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1.
Clin Transplant ; 35(9): e14426, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-34269480

RESUMEN

Addressing racial disparities in living donor kidney transplants (LDKT) among Black patients warrants innovative programs to improve living donation rates. The Living Organ Video Educated Donors (LOVED) program is a 2-arm, culturally-tailored, distance-based, randomized controlled feasibility trial. The group-based, 8-week program used peer-navigator led video chat sessions and web-app video education for Black kidney waitlisted patients from United States southeastern state. Primary feasibility results for LOVED (n = 24) and usual care (n = 24) arms included LOVED program tolerability (i.e., 95.8% retention), program fidelity (i.e., 78.9% video education adherence and 72.1% video chat adherence). LDKT attitudinal and knowledge results favored the LOVED group where a statistically significant effect was reported over 6-months for willingness to approach strangers (estimate ± SE: -1.0 ± .55, F(1, 45.3) = 7.5, P = .009) and self-efficacy to advocate for a LDKT -.81 ± .31, F(1, 45.9) = 15.2, P < .001. Estimates were improved but not statistically significant for willingness to approach family and friends, LDKT knowledge and concerns for living donors (all P's > .088). Secondary measures at 6 months showed an increase in calls for LOVED compared to usual care (P = .008) though no differences were found for transplant center evaluations or LDKTs. Findings imply that LOVED increased screening calls and attitudes to approach potential donors but feasibility outcomes found program materials require modification to increase adherence.


Asunto(s)
Donadores Vivos , Listas de Espera , Negro o Afroamericano , Estudios de Factibilidad , Humanos , Riñón , Estados Unidos
2.
Prog Transplant ; 25(1): 26-34, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25758797

RESUMEN

CONTEXT: Dialysis patients' lifestyles are associated with low levels of physical activity, increasing the chances of being removed from kidney waiting lists or dying while awaiting transplant because of increased cardiovascular risk factors and deteriorating health conditions. Personalized mobile health (mHealth) delivered programs may support their engagement in healthier lifestyles, maintain transplant eligibility, and reduce premature mortality. OBJECTIVE: To explore barriers and perceptions of physical activity behaviors and gauge interest in using mHealth in a physical activity wellness program for dialysis patients on the kidney transplant waiting list. PARTICIPANTS AND DESIGN: In-depth key informant interviews were conducted with 22 randomly selected dialysis patients during dialysis treatment in an urban Southeastern coastal city. A theory-guided community-based participatory research approach was used to develop the interview content. Constructivist grounded theory guided the data analysis using NVIVO 10 (QSR Int). The 32-item checklist from the Consolidated Criteria for Reporting Qualitative Studies was used in the qualitative reporting. RESULTS: Dialysis patients had a mean age of 46 (SD, 10.7) years, 45% were female, and 82% were African American. Their mean duration on transplant waiting lists was 6.7 (SD 4.3) years, and 73% owned smartphones. After saturation was reached, predominant themes included (1) physical activity was perceived as optional, (2) social support both encouraged and limited physical activity, (3) chronic stress and coping influenced physical activity, (4) spirituality provided strength to engage in physical activity, (5) self-care management practices varied considerably, and (6) high interest (95%) for using mHealth to promote physical activity was found. Patients preferred their home and neighborhood environments to intradialytic settings for engaging in physical activity.


Asunto(s)
Actitud hacia los Computadores , Actitud Frente a la Salud , Teléfono Celular , Ejercicio Físico , Trasplante de Riñón/psicología , Trasplante de Riñón/rehabilitación , Listas de Espera , Actitud Frente a la Muerte , Lista de Verificación , Investigación Participativa Basada en la Comunidad , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Calidad de Vida , Diálisis Renal , Factores de Riesgo , Autocuidado , Determinantes Sociales de la Salud , Apoyo Social , Estrés Psicológico
3.
Prog Transplant ; 25(2): 164-75, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26107278

RESUMEN

CONTEXT: The increasing shortage of deceased donor kidneys suitable for African Americans highlights the critical need to increase living donations among African Americans. Little research has addressed African American transplant recipients' perspectives on challenges and barriers related to the living donation process. OBJECTIVE: To understand the perspectives of African American recipients of deceased and living donor kidney transplants on challenges, barriers, and educational needs related to pursuing such transplants. PARTICIPANTS AND DESIGN: A mixed-method design involved 27 African American kidney recipients (13 male) in 4 focus groups (2 per recipient type: 16 African American deceased donor and 11 living donor recipients) and questionnaires. Focus group transcripts were evaluated with NVivo 10.0 (QSR, International) by using inductive and deductive qualitative methods along with crystallization to develop themes of underlying barriers to the living donor kidney transplant process and were compared with the questionnaires. RESULTS: Four main themes were identified from groups: concerns, knowledge and learning, expectations of support, and communication. Many concerns for the donor were identified (eg, process too difficult, financial burden, effect on relationships). A general lack of knowledge about the donor process and lack of behavioral skills on how to approach others was noted. The latter was especially evident among deceased donor recipients. Findings from the questionnaires on myths and perceptions supported the lack of knowledge in a variety of domains, including donors' surgical outcomes risks, costs of surgery, and impact on future health. Participants thought that an educational program led by an African American recipient of a living donor kidney transplant, including practice in approaching others, would increase the likelihood of transplant-eligible patients pursuing living donor kidney transplant.


Asunto(s)
Negro o Afroamericano/psicología , Conocimientos, Actitudes y Práctica en Salud/etnología , Fallo Renal Crónico/cirugía , Trasplante de Riñón/psicología , Donadores Vivos/psicología , Obtención de Tejidos y Órganos , Adulto , Actitud Frente a la Salud , Femenino , Grupos Focales , Humanos , Donadores Vivos/educación , Masculino , Persona de Mediana Edad , Educación del Paciente como Asunto , Encuestas y Cuestionarios , Estados Unidos/epidemiología
5.
J Sports Sci Med ; 11(1): 57-63, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-24149122

RESUMEN

UNLABELLED: This study was performed to assess the validity of the MyWellness Key (MWK) accelerometer during a treadmill-based protocol. The identification of different exercise intensities is imperative to objectively measure time spent at a specified exercise intensity. Thirty subjects, 15 men and 15 women (age = 24.5 ± 2.6 years; body mass index = 22.5 ± 2.5 kg·m(-1)), participated in a 4-phase treadmill protocol (5 minutes each one) using three different walking velocities (3, 4.5, and 6 km·h(-1)) and run (8 km·h(-1)) while outfitted with a MWK uniaxial accelerometer. Oxygen consumption was measured by indirect calorimetry (ICVO2). RESULTS: The relationship between VO2 predicted from MWK (MWKVO2) and oxygen consumption (VO2 (ICVO2)), yielded a high and significant correlation (r = 0. 944; p < 0.001) with standard error of estimate (SEE) = 2.42 mL·kg(-1)·min(-1). The average differences between the two methods (MWKVO2 - ICVO2) were -0.79 (-8. 8% at 3 km·h(-1)), -0.02 (-0.2% at 4.5 km·h(-1)), 0.51 (3.3% at 6 km·h(-1)) and -0.74 (-2.7% at 8 km·h(-1)) ml·kg(-1)·min(-1). Only the 3 km·h(-1) speed showed a difference when compared to the criterion measure (p < 0.001). Bland and Altman analysis revealed less than a 1 MET difference in the mean at each point estimate and relatively tight distribution with the standard errors, especially with the 2 moderate walking speeds. CONCLUSIONS: We found a high correlation between oxygen utilization and the MWK with low standard errors estimates. This indicates that this accelerometer can be used to identify exercise intensities that are related to walking and running. Key pointsFirst laboratory validation of a new uniaxial accelerometer, the MyWellness Key.Results indicate a good exercise intensity prediction during walking at moderate to high speeds.Comparing with other laboratory validations, MyWellness Key exercise intensity detection is aligned with other accelerometers.MyWellness Key can be used to give valid measurements for a range of ambulatory activity in addition to the capabilities to give real-time feedback to the participant in health promotion studies.

6.
Phys Sportsmed ; 39(2): 119-26, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21673492

RESUMEN

INTRODUCTION: Recent studies have demonstrated that physical activity (PA) and cardiorespiratory fitness (CRF) are independent predictors of stroke in men. The combined associations of these 2 factors are not well established. OBJECTIVE: To investigate the independent and joint associations of PA and CRF with fatal, nonfatal, and total stroke in a group of men. METHODS: The current analyses included 45 689 men aged 18 to 100 years who completed baseline sessions between 1970 and 2001. All participants had no known myocardial infarction, stroke, or cancer. Physical activity was measured by questionnaire, and CRF was assessed from a maximal treadmill exercise test. The National Death Index for fatal stroke and mail-back surveys for nonfatal stroke were used to ascertain cases. Cox regression analyses were used to estimate the risk of stroke outcomes. RESULTS: There were 619 cases over 800 582 person-years of observation. Significant inverse associations were observed between CRF and fatal, nonfatal, and total strokes after adjustment for age and examination year (P for trend < 0.05 for each). No associations were found between PA and any of the 3 outcomes after adjusting for other covariates and CRF. Joint associations of 9 PA fitness groups showed less risk for total stroke in the moderate and high fitness categories. CONCLUSION: These findings suggest that CRF is an independent predictor of incident stroke in asymptomatic men.


Asunto(s)
Actividad Motora , Aptitud Física , Rehabilitación de Accidente Cerebrovascular , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Prueba de Esfuerzo , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Estudios Prospectivos , Factores de Riesgo , Accidente Cerebrovascular/mortalidad , Accidente Cerebrovascular/fisiopatología , Encuestas y Cuestionarios , Adulto Joven
7.
Artículo en Inglés | MEDLINE | ID: mdl-34443991

RESUMEN

Marked racial disparities exist in rates of living donor kidney transplantation (LDKT). The Living Organ Video Educated Donors (LOVED) program is a distance-based, mobile health program designed to help Black kidney transplant wait-list patients advocate for a living donor. This study reported on the acceptability outcomes to aid in future refinements. Participants were randomized to LOVED (n = 24, mean age = 50.9 SD (9.2) years), male = 50%) and usual care groups (n = 24 (mean age 47.9 SD (10.0), male 50%). Four LOVED groups completed an eight-week intervention that consisted of six online video education modules and eight group video chat sessions led by a Black navigator. Qualitative analysis from post-study focus groups resulted in six themes: (1) video chat sessions provided essential support and encouragement, (2) videos motivated and made participants more knowledgeable, (3) connectivity with tablets was acceptable in most areas, (4) material was culturally sensitive, (5) participation was overall a positive experience and (6) participants were more willing to ask for a kidney now. The video chat sessions were pertinent in participant satisfaction, though technology concerns limited program implementation. Results showed that the LOVED program was acceptable to engage minorities in health behavior changes for living donor advocacy but barriers exist that require future refinement.


Asunto(s)
Trasplante de Riñón , Telemedicina , Humanos , Donadores Vivos , Masculino , Persona de Mediana Edad , Grupos Raciales , Listas de Espera
8.
Br J Sports Med ; 44(4): 238-44, 2010 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-19656767

RESUMEN

OBJECTIVE: To assess the independent and joint associations between self-reported physical activity (PA) and objectively measured cardiorespiratory fitness (CRF) from a maximal treadmill exercise test and the development of type 2 diabetes mellitus in a large cohort of men. METHODS: Participants for the current analysis were 23 444 men aged 20-85 years free of cardiovascular disease (CVD), cancer or diabetes at baseline. Incident diabetes were identified from mail-back surveys. Cox regression analysis was used to estimate hazard ratios (HRs), 95% confidence intervals (CIs) and diabetes incidence rates (per 10 000 man-years) according to exposure categories. RESULTS: During an average of 18 years of follow-up, 589 incident cases of diabetes were identified. After adjusting for age, examination year, survey response pattern, body mass index, smoking, drinking, fasting glucose, chronic diseases and family history of CVD or diabetes, the walking/jogging/running (WJR) and sport/fitness groups had a 40% and 28% lower risk of developing diabetes compared with the sedentary men, respectively (both p < 0.05). For CRF, diabetes incidence rates were 31.9, 14.5 and 6.5 for low-, moderate- and high-fitness groups, respectively. After adjustment for the above covariables, moderate and high CRF had a 38% and 63% lower risk of developing diabetes compared with the low CRF group (p trend<0.0001). CONCLUSION: Our findings showed a lower risk of developing diabetes for men who participated in a WJR programme or sport/fitness activity, compared with those who were sedentary. Higher levels of fitness were associated with an inverse gradient of incident diabetes.


Asunto(s)
Fenómenos Fisiológicos Cardiovasculares , Diabetes Mellitus Tipo 2/prevención & control , Ejercicio Físico/fisiología , Aptitud Física/fisiología , Fenómenos Fisiológicos Respiratorios , Adulto , Anciano , Anciano de 80 o más Años , Diabetes Mellitus Tipo 2/epidemiología , Prueba de Esfuerzo , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto Joven
9.
JMIR Form Res ; 4(10): e20501, 2020 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-33021484

RESUMEN

BACKGROUND: African Americans (AAs) experience greater sleep quality problems than non-Hispanic Whites (NHWs). Meditation may aid in addressing this disparity, although the dosage levels needed to achieve such benefits have not been adequately studied. Smartphone apps present a novel modality for delivering, monitoring, and measuring adherence to meditation protocols. OBJECTIVE: This 6-month dose-response feasibility trial investigated the effects of a breathing awareness meditation (BAM) app, Tension Tamer, on the secondary outcomes of self-reported and actigraphy measures of sleep quality and the modulating effects of ethnicity of AAs and NHWs. METHODS: A total of 64 prehypertensive adults (systolic blood pressure <139 mm Hg; 31 AAs and 33 NHWs) were randomized into 3 different Tension Tamer dosage conditions (5,10, or 15 min twice daily). Sleep quality was assessed at baseline and at 1, 3, and 6 months using the Pittsburgh Sleep Quality Index (PSQI) and 1-week bouts of continuous wrist actigraphy monitoring. The study was conducted between August 2014 and October 2016 (IRB #Pro00020894). RESULTS: At baseline, PSQI and actigraphy data indicated that AAs had shorter sleep duration, greater sleep disturbance, poorer efficiency, and worse quality of sleep (range P=.03 to P<.001). Longitudinal generalized linear mixed modeling revealed a dose effect modulated by ethnicity (P=.01). Multimethod assessment showed a consistent pattern of NHWs exhibiting the most favorable responses to the 5-min dose; they reported greater improvements in sleep efficiency and quality as well as the PSQI global value than with the 10-min and 15-min doses (range P=.04 to P<.001). Actigraphy findings revealed a consistent, but not statistically significant, pattern in the 5-min group, showing lower fragmentation, longer sleep duration, and higher efficiency than the other 2 dosage conditions. Among AAs, actigraphy indicated lower sleep fragmentation with the 5-min dose compared with the 10-min and 15-min doses (P=.03 and P<.001, respectively). The 10-min dose showed longer sleep duration than the 5-min and 15-min doses (P=.02 and P<.001, respectively). The 5-min dose also exhibited significantly longer average sleep than the 15-min dose (P=.03). CONCLUSIONS: These findings indicate the need for further study of the potential modulating influence of ethnicity on the impact of BAM on sleep indices and user-centered exploration to ascertain the potential merits of refining the Tension Tamer app with attention to cultural tailoring among AAs and NHWs with pre-existing sleep complaints.

10.
Transplant Direct ; 4(6): e357, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30123830

RESUMEN

BACKGROUND: The purpose of the Living Organ Video Educated Donors (LOVED) program is to address living donor kidney transplantation (LDKT) disparities in African Americans who experience half the rates of LDKTs compared with whites in the United States. METHODS: LOVED is an iterative-designed, distance-based, navigator-led, mobile health educational program, developed via guidance from patients, Self-determination Theory and Social Cognitive Theory. The purpose of this study was to assess the feasibility of LOVED using a proof-of-concept design to increase African Americans' knowledge about the living donor process to improve their willingness to approach others about being a potential kidney donor. The 8-week LOVED program consisted of (1) a computer tablet-delivered education program, (2) group video chat sessions with an African American LDKT recipient navigator, and (3) additional communication between group members and the navigator. RESULTS: Twenty-five participants completed the LOVED study. Poststudy focus groups were analyzed using inductive and deductive qualitative descriptive techniques and analysts found 6 themes reporting LOVED being highly acceptable with the program being overall empowering and helpful. The study had 0% attrition, 90.9% adherence to the education videos and 88% adherence to the video chat sessions. Surveys showed statistically significant improvements in LDKT knowledge, higher willingness to communicate to others about their need, lower donor concerns, and higher self-efficacy about LDKT. CONCLUSIONS: Findings indicate that participation in LOVED can lead to improvements in predictors to increase the number of evaluations and LDKTs in African Americans; however, these findings need to be confirmed in adequately powered, randomized controlled trials. Using LOVED may reduce barriers to broadly address LDKT disparities. Findings from this study will inform the design of a future statewide randomized controlled trials.

11.
Health Psychol ; 37(9): 850-860, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30010353

RESUMEN

OBJECTIVE: Essential hypertension (EH) is the most common chronic disease in the United States and a major cause of morbidity and mortality. Lifestyle interventions (e.g., diet, exercise, stress management) to reduce blood pressure (BP) are often complex with varying effectiveness. Breathing awareness meditation (BAM) is a stress management strategy with encouraging effects on BP, though widespread dissemination is hampered by the lack of an easy-to-use methodology to train and monitor BAM practices. A smartphone application (Tension Tamer [TT]) that implements BAM and tracks adherence has shown promise in addressing these gaps. This 6-month dose-response feasibility trial evaluated effects of the app on BP to further optimize BAM user guidelines. METHODS: Sixty-four adults with prehypertension were randomized to complete TT-guided BAM sessions for 5-, 10-, or 15-min intervals twice daily over 6 months. Continuous heart rate readings derived from the phone's video camera via reflective photoplethysmography were used as feedback and as an index of time-stamped adherence. Outcomes (resting BP, HR) were collected at baseline, 1-, 3-, and 6-months. RESULTS: Mixed modeling results showed a significant time effect for systolic BP (SBP) with a dose-response effect at Months 3 and 6. Adherence declined over time and was lowest in the 15-min dose condition, though SBP reductions were maintained. Generally, adherence was negatively associated with dose as the study progressed. CONCLUSIONS: Smartphone-implemented BAM appears to reduce SBP and can be a low-cost method to reach large populations. (PsycINFO Database Record


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial/métodos , Presión Sanguínea/fisiología , Meditación/métodos , Prehipertensión/fisiopatología , Teléfono Inteligente/estadística & datos numéricos , Adulto , Estudios de Factibilidad , Femenino , Humanos , Masculino
12.
Mhealth ; 3: 44, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29184896

RESUMEN

BACKGROUND: Chronic stress is an independent risk factor for essential hypertension (EH), cardiovascular disease (CVD), and is sometimes confronted by mal-adaptive coping behaviors (e.g., stress eating, excessive alcohol consumption, etc.). Pre-essential hypertension (preEH) is the leading predictor of future EH status. Breathing awareness meditation (BAM) can result in clinically beneficial blood pressure (BP) reductions, though face-to-face sessions presents barriers to reach those in need. The purpose of this study was to identify if a culturally tailored approach is needed in the design and preferences between groups of preEH African American and White adults toward using a smartphone BAM app, the Tension Tamer (TT) app. METHODS: TT includes audio delivered BAM instructions, real-time heart rate, feedback graphs and motivational reinforcement text messaging. Questionnaires and two focus groups each of African American and White adults, [n=34, mean age =43.1 years, (SD 13.8 years), 44.1% African American] were conducted to understand stress, EH knowledge, app usage along with feedback from a hands-on demonstration of TT. Grounded theory using NVivo 10 was used to develop themes and combined with the questionnaires in the analysis. RESULTS: No racial differences were found in the analysis including app use scenarios, preferences, knowledge, technology use or the attitudes and acceptance toward mobile health (mHealth) programs. Reported stress was high for African Americans [PSS-4: mean 6.87 (SD 3.3) versus mean 4.56 (SD 2.6); P=0.03]. Four main themes were found: (I) stress was pervasive; (II) coping strategies were both positive and negative; (III) BAM training was easy to incorporated; and (IV) tracking stress responses was useful. Responses suggest that additional personalization of app interfaces may drive ownership and adherence to protocols. Measures and reports of heart rate monitoring while in session were favorably viewed with low issues with confidentiality or trust issues on collected session data. CONCLUSIONS: Results suggest that a culturally tailored approach may be unnecessary in the design of BAM apps. Further investigation is warranted for other racial groups, age ranges, and disease conditions.

13.
Contemp Clin Trials ; 61: 55-62, 2017 10.
Artículo en Inglés | MEDLINE | ID: mdl-28687348

RESUMEN

PURPOSE: To describe the rationale, methodology, design, and interventional approach of a mobile health education program designed for African Americans with end stage renal disease (ESRD) to increase knowledge and self-efficacy to approach others about their need for a living donor kidney transplant (LDKT). METHODS: The Living Organ Video Educated Donors (LOVED) program is a theory-guided iterative designed, mixed methods study incorporating three phases: 1) a formative evaluation using focus groups to develop program content and approach; 2) a 2-month proof of concept trial (n=27) to primarily investigate acceptability, tolerability and investigate increases of LDKT knowledge and self-efficacy; and 3) a 6-month, 2-arm, 60-person feasibility randomized control trial (RCT) to primarily investigate increases in LDKT knowledge and self-efficacy, and secondarily, to increase the number of living donor inquiries, medical evaluations, and LDKTs. The 8-week LOVED program includes an interactive web-based app delivered on 10″ tablet computer incorporating weekly interactive video education modules, weekly group video chat sessions with an African American navigator who has had LDKT and other group interactions for support and improve strategies to promote their need for a kidney. RESULTS: Phase 1 and 2 have been completed and the program is currently enrolling for the feasibility RCT. Phase 2 experienced 100% retention rates with 91% adherence completing the video modules and 88% minimum adherence to the video chat sessions. CONCLUSIONS: We are in the early stages of an RCT to evaluate the LOVED program; to date, we have found high tolerability reported from Phase 2.


Asunto(s)
Negro o Afroamericano/educación , Educación en Salud/métodos , Fallo Renal Crónico/cirugía , Donadores Vivos , Obtención de Tejidos y Órganos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Proyectos de Investigación , Autoeficacia , Estados Unidos , Grabación de Cinta de Video
14.
Res Q Exerc Sport ; 86(2): 163-71, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25513937

RESUMEN

PURPOSE: The aim of this study was to investigate the physiological responses during upper-body aquatic exercises in older adults with different pool temperatures. METHOD: Eleven older men (aged 65 years and older) underwent 2 identical aquatic exercise sessions that consisted of 3 upper-body exercises using progressive intensities (30, 35, and 40 metronome beat · min(- 1)) on separate visits. Water temperatures for the visits were 28°C (cold water [CW]) and 36°C (hot water [HW]), and water depth ranged from 1.2 m to 1.4 m. Measurements for heart rate (HR), blood pressure (BP), oxygen consumption (VO2), and rate of perceived exertion (RPE) were compared between the CW and HW conditions. RESULTS: The comparison between temperatures showed a higher HR response during exercise in HW, particularly when participants exercised at the highest intensities. During a 30-min postexercise period in resting conditions, HR was statistically significantly higher for the HW condition compared with the CW condition, with a large effect size (15.9%, d = 1.23). Systolic and diastolic BPs were found to be lower for the HW condition ( - 7.2%, d = - 0.60; - 10.1%, d = - 0.65), while VO2 and RPE showed no differences. The effect size between double products (HR · systolic BP) for the 2 conditions was small (CW = 8,649 ± 1,287, HW = 9,340 ± 1,672; d = 0.36), suggesting similar myocardial oxygen requirements. CONCLUSION: This study showed that HR response was higher in an HW condition for older men. Warmer environments may add additional stressors to the body, which may impact training strategies and should be considered when estimating the effort of performing aquatic exercise.


Asunto(s)
Presión Sanguínea/fisiología , Ejercicio Físico/fisiología , Frecuencia Cardíaca/fisiología , Consumo de Oxígeno/fisiología , Percepción/fisiología , Esfuerzo Físico/fisiología , Temperatura , Agua , Anciano , Metabolismo Energético , Humanos , Masculino , Natación/fisiología
15.
J Occup Environ Med ; 57(2): 178-83, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25654519

RESUMEN

OBJECTIVE: The aim of this study was to evaluate a tailored physical activity protocol performed in a work environment with a group of female workers employed in manual precision tasks to reduce upper limb pain. METHODS: Sixty female subjects were randomly assigned to an intervention group or a control group. The IG was administered of a 6-month, twice-a-week, tailored exercise program, whereas the CG received no intervention. RESULTS: The IG showed a reduction on shoulder pain accompanied by increases on the range of motion measures. In addition, reductions in upper limb pain and neck disability were detected with concomitant increases in grip strength. CONCLUSIONS: This study indicated positive effects of a tailored workplace exercise protocol in female workers exposed to moderate risk for work-related musculoskeletal disorders, showing clinically meaningful reductions of pain symptoms and disability on upper limb and neck regions.


Asunto(s)
Terapia por Ejercicio , Dolor de Cuello/terapia , Enfermedades Profesionales/terapia , Salud Laboral , Dolor de Hombro/terapia , Adulto , Femenino , Fuerza de la Mano , Humanos , Industria Manufacturera , Persona de Mediana Edad , Enfermedades Profesionales/fisiopatología , Cooperación del Paciente , Esfuerzo Físico , Rango del Movimiento Articular , Dolor de Hombro/fisiopatología , Método Simple Ciego , Lugar de Trabajo
16.
Arch Gerontol Geriatr ; 58(2): 177-87, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24188735

RESUMEN

The interest in research on exercise and physical activity effects on dual-task performance has grown rapidly in the last decade due to the aging global population. Most of the available literature is focused on exercise benefits for the risk of falls, attention, and gait-speed; however, there is a lack of evidence reporting the exercise effects on balance in healthy older adults during dual-task performance. The objective of this study was to critically review the existing evidence of a potential relationship between exercise and improvement of static and dynamic balance during dual-task in healthy older adults and secondary outcomes in other physical and cognitive indices. A systematic search using online databases was used to source articles. Inclusion criteria included articles classified as randomized controlled trials (RCT), controlled trials (CT) and uncontrolled trials (UT). Moreover, the studies had to include an exercise or physical activity protocol in the intervention. Eight studies met the eligibility criteria and included 6 RCTs, 1 CT, and 1 UT. Several limitations were identified, mainly focused on the lack of a common and standardized method to evaluate the balance during the dual-task performance. Additionally, exercise protocols were extensively different, and generally lacked reporting measures. Preliminary findings show that the current body of evidence does not support that exercises used in these interventions entail clear and noteworthy benefits on static or dynamic balance improvements during dual-task performance. Innovative measures and exercise programs may need to be developed before efficacious screening and treatment strategies can be used in clinical settings.


Asunto(s)
Terapia por Ejercicio/métodos , Ejercicio Físico , Equilibrio Postural , Análisis y Desempeño de Tareas , Anciano , Anciano de 80 o más Años , Envejecimiento , Atención , Marcha/fisiología , Humanos , Masculino
17.
Front Aging Neurosci ; 6: 271, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25374539

RESUMEN

Dual-task performance assessments of competing parallel tasks and postural outcomes are growing in importance for geriatricians, as it is associated with predicting fall risk in older adults. This study aims to evaluate the postural stability during different dual-task conditions including visual (SMBT), verbal (CBAT) and cognitive (MAT) tasks in comparison with the standard Romberg's open eyes position (OE). Furthermore, these conditions were investigated in a sample of young adults and a group of older healthy subjects to examine a potential interaction between type of secondary task and age status. To compare these groups across the four conditions, a within-between mixed model ANOVA was applied. Thus, a stabilometric platform has been used to measure center of pressure velocity (CoPV), sway area (SA), antero-posterior (AP) and medio-lateral (ML) oscillations as extents of postural sway. Tests of within-subjects effects indicated that different four conditions influenced the static balance for CoPV (p < 0.001), SA (p < 0.001). Post-hoc analyses indicated that CBAT task induced the worst balance condition on CoPV and resulted in significantly worse scores than OE (-11.4%; p < 0.05), SMBT (-17.8%; p < 0.01) and MAT (-17.8%; p < 0.01) conditions; the largest SA was found in OE, and it was statistically larger than SMBT (-27.0%; p < 0.01) and MAT (-23.1%; p < 0.01). The between-subjects analysis indicated a general lower balance control in the group of elderly subjects (CoPV p < 0.001, SA p < 0.002), while, the mixed model ANOVA did not detect any interaction effect between types of secondary task and groups in any parameters (CoPV p = 0.154, SA p = 0.125). Postural sway during dual-task assessments was also found to decrease with advancing age, however, no interactions between aging and types of secondary tasks were found. Overall, these results indicated that the secondary task which most influenced the length of sway path, as measured by postural stability was a simple verbal assignment.

18.
Curr Aging Sci ; 7(2): 115-36, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24679341

RESUMEN

Investigations on how exercise and physical activity affect dual-task (DT) performance in the elderly are growing rapidly due to the fact that DT activities are commonplace with activities of daily living. Preliminary evidence has shown the benefit in exercise on DT balance, though it is unclear to what extent the effect exercise has on DT performance in elderly subjects with disease conditions, including subjects with a high risk of falls. Hence, the objective of this study was to critically review the existing evidence of a potential relationship between exercise and improvement of static and dynamic balance during DT conditions as well as secondary outcomes in elderly subjects with different disease conditions. A systematic search using online databases was performed to source documents. Inclusion criteria sourced articles classified as randomized controlled trials (RCT), controlled trials (CT) and uncontrolled trials (UT). Moreover, the studies had to administrate an exercise or physical activity protocol in the intervention. Seventeen studies met the eligibility criteria and were comprised of 12 RCTs, 3 CTs, and 2 UTs. Overall, 13 studies supported exercise being effective to improve parameters of static and dynamic balance during single or DT conditions. Despite the heterogeneity of pathologic conditions, exercise showed similar benefits to improve function in two main areas: neurological conditions and frailty conditions. The lack of a common method to assess DT performance limited the ability to compare different interventions directly. Future research is warranted to study the optimal dose and exercise modalities to best reduce the risk of falls in the elderly with multiple disease conditions.


Asunto(s)
Accidentes por Caídas/prevención & control , Envejecimiento/psicología , Cognición , Terapia por Ejercicio , Actividad Motora , Equilibrio Postural , Actividades Cotidianas , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Anciano Frágil , Evaluación Geriátrica , Humanos , Masculino , Recuperación de la Función , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
19.
J Altern Complement Med ; 20(4): 241-50, 2014 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-24620850

RESUMEN

OBJECTIVE: Evidence is accumulating, predominantly among clinical trials in adults, that yoga improves blood pressure (BP) control, with downregulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS) projected as underlying mechanisms. This pilot study assessed whether Hatha yoga has the potential to reduce BP among youth and whether dampening of the SNS and/or HPA activity is a likely pathway of change. DESIGN: Thirty-one seventh graders were randomly assigned to a Hatha yoga program (HYP) or attention control (AC) music or art class. Baseline and 3-month evaluations included resting BP; overnight urine samples; and saliva collected at bedtime, upon awakening, and at 30 and 60 minutes after awakening for α-amylase and cortisol assays. RESULTS: Twenty-eight (14 in the HYP group and 14 in the AC group) students were assessed both before and after the intervention. BP changes from pre- to post-intervention were -3.0/-2.0 mmHg for the HYP group and -0.07/-0.79 mmHg for the AC group (p=0.30 and 0.57, respectively). Changes in systolic BP (SBP)/diastolic BP (DBP) for the prehypertensive (75th-94th percentiles for SBP) subgroup analyses were -10.75/-8.25 mmHg for the HYP group (n=4) versus 1.8/1.0 mmHg for the AC group (n=5) (p for SBP=0.02; p for DBP=0.09). Although no statistically significant group differences were observed with changes in SNS or HPA awakening curves (area under curve for α-amylase and cortisol, respectively), a small to moderate effect size was seen favoring a reduction of α-amylase activation for the HYP group (Cohen d=0.34; prehypertensive d=0.20). CONCLUSIONS: A school-based Hatha yoga program demonstrated potential to decrease resting BP, particularly among prehypertensive youth. Reduced SNS drive may be an underlying neurohormonal pathway beneficially affected by the program. A large-scale efficacy/effectiveness randomized clinical trial is warranted.


Asunto(s)
Presión Sanguínea/fisiología , Hidrocortisona/sangre , Prehipertensión/terapia , alfa-Amilasas Salivales/análisis , Yoga , Niño , Femenino , Humanos , Masculino , Prehipertensión/sangre , Prehipertensión/fisiopatología
20.
Mhealth ; 4: 13, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29963558
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