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Kähönen E, Kähönen E, Pälve K, Hulkkonen J, Kähönen M, Raitakari OT, Hutri N, Lehtimäki T, Aatola H. Association of childhood socioeconomic status with adulthood maximal exercise blood pressure: the Cardiovascular Risk in Young Finns Study. Blood Press 2024; 33:2323987. [PMID: 38465629 DOI: 10.1080/08037051.2024.2323987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE Socioeconomic status has been related to resting blood pressure (BP) levels at different stages of life. However, the association of childhood socioeconomic status (SES) and adulthood exercise BP is largely unknown. Therefore, we studied the association of childhood SES with adulthood maximal exercise BP. MATERIALS AND METHODS This investigation consisted of 373 individuals (53% women) participating in the Cardiovascular Risk in Young Finns Study who had data concerning family SES in childhood (baseline in 1980, at age of 6-18 years) and exercise BP response data in adulthood (follow-up in adulthood in 27-29 years since baseline). A maximal cardiopulmonary exercise test with BP measurements was performed by participants, and peak exercise BP was measured. RESULTS In stepwise multivariable analysis including childhood risk factors and lifestyle factors (body mass index, systolic BP, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, insulin, fruit consumption, vegetable consumption, and physical activity), lower family SES in childhood was associated with higher maximal exercise BP in adulthood (β value ± SE, 1.63 ± 0.77, p = 0.035). The association remained significant after further adjustment with participants SES in adulthood (β value ± SE, 1.68 ± 0.65, p = 0.011) and after further adjustment with adulthood body-mass index, systolic BP, maximal exercise capacity, and peak heart rate in exercise (β value ± SE, 1.25 ± 0.56, p = 0.027). CONCLUSIONS These findings suggest that lower childhood family SES is associated with higher maximal exercise BP in adulthood.
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Affiliation(s)
- Erika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Emilia Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Kristiina Pälve
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Heart Center, Turku University Hospital, Turku, Finland
| | | | - Mika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
- Finnish Cardiovascular Research Center-Tampere, Tampere, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Nina Hutri
- Tampere Centre for Skills Training and Simulation, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Finnish Cardiovascular Research Center-Tampere, Tampere, Finland
- Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Heikki Aatola
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
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Antonio J, Newmire DE, Stout JR, Antonio B, Gibbons M, Lowery LM, Harper J, Willoughby D, Evans C, Anderson D, Goldstein E, Rojas J, Monsalves-Álvarez M, Forbes SC, Gomez Lopez J, Ziegenfuss T, Moulding BD, Candow D, Sagner M, Arent SM. Common questions and misconceptions about caffeine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2024; 21:2323919. [PMID: 38466174 DOI: 10.1080/15502783.2024.2323919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/17/2024] [Indexed: 03/12/2024] Open
Abstract
Caffeine is a popular ergogenic aid that has a plethora of evidence highlighting its positive effects. A Google Scholar search using the keywords "caffeine" and "exercise" yields over 200,000 results, emphasizing the extensive research on this topic. However, despite the vast amount of available data, it is intriguing that uncertainties persist regarding the effectiveness and safety of caffeine. These include but are not limited to: 1. Does caffeine dehydrate you at rest? 2. Does caffeine dehydrate you during exercise? 3. Does caffeine promote the loss of body fat? 4. Does habitual caffeine consumption influence the performance response to acute caffeine supplementation? 5. Does caffeine affect upper vs. lower body performance/strength differently? 6. Is there a relationship between caffeine and depression? 7. Can too much caffeine kill you? 8. Are there sex differences regarding caffeine's effects? 9. Does caffeine work for everyone? 10. Does caffeine cause heart problems? 11. Does caffeine promote the loss of bone mineral? 12. Should pregnant women avoid caffeine? 13. Is caffeine addictive? 14. Does waiting 1.5-2.0 hours after waking to consume caffeine help you avoid the afternoon "crash?" To answer these questions, we performed an evidence-based scientific evaluation of the literature regarding caffeine supplementation.
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Affiliation(s)
- Jose Antonio
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Daniel E Newmire
- Texas Woman's University, Exercise Physiology and Biochemistry Laboratory, School of Health Promotion and Kinesiology, Denton, TX, USA
| | - Jeffrey R Stout
- University of Central Florida, College of Health Professions and Sciences, Orlando, FL, USA
| | - Brandi Antonio
- University of Central Florida, College of Health Professions and Sciences, Orlando, FL, USA
| | | | - Lonnie M Lowery
- Nutrition, Exercise and Wellness Associates, Cuyahoga Falls, OH, USA
- Walsh University, Department of Exercise Science, North Canton, OH, USA
| | - Joseph Harper
- Walsh University, Department of Exercise Science, North Canton, OH, USA
| | - Darryn Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
| | - Cassandra Evans
- Nova Southeastern University, Department of Health and Human Performance, Davie, FL, USA
| | - Dawn Anderson
- Indiana Tech, Exercise and Sport Performance Laboratory, Fort Wayne, IN, USA
| | - Erica Goldstein
- Stetson University, Department of Health Sciences, Deland, FL, USA
| | - Jose Rojas
- Keiser University, Fort Lauderdale, FL, USA
- Rocky Mountain University of Health Professions, Provo, UT, USA
| | - Matías Monsalves-Álvarez
- Universidad de O´Higgins, Exercise Metabolism and Nutrition Laboratory. Instituto de Ciencias de la Salud, Rancagua, Chile
- Motion Human Performance Laboratory, Lo Barnechea, Chile
| | - Scott C Forbes
- Brandon University, Department of Physical Education Studies, CBrandon, MB, Canada
| | | | - Tim Ziegenfuss
- The Center for Applied Health Sciences, Canfield, OH, USA
| | - Blake D Moulding
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, SK, Canada
| | - Darren Candow
- University of Regina, Faculty of Kinesiology and Health Studies, Regina, SK, Canada
| | | | - Shawn M Arent
- University of South Carolina, Arnold School of Public Health, Columbia, SC, USA
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3
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Aydin S, Kilinc F, Ugur K, Aydin MA, Yalcin MH, Kuloglu T, Kaya Tektemur N, Albayrak S, Emre E, Yardim M, Akkoc RF, Hancer S, Sahin İ, Cinar V, Akbulut T, Demircan S, Evren B, Gencer BT, Aksoy A, Yilmaz Bozoglan M, Aydemir İ, Aydin S. Effects of irisin and exercise on adropin and betatrophin in a new metabolic syndrome model. Biotech Histochem 2024; 99:21-32. [PMID: 37933453 DOI: 10.1080/10520295.2023.2276205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023] Open
Abstract
Metabolic syndrome (MetS) is a prevalent public health problem. Uric acid (UA) is increased by MetS. We investigated whether administration of UA and 10% fructose (F) would accelerate MetS formation and we also determined the effects of irisin and exercise. We used seven groups of rats. Group 1 (control); group 2 (sham); group 3 (10% F); group 4 (1% UA); group 5 (2% UA); group 6 (10% F + 1% UA); and Group 7, (10% F + 2% UA). After induction of MetS (groups 3 -7), Group 3 was divided into three subgroups: 3A, no further treatment; 3B, irisin treatment; 3C, irisin treatment + exercise. Group 4, 1% UA, which was divided into three subgroups: 4A, no further treatment; 4B, irisin treatment; 4C, Irisin treatment + exercise. Group 5, 2% UA, which was divided into three subgroups: 5A, no further treatment; 5B, irisin treatment; 5C, irisin treatment + exercise. Group 6, 10% F + 1% UA, which was divided into three subgroups: 6A, no further treatment; 6B, irisin treatment; 6C, irisin treatment + exercise. Group 7, 10% F + 2% UA, which was divided into three subgroups: 7A, no further treatment; 7B, irisin treatment; 7C, irisin treatment + exercise., İrisin was administered 10 ng/kg irisin intraperitoneally on Monday, Wednesday, Friday, Sunday each week for 1 month. The exercise animals (in addition to irisin treatment) also were run on a treadmill for 45 min on Monday, Wednesday, Friday, Sunday each week for 1 month. The rats were sacrificed and samples of liver, heart, kidney, pancreas, skeletal muscles and blood were obtained. The amounts of adropin (ADR) and betatrophin in the tissue supernatant and blood were measured using an ELISA method. Immunohistochemistry was used to detect ADR and betatrophin expression in situ in tissue samples. The duration of these experiments varied from 3 and 10 weeks. The order of development of MetS was: group 7, 3 weeks; group 6, 4 weeks; group 5, 6 weeks; group 4, 7 weeks; group 3, 10 weeks. Kidney, liver, heart, pancreas and skeletal muscle tissues are sources of adropin and betatrophin. In these tissues and in the circulation, adropin was decreased significantly, while betatrophin was increased significantly due to MetS; irisin + exercise reversed this situation. We found that the best method for creating a MetS model was F + UA2 supplementation. Our method is rapid and simple. Irisin + exercise was best for preventing MetS.
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Affiliation(s)
- Suna Aydin
- Department of Cardiovascular Surgery, Fethi Sekin City Hospital, Elazig, Turkiye
- Department of Anatomy, School of Medicine, Firat University, Elazig, Turkiye
- Department of Histology and Embryology, School of Veterinary Medicine, Firat University, Elazig, Turkiye
| | - Faruk Kilinc
- Department of Internal Medicine (Endocrinology and Metabolism Diseases), School of Medicine, Firat University, Elazig, Turkiye
| | - Kader Ugur
- Department of Internal Medicine (Endocrinology and Metabolism Diseases), School of Medicine, Firat University, Elazig, Turkiye
| | | | - Mehmet Hanifi Yalcin
- Department of Histology and Embryology, School of Veterinary Medicine, Firat University, Elazig, Turkiye
| | - Tuncay Kuloglu
- Department of Histology and Embryology, School of Medicine, Firat University, Elazig, Turkiye
| | - Nalan Kaya Tektemur
- Department of Histology and Embryology, School of Medicine, Firat University, Elazig, Turkiye
| | - Serdal Albayrak
- Department of Brain and Nerve Surgery, Elazig Fethi Sekin City Hospital, Elazig, Turkiye
| | - Elif Emre
- Department of Anatomy, School of Medicine, Firat University, Elazig, Turkiye
| | - Meltem Yardim
- Department of Medical Biochemistry, Faculty of Sport Sciences, Yerkoy State Hospital, Yozgat, Turkiye
| | - Ramazan Fazil Akkoc
- Department of Anatomy, School of Medicine, Firat University, Elazig, Turkiye
| | - Serhat Hancer
- Department of Histology and Embryology, School of Medicine, Firat University, Elazig, Turkiye
| | - İbrahim Sahin
- Department of Medical Biochemistry and Clinical Biochemistry, Firat Hormones Research Group, Medical School, Firat University, Elazig, Turkiye
- Department of Medical Biology, Medical School, Erzincan Binali Yildirim University, Erzincan, Turkiye
| | - Vedat Cinar
- Department of Physical Education and Sports Teaching, Faculty of Sport Sciences, Firat University, Elazig, Turkey
| | - Taner Akbulut
- Department of Sports and Health, Faculty of Sport Sciences, Firat University, Elazig, Turkiye
| | - Selcuk Demircan
- Department of Intensive Care, Inonu University Hospital, Malatya, Turkiye
| | - Bahri Evren
- Department of Internal Medicine, School of Medicine, Inonu University, Malatya, Turkiye
| | - Berrin Tarakci Gencer
- Department of Histology and Embryology, School of Veterinary Medicine, Firat University, Elazig, Turkiye
| | - Aziz Aksoy
- Nature and Engineering Faculty, Malatya Turgut Ozal University, Malatya, Turkiye
| | - Merve Yilmaz Bozoglan
- Department of Medical Pharmacology, Medical School, Firat University, Elazig, Turkiye
| | - İsa Aydemir
- Department of Physical Education and Sports Teaching, Faculty of Sport Sciences, Firat University, Elazig, Turkey
| | - Suleyman Aydin
- Department of Medical Biochemistry and Clinical Biochemistry, Firat Hormones Research Group, Medical School, Firat University, Elazig, Turkiye
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Dominelli PB, Sheel AW. The pulmonary physiology of exercise. Adv Physiol Educ 2024; 48:238-251. [PMID: 38205515 DOI: 10.1152/advan.00067.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 12/14/2023] [Accepted: 01/07/2024] [Indexed: 01/12/2024]
Abstract
The pulmonary system is the first and last "line of defense" in terms of maintaining blood gas homeostasis during exercise. Our review provides the reader with an overview of how the pulmonary system responds to acute exercise. We undertook this endeavor to provide a companion article to "Cardiovascular Response to Exercise," which was published in Advances in Physiological Education. Together, these articles provide the readers with a solid foundation of the cardiopulmonary response to acute exercise in healthy individuals. The intended audience of this review is level undergraduate or graduate students and/or instructors for such classes. By intention, we intend this to be used as an educational resource and seek to provide illustrative examples to reinforce topics as well as highlight uncertainty to encourage the reader to think "beyond the textbook." Our treatment of the topic presents "classic" concepts along with new information on the pulmonary physiology of healthy aging.NEW & NOTEWORTHY Our narrative review is written with the student of the pulmonary physiology of exercise in mind, be it a senior undergraduate or graduate student or those simply refreshing their knowledge. We also aim to provide examples where the reader can incorporate real scenarios.
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Affiliation(s)
- Paolo B Dominelli
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - A William Sheel
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
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Turgeon S, MacKenzie A, Batcho CS, D'Amour J. Making physical activity fun and accessible to adults with intellectual disabilities: A pilot study of a gamification intervention. J Appl Res Intellect Disabil 2024; 37:e13213. [PMID: 38404069 DOI: 10.1111/jar.13213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Only about 9% of individuals with intellectual disabilities reach the government's physical activity (PA) recommendations. Combining gamification and technology seems particularly promising in overcoming personal and environmental barriers to PA participation. METHOD Eighteen adults with varying levels of intellectual disabilities completed a pilot study to assess the initial effects of a cycling gamification intervention on levels of PA, fitness, psychosocial outcomes, and challenging behaviours. The study comprised three designs: pre-post single group, AB single-case, and qualitative. Social validity, implementation barriers and facilitators were also explored. RESULTS Nearly all 18 participants cycled daily. Time and distance cycled daily increase during the intervention while a decrease in stereotyped behaviours was observed. Participants and staff found the intervention enjoyable and socially valid. CONCLUSIONS Results of the multiple-design study suggest that gamification interventions may be a suitable, enjoyable, and promising way to contribute to PA participation of adults with intellectual disabilities.
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Affiliation(s)
- Stéphanie Turgeon
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Alexandra MacKenzie
- Département de psychoéducation et de psychologie, Université du Québec en Outaouais, Gatineau, Canada
| | - Charles Sebiyo Batcho
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec, Canada
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec, Canada
| | - Jason D'Amour
- Département de psychologie, Université du Québec à Trois Rivières, Quebec, Canada
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Prabhu NS, Maiya GA, Bhat K V. Implementation of physical rehabilitation programs for children with cancer across low- and middle-income countries: A need of the hour perspective. Pediatr Blood Cancer 2024; 71:e30876. [PMID: 38243768 DOI: 10.1002/pbc.30876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/21/2024]
Affiliation(s)
- Nivedita S Prabhu
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - G Arun Maiya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vasudeva Bhat K
- Division of Pediatric Hematology and Oncology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Akgüller T, Coşkun R, Analay Akbaba Y. Comparison of the Effects of Cervical Thrust Manipulation and Exercise in Mechanical Neck Pain: A Randomized Controlled Trial. Physiother Theory Pract 2024; 40:789-803. [PMID: 36637358 DOI: 10.1080/09593985.2022.2164475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 12/26/2022] [Accepted: 12/26/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVE This study aimed to compare the effectiveness of cervical thrust manipulation and exercise in patients with mechanical neck pain (MNP). METHOD Sixty (mean age 31.45 ± 7.31 years) patients were randomized into three groups: manipulation (Group 1); exercise (Group 2); and manipulation plus exercise (Group 3). All interventions were performed 2 days a week for 6 weeks. The visual analog scale (VAS) and Neck Disability Index (NDI) were primary outcome measures; pressure pain threshold (PPT), range of motion (ROM), Short form-36 (SF-36), and Global Rating of Change (GROC) were secondary outcome measures. RESULTS All parameters improved in all groups (p < .05). Only the minimal clinically important difference (MCID) for NDI was achieved in Group 3. Group 3 had greater improvement in: VAS-rest (p = .004); NDI (p < .001); PPT-left (p = .012); and vitality (p = .002), as well as higher GROC compared to the other groups (p = .043). Group 3 was superior to Group 2 in terms of: ROM (Lateral flexion [LF]-right, p = .003/left, p = .003, rotation-right, p = .012/left, p = .010), PPT-right (p = .022); and emotional well-being (p = .003). Group 1 was superior to Group 2 in terms of ROM (LF-left, p = .043/rotation-left, p = .049). The between-group effect sizes were large (0.12-0.36). CONCLUSION The combined application of cervical thrust manipulation and exercise in MNP resulted in greater improvement in clinical parameters, especially function, and higher patient satisfaction in the short term compared to their application alone. Because of its positive effects, cervical thrust manipulation can be added to the exercise program according to the patient's needs and suitability for manipulation.
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Affiliation(s)
- Tuğba Akgüller
- Division of Physiotherapy, Vocational School, Istanbul Arel University, Zeytinburnu/Istanbul, Turkey
- Department of Physiotherapy and Rehabilitation, Institute of Graduate Studies, Istanbul University-Cerrahpasa, Büyükçekmece/Istanbul, Turkey
| | - Reşat Coşkun
- Department of Physıotherapy and Rehabılıtatıon, Nisantasi Hospital, Sisli/Istanbul, Turkey
| | - Yıldız Analay Akbaba
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Büyükçekmece/Istanbul, Turkey
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Patel L, Segar MW, Keshvani N, Subramanian V, Pandey A, Chandra A. Association of Beta-Blocker Use With Exercise Capacity in Participants With Heart Failure With Preserved Ejection Fraction: A Post Hoc Analysis of the RELAX Trial. Am J Cardiol 2024; 216:48-53. [PMID: 38336082 DOI: 10.1016/j.amjcard.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/10/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024]
Abstract
Patients with heart failure with preserved ejection fraction (HFpEF) often receive β-blocker (BB) therapy for management of co-morbidities. However, the association of BB therapy with exercise capacity and health-related quality of life (HRQL) in HFpEF is not well-studied. In this post hoc analysis of the Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in HFpEF (RELAX) trial, which included patients with chronic stable HFpEF with peak exercise capacity assessment at baseline and at 12 and 24 weeks of follow-up, we evaluated the association of BB use with the measures of exercise capacity (peak exercise oxygen uptake), anaerobic threshold, and HRQL (Minnesota living with heart failure questionnaire). Separate linear mixed-effect models were constructed for each outcome with adjustment for treatment arm, demographics, medical history, left ventricular ejection fraction, and duration of heart failure. Of the 216 study participants (median age 69 years, 48.2% women), 76% reported BB use at baseline. Participants with (vs without) BB therapy were older (70 vs 63.5 years, p = 0.001) and had a higher prevalence of ischemic heart disease (44% vs 23%, p = 0.01). In the adjusted linear mixed model, BB use over time was not associated with peak exercise oxygen uptake (β 95% confidence interval [CI] 0.2 (-0.31 to 0.7), p = 0.5) and 6-minute walk distance (β 95% CI 14.69 [-14.25 to 43.63], p = 0.3). However, BB use was associated with a higher anaerobic threshold (β 95% CI 0.32 (0.02 to 0.62), p = 0.036) and better HRQL (lower quality of life as assessed by Minnesota living with heart failure questionnaire score) (β 95% CI -6.68 [-10.96 to -2.4], p = 0.002). Future trials are needed to better evaluate the effects of BB on exercise capacity in patients with chronic stable HFpEF.
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Affiliation(s)
- Lajjaben Patel
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | | | - Neil Keshvani
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Vinayak Subramanian
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas
| | - Alvin Chandra
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.
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9
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Nakayama JY, Van Dyke ME, Quinn TD, Whitfield GP. Association Between Leisure-Time Physical Activity and Occupation Activity Level, National Health Interview Survey-United States, 2020. J Phys Act Health 2024; 21:375-383. [PMID: 38423004 DOI: 10.1123/jpah.2023-0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/28/2023] [Accepted: 01/13/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Physical activity for any purpose counts toward meeting Physical Activity Guidelines (PAG). However, national surveillance systems traditionally focus on leisure-time physical activity. There is an incomplete understanding of the association between meeting PAG in leisure time and occupation activity level among US workers. METHODS We used cross-sectional 2020 National Health Interview Survey data to examine US adults aged 18-64 years who worked the week before the survey (n = 14,814). We estimated the proportion meeting aerobic and muscle-strengthening PAG in leisure time by occupation activity level (low, intermediate, and high). Using logistic regression, we examined the association between meeting PAG in leisure time and occupation activity level, adjusted for sociodemographic characteristics and stratified by hours worked. We compared the sociodemographic characteristics of adults working ≥40 hours (the previous week) in high-activity occupations to those in low- or intermediate-activity occupations. RESULTS Adults working in high-activity occupations were less likely to meet PAG in leisure time (26.1% [24.3-28.1]) versus those in low-activity (30.6% [29.1-32.2], P < .01) or intermediate-activity (32.4% [30.8-34.2]) occupations. In stratified, adjusted models, adults working ≥40 hours in low- and intermediate-activity occupations were 13% and 20%, respectively, more likely to meet PAG in leisure time versus those in high-activity occupations. Among those working ≥40 hours, adults in high-activity occupations were more likely to be Hispanic or Latino, male, younger, and have a high school education or lower compared with those in less active occupations. CONCLUSION Traditional surveillance may underestimate meeting PAG among people working in high-activity occupations, potentially disproportionately affecting certain groups.
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Affiliation(s)
- Jasmine Y Nakayama
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Miriam E Van Dyke
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tyler D Quinn
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, Morgantown, WV, USA
| | - Geoffrey P Whitfield
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
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10
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Yildiz TI, Turhan E, Huri G, Ocguder DA, Duzgun I. Cross-education effects on shoulder rotator muscle strength and function after shoulder stabilization surgery: a randomized controlled trial. J Shoulder Elbow Surg 2024; 33:804-814. [PMID: 38122890 DOI: 10.1016/j.jse.2023.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023]
Abstract
HYPOTHESIS This study aimed to investigate the effects of cross education (CE) on rotator cuff (RC) muscle strength recovery and shoulder function in patients who underwent arthroscopic anterior shoulder stabilization surgery. METHODS Twenty-eight patients who underwent shoulder stabilization surgery were included in the study (age, 25 ± 6 years; body mass index, 24.8 ± 3.6 kg/m2). The patients were randomly divided into either the CE group (n = 14) or the control group (n = 14). All patients received a standardized rehabilitation program until the end of the 12th postoperative week. The CE group also received isokinetic training of the nonoperative shoulder focusing on the RC muscles (twice a week, 3 sets of 10 repetitions). RC muscle strength was measured preoperatively and at 3 and 6 months postoperatively using an isokinetic dynamometer at 60°/s and 180°/s angular velocities. Shoulder function was assessed with the Closed Kinetic Chain Upper Extremity Stability Test and Y-Balance Test-Upper Quarter. Analyses of covariance were used for the statistical analyses. RESULTS At 6 months postoperatively, at 60°/s angular velocity, there was higher internal rotator strength in the CE group (P = .02) and similar external rotator strength (P = .62) between the groups. At 180°/s angular velocity, both internal rotator strength (P = .04) and external rotator strength (P = .02) were higher in the CE group. The Closed Kinetic Chain Upper Extremity Stability Test (P = .47), Y-Balance Test-Upper Quarter (P = .95), and Western Ontario Shoulder Instability Index (P = .12) scores were similar between the groups at 6 months after surgery. CONCLUSIONS CE in the early period of postoperative rehabilitation following stabilization surgery improves RC strength recovery. However, it has no effect on functional outcomes. Integrating a CE program into the postoperative rehabilitation protocol may help to improve dynamic shoulder stability but not functional capacity.
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Affiliation(s)
- Taha Ibrahim Yildiz
- Department of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Egemen Turhan
- Department of Orthopedy and Traumatology, Hacettepe University, Ankara, Turkey
| | - Gazi Huri
- Department of Orthopedy and Traumatology, Hacettepe University, Ankara, Turkey
| | - Durmus Ali Ocguder
- Department of Orthopedy and Traumatology, Ankara Sehir Hastanesi, Ankara, Turkey
| | - Irem Duzgun
- Department of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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11
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Fanaroff AC, Coratti S, Farraday D, Norton L, Rareshide C, Zhu J, Levin MG, Damrauer SM, Giri JS, Chokshi NP, Jackson BM, Patel MS. Gamification-augmented home-based exercise for peripheral artery disease: Rationale and design of the GAMEPAD Study. Am Heart J 2024; 270:95-102. [PMID: 38354997 PMCID: PMC10947804 DOI: 10.1016/j.ahj.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/07/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Supervised exercise therapy improves walking performance, functional capacity, and quality of life in patients with peripheral artery disease (PAD). However, few patients with PAD are enrolled in supervised exercise programs, and there are a number of logistical and financial barriers to their participation. A home-based walking intervention is likely to be more accessible to patients with PAD, but no fully home-based walking program has demonstrated efficacy. Concepts from behavioral economics have been used to design scalable interventions that increase daily physical activity in patients with atherosclerotic vascular disease, but whether a similar program would be effective in patients with PAD is uncertain. STUDY DESIGN AND OBJECTIVES GAMEPAD (NCT04536012) is a pragmatic, virtual, randomized controlled trial designed to evaluate the effectiveness of a gamification strategy informed by concepts from behavioral economics to increase daily physical activity in patients with PAD who are seen in cardiology and vascular surgery clinics affiliated with the University of Pennsylvania Health System. Patients are contacted by email or text message, and complete enrollment and informed consent on the Penn Way to Health online platform. A GAMEPAD substudy will evaluate the effectiveness of opt-in versus opt-out framing when approaching patients for study participation. Patients are then provided with a wearable fitness tracker, establish a baseline daily step count, set a goal to increase daily step count by 33%-50%, and are randomized 1:1 to the gamification or control arms. Interventions continue for 16 weeks, including a 4-week period during which goal step count is gradually increased in the gamification arm, with follow-up for an additional 8 weeks to evaluate the durability of behavior change. The trial has met its enrollment goal of 102 participants, with a primary endpoint of change from baseline in daily steps over the 16-week intervention period. Key secondary endpoints include change from baseline in daily steps over the 8-week postintervention follow-up period and changes in patient-reported measures of PAD symptoms and quality of life over the intervention and follow-up periods. CONCLUSIONS GAMEPAD is a virtual, pragmatic randomized clinical trial of a novel, fully home-based walking intervention informed by concepts from behavioral economics to increase physical activity and PAD-specific quality of life in patients with PAD. Its results will have important implications for the application of behavioral economic concepts to scalable home-based strategies to promote physical activity in patients with PAD and other disease processes where physical activity is limited by exertional symptoms. CLINICAL TRIAL REGISTRATION clinicaltrials.gov; NCT04536012.
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Affiliation(s)
- Alexander C Fanaroff
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Penn Center for Digital Cardiology, University of Pennsylvania, Philadelphia, PA.
| | - Samantha Coratti
- Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA
| | - David Farraday
- Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA
| | - Laurie Norton
- Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA; Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA
| | - Charles Rareshide
- Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA
| | - Jingsan Zhu
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA; Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA
| | - Michael G Levin
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Scott M Damrauer
- Penn Cardiovascular Outcomes, Quality, and Evaluative Research Center, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania; Division of Vascular Surgery, University of Pennsylvania, Philadelphia, PA
| | - Jay S Giri
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Penn Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | - Neel P Chokshi
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA; Penn Center for Digital Cardiology, University of Pennsylvania, Philadelphia, PA
| | - Benjamin M Jackson
- Division of Vascular Surgery, Lehigh Valley Heart and Vascular Institute, Allentown, PA
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12
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Van Biesen D, Van Damme T, Morgulec-Adamowicz N, Buchholz A, Anjum M, Healy S. A Systematic Review of Digital Interventions to Promote Physical Activity in People With Intellectual Disabilities and/or Autism. Adapt Phys Activ Q 2024; 41:330-350. [PMID: 37793654 DOI: 10.1123/apaq.2023-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/13/2023] [Accepted: 08/29/2023] [Indexed: 10/06/2023] Open
Abstract
This systematic review synthesized the literature on digital health interventions for the promotion of physical activity (PA) among people with intellectual disabilities and/or autism. From an initial screening of 553 records, 10 studies underwent full-text review. Data were extracted relating to study, intervention, and sample characteristics and PA-related findings. Methodological quality was evaluated using the Crowe Critical Appraisal Tool. There were mixed findings pertaining to the effectiveness of digital health interventions for promoting PA among these populations. Positive results were reported for three of five active-video-game interventions, two of three social-media-based interventions, and one of two e-learning/multicomponent interventions. Digital health interventions can potentially be effective for promoting PA among people with intellectual disabilities and/or autism. However, the large variation in the samples and intervention types and a reliance on pre- and quasi-experimental research designs suggest that inferences should be made with caution and additional research is needed.
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Affiliation(s)
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | | | | | - Momna Anjum
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Séan Healy
- Physical Education and Sports Science, University of Limerick, Limerick, Ireland
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13
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Soares RN, Lessard SJ. Low Response to Aerobic Training in Metabolic Disease: Role of Skeletal Muscle. Exerc Sport Sci Rev 2024; 52:47-53. [PMID: 38112622 PMCID: PMC10963145 DOI: 10.1249/jes.0000000000000331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Aerobic exercise is established to increase cardiorespiratory fitness (CRF), which is linked to reduced morbidity and mortality. However, people with metabolic diseases such as type 1 and type 2 diabetes may be more likely to display blunted improvements in CRF with training. Here, we present evidence supporting the hypothesis that altered skeletal muscle signaling and remodeling may contribute to low CRF with metabolic disease.
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14
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Jia Y, Yang Y, Qu J, Yin L, Wang X. Chemerin affects blood lipid profile of high-fat diet male mice in sedentary and exercise states via glucose and lipid metabolism enzymes. Endocr Connect 2024; 13:e230484. [PMID: 38323605 PMCID: PMC10959035 DOI: 10.1530/ec-23-0484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/07/2024] [Indexed: 02/08/2024]
Abstract
Adipokine chemerin plays important roles in disorders of glucose and lipid metabolism of obesity and obesity-related diseases, and exercise-induced improvement of glucose and lipid metabolism is closely related to the decrease of chemerin, but the mechanisms by which chemerin regulates glucose and lipid metabolism remain unclarified. Hypotestosterone induces male obesity and disorders of glucose and lipid metabolism through androgen receptor (AR) and its target genes: glucose and lipid metabolism-related molecules (including FOXO1, PEPCK, PGC-1α, and SCD1). Recently, the link between them has been reported that chemerin modulated the secretion of androgen. In this study, global chemerin knockout (chemerin (-/-)) mice were established to demonstrate the roles of chemerin in regulating blood glucose and blood lipid of mice under diet (high-fat (HFD) and normal diet) and exercise interventions and then to explore its mechanisms (AR - glucose and lipid metabolism enzymes). We found that the blood lipid and adipocyte size were low accompanied by the improvements in the levels of serum testosterone, gastrocnemius AR, and gastrocnemius FOXO1, SCD1, and PGC-1α in HFD chemerin (-/-) mice, but exercise-induced improvements of these indicators in HFD WT mice were attenuated or abolished in HFD chemerin (-/-) mice. In conclusion, the decrease of chemerin improved the blood lipid profile of HFD male mice at sedentary and exercise states, mediated partly by the increases of testosterone and AR to regulate glucose and lipid metabolism enzymes. To our knowledge, it is the first report that chemerin's regulation of glucose and lipid metabolism might be mediated by testosterone and AR in vivo.
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Affiliation(s)
- Yi Jia
- School of Health and Exercise, The Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Yanan Yang
- School of Health and Exercise, The Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Jing Qu
- School of Health and Exercise, The Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Lijun Yin
- School of Health and Exercise, The Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Xiaohui Wang
- School of Health and Exercise, The Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
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15
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Barbalho-Moulim MC, Paro FM, Pedrosa DF, Serafim LM, Kuster E, Carmo WAD, de Oliveira GP, de Lima MHBS, Pedreira AB, Duarte H, Wittmer VL. Effects of upper limbs' neuromuscular electrical stimulation (NMES) superimposed to voluntary contraction added to a protocol of intradialytic leg cycle ergometer exercise, in muscle strength, functional capacity and quality of life of adult patients with CKD: a randomized clinical trial protocol. Physiother Res Int 2024; 29:e2079. [PMID: 38477078 DOI: 10.1002/pri.2079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 02/02/2024] [Accepted: 02/18/2024] [Indexed: 03/14/2024]
Abstract
OBJECTIVE To investigate the effects of unilateral upper limbs' (ULM) neuromuscular electrical stimulation (NMES) superimposed on a voluntary contraction added to a protocol of intradialytic leg cycle ergometer exercise on muscle strength, functional capacity and quality of life of adult patients with chronic kidney disease (CKD). METHODS This randomized controlled clinical trial will be carried out at a Brazilian University Hospital. The patients will be evaluated and randomly allocated to an intervention group (i.e., unilateral NMES on the upper limb without hemodialysis fistula for 20 min and leg cycle ergometer for 30 min) or a control group (i.e., unilateral NMES-Sham on the upper limb without hemodialysis fistula for 20 min and leg cycle ergometer for 30 min). The patients will be treated for 8 weeks, with three weekly treatment sessions totaling 24 sessions. MEASUREMENTS ULM muscle strength, functional capacity, quality of life and also the feasibility, safety and patient adherence to the exercise protocol. All physical measurements will be collected by trained researchers before treatment (week 0) and at the end of treatment (week 9), always in the second hemodialysis session of the week. It will be used in an intention-to-treat analysis. RESULTS/CONCLUSIONS The outcomes of this clinical trial protocol may help to know the possible benefits of unilateral ULM' NMES superimposed on a voluntary contraction added to a protocol of leg cycle ergometer for patients with CKD and to aid clinical decisions about future implementation or not of this technique (NMES) in intradialytic physical training programs.
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Affiliation(s)
| | - Flavia Marini Paro
- Department of Integrated Education on Health, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Diego França Pedrosa
- Department of Integrated Education on Health, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Lais Mello Serafim
- Department of Integrated Education on Health, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Elizângela Kuster
- Department of Integrated Education on Health, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Willian Assis do Carmo
- Department of Integrated Education on Health, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Gabriela P de Oliveira
- Department of Integrated Education on Health, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Maria Helena B S de Lima
- Cassiano Antônio Moraes University Hospital (HUCAM), Universidade Federal do Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Alexandre Bittencourt Pedreira
- Hemodialysis Sector-Nephrology Unit, Cassiano Antônio Moraes University Hospital (HUCAM), Brazilian Hospital Services Company (EBSERH), Vitória, Espírito Santo, Brazil
| | - Halina Duarte
- Department of Integrated Education on Health, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
| | - Verônica Lourenço Wittmer
- Department of Integrated Education on Health, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
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Saner NJ, Lee MJC, Pitchford NW, Broatch JR, Roach GD, Bishop DJ, Bartlett JD. The effect of sleep restriction, with or without high-intensity interval exercise, on behavioural alertness and mood state in young healthy males. J Sleep Res 2024; 33:e13987. [PMID: 37434366 DOI: 10.1111/jsr.13987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/01/2023] [Accepted: 06/20/2023] [Indexed: 07/13/2023]
Abstract
Mood state and alertness are negatively affected by sleep loss, and can be positively influenced by exercise. However, the potential mitigating effects of exercise on sleep-loss-induced changes in mood state and alertness have not been studied comprehensively. Twenty-four healthy young males were matched into one of three, 5-night sleep interventions: normal sleep (NS; total sleep time (TST) per night = 449 ± 22 min), sleep restriction (SR; TST = 230 ± 5 min), or sleep restriction and exercise (SR + EX; TST = 235 ± 5 min, plus three sessions of high-intensity interval exercise (HIIE)). Mood state was assessed using the profile of mood states (POMS) and a daily well-being questionnaire. Alertness was assessed using psychomotor vigilance testing (PVT). Following the intervention, POMS total mood disturbance scores significantly increased for both the SR and SR + EX groups, and were greater than the NS group (SR vs NS; 31.0 ± 10.7 A.U., [4.4-57.7 A.U.], p = 0.020; SR + EX vs NS; 38.6 ± 14.9 A.U., [11.1-66.1 A.U.], p = 0.004). The PVT reaction times increased in the SR (p = 0.049) and SR + EX groups (p = 0.033) and the daily well-being questionnaire revealed increased levels of fatigue in both groups (SR; p = 0.041, SR + EX; p = 0.026) during the intervention. Despite previously demonstrated physiological benefits of performing three sessions of HIIE during five nights of sleep restriction, the detriments to mood, wellness, and alertness were not mitigated by exercise in this study. Whether alternatively timed exercise sessions or other exercise protocols could promote more positive outcomes on these factors during sleep restriction requires further research.
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Affiliation(s)
- Nicholas J Saner
- Institute for Health and Sport (iHeS), College of Sport and Exercise Science, Victoria University, Melbourne, Australia
| | - Matthew J-C Lee
- Institute for Health and Sport (iHeS), College of Sport and Exercise Science, Victoria University, Melbourne, Australia
| | - Nathan W Pitchford
- School of Health Sciences, University of Tasmania, Launceston, Australia
| | - James R Broatch
- Institute for Health and Sport (iHeS), College of Sport and Exercise Science, Victoria University, Melbourne, Australia
| | - Greg D Roach
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Australia
| | - David J Bishop
- Institute for Health and Sport (iHeS), College of Sport and Exercise Science, Victoria University, Melbourne, Australia
| | - Jonathan D Bartlett
- Institute for Health and Sport (iHeS), College of Sport and Exercise Science, Victoria University, Melbourne, Australia
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Ghanbari A, Ghasemi S, Khaleghian A. Effects of swimming exercise on neuropathic pain in a rat model: role of glutamate. Neurol Res 2024; 46:330-338. [PMID: 38323336 DOI: 10.1080/01616412.2024.2313901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/30/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE The pain-reducing effects of the exercise were exerted through different mechanisms. Knowing more clear mechanisms helps to find more approach that is therapeutic. The objective of the present study is the evaluation of cerebrospinal fluid (CSF) glutamate level alteration in neuropathic pain rats and whether physical activity could modulate it. METHODS In the present study 104 male Wistar rats weighing 180-220 g were randomly divided into 4 groups (Sham, Sham + Exe, Neuropathy, and Neuropathy + Exe) which in turn each group subdivided into 4 groups according to time points for behavioral testing and CSF sampling (Baseline, 2 weeks, 3 weeks, and 4 weeks). To induction of neuropathy (by chronic constriction injury,), after anesthetizing with a mixture of ketamine (80 mg/kg) and xylazine (10 mg/kg), the animal's right sciatic nerve was exposed and was ligated using four movable catgut chromic suture 4/0. The exercise protocol included 25 min of daily swimming, 5 days a week for 4 weeks. Thermal hyperalgesia and mechanical tactile threshold were detected using the plantar test and Von Frey filaments, respectively. CSF glutamate level was determined using high-performance liquid chromatography. RESULTS Findings indicated that mechanical and thermal thresholds significantly (p < 0.01, p < 0.05 respectively) decreased in the neuropathy group against that in sham groups. On the other hand, exercise significantly increased mechanical tactile threshold (p < 0.0012) and thermal threshold (p < 0.05) compared to the neuropathy group. Moreover, CSF glutamate level prominently (p < 0.01) was increased in the neuropathy group compared to the sham group, and swimming exercise significantly (p < 0.001) reduced it. IN CONCLUSION The present findings provide new evidence showing that medium-intensity swimming exercise attenuates pain-like behaviors in neuropathic pain animals, which is possibly due to decreasing CSF glutamate level and its neurotransmission.
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Affiliation(s)
- Ali Ghanbari
- Research Center of Physiology, Semnan University of Medical Sciences, Semnan, Iran
| | - Sahar Ghasemi
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Ali Khaleghian
- Department of Biochemistry, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
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18
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Elavsky S, Burda M, Cipryan L, Kutáč P, Bužga M, Jandackova V, Chow SM, Jandacka D. Physical activity and menopausal symptoms: evaluating the contribution of obesity, fitness, and ambient air pollution status. Menopause 2024; 31:310-319. [PMID: 38377450 PMCID: PMC10959689 DOI: 10.1097/gme.0000000000002319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
OBJECTIVE The menopausal transition is accompanied by transient symptoms that have been linked to subclinical cardiovascular disease (CVD); CVD has also been linked to air pollution. Physical activity (PA) reduces CVD, improves body composition, and can reduce menopausal symptoms. The purpose of this study was to assess the links between PA and menopausal symptoms and whether obesity, fitness, and air pollution status play a role in this relationship. METHODS Women (40-60 y; N = 243; mean [SD] age, 47.8 [5.6] y) from areas with high versus low air pollution enrolled in the Healthy Aging in Industrial Environment Program 4 prospective cohort study completed psychological, cardiorespiratory fitness, body composition, and menopausal status screening followed by a 14-day prospective assessment of menopausal symptoms (Menopause Rating Scale) using a mobile application. Daily PA was assessed objectively across 14 days via Fitbit Charge 3 monitor. General linear mixed models were conducted and controlled for age, menopausal status, day in the study, wear time, and neuroticism. RESULTS Peri/postmenopausal women ( β = 0.43, P < 0.001) and those residing in a high-air-pollution environment ( β = 0.45, P < 0.05) reported more somatovegetative symptoms. Hot flashes alone were associated with peri/postmenopausal status ( β = 0.45, P < 0.001), and for women residing in a high-air-pollution environment, lower reporting of hot flashes was observed on days when a woman was more physically active than usual ( β = -0.15, P < 0.001). No associations were found for cardiorespiratory fitness and visceral fat with any of the symptoms. CONCLUSIONS PA may enhance resilience to hot flashes, especially when residing in high-air-pollution environments where we also observed higher reporting of somatovegetative menopausal symptoms.
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Affiliation(s)
- Steriani Elavsky
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
| | - Michal Burda
- Institute for Research and Applications of Fuzzy Modeling, University of Ostrava, Czech Republic IT4Innovations
| | - Lukáš Cipryan
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
| | - Petr Kutáč
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
| | - Marek Bužga
- Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Vera Jandackova
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Sy-Miin Chow
- Department of Human Development and Family Studies, College of Health and Human Development, Penn State University, USA
| | - Daniel Jandacka
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
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Dao E, Barha CK, Zou J, Wei N, Liu-Ambrose T. Prevention of Vascular Contributions to Cognitive Impairment and Dementia: The Role of Physical Activity and Exercise. Stroke 2024; 55:812-821. [PMID: 38410973 DOI: 10.1161/strokeaha.123.044173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/03/2024] [Indexed: 02/28/2024]
Abstract
Vascular contributions to cognitive impairment and dementia, specifically cerebral small vessel disease (CSVD), are the second most common cause of dementia. Currently, there are no specific pharmacological treatments for CSVD, and the use of conventional antidementia drugs is not recommended. Exercise has the potential to prevent and mitigate CSVD-related brain damage and improve cognitive function. Mechanistic pathways underlying the neurocognitive benefits of exercise include the control of vascular risk factors, improving endothelial function, and upregulating exerkines. Notably, the therapeutic efficacy of exercise may vary by exercise type (ie, aerobic versus resistance training) and biological sex; thus, studies designed specifically to examine these moderating factors within a CSVD context are needed. Furthermore, future research should prioritize resistance training interventions, given their tremendous therapeutic potential. Addressing these knowledge gaps will help us refine exercise recommendations to maximize their therapeutic impact in the prevention and mitigation of CSVD.
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Affiliation(s)
- Elizabeth Dao
- Department of Radiology (E.D.)
- Department of Physical Therapy, Aging, Mobility, and Cognitive Health Laboratory (E.D., J.Z., N.W., T.L.-A.), Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, Canada (E.D., J.Z., N.W., T.L.-A.)
| | - Cindy K Barha
- Faculty of Kinesiology (C.K.B.), University of Calgary, AB, Canada
- Hotchkiss Brain Institute (C.K.B.), University of Calgary, AB, Canada
| | - Jammy Zou
- Department of Physical Therapy (J.Z., N.W., T.L.-A.)
- Department of Physical Therapy, Aging, Mobility, and Cognitive Health Laboratory (E.D., J.Z., N.W., T.L.-A.), Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, Canada (E.D., J.Z., N.W., T.L.-A.)
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, BC, Canada (J.Z., N.W., T.L.-A.)
| | - Nathan Wei
- Department of Physical Therapy (J.Z., N.W., T.L.-A.)
- Department of Physical Therapy, Aging, Mobility, and Cognitive Health Laboratory (E.D., J.Z., N.W., T.L.-A.), Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, Canada (E.D., J.Z., N.W., T.L.-A.)
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, BC, Canada (J.Z., N.W., T.L.-A.)
| | - Teresa Liu-Ambrose
- Department of Physical Therapy (J.Z., N.W., T.L.-A.)
- Department of Physical Therapy, Aging, Mobility, and Cognitive Health Laboratory (E.D., J.Z., N.W., T.L.-A.), Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Djavad Mowafaghian Centre for Brain Health, The University of British Columbia, Vancouver, Canada (E.D., J.Z., N.W., T.L.-A.)
- Centre for Aging SMART at Vancouver Coastal Health, Vancouver Coastal Health Research Institute, BC, Canada (J.Z., N.W., T.L.-A.)
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20
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Carl J, Abu-Omar K, Bernard P, Lohmann J, White P, Peters J, Sahlqvist S, Ma J, Duncan M, Barnett LM. Physical Literacy in the Context of Climate Change: Is There a Need for Further Refinement of the Concept? J Phys Act Health 2024; 21:316-319. [PMID: 38176406 DOI: 10.1123/jpah.2023-0714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024]
Abstract
The concept of physical literacy (PL) has witnessed enormous popularity in recent years and has undergone substantial theoretical evolvement during the last 2 decades. However, the research field pertaining to PL has not yet initiated discussions around the challenges of climate change and the alignment with conceptualizations of planetary health. Therefore, we argue that the consideration of an "ecological domain" for individual physical activity, in the form of ecological awareness, would further evolve the concept. We illustrate how to potentially integrate adjustments within the most frequent PL definitions of the field (eg, those in Australia, Canada, England, Ireland, the United States, or by the International Physical Literacy Association) without questioning the entire integrity of these elaborate conceptualizations. An ecological domain of PL would not only interact with the postulated physical, cognitive, psychological/affective, and social domains of PL but also have important implications for the (re)design of interventions and practices in physical activity contexts. We call the scientific community, both on national and international scales, to intensify the discussions and initiate a research agenda involving an "ecological domain" of PL.
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Affiliation(s)
- Johannes Carl
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Burwood, VIC, Australia
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Paquito Bernard
- Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC, Canada
- Research Center, University Institute of Mental Health at Montreal, Montreal, QC, Canada
| | - Julia Lohmann
- Institute of Sports Science, Augsburg University, Augsburg, Germany
| | - Peta White
- School of Education, Deakin University, Burwood, VIC, Australia
| | - Jacqui Peters
- School of Education, Deakin University, Burwood, VIC, Australia
| | - Shannon Sahlqvist
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Waurn Ponds,VIC, Australia
| | - Jiani Ma
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
| | - Michael Duncan
- Center for Physical Activity, Sport and Exercise Sciences, Coventry University, Coventry, United Kingdom
| | - Lisa M Barnett
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Burwood, VIC, Australia
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21
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Tadrous R, O'Rourke D, Murphy N, Quinn G, Quinn C, Slattery L, Broderick J. Exploring exercise, physical wellbeing and the role of physiotherapy: perspectives from people with narcolepsy. J Sleep Res 2024; 33:e14007. [PMID: 37621198 DOI: 10.1111/jsr.14007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/27/2023] [Accepted: 07/12/2023] [Indexed: 08/26/2023]
Abstract
Narcolepsy is associated with reduced quality of life and physical performance. The study aimed to explore the attitudes of people with Type 1 narcolepsy towards exercise and physical activity, their physical wellbeing, and the potential role of physiotherapy. Semi-structured interviews were conducted with 22 people with narcolepsy attending a dedicated outpatient narcolepsy clinic located in Dublin, Ireland. Transcripts were iteratively coded; a thematic analysis was undertaken, and key themes were identified. Four themes were identified: 'Barriers and Facilitators to Exercising', 'Social Concerns', 'Health Concerns' and 'Suggestions for the Role of Physiotherapy'. Future research should explore the potential role of exercise to help manage narcolepsy-related symptoms in this population.
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Affiliation(s)
- Ragy Tadrous
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Niamh Murphy
- Department of Physiotherapy, St. James's Hospital, Dublin, Ireland
| | - Gillian Quinn
- Department of Physiotherapy, St. James's Hospital, Dublin, Ireland
| | - Caitriona Quinn
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Lisa Slattery
- Department of Neurology, St. James's Hospital, Dublin, Ireland
| | - Julie Broderick
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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22
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Fanuscu A, Asliyüce YÖ, Onan D, Öz M, Berberoğlu U, Ülger Ö. Reliability and validity of the Turkish version of the Health Care Satisfaction Questionnaire in patients with spinal pain. Physiother Res Int 2024; 29:e2083. [PMID: 38513136 DOI: 10.1002/pri.2083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/13/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND The concept of satisfaction is an important concept because of the information it provides about both the quality of health services and the patients' utilization of the health services they receive. The aim of this study was to test the validity and reliability of the Turkish version of the Health Care Satisfaction Questionnaire (HCSQ). METHODS The study sample consisted of 148 patients who received exercise therapy for spinal pain. Psychometric evaluations were analyzed using the Turkish version of the HCSQ (confirmatory factor analysis, convergent validity, test-retest reliability). Convergent validity was determined by examining the relationship between the scale and the Numeric Rating Scale (NRS), Patient Satisfaction Scale for Physiotherapy Outpatient Clinics (PSSPOC) , and the Patient Satisfaction Scale in Physiotherapy (PSSP). RESULTS The HCSQ showed excellent internal consistency (Cronbach's a = 0.96) and excellent test-retest reliability (intraclass correlation coefficient = 0.944). The HCSQ showed high correlation with NRS, PSSPOC , and PSSP. CONCLUSION The HCSQ is a valid and reliable tool for assessing satisfaction with health care services in the Turkish population with spinal pain.
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Affiliation(s)
- Aybüke Fanuscu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Yasemin Özel Asliyüce
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Dilara Onan
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Yozgat Bozok University, Yozgat, Turkey
| | - Müzeyyen Öz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Utku Berberoğlu
- Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, Balıkesir University, Balıkesir, Turkey
| | - Özlem Ülger
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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23
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Leem YH, Park JS, Park JE, Kim DY, Kim HS. Creatine supplementation with exercise reduces α-synuclein oligomerization and necroptosis in Parkinson's disease mouse model. J Nutr Biochem 2024; 126:109586. [PMID: 38262563 DOI: 10.1016/j.jnutbio.2024.109586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/04/2024] [Accepted: 01/17/2024] [Indexed: 01/25/2024]
Abstract
Parkinson's disease (PD) is an incurable neurological disorder that causes typical motor deficits. In this study, we investigated the effects of creatine supplementation and exercise in the subacute 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD. We found that 2% creatine supplementation and/or exercise intervention for 4 weeks elicited neurobehavioral recovery and neuroprotective effects regarding dopaminergic cell loss in MPTP-treated mice; this effect implies functional preservation of dopaminergic cells in the substantia nigra, as reflected by tyrosine hydroxylase expression recovery. Creatine and exercise reduced necroptotic activity in dopaminergic cells by lowering mixed lineage kinase domain-like protein (MLKL) modification to active phenotypes (phosphorylation at Ser345 and oligomerization) and phosphorylated receptor-interacting protein kinase 1 (RIPK1) (Ser166-p) and RIPK3 (Ser232-p) levels. In addition, creatine and exercise reduced the MPTP-induced increase in pathogenic α-synuclein forms, such as Ser129 phosphorylation and oligomerization. Furthermore, creatine and exercise had anti-inflammatory and antioxidative effects in MPTP mice, as evidenced by a decrease in microglia activation, NF-κB-dependent pro-inflammatory molecule expression, and increase in antioxidant enzyme expression. These phenotypic changes were associated with the exercise/creatine-induced AMP-activated protein kinase (AMPK)/nuclear factor erythroid 2-related factor 2 (Nrf2) and sirtuin 3 (SIRT3)/forkhead box O3 (FoxO3a) signaling pathways. In all experiments, combining creatine with exercise resulted in considerable improvement over either treatment alone. Consequently, these findings suggest that creatine supplementation with exercise has anti-inflammatory, antioxidative, and anti-α-synucleinopathy effects, thereby reducing necroptotic cell death in a PD mouse model.
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Affiliation(s)
- Yea-Hyun Leem
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Jin-Sun Park
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Jung-Eun Park
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Do-Yeon Kim
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Hee-Sun Kim
- Department of Molecular Medicine, Inflammation-Cancer Microenvironment Research Center, School of Medicine, Ewha Womans University, Seoul, South Korea; Department of Brain & Cognitive Sciences, Ewha Womans University, Seoul, South Korea.
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24
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Paillard T, Blain H, Bernard PL. The impact of exercise on Alzheimer's disease progression. Expert Rev Neurother 2024; 24:333-342. [PMID: 38390841 DOI: 10.1080/14737175.2024.2319766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 02/13/2024] [Indexed: 02/24/2024]
Abstract
INTRODUCTION The preventive effects of chronic physical exercise (CPE) on Alzheimer's disease (AD) are now admitted by the scientific community. Curative effects of CPE are more disputed, but they deserve to be investigated, since CPE is a natural non-pharmacological alternative for the treatment of AD. AREAS COVERED In this perspective, the authors discuss the impact of CPE on AD based on an exhaustive literature search using the electronic databases PubMed, ScienceDirect and Google Scholar. EXPERT OPINION Aerobic exercise alone is probably not the unique solution and needs to be complemented by other exercises (physical activities) to optimize the slowing down of AD. Anaerobic, muscle strength and power, balance/coordination and meditative exercises may also help to slow down the AD progression. However, the scientific evidence does not allow a precise description of the best training program for patients with AD. Influential environmental conditions (e.g. social relations, outdoor or indoor exercise) should also be studied to optimize training programs aimed at slowing down the AD progression.
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Affiliation(s)
- Thierry Paillard
- Movement, Balance, Performance, and Health Laboratory, Université de Pau & Pays de l'Adour, Tarbes, France
| | - Hubert Blain
- Pole de Gérontologie Antonin Balmes, CHU de Montpellier; EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Alès, France
| | - Pierre Louis Bernard
- UFR STAPS, EuroMov Digital Health in Motion, Université de Montpellier, IMT Mines Ales, Alès, France
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25
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Forster AK, Richards EA, Franks MM, Foli KJ, Hass Z. Positive Affect and Physical Activity Associations in Women and Their Spouses. West J Nurs Res 2024; 46:278-287. [PMID: 38411159 DOI: 10.1177/01939459241233860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
BACKGROUND Only 21% of U.S. women meet the recommended physical activity guidelines, placing them at increased risk for long-term conditions such as heart disease and diabetes. Physical activity is influenced by individual and interpersonal factors (e.g., romantic partners). Individual factors, such as positive affect, are associated with lower mortality risk and improved health behaviors. OBJECTIVES This secondary data analysis, guided by Fredrickson's Broaden and Build Theory, aims to examine the relationship between positive affect of married women (n = 115 couples) and their physical activity behavior on the same- and next- day, while also considering their spouses' positive affect. METHODS Two population average models assessed the relationship of calm and happy (positive affect) to physical activity. Physical activity was assessed as the sum of the minutes of moderate-to-vigorous physical activity (MVPA) over the prior 24 hours. Covariates of age, baseline activity frequency, education, marital quality, and race/ethnicity were also included. RESULTS Women's happiness (β = 0.15, p < .005), not calmness (β = -0.03, p = .60), was found to have a significant association with same-day MVPA. Spouses' happiness (β = 0.11, p = .045) was significantly associated with women's next-day MVPA while their calmness (β = -0.04, p = .44) was not. CONCLUSIONS The results of this study support that incorporating positive affect could be valuable for improving physical activity behaviors. Spouse reports provide additional context to consider in physical activity promotion research.
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Affiliation(s)
- Anna K Forster
- School of Nursing, Indiana University, Indianapolis, IN, USA
| | | | - Melissa M Franks
- Department of Human Development and Family Science, Purdue University, West Lafayette, IN, USA
| | - Karen J Foli
- School of Nursing, Purdue University, West Lafayette, IN, USA
| | - Zachary Hass
- Regenstrief Center for Healthcare Engineering, School of Nursing & Industrial Engineering, Purdue University, West Lafayette, IN, USA
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26
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Alves da Cruz M, Laurino M, Christofaro D, Ghisi G, Vanderlei L. Long-term effects of virtual reality-based therapy in cardiovascular rehabilitation: A longitudinal study. Physiother Theory Pract 2024; 40:727-735. [PMID: 36567613 DOI: 10.1080/09593985.2022.2160222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/12/2022] [Accepted: 12/12/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND In Cardiovascular Rehabilitation (CR), patient adherence to the maintenance phase is a major challenge. Virtual reality-based therapy (VRBT) promotes acute hemodynamic and autonomic repercussions similar to traditional rehabilitation and can increase patient adherence to the program. However, it is unknown whether the combination of VRBT to a traditional CR manages to maintain or even improve clinical and autonomic variables in long term. OBJECTIVE To analyze whether VRBT combination in a traditional CR can maintain or improve clinical and autonomic variables in cardiac patients in the maintenance phase of these programs. METHODS Twenty-six volunteers (62.04 ± 12.22 years) were evaluated, who underwent an initial assessment and two other assessments (in the sixth and 12th week) of the following outcomes: systolic and diastolic blood pressure, respiratory rate, pulse saturation of oxygen, heart rate, perceived exertion, and cardiac autonomic modulation, using linear and non-linear heart rate variability methods. RESULTS Except for the apparent lack of clinical significance observed in Shannon Entropy, LF (nu), and HF (nu), the combination of VRBT as routine in a traditional program did not cause significant changes in the analyzed variables. CONCLUSION combination of VRBT was able to maintain the chronic hemodynamic and autonomic repercussions caused by traditional CR.
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Affiliation(s)
- Mayara Alves da Cruz
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente, Pres. Prudente 19060-900, Brazil
| | - Maria Laurino
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente, Pres. Prudente 19060-900, Brazil
| | - Diego Christofaro
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente, Pres. Prudente 19060-900, Brazil
| | - Gabriela Ghisi
- Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, ON M4G2V7, Canada
| | - Luiz Vanderlei
- São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente, Pres. Prudente 19060-900, Brazil
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27
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Law L, Kelly JT, Savill H, Wallen MP, Hickman IJ, Erku D, Mayr HL. Cost-effectiveness of telehealth-delivered diet and exercise interventions: A systematic review. J Telemed Telecare 2024; 30:420-437. [PMID: 35108135 DOI: 10.1177/1357633x211070721] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Telehealth is a promising tool for delivering lifestyle interventions for the management of health conditions. However, limited evidence exists regarding the cost-effectiveness of these interventions. This systematic review aimed to evaluate the current literature reporting on the cost-effectiveness of telehealth-delivered diet and/or exercise interventions. METHODS Four electronic databases (PubMed, CENTRAL, CINAHL and Embase) were searched for published literature from database inception to November 2020. This review adhered to the preferred reporting items for systematic reviews and meta-analyses guidelines and the ISPOR Criteria for Cost-Effectiveness Review Outcomes Checklist. The quality of reporting was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. The extracted data were grouped into subcategories according to telehealth modality, organised into tables and reported narratively. RESULTS Twenty-four studies of controlled trials (11 combined diet and exercise, 9 exercise-only and 4 diet-only telehealth-delivered interventions) were included for data extraction and quality assessment. Interventions were reported as cost-effective in 12 studies (50%), five studies (21%) reported inconclusive results, and seven studies (29%) reported that the interventions were not cost-effective. Telephone interventions were applied in eight studies (33%), seven studies (29%) used internet interventions, six studies (25%) used a combination of internet and telephone interventions, and three studies (13%) evaluated mHealth interventions. Quality of study reporting varied with between 54% and 92% of Consolidated Health Economic Evaluation Reporting Standards items reported. CONCLUSIONS This review suggests that telehealth-delivered lifestyle interventions can be cost-effective compared to traditional care. There is a need for further investigations that employ rigorous methodology and economic reporting, including appropriate decision analytical models and longer timeframes.
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Affiliation(s)
- Lynette Law
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Jaimon T Kelly
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Holly Savill
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Matthew P Wallen
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
- School of Science, Psychology and Sport, Federation University Australia, Mount Helen, Victoria, Australia
| | - Ingrid J Hickman
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Daniel Erku
- Centre for Applied Health Economics, Griffith University, Nathan, Queensland, Australia
| | - Hannah L Mayr
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Centre for Functioning and Health Research, Metro South Health, Queensland, Australia
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28
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Berg-Hansen K, Gopalasingam N, Christensen KH, Ladefoged B, Andersen MJ, Poulsen SH, Borlaug BA, Nielsen R, Møller N, Wiggers H. Cardiovascular Effects of Oral Ketone Ester Treatment in Patients With Heart Failure With Reduced Ejection Fraction: A Randomized, Controlled, Double-Blind Trial. Circulation 2024. [PMID: 38533643 DOI: 10.1161/circulationaha.123.067971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Heart failure triggers a shift in myocardial metabolic substrate utilization, favoring the ketone body 3-hydroxybutyrate as energy source. We hypothesized that 14-day treatment with ketone ester (KE) would improve resting and exercise hemodynamics and exercise capacity in patients with heart failure with reduced ejection fraction. METHODS In a randomized, double-blind cross-over study, nondiabetic patients with heart failure with reduced ejection fraction received 14-day KE and 14-day isocaloric non-KE comparator regimens of 4 daily doses separated by a 14-day washout period. After each treatment period, participants underwent right-sided heart catheterization, echocardiography, and blood sampling at plasma trough levels and after dosing. Participants underwent an exercise hemodynamic assessment after a second dosing. The primary end point was resting cardiac output (CO). Secondary end points included resting and exercise pulmonary capillary wedge pressure and peak exercise CO and metabolic equivalents. RESULTS We included 24 patients with heart failure with reduced ejection fraction (17 men; 65±9 years of age; all White). Resting CO at trough levels was higher after KE compared with isocaloric comparator (5.2±1.1 L/min versus 5.0±1.1 L/min; difference, 0.3 L/min [95% CI, 0.1-0.5), and pulmonary capillary wedge pressure was lower (8±3 mm Hg versus 11±3 mm Hg; difference, -2 mm Hg [95% CI, -4 to -1]). These changes were amplified after KE dosing. Across all exercise intensities, KE treatment was associated with lower mean exercise pulmonary capillary wedge pressure (-3 mm Hg [95% CI, -5 to -1] ) and higher mean CO (0.5 L/min [95% CI, 0.1-0.8]), significantly different at low to moderate steady-state exercise but not at peak. Metabolic equivalents remained similar between treatments. In exploratory analyses, KE treatment was associated with 18% lower NT-proBNP (N-terminal pro-B-type natriuretic peptide; difference, -98 ng/L [95% CI, -185 to -23]), higher left ventricular ejection fraction (37±5 versus 34±5%; P=0.01), and lower left atrial and ventricular volumes. CONCLUSIONS KE treatment for 14 days was associated with higher CO at rest and lower filling pressures, cardiac volumes, and NT-proBNP levels compared with isocaloric comparator. These changes persisted during exercise and were achieved on top of optimal medical therapy. Sustained modulation of circulating ketone bodies is a potential treatment principle in patients with heart failure with reduced ejection fraction. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT05161650.
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Affiliation(s)
- Kristoffer Berg-Hansen
- Department of Cardiology, Aarhus University Hospital, Denmark. (K.B.-H., N.G., K.H.C., B.L., M.J.A., S.H.P., R.N., H.W.)
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Denmark (K.B.-H., N.G., K.H.C., B.L., S.H.P., N.M., H.W.)
| | - Nigopan Gopalasingam
- Department of Cardiology, Aarhus University Hospital, Denmark. (K.B.-H., N.G., K.H.C., B.L., M.J.A., S.H.P., R.N., H.W.)
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Denmark (K.B.-H., N.G., K.H.C., B.L., S.H.P., N.M., H.W.)
| | - Kristian Hylleberg Christensen
- Department of Cardiology, Aarhus University Hospital, Denmark. (K.B.-H., N.G., K.H.C., B.L., M.J.A., S.H.P., R.N., H.W.)
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Denmark (K.B.-H., N.G., K.H.C., B.L., S.H.P., N.M., H.W.)
| | - Bertil Ladefoged
- Department of Cardiology, Aarhus University Hospital, Denmark. (K.B.-H., N.G., K.H.C., B.L., M.J.A., S.H.P., R.N., H.W.)
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Denmark (K.B.-H., N.G., K.H.C., B.L., S.H.P., N.M., H.W.)
| | - Mads Jønsson Andersen
- Department of Cardiology, Aarhus University Hospital, Denmark. (K.B.-H., N.G., K.H.C., B.L., M.J.A., S.H.P., R.N., H.W.)
| | - Steen Hvitfeldt Poulsen
- Department of Cardiology, Aarhus University Hospital, Denmark. (K.B.-H., N.G., K.H.C., B.L., M.J.A., S.H.P., R.N., H.W.)
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Denmark (K.B.-H., N.G., K.H.C., B.L., S.H.P., N.M., H.W.)
| | - Barry A Borlaug
- Department of Cardiovascular Medicine, Mayo Clinic Hospital, Rochester, MN (B.A.B.)
| | - Roni Nielsen
- Department of Cardiology, Aarhus University Hospital, Denmark. (K.B.-H., N.G., K.H.C., B.L., M.J.A., S.H.P., R.N., H.W.)
| | - Niels Møller
- Department of Endocrinology and Metabolism (N.M.)
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Denmark (K.B.-H., N.G., K.H.C., B.L., S.H.P., N.M., H.W.)
| | - Henrik Wiggers
- Department of Cardiology, Aarhus University Hospital, Denmark. (K.B.-H., N.G., K.H.C., B.L., M.J.A., S.H.P., R.N., H.W.)
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Denmark (K.B.-H., N.G., K.H.C., B.L., S.H.P., N.M., H.W.)
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29
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Matta L, Blaas L, Gibis C, Guerra J. Functions require junctions: endurance exercise protects from age-induced alterations of the neuromuscular system. J Physiol 2024. [PMID: 38530283 DOI: 10.1113/jp286232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/12/2024] [Indexed: 03/27/2024] Open
Affiliation(s)
- Leonardo Matta
- Institute for Cardiovascular Prevention (IPEK), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute for Diabetes and Cancer (IDC), Helmholtz Centre Munich, German Research Centre for Environmental Health, Neuherberg, Germany
| | - Lukas Blaas
- Institute for Cardiovascular Prevention (IPEK), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christoph Gibis
- Institute for Cardiovascular Prevention (IPEK), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Joel Guerra
- Institute for Cardiovascular Prevention (IPEK), Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute for Diabetes and Cancer (IDC), Helmholtz Centre Munich, German Research Centre for Environmental Health, Neuherberg, Germany
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Li C, Zhang J, Pan P, Zhang J, Hou X, Wang Y, Chen G, Muhammad P, Reis RL, Ding L, Wang Y. Humanistic Health Management and Cancer: Associations of Psychology, Nutrition, and Exercise with Cancer Progression and Pathogenesis. Adv Sci (Weinh) 2024:e2400665. [PMID: 38526194 DOI: 10.1002/advs.202400665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/01/2024] [Indexed: 03/26/2024]
Abstract
The incidence rate of cancer is increasing year by year due to the aging of the population, unhealthy living, and eating habits. At present, surgery and medication are still the main treatments for cancer, without paying attention to the impact of individual differences in health management on cancer. However, increasing evidence suggests that individual psychological status, dietary habits, and exercise frequency are closely related to the risk and prognosis of cancer. The reminder to humanity is that the medical concept of the unified treatment plan is insufficient in cancer treatment, and a personalized treatment plan may become a breakthrough point. On this basis, the concept of "Humanistic Health Management" (HHM) is proposed. This concept is a healthcare plan that focuses on self-health management, providing an accurate and comprehensive evaluation of individual lifestyle habits, psychology, and health status, and developing personalized and targeted comprehensive cancer prevention and treatment plans. This review will provide a detailed explanation of the relationship between psychological status, dietary, and exercise habits, and the regulatory mechanisms of cancer. Intended to emphasize the importance of HHM concept in cancer prevention and better prognostic efficacy, providing new ideas for the new generation of cancer treatment.
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Affiliation(s)
- Chenchen Li
- International Joint Research Center of Human-machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Pharmacy & The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, P. R. China
| | - Junfeng Zhang
- Tumor Precision Targeting Research Center & Institute of Nanochemistry and Nanobiology, School of Environmental and Chemical Engineering, Shanghai University, Shanghai, 200444, P. R. China
| | - Pengcheng Pan
- International Joint Research Center of Human-machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Pharmacy & The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, P. R. China
| | - Junjie Zhang
- International Joint Research Center of Human-machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Pharmacy & The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, P. R. China
| | - Xinyi Hou
- International Joint Research Center of Human-machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Pharmacy & The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, P. R. China
| | - Yan Wang
- International Joint Research Center of Human-machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Pharmacy & The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, P. R. China
| | - Guoping Chen
- International Joint Research Center of Human-machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Pharmacy & The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, P. R. China
| | - Pir Muhammad
- International Joint Research Center of Human-machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Pharmacy & The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, P. R. China
| | - Rui L Reis
- 3B's Research Group, I3Bs-Research Institute on Biomaterials Biodegradables and Biomimetics, University of Minho, Guimarães, 4805-017, Portugal
| | - Lin Ding
- Translational Medicine Collaborative Innovation Center, Shenzhen People's Hospital (The First Affiliated Hospital, Southern University of Science and Technology, The Second Clinical Medical College of Jinan University), Shenzhen, Guangdong, 518055, P. R. China
- Guangdong Engineering Technology Research Center of Stem Cell and Cell Therapy, Shenzhen Key Laboratory of Stem Cell Research and Clinical Transformation, Shenzhen Immune Cell Therapy Public Service Platform, Shenzhen, 518020, P. R. China
| | - Yanli Wang
- International Joint Research Center of Human-machine Intelligent Collaborative for Tumor Precision Diagnosis and Treatment of Hainan Province & Key Laboratory of Tropical Translational Medicine of Ministry of Education, School of Pharmacy & The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, P. R. China
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Carrillo BJP, Cope E, Gurel S, Traslosheros A, Kenny A, Michot-Duval O, Mody N, Delibegovic M, Philip S, Thies F, Blana D, Gabriel BM. Morning exercise and pre-breakfast metformin interact to reduce glycaemia in people with type 2 diabetes: a randomized crossover trial. J Physiol 2024. [PMID: 38522033 DOI: 10.1113/jp285722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/29/2024] [Indexed: 03/25/2024] Open
Abstract
Exercise is recommended in the treatment of type 2 diabetes and can improve insulin sensitivity. However, previous evidence suggests that exercise at different times of the day in people with type 2 diabetes may have opposing outcomes on glycaemia. Metformin is the most commonly prescribed initial pharmacological intervention in type 2 diabetes, and may alter adaptions to exercise. It is unknown if there is an interaction between metformin and diurnal exercise outcomes. We aimed to investigate glycaemic outcomes of moderate intensity morning vs. evening exercise in people with type 2 diabetes being prescribed metformin monotherapy. In this study, nine males and nine females with type 2 diabetes undergoing metformin monotherapy (age 61 ± 8.2 years, mean ± SD) completed a 16-week crossover trial including 2-week baseline recording, 6 weeks randomly assigned to a morning exercise (07.00-10.00 h) or evening exercise (16.00-19.00 h) and a 2-week wash-out period. Exercise arms consisted of 30 min of walking at 70% of estimated max heart rate every other day. Glucose levels were measured with continuous glucose monitors and activity measured by wrist-worn monitors. Food-intake was recorded by 4-day food diaries during baseline, first and last 2 weeks of each exercise arm. There was no difference in exercise intensity, total caloric intake or total physical activity between morning and evening arms. As primary outcomes, acute (24 h) glucose area under the curve (AUC), was lower (P = 0.02) after acute morning exercise (180.6 ± 68.4 mmol/l) compared to baseline (210.3 ± 76.7 mmol/l); and there were no differences identified for glucose (mmol/l) between baseline, morning and evening exercise at any specific time point when data were analysed with two-way ANOVA. As secondary outcomes, acute glucose AUC was significantly lower (P = 0.01) in participants taking metformin before breakfast (152.5 ± 29.95 mmol/l) compared with participants taking metformin after breakfast (227.2 ± 61.51 mmol/l) only during the morning exercise arm; and during weeks 5-6 of the exercise protocol, glucose AUC was significantly lower (P = 0.04) for participants taking metformin before breakfast (168.8 ± 15.8 mmol/l), rather than after breakfast (224.5 ± 52.0 mmol/l), only during morning exercise. Our data reveal morning moderate exercise acutely lowers glucose levels in people with type 2 diabetes being prescribed metformin. This difference appears to be driven by individuals that consumed metformin prior to breakfast rather than after breakfast. This beneficial effect upon glucose levels of combined morning exercise and pre-breakfast metformin persisted through the final 2 weeks of the trial. Our findings suggest that morning moderate intensity exercise combined with pre-breakfast metformin intake may benefit the management of glycaemia in people with type 2 diabetes. KEY POINTS: Morning moderate exercise acutely lowers glucose levels in people with type 2 diabetes being prescribed metformin. This difference appears to be driven by individuals that consumed metformin prior to breakfast rather than after breakfast. Morning exercise combined with pre-breakfast metformin persistently reduced glucose compared to morning exercise combined with post-breakfast metformin through the final week (week 6) of the intervention. Our study suggests it may be possible to make simple changes to the time that people with type 2 diabetes take metformin and perform exercise to improve their blood glucose.
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Affiliation(s)
- Brenda J Peña Carrillo
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Emily Cope
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Sati Gurel
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Andres Traslosheros
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Amber Kenny
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Oscar Michot-Duval
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Nimesh Mody
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Mirela Delibegovic
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Sam Philip
- NHS Grampian Diabetes Research Unit, Diabetes Centre, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Frank Thies
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
| | - Dimitra Blana
- Centre for Health Data Science, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Brendan M Gabriel
- Aberdeen Cardiovascular and Diabetes Centre, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- The Rowett Institute, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK
- Department of Physiology and Pharmacology, Integrative Physiology, The Karolinska Institute, Stockholm, Sweden
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Chabronova A, Holmes TL, Hoang DM, Denning C, James V, Smith JGW, Peffers MJ. SnoRNAs in cardiovascular development, function, and disease. Trends Mol Med 2024:S1471-4914(24)00059-5. [PMID: 38523014 DOI: 10.1016/j.molmed.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/26/2024]
Abstract
Small nucleolar RNAs (snoRNAs) are emerging as important regulators of cardiovascular (patho)biology. Several roles of snoRNAs have recently been identified in heart development and congenital heart diseases, as well as their dynamic regulation in hypertrophic and dilated cardiomyopathies, coronary heart disease (CHD), myocardial infarction (MI), cardiac fibrosis, and heart failure. Furthermore, reports of changes in vesicular snoRNA expression and altered levels of circulating snoRNAs in response to cardiac stress suggest that snoRNAs also function in cardiac signaling and intercellular communication. In this review, we summarize and discuss key findings and outline the clinical potential of snoRNAs considering current challenges and gaps in the field of cardiovascular diseases (CVDs).
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Affiliation(s)
- Alzbeta Chabronova
- Department of Musculoskeletal Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK.
| | - Terri L Holmes
- Centre for Metabolic Health, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7UQ, UK
| | - Duc M Hoang
- Department of Stem Cell Biology, Biodiscovery Institute, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Chris Denning
- Department of Stem Cell Biology, Biodiscovery Institute, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Victoria James
- School of Veterinary Medicine and Science, Biodiscovery Institute, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - James G W Smith
- Centre for Metabolic Health, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7UQ, UK
| | - Mandy J Peffers
- Department of Musculoskeletal Ageing Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, L7 8TX, UK
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Kemi OJ, Hoydal MA, Haram PM, Smith GL, Ellingsen O, Koch LG, Britton SL, Wisloff U. Inherited physical capacity: Widening divergence from young to adult to old. Ann N Y Acad Sci 2024. [PMID: 38520387 DOI: 10.1111/nyas.15130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
Cardiorespiratory performance segregates into rat strains of inherited low- and high-capacity runners (LCRs and HCRs); during adulthood, this segregation remains stable, but widens in senescence and is followed by segregated function, health, and mortality. However, this segregation has not been investigated prior to adulthood. We, therefore, assessed cardiorespiratory performance and cardiac cell (cardiomyocyte) structure-function in 1- and 4-month-old LCRs and HCRs. Maximal oxygen uptake was 23% less in LCRs at 1-month compared to HCRs at 1-month, and 72% less at 4 months. Cardiomyocyte contractility was 37-56% decreased, and Ca2+ release was 34-62% decreased, in 1- and 4-month LCRs versus HCRs. This occurred because HCRs had improved contractility and Ca2+ release during maturation, whereas LCRs did not. In quiescent cardiomyocytes, LCRs displayed 180% and 297% more Ca2+ sparks and 91% and 38% more Ca2+ waves at 1 and 4 months versus HCRs. Cell sizes were not different between LCRs and HCRs, but LCRs showed reduced transverse-tubules versus HCRs, though no discrepant transverse-tubule generation occurred during maturation. In conclusion, LCRs show reduced scores for aerobic capacity and cardiomyocyte structure-function compared to HCRs and there is a widening divergence between LCRs and HCRs during juvenile to near-adult maturation.
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Affiliation(s)
- Ole J Kemi
- School of Cardiovascular and Metabolic Health, University of Glasgow College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - Morten A Hoydal
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
| | - Per M Haram
- Department of Cardiothoracic Surgery, St Olav's Hospital, Trondheim, Norway
| | - Godfrey L Smith
- School of Cardiovascular and Metabolic Health, University of Glasgow College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - Oyvind Ellingsen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Cardiology, St Olav's Hospital, Trondheim, Norway
| | - Lauren G Koch
- Department of Physiology and Pharmacology, University of Toledo, Toledo, Ohio, USA
| | - Steven L Britton
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA
- Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ulrik Wisloff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Norway
- School of Human Movement and Nutrition Science, University of Queensland, Saint Lucia, Queensland, Australia
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Rauhut AS, Tuladhar B, Tamvaka N, Warnick J. Differential Effects of Voluntary Exercise and Housing Density on Anxiety-Like Behavior in C57Bl/6 Mice. Behav Processes 2024:105023. [PMID: 38522795 DOI: 10.1016/j.beproc.2024.105023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 03/26/2024]
Abstract
The interaction of voluntary exercise and housing density on a) anxiety-like behavior and b) the stimulant effects of methamphetamine in C57Bl/6 mice were evaluated. Upon arrival, mice were housed singly or in pairs, and permitted access to home-cage running wheels or not for 4 weeks. Testing for anxiety-like behavior occurred over the next 3 weeks, one test per week [Elevated-Plus Maze (EPM) → Hyponeophagia (HNP) task → Open-Field (OF) task]. The final, OF task involved an 8-hour session in which mice were permitted to explore the chamber (drug free) during Hours 1-3; given an injection (s.c.) of methamphetamine (1.0mg/kg) after Hour 3; followed by continued behavioral sampling during Hours 4-8. Several tasks (HNP and OF, but not EPM) consistently showed voluntary exercise induced anxiety-like behavior. In addition, two measures (time in center and time resting in the perimeter) in the OF task revealed that exercise mice compared to controls were more responsive to the anxiogenic effects of methamphetamine. Although pair housing was anxiolytic, it did not ameliorate the anxiogenic effects of voluntary exercise. Taken together, these results, when viewed in tandem with previous studies that utilized a less anxious mouse strain (Swiss Webster), may suggest that voluntary exercise is anxiogenic in an anxiety-prone mouse strain such as C57Bl/6 and highlight the importance of considering mouse strain when evaluating the impact of environmental manipulations on anxiety-like behavior in animal models.
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Affiliation(s)
- Anthony S Rauhut
- Psychology Department, Dickinson College, Carlisle, PA 17013; Neuroscience Program, Dickinson College, Carlisle, PA 17013
| | | | - Nicole Tamvaka
- Neuroscience Program, Dickinson College, Carlisle, PA 17013
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Silveira SL, Motl RW, Froehlich-Grobe K, Kay M. Feasibility, acceptability, and initial efficacy of a wheelchair exercise training program in persons with multiple sclerosis: study protocol for a parallel group randomized controlled trial. Disabil Rehabil Assist Technol 2024:1-8. [PMID: 38520055 DOI: 10.1080/17483107.2024.2332322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
Purpose: This study is a randomized controlled trial (RCT) that examines the feasibility, acceptability, and initial efficacy of a home-based, remotely supported and supervised exercise training program that was developed using a three-step community engaged research process for persons with multiple sclerosis (MS) who are wheelchair users.Materials and Methods: The study design is a parallel group RCT (NCT05888727). We aim to enroll 24 wheelchair users with MS who will be randomly assigned using REDCap randomization module into exercise training or attention/contact wellness control conditions. The conditions will be delivered remotely over 16 weeks and supported using online, one-onone behavioral coaching. The feasibility outcomes of interest include recruitment and retention rates, and safety outcomes collected throughout the study period. The acceptability outcomes include participant satisfaction and perceptions measured using formative surveys and interviews following the 16-week period. Efficacy outcomes include metabolic health, MS symptoms, and exercise behavior measured before and after the 16-week period. The data analysis will follow intent-to-treat principles using 2 group by 2 time mixed factor ANOVA with estimation of Cohen's d values as effect sizes.Conclusions: The results will guide future research targeting health outcomes using exercise training among wheelchair users with MS who have largely been absent from health promotion research.
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Affiliation(s)
- Stephanie L Silveira
- Department of Kinesiology, Health Promotion, and Recreation, University of North TX, Denton, TX, USA
- Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Robert W Motl
- Department of Kinesiology and Nutrition, University of IL Chicago, Chicago, IL, USA
| | | | - Mitch Kay
- Department of Kinesiology, Health Promotion, and Recreation, University of North TX, Denton, TX, USA
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Inskip M, Almendrales Rangel C, Njoku CM, Barnett F, Shih I, O’Neill L, Fiatarone Singh MA, Valenzuela T. The Frailty Reduction via Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial: Study Protocol and Recruitment Results. Methods Protoc 2024; 7:26. [PMID: 38525784 PMCID: PMC10961770 DOI: 10.3390/mps7020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/13/2024] [Accepted: 03/21/2024] [Indexed: 03/26/2024] Open
Abstract
INTRODUCTION Virtually all adults in aged care facilities are frail, a condition which contributes to falls, cognitive decline, hospitalisation, and mortality. Polypharmacy, malnutrition, sedentariness, and sarcopenia are risk factors amenable to intervention. The Asia-Pacific Frailty Management Guidelines recommend anabolic exercise and the optimisation of medications and nutrition. However, no study has evaluated this best practice intervention triad in aged care. METHODS The Frailty Reduction via the Implementation of Exercise, Nutrition, and Deprescribing (FRIEND) Trial (ANZCTR No.ACTRN12622000926730p) is a staged 6-month translational trial evaluating resident outcomes, staff/caregiver knowledge, and institutional implementation in a Townsville aged care facility. Residents received high-intensity resistance exercise and balance training and medication and nutrition optimisation co-implemented by investigators (exercise physiologist, geriatrician, pharmacist, and nutritionist) and facility staff. Staff and caregivers completed comprehensive education modules and training. We report the trial protocol and recruitment results. RESULTS 29 residents (21 female, age: 88.6 ± 6.3 years) were recruited. At baseline, the residents were frail (frailty scale nursing home (FRAIL-NH); 6.3 ± 2.4/14), cognitively impaired (Montreal Cognitive Assessment; 13.8 ± 6.8/30), functionally impaired (Short Physical Performance Battery; 4.9 ± 3.1/12, 6 min walk distance; 222.2 ± 104.4 m), and were prescribed numerous medications (15.5 ± 5.9). Two residents died and one withdrew before the intervention's commencement. Thirty family members and 19 staff (carers, allied health assistants, nurse managers, registered nurses, lifestyle-leisure officers, kitchen/hospitality staff, and senior leadership) were recruited to receive frailty education modules. CONCLUSIONS The FRIEND trial is currently being implemented with results expected in mid-2024. This is the first trial to evaluate the implementation of the best practice frailty guidelines including anabolic exercise and medication/nutritional optimisation in residential aged care.
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Affiliation(s)
- Michael Inskip
- College of Healthcare Sciences, James Cook University, Townsville, QLD 4814, Australia
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Carolina Almendrales Rangel
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | | | - Fiona Barnett
- College of Healthcare Sciences, James Cook University, Townsville, QLD 4814, Australia
| | - Isabel Shih
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | | | - Maria A. Fiatarone Singh
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
- The Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA 02131, USA
| | - Trinidad Valenzuela
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7550196, Chile
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Tamura Y, Jee E, Kouzaki K, Kotani T, Nakazato K. Monocarboxylate transporter 4 deficiency enhances high-intensity interval training-induced metabolic adaptations in skeletal muscle. J Physiol 2024. [PMID: 38513062 DOI: 10.1113/jp285719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024] Open
Abstract
High-intensity exercise stimulates glycolysis, subsequently leading to elevated lactate production within skeletal muscle. While lactate produced within the muscle is predominantly released into the circulation via the monocarboxylate transporter 4 (MCT4), recent research underscores lactate's function as an intercellular and intertissue signalling molecule. However, its specific intracellular roles within muscle cells remains less defined. In this study, our objective was to elucidate the effects of increased intramuscular lactate accumulation on skeletal muscle adaptation to training. To achieve this, we developed MCT4 knockout mice and confirmed that a lack of MCT4 indeed results in pronounced lactate accumulation in skeletal muscle during high-intensity exercise. A key finding was the significant enhancement in endurance exercise capacity at high intensities when MCT4 deficiency was paired with high-intensity interval training (HIIT). Furthermore, metabolic adaptations supportive of this enhanced exercise capacity were evident with the combination of MCT4 deficiency and HIIT. Specifically, we observed a substantial uptick in the activity of glycolytic enzymes, notably hexokinase, glycogen phosphorylase and pyruvate kinase. The mitochondria also exhibited heightened pyruvate oxidation capabilities, as evidenced by an increase in oxygen consumption when pyruvate served as the substrate. This mitochondrial adaptation was further substantiated by elevated pyruvate dehydrogenase activity, increased activity of isocitrate dehydrogenase - the rate-limiting enzyme in the TCA cycle - and enhanced function of cytochrome c oxidase, pivotal to the electron transport chain. Our findings provide new insights into the physiological consequences of lactate accumulation in skeletal muscle during high-intensity exercises, deepening our grasp of the molecular intricacies underpinning exercise adaptation. KEY POINTS: We pioneered a unique line of monocarboxylate transporter 4 (MCT4) knockout mice specifically tailored to the ICR strain, an optimal background for high-intensity exercise studies. A deficiency in MCT4 exacerbates the accumulation of lactate in skeletal muscle during high-intensity exercise. Pairing MCT4 deficiency with high-intensity interval training (HIIT) results in a synergistic boost in high-intensity exercise capacity, observable both at the organismal level (via a treadmill running test) and at the muscle tissue level (through an ex vivo muscle contractile function test). Coordinating MCT4 deficiency with HIIT enhances both the glycolytic enzyme activities and mitochondrial capacity to oxidize pyruvate.
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Affiliation(s)
- Yuki Tamura
- Faculty of Sport Science, Nippon Sport Science University, Tokyo, Japan
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
- Research Institute for Sport Science, Nippon Sport Science University, Tokyo, Japan
- Sport Training Center, Nippon Sport Science University, Tokyo, Japan
- High Performance Center, Nippon Sport Science University, Tokyo, Japan
- Center for Coaching Excellence, Nippon Sport Science University, Tokyo, Japan
| | - Eunbin Jee
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Karina Kouzaki
- Research Institute for Sport Science, Nippon Sport Science University, Tokyo, Japan
- Faculty of Medical Science, Nippon Sport Science University, Tokyo, Japan
- Graduate School of Medical and Health Science, Nippon Sport Science University, Tokyo, Japan
| | - Takaya Kotani
- Research Institute for Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Koichi Nakazato
- Graduate School of Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
- Research Institute for Sport Science, Nippon Sport Science University, Tokyo, Japan
- Faculty of Medical Science, Nippon Sport Science University, Tokyo, Japan
- Graduate School of Medical and Health Science, Nippon Sport Science University, Tokyo, Japan
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Bonn SE, Hummel M, Peveri G, Eke H, Alexandrou C, Bellocco R, Löf M, Trolle Lagerros Y. Effectiveness of a Smartphone App to Promote Physical Activity Among Persons With Type 2 Diabetes: Randomized Controlled Trial. Interact J Med Res 2024; 13:e53054. [PMID: 38512333 DOI: 10.2196/53054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/22/2023] [Accepted: 02/07/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Physical activity is well known to have beneficial effects on glycemic control and to reduce risk factors for cardiovascular disease in persons with type 2 diabetes. Yet, successful implementation of lifestyle interventions targeting physical activity in primary care has shown to be difficult. Smartphone apps may provide useful tools to support physical activity. The DiaCert app was specifically designed for integration into primary care and is an automated mobile health (mHealth) solution promoting daily walking. OBJECTIVE This study aimed to investigate the effect of a 3-month-long intervention promoting physical activity through the use of the DiaCert app among persons with type 2 diabetes in Sweden. Our primary objective was to assess the effect on moderate to vigorous physical activity (MVPA) at 3 months of follow-up. Our secondary objective was to assess the effect on MVPA at 6 months of follow-up and on BMI, waist circumference, hemoglobin A1c, blood lipids, and blood pressure at 3 and 6 months of follow-up. METHODS We recruited men and women with type 2 diabetes from 5 primary health care centers and 1 specialized center. Participants were randomized 1:1 to the intervention or control group. The intervention group was administered standard care and access to the DiaCert app at baseline and 3 months onward. The control group received standard care only. Outcomes of objectively measured physical activity using accelerometers, BMI, waist circumference, biomarkers, and blood pressure were assessed at baseline and follow-ups. Linear mixed models were used to assess differences in outcomes between the groups. RESULTS A total of 181 study participants, 65.7% (119/181) men and 34.3% (62/181) women, were recruited into the study and randomized to the intervention (n=93) or control group (n=88). The participants' mean age and BMI were 60.0 (SD 11.4) years and 30.4 (SD 5.3) kg/m2, respectively. We found no significant effect of the intervention (group by time interaction) on MVPA at either the 3-month (β=1.51, 95% CI -5.53 to 8.55) or the 6-month (β=-3.53, 95% CI -10.97 to 3.92) follow-up. We found no effect on any of the secondary outcomes at follow-ups, except for a significant effect on BMI at 6 months (β=0.52, 95% CI 0.20 to 0.84). However, mean BMI did not differ between the groups at the 6-month follow-up. CONCLUSIONS We found no evidence that persons with type 2 diabetes being randomized to use an app promoting daily walking increased their levels of MVPA at 3 or 6 months' follow-up compared with controls receiving standard care. The effect of the app on BMI was unclear, and we found nothing to support an effect on secondary outcomes. Further research is needed to determine what type of mHealth intervention could be effective to increase physical activity among persons with type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT03053336; https://clinicaltrials.gov/study/NCT03053336.
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Affiliation(s)
- Stephanie E Bonn
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Madeleine Hummel
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Giulia Peveri
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Helén Eke
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Christina Alexandrou
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Rino Bellocco
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
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Cilenti NA, Tamaroff JG, Capiola CJ, Faig W, McBride MG, Paridon SM, O'Malley S, Edelson JB, Lynch DR, McCormack SE, Lin KY. Cardiopulmonary exercise testing on adaptive equipment in children and adults with Friedreich ataxia. Muscle Nerve 2024. [PMID: 38515223 DOI: 10.1002/mus.28085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION/AIMS Traditional exercise is often difficult for individuals with Friedreich ataxia (FRDA), and evidence is limited regarding how to measure exercise performance in this population. We evaluated the feasibility, reliability, and natural history of adaptive cardiopulmonary exercise test (CPET) performance in children and adults with FRDA. METHODS Participants underwent CPET on either an arm cycle ergometer (ACE) or recumbent leg cycle ergometer (RLCE) at up to four visits (baseline, 2 weeks, 4 weeks, and 1 year). Maximum work, oxygen consumption (peak VO2), oxygen (O2) pulse, and anaerobic threshold (AT) were measured in those who reached maximal volition. Test-retest reliability was assessed with intraclass coefficients, and longitudinal change was assessed using regression analysis. RESULTS In our cohort (N = 23), median age was 18 years (interquartile range [IQR], 14-23), median age of FRDA onset was 8 years (IQR 6-13), median Friedreich Ataxia Rating Scale score was 58 (IQR 54-62), and GAA repeat length on the shorter FXN allele (GAA1) was 766 (IQR, 650-900). Twenty-one (91%) completed a maximal CPET (n = 8, ACE and n = 13, RLCE). Age, sex, and GAA1 repeat length were each associated with peak VO2. Preliminary estimates demonstrated reasonable agreement between visits 2 and 3 for peak work by both ACE and RLCE, and for peak VO2, O2 pulse, and AT by RLCE. We did not detect significant performance changes over 1 year. DISCUSSION Adaptive CPET is feasible in FRDA, a relevant clinical trial outcome for interventions that impact exercise performance and will increase access to participation as well as generalizability of findings.
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Affiliation(s)
- Nicolette A Cilenti
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jaclyn G Tamaroff
- Division of Pediatric Endocrinology and Diabetes, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christopher J Capiola
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Walter Faig
- Biostatistics and Data Management Core, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Michael G McBride
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Stephen M Paridon
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Shannon O'Malley
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jonathan B Edelson
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David R Lynch
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Shana E McCormack
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kimberly Y Lin
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Lewis JE, Beattie EH, Ylitalo KR. The Association Between Physical Activity and Fatigue Among Adults With Rheumatic Disease in a Nationally Representative Sample. J Phys Act Health 2024:1-7. [PMID: 38508179 DOI: 10.1123/jpah.2023-0287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE Adults with rheumatic disease (RD) experience high levels of fatigue. Regular physical activity has been shown to reduce fatigue among adults. Despite this evidence, adults with RD are more likely to be physically inactive compared with those without RD. Little information is known about the association of physical activity level and fatigue among adults with RD. This study investigated the association of physical activity level and fatigue among adults with and without RD. METHODS Adults (≥18 y) who participated in the 2018 National Health Interview Survey (unweighted n = 25,471) were included in this cross-sectional study. Physical activity and fatigue were self-reported. Statistical analyses were weighted to account for complex survey sampling design. RESULTS Significantly more adults with RD experience fatigue compared with adults without RD (26.19% vs 13.23%). Adults with RD who were inactive had 2.81 times (95% CI, 2.37-3.34) higher odds of experiencing fatigue compared to adults with RD who were sufficiently active, after adjusting for covariates. CONCLUSIONS Overall, fatigue was more common among adults with RD than it was in the population without RD.
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Affiliation(s)
- Jordan E Lewis
- Department of Public Health, Baylor University, Waco, TX, USA
- Baylor Scott and White Warriors Research Institute, Waco, TX, USA
| | - Emily H Beattie
- Baylor Scott and White Warriors Research Institute, Waco, TX, USA
| | - Kelly R Ylitalo
- Department of Public Health, Baylor University, Waco, TX, USA
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Romein J, Hutchins G, Ottrey E, Talpey S, Bishop J. A community-based modified sport program for rural community-dwelling older adults: A pilot study. Aust J Rural Health 2024. [PMID: 38506498 DOI: 10.1111/ajr.13108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/06/2024] [Accepted: 03/10/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION With Australia's ageing population, especially in rural regions, promoting physical activity among older adults is crucial. OBJECTIVE To identify factors influencing participation of older adults (60 years or over) from a rural community in a modified sport program and assess satisfaction with a pilot modified sport program informed by these findings. DESIGN Insights and ideas from two focus groups exploring community perspectives on a modified sport program informed the development of a six-week pilot modified sport program delivered with the local fitness centre. Post-program surveys assessed participant satisfaction, willingness to continue, and likelihood of recommending the program to others. FINDINGS Nine participants attended the focus groups, highlighting increased social connection, health management, and healthy ageing as key motivators. Joint and health concerns, cost, and time constraints emerged as main barriers. Preferences for the program included weekly sessions, alternating sports, indoor venues, and supporting modifications, but maintaining traditional rules. Thirteen participants participated in the pilot modified sport program. There was strong program attendance (86%). All participants (13/13) rated their satisfaction as very satisfied. They were highly likely to recommend the program to others (8.5/10) and were interested in continuing modified sport after the pilot (7.7/10). DISCUSSION This study demonstrates for the first time that modified sport is of interest to older people in the rural setting, and that delivering such a program is feasible in a small community. Rural communities implementing modified sport should consider the availability of suitable facilities and equipment, access to an engaging facilitator and participant cost. CONCLUSION Through a strong connection between the health service and community fitness centre, a modified sport program was developed and implemented, well-attended and enjoyed by participants in a rural community.
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Affiliation(s)
- Jake Romein
- Exercise Physiology, East Grampians Health Service, Ararat, Victoria, Australia
| | - Gabrielle Hutchins
- Health Promotion, East Grampians Health Service, Ararat, Victoria, Australia
| | - Ella Ottrey
- Development and Improvement, East Grampians Health Service, Ararat, Victoria, Australia
| | - Scott Talpey
- Collaborative Evaluation and Research Group, Federation University Australia, Ballarat, Victoria, Australia
| | - Jaclyn Bishop
- Development and Improvement, East Grampians Health Service, Ararat, Victoria, Australia
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Haapala EA, Leppänen MH, Lee E, Savonen K, Laukkanen JA, Kähönen M, Brage S, Lakka TA. Accumulating Sedentary Time and Physical Activity From Childhood to Adolescence and Cardiac Function in Adolescence. J Am Heart Assoc 2024; 13:e031837. [PMID: 38497441 DOI: 10.1161/jaha.123.031837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/16/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Increased physical activity (PA) may mitigate the negative cardiovascular health effects of sedentary behavior in adolescents. However, the relationship of PA and sedentary time from childhood with cardiac function in adolescence remains underexplored. Therefore, we investigated the associations of cumulative sedentary time and PA from childhood to adolescence with cardiac function in adolescence. METHODS AND RESULTS Participants were 153 adolescents (69 girls) who were aged 6 to 8 years at baseline, 8 to 10 years at 2-year follow-up, and 15 to 17 years at 8-year follow-up. Cumulative sedentary time and PA exposure between baseline and 2-year follow-up and between baseline and 8-year follow-up were measured using a combined accelerometer and heart rate monitor. Cardiac function was assessed using impedance cardiography at 8-year follow-up. The data were analyzed using linear regression analyses adjusted for age and sex. Cumulative moderate to vigorous PA (standardized regression coefficient [β]=-0.323 [95% CI, -0.527 to -0.119]) and vigorous PA (β=-0.295 [95% CI, -0.508 to -0.083]) from baseline to 8-year follow-up were inversely associated with cardiac work at 8-year follow-up. Conversely, cumulative sedentary time had a positive association (β=0.245 [95% CI, 0.092-0.398]). Cumulative vigorous PA from baseline to 8-year follow-up was inversely associated with cardiac work index at 8-year follow-up (β=-0.218 [95% CI, -0.436 to 0.000]). CONCLUSIONS Higher levels of sedentary time and lower levels of PA during childhood were associated with higher cardiac work in adolescence, highlighting the importance of increasing PA and reducing sedentary time from childhood.
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Affiliation(s)
- Eero A Haapala
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
- Institute of Biomedicine, School of Medicine University of Eastern Finland Kuopio Finland
| | - Marja H Leppänen
- Institute of Biomedicine, School of Medicine University of Eastern Finland Kuopio Finland
- Faculty of Medicine University of Helsinki Finland
| | - Earric Lee
- Faculty of Sport and Health Sciences University of Jyväskylä Jyväskylä Finland
| | - Kai Savonen
- Foundation for Research in Health Exercise and Nutrition Kuopio Research Institute of Exercise Medicine Kuopio Finland
| | - Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
- Department of Medicine Wellbeing Services County of Central Finland Jyväskylä Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Health Technology Tampere University Tampere Finland
| | - Soren Brage
- MRC Epidemiology Unit University of Cambridge School of Clinical Medicine Cambridge United Kingdom
| | - Timo A Lakka
- Institute of Biomedicine, School of Medicine University of Eastern Finland Kuopio Finland
- Foundation for Research in Health Exercise and Nutrition Kuopio Research Institute of Exercise Medicine Kuopio Finland
- Department of Clinical Physiology and Nuclear Imaging University of Eastern Finland and Kuopio University Hospital Kuopio Finland
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Everett BM. The Confusing Landscape of Cardiovascular Health Assessment, Promotion, and Prediction. Circulation 2024; 149:914-916. [PMID: 38498613 DOI: 10.1161/circulationaha.123.067982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Affiliation(s)
- Brendan M Everett
- Divisions of Cardiovascular and Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Jian C, Peng X, Yang Y, Xu Y, Wang L, Cai D. A network meta-analysis on the effects of different exercise types on COPD patients. Respir Care 2024:respcare.11476. [PMID: 38503464 DOI: 10.4187/respcare.11476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/28/2024] [Indexed: 03/21/2024]
Abstract
Objective: This study aimed to compare and rank the effects of aerobic exercise (AE), resistance training (RT), endurance training (ET), and high-intensity interval training (HIIT) in chronic obstructive pulmonary disease (COPD) by network meta-analysis (NMA).Methods: PubMed, Cochrane, Embase, and Web of Science were searched to identify randomized controlled trials investigating the effects of exercise training on COPD. The search period began on the date of database establishment and ended in April 8, 2023. Two reviewers independently screened the retrieved articles, extracted relevant data, and assessed the risk of bias in the included studies. NMA was performed using Stata 15.1 and R 4.2.1.Results: This study included a total of 27 studies involving 1415 patients. The NMA findings indicated that HIIT was the most effective intervention for improving 6-Minute Walk Distance (6MWD) with a SUCRA (Surface Under the Cumulative Ranking) score of 87.68%. In addition, HIIT showed the highest efficacy in improving Forced Expiratory Volume in 1 second (FEV1) with a SUCRA score of 73.17%, FEV1/FVC% with a SUCRA score of 79.52%, and St. George's Respiratory Questionnaire (SGRQ) score with a SUCRA score of 73.88%. Conversely, ET was found to be the most effective for ameliorating Forced Vital Capacity (FVC) with a SUCRA score of 73.39%.Conclusion: The findings of this study suggest that HIIT may be more effective than endurance exercise, resistance exercise, and AE in improving the 6MWD, FEV1, FEV1/FVC ratio, and SGRQ scores in patients with COPD. Additionally, ET may be better than resistance exercise, AE, and HIIT in improving FVC in COPD patients. However, due to the limited number of studies conducted on HIIT, more high-quality randomized controlled trials (RCTs) are required to verify these conclusions.
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Affiliation(s)
- Chengping Jian
- College of Nursing, Dali University, Dali Yunnan 671000, China
| | - Xiangdong Peng
- Cardiothoracic Surgery, Mianyang Central Hospital, Mianyang Sichuan 621000, China
| | - Yuting Yang
- College of Nursing, Dali University, Dali Yunnan 671000, China
| | - Yanli Xu
- College of Nursing, Dali University, Dali Yunnan 671000, China
| | - Liying Wang
- Department of Respiratory and Critical Care Medicine, Yuxi People's Hospital, Yuxi Yunnan 653100, China
| | - Defang Cai
- Department of Respiratory and Critical Care Medicine, Yuxi People's Hospital, Yuxi Yunnan 653100, China.
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Tegg NL, Myburgh C, O'Donnell E, Kennedy M, Norris CM. Impact of Secondary Amenorrhea on Cardiovascular Disease Risk in Physically Active Women: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2024; 13:e033154. [PMID: 38497482 DOI: 10.1161/jaha.123.033154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/27/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Exercise-associated secondary amenorrhea results in estrogen deficiency, which may lead to dysfunction in estrogen's normal cardioprotective pathways. Estrogen may be essential in a woman's endothelial adaptations to exercise. The objective of this review was to assess the association between secondary amenorrhea in physically active women and cardiovascular disease (CVD) risk. METHODS AND RESULTS A literature search was performed in January 2023 and updated in August 2023 of the Cumulative Index to Nursing and Allied Health Literature (EBSCOhost), Cochrane Library, Embase (Ovid), MEDLINE (Ovid), SPORTDiscus (EBSCOhost), and Scopus from inception to present with no date or language limitations. Citation chaining was done to screen for additional studies. Eight sources were searched for gray literature. Studies that compared physically active women with amenorrhea to physically active women with eumenorrhea aged 18 to 35 years with evidence of CVD, alterations to cardiovascular physiology, or CVD risks were included. Eighteen observational studies from 3 countries were included. Overall, the quality of evidence was good. A meta-analysis was performed. Physically active women with secondary amenorrhea had significantly lower estradiol, flow-mediated dilation, resting heart rate, systolic blood pressure, and diastolic blood pressure and higher total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein cholesterol. CONCLUSIONS Estrogen deficiency resulting from exercise-associated secondary amenorrhea in physically active women may impact cardiovascular physiology and certain CVD risk factors. The research in this area is observational; therefore, findings should be interpreted cautiously. However, as exercise-associated secondary amenorrhea is reversible and the primary prevention of CVD is important for public health, it may be important to treat secondary amenorrhea and restore estrogen levels.
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Affiliation(s)
- Nicole L Tegg
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
| | - Caitlynd Myburgh
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
- Faculty of Natural Sciences The Kings University Edmonton Alberta Canada
| | | | - Megan Kennedy
- University of Alberta Library Edmonton Alberta Canada
| | - Colleen M Norris
- Faculty of Nursing University of Alberta Edmonton Alberta Canada
- Cavarzan Chair in Mature Women's Research, WCHRI Edmonton Alberta Canada
- Faculty of Medicine, School of Public Health Sciences University of Alberta Edmonton Alberta Canada
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Dorian D, Gustafson D, Quinn R, Bentley RF, Dorian P, Goodman JM, Fish JE, Connelly KA. Exercise-Dependent Modulation of Immunological Response Pathways in Endurance Athletes With and Without Atrial Fibrillation. J Am Heart Assoc 2024; 13:e033640. [PMID: 38497478 DOI: 10.1161/jaha.123.033640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/12/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Atrial fibrillation (AF) is a common arrhythmia characterized by uncoordinated atrial electrical activity. Lone AF occurs in the absence of traditional risk factors and is frequently observed in male endurance athletes, who face a 2- to 5-fold higher risk of AF compared with healthy, moderately active males. Our understanding of how endurance exercise contributes to the pathophysiology of lone AF remains limited. This study aimed to characterize the circulating protein fluctuations during high-intensity exercise as well as explore potential biomarkers of exercise-associated AF. METHODS AND RESULTS A prospective cohort of 12 male endurance cyclists between the ages of 40 and 65 years, 6 of whom had a history of exercise-associated AF, were recruited to participate using a convenience sampling method. The circulating proteome was subsequently analyzed using multiplex immunoassays and aptamer-based proteomics before, during, and after an acute high-intensity endurance exercise bout to assess temporality and identify potential markers of AF. The endurance exercise bout resulted in significant alterations to proteins involved in immune modulation (eg, growth/differentiation factor 15), skeletal muscle metabolism (eg, α-actinin-2), cell death (eg, histones), and inflammation (eg, interleukin-6). Subjects with AF differed from those without, displaying modulation of proteins previously known to have associations with incident AF (eg, C-reactive protein, insulin-like growth factor-1, and angiopoietin-2), and also with proteins having no previous association (eg, tapasin-related protein and α2-Heremans-Schmid glycoprotein). CONCLUSIONS These findings provide insights into the proteomic response to acute intense exercise, provide mechanistic insights into the pathophysiology behind AF in athletes, and identify targets for future study and validation.
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Affiliation(s)
- David Dorian
- Department of Medicine, Division of Cardiology University of Toronto Toronto Ontario Canada
| | - Dakota Gustafson
- Department of Laboratory Medicine & Pathobiology University of Toronto Toronto Ontario Canada
- Toronto General Hospital Research Institute University Health Network Toronto Ontario Canada
- Faculty of Health Sciences Queen's University Kingston Ontario Canada
| | - Ryan Quinn
- Division of Cardiology Li Ka Shing Knowledge Institute of St. Michael's Hospital Toronto Ontario Canada
| | - Robert F Bentley
- Faculty of Kinesiology and Physical Education University of Toronto Toronto Ontario Canada
| | - Paul Dorian
- Department of Medicine, Division of Cardiology University of Toronto Toronto Ontario Canada
- Division of Cardiology Li Ka Shing Knowledge Institute of St. Michael's Hospital Toronto Ontario Canada
- Department of Medicine University of Toronto Toronto Ontario Canada
- Keenan Research Centre for Biomedical Science St Michael's Hospital, University of Toronto Toronto Ontario Canada
- Department of Physiology University of Toronto Toronto Ontario Canada
- Heart and Stroke Richard Lewar Centre for Research Excellence University of Toronto Toronto Ontario Canada
| | - Jack M Goodman
- Faculty of Kinesiology and Physical Education University of Toronto Toronto Ontario Canada
- Heart and Stroke Richard Lewar Centre for Research Excellence University of Toronto Toronto Ontario Canada
- Division of Cardiology Sinai Health/University Health Network Toronto Ontario Canada
| | - Jason E Fish
- Department of Laboratory Medicine & Pathobiology University of Toronto Toronto Ontario Canada
- Toronto General Hospital Research Institute University Health Network Toronto Ontario Canada
- Peter Munk Cardiac Centre University Health Network Toronto Ontario Canada
| | - Kim A Connelly
- Department of Medicine, Division of Cardiology University of Toronto Toronto Ontario Canada
- Division of Cardiology Li Ka Shing Knowledge Institute of St. Michael's Hospital Toronto Ontario Canada
- Department of Medicine University of Toronto Toronto Ontario Canada
- Keenan Research Centre for Biomedical Science St Michael's Hospital, University of Toronto Toronto Ontario Canada
- Department of Physiology University of Toronto Toronto Ontario Canada
- Heart and Stroke Richard Lewar Centre for Research Excellence University of Toronto Toronto Ontario Canada
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Tong HL, Alnasser A, Alshahrani NZ, Bawaked RA, AlAhmed R, Alsukait RF, Rakic S, Cetinkaya V, Al-Hazzaa HM, Alqahtani SA. The Use of Mobile Technologies to Promote Physical Activity and Reduce Sedentary Behaviors in the Middle East and North Africa Region: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e53651. [PMID: 38502160 DOI: 10.2196/53651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/01/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The Middle East and North Africa (MENA) region faces unique challenges in promoting physical activity and reducing sedentary behaviors, as the prevalence of insufficient physical activity is higher than the global average. Mobile technologies present a promising approach to delivering behavioral interventions; however, little is known about the effectiveness and user perspectives on these technologies in the MENA region. OBJECTIVE This study aims to evaluate the effectiveness of mobile interventions targeting physical activity and sedentary behaviors in the MENA region and explore users' perspectives on these interventions as well as any other outcomes that might influence users' adoption and use of mobile technologies (eg, appropriateness and cultural fit). METHODS A systematic search of 5 databases (MEDLINE, Embase, CINAHL, Scopus, and Global Index Medicus) was performed. Any primary studies (participants of all ages regardless of medical condition) conducted in the MENA region that investigated the use of mobile technologies and reported any measures of physical activity, sedentary behaviors, or user perceptions were included. We conducted a narrative synthesis of all studies and a meta-analysis of randomized controlled trials (RCTs). The Cochrane risk-of-bias tool was used to assess the quality of the included RCTs; quality assessment of the rest of the included studies was completed using the relevant Joanna Briggs Institute critical appraisal tools. RESULTS In total, 27 articles describing 22 interventions (n=10, 37% RCTs) and 4 (15%) nonexperimental studies were included (n=6141, 46% women). Half (11/22, 50%) of the interventions included mobile apps, whereas the other half examined SMS. The main app functions were goal setting and self-monitoring of activity, whereas SMS interventions were primarily used to deliver educational content. Users in experimental studies described several benefits of the interventions (eg, gaining knowledge and receiving reminders to be active). Engagement with the interventions was poorly reported; few studies (8/27, 30%) examined users' perspectives on the appropriateness or cultural fit of the interventions. Nonexperimental studies examined users' perspectives on mobile apps and fitness trackers, reporting several barriers to their use, such as perceived lack of usefulness, loss of interest, and technical issues. The meta-analysis of RCTs showed a positive effect of mobile interventions on physical activity outcomes (standardized mean difference=0.45, 95% CI 0.17-0.73); several sensitivity analyses showed similar results. The trim-and-fill method showed possible publication bias. Only 20% (2/10) of the RCTs measured sedentary behaviors; both reported positive changes. CONCLUSIONS The use of mobile interventions for physical activity and sedentary behaviors in the MENA region is in its early stages, with preliminary evidence of effectiveness. Policy makers and researchers should invest in high-quality studies to evaluate long-term effectiveness, intervention engagement, and implementation outcomes, which can inform the design of culturally and socially appropriate interventions for countries in the MENA region. TRIAL REGISTRATION PROSPERO CRD42023392699; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392699.
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Affiliation(s)
- Huong Ly Tong
- Cultural and Indigenous Research Centre Australia, Redfern, Australia
- The World Bank Group, Washington, DC, United States
| | - Aroub Alnasser
- Department of Food Science and Nutrition, King Saud University, Riyadh, Saudi Arabia
| | - Najim Z Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Rowaedh A Bawaked
- Department of Public Health, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Reem AlAhmed
- Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | | | | | - Hazzaa M Al-Hazzaa
- Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Saleh A Alqahtani
- Organ Transplant Center of Excellence, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- Division of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, United States
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Nazir A, Heryaman H, Juli C, Ugusman A, Martha JW, Moeliono MA, Atik N. Resistance Training in Cardiovascular Diseases: A Review on Its Effectiveness in Controlling Risk Factors. Integr Blood Press Control 2024; 17:21-37. [PMID: 38523733 PMCID: PMC10959113 DOI: 10.2147/ibpc.s449086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
Cardiovascular Disease (CVD), a term encompassing various disorders affecting the heart and blood vessels, includes coronary artery disease (CAD). CAD is primarily due to the development of atherosclerotic plaques that disrupt blood flow, oxygenation, and nutrient delivery to the myocardium. Risk factors contributing to CAD progression include smoking, hypertension, diabetes mellitus (DM), dyslipidaemia, and obesity. While aerobic exercise (AE) has shown promising results in controlling CVD risk factors, the impact of resistance training (RT) has not been extensively investigated. This review aims to describe the effects of RT on CVD risk factors based on studies retrieved from PubMed and Google Scholar databases. Both isometric and isotonic RT have been found to decrease systolic blood pressure (SBP), diastolic blood pressure, or mean arterial pressure, with SBP showing a more significant reduction. Hypertensive patients engaging in RT alongside a calorie-restricted diet demonstrated significant improvements in blood pressure. RT is associated with increased nitric oxide bioavailability, sympathetic modulation, and enhanced endothelial function. In type-2 DM patients, 8-12 weeks of RT led to improvements in fasting blood glucose levels, insulin secretion, metabolic syndrome risk, and glucose transporter numbers. Combining AE with RT had a more significant impact in reducing insulin resistance and enhancing blood glucose compared to performing exercises separately. It also significantly decreased total cholesterol, triglycerides, and low-density lipoprotein levels while increasing high-density lipoprotein within 12 weeks of application. However, improvements are considered insignificant when lipid levels are already low to normal at baseline. The administration of RT resulted in weight loss and improved body mass index, with more pronounced effects seen when combining AE with RT and a calorie-restricted diet. Considering these results, the administration of RT, either alone or in combination with AE, proves beneficial in rehabilitating CAD patients by improving various risk factors.
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Affiliation(s)
- Arnengsih Nazir
- Doctoral Program, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
- Department of Physical and Rehabilitation Medicine, Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Henhen Heryaman
- Doctoral Program, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Cep Juli
- Department of Neurology, Dr. Hasan Sadikin General Hospital/Faculty of Medicine Padjadjaran University, Bandung, WJ, Indonesia
| | - Azizah Ugusman
- Department of Physiology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Januar Wibawa Martha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Marina Annette Moeliono
- Department of Physical and Rehabilitation Medicine, Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Nur Atik
- Department of Biomedical Sciences, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
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Ogoh S. Cardiac output-mediated regulation of cerebral blood flow during exercise: Clinical perspectives on the indirect impact of muscle metaboreflex. Exp Physiol 2024. [PMID: 38500291 DOI: 10.1113/ep091591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/15/2024] [Indexed: 03/20/2024]
Abstract
The muscle metaboreflex stimulates the elevation of arterial blood pressure, aiming to rectify the oxygen deficit by enhancing oxygen delivery to support muscle activity. Moreover, activating the muscle metaboreflex significantly increases cardiac output (CO) by increasing factors such as heart rate, ventricular contractility, preload, stroke volume and mobilization of central blood volume. Previous studies indicate that ageing and cardiovascular diseases modify the muscle metaboreflex during exercise, limiting the ability to increase CO during physical activity. Alongside reduced exercise capacity, the attenuated rise in CO due to abnormal muscle metaboreflex in these patients impedes the increase in cerebral blood flow during exercise. Considering that CO plays a pivotal role in regulating cerebral blood flow adequately during exercise, this occurrence might contribute to an elevated risk of cerebral diseases, and it could also, at least, reduce the effective role of exercise in preventing cerebral disease and dementia among elderly individuals and patients with cardiovascular conditions. Therefore, it is important to consider this phenomenon when optimizing the effectiveness of exercise rehabilitation in patients with cardiovascular disease to prevent cerebral diseases and dementia.
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Affiliation(s)
- Shigehiko Ogoh
- Department of Biomedical engineering, Toyo University, Kawagoe, Japan
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50
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O'Connor FK, Meade RD, Notley SR, Ioannou LG, Flouris AD, Kenny GP. Agreement between measured and self-reported physiological strain in males and females during simulated occupational heat stress. Am J Ind Med 2024. [PMID: 38493300 DOI: 10.1002/ajim.23580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/26/2024] [Accepted: 02/23/2024] [Indexed: 03/18/2024]
Abstract
RATIONALE Monitoring physiological strain is recommended to safeguard workers during heat exposure, but is logistically challenging. The perceptual strain index (PeSI) is a subjective estimate thought to reflect the physiological strain index (PSI) that requires no physiological monitoring. However, sex is known to influence perceptions of heat stress, potentially limiting the utility of the PeSI. OBJECTIVES The objective of this study was to assess whether sex modifies the relationship between PeSI and PSI. METHODS Thirty-four adults (15 females) walked on a treadmill (moderate intensity; ~200 W/m2 ) for 180 min or until termination (volitional fatigue, rectal temperature ≥39.5°C) in 16°C, 24°C, 28°C, and 32°C wet-bulb globe temperatures. Rectal temperature and heart rate were recorded to calculate PSI (0-10 scale). Rating of perceived exertion and thermal sensation were recorded to calculate PeSI (0-10 scale). Relationships between PSI and PeSI were evaluated via linear mixed models. Mean bias (95% limits of agreement [LoA]) between PSI and PeSI was assessed via Bland-Altman analysis. Mean absolute error between measures was calculated by summing absolute errors between the PeSI and the PSI and dividing by the sample size. FINDINGS PSI increased with PeSI (p < 0.01) but the slope of this relation was not different between males and females (p = 0.83). Mean bias between PSI and PeSI was small (-0.4 points), but the 95% LoA (-3.5 to 2.7 points) and mean absolute error were wide (1.3 points). IMPACT Our findings indicate that sex does not appreciably impact the agreement between the PeSI and PSI during simulated occupational heat stress. The PeSI is not a suitable surrogate for the PSI in either male or female workers.
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Affiliation(s)
- Fergus K O'Connor
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Robert D Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Leonidas G Ioannou
- Department of Automatics, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Andreas D Flouris
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Karies, Trikala, Greece
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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