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1.
Sensors (Basel) ; 21(9)2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33946361

RESUMEN

In the aging world population, the occurrence of neuromotor deficits arising from stroke and other medical conditions is expected to grow, demanding the design of new and more effective approaches to rehabilitation. In this paper, we show how the combination of robotic technologies with progress in exergaming methodologies may lead to the creation of new rehabilitation protocols favoring motor re-learning. To this end, we introduce the Track-Hold system for neuromotor rehabilitation based on a passive robotic arm and integrated software. A special configuration of weights on the robotic arm fully balances the weight of the patients' arm, allowing them to perform a purely neurological task, overcoming the muscular effort of similar free-hand exercises. A set of adaptive and configurable exercises are proposed to patients through a large display and a graphical user interface. Common everyday tasks are also proposed for patients to learn again the associated actions in a persistent way, thus improving life independence. A data analysis module was also designed to monitor progress and compute indices of post-stroke neurological damage and Parkinsonian-type disorders. The system was tested in the lab and in a pilot project involving five patients in the post-stroke chronic stage with partial paralysis of the right upper limb, showing encouraging preliminary results.


Asunto(s)
Procedimientos Quirúrgicos Robotizados , Robótica , Rehabilitación de Accidente Cerebrovascular , Terapia por Ejercicio , Humanos , Proyectos Piloto
2.
Medicine (Baltimore) ; 100(17): e25730, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33907166

RESUMEN

BACKGROUND: Sleep disorders after stroke is one of the most common neuropsychiatric complications and is associated with increased risk of death and poor functional outcomes. Some evidence shows that patients with sleep disorders after stroke benefit from exercise intervention. However, this result is still conflicting. This study aims to explore the effects of exercise on sleep disorders after stroke and to establish safe and effective exercise prescriptions. METHODS AND ANALYSIS: The databases including Google Scholar, Pubmed, Embase, and Cochrane library will be searched using pre-specified search strategies. Randomized controlled trials and non-randomized prospective controlled cohort studies regarding exercise for sleep disorders after stroke will be included. The primary outcome is the Pittsburgh Sleep Quality Index (PSQI) scale. The secondary outcomes are adverse events associated with exercise and all deaths. The methodological quality of each study will be evaluated by the physiotherapy evidence database scale. The heterogeneity will be evaluated using the I2 test. If I2 > 50%, random effects models will be used in the analysis; otherwise, fixed effects models will be used to pool the data. RESULTS: This study will assess the efficacy and safety of exercise for sleep disorders after stroke. CONCLUSIONS: Our findings will be helpful for clinicians to examine the clinical decision-making in the treatment of sleep disorders after stroke using exercise intervention. ETHICS AND DISSEMINATION: Ethical approval is not required because this study is a secondary analysis. The results of this study will be disseminated through journals and academic exchanges. SYSTEMATIC REVIEW REGISTRATION NUMBER: INPLASY202130106.


Asunto(s)
Terapia por Ejercicio/métodos , Trastornos del Sueño-Vigilia , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular/complicaciones , Humanos , Metaanálisis como Asunto , Proyectos de Investigación , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/psicología , Trastornos del Sueño-Vigilia/terapia , Accidente Cerebrovascular/psicología , Rehabilitación de Accidente Cerebrovascular/métodos , Rehabilitación de Accidente Cerebrovascular/psicología , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
3.
J Strength Cond Res ; 35(5): 1467-1476, 2021 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-33900267

RESUMEN

ABSTRACT: Rosenberg, J, Hyde, PN, Yancy, WS, Ford, KM, and Champ, CE. Quantity of resistance exercise for breast cancer patients: does the dose match the objective? J Strength Cond Res 35(5): 1467-1476, 2021-There is currently a lack of consensus as to what defines exercise and resistance training in the cancer setting and whether current studies comply with exercise guidelines. This study aimed to quantify the available research studies using resistance training exercise interventions in the breast cancer setting for future clinical trial utilization. We systemically reviewed all available resistance exercise studies during and after breast cancer treatment in an attempt to quantify to the prescribed dose and whether regimens aligned with general exercise guidelines to improve functional mobility, body composition, and metabolic function. They were then compared with recommendations set forth by the national committees that create evidence-based exercise guidelines. Fifty studies met the initial criteria, with 35 meeting analysis criteria for evaluation. Fifteen studies evaluated an exercise regimen during cancer treatment, and 20 evaluated a regimen after treatment. The average adherence rates were 84% for all studies. Only 23 studies listed specific exercises used within the protocol. Most exercise regimens relied on open chain movements and machine exercises. Around half of studies met criteria to achieve hypertrophy, and 66% met American College of Sports Medicine exercise guidelines for cancer patients. A minority of breast cancer studies implementing a resistance training exercise regimen prescribed a regimen or specific dose that follows general exercise guidelines. This study highlights a potential deficiency in exercise programs designed for patients with breast cancer, and these findings should be considered in future study design.


Asunto(s)
Neoplasias de la Mama , Entrenamiento de Resistencia , Composición Corporal , Neoplasias de la Mama/terapia , Ejercicio Físico , Terapia por Ejercicio , Humanos
4.
Sheng Li Xue Bao ; 73(2): 342-352, 2021 Apr 25.
Artículo en Chino | MEDLINE | ID: mdl-33903895

RESUMEN

Insulin-like growth factor-1 (IGF-1) is a peptide with a similar molecular structure to insulin. IGF-1 plays a key role in tissue growth and development, as well as cell metabolism, proliferation, differentiation and apoptosis. Liver is the main source of IGF-1, with the production of IGF-1 up to 75% of the total in the whole body, while the remaining 25% are secreted by skeletal muscles, heart, kidney, spleen and other organs. Target organs of IGF-1 include heart, blood vessels, liver, bone and skeletal muscles. It has been well documented that IGF-1 plays an important role in the prevention and treatment of metabolic diseases. Different types of exercise have different effects on IGF-1 expression with organ differences. In this article, we reviewed the preventive and therapeutic effects of IGF-1 on metabolic diseases and IGF-1-mediated exercise-induced benefits.


Asunto(s)
Factor I del Crecimiento Similar a la Insulina , Enfermedades Metabólicas , Terapia por Ejercicio , Humanos , Hígado , Enfermedades Metabólicas/terapia , Músculo Esquelético
5.
Artículo en Inglés | MEDLINE | ID: mdl-33800315

RESUMEN

Aging is a multifactorial physiological phenomenon in which cellular and molecular changes occur. These changes lead to poor locomotion, poor balance, and an increased falling risk. This study aimed to determine the impact and effectiveness of the use of the Wii® game console on improving walking speed and balance, as well as its influence on frailty levels and falling risk, in older adults. A longitudinal study was designed with a pretest/post-test structure. The study population comprised people over 75 years of age who lived in a nursing home or attended a day care center (n = 80; 45 women; 84.2 ± 8.7 years). Forty of them were included in the Wii group (20 rehabilitation sessions during 8 consecutive weeks), and the other 40 were in the control group. Falling risk and frailty were evaluated using the Downton scale and Fried scale; balance and walking speed were assessed with the Berg Balance scale and the Gait Speed Test, respectively, as well as the Short Physical Performance Battery (SPPB). The results showed that there was no significant association between Frailty Phenotype and study groups in baseline. However, there was significant association between Frailty Phenotype and study groups at the end of study. Moreover, a significantly higher and negative percentage change (Δ) in the Wii group with respect to the control group on the in falling risk (-20.05 ± 35.14% vs. 7.92 ± 24.53%) and in walking speed (-6.42 ± 8.83% vs. -0.12 ± 4.51%) during study, while there was a higher and positive significant percent change in static balance (6.07 ± 5.74% vs. 2.13 ± 4.64%) and on the SPPB (20.28 ± 20.05% vs. 0.71 ± 7.99%) after 8 weeks of study. The main conclusion of this study was that the use of the Wii® video console for 8 weeks positively influenced walking speed, falling risk, static balance, and frailty levels in older adults. Through a rehabilitation program with the Wii® game console in the older adults, frailty levels are reduced, accompanied by a reduction in falling risk and an increase in static balance and walking speed.


Asunto(s)
Fragilidad , Juegos de Video , Accidentes por Caídas/prevención & control , Anciano , Anciano de 80 o más Años , Terapia por Ejercicio , Femenino , Marcha , Humanos , Estudios Longitudinales , Masculino , Equilibrio Postural
6.
Sensors (Basel) ; 21(5)2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33804317

RESUMEN

Out-of-distribution (OOD) in the context of Human Activity Recognition (HAR) refers to data from activity classes that are not represented in the training data of a Machine Learning (ML) algorithm. OOD data are a challenge to classify accurately for most ML algorithms, especially deep learning models that are prone to overconfident predictions based on in-distribution (IIN) classes. To simulate the OOD problem in physiotherapy, our team collected a new dataset (SPARS9x) consisting of inertial data captured by smartwatches worn by 20 healthy subjects as they performed supervised physiotherapy exercises (IIN), followed by a minimum 3 h of data captured for each subject as they engaged in unrelated and unstructured activities (OOD). In this paper, we experiment with three traditional algorithms for OOD-detection using engineered statistical features, deep learning-generated features, and several popular deep learning approaches on SPARS9x and two other publicly-available human activity datasets (MHEALTH and SPARS). We demonstrate that, while deep learning algorithms perform better than simple traditional algorithms such as KNN with engineered features for in-distribution classification, traditional algorithms outperform deep learning approaches for OOD detection for these HAR time series datasets.


Asunto(s)
Actividades Humanas , Aprendizaje Automático , Algoritmos , Ejercicio Físico , Terapia por Ejercicio , Humanos
7.
Sensors (Basel) ; 21(6)2021 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-33806813

RESUMEN

Vision-based interfaces are used for monitoring human motion. In particular, camera-based head-trackers interpret the movement of the user's head for interacting with devices. Neck pain is one of the most important musculoskeletal conditions in prevalence and years lived with disability. A common treatment is therapeutic exercise, which requires high motivation and adherence to treatment. In this work, we conduct an exploratory experiment to validate the use of a non-invasive camera-based head-tracker monitoring neck movements. We do it by means of an exergame for performing the rehabilitation exercises using a mobile device. The experiments performed in order to explore its feasibility were: (1) validate neck's range of motion (ROM) that the camera-based head-tracker was able to detect; (2) ensure safety application in terms of neck ROM solicitation by the mobile application. Results not only confirmed safety, in terms of ROM requirements for different preset patient profiles, according with the safety parameters previously established, but also determined the effectiveness of the camera-based head-tracker to monitor the neck movements for rehabilitation purposes.


Asunto(s)
Aplicaciones Móviles , Terapia por Ejercicio , Movimientos de la Cabeza , Humanos , Cuello , Rango del Movimiento Articular
8.
JAMA ; 325(13): 1266-1276, 2021 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-33821898

RESUMEN

Importance: Supervised high-intensity walking exercise that induces ischemic leg symptoms is the first-line therapy for people with lower-extremity peripheral artery disease (PAD), but adherence is poor. Objective: To determine whether low-intensity home-based walking exercise at a comfortable pace significantly improves walking ability in people with PAD vs high-intensity home-based walking exercise that induces ischemic leg symptoms and vs a nonexercise control. Design, Setting, and Participants: Multicenter randomized clinical trial conducted at 4 US centers and including 305 participants. Enrollment occurred between September 25, 2015, and December 11, 2019; final follow-up was October 7, 2020. Interventions: Participants with PAD were randomized to low-intensity walking exercise (n = 116), high-intensity walking exercise (n = 124), or nonexercise control (n = 65) for 12 months. Both exercise groups were asked to walk for exercise in an unsupervised setting 5 times per week for up to 50 minutes per session wearing an accelerometer to document exercise intensity and time. The low-intensity group walked at a pace without ischemic leg symptoms. The high-intensity group walked at a pace eliciting moderate to severe ischemic leg symptoms. Accelerometer data were viewable to a coach who telephoned participants weekly for 12 months and helped them adhere to their prescribed exercise. The nonexercise control group received weekly educational telephone calls for 12 months. Main Outcomes and Measures: The primary outcome was mean change in 6-minute walk distance at 12 months (minimum clinically important difference, 8-20 m). Results: Among 305 randomized patients (mean age, 69.3 [SD, 9.5] years, 146 [47.9%] women, 181 [59.3%] Black patients), 250 (82%) completed 12-month follow-up. The 6-minute walk distance changed from 332.1 m at baseline to 327.5 m at 12-month follow-up in the low-intensity exercise group (within-group mean change, -6.4 m [95% CI, -21.5 to 8.8 m]; P = .34) and from 338.1 m to 371.2 m in the high-intensity exercise group (within-group mean change, 34.5 m [95% CI, 20.1 to 48.9 m]; P < .001) and the mean change for the between-group comparison was -40.9 m (97.5% CI, -61.7 to -20.0 m; P < .001). The 6-minute walk distance changed from 328.1 m at baseline to 317.5 m at 12-month follow-up in the nonexercise control group (within-group mean change, -15.1 m [95% CI, -35.8 to 5.7 m]; P = .10), which was not significantly different from the change in the low-intensity exercise group (between-group mean change, 8.7 m [97.5% CI, -17.0 to 34.4 m]; P = .44). Of 184 serious adverse events, the event rate per participant was 0.64 in the low-intensity group, 0.65 in the high-intensity group, and 0.46 in the nonexercise control group. One serious adverse event in each exercise group was related to study participation. Conclusions and Relevance: Among patients with PAD, low-intensity home-based exercise was significantly less effective than high-intensity home-based exercise and was not significantly different from the nonexercise control for improving 6-minute walk distance. These results do not support the use of low-intensity home-based walking exercise for improving objectively measured walking performance in patients with PAD. Trial Registration: ClinicalTrials.gov Identifier: NCT02538900.


Asunto(s)
Terapia por Ejercicio/métodos , Enfermedad Arterial Periférica/terapia , Caminata , Anciano , Biopsia , Femenino , Humanos , Isquemia/terapia , Extremidad Inferior/irrigación sanguínea , Extremidad Inferior/patología , Masculino , Músculo Esquelético/patología , Enfermedad Arterial Periférica/patología , Enfermedad Arterial Periférica/fisiopatología , Prueba de Paso
9.
Zhongguo Zhen Jiu ; 41(4): 387-90, 2021 Apr 12.
Artículo en Chino | MEDLINE | ID: mdl-33909358

RESUMEN

OBJECTIVE: To compare the therapeutic effect between rehabilitation robot rehabilitation training synchronizing acupuncture exercise therapy and simple acupuncture exercise therapy on lower limb function and life activity ability for postoperative patients with hip fracture. METHODS: A total of 50 elderly postoperative patients with hip fracture were randomly divided into an observation group and a control group, 25 cases in each group. Both groups were treated with acupuncture at hip three points of the affected side and lateral line 1 of vertex, anterior oblique parietotemporal line of the healthy side, hip three needles were retained for 30 min. The scalp acupuncture needles were continue retained, the observation group was given acupuncture exercise therapy to synchronize lower limb rehabilitation robot rehabilitation training, and the control group was given acupuncture exercise therapy. The two groups were treated once a day, 7 times as a course of treatment, and totally 4 courses were required. The Harris score, Barthel index score and quadriceps femoris isokinetic muscle strength indexes [peak torque (PT), average power (AP), flexor peak torque/extensor peak torque (F/E)] were compared between the two groups before and after treatment. RESULTS: After treatment, the Harris score, Barthel index score, PT and AP were higher than those before treatment (P<0.05), and F/E was lower than that before treatment in the two groups (P<0.05). After treatment, the Harris score, Barthel index score, PT and AP in the observation group were higher than those in the control group (P<0.05), and the F/E in the observation group was lower than that in the control group (P<0.05). CONCLUSION: Rehabilitation robot rehabilitation training of lower limbs synchronizing acupuncture exercise therapy could enhance the hip joint activity function and quadriceps muscle group function of elderly postoperative patients with hip fracture, and effectively improve the lower limb function and life activity ability.


Asunto(s)
Terapia por Acupuntura , Robótica , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Puntos de Acupuntura , Anciano , Terapia por Ejercicio , Humanos , Resultado del Tratamiento
11.
BMJ ; 373: n740, 2021 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-33824131

RESUMEN

OBJECTIVE: To test whether StandingTall, a home based, e-health balance exercise programme delivered through an app, could provide an effective, self-managed fall prevention programme for community dwelling older people. DESIGN: Assessor blinded, randomised controlled trial. SETTING: Older people living independently in the community in Sydney, Australia. PARTICIPANTS: 503 people aged 70 years and older who were independent in activities of daily living, without cognitive impairment, progressive neurological disease, or any other unstable or acute medical condition precluding exercise. INTERVENTIONS: Participants were block randomised to an intervention group (two hours of StandingTall per week and health education; n=254) or a control group (health education; n=249) for two years. MAIN OUTCOME MEASURES: The primary outcomes were the rate of falls (number of falls per person year) and the proportion of people who had a fall over 12 months. Secondary outcomes were the number of people who had a fall and the number who had an injurious fall (resulting in any injury or requiring medical care), adherence, mood, health related quality of life, and activity levels over 24 months; and balance and mobility outcomes over 12 months. RESULTS: The fall rates were not statistically different in the two groups after the first 12 months (0.60 falls per year (standard deviation 1.05) in the intervention group; 0.76 (1.25) in the control group; incidence rate ratio 0.84, 95% confidence interval 0.62 to 1.13, P=0.071). Additionally, the proportion of people who fell was not statistically different at 12 months (34.6% in intervention group, 40.2% in control group; relative risk 0.90, 95% confidence interval 0.67 to 1.20, P=0.461). However, the intervention group had a 16% lower rate of falls over 24 months compared with the control group (incidence rate ratio 0.84, 95% confidence interval 0.72 to 0.98, P=0.027). Both groups had a similar proportion of people who fell over 24 months (relative risk 0.87, 95% confidence interval 0.68 to 1.10, P=0.239), but the proportion of people who had an injurious fall over 24 months was 20% lower in the intervention group compared with the control group (relative risk 0.80, 95% confidence interval 0.66 to 0.98, P=0.031). In the intervention group, 68.1% and 52.0% of participants exercised for a median of 114.0 min/week (interquartile range 53.5) after 12 months and 120.4 min/week (38.6) after 24 months, respectively. Groups remained similar in mood and activity levels. The intervention group had a 0.03 (95% confidence interval 0.01 to 0.06) improvement on the EQ-5D-5L (EuroQol five dimension five level) utility score at six months, and an improvement in standing balance of 11 s (95% confidence interval 2 to 19 s) at six months and 10 s (1 to 19 s) at 12 months. No serious training related adverse events occurred. CONCLUSIONS: The StandingTall balance exercise programme did not significantly affect the primary outcomes of this study. However, the programme significantly reduced the rate of falls and the number of injurious falls over two years, with similar but not statistically significant effects at 12 months. E-health exercise programmes could provide promising scalable fall prevention strategies. TRIAL REGISTRATION: ACTRN12615000138583.


Asunto(s)
Accidentes por Caídas/prevención & control , Terapia por Ejercicio/métodos , Telemedicina/métodos , Heridas y Traumatismos/prevención & control , Accidentes por Caídas/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Vida Independiente , Masculino , Cooperación del Paciente/estadística & datos numéricos , Estudios Prospectivos , Calidad de Vida , Método Simple Ciego , Resultado del Tratamiento , Heridas y Traumatismos/epidemiología , Heridas y Traumatismos/etiología
13.
Medicine (Baltimore) ; 100(17): e25523, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-33907101

RESUMEN

BACKGROUND: The pediatric lung transplant is a very important treatment for patients with end-stage lung diseae, and pulmonary rehabilitation (PR) is also an important factor in determining the prognosis. However, there is no much literature available on pulmonary rehabilitation in pediatric patients' post lung transplant. Through this case report, we would like to present our intensive PR program for pediatric patients' post-lung transplant. PATIENT CONCERNS: The 10-year-old boy's breathing before receiving a lung transplant continued to deteriorate and he eventually became dependent on a wheelchair. DIAGNOSIS: He was diagnosed with infantile acute lymphoblastic leukemia at 6 months of age. At the age of one year, he underwent allogeneic bone marrow transplantation, but was diagnosed with post-transplantation bronchiolitis obliterans (PTBO) two months later. He had a lung transplant at the age of 10. INTERVENTIONS: He was hospitalized and received an initial assessment. This assessment included functional, cognitive, and psychological evaluations. He additionally completed PR exercises twice daily for two weeks. After discharge, he continued to participate in an outpatient-based PR program for three months. During the outpatient phase, PR exercises were performed once weekly, in addition to home-based cognitive training. OUTCOMES: Our intensive post-lung PR program improved our patient's exercise capacity, lung function, and quality of life. As a comprehensive rehabilitation service, our program also included a cognitive training component. CONCLUSION: We describe an intensive PR program tailored to pediatric patients' post-lung transplant. The program was feasible and resulted in improvements in functional exercise capacity, lung function, and quality of life. Future research into our method is necessary for continued improvement of this novel program.


Asunto(s)
Bronquiolitis Obliterante/cirugía , Terapia por Ejercicio/métodos , Trasplante de Pulmón/rehabilitación , Terapia Respiratoria/métodos , Trasplante de Médula Ósea/efectos adversos , Bronquiolitis Obliterante/etiología , Bronquiolitis Obliterante/fisiopatología , Niño , Tolerancia al Ejercicio , Humanos , Pulmón/fisiopatología , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Resultado del Tratamiento
14.
Medicine (Baltimore) ; 100(16): e25561, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33879709

RESUMEN

ABSTRACT: Walking is an effective, well accepted, inexpensive, and functional intervention. This study compared the outcomes and changes in walking behavior of self-monitored (SM) and supervised (SU) walking interventions for older adults.Participants were assigned to SM (n = 21) and SU (n = 21) walking groups according to their place of residence. Both groups exercised and wore a pedometer for 3 months.The outcome measures were step count, body mass index (BMI), and physical function. Two-way repeated-measure ANOVA and independent t tests were used to compare the intervention effects. We also plotted the trends and analyzed the walking steps weekly.Only BMI exhibited a group × time interaction. The pre-posttest differences showed knee extension muscle strength (KEMS) and Timed Up and Go test were significantly improved in the SM group, whereas BMI, KEMS, 30-s sit-to-stand, functional reach were significantly improved, but 5-m gait speed significantly slower in the SU group. For participants attending ≥50% of the sessions, those in the SM and SU groups had similar results for all variables, except for 2-min step (2MS) and daily walking step counts.Both self-monitored and supervised walking benefit older adults in most physical functions, especially lower-extremity performance, such as muscle strength, balance, and mobility. The effects of both programs do not differ significantly, except for BMI and 2MS (ie cardiopulmonary endurance). We recommend pedometer-assisted self-monitored walking for older adults because of its ability to cultivate exercise habits over the long term, whereas supervised walking to establish effective exercise intensity.


Asunto(s)
Actigrafía/estadística & datos numéricos , Terapia por Ejercicio/psicología , Automanejo/estadística & datos numéricos , Caminata/fisiología , Caminata/psicología , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Índice de Masa Corporal , Femenino , Humanos , Rodilla/fisiología , Masculino , Fuerza Muscular , Resistencia Física , Taiwán , Estudios de Tiempo y Movimiento
15.
Artículo en Inglés | MEDLINE | ID: mdl-33801389

RESUMEN

Adherence is important for an exercise program's efficacy. This study aims at investigating whether the COVID-19 lockdown had different consequences on the adherence to an exercise program specifically designed for women with postmenopausal osteoporosis when administered as individual home training (IHT) or gym group training (GGT). At the start of the lockdown, which imposed the temporary closure of any gym activities, GGT participants were invited to continue to exercise at home. IHT participants continued to exercise at home as usual. Adherence was recorded via logs and measured as the percentage of exercise sessions actually performed out of the total number of scheduled sessions in three 1-month periods: one before (PRE) and two after (M1 and M2) the beginning of lockdown. Before lockdown, IHT (66.8% ± 26.6) and GGT (76.3% ± 26.6) adherence were similar. During lockdown, IHT participation increased (M1: 81.5% ± 31.0; M2: 88.0% ± 28.3), while that of GGT showed no statistical differences (M1: 79.4% ± 34.2; M2: 80.6% ± 36.4). Exercise protocols based on supervised gym practice must consider the possibility of disruptive events, which could cause a sudden interruption of gym activity and include educational initiatives to instruct participants to exercise effectively and safely without a trainer's direct supervision.


Asunto(s)
Osteoporosis Posmenopáusica , Control de Enfermedades Transmisibles , Ejercicio Físico , Terapia por Ejercicio , Femenino , Humanos , Osteoporosis Posmenopáusica/prevención & control
16.
Top Spinal Cord Inj Rehabil ; 27(1): 36-56, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33814882

RESUMEN

The population with SCI is at a significant risk for both insulin resistance and type 2 diabetes mellitus (T2DM) secondary to neurogenic obesity. The prevalence of insulin resistance and T2DM in persons with SCI suggests that disorders of carbohydrate metabolism are at epidemic proportions within the population. However, the true frequency of such disorders may be underestimated because biomarkers of insulin resistance and T2DM used from the population without SCI remain nonspecific and may in fact fail to identify true cases that would benefit from intervention. Furthermore, diet and exercise have been used to help mitigate neurogenic obesity, but results on disorders of carbohydrate metabolism remain inconsistent, likely because of the various ways carbohydrate metabolism is assessed. The objective of this article is to review current literature on the prevalence and likely mechanisms driving insulin resistance and T2DM in persons with SCI. This article also explores the various assessments and diagnostic criteria used for insulin resistance and T2DM and briefly discusses the effects of exercise and/or diet to mitigate disorders of carbohydrate metabolism brought on by neurogenic obesity.


Asunto(s)
Diabetes Mellitus Tipo 2/etiología , Resistencia a la Insulina , Obesidad/complicaciones , Traumatismos de la Médula Espinal/complicaciones , Diabetes Mellitus Tipo 2/terapia , Carbohidratos de la Dieta/metabolismo , Terapia por Ejercicio , Humanos , Obesidad/terapia , Traumatismos de la Médula Espinal/terapia
17.
Top Spinal Cord Inj Rehabil ; 27(1): 121-134, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33814890

RESUMEN

Background: Physical deconditioning and inactivity following spinal cord injury (SCI) are associated with multiple cardiometabolic risks. To mitigate cardiometabolic risk, exercise is recommended, but it is poorly established whether arm cycling exercise (ACE) or functional electrical stimulation (FES) leg cycling yields superior benefits. Objectives: To determine the adaptations of 16 weeks of FES cycling and ACE on exercise energy expenditure (EEE), cardiorespiratory fitness (CRF), and obesity after SCI. Methods: Thirteen physically untrained individuals were randomly assigned to FES (n = 6) or ACE (n = 7) exercise 5 days/week for 16 weeks. Pre- and post-intervention EEE, peak oxygen consumption (absolute and relative VO2Peak), and work were assessed using indirect calorimetry, while body composition was measured by dual-energy x-ray absorptiometry. Results: Main effects were found for peak power (p < .001), absolute (p = .046) and relative (p = .042) VO2Peak, and peak work (p = .013). Compared to baseline, the ACE group increased in EEE (+85%, p = .002), peak power (+307%, p < .001), VO2Peak (absolute +21%, relative +22%, p ≤ .024), peak work (19% increase, p = .003), and total body fat decreased (-6%, p = .05). The FES group showed a decrease in percentage body fat mass (-5%, p = .008). The ACE group had higher EEE (p = .008), peak power (p < .001), and relative VO2Peak (p = .025) compared to postintervention values in the FES group. Conclusion: In the current study, ACE induced greater increases in EEE and CRF, whereas ACE and FES showed similar results on body fat. Exercise promotional efforts targeting persons with SCI should use both FES and ACE to reduce sedentary behavior and to optimize different health parameters after SCI.


Asunto(s)
Composición Corporal/fisiología , Capacidad Cardiovascular/fisiología , Terapia por Estimulación Eléctrica/métodos , Metabolismo Energético/fisiología , Terapia por Ejercicio/métodos , Obesidad/terapia , Traumatismos de la Médula Espinal/terapia , Adulto , Enfermedades Cardiovasculares/prevención & control , Terapia Combinada , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/etiología , Obesidad/fisiopatología , Consumo de Oxígeno/fisiología , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/fisiopatología , Adulto Joven
18.
Top Spinal Cord Inj Rehabil ; 27(1): 109-120, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33814889

RESUMEN

Spinal cord injury (SCI) results in an array of cardiometabolic complications, with obesity being the most common component risk of cardiometabolic disease (CMD) in this population. Recent Consortium for Spinal Cord Medicine Clinical Practice Guidelines for CMD in SCI recommend physical exercise as a primary treatment strategy for the management of CMD in SCI. However, the high prevalence of obesity in SCI and the pleiotropic nature of this body habitus warrant strategies for tailoring exercise to specifically target obesity. In general, exercise for obesity management should aim primarily to induce a negative energy balance and secondarily to increase the use of fat as a fuel source. In persons with SCI, reductions in the muscle mass that can be recruited during activity limit the capacity for exercise to induce a calorie deficit. Furthermore, the available musculature exhibits a decreased oxidative capacity, limiting the utilization of fat during exercise. These constraints must be considered when designing exercise interventions for obesity management in SCI. Certain forms of exercise have a greater therapeutic potential in this population partly due to impacts on metabolism during recovery from exercise and at rest. In this article, we propose that exercise for obesity in SCI should target large muscle groups and aim to induce hypertrophy to increase total energy expenditure response to training. Furthermore, although carbohydrate reliance will be high during activity, certain forms of exercise might induce meaningful postexercise shifts in the use of fat as a fuel. General activity in this population is important for many components of health, but low energy cost of daily activities and limitations in upper body volitional exercise mean that exercise interventions targeting utilization and hypertrophy of large muscle groups will likely be required for obesity management.


Asunto(s)
Metabolismo Energético , Terapia por Ejercicio/métodos , Obesidad/complicaciones , Obesidad/terapia , Traumatismos de la Médula Espinal/complicaciones , Traumatismos de la Médula Espinal/terapia , Humanos , Conducta Sedentaria
19.
Wiad Lek ; 74(1): 48-51, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33851586

RESUMEN

OBJECTIVE: The aim: The overarching theme of this paper is to discuss implementation of the telemedicine technology for rehabilitation of patients with injuries of the lower extremities. PATIENTS AND METHODS: Materials and methods: Consecutive patients were recruited over a four-year period. A total of 48 polytrauma patients with lower extremity injuries were enrolled in the study after the resolution of the surgical sequelae. 16 patients from the control group underwent traditional rehabilitation procedures for a 3-week period after injury. A total of 32 subjects were enrolled in the telerehabilitation group for a 3-week study period after injury and were trained with a set of exercises for home use. Home remote monitoring for the 96 test subjects included use of a Portable device with Axis-sensor, temperature and volume sensors, that were fixed to the injured limb. Software permits the monitoring of exercise time, local temperature, the biomechanics of active movements of the injured limb. RESULTS: Results: The orthopedic surgeon during telerehabilitation took significantly less time to consult patients (1.9 minutes) than the traditional rehabilitation (15.2 minutes). Patient satisfaction was higher for the telerehabilitation with machine learning algorithm (78.3%) than for the orthopedic surgeon's traditional rehabilitation (36.7%). CONCLUSION: Conclusions: Subjects reported a higher satisfaction with telerehabilitation than with the traditional orthopedic rehabilitation due to the fact that they spent less time at the hospital and had more time for exercises at home under orthopedic remote monitoring. The telerehabilitation system can be used in complex rehabilitation of patients with injuries of the lower extremities.


Asunto(s)
Traumatismo Múltiple , Telemedicina , Telerrehabilitación , Terapia por Ejercicio , Humanos , Articulación de la Rodilla
20.
Artículo en Inglés | MEDLINE | ID: mdl-33801116

RESUMEN

BACKGROUND: The proportion of older adults is increasing worldwide and, with it, the physical inactivity common to this age group. Therefore, the promotion of active aging is a strategic factor in health policies for older people. The aim of this study was to identify the benefits and viability of the strength training program (STRENOLD) in health-related quality of life in adults over 60. METHODS: A controlled experimental study was carried out with a sample of 181 people over 60 years old from different European countries belonging to the European project IN COMMON SPORTS. A pair work strength program was administered (STRENOLD) over a period of 24 months, consisting of two single sessions per week. Their health status was evaluated (EQ-5D-5L) before and after the interventions. RESULTS: The adherence rate was over 89% and the tolerability rate over 100% in all participating countries. Significant improvements in the participants' health were demonstrated in the areas of mobility, usual activities, pain/discomfort, and anxiety/depression. CONCLUSIONS: The regular practice of physical exercise, through the partnered STRENOLD strength program, has benefits on mobility, usual activities, pain/discomfort, and anxiety/depression, in short, health benefits for older adults.


Asunto(s)
Estado de Salud , Calidad de Vida , Anciano , Anciano de 80 o más Años , Europa (Continente) , Ejercicio Físico , Terapia por Ejercicio , Humanos , Persona de Mediana Edad
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