Effects of telerehabilitation-based respiratory and corrective exercises among the elderly with thoracic hyper-kyphosis: a clinical trial.

BACKGROUND: Aging is associated with changes in the musculoskeletal system, including increased susceptibility to spine malalignments. Utilizing corrective exercises with a therapeutic emphasis can be beneficial in the elderly with thoracic spine hyperkyphosis. OBJECTIVE: This study aimed to investigate the effects of six weeks of telerehabilitation-based respiratory and corrective exercises on quality of life, disability, thoracic kyphosis, craniovertebral angle, shoulder angle, cranial angle, and chest expansion in the elderly with thoracic spine hyperkyphosis. METHODS: In this clinical trial, a total of 40 participants aged 60 and above with thoracic hyperkyphosis were randomly divided into the control (N = 20) and experimental (N = 20) groups. The experimental group performed the corrective exercises for six weeks (3 sessions per week). The control group performed general stretching exercises during the same time period. We measured the outcomes of quality of life, disability, thoracic kyphosis, craniovertebral angle, shoulder angle, cranial angle, and lung expansion before and after the intervention. Analysis of covariance (ANCOVA) was employed to analyze the data. A P-value ≤ 0.05 was considered statistically significant. RESULTS: Quality of life (P < 0.001, Effect Size (ES): 0.44), chest expansion (P < 0.001, ES: 0.56), thoracic kyphosis angle (P < 0.001, ES: 0.31), craniovertebral (P < 0.001, ES: 0.33), cranial (P < 0.001, ES: 0.38), and shoulder (P = 0.005, ES: 0.20) angles were significantly improved in the experimental group as compared with controls. However, no statistically significant difference was observed between the two groups in terms of physical ability (P = 0.251, ES: 0.04). CONCLUSION: It is therefore recommended that online corrective exercises be used in the rehabilitation protocol to improve the quality of life, posture, chest expansion, and disability in the elderly with thoracic kyphosis.

Interleukin-10 and brain-derived neurotrophic factor responses to the Mat Pilates training in women with multiple sclerosis / Respostas da Interleucina-10 e do fator neurotrófico derivado do cérebro ao treinamento de Mat Pilates em mulheres com esclerose múltipla

AIMS: To determine the effect of Mat Pilates on serum levels of interleukin-10 and brain-derived neurotrophic factor in women with multiple sclerosis. METHODS: Thirty women with multiple sclerosis with mild to moderate disability were recruited and randomly divided into equal Pilates training and Control groups. Patients in the training group accomplished a Pilates program three times a week for eight weeks. The Control group maintained their routine lifestyle. The serum level of interleukin-10 and brain-derived neurotrophic factor were measured before and after the protocol. The differences between groups were assessed by using analysis of covariance test to compare post-tests by considering covariate pre-tests (assuming a p-value <0.05 as significant). RESULTS: There were no significant changes in interleukin-10 (13.09 ±5.36 ng/ml in the Pilates training group compared to 13.21 ±4.76 ng/ml in the Control group, p =0.81), whereas an increase in brain-derived neurotrophic factor was observed after eight-week Pilates training (11550.14±2619.60 ng/ml in the Pilates training group compared to 9664.35±3161.66 ng/ml in the Control group, p=0.03). CONCLUSIONS: The results suggest that the intensity and duration of this protocol was not related to significant changes in interleukin-10, but was followed by an increase in brain-derived neurotrophic factor in these patients. Based on this finding, physical activity according to the individual's ability is recommended for patients with multiple sclerosis, in parallel with drug therapy.

OBJETIVOS: Determinar o efeito do Mat Pilates sobre os níveis séricos de interleucina-10 e fator neurotrófico derivado do cérebro em mulheres com esclerose múltipla. MÉTODOS: Trinta mulheres com esclerose múltipla e deficiência física leve a moderada foram recrutadas e divididas aleatoriamente em grupos iguais, um de treinamento em Pilates e outro de controle. As pacientes do grupo de treinamento cumpriram um programa de Pilates três vezes por semana durante oito semanas. O grupo controle manteve seu estilo de vida de rotina. O nível sérico de interleucina-10 e o fator neurotrófico derivado do cérebro foram medidos antes e após o protocolo. As diferenças entre os grupos foram avaliadas usando o teste de análise de covariância para comparar pós-testes, considerando pré-testes como covariáveis (assumindo p-valor <0,05 como significativo). RESULTADOS: Não houve alterações significativas na interleucina-10 (13,09±5,36 ng/ml no grupo treinamento em Pilates, em comparação a 13,21±4,76 ng/ml no grupo controle, p=0,81), mas foi observado um aumento no fator neurotrófico derivado do cérebro após o treinamento de Pilates por oito semanas (11550,14±2619,60 ng/ml no grupo treinamento em Pilates em comparação a 9664,35±3161,66 ng/ml no grupo controle, p=0,03). CONCLUSÕES: Os resultados sugerem que a intensidade e duração desse protocolo não se relacionou com mudança significativa na interleucina-10, mas foi seguido por um aumento no fator neurotrófico derivado do cérebro nessas pacientes. Com base neste achado, a atividade física de acordo com a capacidade individual é recomendada para pacientes com esclerose múltipla, paralelamente à terapia medicamentosa.

Physical activity, lipid profiles and leptin.

BACKGROUND: Physical activity and the component of body composition can determine lipid profiles and Leptin concentration plasma. METHOD: Thirty-two untrained females (20-25 yrs.) (aged 20.9±.33 y, weight 57.50±7.52 Kg, height 159.56±4.97 cm, and BMI 22.55 ±2.51 kg.m-2), participated in our study. They randomly were divided into two equal groups, trained and control group (N.=16). The trained group was assigned to a five week aerobic training program (three times/week), with intensity 60-70% HRR (heart rate reserve). The control group continued their normal lifestyle. Body weight (BW) was measured. Body fat percent (FP) and fat mass (FM), and fat free mass (FFM) were assessed, also the concentration of high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (TG), total cholesterol (TC), and leptin were measured. RESULTS: Analysis of covariance (ANCOVA) indicated that BW (F=4.20, P=0.05) significantly decreased and HDL (F=43.32, P=0.01) significantly increased in the trained group (P-value<0.05), whereas we had no significant difference in BMI, FP, FM, FFM, and the serum concentration of LDL, TG, TC, and Leptin between groups and time × group interaction, after the five weeks aerobic training period (P<0.05). CONCLUSIONS: These results suggest the five-week moderate- intensity aerobic training had significant changes in BW and HDL in young female, but had no significant impact on BMI, FP, FM, FFM, LDL, TG, TC, and Leptin concentration, which are required to increase duration or increase the intensity of physical activity.

Effects of whole body vibration on hormonal & functional indices in patients with multiple sclerosis.

BACKGROUND & OBJECTIVES: Multiple sclerosis (MS) is a neurodegenerative disease, which affects the patients' mobility, and exercise training is considered to be beneficial for these patients. The aim of this study was to determine the effects of 10 wk of low intensity exercise and whole body vibration (WBV) training on fatigue, quality of life, functional and physical indices, and serum levels of ghrelin, leptin, and testosterone in MS patients. METHODS: Thirty four MS patients with mild to moderate disability were recruited and randomly divided into two groups, the training group (n=17) and control group (n=17). Patients in the training group did low intensity exercise and WBV training programme three times a week for 10 wk. The control group continued their routine life. Intended variables like expanded disability status scale (EDSS), fatigue, quality of life, functional and physical indices consisted of balance, walking speed, functional mobility, functional muscle endurance, and walking endurance, and serum levels of ghrelin, leptin, and testosterone were measured before and after the protocol. RESULTS: Thirty subjects completed the study (23 females, 7 males; mean age =38.80 ± 9.50 yr). Statistical analysis demonstrated that EDSS in the WBV training group was significantly decreased (P=0.01), balance (P=0.01), and walking endurance significantly increased (P=0.01) in MS patients (P<0.05). INTERPRETATION & CONCLUSIONS: The results suggest that low intensity exercise and WBV training have some beneficial impact on functional and physical indices of MS patients.

The relation between peptide hormones and sex hormone in patients with multiple sclerosis.

BACKGROUND: Hormones can play a significant role in the pathogenesis of multiple sclerosis (MS). The aim of this study was to compare levels of ghrelin, leptin, and testosterone hormones of MS patients with healthy subjects, and assess the relationship between levels of peptide hormone and sex hormones in MS patients. METHODS: 35 MS patients with definite relapsing remitting multiple sclerosis (RRMS) (male = 9, female = 26) and 13 healthy subjects (male = 4, female = 9) were enrolled in the study. Levels of serum ghrelin, leptin, and testosterone hormones were measured in this study. ANOVA and Pearson correlation were used for data analysis (P < 0.05). RESULTS: The female and male participants of the patient group were compared with the healthy group. No significant differences were found in serum of leptin, ghrelin, testosterone, ghrelin/leptin, and testosterone/leptin (P < 0.05). Spearman correlation coefficient showed that leptin had a significant negative correlation with the variability of testosterone (r = -1.00) in the healthy male group. Moreover, leptin had a significant positive correlation with the variability of BMI (r = 0.68) and weight (r = 0.59), at the 0.01 level (2-tailed), in the female patient group. In addition, in the healthy male group, ghrelin had a significant negative correlation with the variability of weight (r = -1.00). CONCLUSION: According to the results, there was no significant difference between peptide and sex hormones of MS patients and healthy persons. Furthermore, there was no significant relationship between peptide and sex hormones of MS patients and healthy persons.

Resistance training and vibration improve muscle strength and functional capacity in female patients with multiple sclerosis.

PURPOSE: The purpose of this study was to evaluate the effect of an eight-week progressive resistance training and vibration program on strength and ambulatory function in multiple sclerosis (MS) patients. METHODS: Twenty-Four female MS patients with the following demographics: age 27-45 years, and expanded disability status scale (EDSS) 2-4, participated in this study. The subjects were randomly allocated to one of two groups. The exercise group (n = 12) trained according to a progressive program, mainly consisting of resistance training and vibration, three times a week for eight weeks and compared with subjects in the control group (n = 12) that received no intervention. Subjects completed one set of 5-12 reps at%50-70 maximal voluntary contraction (MVC). After 5-10 minutes rest, six postures on plate vibration were done. Isotonic MVC of knee extensors, abduction of the scapula and downward rotation of the scapular girdle muscle groups were predicted by using the Brzycki formula. Right leg balance (RLB), left leg balance (LLB), and walking speed (10-Meter Walk Test) were assessed before and after the training program. Descriptive statistics and Co-variance were used for analyzing data. RESULTS: After eight weeks of training the exercise group showed significant increase in MVC of Knee extensors (32.3%), Abduction of the scapula (24.7%) and Downward Rotation Scapular (39.1%) muscle groups, RLB (33.5%), LLB (9.5%), and decrease in 10-Meter Walk Test (10MWT) (9.3%), (P<0.05). CONCLUSIONS: The results of this study indicated this type of training can cause improvements in muscle strength and functional capacity in patients with multiple sclerosis.