Whole-body vibration ameliorates glial pathological changes in the hippocampus of hAPP transgenic mice, but does not affect plaque load.

BACKGROUND: Alzheimer's disease (AD) is the core cause of dementia in elderly populations. One of the main hallmarks of AD is extracellular amyloid beta (Aß) accumulation (APP-pathology) associated with glial-mediated neuroinflammation. Whole-Body Vibration (WBV) is a passive form of exercise, but its effects on AD pathology are still unknown. METHODS: Five months old male J20 mice (n = 26) and their wild type (WT) littermates (n = 24) were used to investigate the effect of WBV on amyloid pathology and the healthy brain. Both J20 and WT mice underwent WBV on a vibration platform or pseudo vibration treatment. The vibration intervention consisted of 2 WBV sessions of 10 min per day, five days per week for five consecutive weeks. After five weeks of WBV, the balance beam test was used to assess motor performance. Brain tissue was collected to quantify Aß deposition and immunomarkers of astrocytes and microglia. RESULTS: J20 mice have a limited number of plaques at this relatively young age. Amyloid plaque load was not affected by WBV. Microglia activation based on IBA1-immunostaining was significantly increased in the J20 animals compared to the WT littermates, whereas CD68 expression was not significantly altered. WBV treatment was effective to ameliorate microglia activation based on morphology in both J20 and WT animals in the Dentate Gyrus, but not so in the other subregions. Furthermore, GFAP expression based on coverage was reduced in J20 pseudo-treated mice compared to the WT littermates and it was significantly reserved in the J20 WBV vs. pseudo-treated animals. Further, only for the WT animals a tendency of improved motor performance was observed in the WBV group compared to the pseudo vibration group. CONCLUSION: In accordance with the literature, we detected an early plaque load, reduced GFAP expression and increased microglia activity in J20 mice at the age of ~ 6 months. Our findings indicate that WBV has beneficial effects on the early progression of brain pathology. WBV restored, above all, the morphology of GFAP positive astrocytes to the WT level that could be considered the non-pathological and hence "healthy" level. Next experiments need to be performed to determine whether WBV is also affective in J20 mice of older age or other AD mouse models.

Passive exercise to improve quality of life, activities of daily living, care burden and cognitive functioning in institutionalized older adults with dementia - a randomized controlled trial study protocol.

BACKGROUND: Dementia affects cognitive functioning, physical functioning, activities of daily living (ADLs), and quality of life (QOL). Pharmacological treatments to manage, cure or prevent dementia remain controversial. Therefore development of non-pharmacological approaches to prevent, or at least delay the onset and progression of dementia is urgently needed. Passive exercise is proposed to be such a non-pharmacological alternative. This study primarily aims to investigate the effects of three different forms of passive exercise on QOL and ADLs of institutionalized patients with dementia. The secondary aims are to assess the effects of three different forms of passive exercise on cognitive functioning and physical functioning of institutionalized patients with dementia as well as on care burden of both the primary formal and primary informal caregivers of these patients. METHODS: This is a multicenter randomized controlled trial. Three forms of passive exercise are distinguished; motion simulation (MSim), whole body vibration (WBV), and a combination of both MSim + WBV. Intervention effects are compared to a control group receiving regular care. Institutionalized patients with dementia follow a six-week intervention program consisting of four 4-12 min sessions a week. The primary outcome measures QOL and ADLs and secondary outcome measure care burden are assessed with questionnaires filled in by the primary formal and informal caregivers of the patient. The other secondary outcome measures cognitive and physical functioning are assessed by individual testing. The four groups are compared at baseline, after 6 weeks of intervention, and 2 weeks after the intervention has ended. DISCUSSION: This study will provide insight in the effects of different forms of passive exercise on QOL, ADLs, cognitive and physical functioning and care burden of institutionalized patients with dementia and their primary formal and informal caregivers. The results of this study might support the idea that passive exercise can be an efficient alternative for physical activity for patients not able to be or stay involved in active physical exercise. TRIAL REGISTRATION: The Netherlands National Trial Register ( NTR6290 ). Retrospectively registered 29 March 2017.

Small scale homelike special care units and traditional special care units: effects on cognition in dementia; a longitudinal controlled intervention study.

BACKGROUND: Evidence shows that living in small scale homelike Special Care Units (SCU) has positive effects on behavioural and psychological symptoms of patients with dementia. Effects on cognitive functioning in relation to care facilities, however, are scarcely investigated. The purpose of this study is to gain more insight into the effects of living in small scale homelike Special Care Units, compared to regular SCU's, on the course of cognitive functioning in dementia. METHODS: A group of 67 patients with dementia who moved from a regular SCU to a small scale homelike SCU and a group of 48 patients with dementia who stayed in a regular SCU participated in the study. Cognitive and behavioural functioning was assessed by means of a neuropsychological test battery and observation scales one month before (baseline), as well as 3 (post) and 6 months (follow-up) after relocation. RESULTS: Comparing the post and follow-up measurement with the baseline measurement, no significant differences on separate measures of cognitive functioning between both groups were found. Additional analyses, however, on 'domain clusters' revealed that global cognitive functioning of the small scale homelike SCU group showed significantly less cognitive decline three months after the transfer (p < 0.05). Effect sizes (95% CI) show a tendency for better aspects of cognition in favour of the homelike small scaled SCU group, i.e., visual memory, picture recognition, cognitive decline as observed by representatives and the clustered domains episodic memory and global cognitive functioning. CONCLUSIONS: While there is no significant longitudinal effect on the progression of cognitive decline comparing small scaled homelike SCU's with regular SCU's for patients with dementia, analyses on the domain clusters and effect sizes cautiously suggest differences in favour of the small scaled homelike SCU for different aspects of cognition.

A 9-Week Aerobic and Strength Training Program Improves Cognitive and Motor Function in Patients with Dementia: A Randomized, Controlled Trial.

OBJECTIVE: To compare training and follow-up effects of combined aerobic and strength training versus aerobic-only training on cognitive and motor function in institutionalized patients with dementia and to explore whether improved motor function mediates improved cognitive function. METHODS: Using a 9-week, parallel, three-group, single-blind, randomized, controlled trial with a follow-up assessment at week 18, we assessed 109 patients with dementia (age 85.5 ± 5.1 years) in a psycho-geriatric nursing home. Each 9-week intervention consisted of 36, 30-minute sessions. A combined group (N = 37) received and completed two strength and two walking sessions per week, an aerobic group (N = 36) completed four walking sessions, and a social group (N = 36) completed four social visits per week. Cognitive and motor functions were assessed at baseline, after the 9-week intervention, and after a consecutive 9 weeks of usual care. RESULTS: Baseline corrected post-test scores in the combined versus the social group were higher for global cognition, visual memory, verbal memory, executive function, walking endurance, leg muscle strength, and balance. Aerobic versus social group scores were higher for executive function. Follow-up effects reversed toward baseline values. Motor improvement did not significantly mediate cognitive improvement. CONCLUSION: Compared with a nonexercise control group, a combination of aerobic and strength training is more effective than aerobic-only training in slowing cognitive and motor decline in patients with dementia. No mediating effects between improvements in cognitive function via improved motor function were found. Future research into the underlying mechanistic associations is needed.

Cognitive deficits in human ApoE4 knock-in mice: A systematic review and meta-analysis.

Apolipoprotein-E4 (ApoE4) is an important genetic risk factor for Alzheimer's disease. The development of targeted-replacement human ApoE knock-in mice facilitates research into mechanisms by which ApoE4 affects the brain. We performed meta-analyses and meta-regression analyses to examine differences in cognitive performance between ApoE4 and ApoE3 mice. We included 61 studies in which at least one of the following tests was assessed: Morris Water Maze (MWM), novel object location (NL), novel object recognition (NO) and Fear Conditioning (FC) test. ApoE4 vs. ApoE3 mice performed significantly worse on the MWM (several outcomes, 0.17 ≤ g ≤ 0.60), NO (exploration, g=0.33; index, g=0.44) and FC (contextual, g=0.49). ApoE4 vs. ApoE3 differences were not systematically related to sex or age. We conclude that ApoE4 knock-in mice in a non-AD condition show some, but limited cognitive deficits, regardless of sex and age. These effects suggest an intrinsic vulnerability in ApoE4 mice that may become more pronounced under additional brain load, as seen in neurodegenerative diseases.

The effects of whole-body vibration therapy on immune and brain functioning: current insights in the underlying cellular and molecular mechanisms.

Whole-body vibration (WBV) therapy is a way of passive exercise in which subjects are exposed to mild and well-controlled mechanical vibrations through a vibrating platform. For a long time, studies have focused on the effects and applications of WBV to enhance musculoskeletal performance in athletes and patients suffering from musculoskeletal disorders. Recent evidence points toward the positive effect of WBV on the brain and its therapeutic potential in brain disorders. Research being done in the field gradually reveals cellular and molecular mechanisms underlying WBV affecting the body and brain. Particularly, the influence of WBV on immune and brain function is a growing field that warrants an up-to-date and integrated review. Immune function is closely intertwined with brain functioning and plays a significant role in various brain disorders. Dysregulation of the immune response is linked to conditions such as neuroinflammation, neurodegenerative diseases, and mood disorders, highlighting the crucial connection between the immune system and the brain. This review aims to explore the impact of WBV on the cellular and molecular pathways involved in immune and brain functions. Understanding the effects of WBV at a cellular and molecular level will aid in optimizing WBV protocols to improve its therapeutic potential for brain disorders.

Factors Affecting Physical Activity in People with Dementia: A Systematic Review and Narrative Synthesis.

Physical activity (PA) has positive effects on the physical and cognitive functioning of people with dementia. Knowledge about what limits and stimulates people with dementia to participate in PA is essential to promote effective PA implementation and enhance PA levels. Previous reviews primarily included opinion-based studies, using data from interviews, focus groups or dyads. By including implementation studies, we aimed to elaborate on previous reviews by identifying new barriers to PA and new facilitators and motivators for PA. We conducted systematic searches in Pubmed, PsychInfo and Web of Science for studies published up to the 21st of September 2021. Search terms were related to the population of people with dementia, PA interventions and implementation outcomes. Studies were included if PA participation was investigated during actual PA implementation. No restrictions were made regarding study design, date of publication, PA type or outcome measures. Studies not implementing PA or not evaluating the implementation were excluded. Based on 13 empirical studies, we identified 35 barriers, 19 facilitators and 12 motivators. Of these, 21 barriers, 11 facilitators and 4 motivators were not identified by previous reviews. New factors are related to the support for people with dementia from informal and formal caregivers, e.g., revealing the importance of a trusting relationship. Furthermore, support for staff from the institution or an external party is needed to overcome doubts about PA, for example, related to safety and effects. New factors also suggested specific recommendations for the content and organization of the PA intervention, for instance, related to how to give instructions. Overall, factors affecting PA identified with opinion-based or implementation studies are complementary. Our extended overview shows the complexity of PA implementation and may help to personalize PA, develop implementation strategies, facilitate actual PA implementation and free up resources needed for effective implementation.

Short-term effects of side-alternating Whole-Body Vibration on cognitive function of young adults.

Recent research in rodents and humans revealed that Whole-Body Vibration (WBV) is beneficial for cognitive functions. However, the optimal WBV conditions are not established: contrary to vertical WBV, side-alternating WBV was not investigated before. The present study investigated the short-term effects of side-alternating WBV in standing and sitting posture on specific cognitive function of young adults. We used a balanced cross-over design. Sixty healthy young adults (mean age 21.7 ± 2.0 years, 72% female) participated. They were exposed to three bouts of two-minute side-alternating WBV (frequency 27 Hz) and three control conditions in two different sessions. In one session a sitting posture was used and in the other session a standing (semi-squat) posture. After each condition selective attention and inhibition was measured with the incongruent condition of the Stroop Color-Word Interference Test. WBV significantly (p = 0.026) improved selective attention and inhibition in the sitting posture, but not in the standing posture. The sitting posture was perceived as more comfortable, joyous and less exhaustive as compared to the standing posture. This study demonstrated that side-alternating WBV in sitting posture improves selective attention and inhibition in healthy young adults. This indicates that posture moderates the cognitive effect of WBV, although the effects are still small. Future studies should focus on the working mechanisms and further optimization of settings, especially in individuals who are unable to perform active exercise.

Falls incidence underestimates the risk of fall-related injuries in older age groups: a comparison with the FARE (Falls risk by Exposure).

BACKGROUND: up till now, the risk of falls has been expressed as falls incidence (i.e. the number of falls or fallers per 100 person-years). However, the risk of an accident or injury is the probability of having an accident or injury per unit of exposure. The FARE (Falls risk by Exposure) is a measure for falls risk which incorporates physical activity as a measure of exposure. The objective of this study was to compare falls incidence and the FARE when expressing the age-related risk of fall-related injuries. METHODS: data of 21,020 community-dwelling elderly aged ≥55 years (60.3% women) obtained from a national survey (2000-05) were used to compare incidence of fall-related injuries and the FARE. In order to compare both measures, risk ratios (of both outcome measures) were calculated for each age group. Hierarchical regression analyses (linear versus exponential model) were conducted to check the best model fit when expressing falls risk by age for the total study population and for men and women separately. RESULTS: the risk of fall-related injuries, calculated on the basis of the incidence of fall-related injuries, showed a linear relationship with age, whereas the risk calculated on the basis of fall-related injuries corrected for exposure (falls risk by exposure, FARE) showed an exponential relationship. Calculations on the basis of the incidence of fall-related injuries underestimated the risk of fall-related injuries in people aged 70 years and older, and especially in women. CONCLUSION: calculation of the risk of fall-related injuries based on the incidence of these injuries underestimates the risk of such injuries relative to that calculated on the basis of the FARE. FARE-based calculations enable the early identification of people at high risk of falls and provide a more sensitive outcome measure for studies evaluating falls prevention interventions.

Self-assessed tactical skills in tennis players: Psychometric evaluation of the Tactical Skills Questionnaire in Tennis.

To our knowledge, no feasible, valid and reliable instrument exists to examine tactical skills over the course of multiple training and game situations in tennis yet. Therefore, the aim of this study was to develop and evaluate the psychometric properties of the Tactical Skills Questionnaire in Tennis (TSQT). The TSQT is a new instrument with closed-ended questions designed to examine tactical skills in tennis players. Participants were 233 competitive tennis players (age: 17.06 ± 4.74 years) competing on national or regional levels. With a principal component analysis (PCA) we identified four theoretically meaningful subscales for the 31-item TSQT: "Anticipation and positioning," "Game intelligence and adaptability," "Decision-making," and "Recognizing game situations" and confirmed them with a confirmatory factor analysis (CFA) (χ2 = 527.02, df = 426, p < 0.001, CFI = 0.93, RMSEA = 0.045, SRMR = 0.079). Internal consistency was good, with Cronbach's alpha of 0.89 for the entire scale and McDonald's omega ranging from 0.69 to 0.78 for the separate subscales. A subsample of 57 players completed the TSQT twice to assess test-retest reliability. Absolute test-retest reliability of the subscales was good with no significant differences in mean scores between test and retest (p > 0.05). Relative test-retest reliability was moderate with ICC values ranging from 0.65 to 0.71. National players outperformed regional players on the subscales "Game intelligence and adaptability," "Decision-making," and "Recognizing game situations" (p < 0.05), and there was a trend toward significance for "Anticipation and positioning" (p = 0.07). This study supported the psychometric properties of the TSQT. Evaluating tactical skills with the TSQT provides players, coaches and other professionals with insight in players' self-assessed tactical skills over the course of multiple training and game situations. It creates the opportunity for players to reflect on their skills and detect personal development areas with their coach. We advise to use this information as input for tailor-made training programs.

Potential of Whole-Body Vibration in Parkinson's Disease: A Systematic Review and Meta-Analysis of Human and Animal Studies.

(1) Background: When the severity of Parkinson's Disease (PD) increases, patients often have difficulties in performing exercises. Whole-Body Vibration (WBV) may be a suitable alternative. This systematic review aims to clarify if WBV shows potential as rehabilitative therapy for PD patients. (2) Methods: We searched several databases for controlled trials investigating the effects of WBV (1) on PD populations and (2) PD neuropathological mechanisms. We included both human and animal studies and performed meta-analyses. (3) Results: The studies on PD populations (14 studies) show an overall significant, but small, effect in favor of WBV (Hedges' g = 0.28), for which the effects on stability (Hedges' g = 0.39) and balance (Hedges' g = 0.30) are the most prominent. The studies on the neuropathological mechanisms (18 studies) show WBV effects on neuroinflammation (Hedges' g = -1.12) and several specific WBV effects on neurotransmitter systems, growth factors, neurogenesis, synaptic plasticity and oxidative stress. (4) Conclusions: The effects of WBV on human PD patients remains inconclusive. Nevertheless, WBV protocols with sufficient duration (≥3 weeks), session frequency (≥3 sessions/week) and vibration frequency (≥20 Hz) show potential as a treatment method, especially for motor function. The potential of WBV for PD patients is confirmed by the effects on the neuropathological mechanisms in mostly non-PD populations. We recommend high-quality future studies on both PD patients and PD mouse models to optimize WBV protocols and to examine the neuropathological mechanisms in PD populations.

Psychometric properties of the PAT: an assessment tool for ADL performance of older people living in residential homes.

BACKGROUND: As the world population ages, the number of people with diminished performance on the Activities of Daily Living (ADL) increases. A reliable and valid measure needs to be developed to determine the effects of interventions focused at increasing self-care abilities. We developed the Performance ADL Test (PAT) for this purpose. OBJECTIVE: The aim of this study was to investigate the reliability and validity of the PAT in older people living in residential homes. METHODS: The PAT contains 16 test items, covering the entire range of Basic ADL and Instrumental ADL performance in elderly people. For this assessment, 40 older people (mean age of 85 ± 7.5 years) participated. All 40 subjects lived in residential institutions in the Netherlands, were able to walk at least 10 m, could understand instructions spoken in Dutch, and had no cognitive impairment. During the first test session, subjects completed the PAT, the Groningen Activity Restriction Scale (GARS), and performance-based physical fitness tests. Two weeks later, subjects were retested on the PAT. RESULTS: Factor analysis revealed three subscales: Organization of Performance, Gross Motor Function, and Fine Motor Function. Internal consistency (Cronbach's α) of all scales and subscales ranged from 0.731 to 0.881. Test-retest reliability (intraclass correlation) ranged from 0.316 to 0.950. Paired sample t-tests revealed no significant differences between subject performance obtained during the two test periods. Pearson's correlations between the PAT and the GARS ranged from 0.490 to 0.831, and between the PAT and the fitness tests from 0.317 to 0.781. CONCLUSION: Although the number of participants was limited (n = 40), the PAT seems to be a useful instrument for assessing ADL performance in older people living in residential homes. In general, internal consistency, test-retest reliability, and validity were satisfactory.

Reporting Guidelines for Whole-Body Vibration Studies in Humans, Animals and Cell Cultures: A Consensus Statement from an International Group of Experts.

Whole-body vibration (WBV) is an exercise modality or treatment/prophylaxis method in which subjects (humans, animals, or cells) are exposed to mechanical vibrations through a vibrating platform or device. The vibrations are defined by their direction, frequency, magnitude, duration, and the number of daily bouts. Subjects can be exposed while performing exercises, hold postures, sitting, or lying down. Worldwide, WBV has attracted significant attention, and the number of studies is rising. To interpret, compare, and aggregate studies, the correct, complete, and consistent reporting of WBV-specific data (WBV parameters) is critical. Specific reporting guidelines aid in accomplishing this goal. There was a need to expand existing guidelines because of continuous developments in the field of WBV research, including but not limited to new outcome measures regarding brain function and cognition, modified designs of WBV platforms and attachments (e.g., mounting a chair on a platform), and comparisons of animal and cell culture studies with human studies. Based on Delphi studies among experts and using EQUATOR recommendations, we have developed extended reporting guidelines with checklists for human and animal/cell culture research, including information on devices, vibrations, administration, general protocol, and subjects. In addition, we provide explanations and examples of how to report. These new reporting guidelines are specific to WBV variables and do not target research designs in general. Researchers are encouraged to use the new WBV guidelines in addition to general design-specific guidelines.

Review of effects of physical activity on strength, balance, mobility and ADL performance in elderly subjects with dementia.

BACKGROUND/AIMS: Elderly individuals with dementia are vulnerable for a decline in physical functioning and basic activities of daily living (BADL) which can lead to a decline in autonomy and participation. This study reviews the effect of physical activity on physical functioning and BADL in elderly subjects with dementia. METHODS: A systematic search of the literature was performed. Key words related to the elderly, dementia, exercise interventions and physical outcome measures were used. RESULTS: Sixteen studies were included. It was found that physical activity was beneficial in all stages of dementia. Multicomponent interventions (e.g. a combination of endurance, strength and balance) led to larger improvements in gait speed, functional mobility and balance, compared to progressive resistance training alone. BADL and endurance improved but were only assessed in multicomponent interventions. Lower-limb strength improved equally in multicomponent interventions and progressive resistance training. CONCLUSION: Multicomponent interventions can improve physical functioning and BADL in elderly subjects regardless of the stage of dementia. The best results were obtained in the interventions with the largest training volume. However, the small number of high-quality studies, and heterogeneity of the participants and interventions prevent us from drawing firm conclusions. Recommendations are given with respect to methodological issues, further research and practical guidelines.

Vibration detection: its function and recent advances in medical applications.

Vibrations are all around us. We can detect vibrations with sensitive skin mechanoreceptors, but our conscious awareness of the presence of vibrations is often limited. Nevertheless, vibrations play a role in our everyday life. Here, we briefly describe the function of vibration detection and how it can be used for medical applications by way of whole body vibration. Strong vibrations can be harmful, but milder vibrations can be beneficial, although to what extent and how large the clinical relevance is are still controversial. Whole body vibration can be applied via a vibrating platform, used in both animal and human research. Recent findings make clear that the mode of action is twofold: next to the rather well-known exercise (muscle) component, it also has a sensory (skin) component. Notably, the sensory (skin) component stimulating the brain has potential for several purposes including improvements in brain-related disorders. Combining these two components by selecting the optimal settings in whole body vibration has clear potential for medical applications. To realize this, the field needs more standardized and personalized protocols. It should tackle what could be considered the "Big Five" variables of whole body vibration designs: vibration amplitude, vibration frequency, method of application, session duration/frequency, and total intervention duration. Unraveling the underlying mechanisms by translational research can help to determine the optimal settings. Many systematic reviews on whole body vibration end with the conclusion that the findings are promising yet inconclusive. This is mainly because of the large variation in the "Big Five" settings between studies and incomplete reporting of methodological details hindering reproducibility. We are of the opinion that when (part of) these optimal settings are being realized, a much better estimate can be given about the true potential of whole body vibration as a medical application.

Ranking Barriers, Motivators, and Facilitators to Promote Physical Activity Participation of Persons With Dementia: An Explorative Study.

BACKGROUND AND PURPOSE: Community-dwelling persons with dementia are inactive most of the day. The purpose of this study was to rank the barriers, motivators, and facilitators that hamper or promote physical activity (PA) participation for persons with dementia. This could provide knowledge that can be used to design effective interventions to promote PA participation for persons with dementia. METHODS: Twenty community-dwelling persons with dementia, mean (SD) age = 79 (5.4) years, 25% female, mean (SD) Mini-Mental Status Examination score = 23 (3.5); their informal caregivers, N = 20, mean (SD) age = 70 (11.5) years, 85% female; and an expert group of physiotherapists, N = 15, mean (SD) age = 41 (12.4) years, 73% female, were asked to rank preselected barriers, motivators, and facilitators of PA participation for persons with dementia. These statements were categorized at the intrapersonal, interpersonal, and community levels. RESULTS AND DISCUSSION: Persons with dementia and their informal caregivers selected only motivators and facilitators as being important for PA participation, with the motivator "beneficial health effects" considered the most important. The experts had a different perspective on PA participation; half of their ranked top 10 most important factors were barriers to PA participation for persons with dementia. This could be explained by the more critical role of a therapist, focusing on symptom control and treatment of disability; in this case, the elimination of barriers to maintain PA participation in their patients. Furthermore, all groups prioritized statements at the intrapersonal level. CONCLUSIONS: The results of this study suggest a difference in perspective between the more optimistic view of persons with dementia and their informal caregivers and the more critical view of physiotherapy experts regarding the most important factors that influence PA participation. In addition, there was a strong focus on the individual characteristics that influence PA behavior that warrant personalized interventions to promote PA in persons with dementia.

Potential Application of Whole Body Vibration Exercise For Improving The Clinical Conditions of COVID-19 Infected Individuals: A Narrative Review From the World Association of Vibration Exercise Experts (WAVex) Panel.

COVID-19 is a highly infectious respiratory disease which leads to several clinical conditions related to the dysfunction of the respiratory system along with other physical and psychological complaints. Severely affected patients are referred to intensive care units (ICUs), limiting their possibilities for physical exercise. Whole body vibration (WBV) exercise is a non-invasive, physical therapy, that has been suggested as part of the procedures involved with pulmonary rehabilitation, even in ICU settings. Therefore, in the current review, the World Association of Vibration Exercise Experts (WAVEX) reviewed the potential of WBV exercise as a useful and safe intervention for the management of infected individuals with COVID-19 by mitigating the inactivity-related declines in physical condition and reducing the time in ICU. Recommendations regarding the reduction of fatigue and the risk of dyspnea, the improvement of the inflammatory and redox status favoring cellular homeostasis and the overall improvement in the quality of life are provided. Finally, practical applications for the use of this paradigm leading to a better prognosis in bed bound and ICU-bound subjects is proposed.

Towards reporting guidelines of research using whole-body vibration as training or treatment regimen in human subjects-A Delphi consensus study.

BACKGROUND: Whole-body vibration (WBV) is a method utilizing vibrating platforms to expose individuals to mechanical vibration. In its various applications, it has been linked to improved muscular, skeletal, metabolic, or cognitive functioning, quality of life, and physiological parameters such as blood pressure. Most evidence concerning WBV is inconclusive and meta-analytical reviews may not readily produce insights since the research has a risk of misunderstandings of vibration parameters and incomplete reporting occurs. This study aims at laying an empirical foundation for reporting guidelines for human WBV studies to improve the quality of reporting and the currently limited comparability between studies. METHOD: The Delphi methodology is employed to exploit the integrated knowledge of WBV experts to distil the specific aspects of WBV methodology that should be included in such guidelines. Over three rounds of completing online questionnaires, the expert panel (round 1/2/3: 51/40/37 experts respectively from 17 countries with an average of 19.4 years of WBV research experience) rated candidate items. RESULTS: A 40-item list was established based on the ratings of the individual items from the expert panel with a large final consensus (94.6%). CONCLUSION: The final consensus indicates comprehensiveness and valuableness of the list. The results are in line with previous guidelines but expand these extensively. The present results may therefore serve as a foundation for updated guidelines for reporting human WBV studies in order to improve the quality of reporting of WBV studies, improve comparability of studies and facilitate the development of WBV study designs.

Inducing Physical Inactivity in Mice: Preventing Climbing and Reducing Cage Size Negatively Affect Physical Fitness and Body Composition.

Physical inactivity has emerged as an important and risk factor for cardiovascular and metabolic diseases, independent of levels of exercise engagement. Moreover, inactivity is associated with poor brain functioning. However, little data on the effects of physical inactivity on the brain is available and few methods are suitable to investigate this matter. We tested whether preventing lid climbing and reducing cage size could be used to model physical inactivity in mice. Sixty young adult C57Bl6 mice (10 weeks old) were divided over six groups with different housing conditions: in cages of three different sizes with lids that either allowed or prevented lid climbing. Housing under these conditions was maintained for a period of 19 weeks before the mice were killed for body composition analysis. Physical fitness tests performed around 5 and 10 weeks into the intervention revealed that motor coordination in the balance beam test was reduced by 30.65%, grip strength by 8.91% and muscle stamina in the inverted screen test by 70.37% in non-climbing mice as compared to climbing controls. Preventing climbing increased visceral fat mass by 17.31%, but did not reduce muscle mass. Neither preventing climbing nor reducing cage size affected anxiety assessed in the Open Field test and the Elevated Plus Maze. We did not find any negative effect of inactivity on spatial learning and memory in the novel object location test or working memory measured with the Y-maze Alternation test. The reduced physical fitness and increase in visceral fat mass show that our inactivity method models most effects of physical inactivity that are observed in experimental and observational studies in humans. Whereas established methods such as hindlimb unloading mimic many of the effects of bed rest, our novel method can be applied to study the effects of less extreme forms of physical inactivity (i.e., sedentary behavior) in various disease models including rodent models for brain diseases (i.e., stroke, Alzheimer's disease).

Dose-response relationship between exercise and cognitive function in older adults with and without cognitive impairment: A systematic review and meta-analysis.

This systematic review and meta-analysis examined the dose-response relationship between exercise and cognitive function in older adults with and without cognitive impairments. We included single-modality randomized controlled aerobic, anaerobic, multicomponent or psychomotor exercise trials that quantified training frequency, session and program duration and specified intensity quantitatively or qualitatively. We defined total exercise duration in minutes as the product of program duration, session duration, and frequency. For each study, we grouped test-specific Hedges' d (n = 163) and Cohen's d (n = 23) effect sizes in the domains Global cognition, Executive function and Memory. We used multilevel mixed-effects models to investigate dose-related predictors of exercise effects. In healthy older adults (n = 23 studies), there was a small positive effect of exercise on executive function (d = 0.27) and memory (d = 0.24), but dose-parameters did not predict the magnitude of effect sizes. In older adults with cognitive impairments (n = 13 studies), exercise had a moderate positive effect on global cognition (d = 0.37). For older adults with cognitive impairments, we found evidence for exercise programs with a short session duration and high frequency to predict higher effect sizes (d = 0.43-0.50). In healthy older adults, dose-parameters did not predict the magnitude of exercise effects on cognition. For older adults with cognitive impairments, exercise programs with shorter session duration and higher frequency may generate the best cognitive results. Studies are needed in which different exercise doses are directly compared among randomized subjects or conditions.