An Interventional strategy of physical activity promotion for reduction of menopause symptoms

Unicompartmental knee arthroplasty improves mental health in patients with single compartment knee osteoarthritis

PURPOSE

The purpose of this study was to determine if preoperative mental health status improves following unicompartmental knee arthroplasty (UKA) in patients with single compartment knee osteoarthritis (OA).

METHODS

A total of 163 patients underwent UKA [115 (71%) medial, 48 (29%) lateral] (mean age = 65 ± 11) completed preoperative and minimum 2-year postoperative veterans RAND 12 item health survey (VR-12) mental component score (MCS). VR-12 MCS was the primary outcome measure. Secondary measures included VR-12 physical component summary score (PCS), knee osteoarthritis outcome score (KOOS) and KOOS patient acceptable symptom state at the final follow-up.

RESULTS

The median VR-12 MCS improved from 50.5 [interquartile range (IQR): 43.7-56.8] to 55.0 [IQR: 52.3-57.0] (p < 0.001) at a mean follow-up of 9.5 ± 4 years (range 2-19 years) following UKA. Preoperative VR-12 MCS was significantly correlated with patients postoperative VR-12 PCS (ρ = 0.294, p < 0.01), KOOS pain (ρ = 0.201, p = 0.012), KOOS ADL (ρ = 0.243, p = 0.002) and KOOS quality of life (ρ = 0.233, p < 0.01). Sixty-three (39%) patients improved from low VR-12 MCS (<50) to normal VR-12 MCS (≥50). One hundred forty-two (87%) achieved a normal VR-12 MCS score (≥50) postoperatively.

CONCLUSION

At a mean of 10-year follow-up, patients who underwent UKA for single compartment osteoarthritic knee pain demonstrated significant improvement in mental health scores. UKA resulted in normal mental health in a majority of patients (87%). The resultant improved mental health scores were associated with improved patient pain and activities of daily living.

LEVEL OF EVIDENCE

Level III retrospective cohort study.

Physical Activity, Self-Care, and Menopausal Symptoms among Women in Al-Ahsa, Saudi Arabia: Adherence to Postmenopausal Guidelines (PMGs)

Menopause is a physiological change in which the menstrual period permanently ends. Every woman experiences this transition in different ways between the ages of 40 and 55. Women may have menopausal symptoms as a result of low estrogen levels. Self-care is a practice which women can use to maintain their wellness. This study aimed to assess physical activity, self-care, and menopausal symptoms and their associations with selected variables. The results showed that women should adhere to postmenopausal guidelines (PMGs). A cross-sectional study was conducted among 212 menopausal women randomly selected from health centers in Al-Ahsa, Saudi Arabia. The international physical activity tool, a self-care questionnaire, and the Kupperman menopausal index scale were used to assess women's physical activity, self-care, and menopausal symptoms, respectively. The chi-square and Pearson correlation tests were used for analysis. The women were 55.01 ± 6.87 years old, and 40.6% reached menopause between the ages of 46 and 50 years; 57.1% of the women had low physical activity, which was associated with menopausal symptoms (p < 0.022). The highest mean score (29.63 ± 5.83) was obtained for physical health, while the lowest (11.92 ± 3.58) was found in self-care screening tests. Regarding menopausal symptoms, 25.9% had mild, 69.8% had moderate, and 4.3% had severe symptoms. A significant association was found between menopausal symptoms and age, menopausal age, education, body mass index, and PMGs awareness at p < 0.001. Self-care positively correlated with menopausal symptoms (p < 0.001). Therefore, attention should be given to women's adherence to PMGs so that they can enjoy healthier lives after menopause.

Obesity and Severity of Menopausal Symptoms: a Contemporary Review

PURPOSE OF REVIEW

Vasomotor symptoms are frequently experienced by women during menopause and have been linked to obesity. Severity of menopausal symptoms is a distinct construct from presence of symptoms, and the relation between severity of symptoms and obesity is less established. The purpose of this brief narrative review was to summarize evidence from recent studies on associations between menopausal symptom severity and measures of obesity.

RECENT FINDINGS

Sixteen articles were identified that specifically assessed and reported on the severity of menopausal symptoms in relation to measures of obesity including body mass index (BMI), waist circumference, and waist-to-hip ratio. Most studies to date show that greater BMI, waist size, and waist-to-hip ratio are associated with greater severity of menopausal symptoms. Given the large segment of women who will experience symptoms and that severity of symptoms influences treatment decisions, future studies are needed to determine how weight management efforts may reduce the severity of menopausal symptoms.

The effect of exercise intervention on improving sleep in menopausal women: a systematic review and meta-analysis

Background

Sleep disturbance is common in menopausal women and negatively affects their quality of life and could cause increased risks of other menopause-related diseases.

Objective

This systematic review aims to synthesize evidence regarding the effects of exercise interventions on improving sleep in menopausal women.

Methods

A comprehensive search in seven electronic databases for randomized controlled trials (RCTs) was performed on June 3, 2022. The systematic review included seventeen trials, ten of which provided data for the meta-analysis. The effects on outcomes were presented as mean differences (MDs) or standard mean differences (SMDs) and their 95% confidence intervals (CI). Cochrane risk-of-bias tool was used in quality assessment.

Results

The results suggest that exercise intervention significantly reduces insomnia severity (SMD = -0.91, 95% CI = -1.45 to -0.36, Z = 3.27, P = 0.001) and alleviates sleep problems (MD = -0.09, 95% CI = -0.17 to -0.01, Z = 2.20, P = 0.03). For sleep quality, the results showed that insignificant differences were found between the exercise intervention and the control groups (MD = -0.93, 95% CI = -2.73 to 0.87, Z = 1.01, P = 0.31). The results of the subgroup analysis indicated that more apparent effects of exercise intervention were found among women with sleep disorders than among women without sleep disorders. Which exercise intervention duration was more beneficial to sleep outcomes could not be judged. Overall, there was a moderate risk of bias in the primary studies.

Conclusion

According to this meta-analysis, exercise interventions can be recommended for menopausal women to improve their sleep. High-quality RCTs applying different types of exercise (e.g., walking, yoga, meditative exercise and so on) with different intervention durations as well as subjective and objective sleep assessment are warranted.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022342277, identifier: CRD42022342277.

Effectiveness of Educational Intervention Based on Transtheoretical Model on Physical Activity and Menopausal Symptoms

Introduction

Menopause is an inevitable part of women's lives. Physical activity as nonhormonal therapy can decrease the symptoms of menopause. This study is aimed at investigating the effect of educational intervention based on the transtheoretical model (TTM) on physical activity and menopausal symptoms of female clients of the health center in Pasargad City, Iran.

Methods

This quasi-experimental study was performed on 140 females admitted to health center of Pasargad City, Fars Province, Iran (intervention = 70 and control = 70). The data collection tool consisted of demographic data, menopause rating scale, international physical activities questionnaire, and TTM questionnaire (stages of change, processes of change, decision-making balance, and self-efficacy) that were completed before and two months after intervention. For intervention group, the educational program was implemented during 5 sessions of 50-55 min. Data were analyzed by SPSS 25 and by using Chi-square test, independent t-test, and paired t-test.

Results

After intervention, the mean scores of physical symptoms are sleep problems, muscle problems and discomfort, psychological symptoms, depression, irritability, and anxiety of intervention group decreased significantly post intervention (p < 0.001). Analysis showed that psychological symptoms, mental fatigue, somatic, and urogenital symptoms, and vaginal dryness increased 2 months after the intervention. Also, the mean score of cons, pros, decision balance, self-efficacy, consciousness raising, dramatic relief, environmental reevaluation, and self-reevaluation have significant changed in intervention group (p < 0.05). In addition, the top percent of progress can be seen in contemplation (31. 5%).

Conclusion

This study showed the effectiveness of educational intervention based on TTM to reduce menopausal symptoms and promote physical activity in postmenopausal women.

Personalised Nutritional Plan and Resistance Exercise Program to Improve Health Parameters in Celiac Women

Celiac disease (CD) is a permanent immune reaction to gluten in those with a genetic predisposition. This study was designed to evaluate menopause-associated symptoms, mood, bone quality, and IgA antibody levels in women with CD, untreated and treated with a gluten-free diet (GFD), and with or without resistance exercise. The randomised controlled trial was conducted on 28 Spanish women (>40 years old). Participants were divided into the following intervention groups: personalised gluten-free nutrition plan + exercise (GFD + E); personalised gluten-free nutrition plan (GFD); celiac controls (NO-GFD); and non-celiac controls (CONTROL). The participants responded to the Menopause Rating Scale and the Profile of Mood States (POMS) questionnaires. Bone quality was measured with ultrasound and IgA with a blood test. After 12 weeks of intervention, the GFD + E group showed significant improvement in urogenital symptoms and scored higher on the ‘vigour’ subscale of the POMS. Negative associations were found between the total score on the Menopause Rating Scale and the ‘vigour’ subscale of the POMS questionnaire. Only those women who underwent a personalised GFD nutritional intervention combined with resistance exercise demonstrated significant changes after the intervention.

Effect of telling older adults their predictive physical fitness age on physical activity: A quasi-experimental study

Physical activity plays an essential role in preventing diseases and improving overall health. Promoting physical activity has become an important intervention against low physical fitness and chronic diseases in older adults. This study aimed to determine whether telling older people their predictive physical fitness age prompts physical activity. Two hundred and fifty-three older Chinese people were assigned single-blindly to either an intervention group (n = 140) or control group (n = 113) in this quasi-experimental study. Participants in the intervention group were informed of the predictive physical fitness age and taught the difference from their chronological age while participants in the control group were not. Participants in both groups were encouraged to get more physical activities each day. The primary outcome was physical activity, and the secondary outcome was the change in physical fitness age. Results showed that for older adults with low physical fitness, all physical activity parameters (vigorous physical activity, moderate physical activity, walking, total physical activity and sitting) showed a significant difference between intervention and control groups after 2 and 12 weeks (p < 0.05). Moreover, physical fitness age was improved remarkably after 12 weeks compared to the control group (73.57 ± 5.75 vs. 66.85 ± 6.33 years, p < 0.05). For older adults with normal physical fitness, a remarkable difference was observed in moderate physical activity, total physical activity, and sitting between intervention and control groups after 2 weeks (p < 0.05), but the difference disappeared after 12 weeks. For older adults with high physical fitness, no significant changes were found between groups (p > 0.05). The findings suggest that telling older people their predictive physical fitness age can become a viable motivational tool to promote physical activity especially for those with low physical fitness, thereby improving their physical fitness age and overall health.

Psycho-behavioral predictors of uncontrolled blood pressure: A case-control study

Background: We aimed to determine the role of demographic, lifestyle, and personality trait factors in predicting control of blood pressure (BP) among patients with hypertension (HTN) in West Azerbaijan, Iran.

Methods: In this case control study we recruited participants from all primary health centers of Salmas city; who were at least 18 years of age, had a HTN diagnosis during the previous six months, and had a mandatory household record. Of 490 random subjects approached, 441 (84.2%) fulfilled our inclusion criteria (case: 221; control: 220). The age-matched controls were recruited from the same source population and were required to have controlled HTN. Data were collected through demographic Checklist, Ten-Item Personality Inventory (TIPI) and International Physical Activity Questionnaire (IPAQ).

Results: Upon multivariate analyses, factors related to personality traits subdomains including extraversion personality (odd ratio [OR]: 0.85; CI: 0.73, 0.97) was effective in control of BP. Factors related to uncontrolled BP were agreement and consciences subdomains (OR 1.26 [CI: 1.07, 1.48] and OR 1.21 [CI: 1. 02, 1.44]), rare fruit consumption (OR 5.95 [CI: 1.24, 12.1]), Grade 1 and 2 obesities (OR 2.29 [CI: 1.28, 4.09] and OR 7.11 [CI: 2.21, 12.52]) and smoking (OR 3.27 [CI: 1.56, 6.89]).

Conclusion: In addition to regular physical activity and fruit consumption and quitting smoking; personality traits such as Agreement and conscience personality traits were predictive of HTN control. We believe our work provides the required knowledge to design comprehensive HTN prevention programs by taking into account the multi-level causality approach.

"I feel too lethargic to do physical activity": Perceptions of Iranian adults on the barriers to perform regular physical activity

Background: Despite the intention to perform physical activity (PA), a number of individuals cannot manage to have PA program on a regular basis. In this study we explored the barriers of regular PA behavior among healthy adults in Tabriz, Iran.

Methods: This qualitative study with a conventional content analysis approach, was carried out from June to September 2020. Nineteen 30-59 years old individuals, were purposefully (purposive sampling) selected to participate in the study. The participants were formerly registered as "physically inactive" in the health records of Tabriz Health System. Individual semi-structured interviews were conducted until data saturation. Data were managed using MAXQDA-10 software.

Results: The barriers of regular PA that emerged from our data were being listless and lethargic, non-supportive environment, disintegration in PA education chain, and restrictive social norms.

Conclusion: Our findings uncover several PA barriers that are less discussed in the literature. Poor level of regular PA among adults in Iran, as a developing context, is rooted in perceptions with social and economic origins, which should be taken into account by public health policy makers while planning PA promotion programs in such communities. To promote regular PA among healthy adults in developing countries, regular PA programs should be tailored to bridge the gap between their recognition of PA barriers and subsequent behavior change through creating group dynamics highlighting the measures to diminish the behavior.

The Greek translation and validation of the electronic version of the Meno-D rating scale for post-menopausal depression

Menopausal transition and post-menopause constitute windows of increased vulnerability to depression. Recently, the Meno-D was introduced, a novel 12-item, with five distinct subscales. The aim of our study was to translate and validate the electronic version of the Meno-D among Greek post-menopausal women. Translation and back-translation were performed by an expert group, while face validity was assessed by five experts. Along with the Beck Depression Inventory-II, the Meno-D scale was distributed online to 502 post-menopausal women. A confirmatory factor analysis was performed to investigate construct validity and both convergent and discriminant validity were evaluated. The data analysis was performed using Statistical Package for Social Sciences and AMOS. The 5-factor model of Meno-D achieved adequate levels of goodness-of-fit indices, scoring lower values in discriminant validity examined with heterotrait-monotrait ratio and composite reliability. The significant correlation with the Beck Depression Inventory-ΙΙ revealed for all subscales was indicative of good convergent validity. An exploratory factor analysis was additionally performed, suggesting a 12-item tool comprising two subscales: (i) psychological and (ii) biological and achieving good levels of fit. Our data confirmed that the electronic version of Meno-D is a valid tool that can be used for screening and evaluation of depression in Greek post-menopausal women.

The impact of physical activity on psychological well-being in women aged 45-55 years during the Covid pandemic: A mixed-methods investigation

Evidence suggests that being physically active may improve quality of life through the menopausal transition. This study is one of the first to investigate how meeting the UK Physical Activity Guidelines (PAG) impacted quality of life, stress, coping and menopausal symptoms in UK midlife women, aged 45-55 years, during the unfolding Covid pandemic (Phase 1 quantitative, n=164). The study also explored their motivation to undertake regular physical activity during Covid lockdown (Phase 2 qualitative, n=4). An explanatory sequential mixed-methods design was used to collate quantitative (survey) and qualitative (focus group) data. Participants who met PAG experienced fewer depressive symptoms and less perceived stress, and had better physical and mental health and quality of life than women who did not. This was supported by focus group discussions reporting lack of facilities, time constraints, reduced social support and existing health complaints as barriers to physical activity. Factors motivating women to exercise during Covid lockdown were benefits for physical and mental health, and support from friends (Qualitative). Women are postmenopausal for one-third of their lives, and health interventions need to promote positive healthy ageing around menopause. Menopausal changes could be used by clinicians as cues to action to promote female health and well-being. Clinicians should be promoting the health benefits of exercise and making women aware of the importance of aiming to meet the PAG for optimal health benefits. Women should be encouraged to increase their levels of physical activity by making plans and setting goals and gaining support by exercising with friends or family, as a way to better control menopausal symptoms.

Online assessment of the perception of loneliness and associated factors in Colombian climacteric women during the COVID-19 pandemic: A cross-sectional study

Background: The coronavirus disease 2019 (COVID-19) pandemic has generated changes due to confinement, this measure can increase the perception of loneliness. The objective was to estimate the frequencies of emotional, social and general loneliness and their association with fear and anxiety with COVID-19, religiosity and severe deterioration of quality of life in middle-aged women. Methods: A cross-sectional study in Colombian women (40-59 y, n=984) surveyed with an electronic form that included sociodemographic characteristics and validated measures (Menopause Rating Scale, de Jong Gierveld Loneliness Scale, fear of COVID-19 scale, Coronavirus Anxiety Scale and Francis Scale for Religiosity). Associations of emotional, social and general loneliness (dependent variables) with severe somatic, psychological, urogenital and quality of life deterioration, as well as with high religiosity, anxiety and high fear of COVID-19 (independent variables), were estimated. Results: The median age was 47 years old, and 39.2% [95% CI: 36.2-42.3] postmenopausal. Severe deterioration in somatic, psychological, urogenital domains and quality of life in women with emotional, social and general loneliness was found (P <0.001). In adjusted models, high fear of COVID-19, severe deterioration of psychological and urogenital domains and quality of life were associated with emotional, social and general loneliness. Anxiety with COVID-19, somatic domain and high religiosity were not associated with loneliness. Conclusion: Emotional, social and general loneliness were identified in 4/10 middle-aged Colombian women surveyed, and the associated factors were high fear of COVID-19, severe deterioration of quality of life and psychological and urogenital domains. Professionals who care for climacteric women should explore the perception of loneliness when assessing menopausal symptoms.

Evaluating psychosocial and physical activity outcomes following an intervention among Filipino Americans

Background: Physical activity (PA) is a strong contributor to enhancing a healthy lifestyle and preventing numerous chronic diseases. As ethnic minorities engage in low levels of PA, psychosocial and activity-based interventions for sustaining PA are crucial.

Methods: The 6-month intervention incorporated culturally tailored educational workshops and weekly PA classes at a community center. Educational workshops were led by six trained community health workers (CHWs). Participants (n=37) completed pre- and post-intervention questionnaires regarding PA related self-efficacy, outcome expectations, social support, enjoyment, self-regulation, goal setting, and overall PA.

Results: Following the intervention, study participants exhibited increases in weekly PA levels. Wilcoxon Signed-Rank test revealed higher median scores for Exercise Self-Efficacy Scale (ESES), Identified Regulation, and Intrinsic Motivation. Positive changes were observed for Physical Outcome Expectations, Social Outcome Expectations, Self-Evaluative Outcome Expectations, Physical Activity Enjoyment, Social Support for Exercise Scale – Family, Social Support for Exercise – Friends, and Exercise Goal-Setting.

Conclusion: Community-based PA interventions may provide potential benefits to Filipino Americans, an ethnic Asian minority group, in identifying exercise benefits, developing proper exercise goals, increasing motivation, promoting PA behavior, and facilitating long-term PA adherence.