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1.
Medicine (Baltimore) ; 99(18): e19826, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32358353

RESUMEN

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is an irreversible disease characterized by cough, sputum production, and dyspnea, and has a high prevalence and mortality. Pulmonary rehabilitation (PR) is a management that improves the quality of life for COPD patients; however, PR is not readily accessible. Therefore, we developed lung-conduction exercises (LCE) that can be performed without any limitations. LCE consists of breathing, stretching, and tapping to relieve dyspnea in COPD patients. METHODS/DESIGN: This randomized, assessor-blind, multicenter trial aims to recruit 54 patients with moderate and severe COPD. Subjects will be randomly allocated to a control group (only medication), an LCE group (medication + LCE, 5 times a week), or a PR group (medication + PR, 5 times a week). The 6-minute walk distance, pulmonary function tests (forced expiratory volume at 1 second, forced vital capacity, and forced expiratory volume at 1 second/forced vital capacity), modified Borg scale, modified medical research council dyspnea scale, COPD assessment test, and St. George respiratory questionnaire will be measured before starting the trial and after the 4th and 8th weeks to determine motor performance, lung function, and dyspnea. CONCLUSION: We aim to demonstrate that LCE is effective in improving symptoms and psychosomatic stability in COPD patients. Therefore, this trial will play an important role in fortifying the foundation of clinical application.


Asunto(s)
Ejercicios Respiratorios/métodos , Terapia por Ejercicio/métodos , Enfermedad Pulmonar Obstructiva Crónica/terapia , Terapia Respiratoria/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Pulmón/fisiopatología , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Ensayos Clínicos Controlados Aleatorios como Asunto , Pruebas de Función Respiratoria , Método Simple Ciego , Resultado del Tratamiento
2.
Med Sci Monit Basic Res ; 26: e924085, 2020 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-32389999

RESUMEN

BACKGROUND The aim of this study was to understand the changes in psychological factors and sleep status of front-line medical staff in the fight against COVID-19 and provide evidence of exercise interventions to relieve psychological stress and improve sleep status for medical staff. MATERIAL AND METHODS A survey study was conducted among 120 front-line medical staff in the fight against COVID-19, of which 60 medical staff worked at the designated hospital (experimental group) and 60 medical staff worked at the non-designated hospital (control group). The Symptom Checklist 90 (SCL-90), Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and PTSD Checklist-Civilian Version (PCL-C) were used to assess mental status. Sleep status was assessed using the Pittsburgh Sleep Quality Index (PSQI). RESULTS SCL-90 scores of somatization, depression, anxiety, and terror were higher than normal in front-line medical staff at the designated hospital. The SAS (45.89±1.117), SDS (50.13±1.813), and PCL-C (50.13±1.813) scores in the experimental group were higher than the normal control group, and were significantly different from those in the control group on SDS and PCL-C scales (P<0.05). The total average PSQI of the experimental group was 16.07±3.761, indicating that the sleep quality was poor. Among them, participants with moderate insomnia reached 61.67%, and participants with severe insomnia reached 26.67%. CONCLUSIONS There are psychological symptoms and sleep symptoms in front-line medical staff who participate in the fight against COVID-19, and they affect each other. Hospitals should improve emergency management measures, strengthen psychological counseling for clinical front-line medical staff, strengthen exercise intervention, and improve their sleep quality and mental health.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Disomnias/psicología , Terapia por Ejercicio , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Salud Mental/estadística & datos numéricos , Neumonía Viral/epidemiología , Sueño/fisiología , Adaptación Psicológica , Adulto , Ansiedad/epidemiología , China/epidemiología , Consejo , Depresión/epidemiología , Disomnias/epidemiología , Humanos , Persona de Mediana Edad , Pandemias , Latencia del Sueño/fisiología , Trastornos por Estrés Postraumático/epidemiología , Estrés Psicológico/epidemiología
3.
Medicine (Baltimore) ; 99(16): e19644, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32311937

RESUMEN

BACKGROUND: Polycystic ovary syndrome (PCOS) affects reproductive-aged women and is associated with increased prevalence of serious clinical problems including: reproductive implications, metabolic dysfunction, and cardiovascular risk. Physical activity offers several health benefits for women with PCOS. The aim of this systematic review was to synthesize evidence on the effect of different types of exercise on reproductive function and body composition for women with PCOS. METHODS: This was a systematic review and meta-analysis of randomized controlled trials (RCTs) following recommended review methods. We searched 6 databases: Cumulative Index of Nursing and Allied Health Literature; Embase; MEDLINE (via Ovid); PubMed; Sport Discus; and Web of Science; and we developed search strategies using a combination of Medical Subject Headings terms and text words related to exercise interventions for women with PCOS. There was no restriction on language or publication year. The search was conducted on April 16, 2019 and updated on November 15, 2019. Two authors independently screened citations, determined risk of bias and quality of evidence with Grading of Recommendations Assessment, Development and Evaluation. We conducted meta-analyses following recommended guidelines, and report results using standardized mean difference (SMD). RESULTS: Ten RCTs (n = 533) were included in this review. Studies tested the following interventions: aerobic, resistance, and combined (aerobic/resistance) training programs. Most studies were small (average 32, range 15-124 participants), and of relatively short duration (8-32 weeks). There was high heterogeneity for outcomes of reproductive function (menstrual cycle, ovulation, and fertility). We noted low certainty evidence for little to no effect of exercise on reproductive hormones and moderate certainty evidence that aerobic exercise reduced body mass index (BMI) in women with PCOS: BMI SMD -0.35, 95% confidence interval -0.56 to -0.14, P = .001. CONCLUSION: For women with PCOS, evidence is limited to discern the effect of exercise on major health outcomes (e.g., reproductive function). There is moderate certainty evidence that aerobic exercise alone is beneficial for reducing BMI in women with PCOS. Future studies should be conducted with longer duration, larger sample sizes, and should provide detailed information on menstrual cycle and fertility outcomes.PROSPERO Systematic review registration: 2017 CRD42017058869.


Asunto(s)
Terapia por Ejercicio , Síndrome del Ovario Poliquístico/terapia , Femenino , Humanos , Síndrome del Ovario Poliquístico/fisiopatología , Ensayos Clínicos Controlados Aleatorios como Asunto
4.
J Frailty Aging ; 9(2): 111-117, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32259186

RESUMEN

BACKGROUND: No study has performed an exercise intervention that included high-intensity, free-weight, functional resistance training, and assessed frailty status as an inclusion criteria and outcome measure via original, standardized tools, in pre-frail females. OBJECTIVES: Determine if the intervention strategy is not only feasible and safe, but can also improve frailty status, functional task performance, and muscle strength. DESIGN: Pilot, quasi-experimental. SETTING: Community. PARTICIPANTS: 20 older-adults with pre-frailty characteristics. INTERVENTION: 12-weeks (3 days/week, 45-60 minutes/session) of multi-component exercise, inclusive of aerobic, resistance, balance and flexibility exercises. The crux of the program was balance and resistance exercises, the latter utilized high-intensity, free-weight, functional resistance training. The control group maintained their usual care. MEASUREMENTS: 1) Feasibility and safety (dropout, adherence, and adverse event); 2) Frailty (Frailty Phenotype, Clinical Frailty Scale, and gait speed); 3) Functional task performance (grip strength and sit-to-stand time); and 4) Isometric and isotonic strength of the knee extensors and elbow flexors. RESULTS: No participants dropped out of the intervention or experienced an adverse event, and adherence averaged 88.3%. The exercise group became less frail, whereas the control group became more frail. There was a significant within-group improvement in exercise participants gait speed (p ≤ 0.01, +0.24 m/sec), grip strength (p ≤ 0.01, +3.9 kg), and sit-to-stand time (p ≤ 0.01, -5.0 sec). There was a significant within-group improvement in exercise participants knee extension isometric torque (p ≤ 0.05, +7.4 Nm) and isotonic velocity (p = ≤ 0.01, +37.5 ˚/sec). Elbow flexion isotonic velocity significantly declined within the control group (p ≤ 0.01, -20.2 ˚/sec) and demonstrated a significant between-group difference (p ≤ 0.05, 40.73 ˚/sec) post-intervention. CONCLUSIONS: The intervention strategy appears to be feasible and safe, and may also improve frailty status, functional task performance, and muscle strength. These results help calculate effect size for a future randomized controlled trial.


Asunto(s)
Terapia por Ejercicio/métodos , Fragilidad/prevención & control , Adulto , Anciano , Ejercicio Físico/fisiología , Femenino , Humanos , Fuerza Muscular/fisiología , Proyectos Piloto , Entrenamiento de Resistencia , Resultado del Tratamiento
5.
Clín. investig. arterioscler. (Ed. impr.) ; 32(2): 49-58, mar.-abr. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-187146

RESUMEN

Background and aims: The first line of therapy in children with hypercholesterolaemia is therapeutic lifestyle changes (TLSC). The efficacy of lifestyle intervention in children with familial hypercholesterolaemia (FH), where LDL-C levels are genetically driven, deserves a focused study. Aims: To evaluate the impact of a lifestyle education program, focused on food patterns and physical activity, on lipid profiles assessed by nuclear magnetic resonance (NMR) in children with FH vs. non-FH. Methods: Phase 1 was a cross-sectional study of baseline characteristics, and phase 2 was a prospective TLSC intervention study. In total, the study included 238 children (4 to 18 years old; 47% girls) attending the lipid unit of our hospital due to high cholesterol levels. Eighty-five were diagnosed with FH (72% genetic positive), and 153 were diagnosed with non-Familial hypercholesterolaemia. A quantitative food frequency questionnaire (FFQ) including 137 items was used. Physical activity (PA) was assessed by the Minnesota questionnaire. The lipid profile was assessed using the 2D-1H-NMR (Liposcale test). A total of 127 children (81 in the FH group) participated in the prospective phase and were re-assessed after 1 year of the TLSC intervention, consisting of education on lifestyle changes delivered by a specialized nutritionist. Results: The FH and non-FH groups were similar in anthropometry and clinical data, except that those in the FH were slightly younger than those in the non-FH group. Both the FH and non-FH groups showed a similar diet composition characterized by a high absolute calorie intake and a high percentage of fat, mainly saturated fat. The PA was below the recommended level in both groups. After one year of TLSC, the percentage of total and saturated fats was reduced, and the amount of fiber increased significantly in both groups. The percentage of protein increased slightly. The number of children engaged in at least 1 hour/day of PA increased by 56% in the FH group and by 53% in the non-FH group, and both these increases were significant. The total and small-LDL particle numbers were reduced in both groups, although the absolute change was greater in the FH group than in the non-FH group. Conclusions: Educational strategies to implement TLSC in children lead to empowerment, increased adherence, and overall metabolic improvement in children with high blood cholesterol, including those with FH


Antecedentes y objetivos: La primera línea de terapia en niños con hipercolesterolemia son los cambios terapéuticos en el estilo de vida (TLSC). La eficacia de la intervención en el estilo de vida en niños con hipercolesterolemia familiar (HF), en los que los niveles de LDL-C son generados genéticamente, merece un estudio específico. Objetivos: Evaluar el impacto de un programa de educación sobre el estilo de vida, centrado en los patrones alimentarios y la actividad física, sobre el perfil lipídico evaluado por resonancia magnética nuclear (RMN) en niños con HF versus no HF. Métodos: La fase 1 fue un estudio transversal de las características basales, y la fase 2 fue un estudio prospectivo de intervención mediante TLSC. En total, el estudio incluyó a 238 niños (de 4 a 18 años; 47% niñas) que asistieron a la unidad de lípidos de nuestro hospital debido a los altos niveles de colesterol. Ochenta y cinco fueron diagnosticados con HF (72% genéticamente positivos), y 153 fueron diagnosticados de no HF. Se utilizó un cuestionario cuantitativo de frecuencia de alimentos (FFQ) que incluye 137 ítems. La actividad física (AF) se evaluó mediante el cuestionario de Minnesota. El perfil lipídico se evaluó mediante la prueba 2D-1H-NMR (Liposcale Test). Un total de 127 niños (81 en el grupo HF) participaron en la fase prospectiva y fueron reevaluados después de 1 año de la intervención mediante TLSC, que consistió en educación sobre cambios en el estilo de vida impartida por una nutricionista especializada. Resultados: Los grupos HF y no HF fueron similares en los datos antropométricos y clínicos, excepto que los HF eran ligeramente más jóvenes que los no HF. Los participantes de ambos grupos mostraron una composición de dieta similar caracterizada por un alto consumo de calorías totales y un alto porcentaje de grasas, principalmente grasas saturadas. La AF estuvo por debajo del nivel recomendado en ambos grupos. Después de un año de TLSC, se redujo el porcentaje de grasas totales y saturadas, y la cantidad de fibra aumentó significativamente en ambos grupos. El porcentaje de proteína aumentó ligeramente. El número de niños involucrados en al menos 1 hora/día de AF aumentó en un 56% en el grupo de HF y en un 53% en el grupo sin HF, y ambos aumentos fueron significativos. Los números de partículas LDL totales y pequeñas se redujeron en ambos grupos, aunque el cambio absoluto fue mayor en el grupo HF que en el grupo no HF. Conclusiones: Las estrategias educativas para implementar TLSC en niños conducen al empoderamiento, al aumento de la adherencia y a la mejora metabólica general en niños con colesterol alto en sangre, incluidos aquellos con HF


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Hipercolesterolemia/sangre , Hipercolesterolemia/terapia , Estilo de Vida , Educación del Paciente como Asunto , Lipoproteínas LDL/sangre , Dietoterapia , Terapia por Ejercicio , Hiperlipoproteinemia Tipo II/sangre , Hiperlipoproteinemia Tipo II/terapia , Resonancia Magnética Nuclear Biomolecular , Estudios Transversales , Estudios Prospectivos , Resultado del Tratamiento
7.
Medicine (Baltimore) ; 99(17): e19874, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32332655

RESUMEN

INTRODUCTION: Heart transplantation (HT) is known to be the final therapy for patients with advanced heart failure; however, the exercise capacity of these patients remains under the aged-predicted value after HT. Many studies have described the effectiveness and safety of cardiac rehabilitation (CR) in HT recipients. Nevertheless, long-term follow-up data of HT recipients undergoing CR are insufficient, and there is a lack of evidence on the long-term effects of CR. In this case report, we present the long-term benefits of CR in an HT recipient, including serial follow-up clinical data over 1 year. PATIENT CONCERNS: A 48-year-old female patient underwent HT because of advanced dilated cardiomyopathy. DIAGNOSIS: Cardiopulmonary exercise test showed reduced exercise capacity and pulmonary function. The grip power and quadriceps muscle strength were also decreased after HT. INTERVENTIONS: The patient underwent a phase I CR program for 3 months, followed by a phase III CR program for 7 months. In the beginning, moderate-intensity continuous training was conducted. Thereafter, high-intensity interval training was implemented after a period of adjustment for interval training. OUTCOMES: The exercise capacity, 6-min walk distance, muscle strength, and vital capacity were improved after CR. CONCLUSION: CR in HT recipients may improve muscle strength and pulmonary function as well as exercise capacity, without serious cardiovascular complications. Phase III CR may help maintain exercise capacity in these patients.


Asunto(s)
Cuidados Posteriores/métodos , Rehabilitación Cardiaca/normas , Trasplante de Corazón/rehabilitación , Resultado del Tratamiento , Rehabilitación Cardiaca/métodos , Rehabilitación Cardiaca/tendencias , Cardiomiopatía Dilatada/complicaciones , Cardiomiopatía Dilatada/fisiopatología , Cardiomiopatía Dilatada/cirugía , Terapia por Ejercicio/métodos , Tolerancia al Ejercicio , Femenino , Trasplante de Corazón/psicología , Trasplante de Corazón/normas , Humanos , Persona de Mediana Edad
8.
Medicine (Baltimore) ; 99(16): e19641, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32311935

RESUMEN

BACKGROUND: We conducted this meta-analysis to analyze the effectiveness of balance training in improving postoperative rehabilitation outcomes in hip fracture surgery patients. METHODS: The Cochrane Library, Web of Science, Embase, and PubMed electronic databases were searched from their inception to December 2018. We selected prospective clinical control analyses and high-quality randomized controlled trials (RCTs) following the inclusion standards. We used Stata 12.0 to perform the meta-analysis. Where possible, the standard mean difference (SMD) with the 95% confidence interval (CI) was determined using a random effects model. RESULTS: Ten RCTs involving 955 hips (balance training = 487, control = 468) published between 2002 and 2019 were assessed for eligibility of inclusion in the meta-analysis. Balance training was shown to remarkably improve the aspects of quality of life associated with physical health (standard mean difference [SMD], 2.20; 95% CI, 1.63-2.78, P = .000), a fast gait speed (SMD, 1.01; 95% CI, 0.25-1.77, P = .009), and balance (SMD = 0.26, 95% CI: [0.12, 0.41], P = .000). Moreover, the balance training group showed increases in independence in activities of daily living (ADLs), performance task scores, and health-related quality of life (HRQoL) scores compared with the control group (P < .05). CONCLUSION: According to the present meta-analysis, balance training improves one's independence in activities of daily living, performance tasks, lower limb strength, gait, and total physical function compared with no balance training. More high-quality RCTs with large sample sizes are required for the identification of the best balance training program after hip fracture.


Asunto(s)
Actividades Cotidianas , Fracturas de Cadera/rehabilitación , Modalidades de Fisioterapia , Equilibrio Postural , Terapia por Ejercicio , Humanos , Rendimiento Físico Funcional , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Velocidad al Caminar
11.
Ann Palliat Med ; 9(2): 405-413, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32233626

RESUMEN

BACKGROUND: Breathing exercises can improve the symptoms of patients with gastroesophageal reflux disease (GERD), but their specific effect and function are disputed. To evaluate and conduct a meta-analysis on the effect of breathing exercises on patients with GERD. METHODS: A literature search for randomized controlled trials (RCTs) and prospective studies on the effects of employing breathing exercises on patients with GERD was conducted of all major online English databases (PubMed, Embase, the Cochrane library, CENTRAL, Web of Science, AMED, and CINAHL). After the systematic review of all the studies according to inclusion and exclusion criteria, we analyzed the extracted data through meta-analysis by using RevMan 5.3 software. RESULTS: This thesis analyzes 7 studies (including three RCTs), which together involved 194 patients and 16 healthy volunteers. The primary outcomes of these studies included GERD symptoms, esophageal manometry, esophageal pH monitoring, laryngoscopic findings, and acid suppression usage. The results of meta-analysis indicate that breathing exercises can improve pressure generated by the lower oesophageal sphincter (LES), and a statistically significant difference was observed. The possible mechanism behind this is the enhancement of the anti-regurgitation barrier [especially crural diaphragm (CD) tension]. CONCLUSIONS: To some extent, breathing exercises can relieve the symptoms of patients with GERD.


Asunto(s)
Ejercicios Respiratorios/métodos , Terapia por Ejercicio/métodos , Reflujo Gastroesofágico/terapia , Femenino , Humanos , Masculino , Estudios Prospectivos , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Pruebas de Función Respiratoria
12.
BMJ ; 369: m877, 2020 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-32253188

RESUMEN

The studyHodkinson A, Kontopantelis E, Adeniji C, et al. Accelerometer- and pedometer-based physical activity interventions among adults with cardiometabolic conditions: a systematic review and meta-analysis JAMA Network Open 2019;2:e1912895.This study was funded by the NIHR School for Primary Care Research (project number 390 ESWG Workstream 3).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000880/pedometers-can-help-people-get-more-active-as-part-of-an-exercise-programme.


Asunto(s)
Actigrafía/instrumentación , Ejercicio Físico , Terapia por Ejercicio , Humanos , Atención Primaria de Salud
13.
14.
Am J Phys Med Rehabil ; 99(4): 285-290, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32195715

RESUMEN

OBJECTIVE: Distal radius fractures in the older population significantly impair grip strength. The aim of the study was to investigate whether a hand strength focused exercise program during the period of immobilization for nonoperatively managed distal radius fractures in this population improved grip strength and quality of life. DESIGN: This is a single-center randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Fifty-two patients older than 60 yrs who experienced distal radius fractures managed nonoperatively with cast immobilization. The intervention group (n = 26) received a home hand strength-focused exercise program from 2 and 6 wks after injury while immobilized in a full short arm cast. The control group (n = 26) performed finger range of motion exercises as per protocol. Primary outcome was grip strength ratio of injured arm compared with uninjured arm. Secondary outcome included functional scores of the 11-item shortened version of the Disabilities of the Arm, Shoulder and Hand. Outcomes were measured at 2, 6, and 12 wks after injury. RESULTS: The intervention group significantly improved grip strength ratio at both 6 and 12 wks (6 wks: 40% vs 25%, P = 0.0044, and 12 wks: 81% vs 51%, P = 0.0035). The intervention group improved the 11-item Disabilities of the Arm, Shoulder and Hand score at 12 wks; however, this was not statistically significant (25 vs 40, P = 0.066). CONCLUSIONS: A hand strength-focused exercise program for elderly patients with distal radius fractures while immobilized significantly improved grip strength.


Asunto(s)
Terapia por Ejercicio/métodos , Fijación de Fractura/rehabilitación , Fuerza de la Mano , Fracturas del Radio/rehabilitación , Traumatismos de la Muñeca/rehabilitación , Anciano , Moldes Quirúrgicos , Femenino , Humanos , Análisis de Intención de Tratar , Masculino , Persona de Mediana Edad , Fracturas del Radio/fisiopatología , Método Simple Ciego , Resultado del Tratamiento , Traumatismos de la Muñeca/fisiopatología
15.
J Rehabil Med ; 52(4): jrm00040, 2020 Apr 14.
Artículo en Inglés | MEDLINE | ID: mdl-32179929

RESUMEN

OBJECTIVES: To investigate if an intensive rehabilitation programme, including intensive exercise and patient education, for young adults with inflammatory arthritis, conducted in a warm climate, has long-term effects on general health status compared with usual care. DESIGN: Open randomized controlled trial. PATIENTS: A total of 64 patients with inflammatory arthritis, aged 20-35 years. METHODS: Patients underwent randomized allocation to an intensive 17-day rehabilitation programme in a warm climate (intervention group) or to usual care with no structured rehabilitation (control group). The primary outcomes were physical function, assessed by the "30-second Sit to Stand test"(30sSTS), and coping, measured by the "Effective Musculoskeletal Consumer Scale" (EC17). RESULTS: A total of 64 patients (mean age 27.5 years, 62.5% female) were randomized. Thirty out of 32 patients completed the intervention. At 12-month follow-up, 7 patients were lost to follow-up; 4 from the intervention group and 3 from the control group. The intervention group showed significant improvement in the physical function test at 3 months; estimated mean difference (95% confidence interval): 5.5 (2.8-8.1), 6 months 3.6 (0.4-6.8) and 12 months 4.0 (0.0-7.9), compared with the control group. There were no differences in coping between the 2 groups at 3, 6 or 12 months. CONCLUSION: Rehabilitation in a warm climate improves physical functioning, but not coping, in young adults with inflammatory arthritis.


Asunto(s)
Artritis/rehabilitación , Clima , Terapia por Ejercicio , Educación del Paciente como Asunto , Adaptación Psicológica , Adulto , Artritis/psicología , Femenino , Estado de Salud , Calor , Humanos , Masculino , España , Adulto Joven
16.
Acta méd. costarric ; 62(1): 18-25, ene.-mar. 2020. tab, graf
Artículo en Español | LILACS | ID: biblio-1088533

RESUMEN

Resumen Antecedente y objetivo: El cáncer es una de las enfermedades que genera mayor mortalidad en el mundo. Los programas de rehabilitación basados en ejercicios se muestran efectivos y seguros para mitigar los efectos del cáncer. El objetivo fue determinar los cambios de la fatiga asociada al cáncer de mama luego de un programa de entrenamiento de alta intensidad (HIIT), o continuo a intensidad moderada (MICT). Métodos: Ensayo clínico aleatorizado con 236 pacientes con cáncer de mama en estadio II, distribuidos en 3 grupos (MICT, HIIT y grupo control), a quienes se les aplicó la escala FACT Fatigue Scale, test de calidad de vida, ecocardiograma, prueba de esfuerzo, tolerancia y percepción nal ejercicio mediante la prueba de caminata de los 6 minutos y escala de Borg, respectivamente. El programa de entrenamiento tuvo una duración de 36 sesiones de 70 minutos, 3 veces por semana. Resultados: Luego de comparar los respectivos grupos, se evidenció cambios significativos en todas las variables de los grupos HIIT y MICT (p=<0,05 %) frente al grupo control. Además, hubo una mejoría posentrenamiento, de la fatiga asociada al cáncer de mama en el grupo HIIT (20,4±5,6 vs 5,1±3,6) y MICT (18.6±9.5 vs 8.0±4.2). Conclusiones: Estos tipos de entrenamiento mejoraron la tolerancia al ejercicio, fuerza, vo2 y sobre todo, la fatiga asociada al cáncer y la calidad de vida de las pacientes. Y el grupo control de atención habitual sin entrenamiento físico o ejercicio supervisado, no presentó cambios significativos ni mejoras en la fatiga asociada al cáncer de mama. Trial registration: Clinicaltrials.gov NCT03915288


Abstract Background and objective: Cancer is one of the diseases that generate the highest mortality in the world. Exercise-based rehabilitation programs are effective and safe to mitigate the effects of cancer. The objective was to determine the changes in fatigue associated with breast cancer after a highintensity training program (HIIT), or a continuous training at moderate intensity (MICT). Methods: Randomized clinical trial with 236 patients with stage II breast cancer, distributed in 3 groups (MICT, HIIT, and control group), to whom the FACT-Fatigue Scale and quality of life test were applied and an effort echocardiogram was performed. Tolerance, and perception of the exercise were evaluated through the test of walk of the 6 minutes and scale of Borg respectively. The training program lasted 36 sessions of 70 minutes, 3 times per week. Results: After comparing the respective groups, significant changes were evident in all the variables of the HIIT and MICT groups (p = <0.05%) compared to the control group. Also, there was a postworkout improvement of fatigue associated with breast cancer in the HIIT group (20.4 ± 5.6 vs. 5.1 ± 3.6) and MICT (18m6 ± 9m5 vs. 8m0 ± 4m2). Conclusions: These types of training improved exercise tolerance, strength, VO2 and, above all, cancer-associated fatigue and patients quality of life. The usual care control group without physical training or supervised exercise did not show significant changes or improvements in fatigue associated with breast cancer. Trial registration: Clinicaltrials.gov NCT03915288


Asunto(s)
Humanos , Neoplasias de la Mama , Ejercicio Físico , Terapia por Ejercicio , Fatiga/rehabilitación , Entrenamiento de Intervalos de Alta Intensidad , Entrenamiento Aeróbico
17.
Rev Med Suisse ; 16(684): 444-447, 2020 Mar 04.
Artículo en Francés | MEDLINE | ID: mdl-32134223

RESUMEN

The health benefits of regular physical activity are undeniable. There is a dose-response relationship between total physical activity and health outcomes, and thus every opportunity should be seized to exercise more. Among the methods used to increase the level of physical activity, physical activity counselling delivered in clinical practice is effective. The Pas à Pas+ project presented in this article allows to extend the advice from the healthcare professional and to lead up the patient to a physically more active lifestyle, providing a support in physical activity on prescription. There are several -challenges that need to be addressed in order to anchor definitely physical activity counselling and its delegation to professionals in adapted physical activity in the healthcare setting.


Asunto(s)
Consejo , Ejercicio Físico/fisiología , Terapia por Ejercicio , Humanos , Estilo de Vida
19.
Medicine (Baltimore) ; 99(10): e19517, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32150113

RESUMEN

INTRODUCTION: Radiotherapy is a valid treatment option for nasopharyngeal carcinoma. However, complications can occur following irradiation of the closest anatomical structures, including brainstem radionecrosis (BRN). The rehabilitation is poorly described in patients with BRN, despite its usefulness in improving functional independence in patients with brain tumors. We aimed at testing the usefulness of intensive, robot-assisted neurorehabilitation program to improve functional independence in a 57-year-old male with BRN. PATIENT CONCERNS: A 57-year-old male diagnosed with a nasopharyngeal carcinoma, received a radiation total dose of 72 Gy. Owing to the appearance of a severe symptomatology characterized by dysphagia, hearing loss, and left sided hemiparesis, the patient was hospitalized to be provided with intensive pharmacological and neurorehabilitation treatment. DIAGNOSIS: Follow-up brain magnetic resonance imaging disclosed no residual cancer, but some brainstem lesions compatible with BRN areas were appreciable. INTERVENTION: The patient underwent a 2-month conventional, respiratory, and speech therapy. Given that the patient only mildly improved, he was provided with intensive robot-aided upper limb and gait training and virtual reality-based cognitive rehabilitation for other 2 months. OUTCOMES: The patient reported a significant improvement in functional independence, spasticity, cognitive impairment degree, and balance. CONCLUSION: Our case suggests the usefulness of neurorobotic intensive rehabilitation in BRN to reduce functional disability. Future studies should investigate whether an earlier, even multidisciplinary rehabilitative treatment could lead to better functional outcome in patients with BRN.


Asunto(s)
Tronco Encefálico/lesiones , Terapia por Ejercicio , Neoplasias Nasofaríngeas/radioterapia , Traumatismos por Radiación/rehabilitación , Robótica , Tronco Encefálico/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Paresia/rehabilitación , Traumatismos por Radiación/diagnóstico por imagen
20.
Med Sci Monit ; 26: e920208, 2020 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-32202262

RESUMEN

BACKGROUND Neck pain is reported by many laborers who are at risk of experiencing musculoskeletal disorders due to muscle stiffness and hypokinetics. This study examined the effects of a lower trapezius exercise program on neck pain patients. MATERIAL AND METHODS The design of this study was a randomized controlled trial. A total of 40 neck pain patients participated in this study. Screening tests were performed and assigned to experimental group (n=20) and control group (n=20) using randomization program. Both groups underwent a scapula and thoracic spine stabilization exercise program. In addition, the experimental group implemented the lower trapezius strengthening exercise program. All interventions were applied 3 times per week for 4 weeks. Visual Analogue Scale (VAS), Neck Disability Index (NDI), postural alignment, muscle thickness and contraction rate were compared to evaluate the effect on intervention. RESULTS Both groups showed significant differences in VAS, NDI, and postural alignment before and after intervention (P<0.05). In addition, the experimental group showed more significant difference in the amount of change in NDI and postural alignment values than the control group. The experimental group showed significant improvement in muscle thickness and contraction (P<0.05). CONCLUSIONS A lower trapezius strengthening exercise program is an effective method with clinical significance for reducing the level of neck dysfunction, and improving the postural alignment, muscle thickness, and contraction rate of the lower trapezius muscle.


Asunto(s)
Terapia por Ejercicio/métodos , Dolor de Cuello/terapia , Músculos Superficiales de la Espalda/fisiología , Adulto , Femenino , Humanos , Masculino , Músculo Esquelético/fisiopatología , Dimensión del Dolor/métodos , Postura , Resultado del Tratamiento
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