Multifactorial inspiratory muscle training and its impact on respiratory and functional parameters of patients with diabetic polyneuropathy-A Randomized Controlled Trial.

BACKGROUND AND PURPOSE: Diabetic polyneuropathy is a long-standing microvascular complication of diabetes that affects the postural control and functional mobility of patients. There are other microvascular complications, including pulmonary complications that reduce lung function. Multifactorial Inspiratory Muscle Training (IMT) can act as a home-based technique targeted to affect both these complications. This study aims to determine the effects of IMT on respiratory and functional parameters in diabetic polyneuropathy patients. METHODS: This is a Pre-Test Post-Test Randomized Controlled Trial (NCT#04947163) with 62 diabetic polyneuropathy patients. Each was randomly assigned to the IMT or sham-IMT group. Both the groups performed OTAGO exercises , with the sham-IMT group performing IMT at 15% of baseline maximal inspiratory pressure (MIP), whereas IMT were trained at 50% of baseline MIP as an initial intensity, which was increased as per the tolerance of patients. Both groups performed training for 12 weeks. The study investigated diaphragmatic strength, pulmonary function, functional capacity through 6MWT, 30s sit to stand test and anterior trunk muscle endurance tested through sit up test as outcome variables. Data was analysed on SPSS v26 at the significance level of 0.0.5. RESULTS: The IMT group significantly improved diaphragmatic strength, pulmonary function, 6MWT and anterior trunk muscle endurance when compared to the sham-IMT group. CONCLUSION: The study concluded that home-based IMT can improve pulmonary parameters including diaphragmatic strength and lung function as well as functional parameters including functional capacity in patients with diabetic polyneuropathy. The study was registered at ClinicalTrials.gov, NCT#04947163.

Does multifactorial inspiratory muscle training improve postural stability and quality of life of patients with diabetes in Pakistan? A randomised controlled trial.

OBJECTIVE: To determine the effects of multifactorial inspiratory muscle training (IMT) combined with Otago Exercise Programme (OEP) on balance and quality of life (QoL) in patients with diabetes. METHODS: Pretest-post-test randomised controlled trial. SETTING: Rehabilitation Department of Pakistan Railway General Hospital. PARTICIPANTS: 70 patients with diabetes were randomly assigned to experimental or placebo groups, out of which 59 patients completed the intervention. INTERVENTION: Patients in the experimental group performed OEP+IMT (at 50% of baseline maximum inspiratory pressure (MIP)) whereas the placebo group performed OEP+sham IMT (at 15% of MIP). Both groups exercised for 12 consecutive weeks. OUTCOME MEASURES: Outcome measures included nine variables: the Berg Balance Scale (BBS), the Biodex Postural Stability System (including postural stability test (Overall Stability Index, Anterior-Posterior Index and Mediolateral Index), fall risk test (FRT), Limits of Stability (LOS) test (time to complete test and direction control), Clinical Test of Sensory Interaction and Balance (CTSIB)) and the Audit of Diabetes Dependent Quality of Life questionnaire. RESULTS: Out of 59 patients who completed treatment, 37.1% were men and 62.9% were women with a mean age of 58.37±5.91 years. Results show significant interaction effects on BBS scores with the mean score improving from 41.87±2.61 to 49.16±2.50 in IMT versus sham IMT group with scores improving from 41.58±2.51 to 45.74±2.30. The IMT group significantly improved in dynamic balance tested through BBS (p=0.003), anticipatory balance through LOS test (p=0.003), reactive balance tested through FRT (p=0.04), direction control (p=0.03) and sensory integration through CTSIB test (p=0.04) when compared with the sham IMT group. While no significant changes (p>0.05) between groups were observed in QoL and static balance; significant changes (p<0.05) within group were observed in both groups in QoL and static balance. CONCLUSION: Additional research is necessary to understand the association between inspiratory muscle strength and balance, however, we demonstrated that a multifactorial IMT intervention should be used with patients with diabetes to improve balance, postural control and reduce fall risks. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, NCT#04947163.

Artistic sports activities effectiveness for enhancing students' academic performance among left-behind children: mediating effects of loneliness.

Introduction: Numerous studies within the school and academic contexts have underscored the profound impact of psychometric variables such as academic self-efficacy, self-esteem, and loneliness on academic achievement among children. Although physical activities and dance practices are known to bolster academic self-efficacy and enhance academic outcomes, the effect of Artistic Sports Activities on these psychological determinants among left-behind children (LBC) in rural schools remains underexplored. Method: This study was conducted from September 2020 to January 2022 among 405 LBCs aged 9 to 13 from six randomly selected primary schools in Hunan Province, China. Schools were chosen in collaboration with the Hunan Women and Children's Federation, ensuring informed consent through stakeholder informational sessions. The study employed rigorous sampling and data analysis methods, including the Shapiro-Wilk test for normal distribution and Cronbach's alpha for reliability, alongside Pearson correlation, independent and paired t-tests, and multiple linear regression analyses to investigate the effects of Artistic Sports Activities on psychometric variables and academic performance among LBCs. Data collection involved standardized questionnaires assessing academic self-efficacy, self-esteem, and loneliness before and after intervention. Results: Findings indicate that Artistic Sports Activities significantly improved academic self-efficacy and self-esteem and reduced loneliness, leading to enhanced academic performance. Notably, loneliness was identified as mediating the relationship between academic self-efficacy and self-esteem among LBCs. Discussion: The findings highlight the critical role of integrating Artistic Sports Activities in educational frameworks to bolster psychological and academic outcomes for LBCs. The study reveals the intricate interplay between loneliness, self-esteem, and academic self-efficacy, underscoring the necessity for targeted educational interventions.

The effects of inspiratory muscle training on balance and functional mobility: a systematic review.

INTRODUCTION: Inspiratory muscle training (IMT) has been widely used in both healthy and diseased populations especially in older adults, and its effects have been proven not only on inspiratory muscle strength but also on dyspnea, exercise capacity, quality of life, and other health parameters. AIM: This study aims to review the effects of IMT on balance and functional ability of healthy and diseased populations. METHODS: A systematic literature search was conducted on MEDLINE, EMBASE, AMED, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomized control trials having participants > 18 years of age and having balance and functional mobility as primary or secondary outcomes were included. Two independent reviewers screened studies against the eligibility criteria, extracted the data, and assessed the quality of evidence. The protocol was prospectively registered on PROSPERO: CRD42021261652. RESULTS: Ten studies were included in the review out of which eight had balance and six had functional mobility as an outcome measure. There was a significant improvement in balance of the participants after treatment with IMT, however the effect on functional mobility was inconclusive. CONCLUSION: The review provided evidence of improvement in balance and functional mobility following inspiratory muscle training in both healthy and diseased adults. Future studies should be conducted to determine the optimal protocol and dosage of treatment.

The effects of Latino Dance intervention on academic and general self-efficacy with left-behind children: An experimental study in China.

Introduction: Although there is considerable research indicating that physical exercise and dance can strengthen children's self-efficacy, and children's self-efficacy can predict students' academic achievement at a wide range of academic levels. Few studies have been conducted using Latino Dance to improve self-efficacy in Left-Behind Children (LBC), especially the two aspects of student academic self-efficacy and general self-efficacy, while the mediator role of self-esteem between student academic self-efficacy and general self-efficacy has been less explored in previous research. Methods: This study proposed to examine Latino Dance interventions to improve general self-efficacy and students' academic self-efficacy among LBC students in rural areas to boost students' academic performance, and the research team hypothesised that general self-efficacy, students' academic self-efficacy and self-esteem would improve following the intervention and that outcomes will have a significant positive correlation as students' self-esteem can mediate both their academic self-efficacy and their general self-efficacy. Dates were collected from 305 LBCs children (160 boys and 145 girls) from 6 left-behind schools in Hunan province, China. Ralf Schwarzer's general self-efficacy scale, Morgan-Jinks Student academic Self-Efficacy Scale, and Rosenberg's self-esteem scale were administered to LBCs between September 2020 and January 2022. Results: The results revealed that the Latino Dance intervention significantly increased the LBC student' academic self-efficacy and general self-efficacy, which also involved a positive effect on the three sub-dimensions (talent, context, and effort) of students' academic self-efficacy. Further, multiple linear regression analysis confirmed that self-esteem (positive esteem/self-deprecation) acted as a partial mediator between student academic self-efficacy and general self-efficacy; perceived self-esteem played a mediating role between them. Discussion: This study filled a gap in the literature concerning the psychological reinforcement effect of Latino Dance on LBC groups and demonstrated that Latino Dance improved the student' academic self-efficacy and general self-efficacy among the LBCs. Our results suggest that Latino Dance can be beneficial for LBC in school by including Latino Dance in Physical Education or Art courses and improving students' self-esteem may lead to an increase in student academic self-efficacy as well as general self-efficacy, thereby improving and enhancing the learning of LBCs.

Pedagogic intervention for health: a narrative systematic review on biodanza / Intervenção pedagógica para a saúde: uma revisão narrativa sistemática sobre a biodanza / Intervención pedagógica para la salud: una revisión narrativa sistemática sobre la biodanza

Abstract This research reports on the first narrative review of Biodanza's effects on health and wellbeing. The review explores manuscripts in four languages (i.e., Italian, Spanish, Portuguese and English) and includes more than 200 documents. The protocol was evaluated according to the most recent SANRA guidelines and Kappa statistics. The research shows that the majority of the studies had descriptive approaches (29.2%), followed by robust control trials (26.8%), while the remaining studies included both narrative and systematic reviews (19.5%) as well as pilot (14.6%), ethnographic (7.3%), and assessment (2.4%) studies. The research team concluded that Biodanza is an innovative intervention to improve clinical and socio-pedagogic outcomes in different cohorts (including kindergartens and chronic senile-disease patients) and should be fostered for additional trials along or in comparison with alternative interventions (such as Bodytasking).

Resumo A pesquisa tem como objetivo relatar a primeira revisão narrativa dos efeitos da Biodanza na saúde e no bem-estar. A revisão explora manuscritos em quatro idiomas (italiano, espanhol, português e inglês) e incluiu mais de 200 documentos. O protocolo foi avaliado de acordo com as mais recentes diretrizes SANRA e estatísticas Kappa. A pesquisa mostra que a maioria dos estudos teve abordagem descritiva (29,2%), seguida de ensaios de controle robusto (26,8%). Enquanto o restante incluía revisões narrativas e sistemáticas (19,5%), estudos-piloto (14,6%), etnográficos (7,3%) e diagnósticos (2,4%). A equipe de pesquisa concluiu que a Biodanza é uma intervenção inovadora para melhorar os resultados clínicos e sociopedagógicos em diferentes coortes (incluindo jardins de infância e com pacientes com doença senil crônica) e deve ser promovida para ensaios adicionais junto ou em comparação com intervenções alternativas (como Bodytasking).

Resumen La investigación tiene como objetivo relatar la primera revisión narrativa de los efectos de la Biodanza en la salud y el bienestar. La revisión explora manuscritos en cuatro idiomas (italiano, español, portugués e inglés) e incluye más de 200 documentos. El protocolo se evaluó de acuerdo con las estadísticas más recientes SANRA directrices y Kappa. La investigación muestra que la mayoría de los estudios tuvo un enfoque descriptivo (29,2%), seguido por ensayos de control robusto (26,8%). El resto incluyó revisiones narrativas y sistemáticas (19,5%), piloto (14,6%), etnografía (7,3%) y estudios de diagnóstico (2,4%). El equipo de investigación concluyó que Biodanza es una intervención innovadora para mejorar los resultados clínicos y sociopedagógicos en diferentes cohortes (incluidos jardines infantiles y con pacientes con enfermedad senil crónica) y debe fomentarse para ensayos adicionales junto o en comparación con intervenciones alternativas (como Bodytasking).

Comparison of balance changes after inspiratory muscle or Otago exercise training.

The inspiratory muscles contribute to balance via diaphragmatic contraction and by increasing intra-abdominal pressure. We have shown inspiratory muscle training (IMT) improves dynamic balance significantly with healthy community-dwellers. However, it is not known how the magnitude of balance improvements following IMT compares to that of an established balance program. This study compared the effects of 8-week of IMT for community-dwellers, to 8-week of the Otago exercise program (OEP) for care-residents, on balance and physical performance outcomes. Nineteen healthy community-dwellers (74 ± 4 years) were assigned to self-administered IMT. Eighteen, healthy care-residents (82 ± 4 years) were assigned to instructor-led OEP. The IMT involved 30 breaths twice-daily at ~50% of maximal inspiratory pressure (MIP). The OEP group undertook resistance and mobility exercises for ~60 minutes, twice-weekly. Balance and physical performance were assessed using the mini Balance Evaluation System Test (mini-BEST) and time up and go (TUG). After 8-week, both groups improved balance ability significantly (mini-BEST: IMT by 24 ± 34%; OEP by 34 ± 28%), with no between-group difference. Dynamic balance sub-tasks improved significantly more for the IMT group (P < 0.01), than the OEP group and vice versa for static balance sub-tasks (P = 0.01). The IMT group also improved MIP (by 66 ± 97%), peak inspiratory power (by 31 ± 12%) and TUG (by -11 ± 27%); whereas the OEP did not. IMT and OEP improved balance ability similarly, with IMT eliciting greater improvement in dynamic balance, whilst OEP improved static balance more than IMT. Unlike IMT, the OEP did not provide additional benefits in inspiratory muscle function and TUG performance. Our findings suggest that IMT offers a novel method of improving dynamic balance in older adults, which may be more relevant to function than static balance and potentially a useful adjunct to the OEP in frailty prevention.