Improvement of pulmonary function with arm swing exercise in patients with type 2 diabetes

Intervention Effects of Physical Activity on Type 2 Diabetic Patients Potentially Infected with COVID-19

The coronavirus disease 2019 (COVID-19) pandemic has clearly had a great influence on the lifestyles of the population, especially on patients with type 2 diabetes mellitus. During the COVID-19 outbreak, many countries/regions implemented social-isolation measures, leading to an increase in negative behaviors and impairing the capability of diabetic patients to resist COVID-19, ultimately causing severe prognoses. Moreover, as the epidemic progressed, multiple studies emphasized the significance of physical exercise in the management of type 2 diabetic patients infected with COVID-19. In this study, we selected research from 1 December 2019 to 9 August 2023 that focused on COVID-19-infected diabetic patients to investigate the impact of type 2 diabetes on the immune functions, inflammation factor levels, lung injuries, and mental disorders of such patients, as well as to assess the risk of novel coronavirus pneumonia in these patients. Additionally, the effects of high-intensity, moderate-intensity, and low-intensity exercises on novel coronavirus pneumonia infection in type 2 diabetic patients and the mechanisms of the effects of such exercise were considered. We concluded that elderly diabetic patients with COVID-19 should perform low-intensity exercises to facilitate their recoveries. This study offers guidance for a proper understanding of the dangers of diabetes and the use of appropriate measures to reduce the risk of novel coronavirus pneumonia infections in type 2 diabetic patients.

The benefits of Shuai Shou Gong (SSG) demonstrated in a Randomised Control Trial (RCT) study of older adults in two communities in Thailand

INTRODUCTION

Shuai Shou Gong (SSG) is a type of Arm Swing Exercise (ASE) developed and practiced especially by older people in China for over one thousand years to maintain physical health and well-being. Until now the potential benefits of SSG have not been investigated in a Randomised Control Trial (RCT).

MATERIALS AND METHODS

Fifty six older women were recruited from each of two urban communities in Khon Kaen, Thailand. One community was randomly assigned as the Exercise Group (mean age 68.3 years, standard deviation 5.6 years) and the other as the Control Group (69.4 years, 4.4 years). The Exercise Group performed SSG for 40 minutes, three days per week for two months, whereas the Control Group maintained their usual daily life. Measurements of Posture (C7 to Wall Distance (C7WD), Standing Height (SH), Flexibility (Back Scratch of Left and Right arms (BSL and BSR) and Chair Sit and Reach of Left and Right legs (CSRL and CSRR), Gait (Timed Up and Go (TUG)), and Cognition (Barthel Activities of Daily Living Index (BADL) and Rosenberg Self Esteem Scale (RSES) questionnaires) were recorded for each group prior to, on day 1, week 4, and week 8 of the SSG training.

RESULTS

The 8 week SSG training course produced a significant interaction between group and time for the combined set of all outcome measures (C7WD, SH, BSL, BSR, CSRL, CSRR, TUG, BADL, and BSES) (Modified ANOVA-Type Statistic (MATS) p-value < 0.001) and for the four categories of Posture, Flexibility, Gait, and Cognition (all Wald-Type Statistic (WTS) p-values < 0.05) and in all cases the changes in the Exercise Group were in the direction predicted to be beneficial. No significant interaction effect between time and group was found after either one session or four weeks of SSG training for any of the categories (all WTS p > 0.05) with significant effects only arising after eight weeks (all WTS p < 0.05). Thus although alterations were shown to be increasingly beneficial over time the minimum period required to produce a statistically significant benefit from performing SSG training was 8 weeks. For the Control Group no significant changes were identified for Posture, Flexibility and Cognition however a significant deterioration was observed in TUG (WTS p = 0.003).

CONCLUSIONS

SSG is a holistic, gentle, rhythmic, whole body sequence of movements that may be readily learned and enjoyed in a group setting and has been confirmed in an RCT study of older adult females to produce significant benefits in Posture, Flexibility, Gait and Cognition.

Association of obesity-related inflammatory pathways with lung function and exercise capacity

BACKGROUND

Obesity has multifactorial effects on lung function and exercise capacity. The contributions of obesity-related inflammatory pathways to alterations in lung function remain unclear.

RESEARCH QUESTION

To examine the association of obesity-related inflammatory pathways with pulmonary function, exercise capacity, and pulmonary-specific contributors to exercise intolerance.

METHOD

We examined 695 patients who underwent cardiopulmonary exercise testing (CPET) with invasive hemodynamic monitoring at Massachusetts General Hospital between December 2006-June 2017. We investigated the association of adiponectin, leptin, resistin, IL-6, CRP, and insulin resistance (HOMA-IR) with pulmonary function and exercise parameters using multivariable linear regression.

RESULTS

Obesity-related inflammatory pathways were associated with worse lung function. Specifically, higher CRP, IL-6, and HOMA-IR were associated with lower percent predicted FEV₁ and FVC with a preserved FEV₁/FVC ratio suggesting a restrictive physiology pattern (P ≤ 0.001 for all). For example, a 1-SD higher natural-logged CRP level was associated with a nearly 5% lower percent predicted FEV₁ and FVC (beta -4.8, s.e. 0.9 for FEV1; beta -4.9, s.e. 0.8 for FVC; P < 0.0001 for both). Obesity-related inflammatory pathways were associated with worse pulmonary vascular distensibility (adiponectin, IL-6, and CRP, P < 0.05 for all), as well as lower pulmonary artery compliance (IL-6 and CRP, P ≤ 0.01 for both).

INTERPRETATION

Our findings highlight the importance of obesity-related inflammatory pathways including inflammation and insulin resistance on pulmonary spirometry and pulmonary vascular function. Specifically, systemic inflammation as ascertained by CRP, IL-6 and insulin resistance are associated with restrictive pulmonary physiology independent of BMI. In addition, inflammatory markers were associated with lower exercise capacity and pulmonary vascular dysfunction.

Effects of incentive spirometry on cardiopulmonary parameters, functional capacity and glycemic control in patients with Type 2 diabetes

BACKGROUND

Patients with Type 2 diabetes mellitus (T2DM) suffer cardiopulmonary impairment and may present with weakness of the inspiratory muscles.

OBJECTIVE

This study was designed to determine the effects of incentive spirometry (IS) on selected cardiopulmonary parameters, functional capacity and glycemic control in patients with T2DM.

METHODS

Fifty-nine participants (25 males and 34 females) recruited from the out-patient clinic of the Department of Medicine of two hospitals in Lagos State, Nigeria, who were randomly assigned into two groups, completed the study. In addition to the medical management of T2DM, IS group received incentive spirometry while control group continued with the medical management of T2DM alone. Selected cardiovascular parameters, pulmonary parameters, functional capacity (using 6-min walk test) and fasting blood glucose level were assessed at baseline and at the end of eight weeks intervention period. Data were analyzed using the Statistical Package for Social Sciences (SPSS Version 21). Level of significance was set at p < 0 . 05 .

RESULTS

There were statistically significant improvements in all the cardiovascular parameters ( p = 0 . 001 ) of IS group except systolic blood pressure. There were significant changes in all the pulmonary parameters, functional capacity and glycemic control ( p < 0 . 05 ) of IS group while there was none in control group. There were significant differences between the mean changes of various selected outcome measures of the two groups ( p < 0 . 05 ) except for diastolic blood pressure and blood glucose level.

CONCLUSION

IS had positive effects in improving cardiopulmonary function, functional capacity and glycemic control in patients with T2DM.

Effects of arm swing exercise training on cardiac autonomic modulation, cardiovascular risk factors, and electrolytes in persons aged 60-80 years with prehypertension: A randomized controlled trial

Background/Objective

This study aimed to investigate the effect and carry-over effect of arm swing exercise (ASE) training on cardiac autonomic modulation, cardiovascular risk factors, and blood electrolytes in older persons with prehypertension.

Methods

Subjects were 50 individuals with prehypertension (aged 66.90 ± 5.50 yr, body mass index 23.84 ± 3.65 kg/m²). They were randomly assigned into ASE group and control group. Subjects in the ASE group underwent an ASE training program for 3 months at a frequency of 30 min/day, 3 days/week. Subjects in the control group maintained their daily routine activities minus regular exercise. Blood pressure, heart rate variability (HRV), cardiovascular risk factors including blood glucose, lipid profile, high-sensitive C-reactive protein (hsCRP), and electrolytes were evaluated on 3 occasions: before and after the 3-month intervention, and 1 month after intervention ended.

Results

Following the 3-month intervention, systolic blood pressure (SBP) and serum hsCRP concentration were significantly lower, while serum high-density lipoprotein (HDL)-cholesterol, potassium (K⁺), magnesium (Mg²⁺) concentrations, standard deviation of normal R-R intervals (RMSSD) and high frequency (HF) power values were higher in the ASE group when compared with the control group (p < 0.05). At the 1-month follow-up interval, SBP and serum hsCRP concentration remained lower while serum HDL-cholesterol and K⁺ concentrations remained higher in the ASE group as compared to the control group (p < 0.05).

Conclusion

ASE training decreased SBP and serum hsCRP concentration, increased serum HDL-cholesterol, K⁺, and Mg²⁺ concentrations and increased RMSSD and HF power values in older persons with prehypertension. In addition, there were carry-over effects of ASE training i.e. decreased SBP and serum hsCRP concentration as well as increased serum HDL-cholesterol and K⁺ concentrations.

Physical Exercise Improves Glycemic and Inflammatory Profile and Attenuates Progression of Periodontitis in Diabetic Rats (HFD/STZ)

The authors aimed to evaluate the effects of physical exercise on the metabolism and progression of periodontal disease (PD), induced by ligature in diabetic rats induced by high fat diet and streptozotocin (HFD/STZ). Diabetes Mellitus (DM) was induced by four weeks of a hyperlipidic diet associated with a single low-dose of streptozotocin (35 mg/kg/animal). The exercise groups swam for 60 min/day for eight weeks (five times/week). In the last two weeks of exercise, a ligature was placed around the right and left mandibular first molars. The authors determined alveolar bone loss by morphometry. Blood biochemical profile and serum levels of IL-10 and TNF-α were evaluated by colorimetric and enzyme-linked immunosorbent assays (ELISA), respectively. The diabetic animals subjected to exercise showed decreased alveolar bone loss, lower glycemia, triacylglycerols and glycosylated hemoglobin levels than the controls. Total cholesterol and its fractions (High density lipoprotein—HDL-c, Low density lipoprotein—LDL-c and Very low density lipoprotein—VLDL-c) remained similar among the groups. Animals with PD showed higher levels of TNF-α and lower levels of IL-10, when compared to animals without PD. In diabetic animals with PD, physical exercise decreased TNF-α levels and increased IL-10 levels as well as the IL10/TNF-α ratio. In conclusion, eight weeks of physical exercise improved glycemic control and systemic inflammatory profile, and attenuated alveolar bone loss in rats with DM and PD.

Physical activity and sedentary behaviour research in Thailand: a systematic scoping review

BACKGROUND

The number of deaths per year attributed to non-communicable diseases is increasing in low- and middle-income countries, including Thailand. To facilitate the development of evidence-based public health programs and policies in Thailand, research on physical activity (PA) and sedentary behaviour (SB) is needed. The aims of this scoping review were to: (i) map all available evidence on PA and SB in Thailand; (ii) identify research gaps; and (iii) suggest directions for future research.

METHODS

A systematic literature search was conducted through 10 bibliographic databases. Additional articles were identified through secondary searches of reference lists, websites of relevant Thai health organisations, Google, and Google Scholar. Studies written in Thai or English were screened independently by two authors and included if they presented quantitative or qualitative data relevant to public health research on PA and/or SB.

RESULTS

Out of 25,007 screened articles, a total of 564 studies were included in the review. Most studies included PA only (80%), 6.7% included SB only, and 13.3% included both PA and SB. The most common research focus was correlates (58.9%), followed by outcomes of PA/SB (22.2%), prevalence of PA/SB (12.4%), and instrument validation (3.2%). Most PA/SB research was cross-sectional (69.3%), while interventions (19.7%) and longitudinal studies (2.8%) were less represented. Most studies (94%) used self-reports of PA/SB, and few (2.5%) used device-based measures. Both sexes were examined in most studies (82.5%). Adults were the main target population group (51.1%), followed by older adults (26.9%), adolescents (15.7%), and children (6.3%). Clinical populations were investigated in the context of PA/SB in a relatively large number of studies (15.3%), most frequently those with cardiovascular disease, diabetes, and hypertension (22%, 21%, and 21% respectively).

CONCLUSIONS

The number of Thai papers on PA published per year has been increasing, indicating a growing interest in this research area. More studies using population-representative samples are needed, particularly among children and adolescents, and investigating SB as a health risk factor. To provide stronger evidence on determinants and outcomes of PA/SB, longitudinal studies using standardised measures of PA and SB are required.

Pulmonary function evaluation in type 2 diabetes mellitus patients submitted to metabolic surgery

Abstract Introduction: Diabetes Mellitus (DM) is a multifactorial metabolic disorder. As considered a public health problem needing additional treatment options. Objective: This prospective study aimed at evaluating pulmonary function through spirometry, before and after metabolic surgery without gastric resection in type 2 DM patients. Methods: Sample was composed by 17 type 2 DM females. They were analyzed in pre (24 hours before surgical procedure), immediate post-operative period POST1 (24 hours after surgical procedure) and in the late postoperative period POST2 (two years after surgical procedure). Besides statistical analysis, it was evaluated the following spirometric parameters: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and the FEV1 / FVC ratio (%). Results: Spirometric parameters showed a value increase when compared PRE and POS2 values, except for FVC and FEV1, which was not statistically significant. Conclusion: Type 2 DM women submitted to metabolic surgery without gastric resection showed spirometric value increased after two-year surgical procedure, when compared to preoperative period values. It is important additional studies about pulmonary function, diabetic patients and metabolic surgery without gastric resection.

Effects of aerobic exercise training on peripheral brain-derived neurotrophic factor and eotaxin-1 levels in obese young men

[Purpose] The aim of the present study was to investigate the effects of aerobic exercise training on the levels of peripheral brain-derived neurotrophic factor and eotaxin-1 in obese young men. [Subjects and Methods] The subjects included sixteen obese young men with a body mass index greater than 25 kg/m². They were randomly divided between control and exercise groups (n = 8 in each group). The exercise group performed treadmill exercise for 40 min, 3 times a week for 8 weeks at the intensity of 70% heart rate reserve. Blood collection was performed to examine the levels of serum glucose, plasma malonaldehyde, serum brain-derived neurotrophic factor, and plasma eotaxin-1 before and after the intervention (aerobic exercise training). [Results] Following the intervention, serum BDNF levels were significantly higher, while serum glucose, plasma MDA, and plasma eotaxin-1 levels were significantly lower than those prior to the intervention in the exercise group. [Conclusion] Aerobic exercise training can induce neurogenesis in obese individuals by increasing the levels of brain-derived neurotrophic factor and reducing the levels of eotaxin-1. Alleviation of oxidative stress is possibly responsible for such changes.

Relationship of visfatin level to pancreatic endocrine hormone level, HOMA-IR index, and HOMA β-cell index in overweight women who performed hydraulic resistance exercise

[Purpose] This study aimed to examine the correlation of visfatin level to pancreatic endocrine hormone level, homeostasis model assessment of insulin resistance (HOMA-IR) index, and HOMA β-cell index in hydraulic resistance exercise. Furthermore, it investigated the relationship between visfatin level and other variables affected by exercise in overweight women. [Subjects and Methods] The exercise group trained for 12 weeks, 70 minutes/day, 5 days/week. Visfatin level, pancreatic endocrine hormone level, HOMA-IR index, and HOMA β-cell index were measured before and after the intervention. Based on the blood insulin and glucose concentrations, HOMA-IR index, the indicator of insulin resistance, and HOMA β-cell index, the indicator of insulin secretion level, were assessed. [Results] Interaction effects on visfatin level, insulin level, HOMA-IR index, and HOMA β-cell index were observed. Interaction effects on glucagon and glucose levels were not observed between the intervention groups. The correlations of visfatin level to insulin, glucagon, and glucose levels, and HOMA-IR and HOMA β-cell indexes were not significant for any of the subjects. [Conclusion] Therefore, the 12-week resistance exercise affected body composition, visfatin level, insulin level, HOMA-IR index, and HOMA β-cell index. Finally, visfatin was not related to insulin, glucagon, and glucose levels, and HOMA-IR and HOMA β-cell indexes.