The effects of 16-weeks of prebiotic supplementation and aerobic exercise training on inflammatory markers, oxidative stress, uremic toxins, and the microbiota in pre-dialysis kidney patients: a randomized controlled trial-protocol paper.

BACKGROUND: Chronic kidney disease (CKD) is characterized by dysbiosis, elevated levels of uremic toxins, systemic inflammation, and increased markers of oxidative stress. These factors lead to an increased risk of cardiovascular disease (CVD) which is common among CKD patients. Supplementation with high amylose maize resistant starch type 2 (RS-2) can change the composition of the gut microbiota, and reduce markers of inflammation and oxidative stress in patients with end-stage renal disease. However, the impact of RS-2 supplementation has not been extensively studied in CKD patients not on dialysis. Aerobic exercise training lowers certain markers of inflammation in CKD patients. Whether combining aerobic training along with RS-2 supplementation has an additive effect on the aforementioned biomarkers in predialysis CKD patients has not been previously investigated. METHODS: The study is being conducted as a 16-week, double-blind, placebo controlled, parallel arm, randomized controlled trial. Sixty stage 3-4 CKD patients (ages of 30-75 years) are being randomized to one of four groups: RS-2 & usual care, RS-2 & aerobic exercise, placebo (cornstarch) & usual care and placebo & exercise. Patients attend four testing sessions: Two baseline (BL) sessions with follow up visits 8 (wk8) and 16 weeks (wk16) later. Fasting blood samples, resting brachial and central blood pressures, and arterial stiffness are collected at BL, wk8 and wk16. A stool sample is collected for analysis of microbial composition and peak oxygen uptake is assessed at BL and wk16. Blood samples will be assayed for p-cresyl sulphate and indoxyl sulphate, c-reactive protein, tumor necrosis factor α, interleukin 6, interleukin 10, monocyte chemoattractant protein 1, malondialdehyde, 8-isoprostanes F2a, endothelin-1 and nitrate/nitrite. Following BL, subjects are randomized to their group. Individuals randomized to conditions involving exercise will attend three supervised moderate intensity (55-65% peak oxygen uptake) aerobic training sessions (treadmills, bikes or elliptical machine) per week for 16 weeks. DISCUSSION: This study has the potential to yield information about the effect of RS-2 supplementation on key biomarkers believed to impact upon the development of CVD in patients with CKD. We are examining whether there is an additive effect of exercise training and RS-2 supplementation on these key variables. TRIAL REGISTRATION: Clinicaltrials.gov Trial registration# NCT03689569 . 9/28/2018, retrospectively registered.

Blood pressure response to acute and chronic exercise in chronic kidney disease.

AIM: The current study was designed to determine if a relationship exists between acute and chronic blood pressure responses to aerobic exercise in pre-dialysis patients. METHODS: Pre-dialysis kidney patients attended four sessions before being randomized to the treatment (n = 25) or control group (n = 21). In session 1, resting blood pressure was recorded, and these measurements were repeated during the second visit when peak oxygen uptake (VO2peak ) was assessed. In the third and fourth sessions, blood pressures were taken prior to a 40 min walk or period of seated rest. After the 40 min walk or seated rest, blood pressures were monitored for 60 min in the laboratory and for the subsequent 24 h. After session 4, subjects in the treatment group trained aerobically at a moderate intensity, three times per week for 16 weeks. Control subjects were asked to be sedentary. All measurements were repeated after 16 weeks of training or sedentary living. RESULTS: Training increased VO2peak (mL/kg per minute) in the treatment group (baseline 19.6 ± 6.7 vs 21.2 ± 7.7, P < 0.05), with no change in the control (18.0 ± 6.0 vs 17.5 ± 5.7) group. Post-exercise hypotension occurred at baseline prior to training but was unaffected by 16 weeks of training. CONCLUSION: Post-exercise hypotension occurs in pre-dialysis patients following aerobic exercise, but short-term moderate-intensity continuous aerobic training has no effect upon this response. There seems to be no relationship between the acute and chronic blood pressure responses to exercise in pre-dialysis kidney patients.

Adversarial Growth After Anterior Cruciate Ligament Reconstruction.

Although psychological research on sport injury has long focused on negative responses to injury, investigators have begun to explore positive consequences as well. This study examined adversarial growth longitudinally after anterior cruciate ligament surgery and rehabilitation. Participants (N = 108) completed questionnaires measuring (a) aspects of adversarial growth before anterior cruciate ligament surgery and at 6, 12, and 24 months after surgery and (b) daily pain and negative mood for 42 days postoperatively. Although most participants reported little or no adversarial growth due to their injury and rehabilitation, significant increases over preoperative values were found at 6 months postsurgery for three aspects of adversarial growth. Daily pain and negative mood were positively associated with aspects of adversarial growth at each postoperative assessment. It appears that modest but detectable increases in aspects of perceived adversarial growth can occur after anterior cruciate ligament reconstruction and be related to indices of adversity experienced during rehabilitation.

Short-term aerobic exercise and vascular function in CKD stage 3: a randomized controlled trial.

BACKGROUND: The present study was designed to determine the effect of short-term moderate-intensity exercise training on arterial stiffness in patients with chronic kidney disease (CKD) stage 3. STUDY DESIGN: Randomized controlled trial with a parallel-group design. SETTING & PARTICIPANTS: Testing and training sessions were performed at Springfield College. 46 (treatment group, n=25; control group, n=21) patients with CKD with diabetes and/or hypertension completed the study. INTERVENTION: The aerobic training program consisted of 16 weeks of supervised exercise training at 50%-60% peak oxygen uptake (Vo2peak) 3 times per week, while the control group remained sedentary. Identical testing procedures were performed following the 16-week intervention. OUTCOMES: The primary outcome was arterial stiffness. Secondary outcomes were aerobic capacity, various blood parameters (endothelin 1, nitrate/nitrite, and high-sensitivity C-reactive protein), and health-related quality of life. MEASUREMENTS: Arterial stiffness was assessed with aortic pulse wave velocity (PWV), aerobic capacity by Vo2peak, blood parameters by enzyme-linked immunosorbent assays, and health-related quality of life by the 36-Item Short Form Health Survey (SF-36). Participants attended 4 sessions before being randomly assigned to either the treatment or control group. Participants gave consent during the first session, whereas a graded exercise test with measurement of Vo2peak was completed during the second session. During sessions 3 and 4, aortic PWV was measured at rest prior to 40 minutes of either moderate-intensity exercise training or seated rest. A venous blood sample was obtained prior to exercise or rest and participants completed the SF-36 questionnaire. RESULTS: 16 weeks of training led to an 8.2% increase in Vo2peak for the treatment group (P=0.05), but no changes in aortic PWV . LIMITATIONS: Randomization was not concealed and was violated on one occasion; also, use of an indirect measurement of endothelial function and the short duration of the intervention. CONCLUSIONS: Short-term moderate-intensity exercise training does not alter arterial stiffness in patients with CKD, but seems to reduce endothelin 1 levels.

Greater usage and positive mood change for users of a dynamic VR app before and after the COVID-19 pandemic onset.

Americans reported an increase in stress during the novel coronavirus disease 2019 (COVID-19). Virtual reality (VR) apps have been shown to distract users from stressors in the environment, but little is known about the efficacy of specific content features to reduce stress or improve mood for consumer users during a pandemic. The present study investigated secondary archival data to explore how mood and usage behavior changed before and after the onset of COVID-19 for consumer users of a VR app with dynamic, interactive content. Study findings indicate that the COVID-19 pandemic had significant effects on user behavior and mood. Users created more accounts and used app content more often during the pandemic, while reporting increased negative mood states. This suggests that users were motivated to use the content to cope with pandemic stressors. Users also experienced a greater positive mood change after using the content during the pandemic than before, which implies that elements related to the VR app content met users' psychological needs. Passive content with less interactivity resulted in a greater positive mood state after the COVID-19 onset, likely related to its capacity to reduce stress, facilitate restoration, and improve persistent affective states in stressful environments. This study offers a vital window into how consumer users respond to psychosocial pandemic stressors outside of a controlled environment as well as the prospective for VR app content to serve as a valuable mental health intervention during similar stressful events.

Development and evaluation of a webinar to reduce stigma toward people with serious mental illness.

OBJECTIVE: This study involved the development, dissemination, and pre- and postassessment of a mental illness awareness webinar. The goal of the webinar is to educate the general public about serious mental illness (SMI) and reduce stigmatizing attitudes. METHOD: The study included 203 participants (n = 101 treatment group; n = 102 control group). Each completed a pretest and posttest measure of a mental illness stigma scale and a transphobia scale in this randomized control trial research design, along with a demographic form and participant feedback questionnaire. RESULTS: Results revealed that stigma was significantly reduced from pretest to posttest depending on group condition. Participant feedback reflected generally positive responses to the benefits of participating in the webinar in terms of feeling more knowledgeable about SMI in particular (75.5%). Furthermore, while prior contact with people with-and prior education about-SMI alone did not appear to significantly impact stigma scores from pre- to posttest, these variables did appear to have a significant interaction in their combined impact on stigma scores. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Findings suggest that the mental illness awareness training holds promise as an effective tool or reducing stigma among members of the general public. The electronic nature of the webinar allows for widespread and cost-effective dissemination and can also be tailored to meet the needs of specific populations such as law enforcement, first responders, and veterans to destigmatize SMI and improve treatment seeking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An Interactive Cognitive-Behavioural Multimedia Program Favourably Affects Pain and Kinesiophobia During Rehabilitation After Anterior Cruciate Ligament Surgery: An Effectiveness Trial.

Psychological interventions have been found effective in helping athletes cope with the challenges associated with knee surgery. In this investigation, an interactive cognitive-behavioural multimedia program was evaluated as a means of delivering psychological interventions to individuals experiencing anterior cruciate ligament (ACL) surgery in a field trial with 69 ACL surgery patients (30 women and 39 men; 24 competitive athletes, 41 recreational athletes, and 4 nonathletes; M age = 35.01, SD = 11.98 years). Results indicated that compared to participants who received standard care, participants who received the multimedia program reported greater preoperative confidence in ability to cope, lower postoperative pain and kinesiophobia, and greater use and perceived utility of patient education materials. The findings suggest that the multimedia program has promise as an economical and effective means of educating and delivering psychological interventions to people experiencing ACL surgery and rehabilitation.

Sleep Disturbance and Its Association With Sluggish Cognitive Tempo and Attention in Pediatric Brain Tumor Survivors.

Background: Pediatric brain tumor (PBT) survivors are at risk for developing sleep disturbances. While in other pediatric populations sleep disturbance has been associated with worse cognitive functioning, it is unclear to what extent this relationship generalizes to PBT survivors. The aim of the current study was to assess the relationship between sleep disturbance and aspects of cognition, including sluggish cognitive tempo (SCT) as well as attention and working memory. Materials and Methods: Eighty-three PBT survivors 6-18 years of age who were at least 3 months post-treatment were included in the present cross-sectional study. Level of sleep disturbance was measured as a composite score reflecting various sleep problems as rated by caregivers. Cognitive measures included caregiver-ratings of sluggish cognitive tempo and attention problems, as well as performance-based cognitive measures assessing attention and executive functioning. Hierarchical regression analysis was used to assess associations between sleep and cognition. Results: Of all caregivers, 32.5% reported one or more sleep disturbances as "very/often true" and over 68% of caregivers rated at least one sleep-related item as "somewhat true." Of all cognitive variables, scores were most frequently impaired for SCT (30%). A higher level of sleep disturbance was associated with worse SCT and parent-rated attention problems. Associations between sleep and performance-based cognitive measures assessing attention and working memory were not statistically significant. Conclusion: Findings of the current study highlight the importance of further investigation into the relationship between sleep and cognition in PBT survivors, which may assist efforts to maximize cognitive outcome and health-related quality of life in PBT survivors. The current study additionally suggests further investigation of SCT in this population is warranted, as it may be more sensitive to detecting possible associations with sleep disturbance relative to discrete measures that assess cognitive performance under ideal circumstances.

Self-Protective Changes in Athletic Identity Following Anterior Cruciate Ligament Reconstruction.

OBJECTIVES: This study was designed to examine the possibility of self-protective changes in athletic identity (AI) being initiated after the occurrence of a severe injury. METHOD: People (72 men and 36 women) undergoing anterior cruciate ligament (ACL) surgery and rehabilitation were asked to complete a measure of AI prior to surgery and measures of AI and rehabilitation progress at approximately 6, 12, and 24 months after surgery. RESULTS: A repeated-measures ANCOVA controlling for age and gender indicated that AI decreased significantly across the 24-month period following surgery, with the most substantial decline occurring between 6 and 12 months postsurgery. Significantly greater decreases in AI were observed among participants whose rehabilitation progress was slowest from 6 to 12 months postsurgery. CONCLUSIONS: The findings suggest that some participants reduced their identification with the athlete role in response to the threat to a positive self-image posed by their ACL injuries and the difficulties they encountered in postoperative rehabilitation.

Effects of a Mental Warmup on the Workout Readiness and Stress of College Student Exercisers.

The importance of warming up prior to sport competition has been highlighted in the scientific literature, with increasing attention paid to the benefits of mental warmups. The purpose of this research was to explore the possibility that a mental warmup may also benefit exercisers. Two studies were conducted in which the effects of a mental warmup on the psychological readiness and psychological stress of exercisers were examined. Study 1 used a pretest-posttest design and Study 2 used an experimental pretest-posttest design, comparing mental warmup participants to a control group. In both studies, exercisers were assessed before and after they completed a prerecorded mental warmup that consisted of goal setting, imagery, and arousal control. Overall, the results showed that completing a mental warmup increased exercisers' readiness to exercise and to use mental skills to enhance workouts. The mental warmup also reduced stress. These findings suggest that mental warmup strategies that facilitate readiness for sport performance may have utility in exercise settings. Future research exploring the applicability of a mental warmup in diverse settings, as a stress reduction, and as a potential injury reduction intervention is warranted.

It's about Time: Effects of Physical Exertion on Duration Estimates.

BACKGROUND: Task duration is a fundamental aspect of exercise, but little is known about how completed bouts of physical activity are perceived. Consequently, the purpose of the five experiments conducted for this investigation was to examine the effects of engaging in physical tasks on retrospective duration estimates with college student participants. METHODS: Across the five experiments, participants were 113 college students (82 women, 31 men). In Experiments 1 and 2, participants provided duration estimates of a period spent engaging in physical activity or rest. In Experiments 3, 4, and 5, participants provided duration estimates of periods spent engaged in physical tasks of high intensity and low intensity. RESULTS: In Experiments 1, 2, and 3, participants engaged in physical activity tended to perceive durations as shorter than participants at rest. When completing less familiar tasks (Experiments 4 and 5), however, participants recalled a high intensity bout of physical activity as lasting longer than a low intensity bout of physical activity of comparable duration. Cohen's d values for physical activity effects on duration estimates ranged from 0.40 to 1.60. CONCLUSION: The findings, which partially support a contextual-change interpretation, suggest that factors, such as perceived exertion and task familiarity, affect retrospective duration estimates.

High-density lipoprotein particle pattern and overall lipid responses to a short-term moderate-intensity aerobic exercise training intervention in patients with chronic kidney disease.

BACKGROUND: Chronic kidney disease (CKD) is associated with abnormal lipid profiles and altered high-density lipoprotein (HDL) particle size patterns. Lower levels of the larger, cardioprotective HDL particles found in CKD may play a role in the increased risk for cardiovascular disease in these patients. The current study was designed to assess the effects of short-term moderate-intensity aerobic exercise training on the HDL particle pattern and overall lipid profiles in stage 3 CKD patients. METHODS: Forty-six men and women with stage 3 CKD were randomized to either exercise (EX, n = 25) or control (CON, n = 21). Those in the EX group completed 16 weeks of supervised moderate-intensity aerobic exercise three times per week. Serum total cholesterol, HDL cholesterol (HDL-C), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), HDL particle size, estimated glomerular filtration rate (eGFR), body composition and peak oxygen uptake (VO2peak) were assessed at baseline and week 16. RESULTS: The rate of compliance in the EX group was 97 ± 7.2%. No change was observed in eGFR over time in either group. There was an 8.2% improvement in VO2peak in the EX group (P = 0.05), while VO2peak decreased in the CON group. HDL-C, TGs, HDL particle size and body composition remained unchanged in both groups. A trend was found for lower total cholesterol (TC) (P = 0.051) and LDL-C (P = 0.07) in the CON group. CONCLUSION: Our findings indicate that a short-term aerobic exercise training intervention in stage 3 CKD patients does not induce changes in HDL particle size or favorable lipid profile modifications.

Big Five Personality Characteristics and Adherence to Clinic-Based Rehabilitation Activities after ACL Surgery: A Prospective Analysis.

PURPOSE: A prospective, longitudinal study was conducted to examine Big Five personality characteristics as predictors of adherence to clinic-based rehabilitation activities following anterior cruciate ligament (ACL) reconstruction surgery. METHOD: Participants (72 men, 36 women) completed a questionnaire assessing Big Five personality dimensions prior to surgery. For the first 7 weeks after surgery, participants' rehabilitation session attendance was recorded and rehabilitation professionals rated participants' adherence during rehabilitation sessions.. RESULTS: Results of multiple regression analyses indicated that the 5 personality factors explained 11 percent of the variance in attendance and 17 percent of the variance in adherence ratings, that agreeableness was a significant positive predictor of attendance, and that conscientiousness and openness to experience were significant positive predictors of adherence ratings. CONCLUSION: As a potential contributor to adherence, personality warrants consideration when implementing rehabilitation programs after ACL surgery.

Predictors of adherence to home rehabilitation exercises following anterior cruciate ligament reconstruction.

OBJECTIVE: Although home exercises are commonly prescribed following anterior cruciate ligament (ACL) reconstruction and are considered important in obtaining successful rehabilitation outcomes, little is known about factors associated with the completion of such exercises. Consequently, this study was designed to identify predictors of adherence to home rehabilitation exercises after ACL surgery. METHOD: Participants (33 women, 58 men) completed indices of athletic identity, neuroticism, optimism, and pessimism before ACL surgery and measures of daily pain, negative mood, stress, and home exercise completion for 42 days postoperatively. RESULTS: Participants reported a high level of adherence to the prescribed regimen. Home exercise completion increased significantly over time as the number of sets of prescribed home exercises declined. Personal factors were not predictive of home exercise completion. Participants completed fewer home exercises on days when they experienced more stress or negative mood. CONCLUSIONS: Day-to-day variations in negative mood and stress may contribute to adherence to prescribed home exercises.

Exercise training improves HR responses and V˙O2peak in predialysis kidney patients.

PURPOSE: The current pilot and feasibility study was designed to examine the effect of 48 wk of moderate-intensity exercise training and dietary modification on kidney function and vascular parameters in chronic kidney disease (CKD) patients. METHODS: Twenty-one stage 2-4 CKD patients (age, 18-70 yr) were randomly assigned to either the training group (TG, n = 10) or the usual care group (n = 11) for 48 wk. The TG received 48 wk of personal training (3 d·wk for up to 55 min per session at 50%-60% V˙O2peak) and dietary counseling, whereas individuals in the usual care group received standard of care and were instructed not to start a structured exercise program while in the study. V˙O2peak, estimated glomerular filtration rate (eGFR), resting and ambulatory HR, plasma lipids (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides), and inflammatory markers (high-sensitivity C-reactive protein and interleukin 6) were assessed at baseline and weeks 24 and 48. An independent group's t-test was used to compare glomerular filtration rate slopes between groups, whereas all other data were analyzed with ANCOVA using the baseline value as the covariate. RESULTS: There were no statistically significant differences in any of the parameters at baseline. The 48-wk intervention led to a significant increase in V˙O2peak, reductions in both resting and ambulatory HR, and increases in LDL cholesterol and in TG, but it had no effect on the rate of change of eGFR over time. CONCLUSIONS: A 48-wk exercise training program, primarily focused on aerobic exercise, increases V˙O2peak and favorably alters autonomic function as evidenced by reductions in HR in stages 2-4 CKD patients. The exercise intervention had no effect on kidney function as assessed by eGFR.

Electronic CommunKNEEcations: A Descriptive Analysis of Anterior Cruciate Ligament Message Board Postings.

OBJECTIVE: The purpose of this study was to identify topics of potential concern to anterior cruciate ligament (ACL) surgery patients. DESIGN: An archival design was used. SETTING: Qualitative data were collected from two Internet message boards. METHOD: A thematic content analysis was performed on the initial postings of 900 threads from the archives of two online forums. Postings (N = 797) in which questions were asked of the message board communities were placed in 1 of 22 content themes by two independent raters. RESULTS: More than half of the postings in which questions were asked pertained to rehabilitation and the postoperative period (N = 436, 55%), with approximately one-third of the postings (N = 287, 36%) corresponding to issues associated with surgery and the preoperative period. The content themes observed most frequently (all with more than 51 postings) were those pertaining to rehabilitation progress, pain, complications, physical therapy, diagnosis, returning to sport, and whether to have surgery. CONCLUSIONS: A substantial number of individuals use Internet message boards to learn about ACL surgery and rehabilitation. Information gleaned from this study can be used to help ensure that the primary concerns of patients are addressed in educational materials.

Muscle dysmorphia in elite-level power lifters and bodybuilders: a test of differences within a conceptual model.

The purpose of this study was to determine if associated characteristics of muscle dysmorphia (MD) were different between elite-level competitive bodybuilders and power lifters. Elite-level competitive bodybuilders (n = 100) and power lifters (n = 68) completed the muscle dysmorphia inventory (MDI) at the time of or immediately before competition. A 2 x 6 (group x MDI subscales) multivariate analysis of variance indicated that bodybuilders were significantly more likely to report body size-symmetry concerns (F(1, 167) = 10.31, p < 0.001), physique protection (F(1, 167) = 10.27, p < 0.001), dietary behavior (F(1, 167) = 28.38, p < 0.001), and pharmacological use (F(1, 167) = 19.64, p < 0.001) than were power lifters. These results suggest that elite-level bodybuilders are significantly more likely to engage in characteristics associated with MD than are elite-level power lifters.

Age-Related Differences in Predictors of Adherence to Rehabilitation After Anterior Cruciate Ligament Reconstruction.

OBJECTIVE: To examine whether the relationships between psychological factors and rehabilitation adherence after knee surgery differ as a function of age. DESIGN AND SETTING: Participants completed inventories of self-motivation, social support, athletic identity, and psychological distress before anterior cruciate ligament (ACL) reconstruction. After surgery, participants recorded their completion of home rehabilitation exercises and cryotherapy, and the sport rehabilitation professionals providing their treatment reported on the patients' attendance at, and adherence during, rehabilitation sessions. SUBJECTS: Sixty-one individuals with acute ACL tears. MEASUREMENTS: The Self-Motivation Inventory, Social Support Inventory, Athletic Identity Measurement Scale, Brief Symptom Inventory, and Sport Injury Rehabilitation Adherence Scale were used to measure self-motivation, social support, athletic identity, psychological distress, and adherence, respectively, during rehabilitation sessions. RESULTS: Hierarchic regression analyses indicated that age moderated the relationships between (1) self-motivation and home exercise completion, (2) social support and home exercise completion, (3) athletic identity and home exercise completion, and (4) athletic identity and home cryotherapy completion. CONCLUSIONS: The prospective moderating relationships for between psychological factors and indices of adherence to home-based rehabilitation activities indicate the need to consider developmental issues when examining psychological aspects of sport-injury rehabilitation.