Body Composition Changes in Adolescents Who Underwent Bariatric Surgery: A Systematic Review and Meta-analysis.

PURPOSE OF REVIEW: The purpose of this review and meta-analysis is to characterize the changes in body composition of children and adolescents who underwent bariatric surgery and identify possible negative effects of performing this procedure during pediatric ages. RECENT FINDINGS: Bariatric surgery in children and adolescents is an emerging strategy to promote higher and faster body weight and fat mass losses. However, possible negative effects usually observed in surgical patients' muscle-skeletal system raise a major concern perform this intervention during growth. Despite these possible issues, most experimental studies and reviews analyze bariatric surgery's effectiveness only by assessing anthropometric outcomes such as body weight and BMI, disregarding the short- and long-term impact of bariatric surgery on all body composition outcomes. Bariatric surgery is effective to reduce fat mass in adolescents, as well as body weight, waist circumference, and BMI. Significant reduction in lean mass and fat-free mass is also observed. Bone mass seems not to be impaired. All outcomes reduction were observed only in the first 12 months after surgery. Sensitivity analysis suggests possible sex and type of surgery-related differences, favoring a higher fat mass, body weight, and BMI losses in boys and in patients who underwent RYGB.

The Role of Facebook® in Promoting a Physically Active Lifestyle: A Systematic Review and Meta-Analysis.

BACKGROUND: it is well known in literature that sedentary lifestyle contributes to worsening people's health. This issue highlights the need for effective interventions to promote an active lifestyle. Research suggested multilevel intervention strategies to promote adherence to recommended physical activity levels, including the use of social networks that may simplify access to health notions. Being Facebook® the most extensive worldwide social network, this document aimed to analyze the current body of evidence on the role of Facebook® in the promotion of physical activity. METHODS: eighteen manuscripts were considered eligible for this systematic review, and it was performed a meta-analysis (PRISMA guidelines) for overall physical activity parameters in eleven out of eighteen studies. RESULTS: significant improvements were detected in the total amount of physical activity. In parallel, an increase in other parameters, such as cardiovascular, body composition, and social support, were found. The aerobic training, with supervised and tailored modalities, showed more considerable improvements. CONCLUSIONS: this study showed that Facebook® might be considered a feasible and accessible approach to promoting regular exercise practice and achieving health benefits indicators. Future research on the cross-link between physical activity and social network management could also focus on strength training to verify if a more structured intervention would show an effect.

Are Gyms a Feasible Setting for Exercise Training Interventions in Patients with Cardiovascular Risk Factors? An Italian 10-Years Cross-Sectional Survey Comparison.

BACKGROUND: Exercise training is a known important prevention and treatment modality in patients with cardiovascular (CV) diseases. However, the CV risk factors in gym users have been poorly studied. The aim of this study was to monitor CV risk factors of gym users over 10 years in order to investigate whether gyms are used settings for secondary disease prevention. METHODS: In 2007 and 2017, a cross-sectional research survey was adopted to determine CV risk factors and habits in gym users (18-69 years) of the Veneto region. These data were analyzed and compared with those of PASSI, a national surveillance system of the Italian population. RESULTS: During the last decade, there has been an increase in gym users over 50 years of age and in people with arterial hypertension and hypercholesterolemia. People attending the gym on medical referral are increasing, but they are still few (<10%). When comparing the collected data with PASSI surveillance, most of the CV risk factors are strongly underrepresented in gym users. CONCLUSION: The prevalence of gym users with CV risk factors is rather low, regardless of age. Physicians still need to encourage and prescribe physical exercise for secondary prevention and treatment of chronic diseases.

The Effect of Exercise Training on Irisin Secretion in Patients with Type 2 Diabetes: A Systematic Review.

INTRODUCTION: Irisin is a myokine considered to be a potential mediator of exercise-induced energy metabolism and its secretion is known to promote the browning of beige fat cells in white adipose tissue. However, it is currently not known which exercise protocol is the best to enhance irisin concentration in patients with type 2 diabetes (T2D). OBJECTIVE: The purpose of this study is to provide a review investigating the irisin response to different exercise training modalities and intensities in T2D. METHODS: A systematic literature search was performed in May 2022. RESULTS: After the selection process from 938 articles, six studies were included. Selected papers presented different exercise training interventions regarding intensity and modality. One study reported no significant differences in serum irisin levels after exercise training, whereas the other five showed a higher increase in serum irisin levels after exercise training with higher differences in irisin secretion after high-intensity training (HIT). No consideration was possible on exercise modalities. CONCLUSIONS: The impact of training intensity and modality was found to be partly discordant but data seem to suggest that HIT promotes greater irisin secretion. Despite the limited evidence, HIT, both in interval and continuous modalities, could be suggested as valid exercise training to increase circulating irisin in patients with T2D.

Influence of age on postural control during dual task: a centre of pressure motion and electromyographic analysis.

BACKGROUND: Dual task influences postural control. A cognitive task seems to reduce muscle excitation during a postural balance, especially in older adults (OA). AIM: The aim of this study is to evaluate the effect of three cognitive tasks on muscle excitation and static postural control in OA and young adults (YA) in an upright posture maintenance task. METHODS: 31 YA and 30 OA were evaluated while performing a modified Romberg Test in five different conditions over a force plate: open eyes, closed eyes, spatial-memory brooks' test, counting backwards aloud test and mental arithmetic task. The surface electromyographic signals of Tibialis anterior (TA), Lateral Gastrocnemius (GL), Peroneus Longus (PL), and Erector Spinae (ES) was acquired with an 8-channel surface electromyographic system. The following variables were computed for both the electromyographic analysis and the posturographic assessment: Root mean square (RMS), centre of pressure (CoP) excursion (Path) and velocity, sway area, RMS of the CoP Path and 50%, 95% of the power frequency. Mixed ANOVA was used to detect differences with group membership as factor between and type of task as within. The analysis was performed on the differences between each condition from OE. RESULTS: An interaction effect was found for Log (logarithmic) Sway Area. A main effect for task emerged on all posturographic variables except Log 95% frequencies and for Log PL and ES RMS. A main effect for group was never detected. DISCUSSION AND CONCLUSION: This study indicates a facilitating effect of mental secondary task on posturographic variables. Non-silent secondary task causes increase in ES and TA muscle activation and a worsening in static postural control performance.

Effectiveness of Text Messaging as an Incentive to Maintain Physical Activity after Cardiac Rehabilitation: A Randomized Controlled Pilot Study.

Although the efficacy of cardiac rehabilitation (CR) is proven, the need to improve patients' adherence has emerged. There are only a few studies that have investigated the effect of sending text messages after a CR period to stimulate subjects' ongoing engagement in regular physical activity (PA). A randomized controlled pilot trial was conducted after CR, sending a daily PA text message reminder to an intervention group (IG), which was compared with a usual care control group (CG) during three months of follow-up. Thirty-two subjects were assessed pre- and post-study intervention with GPAQ, submaximal iso-watt exercise testing, a 30 s sit-to-stand test, a bilateral arm curl test, and a final survey on a seven-point Likert scale. A statistically significant difference in the increase of moderate PA time (Δ 244.7 (95% CI 189.1, 300.4) minutes, p < 0.001) and in the reduction of sedentary behavior time (Δ -77.5 (95% CI 104.9, -50.1) minutes, p = 0.004) was shown when the IG was compared with the CG. This was associated with an improvement in heart rate, blood pressure, and patients' Borg rating on the category ratio scale 10 (CR10) in iso-watt exercise testing (all p < 0.05). Furthermore, only the IG did not show a worsening of the strength parameters in the follow-up leading to a change of the 30 s sit-to-stand test with a difference of +2.2 (95% CI 1.23, 3.17) repetitions compared to CG (p = 0.03). The telemedical intervention has been appreciated by the IG, whose willingness to continue with regular PA emerged to be superior compared to the CG. Text messages are an effective and inexpensive adjuvant after phase 2 CR that improves adherence to regular PA. Further studies are needed to confirm these results in a larger patient population and in the long term.

Lower Limb Strength Profile in Elderly with Different Pathologies: Comparisons with Healthy Subjects.

Sarcopenia and muscle strength reduction are a frequent disorder in non-communicable chronic diseases. The aims of this study are: a) to verify if the absolute and relative to body weight muscle strength of lower limb is affected by the presence of pathology; b) to verify if the trends are different among knee and ankles joints. One-hundred and forty-five elderly were recruited (16 liver transplant recipients, 48 kidney transplant recipients, 52 elderly with obesity, 30 healthy elderly). Muscular strength of lower limb was evaluated. Evaluation protocol included maximal isometric knee extension, maximal isokinetic knee extension and flexion, maximal isokinetic ankle (both right and left) extension and flexion. A statistically significant interaction between measurement and group membership was found for absolute strength measure (F(4.23, 170.56) = 3.316, p = 0.011, partial η2 (η2p) = 0.076), and relative strength measure(F(4.44, 174.72) = 16.407, p < 0.01, partial η2 (η2p) = 0.294). Elderly patients living with kidney transplants showed the lower level of absolute muscular strength, while relative muscular strength is mainly lacking in the elderly with obesity. The strength profile of elderly subjects is affected by obesity, liver transplantation, and kidney transplantation.

Postural control data from prevalent kidney transplant patients with and without history of falls.

This article presents data from a research paper entitled "Postural balance, muscle strength, and history of falls in end-stage renal disease patients living with a kidney transplant: a cross-sectional study" available in Journal Gait and Posture [1]. In this article, we reported the minimal detectable changes at the 95% level of confidence (MDC95) of postural balance variables measured in eyes open (EO) and eyes closed (EC) conditions, with a stabilometric platform, in 59 kidney transplant (KT) recipients (mean age= 53.2 ±â€¯11 years). In addition, we also performed receiver operating characteristics (ROC) curve analysis to explore the ability of postural balance measures to discriminate fallers and non-fallers (history of falls: yes or no). Sensitivity, specificity and area under the curve (AUC) of mean center of pressure velocity (CoPv), sway area (SA), center of pressure range of displacement in the anterior-posterior (AP) and medio-lateral (ML) directions were calculated. These data can be used by researchers aiming to design psychometric studies of postural balance in KT patients and they also provide clinicians with information on possible prioritization of outcome assessment for future fall-risk research in this clinical population.

Postural balance, muscle strength, and history of falls in end-stage renal disease patients living with a kidney transplant: A cross-sectional study.

BACKGROUND: End-stage renal disease patients living with a kidney transplant (KT) often present with frailty, functional disability, and mobility impairments that may result in a high risk of falls. Postural balance and muscle strength are implicated in the etiology of falls in the geriatric population, and both may be impaired in KT patients. RESEARCH QUESTION: We conducted a cross-sectional investigation to estimate the prevalence of falls, as well as to explore the association between postural balance, muscle strength and history of falls in end-stage renal disease patients living with a KT. METHODS: Fifty-nine prevalent KT patients (age = 53.2 ±â€¯11 years) were enrolled in this cross-sectional study. Participants were classified as fallers/non-fallers and underwent an objectively-measured assessment of postural balance on a stabilometric platform in eyes open (EO), eyes closed (EC), and dual-task (DT) conditions. Center of pressure (CoP) variables were taken for the analysis. In addition, participants underwent isometric (IM) and isokinetic (IK) assessments of lower limb muscle strength on a multi-joint evaluation system. RESULTS: Thirty-four percent of the study participants reported at least one fall in the previous 12 months. In logistic regression analysis, CoP velocity in EO (OR: 1.23, 95 % CI: 1.06-1.43, p = .007), and IK ankle dorsiflexion strength (OR: 0.87, 95 % CI: 0.77-0.99, p = .034) were independently associated with increased odds of falling. SIGNIFICANCE: This cross-sectional study indicates that patients living with a KT presented with a prevalence of falls indicative of a high risk of falling. Postural balance and muscle strength are exercise-modifiable factors and further research is warranted to establish to what extent these measures may be implicated in the etiology of falling in this patient group.

Reliability of an Integrated Inertial Sensor for the Continuous Measurement of Active Cervical Range of Motion in a Group of Younger and Elderly Individuals.

The aim of this study was to evaluate the test-retest reliability of an integrated inertial sensor (IIS) for cervical range of motion assessment. An integrated inertial sensor was placed on the forehead center of thirty older adults (OA) and thirty younger adults (YA). Participants had to perform three continuous rotations, lateral bandings and flexion-extensions with their head. Test-retest reliability was assessed after 7 days. YA showed moderate to good agreement for rotation (0.54-0.82), lateral bending (0.74-0.8), and flexion-extension (0.74-0.81) movements and poor agreement for zero point (ZP). OA showed moderate to good agreement for rotation (0.65-0.86), good to excellent agreement in lateral bending (0.79-0.92), and poor to moderate agreement for flexion-extension (0.37-0.72). Zero point showed poor to moderate agreement. In conclusion, we can affirm that this IIS is a reliable device for cervical range of motion assessment in young and older adults; on the contrary, the ZP seems to be unreliable and the addition of an external reference point could help the subject to solve this shortcoming and reduce possible biases.

Comparison of cardiovascular screening guidelines for middle-aged/older adults.

PURPOSE: Although both European (EACPR) and American (ACSM) Scientific Societies have devised cardiovascular protocols for the assessment of "middle-aged/older" individuals who are about to participate in sports or physical exercise, there are no data regarding the guidelines' sensitivity of these measures. The aim of this study was to compare the outcomes of different international screening protocols. METHODS: This observational cross-sectional study evaluated 525 subjects (80% males; median age 50 [35-85] years) seeking medical certification before participating in sports or regular exercise. The screening protocol consisted in completing a personal history profile, a physical examination, a resting ECG, a maximal exercise test, and, when required, additional instrumental evaluations. The effectiveness of the current EACPR as well as the former and new ACSM guidelines was thereby analyzed. RESULTS: The full screening protocol uncovered 100 previously undetected cardiovascular conditions (main pathologies detected: 21 coronary artery disease (CAD), 14 arterial hypertension, 38 complex arrhythmias). When the European guideline was used, 49% of these conditions went undetected, including 10 CAD. When the former American guideline was used, 29% (6 CAD) went undetected; when the recently updated edition was used, 50% including 11 CAD went undetected. CONCLUSION: The former ACSM guideline demonstrated a higher diagnostic sensitivity than the newer version and the EACPR guideline. Current screening protocols might be adapted for subjects performing high-intensity exercise due to their higher risk for cardiovascular and exercise-associated adverse events. The use of an incremental ECG-monitored maximal exercise test seems to improve these screening outcomes.

Exercise prescription and tailored physical activity intervention in onco-hematology inpatients, a personalized bedside approach to improve clinical best practice.

Therapy of hematological malignancies lasts for long periods implicating various complications. The chemotherapy induces fatigue and forces bed rest. These features strongly contribute to a general impairment of the physical efficiency. Oppositely, an increase of physical exercise can prevent or reduce this weakening. Few trials examined the efficacy of an exercise in onco-hematological inpatients, during their hospitalization. Therefore, this study aimed to determine the feasibility of an inter-hospital intervention and the beneficial role of a tailored exercise program in the maintenance of the physical function in onco-hematological inpatients. The study included 42 patients, which were allocated in two groups. In the intervention group (IG) a tailored exercise protocol during patient's hospitalization was administered. Exercise protocol was focused on development of strength, balance control, and flexibility; sessions were directly performed in the patient's hospital room everyday for 15 to 30 minutes. Exercise was supervised by an exercise specialist and driven by a multimedia support. Control group (CG) remained physically inactive for all period of hospitalization. To examine the interaction between the two situations (T0 and T1 ) and the two groups (IG and CG) for all dependent variables, a 2 × 2 within-subjects contrasts model analysis of variance was applied. Within groups analysis displayed significant differences in grip and leg strength and in static balance control (P < 0.05) with medium to very large effect size. Results from this investigation showed that a tailored exercise protocol administered to hospitalized onco-hematological patients was feasible and efficient to promote the maintenance of their physical function, improving clinical best practice including exercise to the traditional treatment. Moreover, the magnitude of the difference between the IG and the CG underlined the importance to invite and stimulate patients to workout to preserve the physical function, counteracting side effects of chemotherapy treatments with a concurrent reduction in bed rest syndrome.

Nordic Walking Promoted Weight Loss in Overweight and Obese People: A Systematic Review for Future Exercise Prescription.

The aim of this systematic review was to analyze the effect of Nordic Walking (NW) on anthropometric parameters, body composition, cardiovascular parameters, aerobic capacity, blood sample, and glucose tolerance in overweight and obese subjects. The main keywords "Nordic Walking" or "Pole Walking", associated with either "obese", "obesity", "overweight", or "weight loss" were used on the online database MEDLINE, PubMed, SPORTDiscus and Scopus. Additionally, references of the studies included were screened to identify eligible articles. Applying the inclusion and exclusion criteria, ten manuscripts were considered as eligible for this review. The results of the studies were categorized in several domains with regard to "anthropometric parameters and body composition", "cardiovascular parameters and aerobic capacity", and "blood sample and glucose tolerance". The results showed positive effects on the anthropometric parameters, body composition, cardiovascular parameters, blood sample, and glucose tolerance. The greatest improvements were observed in supervised and high weekly frequency of NW interventions. NW could be considered as an effective modality through which to involve the obese in physical activity. For weight loss, NW should be prescribed 4-5 times per week, at least 60 min per session, preferably combined with diet control.

Physical Exercise Is Confirmed to Reduce Low Back Pain Symptoms in Office Workers: A Systematic Review of the Evidence to Improve Best Practices in the Workplace.

This systematic review aimed to analyze the effects of a physical exercise (PE) program on low back pain (LBP) symptoms of office workers and the modification of flexibility and range of motion (ROM), muscular strength, and quality of life (QoL). A literature research was performed on PubMed, Scopus, MEDLINE, and SPORTDiscus from April to May 2018. The keyword "low back pain" was associated with "office worker" OR "VDT operators" OR "office employees" OR "workplace" AND "exercise", OR "exercise therapy" OR "physical activity". Inclusion criteria were a home- or work-based exercise protocol for office workers with LBP symptoms and pre- to post-intervention evaluation of LBP symptoms. Three researchers independently examined all abstracts. The modified Cochrane methodological quality criteria were used for quality assessment and 11 articles were included. Exercise protocols were performed from 6 weeks to 12 months, 1-5 day per week, lasting 10-60 min for each session. Physical Exercise in the workplace improved all the considered outcomes. The best improvement was recorded in supervised protocols and in video-supported protocols performed in the workplace. The effect may be generated with small duration sessions during the working day, with only 10-15 min of adapted exercise to be performed 3-5 days per week.

Nordic Walking Can Be Incorporated in the Exercise Prescription to Increase Aerobic Capacity, Strength, and Quality of Life for Elderly: A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis was to summarize and analyze the effects of Nordic Walking on physical fitness, body composition, and quality of life in the elderly. Keyword "Nordic Walking" associated with "elderly" AND/OR "aging" AND/OR "old subjects" AND/OR "aged" AND/OR "older adults" were used in the online database MEDLINE, Embase, PubMed, Scopus, PsycINFO, and SPORTDiscus. Only studies written in English language and published in peer-reviewed journals were considered. A meta-analysis was performed and effect sizes calculated. Fifteen studies were identified; age of participants ranged from 60 to 92 years old. Comparing with a sedentary group, effect sizes showed that Nordic Walking was able to improve dynamic balance (0.30), functional balance (0.62), muscle strength of upper (0.66) and lower limbs (0.43), aerobic capacity (0.92), cardiovascular outcomes (0.23), body composition (0.30), and lipid profile (0.67). It seemed that Nordic Walking had a negative effect on static balance (-0.72). Comparing with a walking (alone) training, effect sizes showed that Nordic Walking improved the dynamic balance (0.30), flexibility of the lower body (0.47), and quality of life (0.53). Walking training was more effective in improving aerobic capacity (-0.21). Comparing Nordic Walking with resistance training, effect sizes showed that Nordic Walking improved dynamic balance (0.33), muscle strength of the lower body (0.39), aerobic capacity (0.75), flexibility of the upper body (0.41), and the quality of life (0.93). Nordic Walking can be considered as a safe and accessible form of aerobic exercise for the elderly population, able to improve cardiovascular outcomes, muscle strength, balance ability, and quality of life.

Effects of exercise on cancer patients suffering chemotherapy-induced peripheral neuropathy undergoing treatment: A systematic review.

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is the most common neurological and clinically relevant side effect of many commonly used chemotherapeutic agents. Moreover, little effort has been done to investigate the potentially beneficial effects of specific exercises to counteract the CIPN symptoms. OBJECTIVE: This document aims to summarize and analyze systematically the current body of evidence about the effects of specific exercise protocols on CIPN symptoms, balance control, physical function and quality of life in patients with CIPN. LITERATURE SURVEY: Specific terms were identified for the literature research in MEDLINE, Scopus, Bandolier, PEDro, and Web of Science. METHODOLOGY: Five manuscripts were considered eligible for this review. Quality appraisal distinguished two studies as high quality investigations while three with low quality. Results were summarized in the following domains: "CIPN symptoms", "Static balance control", "Dynamic balance control", "Quality of life and Physical function". SYNTHESIS: Significant improvements were detected on postural control. Additionally, patients' quality of life and independence were found ameliorated after exercise sessions. Combined exercise protocols including endurance, strength and sensorimotor training showed larger improvements. CONCLUSIONS: This systematic review comes from a highly selected but small source of data. Nevertheless, specific exercise for cancer patients undergoing chemotherapy with CIPN symptoms should be recommended since these interventions appeared as feasible and have been demonstrated as useful tools to counteract some of the limitations due to chemotherapy.

Reliability of a device for the knee and ankle isometric and isokinetic strength testing in older adults.

BACKGROUND: Lower extremity muscle mass, strength, power, and physical performance are critical determinants of independent functioning in later life. Isokinetic dynamometers are becoming very common in assessing different features of muscle strength, in both research and clinical practice; however, reliability studies are still needed to support the extended use of those devices. OBJECTIVE: The purpose of this study is to assess the test-retest reliability of knee and ankle isokinetic and isometric strength testing protocols in a sample of older healthy subjects, using a new and untested isokinetic multi-joint evaluation system. METHODS: Sixteen male and fourteen female older adults (mean age 65.2 ± 4.6 years) were assessed in two testing sessions. Each participant performed a randomized testing procedure that includes different isometric and isokinetic tests for knee and ankle joints. RESULTS: All participants concluded the trial safety and no subject reported any discomfort throughout the overall assessment. Coefficients of correlation between measures were calculated showing moderate to strong effects among all test-retest assessments and paired-sample t test showed only one significant difference (p<0.05) in the maximal isokinetic bilateral knee flexion torque. CONCLUSIONS: The multi-joint evaluation system for the assessment of knee and ankle isokinetic and isometric strength provided reliable test-retest measures in healthy older adults. LEVEL OF EVIDENCE: Ib.

Health Benefits of Zumba Fitness Training: A Systematic Review.

OBJECTIVE: As an alternative to the traditional approach to physical exercise, new kinds of organized physical activity have been developed designed to engage large segments of the population. Among these, Zumba fitness is extremely popular, with a growing number of participants. This article aims to summarize and analyze the body of evidence on the effects of Zumba fitness interventions on physical function, fitness, and wellbeing. TYPE: Systematic review. LITERATURE SURVEY: Keyword "Zumba" was identified as term for the literature research in MEDLINE, Scopus, Bandolier, PEDro, and Web of Science. Only studies published in peer-reviewed journals written in English language were considered. METHODOLOGY: Eleven manuscripts were classified as eligible with 586 total participants, ranging in age from 18 to 65 years. After a quality appraisal, we classified 4 studies as high-quality investigations and 7 as low quality. Results were summarized in several domains: "anthropometric parameters and body composition," "hormonal and metabolic profiles," "aerobic and cardiovascular performance," "muscular fitness parameters," and "quality of life, pain score and physical activity questionnaire." SYNTHESIS: Results from this systematic review indicated that Zumba fitness could be considered an effective type of physical activity able to improve aerobic capacity. Small but positive benefits were noted for reducing body weight and other body measurements. Furthermore, other effects, including psychological and social benefits on quality of life, were found after Zumba fitness interventions. Otherwise, limited evidence described positive effects on muscular strength and flexibility. CONCLUSIONS: Zumba fitness could be considered an effective type of physical activity able to improve aerobic capacity. Limited evidence described positive effects on muscular strength and flexibility. LEVEL OF EVIDENCE: II.