Effect of Exercise Prior to Sedentary Behavior on Vascular Health Parameters: A Systematic Review and Meta-Analysis of Crossover Trials.

BACKGROUND: Sedentary behavior has been shown to negatively affect parameters of endothelial function and central hemodynamics, both of which are closely associated with vascular health. Exercise prior to sedentary behavior has demonstrated potential as a preventive strategy to mitigate these detrimental effects. To evaluate the impact of exercise prior to sedentary behavior on vascular health parameters in the adult population, a systematic review and meta-analysis were conducted, synthesizing the available body of knowledge. METHODS: A literature search was carried out in 6 databases. For each outcome, standard error and mean difference or standardized mean difference were calculated, as appropriate. An analysis was performed using a random effects model with a 95% confidence interval, using the inverse variance statistical method. Risk of bias assessment was performed using ROB2 and considerations for crossover trials. The quality of evidence was assessed using the GRADE system. RESULTS: Exercise performed prior to prolonged sedentary behavior resulted in increased flow-mediated vasodilation at the first and third hours of sedentary time, compared with the control condition of sedentary behavior without prior exercise [MD: 1.51% (95% CI: 0.57 to 2.45) and MD: 1.36% (95% CI: 0.56 to 2.16), respectively]. Moreover, prior exercise led to increased shear rate at the first and third hours of sedentary time [MD: 7.70 s^-1 (95% CI: 0.79 to 14.61) and MD: 5.21 s^-1 (95% CI: 1.77 to 8.43), respectively]. Furthermore, it increased blood flow at the third hour [SMD: 0.40 (95%CI: 0.07 to 0.72)], compared with the control condition of prolonged sedentary behavior without prior exercise. Regarding hemodynamic parameters, exercise prior to prolonged sedentary behavior decreased mean arterial pressure during the first and third hours of sedentary behavior [MD: -1.94 mmHg (95% CI: -2.77 to -1.11) and MD: -1.90 mmHg (95% CI: -3.27 to -0.53), respectively], and an increase in heart rate during the first hour [MD: 4.38 beats per minute (95%CI: 2.78 to 5.98)] compared with the control condition of prolonged sedentary behavior without prior exercise. CONCLUSIONS: The findings of this research suggest that prior exercise may prevent the impairment of vascular health parameters caused by sedentary behavior. However, the quality of the evidence was estimated as moderate. Therefore, further experimental studies and high-quality clinical trials are needed in this field to strengthen the results and conclusions drawn. PROSPERO REGISTRATION NUMBER: CRD42023393686.

Benefits of Adaptive Sport on Physical and Mental Quality of Life in People with Physical Disabilities: A Meta-Analysis.

Adaptive sports could produce multiple health benefits in people with physical disabilities. The aim is to evaluate if adaptive sports practice has an influence on physical and mental quality of life. A meta-analysis was performed using electronic databases and other sources. A within- and between-group analysis for physical and mental quality of life was conducted. Standardized mean difference (SMD) was used as a measure of the mean size effect. The statistical heterogeneity, the risk of bias, and the quality of evidence were evaluated. Eight studies met the inclusion criteria and four of them were included in the meta-analysis. In mental quality of life, significant differences were observed in the within-group analysis (SMD = 0.71, p < 0.001) and between people practicing adaptive sports and those not engaging in them (SMD = 0.62, p = 0.009). In physical quality of life, significant differences were also found between pre- and post-practice of adaptive sports (SMD = 1.03, p = 0.007). The engagement in adaptive sports showed a positive impact on the mental quality of life among adults with physical disabilities. However, the positive effect of adaptive sports practice on physical quality of life was shown only in the pre-post-test analysis. Further studies are required to validate the obtained findings.

Calidad de vida, nivel de actividad física y pruebas funcionales en personas adultas y mayores laboralmente activas / Quality of life, level of physical activity and functional tests in actively working adults and older people

BACKGROUND: The population of actively working older people is growing rapidly. The relationship between quality of life, levels of physical activity and functionality in this population is not entirely clear. AIM: To determine the association between quality of life, levels of physical activity and functional tests in actively working adults and older people. MATERIAL AND METHODS: Cross sectional assessment of 138 adults aged 40 to 50 years (53% women) and 119 older people aged 60 to 75 years (53% women) who were actively working in two public services. Quality of life was measured with the SF-36 questionnaire and usual physical activity was assessed with the International Physical Activity Questionnaire (IPAQ-short). Handgrip strength, the timed up and go (TUG) and chair stand test (CST) were used as functional tests. RESULTS: Compared to older people, adults had better physical functional tests (P < 0.01). Older people had better scores in the mental health component (MHC) of quality of life (p < 0.05). In adults, the physical health component of quality of life (CSF) had a positive association with physical activity (Spearman Rho (rs)= 0.270; p = 0.01), grip strength (rs = 0.330; p < 0.01) and the TUG (rs = −0.229; p < 0.01). In older patients, CSM and CST were positively correlated (rs = 0.201; P = 0.029). In both groups, a correlation was observed between CSM, grip strength (adults rs = 0.283; p < 0.01; older people rs = 0.211; P = 0.02) and with TUG (adults rs = −0.197; P = 0.021; older people rs = - 0.212; p = 0.02). CONCLUSIONS: There is a positive correlation between quality of life and level of physical activity in working adults, which is not observed in older people. Adequate performance in physical functional tests is positively correlated with better quality of life (CSF and CSM) in adults and only with the mental health component in older people.

Impact of prolonged sitting interruption strategies on shear rate, flow-mediated dilation and blood flow in adults: A systematic review and meta-analysis of randomized cross-over trials.

Prolonged sitting has been shown to affect endothelial function. Strategies that promote interruption of sitting have shown varying results on the shear rate (SR), flow-mediated dilation (FMD) and blood flow (BF). Thus, we conducted a systematic review and meta-analysis to 1) increase the existing knowledge of the impact of sitting interruption in the prevention of endothelial dysfunction in adults and 2) determine the effect of the sitting interruption strategies on SR, FMD, BF. Literature search was carried out through 7 databases. A random effects model was used to provide the overall mean difference with a 95%CI, and forest plots were generated for pooled estimates of each study outcome. Assessment of biases was performed using ROB2 and considerations for crossover trials. Prolonged sitting interruption strategies showed a significant effect in increasing SR (MD: 7.58 s-1; 95% CI: 3.00 to 12.17), FMD (MD: 1.74%; 95% CI: 0.55 to 2.93) and BF (MD: 12.08 ml/min; 95% CI: 7.61 to 16.55) when compared with the uninterrupted prolonged sitting condition. Prolonged sitting interruption strategies significantly increase SR, FMD and BF, therefore, they represent a considerable effective preventive method on endothelial dysfunction caused by acute exposure to uninterrupted prolonged sitting.

[Quality of life, level of physical activity and functional tests in actively working adults and older people]. / Calidad de vida, nivel de actividad física y pruebas funcionales en personas adultas y mayores laboralmente activas.

BACKGROUND: The population of actively working older people is growing rapidly. The relationship between quality of life, levels of physical activity and functionality in this population is not entirely clear. AIM: To determine the association between quality of life, levels of physical activity and functional tests in actively working adults and older people. MATERIAL AND METHODS: Cross sectional assessment of 138 adults aged 40 to 50 years (53% women) and 119 older people aged 60 to 75 years (53% women) who were actively working in two public services. Quality of life was measured with the SF-36 questionnaire and usual physical activity was assessed with the International Physical Activity Questionnaire (IPAQ-short). Handgrip strength, the timed up and go (TUG) and chair stand test (CST) were used as functional tests. RESULTS: Compared to older people, adults had better physical functional tests (P < 0.01). Older people had better scores in the mental health component (MHC) of quality of life (p < 0.05). In adults, the physical health component of quality of life (CSF) had a positive association with physical activity (Spearman Rho (rs)= 0.270; p = 0.01), grip strength (rs = 0.330; p < 0.01) and the TUG (rs = -0.229; p < 0.01). In older patients, CSM and CST were positively correlated (rs = 0.201; P = 0.029). In both groups, a correlation was observed between CSM, grip strength (adults rs = 0.283; p < 0.01; older people rs = 0.211; P = 0.02) and with TUG (adults rs = -0.197; P = 0.021; older people rs = - 0.212; p = 0.02). CONCLUSIONS: There is a positive correlation between quality of life and level of physical activity in working adults, which is not observed in older people. Adequate performance in physical functional tests is positively correlated with better quality of life (CSF and CSM) in adults and only with the mental health component in older people.

The association of musculoskeletal complaints and individual and work-related factors with work ability in Chilean white-collar and blue-collar workers.

Objective. The maintenance of good work ability has proven to have a positive effect on health, quality of work and productivity. There is little evidence regarding the association between musculoskeletal complaints, individual and work-related factors, and work ability in blue-collar and white-collar workers. Methods. A cross-sectional study of hospital and university workers (n = 360) was performed to determine the association between musculoskeletal complaints, individual and work-related factors, and work ability; two multiple linear regression models were created. Results. In white-collar workers, musculoskeletal complaints of the dorsal/lumbar region (ß = -0.259) and the wrist/hand segment (ß = -0.151) were significantly associated with reduced work ability. A higher body mass index (ß = -0.227) was also negatively associated with the dependent variable. In blue-collar workers, musculoskeletal complaints of the dorsal/lumbar region (ß = -0.317) and the elbow/forearm segment (ß = -0.171) were significantly associated with lower work ability. Increased age (ß = -0.204) was associated with reduced work ability in this group. No significant correlations were found between work-related factors and work ability. Conclusions. Musculoskeletal complaints and individual factors, but not work-related factors, are associated with work ability in Chilean blue-collar and white-collar workers. Nevertheless, the variables that explain the change in work ability are different between these groups.

Influence of age on functional capacity and work ability in Chilean workers: a cross-sectional study.

OBJECTIVE: To determine if there are differences in functional capacity and work ability between older and younger active workers in public institutions, and to relate functional capacity to work ability. METHODS: This cross-sectional study evaluated 360 subjects from two public institutions, a university and a high-complexity regional hospital. The participants were divided into 3 age ranges 40-49, 50-59 and ≥ 60 years. The following evaluations were applied: a multidimensional assessment questionnaire, work ability and functional capacity using physical tests (strength, flexibility and balance). RESULTS: There are no significant differences in work ability among the different age groups (P > 0.05). Significant differences were found according to age group in 30-s chair-stand test (30-s CST), 1 repetition maximum (1RM) extending the knee 90° (1RM-leg extension) and 1RM of handgrip strength (1RM-handgrip), upper body flexibility, lower body flexibility, static balance or dynamic balance (P < 0.05). Only the variables 30-s CST (rs = 0.13, P = 0.018), lower body flexibility (rs = 0.13, P = 0.012) and static balance (rs = 0.13, P = 0.012) were related to work ability. CONCLUSIONS: There are differences in functional capacity as the workers' ages increase. By contrast, work ability does not present any differences when comparing older and younger adults. Some physical tests of the lower extremities presented a small correlation with work ability.

Effectiveness of Telerehabilitation in Physical Therapy: A Rapid Overview.

OBJECTIVE: The purpose of this article was to summarize the available evidence from systematic reviews on telerehabilitation in physical therapy. METHODS: We searched Medline/PubMed, EMBASE, and Cochrane Library databases. In addition, the records in PROSPERO and Epistemonikos and PEDro were consulted. Systematic reviews of different conditions, populations, and contexts-where the intervention to be evaluated is telerehabilitation by physical therapy-were included. The outcomes were clinical effectiveness depending on specific condition, functionality, quality of life, satisfaction, adherence, and safety. Data extraction and risk of bias assessment were carried out by a reviewer with non-independent verification by a second reviewer. The findings are reported qualitatively in the tables and figures. RESULTS: Fifty-three systematic reviews were included, of which 17 were assessed as having low risk of bias. Fifteen reviews were on cardiorespiratory rehabilitation, 14 on musculoskeletal conditions, and 13 on neurorehabilitation. The other 11 reviews addressed other types of conditions and rehabilitation. Thirteen reviews evaluated with low risk of bias showed results in favor of telerehabilitation versus in-person rehabilitation or no rehabilitation, while 17 reported no differences between the groups. Thirty-five reviews with unclear or high risk of bias showed mixed results. CONCLUSIONS: Despite the contradictory results, telerehabilitation in physical therapy could be comparable with in-person rehabilitation or better than no rehabilitation for conditions such as osteoarthritis, low-back pain, hip and knee replacement, and multiple sclerosis and also in the context of cardiac and pulmonary rehabilitation. It is imperative to conduct better quality clinical trials and systematic reviews. IMPACT: Providing the best available evidence on the effectiveness of telerehabilitation to professionals, mainly physical therapists, will impact the decision-making process and therefore yield better clinical outcomes for patients, both in these times of the COVID-19 pandemic and in the future. The identification of research gaps will also contribute to the generation of relevant and novel research questions.

Measuring diet quality in health personnel of a Chilean hospital using the Healthy Eating Index / Calidad de la dieta del personal de salud de un hospital chileno según el índice de alimentación saludable

Abstract Introduction: Evidence has shown that personnel working in hospital services have a high probability of developing modifiable risk factors associated with noncommunicable diseases such as poor nutrition, high levels of stress, changes of sleep patterns and a sedentary lifestyle. Objective: To assess diet quality among health personnel who eat at the cafeteria of the Hospital Regional de Temuco based on their work shifts, sex, and age. The Healthy Eating Index (HEI) was used to measure diet quality. Materials and methods: Cross-sectional study conducted on 201 workers (156 women and 45 men) who were asked to complete a survey on food consumption in order to evaluate their individual HEI. The questionnaire was divided by food groups. Results: The average age was 34.8±10.7 years and the average HEI score was 67.5 ± 14.5. 12.9% of the participants had unhealthy eating habits, 65.2% required dietary changes, and 21.9% had a healthy diet. Statistically significant differences were observed with respect to the HEI score according to sex (p=0.033) and age (p=0.009). No statistically significant differences were found between the HEI score and the shift system (p=0.334). Conclusions: Most participants need to modify their eating habits. Therefore, hospitals, as a workplace, should implement actions that promote the adoption of healthy eating habits among their staff, particularly in the case of men, who had significantly low HEI scores in several food groups compared to women.

Resumen Introducción. Se ha reportado que los trabajadores hospitalarios tienen una alta probabilidad de presentar factores de riesgo modificables asociados al desarrollo de enfermedades crónicas no transmisibles, tales como mala alimentación, altos niveles de estrés y cambios de los patrones del sueño. Objetivo. Determinar la calidad de la dieta del personal de salud que usa los servicios del Casino de Funcionarios de Hospital Dr. Hernán Henríquez Aravena de Temuco, Chile, de acuerdo a sistemas de turno, sexo y edad. Para la medición de la calidad de la dieta se utilizó el índice de alimentación saludable (IAS). Materiales y métodos. Estudio transversal realizado en 201 trabajadores (156 mujeres y 45 hombres), a quienes se les solicitó completar una encuesta sobre consumo de alimentos para evaluar sus IAS; el instrumento estuvo dividido por grupos de alimentos. Resultados. La edad promedio de la muestra fue 34.8±10.7 años y el puntaje promedio de IAS fue 67.5±14.5. El 12.9% de los participantes tenía hábitos alimenticios poco saludables, el 65.2% requería cambios dietarios y el 21.9% presentaba una alimentación saludable. Se observaron diferencias estadísticamente significativas respecto al IAS según sexo (p=0.033) y edad (p=0.009), pero no entre puntaje del IAS y el sistema de turnos (p=0.334). Conclusiones. La mayoría de los participantes necesita modificar sus hábitos alimenticios, por lo que es necesario que en los hospitales, como lugar de trabajo, se implementen acciones que promuevan la adopción de hábitos alimenticios saludables por parte del personal de salud, en particular en el caso de los hombres, quienes tuvieron puntajes de IAS significativamente bajos en varios grupos de alimentos en comparación con las mujeres.

Psychometric Properties of the Spanish Version of the Work Ability Index in Working Individuals.

It is increasingly important to have validated instruments to assess the ability to work. Thus, the aim of this study was to evaluate the psychometric properties of the Spanish version of the Work Ability Index (WAI) in working individuals. A cross-sectional study was conducted on 360 workers (men and women) in a high-complexity public hospital and in a public university. The participants were between 40 and 75 years, with a contract of at least 11 h weekly. The ability to work was assessed using the WAI and the perception of health through the Short Form 36 Health Survey version 2 (SF-36 v2). The concurrent validity was analyzed, correlating the WAI with the SF-36 v2. An exploratory factor analysis was performed to test construct validity. In addition, the internal consistency of the WAI was analyzed using the standardized Cronbach's alpha coefficient. The WAI showed a positive and statistically significant correlation (p < 0.001) with the SF-36 v2. The exploratory factor analysis showed three factors interpreted as, "Mental Resources", "Diseases and Health-Related Restrictions", and "Self-perception of Work Ability". The reliability of the factors was acceptable, except for the second factor, which was poor. The WAI demonstrated acceptable psychometric properties, such as internal consistency, concurrent and construct validity, constituting a reliable instrument to measure work ability for the population of active working individuals in the service sector.

Percepción del beneficio del ejercicio para la prevención de trastornos musculoesqueléticos: una perspectiva del trabajador / Workers' perception of benefit of the exercise for the prevention of musculoskeletal disorders

Resumen: Distintas modalidades de prevención para disminuir la incidencia de Trastornos musculoesqueléticos (TME) han sido propuestas, sin embar go, no existe evidencia nacional sobre la valoración que hacen los trabajadores sobre las acciones implementadas por las empresas. El propósito de este estudio fue evaluar la percepción de los trabajadores sobre el beneficio del ejercicio en el puesto de trabajo (EPT) para prevenir TME. Método: Bajo el contexto de un estudio de evaluación de efectividad del ejercicio en la prevención de TME en trabajadores manu factureros, se le aplicó una encuesta de percepción a la totalidad de los trabajadores (n = 109). Resultados: Un 92.3% de los trabajadores con sidera importante realizar EPT y el 82.8% lo asocia a una conducta saludable, destaca un alto nivel de satisfacción en la práctica grupal de los ejercicios (96%) y estar de acuerdo con implementarla como estra tegia de prevención permanente. Conclusión: Los trabajadores otorgan gran importancia a la aplicación de EPT, independiente de su modali dad, los cuales tienden a relacionarse con la percepción positiva respec to a los efectos beneficiosos para su salud. La aplicación de esta moda lidad de ejercicios tiene una alta aceptabilidad por los trabajadores, facilitando su implementación y logro de objetivos.

Abstract: Different forms of prevention to reduce the incidence of musculoskel etal disorders (MSDs) have been proposed, however, there is no national evidence on the assessment made by workers on the actions implemented by companies. The purpose of this study was to assess workers' perception of the benefit of exercise in the workplace to prevent MSDs. Method: In the context of an evaluation study of exercise effectiveness in the prevention of MSDs in manufacturing workers, a perception survey was applied to all workers (n = 109). Results: 92.3% of the workers considered it important to exercise in the workplace and 82.8% associated it with a healthy behavior, they reported a high level of satisfaction in the group practice of the exer cises (96%) and agree to implement it as a permanent prevention strategy. Conclusion: The workers give high importance to the appli cation of exercise in the workplace, regardless of their modality, which tend to relate to positive perception and beneficial effects for their health.. The application of this type of exercise has a high acceptabil ity by workers, facilitating its implementation and achievement of objectives.