reliable and valid instruments are needed to estimate physical activity levels. The aim was to culturally adapt the “Rapid Assessment of Physical Activity” (RAPA) into Hungarian and to investigate the validity and reliability of this adapted version in the elderly over 50 years.

Methods

In our cross-sectional study 222 subjects were recruited in Hungary between December 2020 and January 2021(age 61.1 ± 7.9 years, 28% male). Criterion validity of RAPA and International Physical Activity Questionnaire (IPAQ)—Hungarian long version was tested by Spearman’s rank correlation. The examination of repeatability was based on a group of 32 people, and on the one-week test–retest reliability approach, and in addition to this during the statistical analysis intra-class correlation coefficient was calculated. To examine the sensitivity and specificity of the RAPA, negative and positive physical activity values were calculated from the results of the long version of the IPAQ and the RAPA. We tested 4 hypotheses (3 validity, 1 reliability). We considered acceptable validity and reliability if > 75% of hypotheses were confirmed. Results: All of the hypotheses (100%) were confirmed. Based on results of the validity testing of the newly adapted questionnaire was showed a moderate correlation between the examined measurement tools (R = 0.542, p < 0.001). The test–retest results of the questionnaire (N = 32, R = 0.988, p < 0.001) showed strong association.

Conclusion

RAPA showed fair to moderate validity and strong test–retest reliability similar to other studies. Based on our study’s results the RAPA is a valid and reliable questionnaire to measure the elderly Hungarian population’s physical activity.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13102-022-00512-3.