The associations between physical activity, health-related quality of life, regimen adherence, and glycemic control in adolescents with type 1 diabetes: A cross-sectional study.

BACKGROUND: Adolescents with Type 1 Diabetes (T1D) display a greater than two-fold higher risk of developing diabetes-related complications compared with their healthy peers and the risk increases markedly as glycated hemoglobin (HbA1c) increases. The majority of the known factors associated with improved glycemic control in adolescents with T1D are geared toward Western populations. Therefore, this study examined the associations between Physical Activity (PA), Health-Related Quality of Life (HRQoL), and regimen adherence on glycemic control in a Middle Eastern population of adolescents with T1D METHODS: The study utilized a cross-sectional design of Jordanian adolescents (aged 12-18) with T1D (n = 74). Self-reported measures used were the Pediatric Quality of Life-Diabetes Module, the International Physical Activity Questionnaire, and the Summary of Diabetes Self-Care Activities. HbA1c values were obtained from the medical records. Correlation analyses were conducted using Pearson's and Spearman's correlation tests. Multiple regression analyses were conducted to determine if HRQoL, PA, and regimen adherence predict glycemic control. RESULTS: Only 14.8 % of the participants demonstrated good glycemic control (HbA1c ≤ 7.5 %). Participants with poor control had a statistically significant lower mean PA of MET-minutes/week (3531.9 ± 1356.75 vs. 1619.81 ± 1481.95, p < .001) compared to those with good control. The total sample was found to demonstrate low HRQoL (47.70 ± 10.32). Participants were within the acceptable range of PA (1885.38 ± 1601.13) MET-minutes/week. HbA1c significantly inversely correlated with PA (r = -0.328, p = .010) and regimen adherence (r = -0.299, p = .018). The regression analysis revealed that PA significantly predicted glycemic control (ß = -0.367, p < .01) as adherence (ß = -0.409, p < .01) and disease duration did (ß = 0.444, p < .01). CONCLUSION: Better glycemic control was significantly associated with higher PA and regimen adherence levels. The correlation between PA and glycemic control depends highly on the level of regimen adherence or arguably, adherence acts as a buffer in the correlation between PA and glycemic control. There was no significant association between glycemic control and HRQoL.

Evidence- based physiotherapy practice in Jordan: Evaluation and identification of implementation factors.

BACKGROUND: Evidence-based physiotherapy practice (EBPTP) is becoming increasingly important to improve patient outcomes and clinical decision-making in the physiotherapy profession. OBJECTIVE: To evaluate the EBPTP in Jordan and identify the barriers to its implementation in clinical practice. METHOD: The study used a cross-sectional survey of licensed physiotherapists working in Jordan using EBPTP self-reported questionnaire. Frequencies, percentages, and one sample Wilcoxon rank test were used to evaluate the EBPTP level. The EBPTP implementation was evaluated by demographic variations of participants, Spearman's correlation, and stepwise multiple linear regression analyses at 95% confidence interval. RESULTS: A total of 210 participants completed the survey. All EBPTP questionnaire elements showed significant positive levels (p = .00) except facility support reflecting non-significant negative level (p = .08). The EBPTP implementation was at a significantly lower level of uptake (p = .00). Clinical decision-making was based mainly on personal experience. The EBPTP implementation was significantly correlated with elements of the EBPTP questionnaire and differed by personal/organizational characteristics. There were four significant predictors of EBPTP implementation: understanding of EBPTP terminologies, facility support, formal training in EBPTP, and being a clinical instructor. CONCLUSION: The findings confirm a clear gap in EBPTP implementation among physiotherapists in Jordan. The EBPTP implementation factors were mainly based on education sectors and work facilities. Engagement of stakeholders and education sectors in EBPTP implementation is required to strengthen the standing of the physiotherapy profession in Jordan.

The Perception of Physical Therapy Students towards Their Profession in Jordan.

Background: The physical therapy profession has grown rapidly in less than a century, increasing its importance, techniques, settings, and the responsibilities provided to its practitioners. Objectives: The aim of the study was to explore how undergraduate physiotherapy students view physiotherapy as their future career and their perception of the educational physiotherapy programs in Jordan. Methods: A cross-sectional study was conducted. A questionnaire designed to collect data on students' perceptions of their profession was delivered to 222 undergraduate physiotherapy students at Jordan University of Science and Technology in Irbid, Jordan. The response rate was 157 (70.72%). Descriptive statistics and the chi-square test were used to analyse the data. Results: Among 157 physiotherapy students, results were collected. Although students were satisfied with being physiotherapy students (p < 0.001), most of the study participants knew about physical therapy from their families, and they were not satisfied with the job opportunities in Jordan. Conclusions: Physiotherapy education in Jordan is rising rapidly. The public, patients, parents, and clinical preceptors in physiotherapy settings must recognize this educational and professional practice. It is noted that some levels of occupational awareness are intermediate. However, it would be beneficial to organize activities such as seminars and interviews in order to increase the level of professional awareness.

Endurance exercise training suppresses myostatin upregulation and nuclear factor-kappa B activation in a mouse model of Parkinson's disease.

Background and Aim: Muscle atrophy is common in Parkinson's disease (PD). Although myostatin has been implicated in muscle atrophy, its expression in PD skeletal muscle has not been investigated. Therefore, this study aimed to elucidate the influence of PD induction and exercise training on myostatin expression in the gastrocnemius skeletal muscle. Materials and Methods: Thirty albino mice were randomly selected and separated into three groups of 10 mice each: Sedentary control, sedentary PD (SPD), and exercised PD (EPD). 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid were used to induce chronic parkinsonism in the PD groups. Immunohistochemistry was used to investigate the expression of myostatin and nuclear factor kappa B (NF-kB) in gastrocnemius muscles of all three groups. Results: Myostatin expression and NF-kB nuclear localization, indicative of its activation, were significantly (p<0.01) higher in gastrocnemius skeletal muscle in the SPD group than in the control and EPD groups. Concomitantly, the average cross-sectional area of gastrocnemius muscle fibers in the SPD albino mice was significantly smaller (p<0.01) than in the control and EPD groups, indicating muscle atrophy. Conclusion: The present data are the first to indicate a correlation between PD induction and myostatin overexpression and NF-kB activation in the gastrocnemius muscle, potentially promoting the muscle atrophy commonly seen in PD. Additionally, the current data are the first to indicate the beneficial effects of exercise training on PD-associated myostatin overexpression, NF-κB activation, and muscle atrophy. Thus, our data are the first to suggest that myostatin and NF-κB might be regarded as potential therapeutic targets in an attempt to ameliorate skeletal muscle abnormalities commonly observed in PD.

Effectiveness of non-pharmacological rehabilitation interventions in pain management in patients with multiple sclerosis: Systematic review and meta-analysis.

BACKGROUND: Multiple sclerosis (MS) is a progressive inflammatory and autoimmune neurological disease caused by inflammation and demyelination of the central nervous system. Pain is a typical symptom of central nervous system demyelination, affecting 63% of adults with MS. Recently, the role of non-pharmacological pain management in patients is growing because the non-pharmacological interventions are considered safe, affordable, easy, and accessible. However, to date, no systematic reviews or meta-analyses have comprehensively examined the therapeutic effects of the variety of non-pharmacological therapeutic interventions in the management of pain in patients with MS. OBJECTIVE: The study aimed to conduct a systematic review with meta-analysis to assess the effectiveness of the non-pharmacological rehabilitation interventions in pain management in patients with MS. METHODS: A comprehensive search using PubMed, Cochrane, and Science Direct databases was performed and included all randomized controlled trials, randomized cross-over trials, and quasi-experimental trials assessing the effect of non-pharmacological interventions for managing pain in patients with MS. This study was conducted according to PRISMA guidelines of a systematic review and pair-wise meta-analysis. Meta-analyses were performed by calculating the standardized mean difference at a 95% confidence interval using Review Manager software. RESULTS: Twenty-nine papers were included in the systematic review, and only 22 of them were included in the meta-analysis. The pooled analysis showed a significant effect of neuromodulation and transcranial direct current stimulation on pain intensity reduction in patients with MS (SMD -0.51, 95% CI -0.51 to -0.09, P = 0.02), (SMD -0.67, 95% CI -1.18 to -0.16 P = 0.01), respectively. The analysis showed significant improvement in pain intensity in patient with MS after mind-body therapies (SMD -0.45, 95% CI -0.82 to -0.7, P = 0.02), mindfulness (SMD -0.55, 95% CI -0.96 to -0.14, P = 0.009), hypnosis (SMD -0.88, 95% CI -1.30 to -0.46, P = 0.0001), trigger point therapies (SMD -0.83, 95% CI -1.65 to -0.01, P = 0.05) and cognitive behavioral therapy (SMD -0.64, 95% CI -1.18 to -0.11, P = 0.02). However, there is no significant effect of relaxation therapy on pain reduction in patients with MS (SMD -0.82, 95% CI -1.94 to 0.31, P = 0.15). CONCLUSIONS: The results indicated that the majority of the non-pharmacological rehabilitation interventions showed potential therapeutic effects in reducing pain intensity in patients with MS.

Melatonin serum level, sleep functions, and depression level after bilateral anodal transcranial direct current stimulation in patients with Parkinson's disease: a feasibility study.

OBJECTIVE: Parkinson's disease (PD) is associated with non-motor complications such as sleep disturbance and depression. Transcranial direct current stimulation (tDCS) showed therapeutic effects on the motor dysfunctions. However, the potential effects of tDCS therapy on melatonin hormone, sleep dysfunctions, and depression in patients with PD still unclear. This feasibility study aimed to identify any potential changes in melatonin serum level, sleep functions and depression after the bilateral anodal tDCS in patients with PD. MATERIAL AND METHODS: Tensessions of bilateral anodal tDCS stimulation applied over left and right prefrontal and motor areas were given to twenty-five patients with PD. Melatonin serum level, Pittsburgh sleep quality index, and geriatric depression scale examined before and after tDCS stimulation. RESULTS: After bilateral anodal tDCS, there was a significant reduction in melatonin serum level, improvement in depression, improvements in overall sleep quality, and sleep latency. Correlations test showed significant associations between melatonin serum level reduction and changes in subjective sleep quality, and sleep duration, as well as between improvements in depression and overall sleep quality, sleep latency, and sleep disturbance. CONCLUSION: Bilateral anodal tDCS therapy was a feasible and safe tool that showed potential therapeutic effects on melatonin serum level, sleep quality, and depression level in patients with PD. Although the further large scale and randomized-control trial studies are crucially needed, there is still a need for such a feasibility study to be established before such trials can be implemented as is recommended in the new medical research council guidelines.

Mental and physical health-related quality of life and their associated factors among students of a comprehensive allied health institution.

BACKGROUND: Healthcare students are subjected to critical levels of mental and physical stress that might hinder their quality of life. OBJECTIVES: This study comprehensively investigated physical and mental Health-related Quality of Life (HR-QoL) and their associated factors among Allied Health (AH) students of nine academic majors. METHODS: Participants completed anonymous questionnaire included demographics and life style, HR-QoL measured by the 12-item Short-Form Health Survey (SF-12), Depression Anxiety Stress Scale (DASS21), and Nordic Musculoskeletal Questionnaire. SF-12 Physical (PCS) and Mental (MCS) Components Summary scores were compared between gender and between academic majors. Multiple linear regressions were conducted to examine factor associated with PCS and MCS scores. RESULTS: A total of 838 students (77.4% females) participated in the study. The overall PCS was 45.64±7.93 and statistically different between majors (P < 0.001). The Overall MCS score was 39.45±10.86 and statistically greater in males (P < 0.001). PCS scores were significantly associated with anxiety score, GPA, diet self-evaluation, and upper back and hip musculoskeletal pain. MCS scores were significantly associated with weekly clinical training hours, stress score, depression score, gender, university year, GPA, sleep self-evaluation, diet self-evaluation, and neck musculoskeletal pain. CONCLUSIONS: Low levels of mental and physical HR-QoL were observed among AH students and were associated with academic-related, health-related, and lifestyle-related factors. Longitudinal studies are needed to assess effective approaches to improve HR-QoL among AH students.

Endurance exercise training suppresses Parkinson disease-induced overexpression of apoptotic mediators in the heart.

BACKGROUNDWe have shown elevated levels of p53 and active caspase-3 in the heart with Parkinson disease (PD). The main aim of this study is to examine the effect of treadmill training on the cardiac expression of p53 and active caspase-3 in the mouse with induced Parkinsonism. METHODS: Thirty randomly selected normal albino mice were equally divided into the following 3 groups: sedentary control (SC), sedentary Parkinson diseased (SPD), and exercised Parkinson diseased (EPD). 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPTP/p) were used to induce chronic Parkinson disease in the SPD and EPD animals. The expression of p53 and active caspase-3 was investigated, using immunohistochemistry, in the heart in each animal group. RESULTS: Both p53 and active caspase-3 expression was significantly (p value < 0.05) reduced in the PD heart following endurance exercise training. CONCLUSION: Our present data suggest that chronic exercise training reduced PD-induced upregulation of p53 and active caspase-3 in the heart. Thus, our study suggests that inhibiting p53 and/or active caspase-3 may be considered as a therapeutic approach to ameliorate PD cardiomyopathy.

Leeds sleep evaluation questionnaire in Jordanian university students. A psychometric investigation using comparative confirmatory factor analysis.

OBJECTIVES: To analyze the fit of different competing factor models (a one-factor model, 3 2-factor models, and 2 4-factor models) of the Leeds sleep evaluation questionnaire (LSEQ) in the data from a Jordanian student population. METHODS: A cross-sectional study was conducted on university students, with 2 sleep-related tools - the LSEQ and the sleep hygiene index (SHI). The students (n=166) at Jordan University of Science and Technology, Irbid, Jordan participated in this study from January-April, 2019. A total of 12 LSEQ models (6 models with all 10-items, and 6 models with one item deleted) were evaluated by using confirmatory factor analysis. The summary statistics of correlation coefficients, descriptive measures of item analysis, the model fit, and Cronbach's alpha were determined. RESULTS: The findings show that a 4-factor correlated solution was a plausible model for the LSEQ with 9-items, compared to a one-factor, 2-factor, and other 4-factor variant models. The deletion of one item from the original LSEQ improved the data fit significantly in the studied population. Moreover, correlation analysis between the LSEQ and SHI confirmed the divergent validity of the LSEQ. CONCLUSION: The results support the validity of a 4-factor structure of the LSEQ with 9-items with adequate internal consistency and divergent validity.

Melatonin and dopamine serum level associations with motor, cognitive, and sleep dysfunctions in patients with Parkinson's disease: A cross-sectional research study.

BACKGROUND: Parkinson's disease (PD) is a multisystem-progressive neurodegenerative disease characterized by dopaminergic neurons, however, the role of the non-dopaminergic system (such as melatonin hormone) in the pathogenesis of PD is now emerging. OBJECTIVE: To identify any potential correlation between the dopamine and melatonin serum levels, and motor, cognitive, and sleep dysfunctions in patients with PD. METHOD: Cross-sectional piloting study conducted with a sample of 34 patients with PD (aged 50-72 yrs old). Correlation tests performed to identify any potential correlations between the biomarkers' serum levels and motor, cognitive, and sleep dysfunctional levels in "on-medication" status. RESULTS: Spearman's test showed significant correlations between the melatonin serum level and sleep dysfunctions including overall sleep quality (P = 0.010) and subjective sleep quality sub-score (P = 0.001). On the other hand, spearman's test showed significant correlations between the dopamine serum level and motor dysfunctions including Berg Balance Scale (P = 0.026), 10-Meter Walk Test (P = 0.016), and Fear of Falling Index (P = 0.007), as well as comparisons between the dopamine serum level and cognitive dysfunction (P = 0.048). CONCLUSIONS: Melatonin serum level would serve as a potential biomarker in understanding the PD pathogenesis, and the melatonin serum level should be considered in future studies related to PD besides the dopamine serum level.

Effects of Exercise Interventions on Habitual Physical Activity and Sedentary Behavior in Adolescents With Cerebral Palsy.

PURPOSE: Exercise interventions have been shown to increase motor capacities in adolescents with cerebral palsy; however, how they affect habitual physical activity (HPA) and sedentary behavior is unclear. The main objective was to correlate changes in HPA with changes in mobility capacity following exercise interventions. METHODS: A total of 54 participants (aged 12-20 y) with bilateral spastic cerebral palsy at Gross Motor Function Classification System (GMFCS) levels II and III received 4 months of group progressive resistance training or treadmill training. Mobility measurements and HPA (averaged over 96 h) were made before and after interventions. RESULTS: Averaged baseline mobility and HPA measures and improvements in each after both interventions were positively correlated in all participants. Percentage of sedentary/awake time decreased 2%, with significant increases in HPA measures of step count (16%), walk time (14%), and upright time (9%). Mobility measures and HPA changes were quite similar between Gross Motor Function Classification System levels, but improvement in HPA after group progressive resistance training was greater than after treadmill training (12% vs 4%) and correlated with mobility improvement. CONCLUSIONS: Mobility capacity improved after these interventions and was clearly associated with improved HPA. The group progressive resistance training intervention seems preferable to improve HPA, perhaps related to greater social interaction and motivation provided by group training.

Comparison of Habitual Physical Activity and Sedentary Behavior in Adolescents and Young Adults With and Without Cerebral Palsy.

PURPOSE: The comparison of habitual physical activity and sedentary time in teenagers and young adults with cerebral palsy (CP) with typically developed (TD) peers can serve to quantify activity shortcomings. METHODS: Patterns of sedentary, upright, standing, and walking components of habitual physical activity were compared in age-matched (16.8 y) groups of 54 youths with bilateral spastic CP (38 who walk with limitations and 16 who require mobility devices) and 41 TD youths in the Middle East. Activity and sedentary behavior were measured over 96 hours by activPAL3 physical activity monitors. RESULTS: Participants with CP spent more time sedentary (8%) and sitting (37%) and less time standing (20%) and walking (40%) than TD (all Ps < .01). These trends were enhanced in the participants with CP requiring mobility devices. Shorter sedentary events (those <60-min duration) were similar for TD and CP groups, but CP had significantly more long sedentary events (>2 h) and significantly fewer upright events (taking <30, 30-60, and >60 min) and less total upright time than TD. CONCLUSION: Ambulant participants with CP, as well as TD youth must be encouraged to take more breaks from being sedentary and include more frequent and longer upright events.

Treadmill exercise training could attenuate the upregulation of Interleukin-1 beta and tumor necrosis factor alpha in the skeletal muscle of mouse model of chronic/progressive Parkinson disease.

BACKGROUND: Induction of Parkinson disease (PD) causes interleukin-1 beta (IL-1ß) and tumor necrosis factor-alpha (TNF-α) upregulation in gastrocnemius skeletal muscles. Endurance exercise suppresses iNOS and HSP90 overexpression in PD skeletal muscle. The purpose of this study is to test the impact of treadmill exercise training on PD-associated IL-1ß and TNF-α upregulation in the gastrocnemius muscle. METHODS: Thirty normal albino mice were randomly selected and divided into three equal groups: sedentary control (SC), sedentary PD (SPD), and Exercised PD (EPD). Chronic Parkinsonism was induced by treating mice in the SPD and EPD groups with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPTP/p). Gastrocnemius muscles were examined for the expression of IL-1ß and TNF-α using immunohistochemistry in the three different groups. RESULTS: Endurance exercise training significantly decreased both IL-1ß and TNF-α expression in skeletal muscle in EPD (P value < 0.01) compared with that in the SPD. CONCLUSION: Our present data suggest that PD-induced upregulation of IL-1ß and TNF-α in the gastrocnemius muscle could be reversed following endurance exercise training. Accordingly, IL-1ß and TNF-α might be considered therapeutically to ameliorate skeletal muscle abnormalities characterizing PD.

Sleep Quality, Depression, and Quality of Life After Bilateral Anodal Transcranial Direct Current Stimulation in Patients with Parkinson's Disease.

BACKGROUND Sleep dysfunctions impose a large burden on quality of life for patients with Parkinson's disease (PD). Several studies on PD reported potential therapeutic effects of transcranial direct current stimulation (tDCS) on motor and non-motor functions, but not related to sleep quality. Therefore, the present study examined sleep quality, depression perception, and quality of life changes after bilateral anodal tDCS in patients with PD. MATERIAL AND METHODS Twenty-one patients (n=21) with PD underwent 10 sessions (20 min each, 5 per week) of bilateral anodal tDCS stimulation applied simultaneously over the left and right prefrontal and motor areas. The Pittsburgh Sleep Quality Index (PSQI) total score and sub-scores, Geriatric Depression Scale (GDS), and Health-related quality of life questionnaire (SF-36) were measured pre/post bilateral tDCS anodal stimulation. RESULTS PSQI total score (P=0.045), sleep latency sub-score (P=0.02), and GDS total score (P=0.016) significantly decreased, and physical and mental components scores of SF-36 (P=0.018 and P=0.001, respectively) significantly increased after bilateral anodal tDCS stimulation. The GDS score decrease was directly correlated with decrease in PSQI total score (P=0.01), sleep latency sub-score (P=0.002), and sleep disturbance sub-score (P=0.003). In addition, the GDS score decrease was inversely correlated with increasing mental component score of SF-36 (P=0.001), which was directly correlated with an increase in sleep efficiency sub-score (P=0.03) and the physical component score of SF-36 (P=0.0001). CONCLUSIONS Bilateral anodal tDCS stimulation showed potential therapeutic effects in patients with PD in terms of sleep quality and depression level improvement, which together improved mental and physical quality of life in patients with PD.

Interleukin-1 Beta and Tumor Necrosis Factor Alpha Upregulation and Nuclear Factor Kappa B Activation in Skeletal Muscle from a Mouse Model of Chronic/Progressive Parkinson Disease.

BACKGROUND Skeletal muscle atrophy has been reported in patients with Parkinson disease (PD). The purpose of this study was to examine the potential implication of interleukin 1 beta (IL-1ß), tumor necrosis factor alpha (TNFα), and nuclear factor kappa B (NF kappa B) in skeletal muscle atrophy following PD induction. MATERIAL AND METHODS Chronic Parkinsonism was induced in 10 albino mice by MPTP/probenecid treatment, while 10 other albino mice remained without treatment and were subsequently used as controls. Gastrocnemius muscles were examined for the expression of IL-1ß and TNF-α, as well as the nuclear localization of NF kappa B, indicative of its activation, using immunohistochemistry in the 2 different groups. RESULTS IL-1ß and TNF-α expression and NF kappa B nuclear localization were significantly higher in the PD skeletal muscle compared with those in the controls (P value <0.01). CONCLUSIONS The present data are indicative of an association of PD with IL-1ß and TNF-α upregulation and NF kappa B activation in gastrocnemius muscles, potentially promoting the atrophy frequently observed in PD.

Association of Parkinson Disease Induction with Cardiac Upregulation of Apoptotic Mediators P53 and Active Caspase-3: An Immunohistochemistry Study.

BACKGROUND Apoptosis plays a key role in the pathogenesis of Parkinson disease (PD). Active caspase-3, which is a proapoptotic factor, has been shown to reduce cardiac contractility, causing cardiac dysfunction in many pathological diseases. Reduced cardiac contractility and cardiac autonomic dysfunction have been reported in PD patients and PD mice treated with MPTP. The aim of this study was to show the impact of PD induction on the expression of the apoptotic mediators p53 and active caspase-3 in the heart. MATERIAL AND METHODS Equal control and PD groups were formed by 20 randomly selected normal albino mice. We used 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (25 mg/kg) and probenecid (250 mg/kg) (MPTP/p) to induce chronic Parkinsonism in the PD group. Immunohistochemistry was performed to investigate the expression of p53, active caspase-3, and ß-adrenergic receptor in hearts from the 2 animal groups. RESULTS P53 and active caspase-3 expression was significantly higher in PD hearts than in the control hearts (p value <0.01). ß-adrenergic receptor expression was significantly lower in PD hearts than in control hearts (p value <0.01). CONCLUSIONS Our results show an association of PD with p53 and active caspase-3 overexpression and ß-adrenergic receptor underexpression in the heart, potentially promoting the cardiac autonomic dysfunction frequently observed in PD.

Dopamine, BDNF and motor function postbilateral anodal transcranial direct current stimulation in Parkinson's disease.

AIM: To examine BDNF, dopamine, and motor function changes after bilateral anodal transcranial direct current stimulation (tDCS) in patients with Parkinson's disease. METHODS: 20 patients undertook ten sessions of bilateral anodal tDCS stimulation applied simultaneously over FC1/FC2, targeting left and right prefrontal and motor areas. Dopamine and BDNF serum levels, and Movement Disorders Society - Unified Parkinson's Disease Rating Scale part three (MDS-UPDRS-III) total score and disability sub-scores were examined pre/post-tDCS stimulation. RESULTS: BDNF serum level increased significantly and came with significant improvement in motor functions (decrease in MDS-UPDRS-III total score/sub-scores), whereas dopamine level showed no changes. However, there was no significant statistical correlation between the motor functions' improvement and BDNF level increase. CONCLUSION: Bilateral anodal tDCS is a safe stimulation protocol that leads to motor functions' improvement and BDNF serum level increase in patients with Parkinson's disease, however the findings of this feasible study are preliminary and further study is needed.

Bilateral anodal transcranial direct current stimulation effect on balance and fearing of fall in patient with Parkinson's disease.

BACKGROUND: A number of studies have examined the therapeutic effects of transcranial direct current stimulation (tDCS) stimulation in patients with Parkinson's disease (PD) using unilateral anodal stimulation applied either on the left or right brain hemisphere. However, PD involves the dysfunctions of both brain hemispheres. OBJECTIVES: This study investigates the therapeutic effects of bilateral anodal tDCS stimulation on balance and fear of fall outcomes in patient with PD. METHODS: Eighteen patients with idiopathic PD completed the study. Ten sessions of bilateral anodal tDCS stimulation were applied over the FC1 and FC2 targeting both pre-frontal and motor areas for each patient, 5 sessions per week for 2 weeks. Berg Balance Scale (BBS), Falls Efficacy Scale-International (FES-I), and 10 meters walk test (10mwt) were applied before and after the stimulation therapy. RESULTS: Paired t-test showed a significant increase in the BBS scores and decrease in the FES-I scores after the bilateral tDCS compared with those scores before tDCS therapy (P < 0.05), as well improvement in the 10mwt scores. CONCLUSION: Our data showed that bilateral anodal tDCS serves as an effective, safe and feasible approach for rehabilitation of patients with PD with the issues related to balance and fear of fall.

Parkinson disease-induced upregulation of apoptotic mediators could be attenuated in the skeletal muscle following chronic exercise training.

BACKGROUND: We have shown elevated levels of p53 and active caspase-3 in gastrocnemius skeletal muscle with Parkinson's disease (PD). The main aim of this study is to examine the impact of endurance exercise training on the expression of p53 and active caspase-3 in the skeletal muscle of mouse with induced Parkinsonism. METHODS: Sedentary control (SC), sedentary Parkinson diseased (SPD), and exercised Parkinson diseased (EPD) groups were formed; each consisting of 10 randomly selected normal albino mice. Chronic Parkinson disease was induced in the SPD and EPD animals using 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and probenecid (MPTP/p). The expression of p53 and active caspase-3 was investigated, using immunohistochemistry, in the gastrocnemius muscle in each animal group. RESULTS: Both p53 and active caspase-3 expression was significantly (p value < 0.05) reduced in the PD gastrocnemius skeletal muscle following endurance exercise training. CONCLUSION: Our present data suggest that chronic exercise training reduced Parkinson disease-induced upregulation of p53 and active caspase-3 in gastrocnemius skeletal muscle. Thus, our study suggests that inhibiting p53 and/or active caspase-3 may be considered as a therapeutic approach to ameliorate PD skeletal muscle abnormalities.

Association between sleep quality and inflammatory complement components in collegiate males.

BACKGROUND: An accumulating amount of evidence has linked humoral mediators of inflammation with sleep measures. Nevertheless, important details of this association, in particular the role of the complement components in the context of chronic sleep attributes, have remained largely uncharacterized. MATERIALS AND METHODS: Fifty university students (age, 23.3 ± 3.8 years; BMI, 23.7 ± 2.9 kg/m(2)) completed the study. Four dichotomized sleep measures assessed by the Pittsburgh Sleep Quality Index (PSQI) were used in association analysis using binary logistic regression with complement component 3, 4, and complement factor I (CFI). The sleep measures were defined as sleep quality (good sleep/poor sleep; PSQI ≤5/PSQI >5), bedtime (early/late; before 00:00 h/after 0:00 h), sleep duration (short/normal ≤6 h/>6 h), and sleep onset latency (normal/disturbed; 0-1 score/2-3 score on the PSQI component of sleep latency). RESULTS: The complement component 4 was associated with sleep quality (unadjusted, OR = 1.025, p < 0.05; adjusted for age, OR = 1.025, p < 0.05; adjusted for BMI, OR = 1.027, p < 0.05) and sleep duration (unadjusted, OR = 1.041, p < 0.01; adjusted for age, OR = 1.041, p < 0.01; adjusted for BMI, OR = 1.046, p < 0.01). CFI was associated with bedtime (unadjusted, OR = 0.737, p < 0.01; adjusted for age, OR = 0.717, p < 0.01; adjusted for BMI, OR = 0.677, p < 0.01) and with sleep duration (unadjusted, OR = 0.796, p < 0.05; adjusted for age, OR = 0.796, p < 0.05). CONCLUSION: The findings indicate the importance of the role of complement components in the dynamics of sleep. Therefore, sleep should be assessed in conditions where complement components are affected.