Concurrent Aerobic and Strength Training with Caloric Restriction Reduces Insulin Resistance in Obese Premenopausal Women: A Randomized Controlled Trial.

Background and Objectives: Obese premenopausal women are at high risk of developing insulin resistance (IR). Concurrent aerobic and strength training (CAST) has been shown to provide remarkable advantages, yet its effects, along with caloric restriction in such a high-risk population, are not yet established. This study aimed to investigate the impact of concurrent aerobic and strength training with caloric restriction (CAST-CR) on IR in obese premenopausal women. Materials and Methods: Forty-two obese premenopausal women with reported IR, aged 40-50 years, were randomly allocated to either the (CAST-CR) intervention group, who underwent CAST with caloric restriction, or the (AT-CR) control group, who received aerobic training in addition to caloric restriction. Both groups completed 12 weeks of controlled training with equivalent training time. Aerobic training began at 60% and gradually progressed to achieve 75% of the maximum heart rate, while strength training was executed at 50% to 70% of the one-repetition maximum (1RM). Anthropometric measures, abdominal adiposity, metabolic parameters, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) were evaluated prior to and following the intervention. Results: Both groups experienced a substantial enhancement in the selected parameters compared to the baseline (p < 0.001), with higher improvement within the CAST-CR group. The changes in HOMA-IR were -1.24 (95%CI, -1.37 to -1.12) in the CAST-CR group vs. -1.07 (95%CI, -1.19 to -0.94) in the AT-CR group. Conclusions: While AT-CR improved insulin sensitivity in premenopausal women who were obese and hyperinsulinemic, CAST with calorie restriction improved insulin sensitivity more significantly, suggesting it as a preferable alternative.

Effect of Combined Electromagnetic Field and Plantar Flexion Resistance Exercise on Wound Healing in Patients with Venous Leg Ulcers: A Randomized Controlled Trial.

Background and Objectives: Venous ulcers are recognized to be more painful and resistant to therapy than ulcers of other etiologies. Various methods have been used for the conservative treatment of venous ulcers, such as pulsed electromagnetic field (PEMF) and plantar exercise, which promote wound healing due to a range of physiological effects. The study aimed to examine the effect of combined pulsed electromagnetic field therapy and plantar flexion resistance exercise (PRE) on patients with venous leg ulcers (VLUs). Materials and Methods: The study was a prospective, randomized controlled trial. A total of 60 patients between the ages of 40 and 55 with venous ulcers were randomly assigned to 1 of 3 groups. For up to 12 weeks, the first group received PEMF therapy and plantar flexion resistance exercise (PRE) therapy in addition to conservative ulcer treatment for up to 12 weeks. The second group received only PEMF therapy in addition to conservative ulcer treatment, while the third group served as the control and received only conservative ulcer treatment. Results: At the four-week follow-up, the two experimental groups revealed a considerable variation in ulcer surface area (USA) and ulcer volume (UV), with no significant change in the control group. At the 12-week follow-up, there were significant differences between the three groups, while group A underwent the most significant changes, with mean differences at [95% confidence interval] of (-4.75, -3.82, -0.98) for USA and (-12.63, -9.55, -2.45) for UV, respectively. Conclusions: On a short-term basis, adding a plantar resistance exercise to the PEMF had no appreciable short-term effects on ulcer healing; however, their combination had more pronounced medium-term effects.

The effectiveness of a multimodal approach in the treatment of patients with upper crossed syndrome: A randomized controlled trial.

OBJECTIVES: Considering the multitude of contributing factors to upper crossed syndrome (UCS), a multimodal treatment may be an effective therapeutic option. This study aimed to examine the effectiveness of the multimodal approach, including muscle energy technique (MET), cervical and scapulothoracic stabilization exercises, and postural correction training with ergonomic advice, in the treatment of patients with UCS. METHODS: This randomized controlled trial randomly assigned 40 patients with UCS aged 30-55 years to either group A (intervention group, n = 20) who received the multimodal approach or group B (control group, n = 20) who received MET only. The trial evaluated the craniovertebral angle (CVA) and sagittal shoulder angle (SSA) measured by photogrammetry, pain intensity estimated using the visual analog scale (VAS), and functional disability evaluated using the Arabic version of the neck disability index (ANDI) pretreatment and four weeks after intervention. RESULTS: The within-group analysis demonstrated a substantial decrease in VAS and ANDI and an increase in CVA post-intervention (P < 0.001). Only the multimodal group exhibited a significant change in SSA (P < 0.0001). Between-group differences were noteworthy, favoring the multimodal intervention (P < 0.0001). CONCLUSIONS: A 4-week multimodal approach that comprises MET, cervical and scapulothoracic stabilization exercises, and postural correction training with ergonomic advice has remarkable improvements in CVA, SSA, pain intensity, and functional disability in patients with UCS, highlighting it as a superior choice.

Combined Effects of Extracorporeal Shockwave Therapy and Integrated Neuromuscular Inhibition on Myofascial Trigger Points of Upper Trapezius: A Randomized Controlled Trial.

OBJECTIVE: To investigate the combined effect of extracorporeal shockwave therapy (ESWT) and integrated neuromuscular inhibition (INI) on myofascial trigger points in the upper trapezius. METHODS: Sixty subjects aged 18-24 years old with active myofascial trigger points in the upper trapezius were studied. Participants were assigned randomly to either group A who received ESWT one session/week, group B who received INI three sessions/week, or group C who received ESWT in addition to INI. All groups completed 4 weeks of intervention. The following main outcome measures were evaluated at baseline and after 4 weeks of intervention: pain intensity, functional disability, pressure pain threshold (PPT), sympathetic skin response (SSR), and neuromuscular junction response (NMJR). RESULTS: Within-group analysis revealed a significant decline in visual analog scale (VAS), Arabic neck disability index (ANDI), and NMJR and incline in PPT and SSR latency post-intervention (p<0.001). Multiple comparison analysis showed a substantial difference between the groups, while the major changes favored group C (p<0.05). CONCLUSION: Combined treatment with ESWT and INI for treating myofascial trigger points in the upper trapezius is more effective than using only one of the two approaches in terms of clinical, functional, and neurophysiological aspects.

Effect of focused ultrasound cavitation augmented with aerobic exercise on abdominal and intrahepatic fat in patients with non-alcoholic fatty liver disease: A randomized controlled trial.

OBJECTIVES: The study aimed to examine the effect of focused ultrasound cavitation augmented with aerobic exercise on localized abdominal and intrahepatic fat in fatty liver patients. METHODS: 34 fatty liver patients aged 30-45 with a body mass index (BMI) of 30-40 kg/m2 were randomly assigned into two equally numbered groups. Group A received focused ultrasound cavitation and moderate aerobic exercise for three months, while Group B (control group) received moderate aerobic exercise only. Abdominal subcutaneous fat volume, visceral fat volume, liver-to-spleen ratio (L/S ratio), body weight, BMI, and waist circumference were measured both before and after the study period. RESULTS: Both groups showed significant improvements in subcutaneous fat volume, visceral fat volume, body weight, BMI, and waist circumference relative to baseline where (P < 0.001), with a higher percentage in group A. L/S ratio only showed a significant improvement in group A. Between-group differences were noteworthy regarding L/S ratio and waist circumference where (P < 0.0001). CONCLUSION: While substantial risky measures in non-alcoholic fatty liver disease have been modified by aerobic exercise, its combination with focused ultrasound cavitation causes more notable effects on the reduction of abdominal and intrahepatic fat, making it a superior option. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04161703.

Impact of moderate intensity aerobic exercise on chemotherapy-induced anemia in elderly women with breast cancer: A randomized controlled clinical trial.

Exercises are often recommended for patients suffering from anemia to improve physical conditioning and hematologic parameters. Hence, the present study aimed to investigate the impact of moderate intensity aerobic exercise on chemotherapy-induced anemia. Thirty elderly women with breast cancer underwent chemotherapy and were randomly assigned into two equal groups; Group A received aerobic exercise for 25-40 min at 50-70% of the maximum heart rate, 3 times/week for 12 weeks in addition to usual daily living activities, medication and nutritional support. Group B who did not train served as controls. Hemoglobin (Hb), and red blood cell count (RBCs) were evaluated pre-treatment and after 12 weeks of training. There were significant declines of both Hb (t = 16.30; P < 0.001) and RBCs (t = 10.38; P < 0.001) in group B relative to group A. Regarding group A, Hb increased from 11.52 ± 0.62 to 12.10 ± 0.59 g/dL with a 5.03% change, while RBCs increased from 4.24 ± 0.37 to 4.49 ± 0.42 million cells/µL with a 5.89% change. Between-group differences were noteworthy regarding Hb (t = -5.34; P < 0.001) and RBCs (t = -5.314; P < 0.001). The results indicate that regular participation in moderate intensity aerobic exercise can enhance chemotherapy-induced anemia.