Impact of structural-level environmental interventions on physical activity: a systematic review.

OBJECTIVE: To determine the effectiveness of structural-level environmental interventions on the changes in PA levels in the populations examined. METHODS: Natural experiments that involve environmental intervention with structural modification were included. The primary outcome PA levels with consideration of both objective and subjective measurements. An electronic search was carried out in Medline/Pubmed, SCIENCE DIRECT, WEB OF SCIENCE, and CINAHL up to January 2022. Two reviewers screened titles and abstracts, selected studies, extracted relevant data, and examined study quality. A qualitative synthesis was performed. RESULTS: Twenty-six articles were included. The structural-level environmental interventions included 4 fundamental areas: schools, work environments, streets or cities, and neighborhoods or parks. Of the 26 studies, 21 examined outdoor environments like parks, cities, pedestrian walkways, or steps, while 5 examined indoor or closed environments like schools and workplaces revealing that structural-level environmental interventions improve PA levels with the greatest effect in parks and active transportation. A risk of bias is inherent in natural experiments which is a limitation of this study. In schools and work areas, there is evidence of both decrease in sedentary time and an increase in PA related to environmental modifications. CONCLUSION: Structural-level environmental modifications in parks and active transportation demonstrated greater effects in promoting PA. Environmental modifications can impact physical activity in the population. Given that the economic and cultural setting is a key variable when considering the effectiveness of structural interventions, and since only 1 of the 26 reviewed articles included such data, more studies examining economic factors are needed especially in low- and middle-income countries like in South America. TRIAL REGISTRATION: PROSPERO CRD42021229718.

Impact of environmental interventions based on social programs on physical activity levels: A systematic review.

Background: The design of social programs at the environmental level such as in schools, parks, bicycle paths, or workspaces generates changes in the behavior of individuals and modifies lifestyles by increasing physical activity (PA) levels. Objective: To determine the effectiveness of environmental interventions based on social programs by changing the population's level of PA. Methodology: Natural experiment studies that involved environmental intervention programs at a social level were included. The primary outcome was PA levels with consideration of both objective and subjective measurements. An electronic search was carried out in Medline/Pubmed, SCIENCE DIRECT, WEB OF SCIENCE, and CINAHL databases up to January 2022 with two reviewers screening titles and abstracts and selecting studies for full-text reading. Two reviewers also acquired relevant data and evaluated study quality using the ROBINS I tool. A qualitative analysis was performed. Results: Three thousand eight hundred and sixty-five articles were found in the 4 consulted databases. After eliminating duplication (200), two reviewers screened 3,665 titles and abstracts and excluded 3,566 that did not meet the inclusion criteria, leaving 99 articles to be read in full text. The 99 full texts were reviewed of which 24 papers met the eligibility criteria. All were natural experiments published between 2011 and 2020 and all evaluated environmental social programs revealing that social programs at the environmental level promoted PA in various populations at the community level worldwide. Conclusion: The 24 reviewed studies suggest innovative proposals for social programs that seek to increase PA and promote healthy lifestyles related to public activity policies developed in the countries in which they were generated. Environmental social programs can positively impact PA levels among children and adults. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=229718, identifier: CRD42021229718.

Interventions based on environmental determinants for nutritional and physical activity behaviours in Colombia: a scoping review.

OBJECTIVE: To identify, systematically, the interventions based on environmental determinants to improve the nutritional and physical activity (PA) habits available in Colombia. DESIGN: A scoping review was performed according to the guidelines of the Joanna Briggs Institute. STUDY SELECTION: All studies about intervention programmes for PA and nutritional behaviours in Colombia were included. METHODS: Searches in Medline/PubMed, Embase, Cochrane, Scielo and Lilacs, using MeSH, Decs and Emtree terms, were performed up to August 2020. Additionally, a manual search was made in specialised national journals. An internet documentary search of the official websites on policies and programmes by departmental, district and municipal secretariats was also performed.Two reviewers independently screened titles and abstracts. Then, the full texts were reviewed to select documents to be included.Data management relevant information from selected documents and articles was extracted. A descriptive analysis was considered. RESULTS: Sixty-seven documents and 70 published articles were found. The programmes were identified in 13 initiatives, 7 in the area of PA and 6 with a nutrition focus. They were on physical and social environmental modifications such as the 'muévete' ('get moving') programmes in Bogota, Quindio and Cartagena; a modification of 'ciclovía'; or bicycle path programmes as well as nutrition programmes in schools, universities and companies. CONCLUSION: This scoping review identified national programmes and policies in Colombia in the area of nutrition and PA from the environmental perspective in different scenarios: from schools to workplaces and communities. The need to implement such programmes from public and private institutions is also noted, promoting the practice of PA and healthy eating in every scenario in the national territory. New research to determine the impact of these programmes is essential to get a glimpse of the effects of these programmes and the implications for public health.

A call to action for blood flow restriction training in older adults with or susceptible to sarcopenia: A systematic review and meta-analysis.

Background: The extent to which exercise training with blood flow restriction (BFR) improves functional performance (FP) in people with sarcopenia remains unclear. We performed a comprehensive search of BFR training in subjects with sarcopenia or susceptible to sarcopenia hoping to perform a systematic review and meta-analysis on the effects of BFR on FP in older adults without medical disorders, but with or susceptible to sarcopenia. Methods: PubMed and the Cochrane library were searched through February 2022. Inclusion criteria were: 1) the study examined older adults (>55 years of age) with or susceptible to sarcopenia and free of overt acute or chronic diseases, 2) there was a random allocation of participants to BFR and active control groups, 3) BFR was the sole intervention difference between the groups, and 4) the study provided post-intervention measures of skeletal muscle and physical function which were either the same or comparable to those included in the revised European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic algorithm. Results: No studies of BFR training in individuals with sarcopenia were found and no study included individuals with FP values below the EWGSOP criteria. However, four studies of BFR training in older adults in which FP was examined were found. BFR training significantly improved the timed up and go (MD = -0.46, z = 2.43, p = 0.02), 30-s chair stand (MD = 2.78, z = 3.72, p < 0.001), and knee extension strength (standardized MD = 0.5, z = 2.3, p = 0.02) in older adults. Conclusion: No studies of BFR exercise appear to have been performed in patients with or suspected sarcopenia based on latest diagnostic criteria. Despite the absence of such studies, BFR training was found to significantly improve the TUG, 30-s chair stand, and knee extension strength in older adults. Studies examining the effects of BFR in subjects below EWGSOP cut-off points are needed.

Characterization of Two Fusarium solani Species Complex Isolates from the Ambrosia Beetle Xylosandrus morigerus.

Ambrosia beetles are insect vectors of important plant diseases and have been considered as a threat to forest ecosystems, agriculture, and the timber industry. Several factors have been suggested as promoters of the pathogenic behavior of ambrosia beetles; one of them is the nature of the fungal mutualist and its ability to establish an infectious process. In Mexico, Xylosandrus morigerus is an invasive ambrosia beetle that damages many agroecosystems. Herein, two different isolates from the X. morigerus ambrosia beetle belonging to the Fusarium genus are reported. Both isolates belong to the Fusarium solani species complex (FSSC) but not to the Ambrosia Fusarium clade (AFC). The two closely related Fusarium isolates are pathogenic to different forest and agronomic species, and the morphological differences between them and the extracellular protease profile suggest intraspecific variability. This study shows the importance of considering these beetles as vectors of different species of fungal plant pathogens, with some of them even being phylogenetically closely related and having different pathogenic abilities, highlighting the relevance of the fungal mutualist as a factor for the ambrosia complex becoming a pest.

Intra- and inter-rater reliability of Fugl-Meyer Assessment of Lower Extremity early after stroke.

BACKGROUND: The Fugl-Meyer Assessment of Lower Extremity (FMA-LE) is a widely used and recommended scale for evaluation of post-stroke motor impairment. However, the reliability of the scale has only been established by using parametric statistical methods, which ignores the ordinal properties of the scale. OBJECTIVE: To determined intra- and inter-rater reliability of the FMA-LE at item and summed score level early after stroke. METHODS: Sixty patients (mean age 65.9 years, median FMA-LE 29 points) admitted to the hospital due to stroke were included. The FMA-LE was simultaneously, but independently, scored by three experienced and trained physical therapists randomly assigned into pairs, on two consecutive days, between 4 to 9 days post stroke. A rank-based statistical method for paired ordinal data was used to assess the level of agreement and systematic and random disagreements. RESULTS: The item-level reliability was high (percentage of agreement [PA] ≥75%). Two items (ankle dorsiflexion during flexor synergy and normal reflex activity) showed some systematic disagreement in intrarater analysis. A satisfactory intrarater reliability (PA ≥70%) was reached for all summed scores when a 1- or 2-point difference was accepted between ratings. CONCLUSION: The FMA-LE is a reliable tool for assessment of motor impairment both within and between raters early after stroke. The scale can be recommended not only for use in Spanish speaking countries, but also internationally. A unified international use of FMA-LE would allow comparison of stroke recovery outcomes worldwide and thereby potentially improve the quality of stroke rehabilitation.

Intra- and inter-rater reliability of Fugl-Meyer Assessment of Upper Extremity in stroke.

OBJECTIVE: The Fugl-Meyer Assessment of Upper Extremity (FMA-UE) is recommended for evaluation of sensorimotor impairment post stroke, but the item-level reliability of the scale is unknown. The study aims to determine intra- and inter-rater reliability of the FMA-UE at item-, subscale- and total score level in patients with early subacute stroke. DESIGN: Intra/inter-rater reliability. SUBJECTS: Sixty consecutively included patients with stroke (mean age 65.9 years) admitted to Central Military Hospital of Colombia, Bogota. METHODS: Two physiotherapists scored FMA-UE independently on 2 consecutive days within 10 days post stroke. A rank-based statistical method for paired ordinal data was used to assess the level of agreement, systematic and random disagreements. RESULTS: Systematic disagreements either in position or concentration were detected in 4 items of the shoulder section. The item level intra- and inter-rater agreement was high (79100%). The 70% agreement was also reached for the subscales and the total score when 13-point difference was accepted. CONCLUSION: The FMA-UE is reliable both within and between raters in patients with stroke in the early subacute phase. A wider international use of FMA-UE will allow comparison of stroke recovery between regions and countries and thereby potentially improve the quality of care and rehabilitation in persons with stroke worldwide.

Translation and cultural validation of clinical observational scales - the Fugl-Meyer assessment for post stroke sensorimotor function in Colombian Spanish.

Purpose: Fugl-Meyer Assessment (FMA) is the most widely used and recommended clinical scale for evaluation of sensorimotor impairment post stroke, but an official Spanish version is not available today. This study aimed to establish methodological structure for translation and cultural adaptation process and perform a transcultural validation of the upper and lower extremity FMA to Colombian Spanish. Methods: Procedures included forward and backward translation, step-wise reviewing by bilingual and professional experts to ensure conceptual and semantic equivalence. Validation included a pilot evaluation of item-level agreement on 10 individuals with stroke at the Central Military Hospital of Colombia. Results: Comprehensive step-wise procedure for transcultural validation was established. Low agreement (less than 70%) was detected for items assessing arm movements within synergies and for coordination/speed subscale. All points of disagreement were systematically reviewed and agreed upon when drafting the final version of the Spanish FMA. Conclusions: Use of FMA will allow unified description of stroke severity and motor recovery in Spanish speaking countries. This will open up possibility to compare stroke and rehabilitation outcomes with other countries and regions world-wide. Comprehensive methodological procedures provided can facilitate introduction of well-established clinical scales in other languages. Implications for Rehabilitation The Fugl-Meyer Assessment (FMA) of upper and lower extremity is the most used and recommended clinical scale for evaluation of sensorimotor impairment after stroke. The Spanish version of FMA, validated in this study, is now first time available for use in research and clinical practice. Use of FMA will allow unified description of stroke severity and motor recovery in Spanish speaking countries, which in turn opens up possibility to compare stroke and rehabilitation outcomes with other countries and regions world-wide.

Efficacy of diaphragmatic breathing in persons with chronic obstructive pulmonary disease: a review of the literature.

The evidence base for diaphragmatic breathing (DB) as an adjunctive treatment modality for persons with COPD is questionable. This article reviews the literature regarding the efficacy of DB in persons with chronic obstructive pulmonary disease (COPD), and reports on the beneficial and detrimental effects of DB in persons with COPD. Diaphragmatic breathing has been described as breathing predominantly with the diaphragm while minimizing the action of accessory muscles that may assist with inspiration. No single or combined patient characteristic has been identified consistently to help predict which person with COPD may benefit from DB. However, it has been suggested that persons with moderate to severe COPD and marked hyperinflation of the lungs without adequate diaphragmatic movement and increase in tidal volume during DB may be poor candidates for instruction in DB. Conversely, persons with COPD who have elevated respiratory rates, low tidal volumes that increase during DB, and abnormal arterial blood gases with adequate diaphragmatic movement may benefit from DB. Identification of an abdominal paradoxical breathing pattern and worsening dyspnea and fatigue during or after DB are criteria to modify or terminate DB. Persons with COPD demonstrating an abdominal paradox during DB may benefit from a more upright body position or trunk flexion. Several methods to examine diaphragmatic movement and the potential for success with DB will be discussed. Future research is needed to better identify which patients may benefit from DB.