Effectiveness of Interventions for Reducing Sedentary Behaviour in Older Adults Living in Long-Term Care Facilities: A Protocol for a Systematic Review.

Background. Sedentary behaviour (SB) is an important risk factor for several health-related outcomes. The prevalence of SB is alarmingly high in older adults, who spend on average 9.4 h being sedentary each day, making them the most sedentary of all age groups. Objectives. The primary objective of this review is to assess the impact of interventions aimed at reducing SB in older adults (aged 60 years and older) living in long-term care facilities (LTCFs). The research question for this systematic review is as follows: in older people living in LTCFs, do interventions aimed at reducing SB, compared to usual care, result in a decrease in SB daily time or a reduction in the length of prolonged and uninterrupted sitting bouts? Data sources. Only peer-reviewed articles will be included in this systematic review, articles will be identified using the PICO method in seven different databases. Participants and interventions. Any primary intervention study (including randomized controlled trials, non-randomized controlled trials, and cohort studies) with the aim to reduce SB daily time or shorten the length of prolonged and uninterrupted sitting bouts in older adults living in LTCFs will be included. After searching databases, abstracts of the studies will be screened, and, after retrieving full text articles, data extraction will be conducted by two independent reviewers. Study appraisal and synthesis methods. The review will adhere to PRISMA reporting guidelines. Risk of bias (RoB) will be assessed using ROBINS-I or the RoB 2.0 tool and will be discussed with a third reviewer. The data will be grouped according to study design, with separate analysis for randomised and non-randomised designs. Results. The primary outcomes will be SB or time spent sedentary, assessed before and after the intervention. For the outcomes with the same measurement units, the pooled mean differences will be calculated. Standardised mean differences will be calculated for the outcomes with different measurement units. The data not suitable in numbers will be synthesised narratively. The strength of evidence of the outcomes will be assessed using GRADE assessment. If the data are suitable for quantitative analysis, we plan to use the Revman software to conduct a meta-analysis. Conclusions and implications of key findings. This protocol can serve as a valuable resource for other researchers interested in conducting similar systematic reviews or meta-analyses in the field of SB and older adult health.

Pelvic Floor Muscle Training versus Functional Magnetic Stimulation for Stress Urinary Incontinence in Women: A Randomized Controlled Trial.

BACKGROUND: There is strong evidence that specific pelvic floor muscle training (PFMT) reduces stress urinary incontinence (SUI), but the application of functional magnetic stimulation (FMS) is still under discussion. OBJECTIVE: To evaluate and compare the effects of FMS and PFMT on pelvic floor muscle function, urinary incontinence symptoms and quality of life (QoL) in women with SUI. METHODS: A randomized controlled, parallel-group trial was executed in an outpatient physical medicine and rehabilitation centre. The study included 68 women and was fully completed by 48 women (n = 24 in each group) aged 29-49 years, with SUI, who were randomly assigned to PFMT and FMS groups. The symptoms of urinary incontinence and their impact on quality of life were assessed with two questionnaires: the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and the Incontinence Impact Questionnaire-Short Form (IIQ-7). Perineometer (Pelvexiser) was used to measure the resting vaginal pressure, pelvic floor muscle (PFM) strength and endurance. All outcome measures were taken at baseline and after 6 weeks of interventions. Cohen's effect size (d) was calculated. RESULTS: A significant improvement (p < 0.05) of ICIQ-SF and IIQ-7 was observed in both groups with a high effect size in the PFMT group (d = 1.56 and d = 1.17, respectively) and the FMS group (d = 1.33 and d = 1.45, respectively). ICIQ-SF and IIQ-7 scores did not differ significantly between groups after the 6-week treatment period. Resting vaginal pressure, PFM strength and endurance increased (p < 0.05) in both groups with a medium (d = 0.52) to large (d = 1.56) effect size. CONCLUSION: No significant difference between groups was found in any measurement of perineometry. PFMT and FMS significantly improved SUI symptoms and the quality of life of the study participants. None of the applied interventions was superior to the other in the short-term effect.

Randomized controlled trial to compare conventional physiotherapy with task-oriented exercises after total hip replacement.

BACKGROUND: Different interventions are used during rehabilitation after hip replacement surgery, but it is unclear if task-oriented exercise is more effective than conventional physiotherapy. OBJECTIVE: This study compared the effectiveness of conventional physiotherapy (CPT) programme with task-oriented exercise (TOE) on hip pain, function, static and dynamic balance during the early rehabilitation stage after total hip replacement. METHODS: This randomized controlled parallel-group trial was executed in an inpatient physical medicine and rehabilitation centre. The study included 40 patients who were randomly classified into CPT and TOE groups (n= 20 in each). Hip pain (assessed by visual analogue scale), function in the operated leg (assessed by modified Harris Hip Score, mHHS), static balance (assessed by Abili Balance analyser system) and dynamic balance (assessed by Berg Balance Scale) were evaluated at baseline and after 18 days of rehabilitation. Cohen's effect size (d) was calculated. RESULTS: Greater pain reduction (p< 0.05; d= 0.08) was observed after TOE (1.6 ± 0.68 scores) compared with the CPT programme (2.2 ± 0.83 scores). Hip function assessed by the modified mHHS improved more (p< 0.05; d= 0.30) in the TOE group (73.45 ± 6.23 scores) than in the CPT group (54.90 ± 6.28 scores). Static balance improved significantly in both groups after the interventions but did not differ significantly between the groups. The improvement in dynamic balance was significantly greater (p< 0.05; d= 0.45) after TOE (50.55 ± 1.57 scores) than after CPT (38.55 ± 3.43 scores). CONCLUSION: Both interventions reduced pain and improved function of the operated leg and static and dynamic balance. The effect on hip function was superior for TOE compared with CPT.

Women's Knowledge and Perceptions of the Effect of Exercise during Pregnancy: A Cross-Sectional Study.

BACKGROUND: Many women may not be aware of the effect of exercise during pregnancy. The objective of this study was to explore the knowledge and perceptions of the effect of exercise and compare whether there was a difference between women who were pregnant at the time of the study, who were not pregnant but had given birth in the past, and those who had never been pregnant and had never given birth. METHODS: A cohort of 291 women, aged 18-55 years, participated in this cross-sectional study. Ninety-one (31.3%) women were pregnant at the time of the study; 97 (33.3%) were not pregnant but had given birth in the past, and 103 (35.4%) were not pregnant and had never given birth. This was a survey by an on-line questionnaire. RESULTS: Only 24.4 % of respondents were aware of the effect of exercise in pregnancy, 44% were not aware of the effect of exercise in pregnancy, and 52.6% did not know if exercise interventions could be prescribed during pregnancy. The perceived aims of exercise, reported by the women, were to keep the body fit (58%), to reduce low back and pelvic pain (55%), and to facilitate childbirth (51%). CONCLUSIONS: Women who were not pregnant but had given birth were significantly less aware of the effect of exercise than women who were pregnant at the time of the study or not pregnant and had never given birth. The internet was the most common source of information about exercise among all respondents. Almost all women in the study felt the need for more knowledge about the effect of exercise during pregnancy. Therefore, exercise specialists must inform and educate women about the benefits of exercise during pregnancy.

Comparison of static balance and gait between subjects with plantar fasciitis and age-matched controls.

BACKGROUND: Plantar fasciitis (PF) is a common condition amongst athletes as well as in non-sporting population. It is characterised by a sharp pain under the calcaneus during walking. The impact of pain due to PF on gait and static balance is examined in this observational study. OBJECTIVE: To compare gait and balance between individuals with PF and age-matched controls without PF. METHOD: A cross-sectional observational study was executed in an Outpatient Rehabilitation Centre. Twenty-nine participants were included, 14 with PF, and 15 age-matched healthy asymptomatic individuals. Main outcome measures were foot pain, foot function index (FFI), static balance measured with modified Romberg test, static balance measured on the TYMO® system, and gait with the G-Walk System. RESULTS: Foot pain and FFI were adversely related to balance and gait parameters in subjects with PF. Static balance with eyes open and eyes closed on firm and soft surface measured on the TYMO® balance platform as well as gait parameters measured with the G-Walk system, were significantly lower in subjects with PF compared to age-matched healthy controls. CONCLUSION: PF negatively affects parameters of static balance measured with TYMO® system and gait parameters measured with the G-Walk System. However, the Romberg balance test did not detect differences between subjects with PF and age-matched healthy controls.

Neurometabolic correlates of posturography in normal aging and older adults with mild cognitive impairment: Evidence from a 1H-MRS study.

Proton magnetic resonance spectroscopy (1H-MRS) holds promise for revealing and understanding neurodegenerative processes associated with cognitive and functional impairments in aging. In the present study, we examined the neurometabolic correlates of balance performance in 42 cognitively intact older adults (healthy controls - HC) and 26 older individuals that were diagnosed with mild cognitive impairment (MCI). Neurometabolite ratios of total N-acetyl aspartate (tNAA), glutamate-glutamine complex (Glx), total choline (tCho) and myo-inositol (mIns) relative to total creatine (tCr) were assessed using single voxel 1H-MRS in four different brain regions. Regions of interest were the left hippocampus (HPC), dorsal posterior cingulate cortex (dPCC), left sensorimotor cortex (SM1), and right dorsolateral prefrontal cortex (dlPFC). Center-of-pressure velocity (Vcop) and dual task effect (DTE) were used as measures of balance performance. Results indicated no significant group differences in neurometabolite ratios and balance performance measures. However, our observations revealed that higher tCho/tCr and mIns/tCr in hippocampus and dPCC were generic predictors of worse balance performance, suggesting that neuroinflammatory processes in these regions might be a driving factor for impaired balance performance in aging. Further, we found that higher tNAA/tCr and mIns/tCr and lower Glx/tCr in left SM1 were predictors of better balance performance in MCI but not in HC. The latter observation hints at the possibility that individuals with MCI may upregulate balance control through recruitment of sensorimotor pathways.

Safe patient handling education: analysis from European higher education institutions.

OBJECTIVES: According to current research, patient handling is not universally taught in academic nursing programs in Europe. Miscellaneous patient handling education may expose students and novice health care workers to occupational hazards, especially if the evidence-based contents of safe patient handling are not recognized. Health care workers deal with high physical workloads daily, which points out the importance of evidence-based curricula contents from the early phases of education. The aim of this study was to describe the patient handling education and to analyse the differences in curricula among higher education institutions (HEIs) in Europe. MATERIAL AND METHODS: The study used a cross-sectional design and was conducted in HEIs educating health care professionals in Europe. The data was collected through a Webropol questionnaire consisting of structured and open-ended questions. RESULTS: Only 68.4% of the respondents stated that they have a framework that guides the patient handling education. Additionally, some answers referred to guidelines that are not adequate to be referred to as evidence-based guidelines on patient handling. There is variation in emphasizing workplace safety and risk assessment issues in the curricula, and variation in teaching of assistive aids. CONCLUSIONS: Currently the patient handling education in the studied HEIs does not meet the requirements of evidence-based practice. The establishment of a European-wide framework, including both theoretical and practical training for safe patient handling is needed. The inclusion of risk assessment and workplace safety issues is essential to improve the risk management knowledge and skills and further avoid work-related musculoskeletal disorders. Int J Occup Med Environ Health. 2022;35(5):615-23.

Sling suspension therapy is an effective treatment method of juvenile spinal osteochondrosis in adolescent girls.

BACKGROUND: Juvenile spinal osteochondrosis (JSO) affects vertebral endplates and may cause intervertebral discs alterations. The condition is typically related to pain, and weakness and shortening of trunk muscles. Sling suspension therapy (SST) has been shown to reduce lumbar pain effectively. It is, however, unclear whether SST is superior to other treatment methods in reducing pain, correcting posture, and activating trunk stabilizers in JSO. OBJECTIVE: In this study, we intended to compare the effectiveness of two different exercise modalities; Sling Suspension Therapy and Gym Ball Exercise in the treatment of JSO in adolescent girls. METHODS: A randomised controlled single centre clinical trial was carried out in an inpatient rehabilitation unit at a sanatorium. Forty adolescent girls (age 16.3 ± 0.47 yrs.), who were diagnosed with JSO (according to ICD-10 Version: 2016 - M 42.0) were randomly assigned into two groups: Group 1 - Sling suspension therapy (SST), Group 2 - Gym ball exercises (GBE). Both groups received interventions for 3 weeks, 15 sessions, and 30 minutes a day for 5 consecutive days a week. Back pain, endurance of trunk muscles and standing posture were evaluated pre- and post-interventions. RESULTS: Both groups demonstrated significant improvement in all measured outcomes. SST was more effective in reducing pain (p< 0.05), increasing the endurance of trunk muscles (p< 0.05) and improving the standing posture (p< 0.05) compared to GBE (p< 0.05). CONCLUSIONS: Sling suspension therapy is more effective compared with Gym ball exercises in the treatment of juvenile spinal osteochondrosis in adolescent girls in terms of back pain, posture and endurance of trunk muscles.

Mechanisms of force depression caused by different types of physical exercise studied by direct electrical stimulation of human quadriceps muscle.

PURPOSE: Force production frequently remains depressed for several hours or even days after various types of strenuous physical exercise. We hypothesized that the pattern of force changes during the first hour after exercise can be used to reveal muscular mechanisms likely to underlie the decline in muscle performance during exercise as well as factors involved in the triggering the prolonged force depression after exercise. METHODS: Nine groups of recreationally active male volunteers performed one of the following types of exercise: single prolonged or repeated short maximum voluntary contractions (MVCs); single or repeated all-out cycling bouts; repeated drop jumps. The isometric force of the right quadriceps muscle was measured during stimulation with brief 20 and 100 Hz trains of electrical pulses given before and at regular intervals for 60 min after exercise. RESULTS: All exercises resulted in a prolonged force depression, which was more marked at 20 Hz than at 100 Hz. Short-lasting (≤2 min) MVC and all-out cycling exercises showed an initial force recovery (peak after ~ 5 min) followed by a secondary force depression. The repeated drop jumps, which involve eccentric contractions, resulted in a stable force depression with the 20 Hz force being markedly more decreased after 100 than 10 jumps. CONCLUSIONS: In accordance with our hypothesis, the results propose at least three different mechanisms that influence force production after exercise: (1) a transiently recovering process followed by (2) a prolonged force depression after metabolically demanding exercise, and (3) a stable force depression after mechanically demanding contractions.

Bimodal recovery of quadriceps muscle force within 24 hours after sprint cycling for 30 seconds.

UNLABELLED: The aim of the study was to investigate the manifestation of potentiation and fatigue as well as the coexistence of these phenomena at different muscle lengths during a 24-hour period after a sprint cycling for 30 s. MATERIAL AND METHODS: Twelve healthy untrained men (mean age 23.6+/-1.7 years) took part in the experiment. The contractility of quadriceps muscle was studied before (Initial) and 2, 5, 30, 60 min and 24 h after exercise via the electrically evoked contractions at 1, 15, 50 Hz and maximal voluntary contractions at short and long muscle length. RESULTS: 1) In early, fast-recovery phase (within the first 5 min), muscle force evoked by electrical stimulation of 1, 15, 50 Hz was restored at short muscle length, conversely at long length (Initial vs. 5 min: 15 Hz and 50 Hz, both P<0.05), whereas maximal voluntary contraction force was still suppressed at both muscle lengths; 2) in the second phase (from 5 min to 30-60 min), muscle force decreased at low- and high-frequency stimulations and was more expressed at low-frequency stimulation and at short muscle length than that at long length, but the maximum voluntary contraction force recovered to initial; 3) in long-lasting phase (within 24 hours), 15 Hz force was still suppressed at both muscle lengths. CONCLUSION: A bimodal recovery of contractility of the quadriceps following sprint cycling for 30 s is determined by the concomitant complex interaction of mechanisms enhancing (potentiation) and suppressing (fatigue) contractile potential of the muscle.

The Time-Course of Voluntary and Electrically Evoked Muscle Performance During and After Stretch-Shortening Exercise is Different.

The aim of the study was to establish the dynamics of maximal voluntary contraction force (MVCF), height of drop jump (DJ) and electrically evoked quadriceps muscle force at different stimulation frequencies during and after 100 DJs (stretch-shortening exercise, SSE). Healthy untrained men (n = 11; age = 21.8 ± 1.7 years) participated in the study. DJs were performed with 30 s intervals between jumps from the height of 0.5 m with counter-movement to 90 degrees angle in the knee and immediate maximal rebound. The force of the quadriceps muscle, evoked by electrical stimulation at 1 Hz (Pt), 20 Hz (P20) and 100 Hz (P100) frequencies (electrically evoked performance, EEP), MVCF and height of DJ (voluntary evoked performance, VEP) were established during SSE (after 10, 50, 100 DJ) as well as at 1, 4, 8, 24, 48 and 72 h after SSE. Time-course of P20 and P100 during and after SSE was time (ANOVA: p < 0.001) and frequency dependent (ANOVA: p < 0.001) The Pt, P20 and P100 decreased significantly (p < 0.01) more than MVCF and H of DJ during SSE. At the beginning of SSE (during 1-10 DJs) P20 and P100 decreased significantly (p < 0.001) more than during 11-50 and 51-100 DJs. There was a significant (p < 0.05) increase in Pt, P20 and P100 from 8 h to 48 h, whereas height of DJ and MVCF significantly decreased at that time. In conclusion, the differences in time course of VEP and EEP are most evident at beginning of SSE, where VEP does not change as EEP decreases, and within 8-48 hours after SSE, where VEP decreases as EEP increases. Key pointsThere was no change in voluntary muscle performance while electrically evoked performance decreased significantly during first 10 drop jumps.There was a significant increase in electrically evoked muscle performance from 8 h to 48 h after 100 drop jumps, whereas voluntary contraction force, decreased significantly.The secondary decrease in the height of drop jump as well as in maximal voluntary contraction force correlated significantly with muscle soreness within 24-48 h after exercise.

[Influence of temperature on the recovery of muscle function after performing maximal intensity exercise]. / Temperaturos poveikis raumens funkcijos atsigavimui po maksimalaus intensyvumo veloergometrinio kruvio.

The purpose of this study was to establish the influence of temperature on quadriceps femoris muscle force, contraction and relaxation time, low frequency fatigue and muscle recovery after performing high-intensity exercise. Healthy untrained men (age 21-30 years, n = 9) gave their informed consent to take part in all experiments within the study. A high voltage stimulator (MG 440, Medicor, Hungary) was used for electrical stimulation; quadriceps muscle was stimulated through surface electrodes (9 x 18 cm) padded with cotton cloth and soaked in saline solution. The following data were measured: the force of quadriceps muscle, aroused by electrical stimulation under 1 Hz (Pt), 20 Hz (P20) and 50 Hz (P50) frequencies (the duration of each electrical stimulation series was 1 second) and maximal voluntary contraction force (MVCF). Hot water (44-45 degrees C) bath was used for muscle heating. Blood lactate concentration was measured before exercise and after 5 min. and 1 hour after performing high-intensity exercise. Two experiments with two months recreation time were carried out. The following conclusions were received: even though muscle heating increases the speed of dominating lactate in blood and increases the muscle force caused by low and high stimulation frequency, it does not influence the recovery properties of muscle contraction and relaxation during 24 hours after performing high-intensity exercise.