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Hammam N, Becher H, Andersen J, Manns PJ, Whittaker JL, Pritchard L. Early indicators of cardiovascular disease are evident in children and adolescents with cerebral palsy. Disabil Health J 2021; 14:101112. [PMID: 34016565 DOI: 10.1016/j.dhjo.2021.101112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is a leading cause of early mortality among young adults with cerebral palsy. While low physical activity in childhood has been hypothesized as a potential contributor to increased CVD risk in early adulthood, little is known about timing of vascular disease progression and the presence of subclinical atherosclerosis has not been extensively evaluated in children with cerebral palsy. OBJECTIVE The aim of this study was to determine if measures of vascular structure and function are different between children and adolescents with and without cerebral palsy. METHODS In this cross-sectional study, we measured carotid intima-media thickness (CIMT), and brachial artery flow-mediated dilation (FMD) of children with and without cerebral palsy. Group means for CIMT and brachial artery FMD absolute (FMDA) and percent of relative change (FMDR%) were compared using Wilcoxon rank-sum tests. RESULTS A total of 26 children and adolescents with cerebral palsy (46.1% girls, mean age = 15.0 ± 2.0 years) and 19 controls (68.4% girls, mean age = 13.3 ± 2.6 years) participated. Children with cerebral palsy had significantly greater average CIMT (0.43 ± 0.02 mm) than children without cerebral palsy (0.41 ± 0.01 mm, p = 0.04), and lower FMDA (0.16 ± 0.15 mm vs. 0.29 ± 0.20 mm; respectively, p = 0.03). CONCLUSIONS Children and adolescents with cerebral palsy may exhibit impairments in vascular structure and function which represent an increased risk of premature atherosclerosis compared to children without cerebral palsy. Additional research to identify risk factors specific to children with cerebral palsy that would support the development of effective screening processes for early identification would enable clinicians to implement targeted preventive strategies.
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Affiliation(s)
- Nevin Hammam
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada; Department of Rheumatology and Rehabilitation, Faculty of Medicine, Assiut University, Assiut, Egypt; Department of Rheumatology, University of California San Francisco, CA, USA
| | - Harald Becher
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada; Division of Cardiology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - John Andersen
- Department of Pediatrics, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada; Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
| | - Patricia J Manns
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada; Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada; Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Arthritis Research Canada, Richmond, BC, Canada
| | - Lesley Pritchard
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
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McPhee PG, Verschuren O, Peterson MD, Tang A, Gorter JW. The Formula for Health and Well-Being in Individuals With Cerebral Palsy: Cross-Sectional Data on Physical Activity, Sleep, and Nutrition. Ann Rehabil Med 2020; 44:301-310. [PMID: 32721989 PMCID: PMC7463117 DOI: 10.5535/arm.19156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/23/2019] [Indexed: 01/02/2023] Open
Abstract
Objective To determine physical activity, sleep, and nutrition patterns in individuals with cerebral palsy (CP) and investigate the association of Gross Motor Function Classification System (GMFCS) and age with these health behaviors. Methods A cross-sectional study was conducted in an outpatient setting. Participants included adolescents and adults with CP (n=28; GMFCS level I–V; mean age 35.1±14.4 years). An Exercise Questionnaire or Leisure Time Physical Activity Questionnaire was used to measure physical activity in adolescents and adults, respectively. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). An adapted version of the PrimeScreen questionnaire was used to assess nutrition. Linear regression analyses were performed to investigate the association between GMFCS and age with physical activity, sleep, and nutrition. Results The average total physical activity was 29.2±30.0 min/day. Seventy-five percent of the participants had poor sleep quality (PSQI score >5). Seventy-one percent reported “fair” eating behaviors; none reported “excellent” eating behaviors. Neither GMFCS nor age were significantly associated with PSQI score, PrimeScreen score, or total physical activity. A negative correlation existed between sleep quantity (hr/night) and PSQI score (r=-0.66, p=0.01). Conclusion The triad of health components, consisting of physical activity, sleep, and nutrition, was not associated with GMFCS or age in our sample of 28 individuals with CP, suggesting that these three health behaviors should be assessed during clinical encounters of CP in adolescents and adults at all levels of the GMFCS.
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Affiliation(s)
- Patrick G McPhee
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.,CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Olaf Verschuren
- Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Mark D Peterson
- Department of Physical Medicine and Rehabilitation, University of Michigan-Medicine, Ann Arbor, MI, USA
| | - Ada Tang
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Jan Willem Gorter
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.,CanChild Centre for Childhood Disability Research, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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3
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Tveten KM, Arnevik K, Jahnsen R. Goal-directed physical activities in group rehabilitation and impact on health-related quality of life and participation among young adults with physical disabilities – a qualitative study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2017. [DOI: 10.1080/21679169.2017.1304573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kine Melfald Tveten
- Children’s Physical Therapy Centre and Turbo, Bergen, Norway
- Department of Global Public Health and Primary Care, Bergen University, Bergen, Norway
| | - Kamilla Arnevik
- Children’s Physical Therapy Centre and Turbo, Bergen, Norway
| | - Reidun Jahnsen
- Department of Neurosciences for Children, Oslo University Hospital, Oslo, Norway
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Shenouda N, Gillen JB, Gibala MJ, MacDonald MJ. Changes in brachial artery endothelial function and resting diameter with moderate-intensity continuous but not sprint interval training in sedentary men. J Appl Physiol (1985) 2017; 123:773-780. [PMID: 28546466 DOI: 10.1152/japplphysiol.00058.2017] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 05/15/2017] [Accepted: 05/18/2017] [Indexed: 11/22/2022] Open
Abstract
Moderate-intensity continuous training (MICT) improves peripheral artery function in healthy adults, a phenomenon that reverses as continued training induces structural remodeling. Sprint interval training (SIT) elicits physiological adaptations similar to MICT, despite a lower exercise volume and time commitment; however, its effect on peripheral artery function and structure is largely unexplored. We compared peripheral artery responses to 12 wk of MICT and SIT in sedentary, healthy men (age = 27 ± 8 yr). Participants performed MICT (45 min of cycling at 70% peak heart rate; n = 10) or SIT (3 × 20-s "all out" cycling sprints with 2 min of recovery; n = 9), and responses were compared with a nontraining control group (CTL, n = 6). Allometrically scaled brachial flow-mediated dilation (FMD) increased 2.2% after 6 wk of MICT and returned to baseline levels by 12 wk, but did not change in SIT or CTL (group × time interaction, P = 0.04). Brachial artery diameter increased after 6 and 12 wk (main effect, P = 0.03), with the largest increases observed in MICT. Neither training protocol affected popliteal relative FMD and diameter, or central and lower limb arterial stiffness (carotid distensibility, central and leg pulse wave velocity) (P > 0.05 for all). Whereas earlier and more frequent measurements are needed to establish the potential presence and time course of arterial responses to low-volume SIT, our findings suggest that MICT was superior to the intense, but brief and intermittent SIT stimulus at inducing brachial artery responses in healthy men.NEW & NOTEWORTHY We compared the effects of 12 wk of moderate-intensity continuous training (MICT) and sprint interval training (SIT) on peripheral artery endothelial function and diameter, and central and lower limb stiffness in sedentary, healthy men. Whereas neither training program affected the popliteal artery or stiffness indexes, we observed changes in brachial artery function and diameter with MICT but not SIT. Brachial artery responses to SIT may follow a different time course or may not occur at all.
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Affiliation(s)
- Ninette Shenouda
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Jenna B Gillen
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Martin J Gibala
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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Haapala EA, Lankhorst K, de Groot J, Zwinkels M, Verschuren O, Wittink H, Backx FJ, Visser-Meily A, Takken T. The associations of cardiorespiratory fitness, adiposity and sports participation with arterial stiffness in youth with chronic diseases or physical disabilities. Eur J Prev Cardiol 2017; 24:1102-1111. [PMID: 28374647 PMCID: PMC5495431 DOI: 10.1177/2047487317702792] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The evidence on the associations of cardiorespiratory fitness, body adiposity and sports participation with arterial stiffness in children and adolescents with chronic diseases or physical disabilities is limited. Methods Altogether 140 children and adolescents with chronic diseases or physical disabilities participated in this cross-sectional study. Cardiorespiratory fitness was assessed using maximal exercise test with respiratory gas analyses either using shuttle run, shuttle ride, or cycle ergometer test. Cardiorespiratory fitness was defined as peak oxygen uptake by body weight or fat-free mass. Body adiposity was assessed using waist circumference, body mass index standard deviation score and body fat percentage. Sports participation was assessed by a questionnaire. Aortic pulse wave velocity and augmentation index were assessed by a non-invasive oscillometric tonometry device. Results Peak oxygen uptake/body weight (standardised regression coefficient β −0.222, 95% confidence interval (CI) −0.386 to −0.059, P = 0.002) and peak oxygen uptake/fat-free mass (β −0.173, 95% CI −0.329 to −0.017, P = 0.030) were inversely and waist circumference directly (β 0.245, 95% CI 0.093 to 0.414, P = 0.002) associated with aortic pulse wave velocity. However, the associations of the measures of cardiorespiratory fitness with aortic pulse wave velocity were attenuated after further adjustment for waist circumference. A higher waist circumference (β −0.215, 95% CI −0.381 to −0.049, P = 0.012) and a higher body mass index standard deviation score (β 0.218, 95% CI −0.382 to −0.054, P = 0.010) were related to lower augmentation index. Conclusions Poor cardiorespiratory fitness and higher waist circumference were associated with increased arterial stiffness in children and adolescents with chronic diseases and physical disabilities. The association between cardiorespiratory fitness and arterial stiffness was partly explained by waist circumference.
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Affiliation(s)
- Eero A Haapala
- 1 Faculty of Sport and Health Sciences, University of Jyväskylä, Finland.,2 Institute of Biomedicine, University of Eastern Finland, Finland.,3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands
| | - Kristel Lankhorst
- 4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
| | - Janke de Groot
- 3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.,4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
| | - Maremka Zwinkels
- 5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.,6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands
| | - Olaf Verschuren
- 5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands.,6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands
| | - Harriet Wittink
- 4 Research Group Lifestyle and Health, University of Applied Sciences, the Netherlands
| | - Frank Jg Backx
- 7 Department of Rehabilitation, University Medical Center Utrecht, the Netherlands
| | - Anne Visser-Meily
- 6 Center of Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, the Netherlands.,7 Department of Rehabilitation, University Medical Center Utrecht, the Netherlands
| | - Tim Takken
- 3 Child Development and Exercise Center, Wilhelmina Children's Hospital, the Netherlands.,5 Partner of Shared Utrecht Pediatric Exercise Research (SUPER) Lab, the Netherlands
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Slattery DJ, Stuckless TJR, King TJ, Pyke KE. Impaired handgrip exercise-induced brachial artery flow-mediated dilation in young obese males. Appl Physiol Nutr Metab 2016; 41:528-37. [PMID: 26985988 DOI: 10.1139/apnm-2015-0459] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Flow mediated dilation (FMD) stimulated by different shear stress stimulus profiles may recruit distinct transduction mechanisms, and provide distinct information regarding endothelial function. The purpose of this study was to determine whether obesity influences brachial artery FMD differently depending on the shear stress profile used for FMD assessment. The FMD response to a brief, intermediate, and sustained shear stress profile was assessed in obese (n = 9) and lean (n = 19) young men as follows: brief stimulus, standard reactive hyperemia (RH) following a 5 min forearm occlusion (5 min RH); intermediate stimulus, RH following a 15 min forearm occlusion (15 min RH); sustained stimulus, 10 min of handgrip exercise (HGEX). Brachial artery diameter and mean shear stress were assessed using echo and Doppler ultrasound, respectively, during each FMD test. There was no group difference in HGEX shear stress (p = 0.390); however, the obese group had a lower HGEX-FMD (5.2 ± 3.0% versus 11.5 ± 4.4%, p < 0.001). There was no group difference in 5 min RH-FMD (p = 0.466) or 15 min RH-FMD (p = 0.181); however, the shear stress stimulus was larger in the obese group. After normalization to the stimulus the 15 min RH-FMD (p = 0.002), but not the 5 min RH-FMD (p = 0.118) was lower in the obese group. These data suggest that obesity may have a more pronounced impact on the endothelium's ability to respond to prolonged increases in shear stress.
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Affiliation(s)
- David J Slattery
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada.,Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Troy J R Stuckless
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada.,Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Trevor J King
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada.,Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Kyra E Pyke
- Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada.,Cardiovascular Stress Response Laboratory, School of Kinesiology and Health Studies, Queen's University, Kingston, ON K7L 3N6, Canada
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7
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McPhee PG, Gorter JW, Cotie LM, Timmons BW, Bentley T, MacDonald MJ. Associations of non-invasive measures of arterial structure and function, and traditional indicators of cardiovascular risk in adults with cerebral palsy. Atherosclerosis 2015; 243:462-5. [DOI: 10.1016/j.atherosclerosis.2015.09.035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 09/11/2015] [Accepted: 09/29/2015] [Indexed: 10/22/2022]
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8
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Comparison of Patterns of Physical Activity and Sedentary Behavior Between Children With Cerebral Palsy and Children With Typical Development. Phys Ther 2015; 95:1609-16. [PMID: 26023216 DOI: 10.2522/ptj.20140337] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 05/21/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Reduced participation in physical activity and increased time spent in sedentary behavior are associated with overweight, chronic disease, and disability. In order to optimize recommendations and interventions to increase physical activity and reduce sedentary behavior in children with cerebral palsy (CP), knowledge of their physical activity and sedentary behavior is needed. OBJECTIVES The aim of this study was to describe light, moderate, and vigorous physical activity and sedentary behavior in preadolescent children with and without CP and compare physical activity and sedentary behavior between the 2 groups. DESIGN This was a cross-sectional study of 33 children, aged 6 to 10 years, with CP (Gross Motor Function Classification System [GMFCS] levels I-III) and 33 age- and sex-matched children with typical development. METHODS Physical activity was measured using the RT3 accelerometer over 7 days. RESULTS Children with CP spent more time in sedentary behavior and accumulated less total activity, moderate activity, vigorous activity, and sustained bouts of moderate-to-vigorous activity (MVPA). They also accumulated a fewer number of bouts of MVPA and vigorous activity, despite spending a similar amount of time in each bout. LIMITATIONS The small number of children in GMFCS levels II and III did not allow for adjustment for GMFCS level when comparing physical activity between children with and without CP. CONCLUSIONS Preadolescent children with CP spent less time in moderate and vigorous activity and more time in sedentary behavior than children with typical development. Children with CP also accumulated less continuous MVPA and vigorous activity as a result of achieving fewer sustained bouts of MVPA and vigorous activity throughout the day.
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Totosy de Zepetnek JO, Pelletier CA, Hicks AL, MacDonald MJ. Following the Physical Activity Guidelines for Adults With Spinal Cord Injury for 16 Weeks Does Not Improve Vascular Health: A Randomized Controlled Trial. Arch Phys Med Rehabil 2015; 96:1566-75. [PMID: 26070976 DOI: 10.1016/j.apmr.2015.05.019] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 04/22/2015] [Accepted: 05/27/2015] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To evaluate the effects of following the physical activity guidelines (PAG) for adults with spinal cord injury (SCI) for 16 weeks. DESIGN Randomized controlled trial. SETTING Community exercise program. PARTICIPANTS Individuals with SCI (N=23; neurological level of injury, C3-T11; American Spinal Injury Association Impairment Scale A-C; time postinjury, 12.0±9.9 y; age, 41.4±11.6 y). INTERVENTIONS Participants were randomly assigned to PAG training (n=12) or active control (n=11) groups. PAG training involved ≥20 minutes of moderate-vigorous aerobic exercise (rating of perceived exertion 3-6 on 10-point scale) and 3×10 repetitions of upper-body strengthening exercises (50%-70% 1 repetition maximum) 2 times per week. The control group maintained existing physical activity levels with no guidance on training intensity. MAIN OUTCOME MEASURES Outcome measures were obtained pre- and postintervention. Vascular health indicators included arterial stiffness via carotid distensibility and pulse wave velocity, and endothelial function via flow-mediated-dilation. Fasted blood samples were analyzed for markers of cardiovascular disease (CVD) risk. Body composition was assessed via anthropometrics and with dual-energy x-ray absorptiometry. RESULTS Twenty-one individuals completed the intervention (PAG=12, control=9). Group-by-time interactions were observed for whole-body mass (P=.03), whole-body fat (P=.04), visceral adipose tissue (P=.04), and carotid artery distensibility (P=.05), suggesting maintained body composition and carotid stiffness in the PAG group concurrent with declines in the control group. No changes were found in any other outcome measure. CONCLUSIONS While 16 weeks of adherence to the PAG in adults with SCI is insufficient to improve many markers of CVD risk, it may prevent declines in others. The PAG should continue to be promoted as a means to increase physical fitness and maintain body composition in individuals with SCI, but changes may be needed to achieve other health outcomes.
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Affiliation(s)
| | | | - Audrey L Hicks
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Endothelial function increases after a 16-week diet and exercise intervention in overweight and obese young women. BIOMED RESEARCH INTERNATIONAL 2014; 2014:327395. [PMID: 24772421 PMCID: PMC3977448 DOI: 10.1155/2014/327395] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 02/10/2014] [Indexed: 12/25/2022]
Abstract
Weight loss improves endothelial function in overweight individuals. The effects of weight loss through combined aerobic and resistance training and caloric restriction on in vivo vascular measures and blood markers associated with the regulation of endothelial function have not been comprehensively examined. Therefore, we investigated brachial artery endothelial function and potential regulatory blood markers in twenty overweight women (30.3 ± 2.0 years) who participated in 16 weeks of aerobic (5 d/wk) and resistance training (2 d/wk) (combined: ≥250 kcal/d) and caloric restriction (−500 kcal/d versus requirement). Resting brachial artery flow mediated dilation (FMD) and circulating endothelin-1 (ET-1) and interleukin-6 (IL-6) were assessed at baseline and following the intervention. Relative and absolute FMD increased (before: 4.0 ± 0.5% versus after: 6.9 ± 0.6%, P < 0.05, and before: 0.14 ± 0.02 mm versus after: 0.23 ± 0.02 mm, P < 0.05, resp.), while body mass decreased (before: 86.9 ± 2.4 kg versus after: 81.1 ± 2.4 kg, P < 0.05) following the intervention. There were no changes in either blood marker (IL-6: before: 1.5 ± 0.2 pg/mL versus after: 1.5 ± 0.1 pg/mL, P > 0.05, and ET-1: before: 0.55 ± 0.05 pg/mL versus after: 0.59 ± 0.09 pg/mL, P > 0.05). 16 weeks of combined aerobic/resistance training and diet-induced weight loss improved endothelial function in overweight and obese young women, but this increase was not associated with changes in blood markers of vasoconstriction or inflammation.
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Shimmell LJ, Gorter JW, Jackson D, Wright M, Galuppi B. "It's the participation that motivates him": physical activity experiences of youth with cerebral palsy and their parents. Phys Occup Ther Pediatr 2013; 33:405-20. [PMID: 23663137 DOI: 10.3109/01942638.2013.791916] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Youth with cerebral palsy (CP) face significant barriers to participation in physical activity (PA). There is little information available about the nature of these barriers. Seventeen (17) youth and/or their parents participated in focus groups and individual interviews to identify factors that make it easy or hard to be physically active. Four themes emerged across functional levels: environmental and personal factors, limitations related to impairment in body structure and function, the perception that health benefits alone do not motivate youth to be physically active, and variable preferences for activity delivery. Dialogue with participants revealed that interventions to promote PA in youth should mitigate the interactions between personal and environmental factors that act as barriers to PA, and enhance the interactions that facilitate PA. Partnerships between researchers, policy makers, service providers, and families must be developed to address system barriers and build capacity in youth with CP and their communities.
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Affiliation(s)
- Lorie J Shimmell
- 1School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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12
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Accelerometry: a feasible method to quantify physical activity in ambulatory and nonambulatory adolescents with cerebral palsy. Int J Pediatr 2012; 2012:329284. [PMID: 22792119 PMCID: PMC3390038 DOI: 10.1155/2012/329284] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 04/23/2012] [Indexed: 11/17/2022] Open
Abstract
Objective. To determine the feasibility of physical activity monitoring in adolescents with cerebral palsy (CP). Methods. A convenience sample of ambulatory and non-ambulatory adolescents (N = 23; 17 males, 6 females; mean age 13.5 y, SD 2.6 y; Gross Motor Function Classification System (GMFCS) distribution: n = 9 Level I, n = 5 Level II, n = 5 Level III, n = 4 Level IV) was recruited. Physical activity (PA) was objectively assessed using the ActiGraph GT1M activity monitor. Discomfort or adverse effects of wearing the accelerometers were recorded by participants. Levels of physical activity were determined as total PA, light PA (LPA), moderate PA (MPA), moderate-to-vigorous (MVPA), and vigorous PA (VPA) using cut-points recently validated for CP. Results. Most participants showed little reluctance. Mean daily MVPA for all participants was 30.7 minutes (SD 30.3), which corresponded to 2.7 (SD 2.4) minutes of MVPA per hour or 4.5% (SD 3.9) of the total monitoring time. Total PA and MVPA were greatest in ambulatory youth (GMFCS levels I and II) compared with youth who use a walking aid or wheelchair (GMFCS levels III and IV) (P < 0.05). Conclusion(s). The results support the use of the accelerometer as a feasible and useful measure of activity in ambulatory and nonambulatory adolescents with CP.
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