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Yu L, Chen Z, Wu W, Xu X, Lv Y, Li C. Effects of Precooling on Endurance Exercise Performance in the Heat: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2024; 16:4217. [PMID: 39683610 DOI: 10.3390/nu16234217] [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: 11/20/2024] [Revised: 12/03/2024] [Accepted: 12/05/2024] [Indexed: 12/18/2024] Open
Abstract
An increasing number of studies have explored the effects of precooling on endurance exercise performance in the heat, yet the available results remain inconsistent. Therefore, this study aimed to investigate the effects of different precooling strategies on endurance exercise performance in the heat. A comprehensive search was conducted across PubMed, Web of Science, Cochrane, Scopus, and EBSCO database. The Cochrane risk assessment tool was employed to evaluate the methodological quality of the included studies. A meta-analysis was subsequently conducted to quantify the standardized mean difference (SMD) and 95% confidence interval for the effects of precooling on endurance exercise performance in the heat. Out of the initially identified 6982 search records, 15 studies were deemed eligible for meta-analysis. Our results showed that precooling significantly improved time trial (TT) performance (SMD, -0.37, p < 0.01, I2 = 0%) and time to exhaustion (TTE) performance in the heat (SMD, 0.73, p < 0.01, I2 = 50%). Further subgroup analyses revealed that external precooling is more effective in improving TT performance (SMD, -0.43, p = 0.004, I2 = 0%) and TTE performance (SMD, 1.01, p < 0.001, I2 = 48%), particularly in running-based performances (TT, SMD, -0.41, p = 0.02, I2 = 0%; TTE, SMD, 0.85, p = 0.0001, I2 = 31%). Precooling is an effective approach to improve endurance exercise performance in the heat. External precooling is more effective in improving endurance exercise performance, particularly in running-based performance.
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Affiliation(s)
- Laikang Yu
- Beijing Key Laboratory of Sports Performance and Skill Assessment, Beijing Sport University, Beijing 100084, China
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China
| | - Zhizhou Chen
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China
| | - Weiliang Wu
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China
| | - Xinhao Xu
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China
| | - Yuanyuan Lv
- Beijing Key Laboratory of Sports Performance and Skill Assessment, Beijing Sport University, Beijing 100084, China
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China
| | - Cui Li
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou 450001, China
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou 450001, China
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Duppen CP, Sachdeva N, Wrona H, Dayan E, Browner N, Lewek MD. Blending motor learning approaches for short-term adjustments to gait in people with Parkinson disease. Exp Brain Res 2024; 242:2853-2863. [PMID: 39361030 DOI: 10.1007/s00221-024-06933-5] [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: 07/10/2024] [Accepted: 09/22/2024] [Indexed: 10/05/2024]
Abstract
Rhythmic auditory cueing (RAC) using an isochronous metronome is an effective approach to immediately enhance spatiotemporal aspects of gait for people with Parkinson disease (PwPD). Whereas entraining to RAC typically occurs subconsciously via cerebellar pathways, the use of metronome frequencies that deviate from one's typical cadence, such as those used in rehabilitation, may require conscious awareness. This heightened awareness may increase cognitive load and limit the persistence of gait training gains. Here, we explore the immediate effects of incorporating an implicit motor learning approach (i.e., error-based recalibration) to gait training with RAC. Twenty older adults (10 with PD and 10 controls) were asked to match their footfalls to both isochronous and subtly varying metronomes while walking on a treadmill and overground. Our findings revealed intriguing differences between treadmill and overground walking. During treadmill walking to a slower metronome frequency, both groups reduced their cadence and increased step lengths, but did not make the necessary adjustments to match the subtly varying metronome. During overground walking, both groups modified their cadence in response to a 3-4% change in metronome frequency (p < 0.05). Both metronomes yielded evidence of implicit and explicit retention during overground and treadmill walking. Furthermore, during overground walking the PD group showed greater implicit retention of cadence changes following the varying metronome, compared to the isochronous metronome. Our results suggest that incorporating implicit motor learning approaches to gait training during a single session of overground walking may enhance short term implicit retention of gait behaviors for PwPD.
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Affiliation(s)
- Chelsea Parker Duppen
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nikhil Sachdeva
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hailey Wrona
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- NC and North Carolina State University, Raleigh, NC, USA
| | - Eran Dayan
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nina Browner
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael D Lewek
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Division of Physical Therapy, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Nakanishi H, Morigaki R, Fujikawa J, Ohmae H, Shinohara K, Yamamoto N, Izumi Y, Takagi Y. Online training program maintains motor functions and quality of life in patients with Parkinson's disease. Front Digit Health 2024; 6:1486662. [PMID: 39606179 PMCID: PMC11599239 DOI: 10.3389/fdgth.2024.1486662] [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: 08/26/2024] [Accepted: 10/28/2024] [Indexed: 11/29/2024] Open
Abstract
Objective Several systematic reviews have shown that physical exercise positively affects motor function (MF) and quality of life (QoL) in patients with Parkinson's disease (PD). After the coronavirus disease (COVID-19) pandemic, numerous studies were conducted to reveal the effects of telerehabilitation for patients with PD. However, only a few empirical results of online programs for PD patients have been reported. Therefore, this study aimed to determine the effects of an online physical and cognitive training program on MF and QoL in patients with PD. Methods We evaluated the impact of our online program on the QoL and MF of patients with PD by comparing data at baseline and after six months of intervention. For the QoL assessment, we used the Schwab and England Activities of Daily Living scale and Parkinson's Disease Questionnaire (PDQ-39), whereas, for MF, we measured movement status using the modified 20-m walk test and timed up-and-go (TUG) test. Results We enrolled 20 patients for QoL and 19 for MF in this study. For PDQ-39, social support (p = 0.046, δ = 0.320) and cognitions (p = 0.028, δ = 0.268) significantly improved. Additionally, cadence (p = 0.032, g = -0.377) in the modified 20-m walk and exam duration (p = 0.003, δ = 0.296) and forward gait (p = 0.003, δ = 0.341) in the TUG test showed significant differences before and after the intervention. Conclusion Our results suggest that online physical and cognitive training programs positively affect MF and QoL in individuals with PD.
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Affiliation(s)
- Hiroshi Nakanishi
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
- Department of Research and Development, Beauty Life Corporation, Nagoya, Japan
| | - Ryoma Morigaki
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
- Parkinson’s Disease and Dystonia Research Center, Tokushima University Hospital, Tokushima, Japan
- Department of Advanced Brain Research, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Joji Fujikawa
- Department of Advanced Brain Research, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Hiroshi Ohmae
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
- Division of Rehabilitation, Tokushima University Hospital, Tokushima, Japan
| | - Keisuke Shinohara
- Department of Advanced Brain Research, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Nobuaki Yamamoto
- Department of Neurology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Yuishin Izumi
- Parkinson’s Disease and Dystonia Research Center, Tokushima University Hospital, Tokushima, Japan
- Department of Neurology, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Yasushi Takagi
- Department of Neurosurgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
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Zhang S, Gu B, Zhen K, Du L, Lv Y, Yu L. Effects of exercise on brain-derived neurotrophic factor in Alzheimer's disease models: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 126:105538. [PMID: 38878598 DOI: 10.1016/j.archger.2024.105538] [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: 12/13/2023] [Revised: 05/27/2024] [Accepted: 06/10/2024] [Indexed: 09/05/2024]
Abstract
A growing body of research examining effects of exercise on brain-derived neurotrophic factor (BDNF) in Alzheimer's disease (AD) models, while due to differences in gender, age, disease severity, brain regions examined, and type of exercise intervention, findings of available studies were conflicting. In this study, we aimed to evaluate current evidence regarding effects of exercise on BDNF in AD models. Searches were performed in PubMed, Web of Science, Cochrane, and EBSCO electronic databases, through July 20, 2023. We included studies that satisfied the following criteria: eligible studies should (1) report evidence on experimental work with AD models; (2) include an exercise group and a control group (sedentary); (3) use BDNF as the outcome indicator; and (4) be randomized controlled trials (RCTs). From 1196 search records initially identified, 36 studies met the inclusion criteria. There was a significant effect of exercise on increasing BDNF levels in AD models [standardized mean differences (SMD) = 0.98, P < 0.00001]. Subgroup analysis showed that treadmill exercise (SMD = 0.92, P< 0.0001), swimming (SMD = 1.79, P< 0.0001), and voluntary wheel running (SMD = 0.51, P= 0.04) were all effective in increasing BDNF levels in AD models. In addition, exercise significantly increased BDNF levels in the hippocampus (SMD = 0.92, P< 0.00001) and cortex (SMD = 1.56, P= 0.02) of AD models. Exercise, especially treadmill exercise, swimming, and voluntary wheel running, significantly increased BDNF levels in hippocampus and cortex of AD models, with swimming being the most effective intervention type.
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Affiliation(s)
- Shiyan Zhang
- Beijing Key Laboratory of Sports Performance and Skill Assessment, Beijing Sport University, Beijing, China; Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Boya Gu
- Beijing Key Laboratory of Sports Performance and Skill Assessment, Beijing Sport University, Beijing, China
| | - Kai Zhen
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Liwen Du
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- Beijing Key Laboratory of Sports Performance and Skill Assessment, Beijing Sport University, Beijing, China; China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Laikang Yu
- Beijing Key Laboratory of Sports Performance and Skill Assessment, Beijing Sport University, Beijing, China; Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China.
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Jagota P, Phutrakool P, Kamble N, Dang THT, Aldaajani Z, Hatano T, Hoskere Sreenivasa DK, Tripura T, Kukkle PL, Jeon B, Nishikawa N, Oji Y, Tran TN, Susatia F, Fabbri M, Leung C, Alonso Canovas A, Kamel WA, Pal PK, Rakesh K, Abu Snineh M, Chairangsaris P, Lolekha P, Jamora RDG, Mohamed Ibrahim N, Desa SHM, Tan AH, Toh TS, Obaid M, Fung VS, Lang A, Lin C, Regragui W, Bouslam N, Bhidayasiri R. Exercise Habits in People with Parkinson's: A Multinational Survey. Mov Disord Clin Pract 2024; 11:1396-1409. [PMID: 39206964 PMCID: PMC11542280 DOI: 10.1002/mdc3.14197] [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: 12/13/2023] [Revised: 06/21/2024] [Accepted: 07/21/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Exercise has been demonstrated to result in improvements in physical function, cognition, and quality of life in People with Parkinson's (PwP) but its adoption is variable. OBJECTIVES To investigate exercise preferences, levels, influencing factors among a diverse Parkinson's disease (PD) population, to understand exercise adoption patterns and plan informed interventions. METHODS A cross-sectional survey collected data through online platforms and paper-based methods. The Exercise Index (ExI) calculated exercise level based on frequency and duration. RESULTS Of 2976 PwP, 40.6% exercised regularly, 38.3% occasionally, and 21.2% did not exercise. The overall mean ExI was 18.99 ± 12.37. Factors associated with high exercise levels included exercising in groups (ExI 24-26), weightlifting (ExI 27 (highest)), using muscle-building equipment (ExI 25-26), and exercising at home following an app (ExI 26). A positive trend between ExI and varied exercise groups, locations, types, and equipment was observed. No expected benefit from exercise achieved the lowest ExI (8). Having at least two exercise-promoting factors, a bachelor's degree or higher, receiving exercise advice at initial visits, and aged ≤40 years at PD onset were strong predictors of exercise (adjust OR = 7.814; 6.981; 4.170; 3.565). Falls and "other" most troublesome PD symptoms were negative predictors (aOR = 0.359; 0.466). Barriers to exercise did not predict the odds of exercise. CONCLUSIONS The study shows that PwP's exercise behavior is influenced by their exercise belief, age at PD onset, doctor's advice at initial visits, education level, symptoms, and exercise-promoting factors. High exercise levels were associated with certain types of exercises and exercising in groups.
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Affiliation(s)
- Priya Jagota
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross SocietyBangkokThailand
| | - Phanupong Phutrakool
- Chula Data Management Center, Faculty of MedicineChulalongkorn UniversityBangkokThailand
- Center of Excellence in Preventive & Integrative Medicine, Faculty of MedicineChulalongkorn UniversityBangkokThailand
| | - Nitish Kamble
- Department of NeurologyNational Institute of Mental Health & Neurosciences (NIMHANS)BengaluruIndia
| | - Thuong Huyen Thi Dang
- Movement Disorder Unit, Neurology DepartmentUniversity Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Zakiyah Aldaajani
- Neuroscience DepartmentKing Fahad Military Medical ComplexDhahranSaudi Arabia
| | - Taku Hatano
- Department of NeurologyJuntendo University Faculty of MedicineTokyoJapan
| | | | - Telugu Tripura
- Center for Parkinson's Disease and Movement DisordersManipal HospitalBangaloreIndia
| | - Prashanth Lingappa Kukkle
- Parkinson's Disease and Movement Disorders ClinicBangaloreIndia
- Center for Parkinson's Disease and Movement DisordersManipal HospitalBangaloreIndia
| | - Beomseok Jeon
- Department of NeurologySeoul National UniversitySeoulRepublic of Korea
- Movement Disorder CenterSeoul National University HospitalSeoulRepublic of Korea
- BJ Center for Comprehensive Parkinson Care and Rare Movement DisordersChung‐Ang University Health Care System, Hyundae HospitalNamyangju‐siRepublic of Korea
| | - Noriko Nishikawa
- Department of NeurologyJuntendo University Faculty of MedicineTokyoJapan
| | - Yutaka Oji
- Department of NeurologyJuntendo University Faculty of MedicineTokyoJapan
| | - Tai Ngoc Tran
- Movement Disorder Unit, Neurology DepartmentUniversity Medical Center HCMC, University of Medicine and Pharmacy at Ho Chi Minh CityHo Chi Minh CityVietnam
| | - Frandy Susatia
- Siloam Parkinson's Disease and Movement Disorders CenterSiloam Hospitals Kebon JerukJakartaIndonesia
| | - Margherita Fabbri
- Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Centre, NS‐Park/FCRIN NetworkToulouse, and Multiple System Atrophy Reference Centre, CHU ToulouseToulouseFrance
| | - Clémence Leung
- Department of Neurosciences, Clinical Investigation Center CIC 1436, Parkinson Toulouse Expert Centre, NS‐Park/FCRIN NetworkToulouse, and Multiple System Atrophy Reference Centre, CHU ToulouseToulouseFrance
| | - Araceli Alonso Canovas
- Movement Disorders UnitHospital Ramón y CajalMadridSpain
- Medicine DepartmentUniversidad de AlcalaMadridSpain
| | - Walaa A. Kamel
- Neurology Department, Faculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
- Neurology DepartmentIbn‐Sina HospitalKuwait CityKuwait
| | - Pramod Kumar Pal
- Department of NeurologyNational Institute of Mental Health & Neurosciences (NIMHANS)BengaluruIndia
| | - Kempaiah Rakesh
- Department of NeurologyNational Institute of Mental Health & Neurosciences (NIMHANS)BengaluruIndia
| | - Muneer Abu Snineh
- Department of NeurologyHadassah Hebrew University HospitalJerusalemIsrael
| | - Parnsiri Chairangsaris
- Neurology Division, Department of MedicinePhramongkutklao Hospital and College of MedicineBangkokThailand
| | - Praween Lolekha
- Division of Neurology, Department of Internal Medicine, Faculty of MedicineThammasat UniversityPathumthaniThailand
| | - Roland Dominic G. Jamora
- Department of Neurosciences, College of Medicine and Philippine General HospitalUniversity of the Philippines ManilaManilaPhilippines
- Section of Neurology, Department of Internal MedicineCardinal Santos Medical CenterSan Juan CityPhilippines
| | - Norlinah Mohamed Ibrahim
- Neurology Unit, Department of Medicine, Faculty of MedicineUniversiti Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Siti Hajar Mat Desa
- Department of Nursing Services, Hospital Canselor Tuanku MuhrizUniversiti Kebangsaan Malaysia (UKM)Kuala LumpurMalaysia
| | - Ai Huey Tan
- Division of Neurology, Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Tzi Shin Toh
- Division of Neurology, Department of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Mona Obaid
- Neuroscience DepartmentKing Fahad Medical CityRiyadhSaudi Arabia
| | - Victor S.C. Fung
- Movement Disorder Unit, Department of NeurologyWestmead HospitalWestmeadNew South WalesAustralia
- Sydney Medical School, Faculty of Medicine and HealthUniversity of SydneySydneyAustralia
| | - Anthony Lang
- Edmond J. Safra Program in Parkinson's DiseaseToronto Western Hospital and the University of TorontoTorontoOntarioCanada
| | - Chin‐Hsien Lin
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan
- Institute of Molecular Medicine, College of MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Wafa Regragui
- Department of Neurology B, hôpital des Spécialités, CHU Ibn Sina, Faculté de Médecine et de Pharmacie de RabatUniversité Mohamed VRabatMorocco
| | - Naima Bouslam
- Department of Neurology B, hôpital des Spécialités, CHU Ibn Sina, Faculté de Médecine et de Pharmacie de RabatUniversité Mohamed VRabatMorocco
| | - Roongroj Bhidayasiri
- Chulalongkorn Centre of Excellence for Parkinson's Disease and Related Disorders, Department of Medicine, Faculty of MedicineChulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross SocietyBangkokThailand
- The Academy of ScienceThe Royal Society of ThailandBangkokThailand
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Langeskov-Christensen M, Franzén E, Grøndahl Hvid L, Dalgas U. Exercise as medicine in Parkinson's disease. J Neurol Neurosurg Psychiatry 2024; 95:1077-1088. [PMID: 38418216 DOI: 10.1136/jnnp-2023-332974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/02/2024] [Indexed: 03/01/2024]
Abstract
Parkinson's disease (PD) is an incurable and progressive neurological disorder leading to deleterious motor and non-motor consequences. Presently, no pharmacological agents can prevent PD evolution or progression, while pharmacological symptomatic treatments have limited effects in certain domains and cause side effects. Identification of interventions that prevent, slow, halt or mitigate the disease is therefore pivotal. Exercise is safe and represents a cornerstone in PD rehabilitation, but exercise may have even more fundamental benefits that could change clinical practice. In PD, the existing knowledge base supports exercise as (1) a protective lifestyle factor preventing the disease (ie, primary prevention), (2) a potential disease-modifying therapy (ie, secondary prevention) and (3) an effective symptomatic treatment (ie, tertiary prevention). Based on current evidence, a paradigm shift is proposed, stating that exercise should be individually prescribed as medicine to persons with PD at an early disease stage, alongside conventional medical treatment.
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Affiliation(s)
- Martin Langeskov-Christensen
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Neurology, Viborg Regional Hospital, Viborg, Denmark
| | - Erika Franzén
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
- Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Grøndahl Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- The Danish MS Hospitals, Ry and Haslev, Denmark
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
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Cui W, Hu Z, Li J, Wang S, Xu R. The impact of aerobic exercise dose based on ACSM recommendations on patients with Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials. Front Aging Neurosci 2024; 16:1419643. [PMID: 39430975 PMCID: PMC11487601 DOI: 10.3389/fnagi.2024.1419643] [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: 04/18/2024] [Accepted: 09/17/2024] [Indexed: 10/22/2024] Open
Abstract
Background To explore the effects of different dose of aerobic exercise on motor function, balance, mobility, and quality of life in Parkinson's disease patients, aiming to provide insights into determining the optimal aerobic exercise dose for treating PD. Methods Searching was conducted in four databases: PubMed, Embase, Web of Science, and Cochrane. The dose of aerobic exercise intervention was evaluated based on the recommendations of the American College of Sports Medicine regarding the development and maintenance of cardiorespiratory health, muscle strength, and functional mobility in patients with PD. The exercise intervention dose of the included studies were first classified into high ACSM compliance and low ACSM compliance based on meeting 4/6 of the ACSM recommendations. The reliability of the results was then validated using the criterion of meeting 5/6 of the ACSM recommendations. Comparisons of the effects of aerobic exercise dose on Motor function, Balance, Mobility, and QOL in PD patients using standardized mean difference with 95% confidence intervals. Results When using the 4/6 ACSM compliance criterion, 17 studies were categorized as high ACSM compliance and 12 as low ACSM compliance. The SMD ratios for high versus low ACSM compliance were: UPDRS-III (-0.79: -0.18), BBS (0.60: 0.05), TUG (-0.60: -0.60), and QOL (-1.05: -0.15). When using the 5/6 ACSM compliance criterion, 11 studies were categorized as high ACSM compliance and 19 as low ACSM compliance. The SMD ratios for high versus low ACSM compliance were: UPDRS-III (-0.95: -0.38), BBS (0.48: 0.37), TUG (-0.71: -0.55), and QOL (-0.7: 0.04). Conclusion This study provides preliminary support for the potential of aerobic exercise to improve certain clinical symptoms in patients with PD. Furthermore, the results indicate that compliance to higher doses of aerobic exercise, as per ACSM standards, may contribute to improvements in motor function, balance, mobility, and quality of life for patients with PD. However, due to the heterogeneity in the studies and the influence of factors that have not yet been fully explored, these conclusions should be interpreted with caution. More high-quality randomized controlled trials are needed in the future to further verify and clarify the effects of aerobic exercise. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier PROSPERO: CRD42024517548.
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Affiliation(s)
- Wenlai Cui
- School of Dance and Martial Arts, Capital University of Physical Education and Sports, Beijing, China
| | - Zepeng Hu
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing, China
| | - Jian Li
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China
| | - Siji Wang
- Institute of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China
| | - Ruilin Xu
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, China
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8
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Li G, Tao X, Lei B, Hou X, Yang X, Wang L, Zhang S, Lv Y, Wang T, Yu L. Effects of exercise on post-stroke cognitive function: a systematic review and meta-analysis of randomized controlled trials. Top Stroke Rehabil 2024; 31:645-666. [PMID: 38825881 DOI: 10.1080/10749357.2024.2356393] [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: 11/15/2023] [Accepted: 04/23/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND A growing body of research examining the effect of exercise on cognitive function in stroke patients, while findings of available studies were conflicting. OBJECTIVES We aimed to estimate the effect of exercise on cognitive function in stroke patients. METHODS For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Cochrane, and Scopus electronic databases, through 13 March 2023. The three-level restricted maximum likelihood random effects model was used to synthesize the data. RESULTS Twenty-five studies met the inclusion criteria. There was a significant effect of exercise on improving cognitive function in stroke patients (Cohen's d = 0.37, 95% CI, 0.16 to 0.58, p < 0.01, I2 = 22.12%). Subgroup analysis showed that exercise significantly improved memory. In addition, aerobic exercise, exercise conducted 12 weeks or more, 3 times or more per week, less than 60 minutes per session, less than 180 minutes per week, and up to 12 months post-stroke increased cognitive function significantly. CONCLUSIONS Exercise improved cognitive function in stroke patients. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that stroke patients participate in aerobic exercise at least 3 times per week for 30-60 minutes, with a goal of 180 minutes per week being achieved by increasing the frequency of exercise. Exercise initiated within 12 months post-stroke and continued for 12 weeks or more is most beneficial for improving cognitive function.
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Affiliation(s)
- Gen Li
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, China
| | - Xifeng Tao
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Bingkai Lei
- School of Physical Education, Xihua University, Chengdu, China
| | - Xiao Hou
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Xiaoguang Yang
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Leiyuyang Wang
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Shiyan Zhang
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Tongling Wang
- Institute of Physical Education, Huzhou University, Huzhou, China
| | - Laikang Yu
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
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9
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Xu S, Liu Y, Lee H, Li W. Neural interfaces: Bridging the brain to the world beyond healthcare. EXPLORATION (BEIJING, CHINA) 2024; 4:20230146. [PMID: 39439491 PMCID: PMC11491314 DOI: 10.1002/exp.20230146] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 02/02/2024] [Indexed: 10/25/2024]
Abstract
Neural interfaces, emerging at the intersection of neurotechnology and urban planning, promise to transform how we interact with our surroundings and communicate. By recording and decoding neural signals, these interfaces facilitate direct connections between the brain and external devices, enabling seamless information exchange and shared experiences. Nevertheless, their development is challenged by complexities in materials science, electrochemistry, and algorithmic design. Electrophysiological crosstalk and the mismatch between electrode rigidity and tissue flexibility further complicate signal fidelity and biocompatibility. Recent closed-loop brain-computer interfaces, while promising for mood regulation and cognitive enhancement, are limited by decoding accuracy and the adaptability of user interfaces. This perspective outlines these challenges and discusses the progress in neural interfaces, contrasting non-invasive and invasive approaches, and explores the dynamics between stimulation and direct interfacing. Emphasis is placed on applications beyond healthcare, highlighting the need for implantable interfaces with high-resolution recording and stimulation capabilities.
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Affiliation(s)
- Shumao Xu
- Department of Biomedical EngineeringThe Pennsylvania State UniversityPennsylvaniaUSA
| | - Yang Liu
- Brain Health and Brain Technology Center at Global Institute of Future TechnologyShanghai Jiao Tong UniversityShanghaiChina
| | - Hyunjin Lee
- Department of Biomedical EngineeringThe Pennsylvania State UniversityPennsylvaniaUSA
| | - Weidong Li
- Brain Health and Brain Technology Center at Global Institute of Future TechnologyShanghai Jiao Tong UniversityShanghaiChina
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10
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Mak MKY, Wong-Yu ISK, Cheung RTH, Ho SL. Effectiveness of Balance Exercise and Brisk Walking on Alleviating Nonmotor and Motor Symptoms in People With Mild-to-Moderate Parkinson Disease: A Randomized Clinical Trial With 6-Month Follow-up. Arch Phys Med Rehabil 2024; 105:1890-1899. [PMID: 38866225 DOI: 10.1016/j.apmr.2024.05.031] [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: 09/13/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE To investigate the effects of balance exercise and brisk walking on nonmotor and motor symptoms, balance and gait functions, walking capacity, and balance confidence in Parkinson disease (PD) at posttraining and 6-month follow-up. DESIGN Two-arm, assessor-blinded randomized controlled trial SETTING: University research laboratory and the community PARTICIPANTS: Ninety-nine eligible individuals with mild-to-moderate PD INTERVENTIONS: Participants were randomized to balance and brisk walking group (B&B, n=49) or active control group (n=50). B&B received ten 90-minute sessions of balance exercises and brisk walking supervised by physical therapists for 6 months (week 1-6: weekly, week 7-26: monthly), whereas control practiced whole-body flexibility and upper limb strength exercise at same dosage (180 min/wk). Both groups performed unsupervised home exercises 2-3 times/wk during intervention and continued at follow-up. MAIN OUTCOME MEASURES Primary outcomes were Movement Disorder Society Unified Parkinson Disease Rating Scale nonmotor (MDS-UPDRS-I) and motor (MDS-UPRDS-III) scores. Secondary outcomes were mini-Balance Evaluation Systems Test (mini-BEST) score, comfortable gait speed (CGS), 6-minute walk test (6MWT), dual-task timed-Up-and-Go (DTUG) time, and Activities-Specific Balance Confidence Scale score. RESULTS Eighty-three individuals completed the 6-month intervention with no severe adverse effects. The mean between-group (95% CI) difference for the MDS-UPDRS nonmotor score was 1.50 (0.19-2.81) at 6 months and 1.09 (-0.66 to 2.85) at 12 months. The mean between-group (95% CI) difference for the MDS-UPDRS motor score was 3.75 (0.69-6.80) at 6 months and 4.57 (1.05-8.01) at 12 months. At 6 and 12 months, there were significant between-group improvements of the B&B group in mini-BEST score, CGS, 6MWT, and DTUG time. CONCLUSIONS This combined balance and brisk walking exercise program alleviates nonmotor and motor symptoms and improves walking capacity, balance, and gait functions posttraining, with positive carryover effects for all except nonmotor outcomes, at 6-month follow-up in mild-to-moderate PD.
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Affiliation(s)
- Margaret K Y Mak
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Irene S K Wong-Yu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Roy T H Cheung
- School of Science and Health, Western Sydney University, Australia; Translational Health Research Institute, Western Sydney University, New South Wales, Australia
| | - Shu-Leong Ho
- Department of Medicine, Queen Mary Hospital, Hong Kong SAR, China
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11
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Mitchell AK, Bliss RR, Church FC. Exercise, Neuroprotective Exerkines, and Parkinson's Disease: A Narrative Review. Biomolecules 2024; 14:1241. [PMID: 39456173 PMCID: PMC11506540 DOI: 10.3390/biom14101241] [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: 08/09/2024] [Revised: 09/23/2024] [Accepted: 09/27/2024] [Indexed: 10/28/2024] Open
Abstract
Parkinson's disease (PD) is a prevalent neurodegenerative disease in which treatment often includes an exercise regimen. Exercise is neuroprotective in animal models of PD, and, more recently, human clinical studies have verified exercise's disease-modifying effect. Aerobic exercise and resistance training improve many of PD's motor and non-motor symptoms, while neuromotor therapy and stretching/flexibility exercises positively contribute to the quality of life in people with PD. Therefore, understanding the role of exercise in managing this complex disorder is crucial. Exerkines are bioactive substances that are synthesized and released during exercise and have been implicated in several positive health outcomes, including neuroprotection. Exerkines protect neuronal cells in vitro and rodent PD models in vivo. Aerobic exercise and resistance training both increase exerkine levels in the blood, suggesting a role for exerkines in the neuroprotective theory. Many exerkines demonstrate the potential for protecting the brain against pathological missteps caused by PD. Every person (people) with Parkinson's (PwP) needs a comprehensive exercise plan tailored to their unique needs and abilities. Here, we provide an exercise template to help PwP understand the importance of exercise for treating PD, describe barriers confronting many PwP in their attempt to exercise, provide suggestions for overcoming these barriers, and explore the role of exerkines in managing PD. In conclusion, exercise and exerkines together create a powerful neuroprotective system that should contribute to slowing the chronic progression of PD.
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Affiliation(s)
- Alexandra K. Mitchell
- Department of Health Sciences, Division of Physical Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | | | - Frank C. Church
- Department of Pathology and Laboratory Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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12
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Cancela-Carral JM, Campo-Prieto P, Rodríguez-Fuentes G. The IntegraPark Study: An Opportunity to Facilitate High-Intensity Exercise with Immersive Virtual Reality in Parkinson's Disease Patients. J Funct Morphol Kinesiol 2024; 9:156. [PMID: 39311264 PMCID: PMC11417750 DOI: 10.3390/jfmk9030156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/30/2024] [Accepted: 09/01/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND high-intensity exercise is a feasible and effective modality in the early stages of Parkinson's disease (PD). However, there are only a few studies that have carried out this type of intervention in customizable immersive virtual reality (IVR) environments. We explore the feasibility and effects of IVR-based high-intensity training through rowing and cycling exercises on the functional capacity, quality of life, and progression of PD. METHODS a total of 12 participants (61.50 ± 10.49 years old; 41.7% female, 58.3% male; stages I-III) were part of the study, which consisted of interventions of rowing and cycling in an IVR commercial exergame (25 min; twice per week for 14 weeks). The main variables measured were functional capacity, handgrip strength, functional mobility (TUG), functional lower-limb strength (FTSST), aerobic capacity (2-min step test), quality of life (PDQ-39), and Parkinson's disease progression (MDS-UPDRS). RESULTS the results showed a general improvement in handgrip strength in both hands (p = 0.008; d = 0.28), FTSST (p = 0.029; d = 0.96), and TUG times (p = 0.152; d = 0.22). Aerobic capacity, assessed by a 2-min step test, showed enhanced scores (p = 0.031; d = 0.78). Related to the PDQ-39, all dimensions of the scale were enhanced, highlighting activities of daily living (p = 0.047; d = 0.29) and bodily discomfort (p = 0.041; d = 0.37). Finally, the main symptoms of the disease were reduced, with an improvement in the parameters that show a better incidence of disease progression, such as Part IA and IB (p = 0.013; d = 0.29 and p = 0.021; d = 0.25, respectively), Part II (p = 0.021; d = 0.23), Part III (p = 0.040; d = 0.39), and Part IV (p = 0.013; d = 0.39). CONCLUSIONS the therapeutic exercise (rowing and cycling), when carried out at a high intensity and in a personalized IVR scenario, appear to be a feasible and safe modality for patients with stages I-III of PD, improving their functional capacity, quality of life, and disease progression.
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Affiliation(s)
- José M. Cancela-Carral
- Departamento de Didácticas Especiais, Facultade de Ciencias da Educación e do Deporte, Universidade de Vigo, E-36005 Pontevedra, Spain;
- HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, E-36312 Vigo, Spain;
| | - Pablo Campo-Prieto
- HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, E-36312 Vigo, Spain;
- Departamento de Bioloxía Funcional e Ciencias da Saúde, Facultade de Fisioterapia, Universidade de Vigo, E-36005 Pontevedra, Spain
| | - Gustavo Rodríguez-Fuentes
- HealthyFit Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, E-36312 Vigo, Spain;
- Departamento de Bioloxía Funcional e Ciencias da Saúde, Facultade de Fisioterapia, Universidade de Vigo, E-36005 Pontevedra, Spain
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13
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Kathia MM, Duplea SG, Bommarito JC, Hinks A, Leake E, Shannon J, Pitman J, Khangura PK, Coates AM, Slysz JT, Katerberg C, McCarthy DG, Beedie T, Malcolm R, Witton LA, Connolly BS, Burr JF, Vallis LA, Power GA, Millar PJ. High-intensity interval versus moderate-intensity continuous cycling training in Parkinson's disease: a randomized trial. J Appl Physiol (1985) 2024; 137:603-615. [PMID: 39008618 DOI: 10.1152/japplphysiol.00219.2024] [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: 03/26/2024] [Revised: 07/04/2024] [Accepted: 07/08/2024] [Indexed: 07/17/2024] Open
Abstract
Exercise training is recommended to improve the quality of life in those living with Parkinson's disease (PD); however, the optimal prescription to improve cardiorespiratory fitness and disease-related motor symptoms remains unknown. Twenty-nine participants with PD were randomly allocated to either 10 wk of high-intensity interval training (HIIT) (n = 15; 6 female) or moderate-intensity continuous training (MICT) (n = 14; 5 female). The primary outcome was the change in maximal oxygen consumption (V̇o2peak). Secondary outcomes included changes in the Unified Parkinson's Disease Rating Scale (UPDRS) Part III motor score, Parkinson's Fatigue Scale (PFS)-16, resting and exercise cardiovascular measures, gait, balance, and knee extensor strength and fatigability. Exercise training increased V̇o2peak (main effect of time, P < 0.01), with a clinically meaningful difference in the change following HIIT versus MICT (Δ3.7 ± 3.7 vs. 1.7 ± 3.2 mL·kg-1·min-1, P = 0.099). The UPDRS motor score improved over time (P < 0.001) but without any differences between HIIT versus MICT (Δ-9.7 ± 1.3 vs. -8.4 ± 1.4, P = 0.51). Self-reported subjective fatigue (PFS-16) decreased over time (P < 0.01) but was similar between HIIT and MICT groups (P = 0.6). Gait, balance, blood pressure (BP), and heart rate (HR) were unchanged with training (all P > 0.09). Knee extensor strength increased over time (P = 0.03) but did not differ between HIIT versus MICT (Δ8.2 ± 5.9 vs. 11.7 ± 6.2 Nm, P = 0.69). HIIT alone increased the muscular endurance of the knee extensors during an isotonic fatigue task to failure (P = 0.04). In participants with PD, HIIT and MICT both increased V̇o2peak and led to improvements in motor symptoms and perceived fatigue; HIIT may offer the potential for larger changes in V̇o2peak and reduced knee extensor fatigability.NEW & NOTEWORTHY The optimal exercise prescription to improve cardiorespiratory fitness and disease-related motor symptoms in adults with Parkinson's disease remains unknown. In a single-center randomized trial consisting of either 10 wk of high-intensity interval training (HIIT) or moderate-intensity continuous training (MICT), we found that both training modes increased V̇o2peak, with a larger clinically meaningful difference following HIIT. Both exercise modes improved motor symptoms and subjective fatigue, whereas HIIT increased the muscular endurance of the knee extensors.
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Affiliation(s)
- Muhammad M Kathia
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Sergiu-Gabriel Duplea
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Julian C Bommarito
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Avery Hinks
- Neuromechanical Performance Research Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Elira Leake
- Neuromechanical Performance Research Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Julia Shannon
- Gait Biomechanics Laboratory, Department of Human Health & Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Jenna Pitman
- Gait Biomechanics Laboratory, Department of Human Health & Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Pardeep K Khangura
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
- Neuromechanical Performance Research Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Alexandra M Coates
- Human Performance and Health Research Laboratory, Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Joshua T Slysz
- Human Performance and Health Research Laboratory, Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Carlin Katerberg
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Devin G McCarthy
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
- Human Performance and Health Research Laboratory, Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Taylor Beedie
- Neuromechanical Performance Research Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Rhianna Malcolm
- Gait Biomechanics Laboratory, Department of Human Health & Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | | | - Barbara S Connolly
- Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jamie F Burr
- Human Performance and Health Research Laboratory, Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Lori Ann Vallis
- Gait Biomechanics Laboratory, Department of Human Health & Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Geoffrey A Power
- Neuromechanical Performance Research Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Philip J Millar
- Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada
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14
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Bange M, Herz DM, Ciolac D, Gonzalez-Escamilla G, Groppa S. Modifying the progression of Parkinson's disease through movement interventions: multimodal quantification of underlying mechanisms. Neural Regen Res 2024; 19:1651-1652. [PMID: 38103225 PMCID: PMC10960283 DOI: 10.4103/1673-5374.389633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/09/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Affiliation(s)
- Manuel Bange
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Damian Marc Herz
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Dumitru Ciolac
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Gabriel Gonzalez-Escamilla
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sergiu Groppa
- Section of Movement Disorders and Neurostimulation, Department of Neurology, Focus Program Translational Neuroscience (FTN), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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15
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Barbieri RA, Kalva-Filho CA, Faria MH, Silveira-Ciola AP, Torriani-Pasin C, Simieli L, Barbieri FA. Parkinson's Critical Heart Rate Test: Applying the Critical Power Model for People with Parkinson's Disease. J Hum Kinet 2024; 93:81-92. [PMID: 39132420 PMCID: PMC11307192 DOI: 10.5114/jhk/186562] [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: 06/21/2023] [Accepted: 03/27/2024] [Indexed: 08/13/2024] Open
Abstract
Aerobic exercise with the correct intensity can attenuate motor and non-motor symptoms of Parkinson's disease (PD) and improve the quality of life. However, a specific, validated, non-invasive, and outside the laboratory protocol that assesses physiological variables to prescribe optimal aerobic exercise intensity for people with PD is nonexistent. Therefore, this study aimed to propose a protocol, the Parkinson's critical heart rate test (Parkinson-CHR test), to determine the critical heart rate (CHR) in individuals with PD and verify its validity, reliability, and sensitivity. Fifteen people with idiopathic PD, who were able to practice exercises, were recruited to participate in the study (71.1 ± 6.6 years). The study consisted of two experiments: i) the first one aimed to assess the validity and reliability of the protocol, with participants performing the test twice at a one-week interval; ii) the second experiment aimed to investigate the protocol sensitivity, with individuals being evaluated before and after an 8-week training program according to Parkinson-CHR intensity. In experiment 1, no differences between test and retest were observed in the time to cover the distances (400, 800 and 1200 m), the total heart rate, the critical heart rate, and critical speed (p > 0.05). In experiment 2, there was a reduction in time to cover 400 and 800 m as well as in the total heart rate for all distances after the 8-week training program. The Parkinson-CHR test is a reliable, reproducible, inexpensive, and non-invasive protocol to assess, prescribe, and monitor aerobic exercise intensity in people with PD.
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Affiliation(s)
| | - Carlos Augusto Kalva-Filho
- School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), São Paulo State University (Unesp), Bauru, SP, Brazil
| | - Murilo Henrique Faria
- School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), São Paulo State University (Unesp), Bauru, SP, Brazil
| | - Aline Prieto Silveira-Ciola
- School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), São Paulo State University (Unesp), Bauru, SP, Brazil
| | - Camila Torriani-Pasin
- Department of Physical Therapy and Movement Sciences, University of Texas, El Paso, USA
| | - Lucas Simieli
- School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), São Paulo State University (Unesp), Bauru, SP, Brazil
| | - Fabio Augusto Barbieri
- School of Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), São Paulo State University (Unesp), Bauru, SP, Brazil
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16
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Yuan Y, Wang J, Wang G, Wang T, Zhang H, Fu X, Wu L, Chen X, Xia R, Zhang L, Lin SC, Yang Y. Optimal dosage ranges of various exercise types for enhancing timed up and go performance in Parkinson's disease patients: a systematic review and Bayesian network meta-analysis. Front Aging Neurosci 2024; 16:1399175. [PMID: 38988329 PMCID: PMC11234838 DOI: 10.3389/fnagi.2024.1399175] [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: 03/11/2024] [Accepted: 06/11/2024] [Indexed: 07/12/2024] Open
Abstract
Objective To examine the dose-response relationship between specific types of exercise for alleviating Timed up and Go (TUG) in Parkinson's disease PD. Design Systematic review and Bayesian network meta-analysis. Data sources PubMed, Medline, Embase, PsycINFO, Cochrane Library, and Web of Science were searched from inception until February 5th, 2024. Study analysis Data analysis was conducted using R software with the MBNMA package. Effect sizes of outcome indicators were expressed as mean deviation (MD) and 95% confidence intervals (95% CrI). The risk of bias in the network was evaluated independently by two reviewers using ROB2. Results A total of 73 studies involving 3,354 PD patients. The text discusses dose-response relationships in improving TUG performance among PD patients across various exercise types. Notably, Aquatic (AQE), Mix Exercise (Mul_C), Sensory Exercise (SE), and Resistance Training (RT) demonstrate effective dose ranges, with AQE optimal at 1500 METs-min/week (MD: -8.359, 95% CI: -1.398 to -2.648), Mul_C at 1000 METs-min/week (MD: -4.551, 95% CI: -8.083 to -0.946), SE at 1200 METs-min/week (MD: -5.145, 95% CI: -9.643 to -0.472), and RT at 610 METs-min/week (MD: -2.187, 95% CI: -3.161 to -1.278), respectively. However, no effective doses are found for Aerobic Exercise (AE), Balance Gait Training (BGT), Dance, and Treadmill Training (TT). Mind-body exercise (MBE) shows promise with an effective range of 130 to 750 METs-min/week and an optimal dose of 750 METs-min/week (MD: -2.822, 95% CI: -4.604 to -0.996). According to the GRADE system, the included studies' overall quality of the evidence was identified moderate level. Conclusion This study identifies specific exercise modalities and dosages that significantly enhance TUG performance in PD patients. AQE emerges as the most effective modality, with an optimal dosage of 1,500 METs-min/week. MBE shows significant benefits at lower dosages, catering to patients with varying exercise capacities. RT exhibits a nuanced "U-shaped" dose-response relationship, suggesting an optimal range balancing efficacy and the risk of overtraining. These findings advocate for tailored exercise programs in PD management, emphasizing personalized prescriptions to maximize outcomes.Systematic Review Registration: International Prospective Register of Systematic Reviews (PROSPERO) (CRD42024506968).
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Affiliation(s)
- Yuan Yuan
- Department of Physical Education, Kunsan National University, Gunsan-si, Jeollabuk-do, Republic of Korea
| | - JunYu Wang
- The School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - GuoTuan Wang
- Institute of Physical Education, Henan University, Kaifeng, China
- School of Physical Education and Health, Krasnoyarsk State Pedagogical University named after V.P., Krasnoyarsk City, Russia
| | - Tao Wang
- College of Physical Education and Health, Southwest University of Science and Technology, Mianyang, China
| | - HaoYang Zhang
- Institute of Physical Education, Henan University, Kaifeng, China
| | - XueYing Fu
- Institute of Physical Education, Henan University, Kaifeng, China
| | - LiHua Wu
- The Seventh Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - XiaoTian Chen
- Second Clinical Medical College, Wenzhou Medical University, Zhejiang, China
| | - Rui Xia
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, Hefei, China
| | - Lin Zhang
- Department of Rehabilitation, West China Hospital Sichuan University Jintang Hospital, Chengdu, China
| | - Shu-Cheng Lin
- Department of Sport, Leisure and Health Management, Tainan University of Technology, Tainan City, Taiwan
| | - Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, Hefei, China
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Wu W, Chen Z, Zhou H, Wang L, Li X, Lv Y, Sun T, Yu L. Effects of Acute Ingestion of Caffeine Capsules on Muscle Strength and Muscle Endurance: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:1146. [PMID: 38674836 PMCID: PMC11054210 DOI: 10.3390/nu16081146] [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: 03/14/2024] [Revised: 04/07/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
This study aimed to explore the effects of acute ingestion of caffeine capsules on muscle strength and muscle endurance. We searched the PubMed, Web of Science, Cochrane, Scopus, and EBSCO databases. Data were pooled using the weighted mean difference (WMD) and 95% confidence interval. Fourteen studies fulfilled the inclusion criteria. The acute ingestion of caffeine capsules significantly improved muscle strength (WMD, 7.09, p < 0.00001) and muscle endurance (WMD, 1.37; p < 0.00001), especially in males (muscle strength, WMD, 7.59, p < 0.00001; muscle endurance, WMD, 1.40, p < 0.00001). Subgroup analyses showed that ≥ 6 mg/kg body weight of caffeine (WMD, 6.35, p < 0.00001) and ingesting caffeine 45 min pre-exercise (WMD, 8.61, p < 0.00001) were more effective in improving muscle strength, with the acute ingestion of caffeine capsules having a greater effect on lower body muscle strength (WMD, 10.19, p < 0.00001). In addition, the acute ingestion of caffeine capsules had a greater effect in moderate-intensity muscle endurance tests (WMD, 1.76, p < 0.00001). An acute ingestion of caffeine capsules significantly improved muscle strength and muscle endurance in the upper body and lower body of males.
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Affiliation(s)
- Weiliang Wu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, China;
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (L.W.); (X.L.)
| | - Zhizhou Chen
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (L.W.); (X.L.)
| | - Huixuan Zhou
- School of Sport Sciences, Beijing Sport University, Beijing 100084, China;
| | - Leiyuyang Wang
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (L.W.); (X.L.)
| | - Xiang Li
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (L.W.); (X.L.)
| | - Yuanyuan Lv
- China Institute of Sport and Health Science, Beijing Sport University, Beijing 100084, China;
| | - Tingting Sun
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, China;
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, China;
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing 100084, China; (Z.C.); (L.W.); (X.L.)
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Xu S, Xiao X, Manshaii F, Chen J. Injectable Fluorescent Neural Interfaces for Cell-Specific Stimulating and Imaging. NANO LETTERS 2024. [PMID: 38606614 DOI: 10.1021/acs.nanolett.4c00815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Building on current explorations in chronic optical neural interfaces, it is essential to address the risk of photothermal damage in traditional optogenetics. By focusing on calcium fluorescence for imaging rather than stimulation, injectable fluorescent neural interfaces significantly minimize photothermal damage and improve the accuracy of neuronal imaging. Key advancements including the use of injectable microelectronics for targeted electrical stimulation and their integration with cell-specific genetically encoded calcium indicators have been discussed. These injectable electronics that allow for post-treatment retrieval offer a minimally invasive solution, enhancing both usability and reliability. Furthermore, the integration of genetically encoded fluorescent calcium indicators with injectable bioelectronics enables precise neuronal recording and imaging of individual neurons. This shift not only minimizes risks such as photothermal conversion but also boosts safety, specificity, and effectiveness of neural imaging. Embracing these advancements represents a significant leap forward in biomedical engineering and neuroscience, paving the way for advanced brain-machine interfaces.
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Affiliation(s)
- Shumao Xu
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Xiao Xiao
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Farid Manshaii
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
| | - Jun Chen
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California 90095, United States
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19
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Du L, Xi H, Zhang S, Zhou Y, Tao X, Lv Y, Hou X, Yu L. Effects of exercise in people with multiple sclerosis: a systematic review and meta-analysis. Front Public Health 2024; 12:1387658. [PMID: 38660348 PMCID: PMC11039920 DOI: 10.3389/fpubh.2024.1387658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
Background A growing body of studies have examined the effect of exercise in people with multiple sclerosis (MS), while findings of available studies were conflicting. This meta-analysis aimed to explore the effects of exercise on balance, walking ability, walking endurance, fatigue, and quality of life in people with MS. Methods We searched PubMed, Web of Science, Scopus, and Cochrane databases, through March 1, 2024. Inclusion criteria were: (1) RCTs; (2) included an intervention and control group; (3) had people with MS as study subjects; (4) had balance, walking ability, walking endurance, fatigue, or quality of life as the outcome measures. Exclusion criteria were: (1) non-English publications; (2) animal model publications; (3) review articles; and (4) conference articles. A meta-analysis was conducted to calculate weighted mean difference (WMD) and 95% confidence interval (CI). Cochrane risk assessment tool and Physiotherapy Evidence Database (PEDro) scale were used to evaluate the methodological quality of the included studies. Results Forty studies with a total of 56 exercise groups (n = 1,300) and 40 control groups (n = 827) were eligible for meta-analysis. Exercise significantly improved BBS (WMD, 3.77; 95% CI, 3.01 to 4.53, P < 0.00001), TUG (WMD, -1.33; 95% CI, -1.57 to -1.08, P < 0.00001), MSWS-12 (WMD, -2.57; 95% CI, -3.99 to -1.15, P = 0.0004), 6MWT (WMD, 25.56; 95% CI, 16.34 to 34.79, P < 0.00001), fatigue (WMD, -4.34; 95% CI, -5.83 to -2.84, P < 0.00001), and MSQOL-54 in people with MS (WMD, 11.80; 95% CI, 5.70 to 17.90, P = 0.0002) in people with MS. Subgroup analyses showed that aerobic exercise, resistance exercise, and multicomponent training were all effective in improving fatigue in people with MS, with resistance exercise being the most effective intervention type. In addition, a younger age was associated with a larger improvement in fatigue. Furthermore, aerobic exercise and multicomponent training were all effective in improving quality of life in people with MS, with aerobic exercise being the most effective intervention type. Conclusion Exercise had beneficial effects in improving balance, walking ability, walking endurance, fatigue, and quality of life in people with MS. Resistance exercise and aerobic exercise are the most effective interventions for improving fatigue and quality of life in people with MS, respectively. The effect of exercise on improving fatigue was associated with the age of the participants, with the younger age of the participants, the greater the improvement in fatigue. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=371056, identifier: CRD42022371056.
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Affiliation(s)
- Liwen Du
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Haoyu Xi
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Shiyan Zhang
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Yilun Zhou
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Xifeng Tao
- School of Physical Education, Xihua University, Chengdu, China
| | - Yuanyuan Lv
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Xiao Hou
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- School of Sport Sciences, Beijing Sport University, Beijing, China
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
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20
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McMahon L, McGrath D, Blake C, Lennon O. Responsiveness of respiratory function in Parkinson's Disease to an integrative exercise programme: A prospective cohort study. PLoS One 2024; 19:e0301433. [PMID: 38551984 PMCID: PMC10980210 DOI: 10.1371/journal.pone.0301433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/15/2024] [Indexed: 04/01/2024] Open
Abstract
INTRODUCTION Respiratory disorders are the most common cause of death in Parkinson's Disease (PD). Conflicting data exist on the aetiology of respiratory dysfunction in PD and few studies examine the effects of exercise-based interventions on respiratory measures. This study was conducted to better understand respiratory dysfunction in PD and to identify measures of dysfunction responsive to an integrative exercise programme. OBJECTIVES The objectives were to compare baseline respiratory measures with matched, published population norms and to examine immediate and longer-term effects of a 12-week integrated exercise programme on these measures. DESIGN Twenty-three people with mild PD (median Hoehn & Yahr = 2) self-selected to participate in this exploratory prospective cohort study. Evaluation of participants occurred at three time points: at baseline; following the 12-week exercise programme and at 4-month follow-up. OUTCOME MEASURES Outcome measures included: Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), FEV1/FVC ratio, Peak Expiratory Flow (PEF), Inspiratory Muscle Strength (MIP), Expiratory Muscle Strength (MEP), Peak Cough Flow (PCF), and Cardiovascular Fitness measures of estimated VO2 max and 6-Minute Walk Test (6MWT). RESULTS Compared to published norms, participants had impaired cough, reduced respiratory muscle strength, FEV, FVC, PEF and cardiovascular fitness. Post exercise intervention, statistically significant improvements were noted in MEP, cardiovascular fitness, and PEF. However only gains in PEF were maintained at 4-month follow-up. CONCLUSIONS Significant respiratory dysfunction exists, even in the early stages of PD. Metrics of respiratory muscle strength, peak expiratory flow and cardiovascular fitness appear responsive to an integrative exercise programme.
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Affiliation(s)
- Laura McMahon
- Health Sciences Centre, UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Denise McGrath
- Health Sciences Centre, UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Catherine Blake
- Health Sciences Centre, UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
| | - Olive Lennon
- Health Sciences Centre, UCD School of Public Health, Physiotherapy and Population Science, University College Dublin, Dublin, Ireland
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21
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Zhang Z, Wu Z, Hu S, He M. Identification of serum microRNA alterations associated with long-term exercise-induced motor improvements in patients with Parkinson disease. Medicine (Baltimore) 2024; 103:e37470. [PMID: 38552099 PMCID: PMC10977540 DOI: 10.1097/md.0000000000037470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/12/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Long-term physical exercise has been shown to benefit patients with Parkinson disease (PD), but there is a lack of evidence regarding the underlying mechanism. A better understanding of how such benefits are induced by exercise might contribute to the development of therapeutic targets for improving the motor function in individuals with PD. The purpose of this study was therefore to investigate the possible association between exercise-induced motor improvements and the changes in serum microRNA (miRNA) levels of PD patients through small RNA sequencing for the first time. METHODS Thirteen PD patients completed our 3-month home-and-community-based exercise program, while 6 patients were assigned to the control group. Motor functions were measured, and small RNA sequencing with data analysis was performed on serum miRNAs both before and after the program. The results were further validated by quantitative real-time polymerase chain reaction. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were then conducted to determine the role of differentially expressed miRNAs. RESULTS The 3-month home-and-community-based exercise program induced significant motor improvements in PD patients in terms of Unified Parkinson's Disease Rating Scale activities of daily living and Motor Subscale (P < .05), comfortable walking speed (P = .003), fast walking speed (P = .028), Six-Minute Walk Test (P = .004), Berg Balance Scale (P = .039), and Timed Up and Go (P = .002). A total of 11 miRNAs (10 upregulated and one downregulated) were identified to be remarkably differentially expressed after intervention in the exercise group, but not in the control group. The results of miRNA sequencing were further validated by quantitative real-time polymerase chain reaction. It was found that the targets of altered miRNAs were mostly enriched in the mitogen-activated protein kinase, Wnt, and Hippo signaling pathways and the GO annotations mainly included binding, catalytic activity, and transcription regulator activity. CONCLUSION The exercise-induced motor improvements were possibly associated with changes in circulating miRNA levels in PD patients. These miRNAs, as well as the most enriched pathways and GO terms, may play a critical role in the mechanism of exercise-induced benefits in PD and serve as novel treatment targets for the disease, although further investigations are needed.
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Affiliation(s)
- Ziyi Zhang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ziwei Wu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shenglan Hu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Miao He
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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22
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Qiu B, Zhou Y, Tao X, Hou X, Du L, Lv Y, Yu L. The effect of exercise on flow-mediated dilation in people with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne) 2024; 15:1347399. [PMID: 38596227 PMCID: PMC11002232 DOI: 10.3389/fendo.2024.1347399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/11/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction An increasing number of studies have investigated the effect of exercise on flow-mediated dilation (FMD) in people with type 2 diabetes mellitus (T2DM), while the findings were controversial. The primary aim of this systematic review and meta-analysis was to investigate the effect of exercise on FMD in T2DM patients, and the secondary aim was to investigate the optimal type, frequency, session duration, and weekly time of exercise for T2DM patients. Methods Searches were conducted in PubMed, Cochrane Library, Scopus, Web of Science, Embase and EBSCO databases. The Cochrane risk of bias tool (RoB2) in randomized trial and Physiotherapy Evidence Database (PEDro) scale were used to assess the methodological quality of the included studies. Results From the 3636 search records initially retrieved, 13 studies met the inclusion criteria. Our meta-analysis revealed that exercise had a significant effect on improving FMD in T2DM patients [WMD, 2.18 (95% CI, 1.78-2.58), p < 0.00001, I2 = 38%], with high-intensity interval training (HIIT) being the most effective intervention type [HIIT, 2.62 (1.42-3.82); p < 0.0001; aerobic exercise, 2.20 (1.29-3.11), p < 0.00001; resistance exercise, 1.91 (0.01-3.82), p = 0.05; multicomponent training, 1.49 (0.15-2.83), p = 0.03]. In addition, a higher frequency [> 3 times, 3.06 (1.94-4.19), p < 0.00001; ≤ 3 times, 2.02 (1.59-2.45), p < 0.00001], a shorter session duration [< 60 min, 3.39 (2.07-4.71), p < 0.00001; ≥ 60 min, 1.86 (1.32-2.40), p < 0.00001], and a shorter weekly time [≤ 180 min, 2.40 (1.63-3.17), p < 0.00001; > 180 min, 2.11 (0.82-3.40), p = 0.001] were associated with larger improvements in FMD. Conclusion This meta-analysis provides clinicians with evidence to recommended that T2DM patients participate in exercise, especially HIIT, more than 3 times per week for less than 60 min, with a target of 180 min per week being reached by increasing the frequency of exercise. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42023466575.
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Affiliation(s)
- Bopeng Qiu
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Yilun Zhou
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Xifeng Tao
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
- School of Physical Education, Xihua University, Chengdu, China
| | - Xiao Hou
- School of Sport Sciences, Beijing Sport University, Beijing, China
| | - Liwen Du
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Laikang Yu
- Department of Strength and Conditioning Assessment and Monitoring, Beijing Sport University, Beijing, China
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Cilia R, Dekker MCJ, Cubo E, Agoriwo MW. Delivery of Allied Health Therapies to People with Parkinson's Disease in Africa. JOURNAL OF PARKINSON'S DISEASE 2024; 14:S227-S239. [PMID: 38143371 PMCID: PMC11380278 DOI: 10.3233/jpd-230262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
Allied health therapies refer to a range of healthcare professionals, including physiotherapists, occupational and speech-language therapists, who aim to optimize daily function and quality of life in conjunction with medical care. In this narrative review of literature on allied health therapies in people with Parkinson's disease (PD), we focused on the diversity in healthcare access, state of the art, current challenges in the African continent, and proposed solutions and future perspectives. Despite the increasing prevalence and awareness of PD in Africa, numerous challenges persist in its management. These include resource limitations, geographical barriers, sociocultural beliefs, and economic constraints. Nevertheless, innovative solutions, including telerehabilitation and community-based rehabilitation, offer hope. Collaborative efforts within the continent and internationally have shown potential in bridging training and resource gaps. Significant strides can be made with tailored interventions, technological advancements, and multifaceted collaborations. This review offers practical insights for healthcare professionals, policymakers, and caregivers to navigate and optimize PD care in the African context.
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Affiliation(s)
- Roberto Cilia
- Department of Clinical Neurosciences, Parkinson and Movement Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Marieke C J Dekker
- Department of Medicine and Pediatrics, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Esther Cubo
- Neurology Department, Hospital Universitario Burgos, Burgos, Spain
| | - Mary W Agoriwo
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho, Ghana
- Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa
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24
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Li J, Aulakh N, Culum I, Roberts AC. Adherence to Non-Pharmacological Interventions in Parkinson's Disease: A Rapid Evidence Assessment of the Literature. JOURNAL OF PARKINSON'S DISEASE 2024; 14:S35-S52. [PMID: 38640167 PMCID: PMC11380228 DOI: 10.3233/jpd-230266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Background Low adherence to non-pharmacological interventions can impact treatment effectiveness. Yet, there is limited information on adherence barriers and facilitators to non-pharmacological interventions in Parkinson's disease (PD). Objective 1) To examine the quality of adherence reporting and 2) to identify key determinants of adherence to PD non-pharmacological interventions. Methods A rapid evidence assessment was conducted, following PRISMA guidelines, that included controlled studies of exercise, physiotherapy, occupational therapy, speech-language therapy with explicit reporting of 'adherence' OR 'compliance', published in the last 15 years. Data extracted included: adherence rates, adherence outcomes, and factors associated with adherence. A collaborative thematic analysis was conducted to identify determinants of adherence. Results The search yielded 2,445 articles of which 114 met criteria for full screening with 45 studies meeting all inclusion criteria. High quality adherence data that aligned with the intervention goals were reported by 22.22%(N = 10) of studies, with the majority reporting attendance/attrition rates only 51.11%(N = 23). Four major themes (34 subthemes) emerged: disease and health, personal, program design, and system and environmental. Conclusions There has been limited progress in the quality of adherence reporting in PD non-pharmacological interventions over the last decade. Acknowledging this limitation, key determinants of adherence included: alignment with personal beliefs, attitudes, and expectations; the demands of the intervention and worsening disease symptoms and personal/time obligations; and accessibility and safety concerns. Program design elements found to facilitate adherence included: opportunities for social engagement and in-person offerings linked to higher levels of interventionist support, performative feedback, and social reinforcement.
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Affiliation(s)
- John Li
- Faculty of Health Sciences, Western University, School of Communication Sciences and Disorders, London, ON, Canada
| | - Nimrit Aulakh
- Faculty of Health Sciences, Western University, School of Communication Sciences and Disorders, London, ON, Canada
| | - Ivan Culum
- Faculty of Health Sciences, Western University, School of Communication Sciences and Disorders, London, ON, Canada
- Canadian Centre for Activity and Aging, London, ON, Canada
| | - Angela C Roberts
- Faculty of Health Sciences, Western University, School of Communication Sciences and Disorders, London, ON, Canada
- Department of Computer Science, Faculty of Science, Western University, London, ON, Canada
- Canadian Centre for Activity and Aging, London, ON, Canada
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Herman T, Barer Y, Bitan M, Sobol S, Giladi N, Hausdorff JM. A meta-analysis identifies factors predicting the future development of freezing of gait in Parkinson's disease. NPJ Parkinsons Dis 2023; 9:158. [PMID: 38049430 PMCID: PMC10696025 DOI: 10.1038/s41531-023-00600-2] [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: 06/11/2023] [Accepted: 11/02/2023] [Indexed: 12/06/2023] Open
Abstract
Freezing of gait (FOG) is a debilitating problem that is common among many, but not all, people with Parkinson's disease (PD). Numerous attempts have been made at treating FOG to reduce its negative impact on fall risk, functional independence, and health-related quality of life. However, optimal treatment remains elusive. Observational studies have recently investigated factors that differ among patients with PD who later develop FOG, compared to those who do not. With prediction and prevention in mind, we conducted a systematic review and meta-analysis of publications through 31.12.2022 to identify risk factors. Studies were included if they used a cohort design, included patients with PD without FOG at baseline, data on possible FOG predictors were measured at baseline, and incident FOG was assessed at follow-up. 1068 original papers were identified, 38 met a-priori criteria, and 35 studies were included in the meta-analysis (n = 8973; mean follow-up: 4.1 ± 2.7 years). Factors significantly associated with a risk of incident FOG included: higher age at onset of PD, greater severity of motor symptoms, depression, anxiety, poorer cognitive status, and use of levodopa and COMT inhibitors. Most results were robust in four subgroup analyses. These findings indicate that changes associated with FOG incidence can be detected in a subset of patients with PD, sometimes as long as 12 years before FOG manifests, supporting the possibility of predicting FOG incidence. Intriguingly, some of these factors may be modifiable, suggesting that steps can be taken to lower the risk and possibly even prevent the future development of FOG.
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Affiliation(s)
- Talia Herman
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Yael Barer
- Maccabitech, Maccabi Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Michal Bitan
- School of Computer Science, The College of Management, Rishon LeZion, Israel
| | - Shani Sobol
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Nir Giladi
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Neurology, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
- Department of Orthopedic Surgery and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
- Department of Physical Therapy, Faculty of Medicine, Tel Aviv, Israel.
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Yang Y, Wang Y, Gao T, Reyila A, Liu J, Liu J, Han H. Effect of Physiotherapy Interventions on Motor Symptoms in People With Parkinson's Disease: A Systematic Review and Meta-Analysis. Biol Res Nurs 2023; 25:586-605. [PMID: 37070664 DOI: 10.1177/10998004231171587] [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: 04/19/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of different types of physiotherapy interventions in people with Parkinson's disease (PD). DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS Five databases (PubMed, Embase, Cochrane Library, CINAHL and Web of Science Core Collection) were searched for relevant RCTs published from database inception to July 14, 2022. Reviewers independently screened the literature, extracted data, and assessed the literature quality according to the Cochrane Collaboration Risk of Bias Tool and PEDro Scale. This meta-analysis was conducted using RevMan 5.4.1 and reported in compliance with the PRISMA statement. RESULTS Forty-two RCTs with 2,530 participants were included. Across all types of physiotherapy, strength training, mind-body exercise, aerobic exercise, and non-invasive brain stimulation (NiBS) were effective in improving motor symptoms as measured by the (Movement Disorders Society-) Unified PD Scale, whereas balance and gait training (BGT) and acupuncture were not. The pooled results showed that the change in mind-body exercise (MD = -5.36, 95% CI [-7.97 to -2.74], p < .01, I2 = 68%) and NiBS (MD = -4.59, 95% CI [-8.59 to -0.59], p = .02, I2 = 78%) reached clinical threshold, indicating clinically meaningful improvements. Considering the effectiveness of the interventions on motor symptoms, balance, gait and functional mobility, mind-body exercise was recommended the most. CONCLUSIONS Exercise appears to be a better form of physiotherapy than NiBS and acupuncture for improving motor function. Mind-body exercise showed beneficial effects on motor symptoms, balance, gait and functional mobility in people with PD, and is worthy of being promoted.
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Affiliation(s)
- Yajie Yang
- School of Nursing, Peking University, Beijing 100191, China
| | - Yang Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
| | - Tianzi Gao
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
| | | | - Jiaxin Liu
- Xiangya School of Nursing, Central South University, Changsha 410013, China
| | - Jiajia Liu
- School of Nursing, Peking University, Beijing 100191, China
| | - Hongbin Han
- Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
- Department of Radiology, Peking University Third Hospital, Beijing 100191, China
- NMPA Key Laboratory for Evaluation of Medical Imaging Equipment and Technique, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging Technology, Beijing 100191, China
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Smith JAB, Murach KA, Dyar KA, Zierath JR. Exercise metabolism and adaptation in skeletal muscle. Nat Rev Mol Cell Biol 2023; 24:607-632. [PMID: 37225892 PMCID: PMC10527431 DOI: 10.1038/s41580-023-00606-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 05/26/2023]
Abstract
Viewing metabolism through the lens of exercise biology has proven an accessible and practical strategy to gain new insights into local and systemic metabolic regulation. Recent methodological developments have advanced understanding of the central role of skeletal muscle in many exercise-associated health benefits and have uncovered the molecular underpinnings driving adaptive responses to training regimens. In this Review, we provide a contemporary view of the metabolic flexibility and functional plasticity of skeletal muscle in response to exercise. First, we provide background on the macrostructure and ultrastructure of skeletal muscle fibres, highlighting the current understanding of sarcomeric networks and mitochondrial subpopulations. Next, we discuss acute exercise skeletal muscle metabolism and the signalling, transcriptional and epigenetic regulation of adaptations to exercise training. We address knowledge gaps throughout and propose future directions for the field. This Review contextualizes recent research of skeletal muscle exercise metabolism, framing further advances and translation into practice.
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Affiliation(s)
- Jonathon A B Smith
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Kevin A Murach
- Molecular Mass Regulation Laboratory, Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Kenneth A Dyar
- Metabolic Physiology, Institute for Diabetes and Cancer, Helmholtz Diabetes Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Juleen R Zierath
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Chen Y, Su Q, Yang J, Li G, Zhang S, Lv Y, Yu L. Effects of rest interval and training intensity on jumping performance: a systematic review and meta-analysis investigating post-activation performance enhancement. Front Physiol 2023; 14:1202789. [PMID: 37427408 PMCID: PMC10328417 DOI: 10.3389/fphys.2023.1202789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/15/2023] [Indexed: 07/11/2023] Open
Abstract
Background: There is no clear agreement regarding the ideal rest interval and training intensity to optimize post-activation performance enhancement (PAPE) after barbell squat (BS). Therefore, the aim of this study was to investigate the effects of rest interval and training intensity on jumping performance due to PAPE. Methods: Searches were performed in PubMed, Web of Science, and EBSCO databases. We included studies that satisfied the following criteria: (1) eligible studies should be randomized controlled trials; (2) eligible studies should investigate the acute effect of barbell squat-induced PAPE on jump performance; (3) eligible studies should use countermovement jump, squat jump, or vertical jump as the outcome measure. Results: From 2518 search records initially identified, 19 studies were eligible for meta-analysis. Our meta-analysis results showed that BS had no significant effect on improving jumping performance due to PAPE (Cohen's d = 0.09, p = 0.08). Subgroup analysis showed that rest interval between 0-1 min was detrimental to jumping performance (Cohen's d = -0.33, p < 0.01), while rest intervals between 4-7 min (Cohen's d = 0.31, p < 0.01) and 8-9 min (Cohen's d = 0.26, p = 0.02) provided favorable jumping performance outcomes. In addition, low-intensity and moderate-intensity BS had no significant effect on jump performance, while high-intensity BS showed results consistent with rest interval. Conclusion: Our study indicated that both low-intensity and moderate-intensity BS failed to induce PAPE, and it is recommended that future studies use high-intensity BS to induce PAPE. A rest interval of 4-9 min had a beneficial impact on jump height, and an interval range of 4-7 min seems to be the best rest interval between conditioning activity and jumping performance.
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Affiliation(s)
- Yiyan Chen
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Qing Su
- Ersha Sports Training Center of Guangdong Province, Guangzhou, China
| | - Juan Yang
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Gen Li
- Department of Sports Performance, Beijing Sport University, Beijing, China
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Shiyan Zhang
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
- Department of Sports Performance, Beijing Sport University, Beijing, China
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Santiago JA, Potashkin JA. Physical activity and lifestyle modifications in the treatment of neurodegenerative diseases. Front Aging Neurosci 2023; 15:1185671. [PMID: 37304072 PMCID: PMC10250655 DOI: 10.3389/fnagi.2023.1185671] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/03/2023] [Indexed: 06/13/2023] Open
Abstract
Neurodegenerative diseases have reached alarming numbers in the past decade. Unfortunately, clinical trials testing potential therapeutics have proven futile. In the absence of disease-modifying therapies, physical activity has emerged as the single most accessible lifestyle modification with the potential to fight off cognitive decline and neurodegeneration. In this review, we discuss findings from epidemiological, clinical, and molecular studies investigating the potential of lifestyle modifications in promoting brain health. We propose an evidence-based multidomain approach that includes physical activity, diet, cognitive training, and sleep hygiene to treat and prevent neurodegenerative diseases.
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Affiliation(s)
| | - Judith A. Potashkin
- Center for Neurodegenerative Diseases and Therapeutics, Cellular and Molecular Pharmacology Department, The Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
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30
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Li G, You Q, Hou X, Zhang S, Du L, Lv Y, Yu L. The effect of exercise on cognitive function in people with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials. J Neurol 2023; 270:2908-2923. [PMID: 36864256 DOI: 10.1007/s00415-023-11649-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE A growing body of research examining the effect of exercise on cognitive function in people with multiple sclerosis (MS), while findings of available studies were conflicting. We aimed to explore the effect of exercise on cognitive function in MS patients. METHODS For this systematic review and meta-analysis, we searched PubMed, Web of Science, EBSCO, Cochrane, and Scopus electronic databases, through July 18, 2022. Cochrane risk assessment tool was used to evaluate the methodological quality of the included literature. RESULTS Twenty-one studies with a total of 23 experimental groups and 21 control groups met the inclusion criteria. There was a significant effect of exercise on improving cognitive function in MS patients, while the effect size was small (Cohen's d = 0.20, 95% CI 0.06-0.34, p < 0.001, I2 = 39.31%). Subgroup analysis showed that exercise significantly improved memory (Cohen's d = 0.17, 95% CI 0.02-0.33, p = 0.03, I2 = 7.59%). In addition, multicomponent training, exercise conducted 8 weeks and 10 weeks, up to 60 min per session, 3 times or more per week, 180 min or more per week increased cognitive function significantly. Furthermore, a worse basal MS status (defined by the Expanded Disability Status Scale) and an older age were associated with greater improvement in cognitive function. CONCLUSION MS patients are recommended to participate in at least three multicomponent training sessions per week, with each session lasting up to 60 min, and the exercise goal of 180 min per week can be achieved by increasing the frequency of exercise. Exercise lasting 8 or 10 weeks is best for cognitive function improvement. Additionally, a worse basal MS status, or the older the age, the greater effect on cognitive function.
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Affiliation(s)
- Gen Li
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China.,School of Physical Education & Sports Science, South China Normal University, Guangzhou, China
| | - Qiuping You
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China
| | - Xiao Hou
- School of Sport Sciences, Beijing Sport University, Beijing, China
| | - Shiyan Zhang
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Liwen Du
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China. .,China Institute of Sport and Health Science, Beijing Sport University, Beijing, China.
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China. .,Department of Sports Performance, Beijing Sport University, Beijing, China.
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31
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Tao X, Chen Y, Zhen K, Ren S, Lv Y, Yu L. Effect of continuous aerobic exercise on endothelial function: A systematic review and meta-analysis of randomized controlled trials. Front Physiol 2023; 14:1043108. [PMID: 36846339 PMCID: PMC9950521 DOI: 10.3389/fphys.2023.1043108] [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: 09/13/2022] [Accepted: 02/01/2023] [Indexed: 02/12/2023] Open
Abstract
Background: Current research suggests that continuous aerobic exercise can be effective in improving vascular endothelial function, while the effect between different intensities and durations of exercise is unclear. The aim of this study was to explore the effect of different durations and intensities of aerobic exercise on vascular endothelial function in different populations. Methods: Searches were performed in PubMed, Web of Science, and EBSCO databases. We included studies that satisfied the following criteria: 1) randomized controlled trials (RCTs); 2) including both an intervention and control group; 3) using flow-mediated dilation (FMD) as the outcome measure; and 4) testing FMD on the brachial artery. Results: From 3,368 search records initially identified, 41 studies were eligible for meta-analysis. There was a significant effect of continuous aerobic exercise on improving flow-mediated dilation (FMD) [weighted mean difference (WMD), 2.55, (95% CI, 1.93-3.16), p < 0.001]. Specifically, moderate-intensity [2.92 (2.02-3.825), p < 0.001] and vigorous-intensity exercise [2.58 (1.64-3.53), p < 0.001] significantly increased FMD. In addition, a longer duration [<12 weeks, 2.25 (1.54-2.95), p < 0.001; ≥12 weeks, 2.74 (1.95-3.54), p < 0.001], an older age [age <45, 2.09 (0.78-3.40), p = 0.002; 45 ≤ age <60, 2.25 (1.49-3.01), p < 0.001; age ≥60, 2.62 (1.31-3.94), p < 0.001], a larger basal body mass index (BMI) [20 < BMI < 25, 1.43 (0.98-1.88), p < 0.001; 25 ≤ BMI < 30, 2.49 (1.07-3.90), p < 0.001; BMI ≥ 30, 3.05 (1.69-4.42), p < 0.001], and a worse basal FMD [FMD < 4, 2.71 (0.92-4.49), p = 0.003; 4 ≤ FMD < 7, 2.63 (2.03-3.23), p < 0.001] were associated with larger improvements in FMD. Conclusion: Continuous aerobic exercise, especially moderate-intensity and vigorous-intensity aerobic exercise, contributed to improving FMD. The effect of continuous aerobic exercise on improving FMD was associated with duration and participant's characteristics. Specifically, a longer duration, an older age, a larger basal BMI, and a worse basal FMD contributed to more significant improvements in FMD. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=341442], identifier [CRD42022341442].
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Affiliation(s)
- Xifeng Tao
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China,Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Yiyan Chen
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Kai Zhen
- Department of Sports Performance, Beijing Sport University, Beijing, China
| | - Shiqi Ren
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Yuanyuan Lv
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China,China Institute of Sport and Health Science, Beijing Sport University, Beijing, China,*Correspondence: Yuanyuan Lv, ; Laikang Yu,
| | - Laikang Yu
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing, China,Department of Sports Performance, Beijing Sport University, Beijing, China,*Correspondence: Yuanyuan Lv, ; Laikang Yu,
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32
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Fabbri M, Barbosa R, Rascol O. Off-time Treatment Options for Parkinson's Disease. Neurol Ther 2023; 12:391-424. [PMID: 36633762 PMCID: PMC10043092 DOI: 10.1007/s40120-022-00435-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023] Open
Abstract
Motor fluctuations (MF) are deemed by patients with Parkinson's disease (PD) as the most troublesome disease feature resulting from the increasing impairment in responsiveness to dopaminergic drug treatments. MF are characterized by the loss of a stable response to levodopa over the nychthemeron with the reappearance of motor (and non-motor) parkinsonian clinical signs at various moments during the day and night. They normally appear after a few years of levodopa treatment and with a variable, though overall increasing severity, over the disease course. The armamentarium of first-line treatment options has widened in the last decade with new once-a-daily compounds, including a catechol O-methyltransferase inhibitor - Opicapone-, two MAO-B inhibitors plus channel blocker - Zonisamide and Safinamide and one amantadine extended-release formulation - ADS5012. In addition to apomorphine injection or oral levodopa dispersible tablets, which have been available for a long time, new on-demand therapies such as apomorphine sublingual or levodopa inhaled formulations have recently shown efficacy as rescue therapies for Off-time treatment. When the management of MF becomes difficult in spite of oral/on-demand options, more complex therapies should be considered, including surgical, i.e. deep brain stimulation, or device-aided therapies with pump systems delivering continuous subcutaneous or intestinal levodopa or subcutaneous apomorphine formulation. Older and less commonly used ablative techniques (radiofrequency pallidotomy) may also be effective while there is still scarce data regarding Off-time reduction using a new lesional approach, i.e. magnetic resonance-guided focused ultrasound. The choice between the different advanced therapies options is a shared decision that should consider physician opinion on contraindication/main target symptom, patients' preference, caregiver's availability together with public health systems and socio-economic environment. The choice of the right/first add-on treatment is still a matter of debate as well as the proper time for an advanced therapy to be considered. In this narrative review, we discuss all the above cited aspects of MF in patients with PD, including their phenomenology, management, by means of pharmacological and advanced therapies, on-going clinical trials and future research and treatment perspectives.
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Affiliation(s)
- Margherita Fabbri
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre, Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN), French NS-Park/F-CRIN Network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France.
| | - Raquel Barbosa
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre, Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN), French NS-Park/F-CRIN Network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France.,Department of Neurology, Hospital de Egas Moniz Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal.,NOVA Medical School, Faculdade de Ciências Médicas Universidade Nova de Lisboa, Lisbon, Portugal
| | - Olivier Rascol
- Department of Clinical Pharmacology and Neurosciences, Toulouse Parkinson Expert Centre, Toulouse NeuroToul Center of Excellence in Neurodegeneration (COEN), French NS-Park/F-CRIN Network, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France
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33
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Ineichen C, Vogel-Baumann H, Sitzler M, Deuschl G, Baumann CR. Worsening of Parkinson's Disease After Termination of COVID-19 Quarantine Cannot Be Reversed Despite Resumption of Physiotherapy. JOURNAL OF PARKINSON'S DISEASE 2023; 13:845-848. [PMID: 37270811 PMCID: PMC10473119 DOI: 10.3233/jpd-230061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/13/2023] [Indexed: 06/06/2023]
Abstract
In a retrospective analysis, we recently reported findings on the detrimental motor effects of interrupted physiotherapy following the COVID-19 pandemic in parkinsonian patients. Using an extended follow-up period, we investigated the beneficial effect of reinstated physiotherapy on patients' disease severity and reversal of interruption-induced motor deterioration. Compared to before the COVID-19 outbreak, we observed persistence of motor disease worsening despite full resumption of state-of-the-art physical therapy suggesting that motor deterioration after discontinuation of physical therapy could not be compensated for. Therefore, and considering possible future crises, establishing means to safeguard continuation of physical therapy and to foster remote provision of care should be major goals.
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Affiliation(s)
- Christian Ineichen
- Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland
| | - Heide Vogel-Baumann
- Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland
| | - Matthias Sitzler
- Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland
| | - Günther Deuschl
- Department of Neurology, UKSH, Christian-Albrechts-University Kiel, Germany
| | - Christian R. Baumann
- Department of Neurology, University Hospital Zurich, University of Zurich, Switzerland
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