The associations between physical activity, health-related quality of life, regimen adherence, and glycemic control in adolescents with type 1 diabetes: A cross-sectional study.

BACKGROUND: Adolescents with Type 1 Diabetes (T1D) display a greater than two-fold higher risk of developing diabetes-related complications compared with their healthy peers and the risk increases markedly as glycated hemoglobin (HbA1c) increases. The majority of the known factors associated with improved glycemic control in adolescents with T1D are geared toward Western populations. Therefore, this study examined the associations between Physical Activity (PA), Health-Related Quality of Life (HRQoL), and regimen adherence on glycemic control in a Middle Eastern population of adolescents with T1D METHODS: The study utilized a cross-sectional design of Jordanian adolescents (aged 12-18) with T1D (n = 74). Self-reported measures used were the Pediatric Quality of Life-Diabetes Module, the International Physical Activity Questionnaire, and the Summary of Diabetes Self-Care Activities. HbA1c values were obtained from the medical records. Correlation analyses were conducted using Pearson's and Spearman's correlation tests. Multiple regression analyses were conducted to determine if HRQoL, PA, and regimen adherence predict glycemic control. RESULTS: Only 14.8 % of the participants demonstrated good glycemic control (HbA1c ≤ 7.5 %). Participants with poor control had a statistically significant lower mean PA of MET-minutes/week (3531.9 ± 1356.75 vs. 1619.81 ± 1481.95, p < .001) compared to those with good control. The total sample was found to demonstrate low HRQoL (47.70 ± 10.32). Participants were within the acceptable range of PA (1885.38 ± 1601.13) MET-minutes/week. HbA1c significantly inversely correlated with PA (r = -0.328, p = .010) and regimen adherence (r = -0.299, p = .018). The regression analysis revealed that PA significantly predicted glycemic control (ß = -0.367, p < .01) as adherence (ß = -0.409, p < .01) and disease duration did (ß = 0.444, p < .01). CONCLUSION: Better glycemic control was significantly associated with higher PA and regimen adherence levels. The correlation between PA and glycemic control depends highly on the level of regimen adherence or arguably, adherence acts as a buffer in the correlation between PA and glycemic control. There was no significant association between glycemic control and HRQoL.

Endurance exercise training suppresses myostatin upregulation and nuclear factor-kappa B activation in a mouse model of Parkinson's disease.

Background and Aim: Muscle atrophy is common in Parkinson's disease (PD). Although myostatin has been implicated in muscle atrophy, its expression in PD skeletal muscle has not been investigated. Therefore, this study aimed to elucidate the influence of PD induction and exercise training on myostatin expression in the gastrocnemius skeletal muscle. Materials and Methods: Thirty albino mice were randomly selected and separated into three groups of 10 mice each: Sedentary control, sedentary PD (SPD), and exercised PD (EPD). 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid were used to induce chronic parkinsonism in the PD groups. Immunohistochemistry was used to investigate the expression of myostatin and nuclear factor kappa B (NF-kB) in gastrocnemius muscles of all three groups. Results: Myostatin expression and NF-kB nuclear localization, indicative of its activation, were significantly (p<0.01) higher in gastrocnemius skeletal muscle in the SPD group than in the control and EPD groups. Concomitantly, the average cross-sectional area of gastrocnemius muscle fibers in the SPD albino mice was significantly smaller (p<0.01) than in the control and EPD groups, indicating muscle atrophy. Conclusion: The present data are the first to indicate a correlation between PD induction and myostatin overexpression and NF-kB activation in the gastrocnemius muscle, potentially promoting the muscle atrophy commonly seen in PD. Additionally, the current data are the first to indicate the beneficial effects of exercise training on PD-associated myostatin overexpression, NF-κB activation, and muscle atrophy. Thus, our data are the first to suggest that myostatin and NF-κB might be regarded as potential therapeutic targets in an attempt to ameliorate skeletal muscle abnormalities commonly observed in PD.

Mental and physical health-related quality of life and their associated factors among students of a comprehensive allied health institution.

BACKGROUND: Healthcare students are subjected to critical levels of mental and physical stress that might hinder their quality of life. OBJECTIVES: This study comprehensively investigated physical and mental Health-related Quality of Life (HR-QoL) and their associated factors among Allied Health (AH) students of nine academic majors. METHODS: Participants completed anonymous questionnaire included demographics and life style, HR-QoL measured by the 12-item Short-Form Health Survey (SF-12), Depression Anxiety Stress Scale (DASS21), and Nordic Musculoskeletal Questionnaire. SF-12 Physical (PCS) and Mental (MCS) Components Summary scores were compared between gender and between academic majors. Multiple linear regressions were conducted to examine factor associated with PCS and MCS scores. RESULTS: A total of 838 students (77.4% females) participated in the study. The overall PCS was 45.64±7.93 and statistically different between majors (P < 0.001). The Overall MCS score was 39.45±10.86 and statistically greater in males (P < 0.001). PCS scores were significantly associated with anxiety score, GPA, diet self-evaluation, and upper back and hip musculoskeletal pain. MCS scores were significantly associated with weekly clinical training hours, stress score, depression score, gender, university year, GPA, sleep self-evaluation, diet self-evaluation, and neck musculoskeletal pain. CONCLUSIONS: Low levels of mental and physical HR-QoL were observed among AH students and were associated with academic-related, health-related, and lifestyle-related factors. Longitudinal studies are needed to assess effective approaches to improve HR-QoL among AH students.

Endurance exercise training suppresses Parkinson disease-induced overexpression of apoptotic mediators in the heart.

BACKGROUNDWe have shown elevated levels of p53 and active caspase-3 in the heart with Parkinson disease (PD). The main aim of this study is to examine the effect of treadmill training on the cardiac expression of p53 and active caspase-3 in the mouse with induced Parkinsonism. METHODS: Thirty randomly selected normal albino mice were equally divided into the following 3 groups: sedentary control (SC), sedentary Parkinson diseased (SPD), and exercised Parkinson diseased (EPD). 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPTP/p) were used to induce chronic Parkinson disease in the SPD and EPD animals. The expression of p53 and active caspase-3 was investigated, using immunohistochemistry, in the heart in each animal group. RESULTS: Both p53 and active caspase-3 expression was significantly (p value < 0.05) reduced in the PD heart following endurance exercise training. CONCLUSION: Our present data suggest that chronic exercise training reduced PD-induced upregulation of p53 and active caspase-3 in the heart. Thus, our study suggests that inhibiting p53 and/or active caspase-3 may be considered as a therapeutic approach to ameliorate PD cardiomyopathy.

Leeds sleep evaluation questionnaire in Jordanian university students. A psychometric investigation using comparative confirmatory factor analysis.

OBJECTIVES: To analyze the fit of different competing factor models (a one-factor model, 3 2-factor models, and 2 4-factor models) of the Leeds sleep evaluation questionnaire (LSEQ) in the data from a Jordanian student population. METHODS: A cross-sectional study was conducted on university students, with 2 sleep-related tools - the LSEQ and the sleep hygiene index (SHI). The students (n=166) at Jordan University of Science and Technology, Irbid, Jordan participated in this study from January-April, 2019. A total of 12 LSEQ models (6 models with all 10-items, and 6 models with one item deleted) were evaluated by using confirmatory factor analysis. The summary statistics of correlation coefficients, descriptive measures of item analysis, the model fit, and Cronbach's alpha were determined. RESULTS: The findings show that a 4-factor correlated solution was a plausible model for the LSEQ with 9-items, compared to a one-factor, 2-factor, and other 4-factor variant models. The deletion of one item from the original LSEQ improved the data fit significantly in the studied population. Moreover, correlation analysis between the LSEQ and SHI confirmed the divergent validity of the LSEQ. CONCLUSION: The results support the validity of a 4-factor structure of the LSEQ with 9-items with adequate internal consistency and divergent validity.

Treadmill exercise training could attenuate the upregulation of Interleukin-1 beta and tumor necrosis factor alpha in the skeletal muscle of mouse model of chronic/progressive Parkinson disease.

BACKGROUND: Induction of Parkinson disease (PD) causes interleukin-1 beta (IL-1ß) and tumor necrosis factor-alpha (TNF-α) upregulation in gastrocnemius skeletal muscles. Endurance exercise suppresses iNOS and HSP90 overexpression in PD skeletal muscle. The purpose of this study is to test the impact of treadmill exercise training on PD-associated IL-1ß and TNF-α upregulation in the gastrocnemius muscle. METHODS: Thirty normal albino mice were randomly selected and divided into three equal groups: sedentary control (SC), sedentary PD (SPD), and Exercised PD (EPD). Chronic Parkinsonism was induced by treating mice in the SPD and EPD groups with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPTP/p). Gastrocnemius muscles were examined for the expression of IL-1ß and TNF-α using immunohistochemistry in the three different groups. RESULTS: Endurance exercise training significantly decreased both IL-1ß and TNF-α expression in skeletal muscle in EPD (P value < 0.01) compared with that in the SPD. CONCLUSION: Our present data suggest that PD-induced upregulation of IL-1ß and TNF-α in the gastrocnemius muscle could be reversed following endurance exercise training. Accordingly, IL-1ß and TNF-α might be considered therapeutically to ameliorate skeletal muscle abnormalities characterizing PD.

Interleukin-1 Beta and Tumor Necrosis Factor Alpha Upregulation and Nuclear Factor Kappa B Activation in Skeletal Muscle from a Mouse Model of Chronic/Progressive Parkinson Disease.

BACKGROUND Skeletal muscle atrophy has been reported in patients with Parkinson disease (PD). The purpose of this study was to examine the potential implication of interleukin 1 beta (IL-1ß), tumor necrosis factor alpha (TNFα), and nuclear factor kappa B (NF kappa B) in skeletal muscle atrophy following PD induction. MATERIAL AND METHODS Chronic Parkinsonism was induced in 10 albino mice by MPTP/probenecid treatment, while 10 other albino mice remained without treatment and were subsequently used as controls. Gastrocnemius muscles were examined for the expression of IL-1ß and TNF-α, as well as the nuclear localization of NF kappa B, indicative of its activation, using immunohistochemistry in the 2 different groups. RESULTS IL-1ß and TNF-α expression and NF kappa B nuclear localization were significantly higher in the PD skeletal muscle compared with those in the controls (P value <0.01). CONCLUSIONS The present data are indicative of an association of PD with IL-1ß and TNF-α upregulation and NF kappa B activation in gastrocnemius muscles, potentially promoting the atrophy frequently observed in PD.

Association of Parkinson Disease Induction with Cardiac Upregulation of Apoptotic Mediators P53 and Active Caspase-3: An Immunohistochemistry Study.

BACKGROUND Apoptosis plays a key role in the pathogenesis of Parkinson disease (PD). Active caspase-3, which is a proapoptotic factor, has been shown to reduce cardiac contractility, causing cardiac dysfunction in many pathological diseases. Reduced cardiac contractility and cardiac autonomic dysfunction have been reported in PD patients and PD mice treated with MPTP. The aim of this study was to show the impact of PD induction on the expression of the apoptotic mediators p53 and active caspase-3 in the heart. MATERIAL AND METHODS Equal control and PD groups were formed by 20 randomly selected normal albino mice. We used 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (25 mg/kg) and probenecid (250 mg/kg) (MPTP/p) to induce chronic Parkinsonism in the PD group. Immunohistochemistry was performed to investigate the expression of p53, active caspase-3, and ß-adrenergic receptor in hearts from the 2 animal groups. RESULTS P53 and active caspase-3 expression was significantly higher in PD hearts than in the control hearts (p value <0.01). ß-adrenergic receptor expression was significantly lower in PD hearts than in control hearts (p value <0.01). CONCLUSIONS Our results show an association of PD with p53 and active caspase-3 overexpression and ß-adrenergic receptor underexpression in the heart, potentially promoting the cardiac autonomic dysfunction frequently observed in PD.

Parkinson disease-induced upregulation of apoptotic mediators could be attenuated in the skeletal muscle following chronic exercise training.

BACKGROUND: We have shown elevated levels of p53 and active caspase-3 in gastrocnemius skeletal muscle with Parkinson's disease (PD). The main aim of this study is to examine the impact of endurance exercise training on the expression of p53 and active caspase-3 in the skeletal muscle of mouse with induced Parkinsonism. METHODS: Sedentary control (SC), sedentary Parkinson diseased (SPD), and exercised Parkinson diseased (EPD) groups were formed; each consisting of 10 randomly selected normal albino mice. Chronic Parkinson disease was induced in the SPD and EPD animals using 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPTP/p). The expression of p53 and active caspase-3 was investigated, using immunohistochemistry, in the gastrocnemius muscle in each animal group. RESULTS: Both p53 and active caspase-3 expression was significantly (p value < 0.05) reduced in the PD gastrocnemius skeletal muscle following endurance exercise training. CONCLUSION: Our present data suggest that chronic exercise training reduced Parkinson disease-induced upregulation of p53 and active caspase-3 in gastrocnemius skeletal muscle. Thus, our study suggests that inhibiting p53 and/or active caspase-3 may be considered as a therapeutic approach to ameliorate PD skeletal muscle abnormalities.

Duration and patterns of habitual physical activity in adolescents and young adults with cerebral palsy.

AIM: Adolescents and young adults with cerebral palsy (CP) show reduced motor function and gait efficiency, and lower levels of habitual physical activity (HPA), than adolescents with typical development and children with CP. This study examined activity duration and patterns in this population in the Middle East through long-term monitoring of a large sample using accelerometers. METHOD: Adolescents and young adults with bilateral CP at Gross Motor Function Classification System (GMFCS) levels II, III, and IV, were monitored in their habitual environment for four consecutive days with ActivPAL3 monitors. Time spent in sedentary, standing, and walking activities, and frequency of walking steps and transitions, were analysed for each GMFCS level. RESULTS: Measurements were made on 222 participants (132 males, 90 females; mean age 16 y 9 mo SD 2y, range 13 y 4 mo-22 y). The Mann-Whitney U test demonstrated significant differences (p<0.05) between GMFCS levels, showing reduced walking and standing activity and increased sedentary duration at higher GMFCS levels (p<0.001), except for increased standing time between GMFCS levels II and III (p=0.07). Participants in educational facilities exhibited less sedentary behaviour than those who were homebound (p<0.05). INTERPRETATION: These descriptions of duration and frequency of active and sedentary behaviours may serve as a basis for recommendations to minimize inactivity in this population. Adolescents and young adults with CP in the Middle East demonstrate similar patterns of HPA to their peers in other regions.

Treadmill Exercise Training Improves Vascular Endothelial Growth Factor Expression in the Cardiac Muscle of Type I Diabetic Rats.

BACKGROUND: Vascular endothelial growth factor (VEGF) expression is a potent mitogen for endothelial cells that is involved in angiogenesis. Cardiac VEGF is decreased in many pathologic conditions, including diabetes mellitus and aging. Exercise training has improved VEGF expression in the aging heart. Thus, the aim of our study is to illustrate the impact of treadmill exercise training on the cardiac VEGF expression in type I diabetic rats. METHODS: Twenty normal Sprague-Dawley rats and Sprague-Dawley rats with streptozotocin-induced diabetes were divided into the following equal groups: sedentary control (SC), exercised control (EC), sedentary diabetic rats (SD) and exercised diabetic rats (ED). Immunohistochemistry was used to investigate VEGF expression in the cardiac tissue in each of the four different groups. RESULTS: Cardiac VEGF expression was significantly (P < 0.05) lower in SD compared with that in SC. However, exercise training significantly (P < 0.01) enhanced VEGF expression in the cardiac tissue in ED compared with that in SD. CONCLUSION: Our present data suggest that treadmill exercise training improved diabetes-induced downregulation in the cardiac VEGF expression.

Effect of endurance exercise training on the expression of GFAP, S100B, and NSE in the striatum of chronic/progressive mouse model of Parkinson's disease.

GOALS AND OBJECTIVES: Parkinson's disease (PD) is one of the most common neurodegenerative diseases in elderly. Glial fibrillary acidic protein (GFAP), calcium-binding protein (S100B), and neuron-specific enolase (NSE) are brain damage markers. The main goal of this study is to investigate the expression of these markers in the striatum (ST) of chronic/progressive mouse model of PD, and to study the effect of endurance exercise training on the expression of those markers. MATERIALS AND METHODS: In this study, forty C57BL/6 albino mice were randomly divided into four groups. Sedentary control (SC, n=10), exercise control (ExC, n=10), sedentary Parkinson's (SPD, n=10), and exercised Parkinson's (ExPD, n=10). Chronic Parkinsonism was induced by injecting the animals with 10 doses of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (25 mg/kg) and probenecid (250 mg/kg) over 5 weeks. Modified human treadmill was used to train the mice at a speed of 18 m/min, 0 degrees of inclination, 40 min/day, 5 days/week for 4 weeks. At the end of exercise training, we examined the expression of these markers on the striatum of the four animal groups using immunohistochemistry. RESULTS AND DISCUSSION: Parkinsonism increases the expression of NSE, S100B, and GFAP in the ST, p value P < 0.001, < 0.05, and < 0.7 respectively compared with control group. Exercise training decreases the expression of NSE, S100B, and GFAP in the exercised PD mice compared with sedentary PD mice p value < 0.005, < 0.02, and < 0.40 respectively. CONCLUSION: Treadmill exercise training decreased the expression of brain damage markers in the striatum of chronic Parkinsonian mice, which can partially explain the beneficial neuroprotective role of exercise in patients with PD.

Association between the functional independence measure and Glasgow coma scale regarding the rehabilitation outcomes of traumatic brain injury.

OBJECTIVE: To evaluate the outcomes of early comprehensive rehabilitation protocols for traumatic brain injury (TBI) using the functional independence measure (FIM), and to study the relationship between FIM and Glasgow coma scale (GCS) variables to determine which patients will be best served by rehabilitation therapies. METHODS: Fifty-one subjects with diagnosed TBI receiving treatment at a single inpatient rehabilitation facility at Jordan University of Science and Technology, Teaching Hospital, Irbid, Jordan were enrolled in this experimental study between August 2006 and February 2008. Of the enrolled subjects, 47 completed the study. The mean age of the participants was 33 years (8 females and 39 males). Glasgow coma scale was measured on admission. Functional independence measure score was measured on admission and on discharge. According to the GCS, the participants were divided into 3 groups as severe injury (GCS: 3-8 [n=24]), moderate injury (GCS: 9-12 [n=12]), and mild or no injury (GCS: 13-15 [n=11]). The FIM score and CGS and their relation were evaluated. RESULTS: Evaluation outcomes revealed a significant improvement in FIM scores after rehabilitation compared to the FIM admission (p=0.00006) in severe TBI. In moderate TBI, the FIM scores were significantly improved (p=0.0004) after rehabilitation. However, with minimal injury, the FIM scores were not significantly improved (p=0.15). CONCLUSION: Early rehabilitation interventions significantly improved the FIM scores in moderate and severe TBI patients. ERRATUM NOTICE PUBLISHED IN NEUROSCIENCES 2009; 14: 306.