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McCartney A, Crosswell J, Rafnsson SB, Hoe J. The effectiveness of structured physical activity on agitation in people with dementia: a rapid review. Aging Ment Health 2024; 28:1067-1077. [PMID: 38683159 DOI: 10.1080/13607863.2024.2345129] [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: 11/02/2023] [Accepted: 04/13/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVES Managing agitation and other behaviours that challenge is a significant dementia care challenge. The priority is to find effective non-pharmacological interventions as drug treatments can have significant side effects. This review evaluates the effectiveness of structured physical activity on agitation in dementia. METHOD Our rapid review searched four electronic databases, Cochrane CENTRAL, MEDLINE, CINAHL and Embase, for interventional studies using a structured physical activity programme in people with dementia and studied the effect of this activity on behaviours that challenge. Study quality was assessed using CASP criteria and data was narratively synthesised. RESULTS We included 13 studies in this review (four rated as high quality), involving a total of 1546 participants. Results were analysed according to exercise type, frequency and intensity of the intervention. Exercise is effective in reducing agitation and studies with higher adherence to exercise demonstrated more positive effects on agitation and behaviours that challenge. CONCLUSION Physical activity can be effective in reducing agitation in older adults with dementia. Further research is needed to clarify the type of intervention that is most beneficial. Strategies to make physical activity more acceptable and available to people with dementia need to be established.
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Affiliation(s)
- A McCartney
- Estuary View Medical Centre, Whitstable Medical Practice, Kent, United Kingdom
| | - J Crosswell
- Estuary View Medical Centre, Whitstable Medical Practice, Kent, United Kingdom
| | - S B Rafnsson
- Geller Institute of Ageing and Memory, School of Biomedical Sciences, University of West London, London, United Kingdom
| | - J Hoe
- Geller Institute of Ageing and Memory, School of Biomedical Sciences, University of West London, London, United Kingdom
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2
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Xian G, Chai Y, Gong Y, He W, Ma C, Zhang X, Zhang J, Ma Y. The relationship between healthy lifestyles and cognitive function in Chinese older adults: the mediating effect of depressive symptoms. BMC Geriatr 2024; 24:299. [PMID: 38549104 PMCID: PMC10979595 DOI: 10.1186/s12877-024-04922-5] [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: 11/29/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Previous studies have proven the positive relationship between healthy lifestyles and cognitive function in older adults. However, the specific impacts and mechanisms require further investigation. Therefore, this study aimed to investigate whether healthy lifestyles and cognitive function were associated with Chinese older adults and whether depressive symptoms mediated their association. METHODS 8272 valid samples were included using the latest data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Pearson's test was applied to investigate the relationship between the key variables. Regression models were employed to examine the mediating effects of healthy lifestyles, using Sobel's test and the bootstrap method to confirm path effects. RESULTS There was a significant correlation between healthy lifestyles, depressive symptoms, and cognitive function (p < 0.01). Healthy lifestyles directly impact cognitive function (β = 0.162, p < 0.01). Healthy lifestyles had a significant effect on depressive symptoms (β=-0.301, p < 0.01), while depressive symptoms have a significant impact on cognitive function (β=-0.108, p < 0.01). Depressive symptoms partially mediated the effect of healthy lifestyles on cognitive function (β = 0.032, p < 0.01). The Sobel and bootstrap tests confirmed the robustness of the regression analysis results. CONCLUSION Depressive symptoms mediate the relationship between healthy lifestyles and cognitive function. Our findings suggest that prevention strategies for cognitive impairment in older adults should focus on healthy lifestyles and mental health.
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Affiliation(s)
- Guowei Xian
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Yulin Chai
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Yunna Gong
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Wenfeng He
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Chunxiao Ma
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Xiaolin Zhang
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Jing Zhang
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China
| | - Yong Ma
- School of Management, Shandong Second Medical University, 261053, Weifang, Shandong, China.
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Boolani A, Yager C, Reid J, Lackman J, Smith ML. Correlates of depressive mood among graduate-level allied health students: An exploratory study examining trait energy and fatigue. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1685-1695. [PMID: 34379564 DOI: 10.1080/07448481.2021.1960843] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/28/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
Objective: The objective of this study was to identify factors associated with the occurrence and severity of depressive mood states among graduate-level allied health students. Participants: Students (N = 77) completed this study. Methods: Participants completed a series of self-reported surveys measuring moods, lifestyle behaviors, trait mental and physical energy and fatigue, and objective assessments of Trail-Making Test Part-B, and muscle oxygen consumption. Multiple backwards linear regression models were fitted to identify factors associated with depressive mood states. Results: When accounting for all subjects, increased severity of depressive mood states was associated with worse sleep quality (SQ), increased sitting time (ST), and trait physical fatigue (TPF). When examining subjects reporting depressive mood states, increased severity of depressive mood states was associated with worse SQ, increased ST, decreased mental workload on non-school days, and trait physical energy (TPE). Conclusion: Adjustments in lifestyle factors such as sleep, mental workload, and ST, may ameliorate depressive mood states.
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Affiliation(s)
- Ali Boolani
- Department of Physical Therapy, Clarkson University, Potsdam, New York, USA
| | - Chelsea Yager
- Department of Neurology, St. Joseph's Hospital, Syracuse, New York, USA
| | - Jeri Reid
- Department of Neurology, St. Joseph's Hospital, Syracuse, New York, USA
| | - Jeremy Lackman
- Department of Health and Physical Education, Monmouth University, West Long Branch, New Jersey, USA
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, Texas, USA
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas, USA
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Boolani A, Martin J, D'Acquisto F, Balestra C. Editorial: Feelings of energy and fatigue: Two different moods. Front Psychol 2023; 14:1180285. [PMID: 37151336 PMCID: PMC10156440 DOI: 10.3389/fpsyg.2023.1180285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 03/31/2023] [Indexed: 05/09/2023] Open
Affiliation(s)
- Ali Boolani
- Honors Department, Clarkson University, Potsdam, NY, United States
- *Correspondence: Ali Boolani
| | - Joel Martin
- Sports Medicine Assessment Research and Testing (SMART) Laboratory, George Mason University, Manassas, VA, United States
| | - Fulvio D'Acquisto
- School Life and Health Sciences, University of Roehampton, London, United Kingdom
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Pan Y, Yang H, Quan L, Wang S, Xu Y, Chen Y. Effects of full-body exercise-based pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e064212. [PMID: 36564122 PMCID: PMC9791421 DOI: 10.1136/bmjopen-2022-064212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease characterised by progressive and irreversible fibrosis of the lung parenchyma, resulting in reduced lung function. Since conventional medicines can be associated with low effective rates and adverse events, pulmonary rehabilitation may be a promising non-pharmacological therapy for IPF. Thus, we aimed to evaluate the effects of full-body exercise-based pulmonary rehabilitation on patients with IPF by conducting a systematic review and meta-analysis of randomised controlled trials (RCTs). METHODS AND ANALYSIS This systematic review and meta-analysis has been registered in the International Prospective Register of Systematic Reviews (PROSPERO). From inception to 31 August 2022, electronic databases in English and Chinese were searched, including PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials among the English databases. China National Knowledge Infrastructure, Chinese Biomedical Literature, VIP Chinese Science and Technology Periodical, and Wan Fang Data were among the Chinese databases. Two independent reviewers then screened the potential RCT studies, which were analysed according to the Cochrane Handbook criteria. The efficacy and safety of full-body exercise pulmonary rehabilitation for IPF were evaluated based on outcomes, including exercise capacity measured by 6 min walking distance and quality of life measured by St. George's Respiratory Questionnaire. Lung function was measured based on the forced vital capacity, total lung capacity, diffusing capacity of the lungs for carbon monoxide and dyspnoea assessed by the modified Medical Research Council scale. ETHICS AND DISSEMINATION Ethical approval was not required for this systematic review and meta-analysis. Results will be published in a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER CRD42021284293.
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Affiliation(s)
- Yi Pan
- Chengdu Second People's Hospital, Chengdu, China
| | - Han Yang
- Chengdu University of Traditional Chinese Medicine Affiliated Hospital, Chengdu, Sichuan, China
| | - Luo Quan
- Chengdu Second People's Hospital, Chengdu, Sichuan Province, China
| | - Shurong Wang
- Chengdu Second People's Hospital, Chengdu, Sichuan Province, China
| | - Youli Xu
- Chengdu Second People's Hospital, Chengdu, Sichuan Province, China
| | - Yu Chen
- Chengdu Second People's Hospital, Chengdu, Sichuan, China
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Boolani A, Gallivan KM, Ondrak KS, Christopher CJ, Castro HF, Campagna SR, Taylor CM, Luo M, Dowd SE, Smith ML, Byerley LO. Trait Energy and Fatigue May Be Connected to Gut Bacteria among Young Physically Active Adults: An Exploratory Study. Nutrients 2022; 14:nu14030466. [PMID: 35276824 PMCID: PMC8839554 DOI: 10.3390/nu14030466] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/15/2022] [Accepted: 01/18/2022] [Indexed: 02/04/2023] Open
Abstract
Recent scientific evidence suggests that traits energy and fatigue are two unique unipolar moods with distinct mental and physical components. This exploratory study investigated the correlation between mental energy (ME), mental fatigue (MF), physical energy (PE), physical fatigue (PF), and the gut microbiome. The four moods were assessed by survey, and the gut microbiome and metabolome were determined from 16 S rRNA analysis and untargeted metabolomics analysis, respectively. Twenty subjects who were 31 ± 5 y, physically active, and not obese (26.4 ± 4.4 kg/m2) participated. Bacteroidetes (45%), the most prominent phyla, was only negatively correlated with PF. The second most predominant and butyrate-producing phyla, Firmicutes (43%), had members that correlated with each trait. However, the bacteria Anaerostipes was positively correlated with ME (0.048, p = 0.032) and negatively with MF (−0.532, p = 0.016) and PF (−0.448, p = 0.048), respectively. Diet influences the gut microbiota composition, and only one food group, processed meat, was correlated with the four moods—positively with MF (0.538, p = 0.014) and PF (0.513, p = 0.021) and negatively with ME (−0.790, p < 0.001) and PE (−0.478, p = 0.021). Only the Firmicutes genus Holdemania was correlated with processed meat (r = 0.488, p = 0.029). Distinct metabolic profiles were observed, yet these profiles were not significantly correlated with the traits. Study findings suggest that energy and fatigue are unique traits that could be defined by distinct bacterial communities not driven by diet. Larger studies are needed to confirm these exploratory findings.
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Affiliation(s)
- Ali Boolani
- Department of Physical Therapy, Clarkson University, Potsdam, NY 13699, USA
- Department of Biology, Clarkson University, Potsdam, NY 13699, USA
- Correspondence: (A.B.); (L.O.B.); Tel.: +504-319-5828 (A.B.); +704-340-4482 (L.O.B.)
| | - Karyn M. Gallivan
- Sports and Health Sciences, School of Health Sciences, American Public University System, Charles Town, WV 25414, USA; (K.M.G.); (K.S.O.)
| | - Kristin S. Ondrak
- Sports and Health Sciences, School of Health Sciences, American Public University System, Charles Town, WV 25414, USA; (K.M.G.); (K.S.O.)
| | - Courtney J. Christopher
- Department of Chemistry, University of Tennessee, Knoxville, TN 37996, USA; (C.J.C.); (H.F.C.); (S.R.C.)
| | - Hector F. Castro
- Department of Chemistry, University of Tennessee, Knoxville, TN 37996, USA; (C.J.C.); (H.F.C.); (S.R.C.)
- Biological and Small Molecule Mass Spectrometry Core, University of Tennessee, Knoxville, TN 37996, USA
| | - Shawn R. Campagna
- Department of Chemistry, University of Tennessee, Knoxville, TN 37996, USA; (C.J.C.); (H.F.C.); (S.R.C.)
- Biological and Small Molecule Mass Spectrometry Core, University of Tennessee, Knoxville, TN 37996, USA
| | - Christopher M. Taylor
- Department of Microbiology, Immunology and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; (C.M.T.); (M.L.)
| | - Meng Luo
- Department of Microbiology, Immunology and Parasitology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA; (C.M.T.); (M.L.)
| | - Scot E. Dowd
- Molecular Research LP, 503 Clovis Rd, Shallowater, TX 79363, USA;
| | - Matthew Lee Smith
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX 37916, USA;
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77807, USA
| | - Lauri O. Byerley
- Sports and Health Sciences, School of Health Sciences, American Public University System, Charles Town, WV 25414, USA; (K.M.G.); (K.S.O.)
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
- Correspondence: (A.B.); (L.O.B.); Tel.: +504-319-5828 (A.B.); +704-340-4482 (L.O.B.)
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РROKOPCHUK Y, VOLYANSKAYA V, SERAFIMOVA E, GUSHCHA S, PLAKIDA A. Modern views on the role and place of gerontological rehabilitation in the nation's health improvement system. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The article discusses the aging process (theory of aging, mechanism, concept of the aging process, physiological and functional changes that negatively affect the condition of a patient with a gerontological profile). Geriatric rehabilitation is discussed, including physical (professional geriatric rehabilitation based on rehabilitation centers) and mental rehabilitation. It is shown that medical and psychological rehabilitation, which includes psychocorrection and psychotherapy, is essential. The paper assesses the rehabilitation possibilities (rehabilitation algorithms involving both natural and preformed physical factors) in gerontological patients suffering from various somatic diseases
Keywords: aging, geriatric rehabilitation, medical and physical rehabilitation, medical and psychological rehabilitation,
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Affiliation(s)
- Yulia РROKOPCHUK
- 1 Special specialized clinical sanatorium named after V.P. Chkalov, Ministry of Health of Ukraine», Odessa, Ukraine
| | - Veronika VOLYANSKAYA
- 1 Special specialized clinical sanatorium named after V.P. Chkalov, Ministry of Health of Ukraine», Odessa, Ukraine
| | - Elvira SERAFIMOVA
- 1 Special specialized clinical sanatorium named after V.P. Chkalov, Ministry of Health of Ukraine», Odessa, Ukraine
| | - Sergey GUSHCHA
- State Institution «Ukrainian Research Institute of Medical Rehabilitation and Balneology of the Ministry of Health of Ukraine», Odessa, Ukraine
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Xie Y, Wu Z, Sun L, Zhou L, Wang G, Xiao L, Wang H. The Effects and Mechanisms of Exercise on the Treatment of Depression. Front Psychiatry 2021; 12:705559. [PMID: 34803752 PMCID: PMC8602192 DOI: 10.3389/fpsyt.2021.705559] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/05/2021] [Indexed: 12/12/2022] Open
Abstract
Background: It is necessary to seek alternative therapies for depression, because side effects of medications lead to poor adherence and some patients do not achieve a clinical treatment effect. Recently the role of exercise as a low-cost and easy-to-use treatment for depression has gained attention with a number of studies showing that exercise is effective at reducing depressive symptoms and improving body functions such as cardiorespiratory system and cognitive function. Because of the heterogeneity of exercise therapy programs, there is no standardized and unified program. Few studies have summarized the specific properties of exercise programs (type, intensity, duration, and frequency) and clinical prescriptions for exercise are not mentioned in most articles. Aims: This study aimed to investigate the feasibility and efficacy of exercise therapy for patients with depression, in order to appraise the evidence and outline accepted guidelines to direct individualized treatment plans for patients with depression based on their individual situations. Methods: A systematic review of English language literature including papers published from 2010 to present in PubMed was performed. Given the feasibility of prescribing exercise therapy for patients with depression, nearly 3 years of clinical studies on the treatments of depressive symptoms with exercise were first reviewed, comparing the exercise programs utilized. Conclusions: Exercise has therapeutic effects on depression in all age groups (mostly 18-65 years old), as a single therapy, an adjuvant therapy, or a combination therapy, and the benefits of exercise therapy are comparable to traditional treatments for depression. Moderate intensity exercise is enough to reduce depressive symptoms, but higher-dose exercise is better for overall functioning. Exercise therapy has become more widely used because of its benefits to the cardiovascular system, emotional state, and systemic functions. Recommendations: Aerobic exercise/mind-body exercise (3-5 sessions per week with moderate intensity lasting for 4-16 weeks) is recommended. Individualized protocols in the form of group exercise with supervision are effective at increasing adherence to treatment.
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Affiliation(s)
- Yumeng Xie
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zuotian Wu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Limin Sun
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lin Zhou
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ling Xiao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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Boolani A, Ryan J, Vo T, Wong B, Banerjee NK, Banerjee S, Fulk G, Smith ML, Martin R. Do Changes in Mental Energy and Fatigue Impact Functional Assessments Associated with Fall Risks? An Exploratory Study Using Machine Learning. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2020.1748788] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Ali Boolani
- Department of Physical Therapy, Clarkson University, Potsdam, New York, USA
| | - Jenna Ryan
- Department of Computer Science, Clarkson University, Potsdam, New York, USA
| | - Trang Vo
- Department of Physician Assistant, Clarkson University, Potsdam, New York, USA
| | - Brandon Wong
- Department of Physician Assistant, Clarkson University, Potsdam, New York, USA
| | | | - Sean Banerjee
- Department of Computer Science, Clarkson University, Potsdam, New York, USA
| | - George Fulk
- Department of Physical Therapy, Clarkson University, Potsdam, New York, USA
- Department of Physical Therapy, State University of New York (SUNY) Upstate Medical Center, Syracuse, New York, USA
| | - Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, Texas, USA
| | - Rebecca Martin
- Department of Physical Therapy, Clarkson University, Potsdam, New York, USA
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Manierre M, Jansen E, Boolani A. Sleep quality and sex modify the relationships between trait energy and fatigue on state energy and fatigue. PLoS One 2020; 15:e0227511. [PMID: 31914459 PMCID: PMC6949111 DOI: 10.1371/journal.pone.0227511] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 12/19/2019] [Indexed: 01/28/2023] Open
Abstract
The objective of this study was to identify the associations between trait energy and fatigue with state energy fatigue, as well as exploring if these relationships interacted with sex and/or sleep quality. The study population included a convenience sample of adults and college students (n ranges from 687 to 694). Key measures were state and trait mental and physical energy and fatigue scales, PSQI (a measure of sleep quality), and sex. Multiple regression models included age, polyphenol consumption, POMS scores, physical activity, mental load, and caffeine consumption as covariates. Analyses yielded a strong (r = .65) positive association between each trait and state variable. Overall, several statistically significant interactions were identified. First, the relationship between state and trait physical fatigue was particularly strong for women with high trait scores. There were also interactions with sleep quality. In the case of physical fatigue, poor sleep quality magnified the association between physical fatigue trait and state among those with low trait physical fatigue, while sleep quality did not make a difference for those with high trait physical fatigue. Conversely, in the case of physical energy and mental fatigue, good sleep quality was associated with both higher “highs” and lower “lows” of their respective traits; both interactions were present only among males. Our analyses suggest that sleep quality and sex could influence the effects of trait physical and mental energy and fatigue on state. Findings were more complex than initially assumed, suggesting that the interrelationship between trait and state may be modified by how males and females react and adapt to their trait.
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Affiliation(s)
- Matthew Manierre
- Department of Humanities and Social Sciences, Clarkson University, Potsdam, New York, United States of America
- * E-mail:
| | - Erica Jansen
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Ali Boolani
- Department of Physical Therapy, Clarkson University, Potsdam, New York, United States of America
- Department of Biology, Clarkson University, Potsdam, New York, United States of America
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