Exercise response on dose curve among class I obese young adult population.

Objectives: To identify exercise regimes having a short duration and yet incorporating the effects of both aerobic and resistance exercises. METHODS: The randomised study was conducted from December 1, 2019, to April 31, 2020, at Ziauddin Hospital, Karachi, and comprised individuals of either gender aged 20-40 years with class-I obesity. All participants were initially screened using a physical activity and readiness questionnaire to determine if they were fit to perform the exercises. Subsequently, dynamic exercises were introduced based on the guidelines of the American College of Sports Medicine. The subjects were randomised into aerobic group A, resistance group B and dynamic resistance group C. The intervention lasted 12 weeks. The quantification of exercises was done using the frequency, intensity, time, and type protocol. RESULTS: The results were analysed on MedCalc statistical software. Out of the 102 participants, 51(50%) each were males and females. Each of the three groups had 34(33.3%) subjects; 17(50%) males and as many females. The impact was significant in all the three groups (p<0.05). The effect was significantly better in group C than groups A and B. CONCLUSIONS: Body mass index and body fat percentage values improved through aerobic, resistance and dynamic resistance exercises.

Role of structured and supervised exercise programmes in peripheral artery disease patients with and without claudication - A Systematic Review and Metaanalysis.

OBJECTIVE: This review aimed to determine the impact of exercise protocol among peripheral artery disease patients. Literature search was done from 2005 to 2018. METHODS: Databases such as Google Scholar, Medline and PubMed was reconnoitred for the purpose of research articles by using key words like exercise training, peripheral artery disease, ankle brachial index, haemodynamic and atherosclerosis. Studies fulfilling the inclusion criteria were retrieved and encompassed in the present study. RESULTS: The heterogeneity of the studies included in the analysis and the impact of exercise programmes on outcome measures were assessed by using hedge gstatistical model.Of the54 studies found, 9(16.6%) were analysed that suggest supervised and structured exercises programmes significantly improved (p<0.05) outcome variables. CONCLUSIONS: Future randomized controlled trials related to the duration of exercises regimes are required in order to tailor the training programmes according to the need of individuals.

Foot Muscle Exercise: A Novel Approach to Improve Motor Functions in Children with Down Syndrome Having Pes Planus - A Randomized Controlled Trial.

OBJECTIVE: The study aimed to determine the efficacy of foot muscle exercises in children with DS having pes planus. METHODS: Forty-seven subjects randomly assigned to foot muscle exercises (study group) or an arch support insole with one-leg balance exercises (control group), thrice weekly intervention for 12-weeks followed by a home program with residual effect assessed after 24-weeks from baseline. RESULTS: The motor functions were significantly improved in both groups (p = 0.00). A positive residual effect was found in the study group for both parameters. Whilst in the control group it failed to give a positive residual effect for GMFM-88, while PBS yielded positive outcomes. The study group showed significantly better results than the control group in comparison. CONCLUSION: The novel finding suggests that the foot muscle exercise has the potential to improve motor functions in children with Down syndrome and it can be used as an alternative therapeutic approach to the conventional method.

Effects of Physical Activity on Thyroid Stimulating Hormone Levels in Obese Metabolic Syndrome Patients: A Meta-Analysis.

Metabolic syndrome is a combination of multiple disorders that predispose an individual to risk of diabetes, obesity, cardiovascular diseases (CVDs), cerebrovascular accidents (CVAs), and insulin-resistance. Hypothyroidism is the most prevalent metabolic disorder causing obesity, followed by hypercortisolism and hypogonadism. Hence, this study aimed to determine the effects of various exercises on thyroid stimulating hormone (TSH) levels in obese patients with metabolic syndrome. The study conformed to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) standards. The PubMed, Cochrane, Google Scholar, Medline, and Biomed Central databases were searched using the keywords exercise, aerobic, rehabilitation, etabolic syndrome, and thyroid stimulating hormone. Studies in English language published between 2010 and 2021 and that examined the efficacy of physical therapy management with sham treatment on TSH levels in patients with obesity were included. The meta-analysis comprised of 526 patients with metabolic obesity from 10 randomised controlled trials. The analysis revealed that when compared with the control group, exercise had a moderate pooled effect on lowering TSH levels, with an effect size standardised mean difference (SMD) of -0.56 (95% Confidence Interval (CI), -1.09-0.02) estimated using a random effects model, with an I2 of 86.61% (95% CI, 77.31-92.10) in the interventional group. It was concluded that although a pooled moderate effect of training on TSH levels was observed when all the studies were analysed using a continuous measure analysis SMD model, an individual analysis of the studies revealed a mild effect, with many studies also revealing the negative impact of training on TSH levels. Nonetheless, exercise-based intervention strategies are safe and effective as a management strategy for hypothyroidism and obesity due to hypothyroidism. Key Words: Thyroid hormone, Exercise, Metabolic syndrome, Obesity, TSH level.

Effects of Exercise-based Management on Motor Symptoms in Parkinson's Disease - A Meta-analysis.

Parkinson's disease (PD) is the second most common neurological illness after Alzheimer's disease. According to research, medication alone can give palliative alleviation; however, freezing of gait (FOG) and balance can be treated with physical therapy. This meta-analysis aims to bridge gaps about exercise-based therapy's impact on balance and FOG in patients with PD. Google Scholar, CINHAL, Medline, PubMed, and PEDro were searched for 2016-2021 citations using the PIOD paradigm. Pooled effect size mean and SD were analysed using a fixed and random effects model. A total of 21 trials were included in this review, with SMD=0.60 and p=0.0007 utilising BBS. The pooled analysis revealed statistically significant impacts on exercise-based management in the experimental group. With SMD=0.87 and p<0.00001 using Mini-BESTest, the pooled analysis revealed that exercise-based management was also effective on balance in the experimental group. The fixed effect model of FOG in terms of SMD was used to draw the pooled effects of FOG in terms of SMD and FOG in terms of SMD (0.21; 95 percent CI -0.01 to 0.44; p=0.06). According to this research, several physiotherapy approaches such as exergaming, gamepad systems, virtual reality, gait exercises, and core training, help Parkinson's patients regain balance and FOG. Key Words: Parkinson's disease, Physical therapy techniques, Neurological rehabilitation, Balance, Freezing of gait, Motor symptoms.

Effectiveness of Evidence Based Physical Therapy Management Approaches in Sacroiliac Joint Dysfunction: A Meta-analysis.

Worldwide the prevalence of sacroiliac joint dysfunction (SIJD) lies within a range of 13% to 30%. In approximately 10% to 25% of patients, SIJD is a cause of mechanical low back and leg pain. A total of 498 subjects included in 10 studies conducted from 2018 to 2022 were included in this analysis. The guidelines of PRISMA were followed for study identifications and analysis in which pain and disability were monitored as an outcome measure. The results revealed statistically significant findings of physical therapy-based management approaches in decreasing pain (SMD -1.068, p=0.0001, I2=95.11%) and lowering the levels of disability (SMD -0.997, p=0.0001, I2=95.76%) among patients with SIJD as estimated using a random effect model. It was concluded that physical therapy-based management approaches ranging from combined exercise therapy to MET and K-taping are significantly more effective than traditional approaches. Key Words: Exercise, Sacroiliac joint, Pain, Disability, Physical therapy, Muscle energy technique, Kinesiotaping.

High-intensity circuit training for improving anthropometric parameters for women from low socioeconomic communities of Sikandarabad: A clinical trial.

BACKGROUND: An alarming trend of sustained physical inactivity has been observed among women in socioeconomically disadvantaged areas, mainly due to the lack of time and high cost of gym facilities. Although physical activity essentially contributes to disease prevention, evidence supporting time-efficient exercise on anthropometric measures is limited. This study aimed to identify the effectiveness of interval-based high-intensity circuit training (HICT) on anthropometric measures and the nature of the relationship between these measures. METHODS: A single-group, quasi-experimental study was conducted in the community park of Ziauddin Hospital at Sikandarabad. Sixty women who were overweight and had sedentary lifestyles were recruited for a six-week HICT-based program conducted at 85%-95% maximum heart rate (MHR) on every alternate day. Outcome measures were assessed at baseline and at 6-weeks including anthropometric parameters (body mass index [BMI], body fat percentage [BF%], and waist-to-hip ratio [WHR]). RESULTS: The six-week HICT-based program demonstrated a significant reduction in BMI (p<0.001), BF% (p<0.001), and WHR (p<0.001). Reductions in the BMI mean from 27.3±1.3 to 25.1±1.4 and BF% mean from 31.9±2.3 to 27.6±2.4 were observed following 18 sessions of HICT. The effect of age on BF% and WHR was linearly significant (p<0.001) with increasing age (BF%) and WHR. CONCLUSION: Interval-based HICT was an effective exercise regimen for improving BMI, BF%, and WHR. Furthermore, the exercise protocol was feasible and well tolerated, with no reported adverse events, and it could be easily implemented in real-world community settings. BF% and WHR were significantly influenced by increasing age; therefore, our findings support the importance of exercise implementation, especially with increasing age, for the maintenance of a disease-free healthy lifestyle.

Effect of Exercise on Inter-Recti Distance and Associated Low Back Pain Among Post-Partum Females: A Randomized Controlled Trial.

Objective: This study aimed to emphasize facilitation training and strengthening of abdominal and core muscles in improving the inter-recti distance (IRD) and associated low back pain (LBP) among young postpartum females. Materials and methods: A single-blinded randomized controlled trial, among forty young postpartum females, was conducted at a community health center. The females were divided into two equal groups through the envelope method where Group A received abdominal crunch training protocol whereas group B received double straight leg raise (DSLR) exercise protocol for 6 weeks and pre and post IRD and Oswestry disability index (ODI) scores were recorded. Results: Group A showed improvement in IRD with a mean difference of 1.95±0.4 whereas in group B it was found to be 2.85±0.35 when assessed through finger palpation method. The mean difference of IRD, when measured through digital nylon caliper method in abdominal crunch and DSLR exercise group was 4.06±0.74 and 1.2±0.49 respectively. Moreover, ODI scores of group A were 2.70±1.05 whereas, group B scores were found to be 1.1±0.06 showing that LBP reduced in participants who performed abdominal crunch exercise. Conclusion: This study reveals that 6 weeks of exercise protocol was observed to be effective in the management of DRA. Thus, abdominal crunch exercise seemed to produce promising results in a reduction of IRD and associated LBP.

Impact on Mental Health of Families during Covid-19: A Cross-Sectional Survey.

Background: The global pandemic of novel coronavirus outbreaks threatens the general public and health care workers' physical, social and mental well-being. Therefore, the current study is aimed to highlight the status of mental health of families suffering from the COVID-19 pandemic. Methods: An online cross-sectional survey was conducted on 560 families through Google Form distributed via email, Whatsapp groups, Facebook, and LinkedIn from November 2020 to January 2021 during the pandemic period in Karachi through the snowball sampling technique. The status of COVID-19 patients was assessed through demographics information and contextual factors questions whereas impact on mental health was assessed through Depression Anxiety Stress Scale (DASS-21). Results: A total number of 536 participated in the study. The prevalence of depression, anxiety and stress was found to be 38.99%, 26.67%, and 15.48% respectively included 31% of males and 69% where the highest number of respondents belonged to district Central (37.8%). Chi square estimation was found to be significant among both the gender and in between all the age group ranges from 20 to 60 years. Moreover, significant association among categorical division of demography and DASS-21 p<0.05 was observed. Conclusion: The results of our study indicated high rate of depression and anxiety in majority of families; in particular females. Consistent with these symptoms, significant association was found between gender and age from high to low socioeconomic status.

Effects of Mode and Duration of Exercises on Fat Mass of Obese Population.

A meta-analysis was performed to determine impact of resistance and aerobic exercise on body fat of obese population. Database of Google Scholar, BioMed Central, and Medline was reconnoitered for the purpose of research article of interest. Inclusion criteria encompass all those studies in which effects of aerobic and resistance exercise were determined on body fat mass of obese participants. Studies in which combination of aerobic and resistance exercise were used, or outcome measures were other than body fat mass or studies conducted before 2010 were excluded from this review. A total of 805 obese participants were included in 10 randomized controlled trials (RCT) including 401 in resistance training protocol and 404 in aerobic training protocol were part of this meta-analysis. Results revealed that resistance exercise had a mild pool affect in increasing weight of participants with an effect size (SMD) of 0.26 (95% of CI -0.09 to 0.63) calculated at random effect model, I2 83.80% (95% of CI 71.76 to 90.71) in comparison to aerobic exercises performed during the duration of two to eight weeks of training protocol. The meta-analysis concluded that resistance exercises had a mild pool effect in increasing the weight of the participants in comparison to aerobic exercises. Key Words: Aerobic exercises, Resistance exercises, Obesity, Fat mass, Body fat index and body fat composition.

Effect of aerobic and anaerobic exercise on estrogen level, fat mass, and muscle mass among postmenopausal osteoporotic females.

OBJECTIVE: The life expectancy of women increases with the advancement in modern medicine, leading them to spent about two decades in menopausal state along with its associated complications. The process of aging triggers a deleterious cascade of physiological changes in the body. Hence, the aim of our study is to determine the effects of both aerobic and anaerobic exercises on estrogen level in postmenopausal osteoporotic females. METHODOLOGY: A randomized control trial was conducted among 94 postmenopausal osteoporotic females, randomly divided into two equal groups. The participants in Group A were assigned to perform aerobic exercise, whereas Group B performed resistance exercises. Each group performed exercises for 12 weeks, whereas reading was collected for blood estrogen level, fat mass, and muscle mass before exercise training and after 12 weeks of training. RESULTS: Twelve weeks of aerobic and anaerobic exercise program based on the American College of Sports Medicine (ACSM); frequency, intensity, time, and type protocol has beneficial effect on estradiol level and lean mass, whereas inversely correlated with fat mass of postmenopausal osteoporotic female. CONCLUSION: The study concluded that 12 weeks of exercise programs was found to be effective in improving estradiol level of postmenopausal osteoporotic female. The efficacy of anaerobic exercise was found to be more potent on estradiol level and lean mass than aerobic exercises as only 36 sessions of resisted exercises performed during a period of 12 weeks provided more significant result than 72 session of aerobic exercises.

Effects of spinal mobilization techniques in the management of adolescent idiopathic scoliosis - A meta-analysis.

OBJECTIVES: The aim of this study is to examine the effectiveness of diverse exercise regimes used in multiple Randomized Control Trials as the only conservative management strategy for increased Cobb angle among Adolescent Idiopathic Scoliosis. METHODS: Database such as Google Scholar, Medline, and BioMed Central was reconnoitered for the purpose of research articles of interest. Studies in which the effects of conservative management of scoliosis on the magnitude of Cobb angle were calculated were scrutinized procedurally, studies fulfilling the inclusion criteria were retrieved and encompassed in the present study. RESULT: A total of 698 cases of AIS that were included in 17 controlled trials are part of this meta-analysis. The pool effects were measured using a standardized mean difference between the experimental and control group at 95% of confidence interval using Hedges'g statistics. Outcomes analyzed, reveals favorable for exercises based experimental group in term of standardized mean difference with an impact of 0.42° on random effect model, according to a Cohen's rule of thumb that depicts a near to moderate effects of exercises based interventions on Cobb angle. CONCLUSION: The present study concludes that therapeutic exercise regimes alone have a pivotal role in both decelerating the progression of the curve and reducing the already increased magnitude of the curve.