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Medicinas Complementárias
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1.
Chron Respir Dis ; 21: 14799731241238435, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38553857

RESUMEN

OBJECTIVES: This study aimed to determine the feasibility of a group-based pilot programme of low-to-moderate physical activity training, education and social activities, by investigating acceptability, practicality, implementation and efficacy testing. We offer suggestions on programme adaptions for future study. METHODS: People with a range of chronic respiratory diseases were invited to participate in a pilot 12 week group activity programme. Activities included outdoor walking, tai-chi, education and a range of social activities. Acceptability was determined by participant experiences determined during interviews. Practicality was determined by programme and outcome measure completion, cost and adverse events. Implementation was determined according to whether the programme ran as planned. Efficacy was determined by statistical analyses of outcomes including hand grip strength, timed up and go test, COPD Helplessness Index, COPD Assessment Test, and measures of physical activity via accelerometry. RESULTS: Thematic analysis indicated that the "BreatheHappy" programme was acceptable. Seven of nine participants completed eight out of 10 sessions and the majority completed all outcome measures. "BreatheHappy" was therefore considered practical. The programme was not implemented as planned, with only 10 sessions running rather than the 12 intended. There was a significant increase in daily step counts (MD: 1284 95% CI: 240-2329 p: 0.024 effect size: 0.988), stepping time (MD: 16 min 95% CI: 5-27 min p: 0.011 effect size: 1.36) and daily minutes completing light physical activity (MD: 23 95% CI: 6-38 p: 0.006 effect size: 1.6). However, time spent sitting for ≥30 min but ≤60 min significantly increased (MD: 26 95% CI: 0.2-52 min p: 0.049 effect size: 0.931), showing signs of efficacy and changing physical activity behaviour patterns. DISCUSSION: A 10-week programme of low-moderate physical activity training, education and social activities shows signs of feasibility for future research. Suggested adaptions for future study include using physical activity measures such as daily step count or light physical activity for a primary outcome, and mental health and social health related outcome measures relatable to participant's beneficial experiences of the programme. Recruitment in future studies will try and reach both those less socially active and possibly those who have completed pulmonary rehabilitation (PR). Venues should be close to efficient transport links whilst different frequencies and durations of programme delivery should be trialled. Adequate funding should be provided for both staff running the programme and blinded research staff for outcome measurement.


Asunto(s)
Fuerza de la Mano , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Estudios de Factibilidad , Equilibrio Postural , Estudios de Tiempo y Movimiento , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Calidad de Vida
2.
Sports Med Open ; 10(1): 17, 2024 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-38356036

RESUMEN

BACKGROUND: A new commercially available sodium bicarbonate (SB) supplement claims to limit gastrointestinal (GI) discomfort and increase extracellular buffering capacity. To date, no available data exists to substantiate such claims. Therefore, the aim of this study was to measure blood acid-base balance and GI discomfort responses following the ingestion of SB using the novel "Bicarb System" (M-SB). Twelve well-trained male cyclists completed this randomised crossover designed study. Maximal oxygen consumption was determined in visit one, whilst during visits two and three participants ingested 0.3 g∙kg-1 BM SB using M-SB (Maurten, Sweden) or vegetarian capsules (C-SB) in a randomised order. Finger prick capillary blood samples were measured every 30 min for pH, bicarbonate (HCO3-), and electrolytes (potassium, chloride, calcium, and sodium), for 300 min. Visual analogue scales (VAS) were used to assess GI symptoms using the same time intervals. RESULTS: Peak HCO3- was 0.95 mmol∙L-1 greater following M-SB (p = 0.023, g = 0.61), with time to peak HCO3- achieved 38.2 min earlier (117 ± 37 vs. 156 ± 36 min; p = 0.026, r = 0.67) and remained elevated for longer (p = 0.043, g = 0.51). No differences were observed for any electrolytes between the conditions. Aggregated GI discomfort was reduced by 79 AU following M-SB (p < 0.001, g = 1.11), with M-SB reducing stomach cramps, bowel urgency, diarrhoea, belching, and stomach-ache compared to C-SB. CONCLUSIONS: This is the first study to report that M-SB can increase buffering capacity and reduce GI discomfort. This presents a major potential benefit for athletes considering SB as an ergogenic supplement as GI discomfort is almost eliminated. Future research should determine if M-SB is performance enhancing.


The novel 'Bicarb System' (M-SB) reduced, and almost eliminated the gastrointestinal (GI) discomfort compared to vegetarian capsules (C-SB). The changes in acid-base balance following ingestion of M-SB were significantly greater compared to C-SB. It is unkown if this would translate to increased performance benefits, however, and the next step therefore is to determine the performance responses from M-SB. The increase in HCO3 was sustained >5 mmol L−1 HCO3 for longer with M-SB ingestion versus C-SB. This might suggest there is an "ergogenic window", and ingestion timing could therefore be flexible prior to exercise.

3.
Aging Cell ; 23(1): e14023, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37905388

RESUMEN

Age-related alterations in physiology lead to declines in physical function that are associated with numerous adverse outcomes among older adults. Utilizing a hybrid design, we aimed to understand whether both long-term and short-term Tai Chi (TC) training are associated with age-related decline in physical function in healthy older adults. We first conducted cross-sectional comparisons among TC-naïve older adults (n = 60, 64.2 ± 7.7 years), TC-expert older adults (n = 27, 62.8 ± 7.6 years, 24.5 ± 12 years experience), and TC-naïve younger adults (n = 15, 28.7 ± 3.2 years) to inform long-term effects of TC training on physical function, including single leg stance time with eyes closed, grip strength, Timed Up and Go, maximum walking speed, functional reach, and vertical jump for lower-extremity power. There were significant differences among the three groups on all the six tests. For most functional tests, TC-experts performed better than age-matched TC-naïve controls and were statistically indistinguishable from young healthy adult controls. Long-term TC training was associated with higher levels of physical function in older adults, suggesting a potential preventative healthy aging effect. In the randomized longitudinal trial, TC-naïve subjects were randomized (n = 31 to Tai Chi group, n = 29 to usual care control group) to evaluate the short-term effects of TC over 6 months on all outcomes. TC's short-term impacts on physical function were small and not statistically significant. The impact of short-term training in healthy adults is less clear. Both potential longer-term preventive effects and shorter-term restorative effects warrant further research with rigorous, adequately powered controlled clinical trials.


Asunto(s)
Taichi Chuan , Humanos , Anciano , Estudios Transversales , Equilibrio Postural/fisiología
4.
Nutrients ; 15(15)2023 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-37571244

RESUMEN

The aim of this study was to observe the nutritional supplement practices of highly trained swimmers on a national talent pathway, since it is often reported that swimmers engage in widespread supplement use at the elite level. Thus, this study employed a validated supplement intake questionnaire with forty-four swimmers from a high-performance swimming club, which had three distinct talent stages: development (aged 11-14 years, n = 20), age-group (aged 13-17 years, n = 13), and national level (aged ≥ 16 years, n = 11). Ninety-eight percent of the interviewed swimmers reported using at least one supplement, with performance (34%) and recovery (19%) cited as the primary reasons. National swimmers used more total supplements (8.1 ± 3.4 supplements) compared to age-group (4.8 ± 2.0 supplements, p = 0.003, g = 1.17) and development (3.9 ± 1.7 supplements, p < 0.001, g = 1.69) swimmers, mostly because of a greater intake of ergogenic aids (2.4 ± 1.4 supplements vs. age-group: 0.5 ± 0.5 supplements, p < 0.001, g = 1.12; vs. development: 0.1 ± 0.2 supplements, p < 0.001, g = 1.81). Parents/guardians were the primary supplement informants of development swimmers (74%, p < 0.001, V = 0.50), whereas performance nutritionists informed ~50% of supplements used by age-group and national swimmers (p < 0.001, V = 0.51). Based on these results, supplement education and greater focus on basic sport nutrition practices may be required for parents/guardians at the development level. Moreover, further research is needed to support the high number of ergogenic aids used by national swimmers, with the efficacy of these supplements currently equivocal in the applied setting.


Asunto(s)
Atletas , Natación , Humanos , Suplementos Dietéticos , Estado Nutricional , Reino Unido
5.
J Int Soc Sports Nutr ; 20(1): 2216678, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37227399

RESUMEN

OBJECTIVE: This study examined the effects of oral and topical (PR Lotion; Momentous) sodium bicarbonate (NaHCO3) during a battery of team sport-specific exercise tests. METHOD: In a block randomized, crossover, double-blind, placebo-controlled design, 14 recreationally trained male team sport athletes performed a familiarization visit and three experimental trials receiving: (i) 0.3 g·kg-1 body mass (BM) NaHCO3 in capsules + placebo lotion (SB-ORAL), (ii) placebo capsules +0.9036 g·kg-1 BM PR Lotion (SB-LOTION), or (iii) placebo capsules + placebo lotion (PLA). Supplements were given ~120 min prior to the team sport-specific exercise tests: countermovement jumps (CMJ), 8 × 25 m repeated sprints and Yo-Yo Intermittent Recovery Level 2 (Yo-Yo IR2). Blood acid-base balance (pH, bicarbonate) and electrolytes (sodium, potassium) were measured throughout. Rating of perceived exertion (RPE) was recorded after each sprint and post-Yo-Yo IR2. RESULTS: Distance covered during the Yo-Yo IR2 was 21% greater for SB-ORAL compared with PLA (+94 m; p = 0.009, d = 0.64) whereas performance was only 7% greater for SB-LOTION compared with PLA (480 ± 122 vs. 449 ± 110 m; p = 0.084). Total completion time for the 8 × 25 m repeated sprint test was 1.9% faster for SB-ORAL compared with PLA (-0.61 s; p = 0.020, d = 0.38) and 2.0% faster for SB-LOTION compared with PLA (-0.64 s; p = 0.036, d = 0.34). CMJ performance was similar between treatments (p > 0.05). Blood acid-base balance and electrolytes were significantly improved for SB-ORAL compared with PLA, but no differences were observed for SB-LOTION. Compared to PLA, RPE was lower for SB-LOTION after the fifth (p = 0.036), sixth (p = 0.012), and eighth (p = 0.040) sprints and for SB-ORAL after the sixth (p = 0.039) sprint. CONCLUSIONS: Oral NaHCO3 improved 8 × 25 m repeated sprint (~2%) and Yo-Yo IR2 performance (21%). Similar improvements in repeated sprint times were observed for topical NaHCO3 (~2%), but no significant benefits were reported for Yo-Yo IR2 distance or blood acid-base balance compared to PLA. These findings suggest that PR Lotion might not be an effective delivery system for transporting NaHCO3 molecules across the skin and into systematic circulation, therefore further research is needed to elucidate the physiological mechanisms responsible for the ergogenic effects of PR Lotion.


Asunto(s)
Rendimiento Atlético , Carrera , Humanos , Masculino , Atletas , Rendimiento Atlético/fisiología , Método Doble Ciego , Prueba de Esfuerzo , Poliésteres , Carrera/fisiología , Bicarbonato de Sodio/farmacología , Deportes de Equipo , Estudios Cruzados
6.
Psychol Rep ; : 332941231152391, 2023 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-36645725

RESUMEN

This study investigated if trait mindfulness and its components, mindful attention, acceptance, and non-judging correlate negatively with self-reported and indirect markers of mind-wandering. The 552 participants of the study completed an anonymous online questionnaire consisting of trait mindfulness and mind-wandering scales. They also completed the computer-based Sustained Attention to Response Task (SART), an objective measure of mind-wandering. The total mindfulness score and acceptance and non-judging subscale scores were strongly negatively correlated with both self-reported trait mind-wandering (TMW) and SART indices of mind-wandering. In contrast, attention was significantly positively correlated with both. These findings suggest that trait mindfulness conceptualised as a multi-component construct, but not a uni-component one, is probably an opposing construct to trait mind-wandering. Furthermore, mindfulness and its components, acceptance and non-judging, are associated with a reduction in the more common form of SART errors. However, only the acceptance component made a unique contribution to the variance in TMW and SART performance. Therefore, it is advisable for researchers to specify whether they investigated mindfulness as a uni-component or multi-component construct. Furthermore, it would be beneficial if future research investigates the relationship of mindfulness and its components with mind-wandering further by also incorporating a measure of state mindfulness.

7.
Eur J Appl Physiol ; 122(12): 2555-2563, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36053364

RESUMEN

Sodium bicarbonate (NaHCO3) is a widely researched ergogenic aid, but the optimal blinding strategy during randomised placebo-controlled trials is unknown. In this multi-study project, we aimed to determine the most efficacious ingestion strategy for blinding NaHCO3 research. During study one, 16 physically active adults tasted 0.3 g kg-1 body mass NaHCO3 or 0.03 g kg-1 body mass sodium chloride placebo treatments given in different flavour (orange, blackcurrant) and temperature (chilled, room temperature) solutions. They were required to guess which treatment they had received. During study two, 12 recreational athletes performed time-to-exhaustion (TTE) cycling trials (familiarisation, four experimental). Using a randomised, double-blind design, participants consumed 0.3 g kg-1 body mass NaHCO3 or a placebo in 5 mL kg-1 body mass chilled orange squash/water solutions or capsules and indicated what they believed they had received immediately after consumption, pre-TTE and post-TTE. In study one, NaHCO3 prepared in chilled orange squash resulted in the most unsure ratings (44%). In study two, giving NaHCO3 in capsules resulted in more unsure ratings than in solution after consumption (92 vs 33%), pre-TTE (67 vs. 17%) and post-TTE (50 vs. 17%). Administering NaHCO3 in capsules was the most efficacious blinding strategy which provides important implications for researchers conducting randomised placebo-controlled trials.


Asunto(s)
Ácido Láctico , Bicarbonato de Sodio , Adulto , Humanos , Bicarbonato de Sodio/farmacología , Cápsulas , Ciclismo , Método Doble Ciego , Ingestión de Alimentos
8.
J Am Geriatr Soc ; 70(8): 2310-2319, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35451096

RESUMEN

BACKGROUND: Orthostatic hypotension (OH) based on a change from seated-to-standing blood pressure (BP) is often used interchangeably with supine-to-standing BP. METHODS: The Study to Understand Fall Reduction and Vitamin D in You (STURDY) was a randomized trial of vitamin D3 supplementation and fall in adults aged ≥70 years at high risk of falls. OH was defined as a drop in systolic or diastolic BP of at least 20 or 10 mmHg, measured at pre-randomization, 3-, 12-, and 24-month visits with each of 2 protocols: seated-to-standing and supine-to-standing. Participants were asked about orthostatic symptoms, and falls were ascertained via daily fall calendar, ad hoc reporting, and scheduled interviews. RESULTS: Among 534 participants with 993 paired supine and seated assessments (mean age 76 ± 5 years, 42% women, 18% Black), mean baseline BP was 130 ± 19/68 ± 11 mmHg; 62% had a history of high BP or hypertension. Mean BP increased 3.5 (SE, 0.4)/2.6 (SE, 0.2) mmHg from sitting to standing, but decreased with supine to standing (mean change: -3.7 [SE, 0.5]/-0.8 [SE, 0.3] mmHg; P-value < 0.001). OH was detected in 2.1% (SE, 0.5) of seated versus 15.0% (SE, 1.4) of supine assessments (P < 0.001). While supine and seated OH were not associated with falls (HR: 1.55 [0.95, 2.52] vs 0.69 [0.30, 1.58]), supine systolic OH was associated with higher fall risk (HR: 1.77 [1.02, 3.05]). Supine OH was associated with self-reported fainting, blacking out, seeing spots and room spinning in the prior month (P-values < 0.03), while sitting OH was not associated with any symptoms (P-values ≥ 0.40). CONCLUSION: Supine OH was more frequent, associated with orthostatic symptoms, and potentially more predictive of falls than seated OH.


Asunto(s)
Hipertensión , Hipotensión Ortostática , Accidentes por Caídas/prevención & control , Anciano , Anciano de 80 o más Años , Presión Sanguínea/fisiología , Femenino , Humanos , Hipertensión/complicaciones , Masculino , Sedestación
9.
JAMA Netw Open ; 4(12): e2138911, 2021 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-34910151

RESUMEN

Importance: With the global population aging, falls and fall-related injuries are ubiquitous, and several clinical practice guidelines for falls prevention and management for individuals 60 years or older have been developed. A systematic evaluation of the recommendations and agreement level is lacking. Objectives: To perform a systematic review of clinical practice guidelines for falls prevention and management for adults 60 years or older in all settings (eg, community, acute care, and nursing homes), evaluate agreement in recommendations, and identify potential gaps. Evidence Review: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analyses statement methods for clinical practice guidelines on fall prevention and management for older adults was conducted (updated July 1, 2021) using MEDLINE, PubMed, PsycINFO, Embase, CINAHL, the Cochrane Library, PEDro, and Epistemonikos databases. Medical Subject Headings search terms were related to falls, clinical practice guidelines, management and prevention, and older adults, with no restrictions on date, language, or setting for inclusion. Three independent reviewers selected records for full-text examination if they followed evidence- and consensus-based processes and assessed the quality of the guidelines using Appraisal of Guidelines for Research & Evaluation II (AGREE-II) criteria. The strength of the recommendations was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation scores, and agreement across topic areas was assessed using the Fleiss κ statistic. Findings: Of 11 414 records identified, 159 were fully reviewed and assessed for eligibility, and 15 were included. All 15 selected guidelines had high-quality AGREE-II total scores (mean [SD], 80.1% [5.6%]), although individual quality domain scores for clinical applicability (mean [SD], 63.4% [11.4%]) and stakeholder (clinicians, patients, or caregivers) involvement (mean [SD], 76.3% [9.0%]) were lower. A total of 198 recommendations covering 16 topic areas in 15 guidelines were identified after screening 4767 abstracts that proceeded to 159 full texts. Most (≥11) guidelines strongly recommended performing risk stratification, assessment tests for gait and balance, fracture and osteoporosis management, multifactorial interventions, medication review, exercise promotion, environment modification, vision and footwear correction, referral to physiotherapy, and cardiovascular interventions. The strengths of the recommendations were inconsistent for vitamin D supplementation, addressing cognitive factors, and falls prevention education. Recommendations on use of hip protectors and digital technology or wearables were often missing. None of the examined guidelines included a patient or caregiver panel in their deliberations. Conclusions and Relevance: This systematic review found that current clinical practice guidelines on fall prevention and management for older adults showed a high degree of agreement in several areas in which strong recommendations were made, whereas other topic areas did not achieve this level of consensus or coverage. Future guidelines should address clinical applicability of their recommendations and include perspectives of patients and other stakeholders.


Asunto(s)
Accidentes por Caídas/prevención & control , Servicios de Salud para Ancianos/normas , Anciano , Anciano de 80 o más Años , Terapia Combinada , Consenso , Planificación Ambiental , Promoción de la Salud/métodos , Promoción de la Salud/normas , Humanos , Revisión de Medicamentos , Persona de Mediana Edad , Osteoporosis/complicaciones , Osteoporosis/terapia , Modalidades de Fisioterapia/normas , Guías de Práctica Clínica como Asunto , Heridas y Lesiones/etiología , Heridas y Lesiones/terapia
10.
Eur J Appl Physiol ; 121(12): 3283-3295, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34417881

RESUMEN

As a nitric oxide (NO) enhancer, citrulline malate (CM) has recently been touted as a potential ergogenic aid to both resistance and high-intensity exercise performance, as well as the recovery of muscular performance. The mechanism has been associated with enhanced blood flow to active musculature, however, it might be more far-reaching as either ammonia homeostasis could be improved, or ATP production could be increased via greater availability of malate. Moreover, CM might improve muscle recovery via increased nutrient delivery and/or removal of waste products. To date, a single acute 8 g dose of CM on either resistance exercise performance or cycling has been the most common approach, which has produced equivocal results. This makes the effectiveness of CM to improve exercise performance difficult to determine. Reasons for the disparity in conclusions seem to be due to methodological discrepancies such as the testing protocols and the associated test-retest reliability, dosing strategy (i.e., amount and timing), and the recent discovery of quality control issues with some manufacturers stated (i.e., citrulline:malate ratios). Further exploration of the optimal dose is therefore required including quantification of the bioavailability of NO, citrulline, and malate following ingestion of a range of CM doses. Similarly, further well-controlled studies using highly repeatable exercise protocols with a large aerobic component are required to assess the mechanisms associated with this supplement appropriately. Until such studies are completed, the efficacy of CM supplementation to improve exercise performance remains ambiguous.


Asunto(s)
Rendimiento Atlético , Citrulina/análogos & derivados , Malatos/farmacología , Sustancias para Mejorar el Rendimiento/farmacología , Citrulina/farmacología , Suplementos Dietéticos , Humanos
11.
Nutrients ; 13(8)2021 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-34444873

RESUMEN

The aim of this study was to evaluate the effects of a seven-week nutrition education intervention on the sports nutrition knowledge (SNK) of highly trained UK adolescent swimmers. Fifteen national and international adolescent swimmers (males = 5; females = 10, 15.5 ± 1.1 years, 170.2 ± 7.5 cm, 60.3 ± 5.7 kg) participated in the study during seven consecutive weeks of the competitive swimming season. The participants received 30 min of nutrition education once per week in a classroom-based setting after they had completed their regular swim training. An undergraduate sports nutrition student delivered all nutrition education sessions and SNK questionnaires were administered to the participants pre- and post-intervention. The mean total SNK score improved by 8.3% (SD = 8.4%, 95% CI = 4.1-12.6; p = 0.006; ES = 1.0) following the nutrition education sessions. On an individual basis, ten swimmers significantly improved their total SNK score, whereas four swimmers did not improve, and one swimmer performed significantly worse after the intervention. Moreover, the swimmers' knowledge of hydration improved by 22.2% (SD = 20.6%, 95% CI = 11.8-32.6, p = 0.004, ES = 1.1) over the seven-week timeframe, which was the only nutrition topic to have a significantly increased knowledge score. The current study therefore suggests that a nutrition education intervention can positively influence the SNK of highly trained adolescent swimmers.


Asunto(s)
Atletas/educación , Dieta Saludable , Conocimientos, Actitudes y Práctica en Salud , Ciencias de la Nutrición/educación , Acondicionamiento Físico Humano , Natación , Adolescente , Atletas/psicología , Conducta Competitiva , Estudios Transversales , Suplementos Dietéticos , Ingestión de Energía , Femenino , Humanos , Masculino , Estado Nutricional , Valor Nutritivo , Ingesta Diaria Recomendada , Reino Unido
12.
Cell Biosci ; 11(1): 100, 2021 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-34051873

RESUMEN

BACKGROUND: The ongoing global pandemic of coronavirus disease 2019 (COVID-19) has resulted in the infection of over 128 million people and has caused over 2.8 million deaths as of April 2021 in more than 220 countries and territories. Currently, there is no effective treatment for COVID-19 to reduce mortality. We investigated the potential anti-coronavirus activities from an oral liquid of traditional medicine, Respiratory Detox Shot (RDS), which contains mostly herbal ingredients traditionally used to manage lung diseases. RESULTS: Here we report that RDS inhibited the infection of target cells by lenti-SARS-CoV, lenti-SARS-CoV-2, and hybrid alphavirus-SARS-CoV-2 (Ha-CoV-2) pseudoviruses, and by infectious SARS-CoV-2 and derived Ha-CoV-2 variants including B.1.1.7, B.1.351, P.1, B.1.429, B.1.2, B.1.494, B.1.1.207, B.1.258, and B.1.1.298. We further demonstrated that RDS directly inactivates the infectivity of SARS-CoV-2 virus particles. In addition, we found that RDS can also block the infection of target cells by Influenza A virus. CONCLUSIONS: These results suggest that RDS may broadly inhibit the infection of respiratory viruses.

13.
Prog Cardiovasc Dis ; 67: 2-10, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33549590

RESUMEN

COVID-19 is one of the biggest health crises that the world has seen. Whilst measures to abate transmission and infection are ongoing, there continues to be growing numbers of patients requiring chronic support, which is already putting a strain on health care systems around the world and which may do so for years to come. A legacy of COVID-19 will be a long-term requirement to support patients with dedicated rehabilitation and support services. With many clinical settings characterized by a lack of funding and resources, the need to provide these additional services could overwhelm clinical capacity. This position statement from the Healthy Living for Pandemic Event Protection (HL-PIVOT) Network provides a collaborative blueprint focused on leading research and developing clinical guidelines, bringing together professionals with expertise in clinical services and the exercise sciences to develop the evidence base needed to improve outcomes for patients infected by COVID-19.


Asunto(s)
COVID-19/rehabilitación , Capacidad Cardiovascular , Ejercicio Físico , Rehabilitación Cardiaca , Tolerancia al Ejercicio , Política de Salud , Humanos , Política Organizacional , Rehabilitación/métodos , Enfermedades Respiratorias/rehabilitación , Telemedicina
14.
PLoS One ; 16(1): e0242963, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33481829

RESUMEN

BACKGROUND: Tai Chi (TC) mind-body exercise has been shown to reduce falls and improve balance and gait, however, few studies have evaluated the role of lower extremity muscle activation patterns in the observed benefits of TC on mobility. PURPOSE: To perform an exploratory analysis of the association between TC training and levels of lower extremity muscle co-contraction in healthy adults during walking under single-task (ST) and cognitive dual-task (DT) conditions. METHODS: Surface electromyography of the anterior tibialis and lateral gastrocnemius muscles was recorded during 90 sec trials of overground ST (walking normally) and DT (walking with verbalized serial subtractions) walking. A mean co-contraction index (CCI), across all strides, was calculated based on the percentage of total muscle activity when antagonist muscles were simultaneously activated. A hybrid study design investigated long-term effects of TC via a cross-sectional comparison of 27 TC experts and 60 age-matched TC-naïve older adults. A longitudinal comparison assessed the shorter-term effects of TC; TC-naïve participants were randomly allocated to either 6 months of TC training or to usual care. RESULTS: Across all participants at baseline, greater CCI was correlated with slower gait speed under DT (ß(95% CI) = -26.1(-48.6, -3.7)) but not ST (ß(95% CI) = -15.4(-38.2, 7.4)) walking. Linear models adjusting for age, gender, BMI and other factors that differed at baseline indicated that TC experts exhibited lower CCI compared to TC naives under DT, but not ST conditions (ST: mean difference (95% CI) = -7.1(-15.2, 0.97); DT: mean difference (95% CI) = -10.1(-18.1, -2.4)). No differences were observed in CCI for TC-naive adults randomly assigned to 6 months of TC vs. usual care. CONCLUSION: Lower extremity muscle co-contraction may play a role in the observed benefit of longer-term TC training on gait and postural control. Longer-duration and adequately powered randomized trials are needed to evaluate the effect of TC on neuromuscular coordination and its impact on postural control. TRIAL REGISTRATION: The randomized trial component of this study was registered at ClinicalTrials.gov (NCT01340365).


Asunto(s)
Marcha/fisiología , Extremidad Inferior/fisiología , Contracción Muscular/fisiología , Músculo Esquelético/fisiología , Taichi Chuan , Análisis y Desempeño de Tareas , Anciano , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad
15.
J Sci Med Sport ; 24(1): 92-97, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32660833

RESUMEN

OBJECTIVES: This study aimed to investigate whether supplementation with 12 mg⋅day-1 astaxanthin for 7 days can improve exercise performance and metabolism during a 40 km cycling time trial. DESIGN: A randomised, double-blind, crossover design was employed. METHODS: Twelve recreationally trained male cyclists (VO2peak: 56.5 ± 5.5 mL⋅kg-1⋅min-1, Wmax: 346.8  ± 38.4 W) were recruited. Prior to each experimental trial, participants were supplemented with either 12 mg⋅day-1 astaxanthin or an appearance-matched placebo for 7 days (separated by 14 days of washout). On day 7 of supplementation, participants completed a 40 km cycling time trial on a cycle ergometer, with indices of exercise metabolism measured throughout. RESULTS: Time to complete the 40 km cycling time trial was improved by 1.2 ± 1.7% following astaxanthin supplementation, from 70.76 ± 3.93 min in the placebo condition to 69.90 ± 3.78 min in the astaxanthin condition (mean improvement = 51 ± 71 s, p = 0.029, g = 0.21). Whole-body fat oxidation rates were also greater (+0.09 ± 0.13 g⋅min-1, p = 0.044, g = 0.52), and the respiratory exchange ratio lower (-0.03 ± 0.04, p = 0.024, g = 0.60) between 39-40 km in the astaxanthin condition. CONCLUSIONS: Supplementation with 12 mg⋅day-1 astaxanthin for 7 days provided an ergogenic benefit to 40 km cycling time trial performance in recreationally trained male cyclists and enhanced whole-body fat oxidation rates in the final stages of this endurance-type performance event.


Asunto(s)
Tejido Adiposo/metabolismo , Ciclismo/fisiología , Fibrinolíticos/farmacología , Sustancias para Mejorar el Rendimiento/farmacología , Adulto , Intervalos de Confianza , Estudios Cruzados , Método Doble Ciego , Fibrinolíticos/administración & dosificación , Humanos , Masculino , Oxidación-Reducción/efectos de los fármacos , Sustancias para Mejorar el Rendimiento/administración & dosificación , Recreación , Fenómenos Fisiológicos en la Nutrición Deportiva/efectos de los fármacos , Factores de Tiempo , Xantófilas/administración & dosificación , Xantófilas/farmacología
16.
Perspect Public Health ; 140(3): 172-180, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32414311

RESUMEN

AIMS: In breathless individuals with respiratory disease, pulmonary rehabilitation (PR) can improve exercise capacity, symptoms and ability to cope with their condition. However, access is often limited, and adherence can be poor. Thus, there is interest in developing alternative and complementary forms of exercise intervention and tai chi may be effective in this context. METHOD: The British Lung Foundation worked in collaboration with 'Tai Chi Movements for Wellbeing' Training to train leaders to run community-based tai chi groups in the UK. Leaders received funding to run 3 months of once-a-week classes consisting of a 12 movement sequence of tai chi. Participants completed a questionnaire survey to evaluate the service at the start of their first session and again after 3 months. RESULTS: Ten tai chi groups recruited 128 participants, 65% women, mean (standard deviation (SD)) age 70.1 (7.4) years at baseline. Seventy individuals completed the follow-up questionnaire at 3 months. Participants demonstrated an improvement in Medical Research Council (MRC) Dyspnoea Score pre 3 (interquartile range (IQR) = 1.8), post 2 (IQR = 1), p = .013 and disease burden; chronic obstructive pulmonary disease (COPD) assessment test score pre 19.4 (8.7), post 17.9 (9.4), mean change -1.5 (confidence interval (CI): -2.89 to -0.127), p = .033. Those who completed the programme had a worse baseline COPD assessment test (CAT) score and were more likely to have participated in maintenance exercise previously. Qualitative feedback suggested that participants felt the classes had helped with breathlessness and relaxation. CONCLUSION: Establishing a tai chi for wellbeing programme for people with respiratory disease is feasible, with a reasonable level of compliance, and is perceived to be helpful by participants.


Asunto(s)
Disnea/terapia , Taichi Chuan/métodos , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Enfermedades Pulmonares/terapia , Masculino , Persona de Mediana Edad , Proyectos Piloto , Enfermedad Pulmonar Obstructiva Crónica/terapia , Calidad de Vida
17.
Chemosphere ; 253: 126617, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32278905

RESUMEN

Remediation of wetland soils contaminated with petroleum hydrocarbons is a challenging task. Biosurfactant and biochar have been used in oil remediation. However, little is known about the ecotoxicity of these materials when applied in wetland ecosystems. In this study, the ecotoxicity of biochar and rhamnolipid (RL) biosurfactant as crude oil remediation strategies in a Louisiana wetland soil was investigated. A pot experiment was set up with wetland soil treated with/without crude oil followed by subjecting to application of 1% biochar and various levels of RL ranging from 0.1% to 1.4%. The ecotoxicity was evaluated regarding to high plant (S. Alterniflora), algae, and soil microbes. Specifically, after a 30-day growth in a controlled chamber, plant biomass change as well as shoot/root ratio was measured. Algae growth was estimated by quantifying chlorophyll by spectrometry following separation, and soil microbial community was characterized by phospholipid fatty acids analysis. Results showed that plant can tolerate RL level up to 0.8%, while algae growth was strongly inhibited at RL > 0.1%. Algal biomass was significantly increased by biochar, which offset the negative impact of oil and RL. Additionally, soil microbial community shift caused by crude oil and RL was alleviated by biochar with promoting Gram-positive bacteria, actinomycetes, and arbuscular mycorrhizal fungi. Overall, this study shows that integrated treatment of biochar and RL has the lowest ecotoxicity to plant and algae when used in oil remediation of contaminated wetland soils.


Asunto(s)
Carbón Orgánico/química , Restauración y Remediación Ambiental/métodos , Glucolípidos/química , Petróleo/toxicidad , Contaminantes del Suelo/toxicidad , Humedales , Biodegradación Ambiental , Biomasa , Ecosistema , Hidrocarburos , Louisiana , Micorrizas , Petróleo/análisis , Suelo/química , Microbiología del Suelo , Contaminantes del Suelo/análisis , Contaminantes del Suelo/química
18.
J Integr Med ; 18(3): 229-241, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32307268

RESUMEN

OBJECTIVE: Lung-toxin Dispelling Formula No. 1, referred to as Respiratory Detox Shot (RDS), was developed based on a classical prescription of traditional Chinese medicine (TCM) and the theoretical understanding of herbal properties within TCM. Therapeutic benefits of using RDS for both disease control and prevention, in the effort to contain the coronavirus disease 2019 (COVID-19), have been shown. However, the biochemically active constituents of RDS and their mechanisms of action are still unclear. The goal of the present study is to clarify the material foundation and action mechanism of RDS. METHODS: To conduct an analysis of RDS, an integrative analytical platform was constructed, including target prediction, protein-protein interaction (PPI) network, and cluster analysis; further, the hub genes involved in the disease-related pathways were identified, and the their corresponding compounds were used for in vitro validation of molecular docking predictions. The presence of these validated compounds was also measured in samples of the RDS formula to quantify the abundance of the biochemically active constituents. In our network pharmacological study, a total of 26 bioinformatic programs and databases were used, and six networks, covering the entire Zang-fu viscera, were constructed to comprehensively analyze the intricate connections among the compounds-targets-disease pathways-meridians of RDS. RESULTS: For all 1071 known chemical constituents of the nine ingredients in RDS, identified from established TCM databases, 157 passed drug-likeness screening and led to 339 predicted targets in the constituent-target network. Forty-two hub genes with core regulatory effects were extracted from the PPI network, and 134 compounds and 29 crucial disease pathways were implicated in the target-constituent-disease network. Twelve disease pathways attributed to the Lung-Large Intestine meridians, with six and five attributed to the Kidney-Urinary Bladder and Stomach-Spleen meridians, respectively. One-hundred and eighteen candidate constituents showed a high binding affinity with SARS-coronavirus-2 3-chymotrypsin-like protease (3CLpro), as indicated by molecular docking using computational pattern recognition. The in vitro activity of 22 chemical constituents of RDS was validated using the 3CLpro inhibition assay. Finally, using liquid chromatography mass spectrometry in data-independent analysis mode, the presence of seven out of these 22 constituents was confirmed and validated in an aqueous decoction of RDS, using reference standards in both non-targeted and targeted approaches. CONCLUSION: RDS acts primarily in the Lung-Large Intestine, Kidney-Urinary Bladder and Stomach-Spleen meridians, with other Zang-fu viscera strategically covered by all nine ingredients. In the context of TCM meridian theory, the multiple components and targets of RDS contribute to RDS's dual effects of health-strengthening and pathogen-eliminating. This results in general therapeutic effects for early COVID-19 control and prevention.


Asunto(s)
Antivirales/química , Betacoronavirus/química , Infecciones por Coronavirus/tratamiento farmacológico , Medicamentos Herbarios Chinos/química , Medicina Tradicional China , Simulación del Acoplamiento Molecular , Neumonía Viral/tratamiento farmacológico , Antivirales/uso terapéutico , Betacoronavirus/enzimología , COVID-19 , Proteasas 3C de Coronavirus , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Cisteína Endopeptidasas/química , Medicamentos Herbarios Chinos/uso terapéutico , Humanos , Espectrometría de Masas , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/virología , Mapas de Interacción de Proteínas , SARS-CoV-2 , Proteínas no Estructurales Virales/química
19.
J Hazard Mater ; 396: 122595, 2020 09 05.
Artículo en Inglés | MEDLINE | ID: mdl-32298868

RESUMEN

Decontamination of oil spills from coastal wetland soils requires a delicate approach. A microcosm study was carried out to investigate the impact of integrated application of biochar, rhamnolipid (RL) biosurfactant and nitrogen (N) on petroleum hydrocarbon remediation in a Louisiana coastal saline marsh and their impact on soil microbial community. The soil was artificially contaminated with crude oil and subjected to treatments of different combinations of sugarcane residue biochar, RL, and coated urea. Total petroleum hydrocarbons (TPH) in the contaminated soil were analyzed periodically using gas chromatograph and associated soil bacterial community was studied using 16 s rRNA sequencing technologies. Results showed that integrated application of biochar + RL, biochar + N, and biochar + N+RL reduced 32.3%, 73.2%, 80.9% of TPH, respectively, and exhibited synergic interaction with higher efficiency than application individually. Combined treatments showed distinct functions that biochar increased the sorption of aromatic compounds, while RL and N enhanced the degradation of heavy and light aliphatic compounds. All remediation treatments caused reduction of soil bacterial diversity while RL and N shifted the microbial community to higher abundances of Proteobacteria and Bacteroidetes, respectively. Overall, the findings of this study demonstrate the positivity of applying integrated biochar, biosurfactant, and N treatment in oil remediation in wetland soils.


Asunto(s)
Petróleo , Contaminantes del Suelo , Biodegradación Ambiental , Carbón Orgánico , Glucolípidos , Hidrocarburos , Nitrógeno/análisis , Suelo , Microbiología del Suelo , Contaminantes del Suelo/análisis , Humedales
20.
Gerontologist ; 60(4): 672-682, 2020 05 15.
Artículo en Inglés | MEDLINE | ID: mdl-30544227

RESUMEN

BACKGROUND AND OBJECTIVES: Older adults living in subsidized housing have typically been excluded from exercise intervention studies. We conducted a qualitative study to explore the perceived physical, psychological, social, and economic factors that influenced participation in and adherence to a year-long Tai Chi intervention within an ongoing cluster-randomized controlled trial (RCT) for older adults living within subsidized housing facilities. RESEARCH DESIGN AND METHODS: Focus groups were held with participants of the RCT who were allocated to the trial's Tai Chi intervention. Individual phone interviews were conducted with those allocated to Tai Chi who had low adherence or who had withdrawn their participation from the study. Emergent themes were extracted using grounded-theory methods. RESULTS: In this qualitative study, we enrolled 41 participants who were allocated to the RCT's Tai Chi intervention: 38 completed and 3 withdrew from the study. Average Tai Chi class attendance was 64.3%. Pragmatic factors that led to higher adherence and retention included: locating classes within each facility; providing programs at no cost; and deployment of a skilled research support team. In addition, the use of an accessible, simplified Tai Chi program improved confidence, social support, self-efficacy, and self-reported improvements in physical and psychological well-being. DISCUSSION AND IMPLICATIONS: Perceived physical, psychological, social benefits, and self-efficacy likely enhance adherence and retention to research-based Tai Chi interventions for older adults. Delivering an on-site, no cost, and supportive program appears critical to overcoming financial and environmental barriers to participation for those living within subsidized housing.


Asunto(s)
Vivienda Popular , Taichi Chuan/psicología , Poblaciones Vulnerables , Anciano , Anciano de 80 o más Años , Boston , Ejercicio Físico/psicología , Femenino , Humanos , Masculino , Investigación Cualitativa , Ensayos Clínicos Controlados Aleatorios como Asunto , Autoeficacia , Apoyo Social
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