Assessment of functional respiratory complaints and related factors in people with hypermobile Ehlers-Danlos syndrome: Cross-sectional study.

BACKGROUND: Hypermobile Ehlers-Danlos Syndrome (hEDS) is the most common type of EDS. Apart from joint symptoms, people with hEDS have systemic manifestations as a chronic modification of the breathing pattern (functional respiratory complaints (FRCs)) and mental disorders. However, the prevalence of FRCs, and its relationship with mental disorders, have not yet been estimated for this population. OBJECTIVES: To assess the FRCs, central sensitization, disease perception, depression, and anxiety in people with hEDS from Belgium; and to identify the clustering of FRCs and determine any association with the characteristics assessed for this sample. METHODS: This cross-sectional study assessed socio-demographic characteristics, Nijmegen questionnaire (NQ), Central Sensitization Inventory (CSI), Brief Illness Perception Questionnaire, and the Hospital Anxiety and Depression Scale (HADS) in people with hEDS from Belgium. A two-step cluster analysis was performed to identify clusters according to NQ, and to understand how the other questionnaires are grouped among these clusters. RESULTS: The Spearman correlation coefficients showed that all the outcomes were significantly and positively correlated with each other (p<0.05). Furthermore, 84.9% of the sample had symptoms suggestive of FRCs, and 54.3% had probable anxiety. Three clusters were grouped (no FRCs, mild FRCs, and severe FRCs), with NQ, HADS-D and CSI-part A being the variables that contributed the most. People from cluster of severe FRCs got the worst scores for all the questionnaires. CONCLUSION: FRCs, central sensitization, depression, and anxiety are prevalent comorbidities in people with hEDS. Moreover, those people with FRCs had worse results in the investigated parameters, with depression being the variable that contributed the most to the clusters of FRCs. Consequently, investigating mechanisms for these co-occurring symptom profiles may improve our understanding of pathogenesis and indicate new management strategies to alleviate these symptoms and lead to the development of more effective care for persons with hEDS.

High-intensity aerobic interval training and resistance training are feasible in rectal cancer patients undergoing chemoradiotherapy: a feasibility randomized controlled study.

Background: There has been growing evidence of the benefits of high-intensity aerobic interval training (HIIT) and resistance training (RES) for populations with cancer. However, these two modalities have not yet been performed alone in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (NACR T). Therefore, this study aimed to determine the feasibility of HIIT and RES in rectal cancer patients undergoing NACR T. Materials and methods: Rectal cancer patients set to undergo NACRT were randomly assigned to HIIT intervention, RES intervention, or the usual care. Feasibility of HIIT and RES was assessed by measuring recruitment rate, adherence (retention rate, attendance rate, and exercise sessions duration and intensity), and adverse events. Endpoints (changes in fatigue, health-related quality of life, depression, daytime sleepiness, insomnia, sleep quality, functional exercise capacity, and executive function) were assessed at baseline and at week 5. Results: Among the 20 eligible patients, 18 subjects were enrolled and completed the study, yielding a 90% recruitment rate and 100% retention rate. Attendance at exercise sessions was excellent, with 92% in HIIT and 88% in RES. No exercise-related adverse events occurred. Conclusion: This study demonstrated that HIIT and RES are feasible in rectal cancer patients undergoing NACR T. Trial registration: www.clinicaltrials.gov, NCT03252821 (date of registration: March 30, 2017).

Telerehabilitation as a Form of Pulmonary Rehabilitation in Chronic Lung Disease: A Systematic Review.

INTRODUCTION: Tele-rehabilitation is increasingly used to deliver pulmonary rehabilitation. The aim of this systematic review was to compare the effect between tele-pulmonary rehabilitation and classical supervised pulmonary rehabilitation. METHOD: Three databases were analysed (PubMed, PEDro, Scopus). The selection and evaluation of studies followed the PRISMA guidelines. The risk of bias was evaluated using the PEDro Scale. RESULTS: From the initial selection (n = 245), ten studies were retrieved, including from 10 to 67 patients. All but two (IPF) included patients with COPD. Based on the FEV1, patients with COPD were mainly categorised as moderate and severe. The teleactivities were heterogenous in terms of proposed exercises and way of settings and often not in agreement with the guidelines about pulmonary rehabilitation. Despite this, the effects of the interventions were globally positive on functional exercise capacity, quality of life, anxiety and depression, and impact of COPD on personal life but not on dyspnoea. The PEDro scores varied from 4 to 8. The adherence was higher than 80% when supervision during the exercise was included. CONCLUSION: This review demonstrated that the telerehabilitation is safe and well accepted by the patients, and could be considered as one option of classical pulmonary rehabilitation to improve the functional exercise capacity, quality of life, anxiety and depression, and the impact of COPD on personal's life. This conclusion cannot be extrapolated to the other chronic lung diseases due to the lack of data.

Telerehabilitation physical exercise for patients with lung cancer through the course of their disease: A systematic review.

BACKGROUND AND OBJECTIVE: Evidence is shown for the benefits of physical activity, for patients with lung cancer, at different times through the course of the disease. Telerehabilitation can overcome some of barriers often met by patients to practice physical activity. The objective of this systematic review is to assess feasibility and safety of telerehabilitation for patients with lung cancer, its effects on physical capacity, quality of life, symptoms severity, depression and anxiety, survival, lung function, post-operative outcomes, dyspnoea and body composition. Secondary aim was to distinguish the telerehabilitation efficacy between the different phases of the disease. DATA SOURCE AND SELECTION CRITERIA: Pubmed, PEDro, Scopus, ScienceDirect, randomized controlled trials and non-randomized controlled trials, written in French or English, of telerehabilitation among patients with lung cancer. RESULTS: Eight studies were included. Telerehabilitation is safe but was characterized by a low recruitment and attendance rate (<70%). It enhances quality of life, muscle mass, depression and anxiety but it does not improve physical capacity (except in preoperative period), symptoms severity, survival, lung function or dyspnoea. After surgery, it ameliorates quality of life, depression and anxiety. During systemic treatments of lung cancer, it improves quality of life, symptoms severity and muscle mass. CONCLUSION: Telerehabilitation could be proposed in patients with lung cancer as a complementary intervention of hospital-based programme to increase physical activity volume, compliance and self-efficacy. In case the classic programmes are not possible, it could also be an alternative approach for patients unable to participate to a hospital or community-based training programme.

Effects of surgical facemasks on perceived exertion during submaximal exercise test in healthy children.

Only a few data associated to wearability of facemask during exercise are available in children. The aim of the study was to evaluate the effect of wearing a facemask on perceived exertion (primary aim), dyspnea, physical performance, and cardiorespiratory response during a submaximal exercise test in children aged between 8 and 12 years. This study was performed in 2021 in healthy volunteer children from 8 to 12 years. They performed prospectively two 1-min sit-to-stand tests (STST), with or without a surgical facemask. The perceived exertion (modified Borg scale), dyspnea (Dalhousie scale), heart rate, and pulsed oxygen saturation were recorded before and after STST. The STST measured the submaximal performance. Thirty-eight healthy children were recruited (8-9 years: n = 19 and 10-11 years: n = 19). After the STST, the perceived exertion increased with or without a facemask (8-9 years group: + 1 [0.6; 1.4] and + 1.6 [1.0; 2.1] - 10-11 years group: + 1.3 [0.7; 1.8] and + 1.9 [1.3; 2.6]) and it was higher with the facemask. The difference between the two conditions in perceived exertion was not clinically relevant in any group (mBorgf: 0.56 pts and 0.68 pts, respectively). The different domains of dyspnea assessed with Dalhousie scale were not influenced by the facemask. The submaximal performance measured by the STST was not changed by the mask whatever the age group. The cardio-respiratory demand was not clinically modified.Conclusion: The surgical facemask had no impact on dyspnea, cardiorespiratory parameters, and exercise performance during a short submaximal exercise in healthy children.

A distância entre o domicílio e o centro de reabilitação não influencia a adesão ao programa de reabilitação pulmonar: um estudo retrospectivo / Distance from home to rehabilitation center did not influence adherence to pulmonary rehabilitation program: a retrospective study

Background: Adherence to treatment is critical when dealing with chronic diseases. One of the difficulties in maintain long-term adherence is the distance from home to rehabilitation center. Objective: To determine the influence of the distance from subjects' residence to rehabilitation center on adherence of a 12-week pulmonary rehabilitation program in chronic respiratory disease. Methods: This retrospective study analyzed patients' medical records with chronic respiratory diseases from a pulmonary rehabilitation center. Driving distance between patients' home and rehabilitation center was calculated with Google maps. The home-rehabilitation center distances were classified in three levels: up to 10, 10-30 and more than 30 km. Results: 280 medical records from patients with chronic pulmonary diseases with medical indication to follow the pulmonary rehabilitation program were found and 148 medical records were included in our study. Out of them, the majority (n = 93) had chronic obstructive pulmonary disease (COPD). Seventy percent of patients lived up to 10 km, 24% lived between 10 and 30 km and 6% lived more than 30 km. No difference in adherence was found comparing the three groups based on the distance from home to rehabilitation center. Conclusion: In this study, distance between home and rehabilitation center did not influence adherence to pulmonary rehabilitation program. (AU)

Is the Peri-Bariatric Surgery Exercise Program Effective in Adults with Obesity: a Systematic Review.

The number of people with obesity continues to increase. Bariatric surgery is the most effective treatment for severe obesity. However, this surgery also has disadvantages, such as an increased risk of excessive loss of fat-free mass, lean body mass, and muscle mass compared to other weight loss interventions. PubMed and Cochrane Library database including articles in English, Dutch, French, and German were used. From the 3609 retrieved references, 20 articles were selected. Compared with the control group, physical exercise improved body mass index (5 of 13 articles), weight loss (7 of 17 articles), functional capacity (2 of 5 articles), muscle strength (1 of 1 article), fat-free mass (3 of 5 articles), cardiorespiratory endurance (4 of 6 articles), and quality of life (2 of 4 articles) in obese patients undergoing BS. Current data is suggestive of positive effects of exercise on body mass index, weight loss, functional capacity, muscle strength, fat-free mass, cardiorespiratory endurance, and quality of life in obese patients undergoing bariatric surgery. However, our conclusions are limited because of the heterogeneity of programs and short studies. Further research is needed to determine the most effective physical exercise program in peri-bariatric surgery.

Physical therapy treatment of hypermobile Ehlers-Danlos syndrome: A systematic review.

Physiotherapy techniques are regularly prescribed in the hypermobile type Ehlers-Danlos syndrome (hEDS) and they are appreciated by the patients. The objective of this systematic review was to investigate the effect of the different physiotherapy techniques related to the children and adult patients with hEDS. PubMed, SPORTDiscus, Cochrane Library, PEDro, Scopus, and Embase databases were analyzed from inception to April 2020. Characteristics of the studies (authors), patients (sample size, sex, age, Beighton score), and nonpharmacological treatment (length of the program, number of session, duration of the session, and type of intervention), and the results with the dropout rate were extracted. From the 1045 retrieved references, 6 randomized controlled trial with a sample size ranging from 20 to 57 patients were included in the systematic review. There was a huge heterogeneity in the interventions. The durations of the program were from 4 to 8 weeks. Pain or proprioception demonstrated significant improvements in the intervention group regardless of the type of intervention. A benefit of the inspiratory muscle training was observed on functional exercise capacity. The quality of life was systematically improved. Physiotherapy benefits on proprioception and pain in patients with hEDS even if robust randomized control studies are missing.

Global and Leisure-Time Physical Activity Levels Among People Living With HIV on Antiretroviral Therapy in Burundi: A Cross-sectional Study.

ABSTRACT: The latest recommendations for HIV therapeutic management emphasize the importance of regular physical activity (PA). This cross-sectional study assessed the self-reported level of PA, amount of leisure time PA (LTPA), and the predictors of PA practiced in 257 people living with HIV (PLWH) in Burundi. The World Health Organization recommends 150 min of PA per week. In our study, 80.2% of the participants met this recommendation. Participants were more engaged in PA at work (436.8 ± 682.1 min/week) compared with leisure time (231.7 ± 383.8 min/week) and transportation (235.9 ± 496.5 min/week). Multivariate analysis revealed that men (ß = -101.65; p = .01) who were white-collar workers (ß = 67.21; p < .03) with higher education level (ß = 274.21; p < .001) reported higher levels of LTPA than other groups. Integrating PA counseling into the routine care and implementing community-based exercise programs could enhance participation in PA in PLWH.

What are the impact and the optimal design of a physical prehabilitation program in patients with esophagogastric cancer awaiting surgery? A systematic review.

BACKGROUND: Substantial postoperative complications occur after tumor resection for esophagogastric cancers. Physical prehabilitation programs aim to prepare patients for surgery by improving their functional status with the aim of reducing postoperative complications. This systematic review aims to summarize the effects of physical prehabilitation programs on exercise capacity, muscle strength, respiratory muscle function, postoperative outcomes, and health-related quality of life and to determine the optimal design of such a program to improve these outcomes in esophagogastric cancer patients undergoing tumor resection. METHODS: A systematic literature review was conducted using PubMed, The Cochrane Library, Scopus, and PEDro databases to identify studies evaluating the effects of physical prehabilitation program on exercise capacity, muscle strength, respiratory muscle function, postoperative complications, length of hospital stay, mortality, and health-related quality of life in patients with esophagogastric cancer awaiting surgery. Data from all studies meeting the inclusion criteria were extracted. The quality of each selected study was determined using the Downs and Black checklist. RESULTS: Seven studies with 645 participants were included. The preoperative exercise program consisted of respiratory training alone in three studies, a combination of aerobic and resistance training in two studies, and a combination of respiratory, aerobic, and resistance training in two studies. Training frequency ranged from three times a day to twice a week and each session lasted between 20 and 75 min. Four studies were of fair quality and three of good quality. Some studies reported improvements in maximal inspiratory pressure, inspiratory muscle endurance, postoperative (pulmonary) complications, and length of hospital stay in the preoperative exercise group compared to the control group. CONCLUSION: This systematic review reports the current evidence for physical prehabilitation programs in patients with esophagogastric cancer awaiting surgery. However, due to the limited number of randomized controlled trials, the significant heterogeneity of exercise programs, and the questionable quality of the studies, higher quality randomized controlled trials are needed. TRIAL REGISTRATION: PROSPERO Registration Number: CRD42020176353 .

Effects of high-intensity interval training compared with resistance training in prostate cancer patients undergoing radiotherapy: a randomized controlled trial.

BACKGROUND: Exercise training has shown beneficial effects in the management of radiotherapy-related side effects in prostate cancer (PCa) patients undergoing radiation therapy (RT). However, the optimal modality of the exercise programs have not been yet determined. The aim of this randomized controlled trial was to investigate the effects of high-intensity interval training (HIIT) and resistance training (RES) compared to usual care (UC) on cancer-treatment-related fatigue (CTRF) (primary outcome), quality of life, depression, daytime sleepiness, insomnia, sleep quality, functional exercise capacity and executive function in PCa patients during RT. METHODS: PCa patients undergoing RT with or without ADT were randomized in HIIT, RES or UC. Both exercise programs included three sessions per week during 5-8 weeks. HIIT consisted of 8-15 × 60 s intervals (≥85% maximal heart rate). RES was performed with 1-3 sets of 8-12 repetitions for each large muscle groups. The primary outcome was changed in CTRF measured with the Functional Assessment of Chronic Illness Therapy-Fatigue. RESULTS: Seventy-two subjects (69.1 ± 8.2 years) completed the study. No exercise-related adverse events occurred. HIIT (p = 0.012) and RES (p = 0.039) training attenuated increases in CTRF compared to UC. Functional exercise capacity, evaluated by the 6-min walk test, increased after HIIT (p = 0 = 0.43) and RES (p = 0.041) compared to UC (+0.1%). No other secondary variables were different between groups. CONCLUSIONS: Both intervention groups displayed beneficial effects on CTRF and functional exercise capacity in PCa patients undergoing RT. In addition, HIIT and RES are both safe with an excellent attendance rate to the exercise sessions.

Assessing thermal sensitivity using transient heat and cold stimuli combined with a Bayesian adaptive method in a clinical setting: A proof of concept study.

BACKGROUND: Quantitative sensory testing of thermal detection abilities is used as a clinical tool to assess the function of pain pathways. The most common procedure to assess thermal sensitivity, the 'method of limits', provides a quick but rough estimate of detection thresholds. Here, we investigate the potential of evaluating not only the threshold but also the slope of the psychometric functions for cold and warm detection. METHOD: A convenience sample of 15 patients with diabetes mellitus (DM) and 15 age-matched healthy controls (HC) was tested. Thirty brief (100 ms) stimuli of each modality were applied to the volar wrist and foot dorsum. Cold and warm stimuli were delivered with a Peltier thermode and a temperature-controlled CO2 laser, respectively. Stimulus intensities were dynamically selected using an adaptive Bayesian algorithm (psi method) maximizing information gain for threshold and slope estimation. ROC analyses were used to assess the ability of slopes, thresholds and the combination of both to discriminate between groups. RESULTS: Assessment of the slope and threshold of the psychometric function for thermal detection took about 10 min. The ability to detect warmth was not reduced in DM patients as compared to HC. Cold detection performance assessed using slope or threshold parameters separated DM from HC with good discriminative power. Discrimination was further increased when both parameters were used together (93% sensitivity and 87% specificity), indicating that they provide complementary information on patient status. CONCLUSION: The psi method may be an interesting alternative to the classical method of limits for thermal QST. SIGNIFICANCE: Current QST protocols provide an incomplete and potentially biased estimate of sensory detection performance. We propose a method that estimates the slope and the threshold of the psychometric function, defining heat and cold sensory detection performance, in only a few minutes. Furthermore, we provide preliminary evidence that combining slope and threshold parameters of cold detection performance leads to a better discriminative ability than relying solely on the threshold.

Feasibility and Preliminary Effectiveness of a Tele-Prehabilitation Program in Esophagogastric Cancer Patients.

Tele-rehabilitation provides better access to healthcare services and optimizes exercise adherence. However, its feasibility and effectiveness are unknown in the preoperative period in esophagogastric cancer patients. We aimed to assess the feasibility and the preliminary effects of a "tele-prehabilitation" program in esophagogastric cancer patients requiring surgery. Enrolled participants performed an internet-based tele-prehabilitation including aerobic, resistance and inspiratory muscle training over 2-4 weeks. The primary outcome was feasibility, measured in terms of recruitment, retention and attendance rates, adverse events and patient satisfaction. Secondary outcomes (functional exercise capacity, fatigue, quality of life, anxiety and depression) were assessed at baseline, presurgery, and 4 and 12 weeks postsurgery. Among the 24 eligible subjects, 23 were enrolled, 22 performed the intervention and 15 completed the study. Recruitment and retention rates were both 96%. Attendances to aerobic and resistance sessions and inspiratory muscle training were 77% and 68%, respectively. No adverse events occurred, and the satisfaction was excellent. After prehabilitation, participants significantly improved fatigue (p = 0.039), quality of life (p = 0.009), physical well-being (p = 0.034), emotional well-being (p = 0.005) and anxiety (p = 0.044). This study demonstrated the feasibility of a tele-prehabilitation in esophagogastric cancer patients undergoing surgery, with a high recruitment rate, retention rate and satisfaction, a good attendance to exercise sessions and no exercise-related adverse events.

Effects of exercise therapy in cancer patients undergoing radiotherapy treatment: a narrative review.

Despite its beneficial effects, radiotherapy still results in a range of side effects that negatively impact quality of life of patients. Exercise has been shown to counteract the side effects induced by cancer treatment. This narrative review aims to provide an up-to-date review of the effects of an exercise intervention in cancer patients during radiotherapy. A literature search was performed on PubMed to identify original articles that evaluated the effects of an exercise programme to alleviate treatment-related side effects in cancer patients undergoing radiotherapy with or without other cancer treatments. Benefits related to exercise training have been shown in breast, prostate, rectal, lung, head and neck cancer patients undergoing radiotherapy. Therefore, exercise should be considered as a concurrent treatment alongside radiotherapy to alleviate treatment-related side effects and facilitate effective recovery. Due to the onset and progress of treatment-related side effects throughout radiotherapy, a regular clinical evaluation seems strongly advisable in order to continuously adapt the exercise programme depending on symptoms and side effects. An exercise professional is needed to personalize exercise training based on the medical condition and tailor it throughout the intervention according to progress and the patient's medical status. Future studies are needed to confirm the potential benefits of exercises observed on treatment-related side effects. Furthermore, because of the narrative design of this study, a systematic review is required to evaluate the strength of the evidence reported.

Feasibility and Preliminary Effects of a Telerehabilitation Program for People Living With HIV: A Pilot Randomized Study.

We investigated feasibility and preliminary effects of telerehabilitation for people living with HIV (PLWH) and taking antiretroviral therapy. We randomized 25 PLWH to either an endurance and resistance training exercise (ERTE) group or a control group. Endurance and resistance training exercise sessions occurred in a public fitness center, with online guidance and weekly telephone advice. The primary outcome was feasibility (recruitment and retention rates and safety). Secondary outcomes were assessed at baseline and 6 weeks according to the three International Classification of Functioning, Disability, and Health domains. Nine patients completed the ERTE program. Recruitment and retention rates were 93% and 69%, respectively. No adverse events occurred. After 6 weeks, percentage change in D-dimer was lower in the ERTE group, but not significantly after the Bonferroni correction. Other parameters were not different between the groups. Therefore, telerehabilitation is feasible in PLWH taking antiretroviral therapy; however, the performance of the program is still questioned, and future research is warranted.

Physical Activity Program Improves Functional Exercise Capacity and Flexibility in Extremely Preterm Children With Bronchopulmonary Dysplasia Aged 4-6 Years: A Randomized Controlled Trial.

INTRODUCTION: Bronchopulmonary dysplasia (BPD) is the most common complication of extreme preterm delivery, and is associated with reduced exercise tolerance and exercise capacity. The aim of this study was to assess the effects of a physical activity programme on exercise tolerance, exercise capacity, flexibility, and lung function in prematurely born children with BPD. METHODS: This was a randomized controlled trial. Preterm children with BPD (4-6 years) were randomized to intervention (IG) and control (CG) groups. The CG did not participate in any physical activity during the study period. The IG performed a 4-week exercise programme based on aerobic interval and resistance training. Outcomes were based on the 6-minute walk test (6MWT), incremental shuttle walk test (ISWT), modified sit and reach test (MSRT) and spirometry results. RESULTS: Twenty individuals were recruited. In the IG (n=10), statistical and clinical improvement was observed in the 6MWT (316.3±31.4m vs 376.2±39.5m; P=.002). Significant improvements were also seen in the IG in the ISWT (248.0±45.2m vs 465.3±58.2m; P=.013), MSRT (14.5±7.7cm vs 22.8±6.9cm; P=.003), and FEV1 (102%±16% pred vs 104%±17% pred; P=.004). No significant differences between pre- and post-intervention were observed in the CG for all outcomes (n=10). CONCLUSION: This 4-week programme resulted in statistical and clinical improvements in exercise tolerance, exercise capacity and flexibility in preterm children with BPD.

Physical Activity Program Improves Functional Exercise Capacity and Flexibility in Extremely Preterm Children With Bronchopulmonary Dysplasia Aged 4-6 Years: A Randomized Controlled Trial / Mejora de la capacidad funcional al ejercicio y de la flexibilidad a través de un programa de actividad física en niños de entre 4 a 6 años prematuros extremos con displasia broncopulmonar: ensayo controlado aleatorizado

Introduction: Bronchopulmonary dysplasia (BPD) is the most common complication of extreme preterm delivery, and is associated with reduced exercise tolerance and exercise capacity. The aim of this study was to assess the effects of a physical activity programme on exercise tolerance, exercise capacity, flexibility, and lung function in prematurely born children with BPD. Methods: This was a randomized controlled trial. Preterm children with BPD (4-6 years) were randomized to intervention (IG) and control (CG) groups. The CG did not participate in any physical activity during the study period. The IG performed a 4-week exercise programme based on aerobic interval and resistance training. Outcomes were based on the 6-minute walk test (6MWT), incremental shuttle walk test (ISWT), modified sit and reach test (MSRT) and spirometry results. Results: Twenty individuals were recruited. In the IG (n = 10), statistical and clinical improvement was observed in the 6MWT (316.3 ± 31.4 m vs 376.2 ± 39.5m; P = .002). Significant improvements were also seen in the IG in the ISWT (248.0 ± 45. 2m vs 465.3 ± 58.2 m; P=.013), MSRT (14.5 ± 7.7 cm vs 22.8 ± 6.9 cm; P = .003), and FEV1 (102% ± 16% pred vs 104% ± 17% pred; P = .004). No significant differences between pre- and post-intervention were observed in the CG for all outcomes (n = 10). Conclusion: This 4-week programme resulted in statistical and clinical improvements in exercise tolerance, exercise capacity and flexibility in preterm children with BPD

Introducción: La displasia broncopulmonar (DBP) es una secuela frecuente entre los prematuros extremos, asociándose a una reducción en la tolerancia y en la capacidad al ejercicio. El objetivo de este estudio es evaluar los efectos de un programa de entrenamiento basado en la tolerancia y en la capacidad al ejercicio, la flexibilidad y la función pulmonar en niños prematuros con DBP. Métodos: El ensayo clínico se hizo con niños prematuros con DBP (de 4 a 6 años), aleatorizados en 2 grupos, control (GC) e intervención (GI). El GC no participó en ninguna actividad física durante el estudio. El GI realizó un programa interválico y de resistencia de 4 semanas. Se evaluó el Six Minute Walking test (6MWT), el Incremental Shuttle Walk test (ISWT), el Modified Sit and Reach test (MSRT) y la espirometría. Resultados: Se reclutaron 20 niños. No se observaron diferencias significativas entre la pre- y la postintervención en el GC (n = 10). En el 6MWT se observó una mejoría significativa y clínica (316,3 ± 31,4 m vs. 376,2 ± 39,5 m; p=0,002) al final de la intervención en el GI (n = 10). El ISWT (248,0 ± 45,2 m vs. 465,3 ± 58,2 m; p = 0,013), el MSRT (14,5 ± 7,7 cm vs. 22,8 ± 6,9 cm; p=0,003) y la FEV1 (102 ± 16% pred vs. 104 ± 17% pred; p = 0,004) también mejoraron significativamente en el GI. Conclusiones: Este programa de 4 semanas, mejora estadísticamente y clínicamente la tolerancia y la capacidad al ejercicio, y la flexibilidad en niños prematuros con DBP

Effects of preoperative combined aerobic and resistance exercise training in cancer patients undergoing tumour resection surgery: A systematic review of randomised trials.

BACKGROUND: Surgical management remains the cornerstone of treatment for many cancers, but is associated with a high rate of postoperative complications, which are linked to poor preoperative functional capacity. Prehabilitation may have beneficial effects on functional capacity and postoperative outcomes. We evaluated the effects of prehabilitation combining endurance and resistance training (CT) on physical fitness, quality of life (QoL) and postoperative outcomes in cancer patients undergoing tumour resection surgery. METHODS: We performed a literature search in PubMed, PEDro, EMBASE (via Scopus) and the Cochrane library for clinical trials until September 2017. Randomised controlled trials investigating the effects of CT in adult cancer patients undergoing surgery were included when at least one of the following outcomes was reported: physical capacity, muscle strength, QoL, length of stay (LOS), postoperative complications and mortality. RESULTS: Ten studies (360 patients) were retrieved and included patients with lung, colorectal, bladder and oesophageal cancer. No adverse effects of CT were reported. Compared with the control group, CT improved physical capacity (3 of 5 studies), muscle strength (2 of 3 studies) and some domains of QoL (2 of 4 studies), shortened LOS (1 of 6 studies) and reduced postoperative pulmonary complications (2 of 6 studies). CONCLUSIONS: The benefits of CT in cancer population are demonstrated. CT may improve physical fitness and QoL and decrease LOS and postoperative pulmonary complications. However, our conclusions are limited by the heterogeneity of the preoperative CT programs, patient characteristics and measurement tools. Future research is required to determine the optimal composition of CT.