Effect of a Standardized Ginger Root Powder Regimen on Chemotherapy-Induced Nausea and Vomiting: A Multicenter, Double-Blind, Placebo-Controlled Randomized Trial.

BACKGROUND: There is substantial interest in the role of ginger as an adjuvant therapy for chemotherapy-induced nausea and vomiting (CINV). However, available evidence lacks robust methodology. OBJECTIVE: To assess the effect of adjuvant ginger compared with placebo on chemotherapy-induced nausea-related quality of life (QoL) and CINV-related outcomes. DESIGN: A parallel, double-blind, placebo-controlled randomized trial with 1:1 allocation was conducted. PARTICIPANTS/SETTING: One hundred three chemotherapy-naïve adults scheduled to receive moderately to highly emetogenic chemotherapy at two hospitals in Australia were enrolled and analyzed. INTERVENTION: Four standardized ginger capsules (totaling 84 mg/day active gingerols/shogaols), or placebo, were administered commencing the day of chemotherapy and continuing for 5 days for chemotherapy cycles 1 through 3. MAIN OUTCOME MEASURES: The primary outcome was chemotherapy-induced nausea-related QoL. Secondary outcomes were vomiting- and CINV-related QoL; anticipatory, acute, and delayed nausea and vomiting; fatigue; nutritional status; depression and anxiety; health-related QoL; and adverse events. STATISTICAL ANALYSES PERFORMED: Intention-to-treat analysis was performed. Mixed analysis of variance with repeated measures determined differences between groups. The null hypothesis was no difference between groups. After applying a Bonferroni multiple testing correction, evidence against the null hypothesis was considered at P= 0.003. RESULTS: One hundred three participants (ginger: n = 52; placebo: n = 51) were enrolled and analyzed. There was clinically relevant evidence against the null hypothesis, favoring ginger, in change scores for nausea-related QoL (F[df] = 9.34[1,101]; P = 0.003; partial η2 = 0.09), overall CINV-related QoL (F[df] = 12.26[1,101]; P < 0.001; partial η2 = 0.11), delayed nausea severity (F[df] = 9.46[1,101]; P = 0.003; partial η2 = 0.09), and fatigue (F[df] = 10.11[1,101]; P = 0.002; partial η2 = 0.09). There was a clinically meaningful lower incidence of delayed nausea and vomiting in the ginger group at Cycle 2 (53% vs 75%; P = 0.020 and 4% vs 27%; P = 0.001, respectively) and Cycle 3 (49% vs 79%; P = 0.002 and 2% vs 23%; P = 0.001, respectively). There was a clinically meaningful lower incidence of malnutrition in the ginger group at Cycle 3 (18% vs. 41%; P = 0.032) and in change scores for Patient-Generated Subjective Global Assessment (F[df)] = 4.32[1,100]; P = 0.040; partial η2 = 0.04). Change scores between groups favored ginger for vomiting-related QoL and number of vomiting episodes; however, findings were not clinically meaningful. There was no effect of ginger on anticipatory or acute CINV, health-related QoL, anxiety, or depression. No serious adverse events were reported. CONCLUSIONS: Ginger supplementation was a safe adjuvant to antiemetic medications for CINV that enhanced QoL during chemotherapy treatment. Future trials are needed to examine dose-dependent responses to verify optimal dosing regimens.

Comparative effect of progressive relaxation technique and Benson's technique on anxiety and fatigue in cancer survivors - an experimental study.

BACKGROUND AND PURPOSE: Anxiety and fatigue is a common symptom that is seen in cancer survivors, who have recently been diagnosed as well as those who are undergoing chemotherapy and radiation therapy as they are emotionally distressed. Progressive relaxation technique and Benson's relaxation is seen to be efficacious in lowering anxiety and fatigue in cancer survivors as individual treatment. To compare the depiction of progressive relaxation technique and Benson's technique on anxiety using Hamilton anxiety scale (HAM-A), blood pressure (BP) and heart rate (HR), and fatigue using cancer fatigue scale (CFS). MATERIALS AND METHODS: A randomized clinical trial (chit method) was carried out on 42 subjects with cancer related anxiety and fatigue. Subjects were randomly allotted to Group A and Group B. Group A was administered Progressive relaxation technique. Group B was administered Benson's technique. Primary outcome measures used were Hamilton Anxiety Scale and Cancer fatigue scale, secondary outcome measures were HR and BP. Outcomes were evaluated at baseline, immediate and after 5 days of the treatment. RESULTS: The results were analyzed using independent t test for comparing the 2 groups. On comparing group, A and B for baseline to immediate and baseline to after 5 days, using HAM-A, BP, HR, CFS, no statistical significance was found. Whereas within group analysis (within group A and B) showed significant reduction in anxiety and fatigue in cancer survivors, with a P value significant at <0.05 as seen from baseline to immediate and baseline to 5 days, with 0.7 effect size. CONCLUSION: The study concludes that both Progressive relaxation technique and Benson's technique are equally effective in reducing anxiety and PRT lowers fatigue more effectively than Benson's technique in cancer survivors.

The Effect of Nonpharmacological Integrated Care Protocols on Patients with Fatigue Undergoing Hemodialysis: A Randomized Controlled Trial.

This study was designed to investigate the effects of nonpharmacological integrated care protocols on fatigue in patients with hemodialysis. This parallel randomized controlled trial was conducted on patients undergoing hemodialysis from May to October 2020 at the Dialysis Center of the Fifth Affiliated Hospital of Zunyi Medical University. The patients were randomized into an intervention group (accepting nonpharmacological integrated care protocols and standard care) or a control group (accepting standard care only) using a computer-generated random number. The nonpharmacological holistic care intervention used in this study involved a well-rounded multidisciplinary team that worked together to improve dietary compliance, medication adherence, and self-management to improve patients' care and promote self-management. From the 120 evaluated patients, 116 cases were eligible and analyzed. The results showed that patients from the intervention group had obviously reduced overall fatigue, mental fatigue, and muscular fatigue relative to the control group. The nonpharmacological integrated care protocols were interactive and promotive to each other. Meanwhile, the role and function of nurses in the management of chronic disease were demonstrated to be crucial.

The effect of music therapy interventions on fatigue in patients with hematological cancers: a systematic review and meta-analysis of randomized controlled trials.

PURPOSE: To systematically synthesize the effect of music therapy interventions applied to patients with hematological cancer on fatigue. METHODS: The searches were conducted on PubMed, Web of Science, EBSCOhost/CINAHL Complete, Science Direct, Scopus, Cochrane Library, Ovid, ProQuest, and Springer Link databases until August 2021 without any year limitation. The review covered the period between 2003 and 2020. Comprehensive Meta-Analysis 3 software was used in the analysis of meta-analysis data. The meta-analysis was carried out following the PRISMA checklist. Risks of bias were examined by two independent researchers using the Cochrane Collaboration tool. RESULTS: Six randomized controlled trials consisting of 279 participants were included in the systematic review and meta-analysis. The count of music therapy interventions in the included studies ranged between 1 and 8 sessions per participant, each of which was 20 to 45 min long. The music therapy interventions applied to patients with hematological cancers were found to be effective in reducing the severity of fatigue (95% Cl = 0.10 ~ 0.57; Hedge's g = 0.03; p = 0.006). CONCLUSIONS: The findings of the meta-analysis indicated that music therapy interventions made important and positive contributions to reducing fatigue in patients with hematological cancer. Music therapy interventions are a convenient method to reduce fatigue because they are comfortable and non-invasive. It will be beneficial to increase the awareness of nurses about the implementation of music therapy interventions. It is recommended that music therapy interventions applied to patients with a diagnosis of hematological cancer should be considered interventions that can be used together with other non-pharmacological or pharmacological methods to reduce fatigue.

Reducing passive driver fatigue through a suitable secondary motor task by means of an interactive seating system.

OBJECTIVE: The primary objective of the study was to evaluate the effect of a secondary motor task induced by an interactive seating system (IASS) on passive driver fatigue in a monotonous simulated driving task. The effect was compared to that of a state-of-the-art massage seating system (MS), which may reduce monotony through additional tactile stimuli. The secondary objective was to compare the user experience of both systems. METHOD: The independent variables were three conditions: one with the IASS, another with the MS, and a control without intervention. The study included seven dependent variables in total: a rating of subjective fatigue, three parameters measuring lane keeping ability, and three parameters reflecting fatigue-related eye movements. The duration of the simulator ride was 40 min in each condition. The study included thirty-five subjects. RESULTS: The assessment of subjective fatigue and lane keeping showed that the use of the IASS resulted in significantly lower passive driver fatigue compared to the massage and control conditions. The alerting effects of the IASS were also reflected by an increased eyelid distance. Frequency and duration of blinks, however, showed no clear patterns of fatigue over time in any of the conditions. Thus, both parameters did not seem be suitable to capture passive driver fatigue in this study. Regarding user experience, the subjects preferred the IASS over the MS as well. CONCLUSION: The IASS showed a strong potential as an effective measure against passive driver fatigue within monotonous driving situations. The MS, on the other hand, induced no measurable effects.

Effects of Perch Essence Supplementation on Improving Exercise Performance and Anti-Fatigue in Mice.

Silver perch (Bidyanus bidyanus) has many nutrition and health benefits, being a rich source of macro and micronutrients, phospholipids, polyunsaturated fatty acids, and a variety of essential minerals while having a high protein content. In addition to direct consumption, it is often made into a soup as an important nutritional supplement for strengthening the body and delaying fatigue. By extracting the essence, its quality can be controlled, and it is convenient to supplement. This study aimed to evaluate the effect of supplementation with Santé premium silver perch essence (SPSPE) on improving exercise performance and anti-fatigue. Fifty male institute of cancer research (ICR) mice were divided into five groups (n = 10/group): (1) vehicle (vehicle control or water only), (2) isocaloric (0.93 g casein/kg/mice/day), (3) SPSPE-1X (0.99 g/kg/mice/day), (4) SPSPE-2X (1.98 g/kg/mice/day), and (5) SPSPE-5X (4.95 g/kg/mice/day). A sample or an equal volume of liquid was fed orally for four consecutive weeks. Grip strength and swimming exhaustion tests were used as exercise performance assessments. After 10 and 90 min of unloaded swimming, biochemical parameters of fatigue were evaluated. We found that supplementation with SPSPE for four consecutive weeks could significantly improve mice's grip strength, exercise endurance performance, and glycogen content (p < 0.05), and significantly reduced post-exercise fatigue biochemical parameters, such as lactate, blood ammonia (NH3), blood urea nitrogen (BUN) concentration, and muscle damage index creatine kinase (CK) activity (p < 0.05). In summary, supplementation with SPSPE for 4 weeks could effectively improve exercise performance, reduce sports fatigue, and accelerate fatigue recovery. In addition, it did not cause any physiological or histopathological damage.

The Effect of Omega-3 Enriched Oral Nutrition Supplement on Nutritional Indices and Quality of Life in Gastrointestinal Cancer Patients: A Randomized Clinical Trial.

OBJECTIVE: Gastrointestinal (GI) cancer patients often experience severe malnutrition during cancer therapies due to gastrointestinal dysfunctions including poor digestion and absorption as well as tumor-associated anorexia. In this study, we performed a randomized clinical trial to determine the efficacy of oral nutrition supplement (ONS) enriched with omega-3 fatty acids on nutritional status, quality of life (QOL), and pro-inflammatory indices. METHODS: Patients diagnosed with GI cancers were recruited and screened for eligibility. A total of 58 patients were randomly allocated to either the control group (n=27) or the experimental group (n=31). The intervention group received 200 ml ONS twice a day while the control group received routine care. Anthropometrics, Patient-Generated Subjective Global Assessment (PG-SGA) score, QOL score and nutrient intake data were collected at baseline, week 4 and week 8. Blood was drawn for biochemical assessments. Nine patients from each group dropped out of the study Forty patients (18 control patients and 22 intervention patients) completed the study. RESULTS: This study showed that ONS intervention improved PG-SGA scores in the intervention group (p<0.01). Scores of physical functioning score and role functioning were declined only in the control group and the difference between week 8 and baseline for role functioning was significant (p<0.001). Fatigue score was steadily decreased in the experiment group, and the differences between week 8 and baseline was significant between two groups (p<0.02). However, no statistically significant improvement in biochemical markers of nutritional status and pro-inflammatory cytokine concentrations were found. These results suggests that ONS intervention for 8 weeks improves PG-SGA scores and QOL scores in patients undergoing cancer therapy.

Prevention of work-related stress, fatigue, loss of cognitive function, improved attention and recovery of stamina with Robuvit® in professionals with increased oxidative stress.

BACKGROUND: The aim of this open, pilot supplement registry study was to evaluate the protective, preventive effects of Robuvit® on professional-related fatigue symptoms and on aspects of cognitive functions, professional attitudes and decision-making in healthy nurses under professional stress and with increased oxidative stress. METHODS: In total, 40 subjects, aged 30-37, completed the 4-week registry study. A control group of 20 subjects used only the standard management (SM) and one group of 20 subjects took 300 mg Robuvit® in addition. Safety and tolerability of Robuvit® were optimal. The two registry groups were comparable at inclusion. RESULTS: The overall scores of the real daily life and tasks questionnaire after 4 weeks were significantly higher in the Robuvit® group (P<0.05) as compared to controls. It increased from 4.3±0.4 at baseline to 6.78±0.8 after 4 weeks of Robuvit® intake and from 4.2±0.5 to 5.12±1.0 in the control group. The supplementation significantly improved the subjective perception of fatigue in comparison with controls (P<0.05). A practical professional score evaluation provided an indication of professional attitude and stamina, in difficult, stressful working conditions under continuous pressure. The results showed that after 4-week supplementation, all assessed parameters improved significantly and the difference with controls was statistically significant (P<0.05). Furthermore, oxidative stress as plasma free radicals decreased significantly in the Robuvit® group (P<0.05) but not in the control group. CONCLUSIONS: Robuvit® supplementation appears to improve most symptoms related to work-induced fatigue, stress and cognitive function and supports stamina. Further evaluations need to be planned according to the concept of this pilot registry in a field that requires more attention.

Ergogenic Effects of Green Tea Combined with Isolated Soy Protein on Increasing Muscle Mass and Exercise Performance in Resistance-Trained Mice.

It is well known that supplementation with high protein after exercise can effectively promote muscle synthesis and repair, while green tea is rich in catechins that have antioxidant effects. We aimed to explore the effects of green tea combined with isolated soy protein on increase muscle mass in resistance-trained mice. A total of 32 male ICR mice (8-weeks old) were divided into four groups (n = 8/group), sedentary control group (SC), isolated soy protein with green tea group (ISPG), resistance training group (RT), isolated soy protein and green tea combine with resistance training group (ISPG + RT). All mice received control or ISPG by oral gavage for four consecutive weeks. Forelimb grip and exhaustive swimming time were used for exercise performance evaluation. In biochemical profile, we analyzed lactate, ammonia, blood urea nitrogen (BUN), and glucose and muscle damage index creatine kinase (CK) after exercise as biochemical parameters of exercise fatigue. The grip strength, muscular endurance, and exhaustive swimming time of the ISPG + RT group were significantly increased than other groups (p < 0.05), and also significantly decreased in serum lactate and ammonia levels (p < 0.05, respectively). The ISP + RT group was not only increased in quadriceps weight, (p < 0.05) but also decreased EFP (p < 0.05). We recommend using a 4-week supplementation with ISPG, combined with RT, to increase muscle mass, exercise performance, glycogen storage, and reduce fatigue biochemical parameters after exercise. The benefits of long-term supplementation or application to human supplementation can be further explored in the future.

The anti-fatigue potential of water-soluble polysaccharides of Semen cassiae on BALB/c mice.

Fatigue syndrome is a major health problem that affects the voluntary activities of an individual. Particularly, exercise-induced fatigue has become a serious concern in people's health. Since polysaccharides from various medicinal plants have been reported for anti-fatigue effect, the current study deals with the anti-fatigue potential of water-soluble polysaccharides of the Chinese medicinal plant Semen cassiae (Cassia obtusifolia L.) in BALB/c mice. Water-soluble polysaccharides from Semen cassiae were extracted using aqueous solvent (water). An orthogonal test design was employed for the optimization of polysaccharide extraction. The conditions optimized through this design unveiled the raw materials to solvent ratio as 1:30. The optimal temperature and time duration were found to be 80°C and 3.5 h, respectively. The yield of soluble polysaccharides at these specified conditions was 5.42%. Strikingly, the water-soluble polysaccharide from S. cassiae exhibited strong anti-fatigue activity at 100 mg/kg in BALB/c mice. S. cassiae polysaccharide extended the weight-loaded swimming duration in BALB/c mice. In addition, it ameliorated the level of antioxidant enzymes (SOD, GPX) while decreased the blood urea nitrogen, creatine phosphokinase, triglyceride, lactic acid, lactate dehydrogenase, and malondialdehyde levels in blood serum. Moreover, the assessment of the immunomodulatory effect of S. cassia polysaccharides unveiled the enhancement of B-cell and T-cell lymphocytes, denoting the positive effect on physical immunity.

Tai Chi for cancer survivors: A systematic review toward consensus-based guidelines.

To manage acute, long-term, and late effects of cancer, current guidelines recommend moderate-to-vigorous intensity aerobic and resistance exercise. Unfortunately, not all cancer survivors are able or willing to perform higher intensity exercise during difficult cancer treatments or because of other existing health conditions. Tai Chi is an equipment-free, multicomponent mind-body exercise performed at light-to-moderate intensity that may provide a more feasible alternative to traditional exercise programs for some cancer survivors. This systematic review evaluated the therapeutic efficacy of Tai Chi across the cancer care continuum. We searched MEDLINE/PubMed, Embase, SCOPUS, and CINAHL databases for interventional studies from inception to 18 September 2020. Controlled trials of the effects of Tai Chi training on patient-reported and objectively measured outcomes in cancer survivors were included. Study quality was determined by the RoB 2 tool, and effect estimates were evaluated using the Best Evidence Synthesis approach. Twenty-six reports from 14 trials (one non-randomized controlled trial) conducted during (n = 5) and after treatment (after surgery: n = 2; after other treatments: n = 7) were included. Low-level evidence emerged to support the benefits of 40-60 min of thrice-weekly supervised Tai Chi for 8-12 weeks to improve fatigue and sleep quality in cancer survivors. These findings need to be confirmed in larger trials and tested for scaling-up potential. Insufficient evidence was available to evaluate the effects of Tai Chi on other cancer-related outcomes. Future research should examine whether Tai Chi training can improve a broader range of cancer outcomes including during the pre-treatment and end of life phases.

Effectiveness of nonpharmacological interventions for reducing postpartum fatigue: a meta-analysis.

BACKGROUND: Postpartum fatigue is the most common issue among postnatal women and it could not only seriously affect the health of mothers but also bring about adverse impacts on their offspring. This meta-analysis aims to synthesize nonpharmacological evidence and evaluate the effectiveness of interventions for reducing postpartum fatigue among puerperae. METHODS: The Cochrane Library, PubMed, Embase, Web of Science, PsycINFO, CINAHL and ProQuest databases were searched for papers published from inception until June 2021. Grey literature was searched using OpenGrey. Randomized controlled trials (RCTs) or controlled clinical trials (CCTs) evaluating nonpharmacological interventions conducted during 0 ~ 78 weeks postpartum for fatigue reduction were eligible for inclusion. The methodological quality of the included studies was independently assessed by two reviewers using the Cochrane risk-of-bias tool and the risk of bias in nonrandomized studies of interventions. Cohen's kappa coefficient was used to measure inter-rater agreement. The meta-analysis was conducted using Review Manager 5.3. RESULTS: Seventeen published clinical trials matched the eligibility criteria and ten studies involving 1194 participants were included in this meta-analysis. The intervention start time varied from immediately postpartum care to 1 year after delivery, and duration ranged from 1 day to 3 months. The results revealed that exercise (SMD = - 1.74, 95% CI = -2.61 to - 0.88) and drinking tea (MD = - 3.12, 95% CI = -5.44 to - 0.80) resulted in significant improvements in women's postpartum fatigue at postintervention. Drinking tea may have beneficial effects on depression (MD = - 2.89, 95% CI = -4.30 to - 1.49). Positive effects of psychoeducational interventions on postpartum fatigue or depression were not observed. Physical therapies including mother-infant skin-to-skin contact, taking warm showers and breathing lavender oil aroma were used for reducing postpartum fatigue. No significant risk of publication bias was found. Small number of included studies and sample sizes, not time-matched conditions of control groups, high heterogeneity and the risk of bias within the included studies were the main limitations of our review. CONCLUSIONS: This review provides evidence that exercise and drinking tea may be effective nonpharmacological interventions for relieving postpartum fatigue. More effective and targeted exercise programs need to be further studied. Rigorous RCTs of drinking tea are needed. Caution is required when interpreting the findings due to the limitations of our study. Further studies are still needed to validate our findings and increase confidence in the results.

Guided imagery relaxation in quality of life of patients undergoing hematopoietic stem cell transplantation: a quasi-experiment.

OBJECTIVE: The aim of this study was to evaluate the effects of the relaxation technique with guided imagery by means of virtual reality on health-related quality of life in patients undergoing hematopoietic stem cell transplantation. METHODS: A quasi-experiment conducted in a Bone Marrow Transplantation Service of a public hospital in southern Brazil. From October 2019 to October 2020, forty-two adult participants who underwent transplantation were included, 35 in the intervention group and seven in the control group. A guided imagery intervention, with audio guiding the relaxation associated with nature images in 360º, was performed during the hospitalization period. Data were collected on the first day of hospitalization, on the transplantation day, during the neutropenia stage, and at pre-hospital discharge. The Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) and Functional Assessment of Cancer Therapy-Neutropenia (FACT-N) were used to assess health-related quality of life, fatigue and neutropenia. Data were analyzed using the Generalized Linear Mixed Model for the evolution of the health-related quality of life assessments over time, considering the groups and stages. Pearson's correlation coefficient was adopted for the correlation analyses. RESULTS: Allogeneic transplantation was predominant: 28 (80%) in the intervention group and 5 (71.43%) in the control group. There were improvements in the health-related quality of life scores, although not significant. A significant difference was found among the stages (p <0.050) and a significant positive correlation (p <0.000) among the variables on general quality of life, additional concerns, fatigue and neutropenia in all stages. CONCLUSION: Patients undergoing hematopoietic stem cell transplantation suffer changes in their quality of life. Interventions based on integrative practices emerge as an option to minimize them. 
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Reducing fatigue in pediatric rheumatic conditions: a systematic review.

BACKGROUND: Although fatigue is a prevalent distressing symptom in children and adolescents with Pediatric Rheumatic Conditions (PRCs), intervention studies designed for reducing fatigue in PRCs are limited. AIM: To systematically review evidence regarding the efficacy of interventions intended to reduce fatigue in patients with PRCs. METHODS: Comprehensive electronic searches were performed in PubMed/ MEDLINE, Embase, Web of Science and Cinahl. The risk of bias was assessed using the 'Revised Cochrane risk-of-bias tool for randomized trials' and 'Quality Assessment Tool for Before-After Studies With No Control Group' for respectively studies with and without a control group. RESULTS: Ten out of 418 studies were included with a total of 240 participants (age range 5-23 years). Interventions included land-based and aquatic-based exercise therapy, prednisolone, vitamin-D and creatine supplementation, psychological therapy and a transition program into an adult rheumatology program. Fatigue was assessed with self-reported questionnaires in all included studies. Land-based exercise therapy was effective in one pre-post intervention study, whereas not effective in two randomized controlled trials. Aquatic-based exercise therapy was found more effective than land-based exercise therapy. Two placebo-controlled studies showed a significant positive effect in reducing subjective fatigue with prednisolone and vitamin-D. Creatine was not found effective. Cognitive therapy was effective in one pre-post intervention study, while one RCT did not show an effect in reducing fatigue. A transition program based on health education showed a small reducing effect, however, it was not clear if this was a significant effect. Six studies showed a high risk of bias, three studies a moderate risk, and one study had a low risk of bias. CONCLUSIONS: Insufficient evidence is provided to substantiate the efficacy of current interventions to reduce fatigue in PRCs. The low number of studies, non-comparable interventions, risk of bias, and inconclusive outcomes of the included studies denote future research should focus on intervention studies aimed at the treatment of fatigue in children and adolescents with PRCs. Identification of possible underlying biological and psychosocial mechanisms as possible treatment targets to reduce complaints of fatigue in children and adolescents with PRCs is warranted.

Reduced Self-Perception of Fatigue after Intake of Panax ginseng Root Extract (G115®) Formulated with Vitamins and Minerals-An Open-Label Study.

BACKGROUND: Unexplained fatigue is a common complaint. When underlying disease causes have been eliminated, lifestyle measures and supplementation can be indicated. Elaborating on clinical findings that G115®, a dry extract from the root of Panax ginseng, combined with vitamins and minerals could alleviate fatigue, this open label study aimed at assessing its effect on perceived fatigue and energy. METHODS: Healthy adults self-reporting fatigue (n = 103) completed the Multidimensional Fatigue Inventory questionnaire. They rated their perceptions of mental and physical fatigue, energy, performance, and stress at baseline and 15, 30, 60 and 90 days after a daily intake of 40 mg G115® formulated with vitamins and minerals. RESULTS: Compared with baseline values, mean self-perception of general fatigue was reduced by -7.55 units [95% CI: -8.44; -6.66] (-41.8%, p < 0.0001) at 90 days. All assessed perception ratings (mental and physical fatigue, reduced activity and motivation, performance, and stress) were significantly and steadily improved from two weeks after supplementation up to study's end. Overall satisfaction with the ability of the product to reduce fatigue reached 85% at Day 90. CONCLUSION: Daily intake with G115® extract formulated with vitamins and minerals suggests an improvement of self-perception of fatigue and energy in a fatigued adult population.

The effects of spirulina (Arthrospira platensis) supplementation on anthropometric indices, blood pressure, sleep quality, mental health, fatigue status and quality of life in patients with ulcerative colitis: A randomised, double-blinded, placebo-controlled trial.

BACKGROUND: An emerging body of evidence has highlighted the protective role of spirulina in human health. Thus, we conducted a randomised controlled trial to discern the effects of spirulina supplementation on anthropometric indices, blood pressure, sleep quality, mood, fatigue status and quality of life among ulcerative colitis patients. METHODS: Eighty participants with ulcerative colitis were randomly allocated to receive, either, 1 g/day (two 500 mg capsules) spirulina (n = 40) or placebo (n = 40), in a clinical trial for eight weeks. Dietary intake, physical activity, sleep quality, mental health, fatigue status and quality of life were assessed for each participant at baseline and trial cessation. Anthropometric indices and blood pressure were also assessed. RESULTS: Seventy-three participants completed the intervention. Our results revealed that spirulina supplementation significantly reduced sleep disturbances (P = .03), while no significant changes occurred in the sleep quality score or other sleep parameters, vs the placebo group (P > .05). Furthermore, a significant reduction in stress score (P = .04) and increase in quality of life (P = .03) was detected; but not anxiety, depression or fatigue scores (P > .05). Additionally, anthropometric indices and blood pressure did not significantly change (P > .05). CONCLUSION: An improved quality of life was observed among ulcerative colitis patients following spirulina supplementation, which could be attributed to improved sleep disturbance and stress status. Further clinical studies, with longer duration interventions and suitably powered sample sizes, are necessary to elucidate the veracity of our findings.

The curative effect of traditional chinese medicine compounded medications in relieving racewalking fatigue / O efeito curativo dos medicamentos manipulados da medicina chinesa tradicional para aliviar a fadiga da marcha atlética / Observación del efecto curativo del compuesto de medicina tradicional china para aliviar la fatiga de la carrera

ABSTRACT Racewalking fatigue is a kind of fatigue symptom after a period of racewalking, which may lead to limb weakness, mental fatigue, muscle fatigue and other phenomena. If we do not timely adjust the stretching and effective treatment after exercise, it is very easy to produce sports injury and seriously affect the athletes' physical function. In order to effectively alleviate the fatigue of racewalking, this study focused on the traditional Chinese medicine (TCM) compounded medication, analyzed the mechanism of action and medicinal effectiveness of the TCM compound, and carried out control experiment on 80 male ICR mice. The mice in the experimental group were given sedentary training and racewalking training in groups. The results showed that the two groups of ICR mice, after racewalking training, had exercise fatigue symptoms and a large amount of serum lactic acid and other substances, while mice in group D treated by gavage of traditional Chinese medicine compounded medication had the symptoms of exercise fatigue, but the contents of blood urea nitrogen and lactic acid were decreased, the gastrocnemius muscle fibers were evenly arranged, the transverse lines were neat, and a rebound of protein expression. This shows that Chinese medicine compound can play a significant role in relieving racewalking fatigue.

RESUMO A fadiga causada pela marcha atlética é um tipo de sintoma que acomete os atletas após um período de prática do exercício, que pode ocasionar fraqueza dos membros, fadiga mental, fadiga muscular e outros fenômenos. Na ausência de alongamento e tratamento eficaz após o exercício, as lesões causadas pelo esporte podem afetar seriamente a função física dos atletas. A fim de aliviar de maneira eficaz a fadiga causada pela marcha atlética, o presente estudo se concentrou nos medicamentos manipulados na medicina tradicional chinesa (MTC), analisou o mecanismo de ação e eficácia medicinal dos medicamentos da MTC, e realizou experimentos de controle em 80 camundongos do tipo ICR masculinos. Os camundongos do grupo experimental receberam treinamento sedentário e treinamento de corrida em grupo. Os resultados mostraram que os dois grupos de camundongos ICR, após treino de marcha atlética, apresentavam sintomas de fadiga, e grande quantidade de ácido láctico sérico, além de outras substâncias, enquanto os camundongos do grupo D tratados com gavagem do medicamento manipulado tiveram sintomas de fadiga, mas com redução do teor sanguíneo de ureia e ácido láctico, fibras musculares gastrocnêmias uniformemente arranjadas, linhas transversais regulares, e efeito rebote da expressão proteica. Isto mostra que os medicamentos manipulados da medicina chinesa podem desempenhar um papel significativo no alívio da fadiga causada pela marcha atlética.

RESUMEN La fatiga causada por la marcha atlética es un tipo de síntoma que afecta los atletas después de un período de práctica del ejercicio, que puede ocasionar debilidad de los miembros, fatiga mental, fatiga muscular y otros fenómenos. En ausencia de elongación y tratamiento eficaz después del ejercicio, las lesiones causadas por el deporte pueden afectar seriamente la función física de los atletas. A fin de aliviar de manera eficaz la fatiga causada por la marcha atlética, el presente estudio se concentró en los medicamentos manipulados en la medicina tradicional china (MTC), analizó el mecanismo de acción y eficacia medicinal de los medicamentos da MTC, y realizó experimentos de control en 80 ratones del tipo ICR masculinos. Los ratones del grupo experimental recibieron entrenamiento sedentario y entrenamiento de carrera en grupo. Los resultados mostraron que los dos grupos de ratones ICR, después de entrenamiento de marcha atlética, presentaban síntomas de fatiga, y gran cantidad de ácido láctico sérico, además de otras sustancias, mientras que los ratones del grupo D tratados con gavaje del medicamento manipulado tuvieron síntomas de fatiga, pero con reducción del tenor sanguíneo de urea y ácido láctico, fibras musculares del gastrocnemio uniformemente arregladas, líneas transversales regulares, y efecto rebote de la expresión proteica. Esto muestra que los medicamentos manipulados de la medicina china pueden desempeñar un papel significativo en el alivio de la fatiga causada por la marcha atlética.

The mechanism and prevention of mitochondrial injury after exercise.

With the development of society, physical activity has come to be an effective means by which people pursue good health to improve the quality of life. However, with the increase of intensity and the passage of time, exercise injury has become a hazard that can no longer be ignored. It is imperative to find effective ways to inhibit or reduce the negative effects of exercise. Mitochondria are important organelles involved in exercise and play an important role in exercise injury and prevention. Studies have found that exercise preconditioning and increased mitochondrial nutrition can effectively decrease mitochondrial damage after exercise. Against this background, some of the newest developments in this important field are reviewed here. The results discussed indicate that exercise preconditioning and supplement mitochondrial nutrition need to be increased to prevent exercise-related injuries.

Traditional Chinese medicine auricular point acupressure for the relief of pain, fatigue, and gastrointestinal adverse reactions after the injection of novel coronavirus-19 vaccines: a structured summary of a study protocol for a multicentre, three-arm, single-blind, prospective randomized controlled trial.

OBJECTIVES: To investigate if traditional Chinese medicine (TCM) auricular point acupressure (APA) can alleviate and (or) reduce the pain (including injection site pain, headache, other muscle and joint pain), fatigue, and gastrointestinal adverse reactions (including nausea, vomiting, diarrhea), after the injection of novel coronavirus-19 vaccines (NCVs). TRIAL DESIGN: The study is designed as a multicentre, parallel-group, three-arm, single-blind, prospective, randomized (1:1:1 ratio) study. PARTICIPANTS: More than 360 participants will be recruited from healthy people who vaccinate NCVs in 5 community healthcare centres in the Sichuan province of China and 1 university hospital (Hospital of Chengdu University of Traditional Chinese Medicine). INCLUSION CRITERIA: ①Vaccinators meets the conditions of NCVs injection and have no contraindications to it. The details shall be subject to the instructions of the NCVs used and the statement of medical institutions. The first dose of NCVs injection shall be completed within 24 hours from the time of injection to the time of enrolment; ②No redness, swelling, injury or infection of the skin or soft tissue of both ears, which is not suitable for APA; ③No history of alcohol and adhesive tape contact allergy; ④18-59 years old, regardless of gender; ⑤Those who were able to complete the questionnaire independently at the time of the first and second dose of NCVs and on the 3rd, 7th and 15th day after the first and second dose of NCVs respectively; ⑥Those who agree to participate in the trial and sign the informed consent, and can seriously abide by the precautions after the injection of NCVs and the requirements of traditional Chinese medicine auricular point plasters sticking and acupressure. EXCLUSION CRITERIA: ①Those who are not suitable to be vaccinated because they belong to the contraindication or cautious population; ②Those who have participated in other clinical trials within 4 weeks before the start of this study; ③No chronic/habitual/persistent headache, Muscle or joint pain, fatigue, diarrhea, nausea, retching or vomiting before the injection of NCVs, and no related diseases present (details of this item is listed in full protocol); ④Those who are in use or have received TCMAPA within 2 weeks before the trial; ⑤Pregnant or lactating women; ⑥Participants with other serious primary diseases and psychosis. INTERVENTION AND COMPARATOR: ①Auricular point acupressure group: participants receive bilateral, symptom-specific TCMAPA in 5 auricular points (per side, 10 points bilateral) for 5 days, 3-4 times (about 1 min each time) of self-acupressure per day, after each NCVs injection (10 days in total). ②Sham auricular point acupressure group: participants receive bilateral, none symptom-specific, sham APA in 5 auricular points (per side, 10 points bilateral) for 5 days, 3-4 times (about 1 min each time) of self-acupressure per day, after each NCVs injection (10 days in total). ③Blank control group: Non-intervention blank control. The Hebei medical device Co. Ltd, Hebei, China manufactured the auricular point sticking plasters. MAIN OUTCOMES: Primary outcomes are all scores of visual analogue scale (VAS) based on subjective judgment of the participants included, including VAS score of pain at injection site, headache, muscle and joint pain, fatigue, nausea, retching, vomiting and diarrhea. Time points for outcomes above are the same: ①Immediately after first and second injection of the vaccine (Baseline assessment); ②Three days after first and second injection of the vaccine; ③Seven days after first and second injection of the vaccine; ④Fifteen days after first and second injection of the vaccine. RANDOMISATION: Participants will be randomized in 1:1:1 ratio to each group by computerized random number generator, and independently in each sub-centre. BLINDING (MASKING): Participants, information collectors and statistical evaluators will be blinded between APA group and sham APA group. No blinding in the control group. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): No less than 360 participants will be randomized in 1:1:1 ratio to each group. TRIAL STATUS: Protocol version 2.0 of February 3rd, 2021. Recruitment is expected to start on February 18th, 2021, and to finish on March 12th, 2021. TRIAL REGISTRATION: This trial was registered in the China Clinical Trial Registry (ChiCTR) ( ChiCTR2100043210 ) on 8th February, 2021. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.

Osteopathic Manipulative Treatment and Cardiovascular Autonomic Parameters in Rugby Players: A Randomized, Sham-Controlled Trial.

OBJECTIVE: The purpose of this study was to investigate the effects of osteopathic manipulative treatment (OMT) on cardiovascular autonomic parameters after a rugby match. METHODS: Resting and reactivity (ie, response to orthostasis) measures of mean arterial pressure, heart rate, and heart rate variability were assessed in 23 male players after a single session of OMT, both 18 to 20 hours after a rugby match and in a corresponding no-match condition, in a randomized, sham-controlled, crossover design. RESULTS: Signs of reduced heart rate variability and elevated mean arterial pressure and heart rate were found 18 to 20 hours after a rugby match compared with the no-match condition. A significant increase in heart rate variability and a significant reduction in mean arterial pressure were observed after OMT in both the after-match and no-match conditions. Heart rate and heart rate variability responses to orthostasis were not affected by previous match competition, but were significantly larger after OMT compared with sham treatment. CONCLUSION: This study suggests the presence of cardiovascular autonomic alterations in rugby players after a competitive match, which may be indicative of prolonged fatigue and incomplete recovery. In these players, favorable changes in cardiovascular autonomic parameters were observed following a single session of OMT.