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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
3.
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
4.
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
5.
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
6.
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
7.
Medicine (Baltimore) ; 99(13): e19260, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32221061

RESUMEN

BACKGROUND: Flexible flatfoot is a condition characterized by the deformations of the foot where the calcaneus is pronated by weight support. Flat feet can affect balance and the entire chain of motion, causing indirect problems in adjacent joints. We investigated the effects of short foot exercise (SFE) using visual feedback on the static balance and function of proximal joints in subjects with flexible flat feet. METHOD AND ANALYSIS: This study involved 30 participants who were assigned to either of the 2 groups: the flexible flatfoot group (n = 15, 8 men and 7 women, aged 22.00 ±â€Š2.07 years) and normal foot group (n = 15, 7 men and 8 women, aged 22.13 ±â€Š1.55 years). All subjects performed the SFE with visual feedback. SFE programs were performed 20 minutes a day, 5 times a week, for a total of 5 weeks. The static balance and accuracy of knee joint motions were compared before and after training. RESULTS: There was a significant difference in static balance pre- and post-exercise in the flatfoot group but not in the normal foot group. Moreover, in the flatfoot group, the accuracy of knee joint motions was significantly different between pre- and post-exercise in the closed chain but not in the open chain. CONCLUSION: This study examined the influence of SFE using visual feedback on the balance and accuracy of knee joint movements in subjects with flatfoot and demonstrated that this exercise, using visual feedback, improved the balance and accuracy of knee movement.


Asunto(s)
Terapia por Ejercicio/métodos , Retroalimentación Sensorial , Pie Plano/terapia , Equilibrio Postural/fisiología , Fenómenos Biomecánicos , Femenino , Humanos , Articulación de la Rodilla/fisiopatología , Masculino , Estudios Prospectivos , Adulto Joven
8.
Medicine (Baltimore) ; 99(12): e19427, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32195937

RESUMEN

BACKGROUND: Severe and morbid obesity are increasing globally, particularly in women. As BMI increases, the likelihood of anovulation is higher. The primary aim of the EMOVAR clinical trial is to examine, over the short (16 weeks) and medium (12 months) term, the effects of a supervised physical exercise program (focused primarily on aerobic and resistance training) on ovarian function in women with severe/morbid obesity who have undergone bariatric surgery. Secondary objectives are to examine the effects of the intervention on chronic inflammation, insulin resistance, arterial stiffness, physical fitness, and health-related quality of life. METHODS: This is a randomized controlled trial in which ∼40 female bariatric surgery patients, aged between 18 and 45 years old, will be included. Participants assigned to the experimental group will perform a total of 48 sessions of supervised concurrent (strength and aerobic) training (3 sessions/week, 60 min/session) spread over 16 weeks. Patients assigned to the control group will receive lifestyle recommendations. Outcomes will be assessed at baseline, week 16 (i.e., after the exercise intervention) and 12 months after surgery. The primary outcome is ovarian function using the Sex-Hormone Binding Globuline, measured in serum. Secondary outcomes are serum levels of anti-mullerian hormone, TSH, T4, FSH, LH, estradiol, prolactine, and free androgen index, as well as oocyte count, the diameters of both ovaries, endometrial thickness, and uterine arterial pulsatility index (obtained from a transvaginal ultrasound), the duration of menstrual bleeding and menstrual cycle duration (obtained by personal interview) and hirsutism (Ferriman Gallwey Scale). Other secondary outcomes include serum markers of chronic inflammation and insulin resistance (i.e., C-reactive protein, interleukin 6, tumor necrosis factor-alpha, leptin, glomerular sedimentation rate, glucose, insulin and the HOMA-IR), arterial stiffness, systolic, diastolic and mean blood pressure, body composition, and total weight loss. Physical fitness (including cardiorespiratory fitness, muscular strength, and flexibility), health-related quality of life (SF-36 v2) and sexual function (Female Sexual Function Index) will also be measured. DISCUSSION: This study will provide, for the first time, relevant information on the effects of exercise training on ovarian function and underlying mechanisms in severe/morbid obese women following bariatric surgery. TRIAL REGISTRATION NUMBER: ISRCTN registry (ISRCTN27697878).


Asunto(s)
Cirugía Bariátrica/rehabilitación , Terapia por Ejercicio/métodos , Obesidad Mórbida/terapia , Adolescente , Adulto , Ejercicio Físico , Femenino , Humanos , Inflamación/fisiopatología , Resistencia a la Insulina/fisiología , Persona de Mediana Edad , Obesidad Mórbida/cirugía , Pruebas de Función Ovárica , Aptitud Física/fisiología , Calidad de Vida , Método Simple Ciego , Rigidez Vascular/fisiología , Adulto Joven
9.
Med Sci Monit ; 26: e921295, 2020 Mar 17.
Artículo en Inglés | MEDLINE | ID: mdl-32182226

RESUMEN

BACKGROUND This study examined the effects of abdominal draw-in lumbar stabilization exercises (ADIM) with respiratory resistance on women ages 40-49 years with low back pain. MATERIAL AND METHODS Forty-four women ages 40-49 years were screened for participation and were randomly assigned to either a respiratory with resistance exercise group (n=22) or a control group (n=22). Abdominal draw-in lumbar stabilization exercises were administered to both groups, but only the respiratory with resistance exercise group received the respiratory resistance training. The exercise training lasted 50 min per session, 3 sessions per week for 4 weeks. The assessment methods used were the quadruple visual analogue scale (QVAS), Oswestry disability index-Korean version (ODI-K), diaphragm thickness and contraction rate, and lung capacity test. RESULTS Both groups showed significant differences in the QVAS, ODI-K, maximum voluntary ventilation (MVV), and diaphragm thickness and contraction rate before and after the intervention (p<0.05). In the respiratory resistance exercise group, the ODI-K, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), MVV, and diaphragm thickness and contraction rate showed significantly better improvement than the control group (p<0.05). CONCLUSIONS A lumbar stabilization exercise program consisting of ADIM and respiratory resistance resulted in decreased pain, reduced dysfunctions, and increased muscle thickness in contraction, contraction rate, and pulmonary function. Strong contraction of the diaphragm and deep abdominal muscles through breathing resistance increased the pressure in the abdominal cavity. Therefore, this may be an effective clinical exercise method for patients with lumbar instability.


Asunto(s)
Ejercicios Respiratorios/métodos , Terapia por Ejercicio/métodos , Dolor de la Región Lumbar/terapia , Músculos Abdominales/fisiopatología , Adulto , Femenino , Humanos , Dolor de la Región Lumbar/fisiopatología , Persona de Mediana Edad , Músculos Respiratorios/fisiopatología , Resultado del Tratamiento
10.
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
11.
Fisioterapia (Madr., Ed. impr.) ; 42(1): 51-55, ene.-feb. 2020. tab
Artículo en Español | IBECS | ID: ibc-187815

RESUMEN

Antecedentes y objetivo: El síndrome de Parkinson-Plus, también conocido como síndrome parkinsoniano atípico, es clínicamente muy heterogéneo y presenta una mala respuesta a los tratamientos farmacológicos antiparkinsonianos. Además, tiene peor pronóstico y una progresión más rápida comparado con la enfermedad de Parkinson. Dada la poca evidencia existente en la aplicación de terapia por ejercicio en este síndrome, y con la intención de ir formando un cuerpo de conocimiento sobre el uso de dichas terapias en estos pacientes, se presenta la intervención realizada en 2 pacientes. Material y métodos: Se intervino en 2 pacientes con síndrome de Parkinson-plus mediante un programa de ejercicios de atención focalizada, concebido específicamente para este colectivo y con la finalidad de atenuar o detener la vertiginosa pérdida de las capacidades físicas y mentales. Se realizaron 2 controles (pre y postintervención) y las escalas empleadas fueron la versión española del 39-item Parkinson's Disease Questionnaire y la Escala de Tinetti, así como el Mini-Mental State Exam para descartar trastorno cognitivo que impidiese seguir la sesión. Resultados y conclusiones: Se objetiva una leve mejoría en los valores absolutos de equilibrio, marcha y calidad de vida. Los hallazgos sugieren una probable utilidad del programa de ejercicios implementado, como una estrategia rehabilitadora válida, ya que podría mejorar y/o evitar la rápida pérdida de capacidades funcionales que afectan al equilibrio, la marcha y la calidad de vida. Se hacen necesarios estudios más apropiados para refrendar estas conclusiones


Background and objective: Parkinson-plus syndrome, also known as atypical Parkinsonian syndrome, is very heterogeneous clinically and responds poorly to antiparkinsonian (drug) therapies. It is characterized by worse prognosis and faster clinical progression compared to Parkinson's Disease. Evidence supporting the application of exercise therapy in this syndrome is lacking, we present here a therapeutic approach to these subjects with the aim of proposing a framework for therapists. Material and methods: Two patients with Parkinson-plus syndrome were treated through a programme of focused-attention exercises, specifically designed for this group and with the aim of decreasing or stopping the loss of physical and mental abilities. Two controls were carried out (pre and post intervention) and the scales used were the Spanish version of the 39-item Parkinson's Disease Questionnaire and the Tinetti Scale, as well as the Mini Mental State Exam to rule out cognitive disorder that would prevent the subjects following the sessions. Results and conclusions: A slight improvement was observed in the absolute values of balance, gait and quality of life. The findings suggest probable utility of the exercise programme implemented, as a valid rehabilitative strategy, since it could improve and/or prevent the rapid loss of functional capacities that affect balance, gait and quality of life. More appropriate studies are necessary to endorse these conclusions


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Anciano , Enfermedad de Parkinson/terapia , Terapia por Ejercicio/métodos , Estudios Controlados Antes y Después/métodos , Equilibrio Postural , Calidad de Vida , Marcha/fisiología , Trastornos Neurológicos de la Marcha/rehabilitación
12.
Rev. neurol. (Ed. impr.) ; 70(3): 93-102, 1 feb., 2020. graf, tab
Artículo en Español | IBECS | ID: ibc-187254

RESUMEN

Introducción: El ictus afecta gravemente a la funcionalidad y la calidad de vida de la persona. Por ello, uno de los objetivos principales es la recuperación funcional del miembro superior. La terapia robótica supone una nueva orientación hacia la cual dirigir la rehabilitación del paciente con ictus. Por ello, se realizó una revisión bibliográfica sobre la efectividad del dispositivo Armeo(R) en la rehabilitación del miembro superior en pacientes con ictus. Desarrollo: Se recopilaron artículos que investigaran la rehabilitación del miembro superior a través de Armeo en pacientes con ictus hasta abril de 2019. Se consultaron las siguientes bases de datos: PubMed, Web of Science, Medline Complete, Scopus, CINAHL y BRAIN. Se analizaron seis artículos, entre los cuales había ensayos controlados aleatorizados y ensayos clínicos. Los principales resultados de los estudios indican una tendencia positiva de la terapia robótica con Armeo combinada con terapia convencional. Conclusión: La baja calidad metodológica y las limitaciones encontradas en los estudios determinan la necesidad de estudios futuros que investiguen la efectividad del dispositivo. A pesar de ello, el efecto positivo observado motiva a nuevas investigaciones


Introduction: The stroke affects the functionality and quality of life of the person. Therefore, one of the main objectives is the functional recovery of the upper limb. Robotic therapy is a new tool of rehabilitation in stroke patients. The aim of this paper is to accomplish a bibliographic review about the effectiveness of the Armeo(R) device in the rehabilitation of the upper limb in patients with stroke. Development: This review includes studies dated until April 2019, which investigate the rehabilitation of the upper limb through Armeo in patients with stroke. The following databases were consulted: PubMed, Web of Science, Medline Complete, Scopus, CINAHL and BRAIN. Six articles were selected and analyzed, including randomized controlled trials and clinical trials. The main results of the studies indicate a positive trend of the robotic therapy with Armeo combined with conventional therapy. Conclusion: The low quality and the limitations found on the studies determine the need for future studies that investigate the effectiveness of the device. Despite this, the positive effect observed motivates new research


Asunto(s)
Humanos , Rehabilitación Neurológica , Extremidad Superior/fisiopatología , Robótica/métodos , Rehabilitación de Accidente Cerebrovascular/métodos , Resultado del Tratamiento , Cognición , Terapia por Ejercicio/métodos , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/terapia
13.
PLoS One ; 15(2): e0218228, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32032358

RESUMEN

Systemic and central cardiovascular adaptations may vary in response to chronic exercise performed with different intensities and volumes. This study compared the effects of aerobic training with different intensities but equivalent volume upon microvascular reactivity in cremaster muscle and myocardial biomarkers of oxidative stress in Wistar rats. After peak oxygen uptake (VO2peak) assessment, rats (n = 24) were assigned into three groups: moderate-intensity exercise training (MI); high-intensity exercise training (HI); sedentary control (SC). Treadmill training occurred during 4 weeks, with exercise bouts matched by the energy expenditure (3.0-3.5 Kcal). Microvascular reactivity was assessed in vivo by intravital microscopy in cremaster muscle arterioles, while biomarkers of oxidative stress and eNOS expression were quantified at left ventricle and at aorta, respectively. Similar increasing vs. sedentary control group (SC) occurred in moderate intensity training group (MI) and high-intensity training group (HI) for endothelium-dependent vasodilation (10-4M: MI: 168.7%, HI: 164.6% vs. SC: 146.6%, P = 0.0004). Superoxide dismutase (SOD) (HI: 0.13 U/mg vs. MI: 0.09 U/mg and SC: 0.06 U/mg; P = 0.02), glutathione peroxidase (GPX) (HI: 0.00038 U/mg vs. MI: 0.00034 U/mg and SC: 0.00024 U/mg; P = 0.04), and carbonyl protein content (HI: 0.04 U/mg vs. MI: 0.03 U/mg and SC: 0.01 U/mg; P = 0.003) increased only in HI. No difference across groups was detected for catalase (CAT) (P = 0.12), Thiobarbituric acid reactive substances (TBARS) (P = 0.38) or eNOS expression in aorta (P = 0.44). In conclusion, higher exercise intensity induced greater improvements in myocardium antioxidant defenses, while gains in microvascular reactivity appeared to rely more on exercise volume than intensity.


Asunto(s)
Terapia por Ejercicio/métodos , Isquemia Miocárdica/terapia , Estrés Oxidativo , Condicionamiento Físico Animal/métodos , Vasodilatación , Animales , Aorta/metabolismo , Glutatión Peroxidasa/genética , Glutatión Peroxidasa/metabolismo , Ventrículos Cardíacos/metabolismo , Masculino , Microvasos/fisiología , Óxido Nítrico Sintasa de Tipo III/metabolismo , Consumo de Oxígeno , Carbonilación Proteica , Ratas , Ratas Wistar , Superóxido Dismutasa/genética , Superóxido Dismutasa/metabolismo
14.
Pneumologie ; 74(4): 201-209, 2020 Apr.
Artículo en Alemán | MEDLINE | ID: mdl-32053838

RESUMEN

BACKGROUND: The aim of this study was to evaluate the effects of an outpatient medical rehabilitation (OMR) mainly composed of exercise therapy and sports for patients with asbestosis and focused on keeping up sustainability effects. METHODS: 157 male patients aged 65.2 ±â€Š5.7 years suffering from asbestosis carried out over a period of three weeks 5 times weekly 6 h at a time phase 1 of the OMR consisting of evidence-based contents of the pulmonary rehabilitation. In the immediately following phase 2, the patients completed once a week for 3 hours over 12 weeks further therapeutic applications with the main focus on exercise therapy and sports and were subsequently transferred to health sports groups near to residence (phase 3). The effects of the OMR were evaluated at the beginning (T1), at the end of phase 1 (T2) and phase 2 (T3) as well as 6 (T4) and 20 months (T5) after T3. 61 patients (73.5 years ±â€Š5.6) were re-examined 6 years after T5 (T6) without any interim care. RESULTS: 72.1 % of the 61 patients (n = 44) carried out health sports twice a week in T5 as well as in T6 eight years after T1 and were able to maintain their physical performance (6-minute walk test, hand force, PWC test) as well as the perceived quality of life (SF-36, baseline/transition dyspnea index) according to age, while the rehab effects of the 17 patients breaking off any sporting activities after T3 fell significantly (p < .01) below the starting condition in T1. CONCLUSIONS: In spite of a restrictive pulmonary disease specific exercise therapy and sports are able to mobilize physical reserves of performance and induce an increasing quality of life as well as a higher resilience in activities of daily living. These positive effects could be stabilized in the long term by a regular training. The results underline the necessity of integrating aftercare strategies into the concept of rehabilitation with special consideration of perceived self-efficacy.


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Asbestosis/rehabilitación , Terapia por Ejercicio/métodos , Actividades Cotidianas , Anciano , Asbestosis/diagnóstico , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pacientes Ambulatorios , Calidad de Vida , Resultado del Tratamiento
15.
Arq Neuropsiquiatr ; 78(1): 13-20, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-32074191

RESUMEN

OBJECTIVE: To investigate the feasibility of a Brazilian samba protocol in individuals with Parkinson's disease. METHODS: Twenty participants, mean age of 66.4±10.7 years, diagnosed with idiopathic Parkinson 's disease, divided into: experimental group that received the intervention of Brazilian samba dance classes (10 individuals); and control group that maintained their routine activities (10 individuals). For data collection, a divided questionnaire was used: General Information; Disability stages scale; Balance and Quality of Life. RESULTS: During class implementation, there were no falls, as all dance activities adhered to the details of the protocol steps without any changes. On average, patients completed 82.7% of activities. After 12 weeks, the experimental group had improvements in the UPDRS global score, in daily activities, and on motor examination. There was also improvement in balance scores and in the mobility domain of the quality of life in the experimental group. CONCLUSION: The samba protocol seems to be feasible and safe for patients with PD. Moreover, it has pleasant characteristics and offers sufficient physical benefits for combination with drug treatment. There were also benefits in social relationships and as a possible rehabilitation tool in individuals with Parkinson's disease.


Asunto(s)
Terapia por Ejercicio/métodos , Musicoterapia/métodos , Enfermedad de Parkinson/rehabilitación , Actividades Cotidianas , Anciano , Brasil , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados no Aleatorios como Asunto , Calidad de Vida , Factores Socioeconómicos , Factores de Tiempo , Resultado del Tratamiento
16.
Am J Phys Med Rehabil ; 99(3): 257-264, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32079897

RESUMEN

In recent years, there has been a shift away from rest until total symptom resolution after concussion, due to the potential adverse consequences of inactivity. Aerobic exercise has been increasingly investigated for the treatment of postconcussion syndrome, whereby symptoms persist beyond 4 wks. The aim of this review was to systematically review the literature on subsymptom threshold aerobic exercise as a treatment for postconcussion syndrome. We conducted systematic literature searches in databases: MEDLINE (Ovid), CINAHL, PubMed, and Embase. After thorough review, 12 articles met the eligibility criteria and were included in the systematic review. The quality of selected studies was low to moderate. Subsymptom threshold aerobic exercise was associated with improvement in symptoms in patients with postconcussion syndrome for all included studies. The most commonly used protocols incorporated 20 mins of exercise at 80% of the heart rate that provoked symptoms, 5-6 days per week, with no adverse events documented. However, there was considerable variation in exercise protocols, and many studies incorporated subsymptom threshold aerobic exercise as part of a broader rehabilitation plan. Evidence supports subsymptom threshold aerobic exercise as a promising treatment for postconcussion syndrome. Further studies are required to delineate the optimal intensity, duration, and frequency of exercise for postconcussion syndrome in a variety of populations.


Asunto(s)
Conmoción Encefálica/rehabilitación , Terapia por Ejercicio/métodos , Ejercicio Físico , Síndrome Posconmocional/rehabilitación , Conmoción Encefálica/fisiopatología , Humanos , Síndrome Posconmocional/fisiopatología
17.
Braz J Med Biol Res ; 53(3): e9391, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32077467

RESUMEN

The oxygen uptake (V˙O2) kinetics during onset of and recovery from exercise have been shown to provide valuable parameters regarding functional capacity of both chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) patients. To investigate the influence of comorbidity of COPD in patients with CHF with reduced ejection fraction on recovery from submaximal exercise, 9 CHF-COPD male patients and 10 age-, gender-, and left ventricle ejection fraction (LVEF)-matched CHF patients underwent constant-load exercise tests (CLET) at moderate and high loads. The V˙O2, heart rate (HR), and cardiac output (CO) recovery kinetics were determined for the monoexponential relationship between these variables and time. Within-group analysis showed that the recovery time constant of HR (P<0.05, d=1.19 for CHF and 0.85 for CHF-COPD) and CO (P<0.05, d=1.68 for CHF and 0.69 for CHF-COPD) and the mean response time (MRT) of CO (P<0.05, d=1.84 for CHF and 0.73 for CHF-COPD) were slower when moderate and high loads were compared. CHF-COPD patients showed smaller amplitude of CO recovery kinetics (P<0.05) for both moderate (d=2.15) and high (d=1.07) CLET. Although the recovery time constant and MRT means were greater in CHF-COPD, CHF and CHF-COPD groups were not differently affected by load (P>0.05 in group vs load analysis). The ventilatory efficiency was related to MRT of V˙O2 during high CLET (r=0.71). Our results suggested that the combination of CHF and COPD may further impair the recovery kinetics compared to CHF alone.


Asunto(s)
Terapia por Ejercicio/métodos , Tolerancia al Ejercicio/fisiología , Ventilación Voluntaria Máxima/fisiología , Consumo de Oxígeno/fisiología , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Recuperación de la Función/fisiología , Anciano , Humanos , Cinética , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología
18.
Med Clin North Am ; 104(2): 189-198, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32035563

RESUMEN

Physicians often overlook exercise as a treatment or prophylactic measure for many common diseases and ailments. It can be used to treat comorbidities including obesity, cardiovascular disease, chronic obstructive pulmonary disease, diabetes mellitus, osteoporosis, osteoarthritis, cancer, and low back pain. Education on the general physical activity guidelines as well as easy exercise prescription methods can improve the ability of physicians to prescribe exercise as a therapeutic option. In addition, identifying barriers to compliance with exercise and ways to overcome these barriers is also necessary in order to use therapeutic exercise effectively.


Asunto(s)
Terapia por Ejercicio/métodos , Afecciones Crónicas Múltiples/terapia , Ejercicio Físico , Conocimientos, Actitudes y Práctica en Salud , Humanos , Cooperación del Paciente
19.
Medicine (Baltimore) ; 99(3): e17318, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011431

RESUMEN

BACKGROUND: Pregnancy-related low back pain (PLPB) and pelvic pain (PP) are common in pregnancy. In spite of its high prevalence rate, treatment of the disorder is a challenging topic. Women commonly utilize complementary exercise therapies such as yoga, motor control exercises, breathing exercises, core stability exercise, pelvic stability exercise, and so on to manage their symptoms. However, it is currently unknown whether exercise produces more beneficial effects than other treatment in patients with PLPB and PP. The aim of this study is to explore the therapeutic effect of exercise for pregnancy-related low back pain and PP. METHODS: This review will only include randomized controlled trials. Published articles from July 1999 to July 2019 will be identified using electronic searches. Search strategy will be performed in 3 English databases, 1 Chinese database, and the World Health Organization International Clinical Trials Registry Platform. Two reviewers will screen, select studies, extract data, and assess quality independently. The methodological quality including the risk of bias of the included studies will be evaluated using a modified assessment form, which is based on Cochrane assessment tool and Physiotherapy Evidence Database scale. Review Manager Software (Revman5.3) will be used for heterogeneity assessment, generating funnel-plots, data synthesis, subgroup analysis, and sensitivity analysis. We will use GRADE system to evaluate the quality of our evidence. RESULTS: We will provide some more practical and targeted results investigating the effect of exercise therapy (ET) for PLPB and PP in the current meta-analysis. Meanwhile, we will ascertain study progress of ET for PLPB and PP and find out defects or inadequacies of previous studies, so that future researchers could get beneficial guidance for more rigorous study. CONCLUSION: The stronger evidence about PLPB and PPs rehabilitative effect and safety will be provided for clinicians and policymakers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD 42017075099.


Asunto(s)
Terapia por Ejercicio/métodos , Dolor de la Región Lumbar/terapia , Dolor Pélvico/terapia , Femenino , Humanos , Embarazo , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Factores de Tiempo
20.
Braz J Med Biol Res ; 53(2): e9171, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049101

RESUMEN

Parkinson's disease cannot be cured but symptoms can be improved by making use of physical therapy. The objective of the study was to compare the effect of routine exercises and Tai Chi on physical and clinical performance in elderly people suffering from Parkinson's disease. Data from interviews, physical and clinical performance, and levodopa consumption of 500 patients with confirmed Parkinson's disease (severity level I to III) were collected and analyzed. Participants who received 80 min/day Tai Chi 3 times/week for 2 months were included in the Tai Chi (TC) group (n=250) and those who received 90 min/day routine exercise 3 times/week for 2 months were included in routine exercise (RE) group (n=250). Timed up-and-go, 50-foot speed walk, and functional reach were improved by Tai Chi and routine exercise (P<0.05 for all) but intensities of Tai Chi for improvement of such parameters was higher than routine exercise. Incidence of falls was decreased by both physical therapies (P<0.05 for all) but more for the TC group (P<0.0001, q=38.512). In the TC group, at the end of follow-up, 22 (9%) patients were successful in withdrawal of levodopa treatment. Also, the dose of levodopa was decreased in patients of the TC group who had to continue levodopa. Tai Chi had the potential to slow down the progression of symptoms of Parkinson's disease and delayed the introduction of levodopa (level of evidence: III).


Asunto(s)
Terapia por Ejercicio/métodos , Enfermedad de Parkinson/rehabilitación , Tai Ji/métodos , Accidentes por Caídas/prevención & control , Anciano , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Índice de Severidad de la Enfermedad
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