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1.
Clin Med Insights Endocrinol Diabetes ; 17: 11795514241244872, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38628617

RESUMO

Introduction: An essential process affecting the course of type 1 diabetes (DM1) is the appearance and duration of clinical remission. One of the most important factors promoting the occurrence of remission is physical activity, due to increased activity of antioxidants, reduces insulin resistance and improves glucose transport. Maximal oxygen capacity (VO2max) is an objective measure of the body's aerobic capacity. To assess VO2max, oxygen uptake should be measured directly during the exercise test. The aim of the study was to evaluate the physical capacity in adults with DM1 and its relationship with the occurrence of partial clinical remission (pCR) during 2 years follow-up. Methods: The pCR was assessed by the following mathematical formula: A1c (%) + [4 × insulin dose (U/kg/d)]. The result ⩽9 indicates pCR. VO2max was assessed between 6th and 24th month of diabetes duration using an ergospirometer (COSMED K5 System), during an exercise test carried out on a cycloergometer (RAMP incremental exercise test). Results: The study group consisted of 32 adults with DM1. People with pCR were proved to have higher VO2max level [36.0 (33.0-41.5) vs 30.9 (26.5-34.4) ml/min/kg, P = .009. Univariate and multivariate regression confirmed a significant association between VO2max and presence of pCR [AOR 1.26 (1.05-1.52), P = .015]. Duration of remission was longer among group with higher VO2max results [15 (9-24) vs 9 (0-12) months, P = .043]. The positive relationship was observed between diabetes duration and VO2max (rs = 0.484, P = .005). Multivariate linear regression confirms a significant association between remission duration and VO2max (ml/min/kg) (ß = 0.595, P = .002). Conclusion: The higher VO2max, the better chance of partial clinical remission at 2 years of DM1 and longer duration of remission.


Better cardiorespiratory fitness increases the chance of partial clinical remission and prolongs remission duration in people with newly diagnosed type 1 diabetes. Introduction An essential process affecting the course of type 1 diabetes (DM1) is the appearance and duration of clinical remission. One of the most important factors promoting the occurrence of remission is physical activity, due to increased activity of antioxidants, reduces insulin resistance and improves glucose transport. Maximal oxygen capacity (VO2max) is an objective measure of the body's aerobic capacity. To assess VO2max, oxygen uptake should be measured directly during the exercise test. The aim of the study was to evaluate the physical capacity in adults with DM1 and its relationship with the occurrence of partial clinical remission (pCR) during 2 years follow-up. Methods The pCR was assessed by the following mathematical formula: A1c (%) + [4 × insulin dose (U/kg/d)]. The result ⩽9 indicates pCR. VO2max was assessed between 6th and 24th month of diabetes duration using an ergospirometer (COSMED K5 System), during an exercise test carried out on a cycloergometer (RAMP incremental exercise test). Results The study group consisted of 32 adults with DM1. People with pCR were proved to have higher VO2max level [36.0 (33.0-41.5) vs 30.9 (26.5-34.4) ml/min/kg, P = .009. Univariate and multivariate regression confirmed a significant association between VO2max and presence of pCR [AOR 1.26 (1.05-1.52), P = .015]. Duration of remission was longer among group with higher VO2max results [15 (9-24) vs 9 (0-12) months, P = .043]. The positive relationship was observed between diabetes duration and VO2max (rs = 0.484, P = .005). Multivariate linear regression confirms a significant association between remission duration and VO2max (ml/min/kg) (ß = 0.595, P = .002). Conclusions The higher VO2max, the better chance of partial clinical remission at 2 years of DM1 and longer duration of remission.

2.
Int J Occup Saf Ergon ; : 1-11, 2024 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-38632949

RESUMO

Objectives. This study aimed to describe work-, lifestyle-, and health-related factors among ambulance personnel, and to analyse differences between women and men. Methods. The cross-sectional study (N = 106) included self-reported and objective measures of work, lifestyle, and health in 10 Swedish ambulance stations. The data collection comprised clinical health examination, blood samples, tests of physical capacity, and questionnaires. Results. A high proportion of the ambulance personnel reported heavy lifting, risk of accidents, threats and violence at work. A low level of smoking and alcohol use, and a high level of leisure-time physical activity were reported. The ambulance personnel had, on average, good self-rated health, high work ability and high physical capacity. However, the results also showed high proportions with risk factors for cardiovascular disease (CVD), e.g., high blood pressure, and high levels of blood lipids. More women than men reported high work demands. Furthermore, women performed better in tests of physical capacity and had a lower level of CVD risk factors. Conclusions. Exposure to work-related factors that might affect health was common among ambulance personnel. Lifestyle- and health-related factors were somewhat contradictory, with a low proportion reporting lifestyle-related risk factors, but a high proportion having risk factors for CVD.

3.
Artigo em Inglês | MEDLINE | ID: mdl-38506057

RESUMO

WHAT IS KNOWN ON THE SUBJECT?: People living with schizophrenia have reduced physical function and are more likely to experience loneliness than those without condition. Low physical function is associated with greater loneliness in people with psychosis. However, it is unclear whether social isolation and loneliness contribute to impaired physical function in this population. Loneliness is linked to an increased risk of physical function impairment among older individuals, but research on patients living with schizophrenia is limited. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study is the first to evaluate the longitudinal association of social isolation and loneliness with physical function among inpatients living with schizophrenia. It showed that more than one third of the participants experienced a decline in physical function over a 2-year period. Loneliness, rather than social isolation, was associated with an increase in physical function impairment over 2 years among inpatients living with schizophrenia. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Healthcare professionals should recognize loneliness as a potential risk factor for impaired physical function among inpatients diagnosed with schizophrenia. It is recommended that people living with schizophrenia are assessed for loneliness and that interventions are offered to alleviate their feelings of loneliness. Implementing interventions to reduce loneliness may help improve physical function and overall quality of life for individuals living with schizophrenia. ABSTRACT: INTRODUCTION: Patients living with schizophrenia often experience low physical function, which is associated with negative health outcomes. Therefore, investigating the risk factors for physical function is crucial in this population. AIM: This study examined the longitudinal association of social isolation and loneliness with physical function among inpatients living with schizophrenia. METHODS: Physical function was assessed using measures of activities daily living (ADL), instrumental activities daily living (IADL) and the combination scores of ADL/IADL. Social isolation was indexed with five types of social connection and loneliness was measured using UCLA Loneliness Scale. RESULTS: Social isolation was not associated with the measures of physical function over 2 years. Loneliness exhibited an association with IADL and ADL/IADL at follow-up, after adjustment for baseline levels of the outcomes. These associations remained when both social isolation and loneliness were simultaneously entered into the model. DISCUSSION: Loneliness, rather than social isolation, was associated with increased physical function impairment over 2 years among inpatients living with schizophrenia. IMPLICATIONS FOR PRACTICE: Healthcare professionals should consider loneliness as a potential risk factor for impaired physical function. It would be beneficial to assess patients for loneliness and implement interventions to reduce feelings of loneliness.

4.
Int Arch Occup Environ Health ; 97(4): 451-460, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38526567

RESUMO

OBJECTIVE: This cross-sectional study aims to examine association between different components of physical fitness and perceived work ability among working age population. METHODS: The population-based study sample included 2050 participants aged 18-74 from the Finnish national Health 2011 study. Physical fitness was assessed by the single leg stand test, the modified push-up test, the vertical jump test and the six-minute walk test, and perceived work ability was assessed via interview. Logistic regression was used for examining the associations between physical fitness and work ability. RESULTS: After adjusting for potential confounders (age, sex, marital status, educational level, work characteristics, total physical activity, daily smoking, BMI and number of diseases), odds ratios indicated that good work ability was more likely among those who had better balance in single leg stand test (OR = 1.54; 95% CI 1.07-2.24), and who belonged in the high fitness thirds in six-minute walking test (OR = 2.08; 95% CI 1.24-3.49) and in vertical jump test (OR = 2.51; 95% CI 1.23-5.12) compared to lowest third. Moreover, moderate (OR = 1.76; 95% CI 1.02-3.05) to high fitness (OR = 2.87; 95% CI 1.40-5.92) in modified push-up test increased the likelihood of good work ability compared to lowest third. CONCLUSION: These study results indicate that good musculoskeletal as well as cardiorespiratory fitness are associated with better perceived work ability. Promoting physical fitness in individual and societal level may be potential targets for maintaining good work ability in working age population.


Assuntos
Aptidão Física , Avaliação da Capacidade de Trabalho , Humanos , Estudos Transversais , Finlândia , Exercício Físico
5.
Sports (Basel) ; 12(2)2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38393269

RESUMO

Physical and cognitive exercises can prevent or at least mitigate the symptoms of certain diseases and help older adults perform a range of daily functions. Yet, most seniors do not meet the World Health Organisation's recommended guidelines for physical activity. The objective of this study is to promote and maintain the physical and cognitive capacity of older adults by implementing a feasible and effective low-threshold, age-appropriate, motor-cognitive training outdoors. In the German city of Chemnitz, citizens aged 60 years and older participated in a quasi-randomised intervention trial. Exercises to train coordination, strength, endurance, and cognition were integrated into a 12-week outdoor motor-cognitive exercise programme. Both the physical (e.g., 6MWT) and cognitive skills (e.g., TMT B) of the intervention group (n = 41) and control group (no intervention, n = 58) were measured before (T1) and after (T2) completion of the exercise programme. Some of the participants' physical and all their cognitive measures improved. Neurocognitive performance (DSST) showed a significant time × group interaction effect (F(1,95) = 6.943, p = 0.010, ηp2 = 0.068). Sex and age were found to be influencing factors. We consider our exercise programme to be successfully implemented, well received by the participants, and feasible and useful to promote the continued exercise of daily functions as part of healthy aging in community-dwelling older adults.

6.
Work ; 77(4): 1245-1259, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38306081

RESUMO

BACKGROUND: Offshore wind technicians (WTs) have been identified as having an occupation with varying physical demands. Therefore, in order to assess WTs capability to undertake the job, there was a need to identify and quantify the physical requirements of the essential tasks. OBJECTIVE: To establish the essential tasks and quantify the associated minimum physical demands of being an offshore WT. METHODS: Wind Farm organisations (n = 10) across five countries, undertook a multi-modal observational approach comprising of semi-structured interviews (n = 45), focus groups (n = 14), survey (n = 167). In addition, observations, objective measurements, video footage and standard operating procedures were reviewed. A service campaign was broken down into component tasks, and analysed in terms of technical specifications, e.g. equipment, frequency, duration, rest breaks, clothing ensembles, and the methods of best practice for undertaking each of the tasks. Task descriptions were produced and minimum performance standards recommended. RESULTS: The job tasks associated with WTs can be broken down into two categories and five areas of work (Essential infrequent = casualty evacuation and prolonged ladder climbing; Essential frequent = short ladder climbs, manual handling and working in restricted spaces). CONCLUSIONS: The results presented constitute work carried out in Phases 1 and 2 of a three phased work programme to establish a physical employment standard required by WTs working in offshore wind. These findings will underpin the development of a minimum performance standard for the global offshore wind industry.


Assuntos
Emprego , Indústrias , Humanos , Exame Físico , Inquéritos e Questionários , Grupos Focais
7.
Work ; 77(4): 1223-1234, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38251086

RESUMO

BACKGROUND: The Ministry of Defence Police recognised the requirement to develop a Physical Employment Standard (PES) for the Authorised Firearms Officer -Counter Terrorism (AFO-CT) role profile. OBJECTIVE: The purpose of this study was to conduct a job task analysis to identify the most critical and physically demanding tasks performed by AFO-CT personnel. METHODS: A focus group and online survey were undertaken to identify a list of job tasks. The down-selected job tasks were objectively monitored during training events to determine the most physically demanding tasks. Tasks were ranked by physical demand and additional factors (e.g., operational load, primary physical actions). Down-selected tasks were then included in a Subject Matter Experts (SME) task scenario generation workshop. The physiological demands of the resulting standardised scenarios were determined. RESULTS: The focus group (n = 11) identified 13 physically demanding and critical role-related tasks. The subsequent survey (n = 907) down-selected eight tasks with a 'moderate' demand or greater. Thirty AFO-CT personnel completed the eight tasks as part of routine training events. From the observed tasks, four tasks were down-selected and combined into two operationally relevant, reasonable worst-case standardised scenarios during a SME workshop. The two scenarios, 'Conduct Armed Search in the Open for an Active Shooter' and 'Victim Focussed Emergency Search' were used in subsequent phases of the research to form the basis of the AFO-CT PES. CONCLUSION: This research elucidated the most physically demanding job tasks within the AFO-CT role profile to inform the development of a MOD armed policing PES.


Assuntos
Emprego , Análise e Desempenho de Tarefas , Humanos , Exame Físico , Polícia , Tomografia Computadorizada por Raios X , Aptidão Física
8.
BMC Geriatr ; 24(1): 69, 2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38233746

RESUMO

BACKGROUND: Geriatric rehabilitation aims to maintain the functional reserves of older adults in order to optimize social participation and prevent disability. After discharge from inpatient geriatric rehabilitation, patients are at high risk for decreased physical capacity, increased vulnerability, and limitations in mobility. As a result, ageing in place becomes uncertain for a plethora of patients after discharge from geriatric rehabilitation and effective strategies to prevent physical decline are required. Collaboration between different health-care providers is essential to improve continuity of care after discharge from inpatient geriatric rehabilitation. The aim of this study is to evaluate the effectiveness of a multi-professional home-based intervention program (GeRas) to improve functional capacity and social participation in older persons after discharge from inpatient geriatric rehabilitation. METHODS: The study is a multicenter, three-arm, randomized controlled trial with a three-month intervention period. Two hundred and seventy community-dwelling older people receiving inpatient geriatric rehabilitation will be randomized with a 1:1:1 ratio to one of the parallel intervention groups (conventional IG or tablet IG) or the control group (CG). The participants of both IGs will receive a home-based physical exercise program supervised by physical therapists, a nutritional recommendation by a physician, and social counseling by social workers of the health insurance company. The collaboration between the health-care providers and management of participants will be realized within a cloud environment based on a telemedicine platform and supported by multi-professional case conferences. The CG will receive usual care, two short handouts on general health-related topics, and facultative lifestyle counseling with general recommendations for a healthy diet and active ageing. The primary outcomes will be the physical capacity measured by the Short Physical Performance Battery and social participation assessed by the modified Reintegration to Normal Living Index, three months after discharge. DISCUSSION: The GeRas program is designed to improve the collaboration between health-care providers in the transition from inpatient geriatric rehabilitation to outpatient settings. Compared to usual care, it is expected to improve physical capacity and participation in geriatric patients after discharge from inpatient geriatric rehabilitation. TRIAL REGISTRATION: German Clinical Trials Register (DRKS00029559). Registered on October 05, 2022.


Assuntos
Pacientes Internados , Alta do Paciente , Humanos , Idoso , Idoso de 80 Anos ou mais , Resultado do Tratamento , Vida Independente/psicologia , Terapia por Exercício/métodos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Multicêntricos como Assunto
9.
Top Stroke Rehabil ; 31(1): 97-103, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37057761

RESUMO

BACKGROUND: Each year, 795,000 Americans experience a stroke. As stroke mortality declines, more individuals are in the chronic phase of recovery (>6 months post-stroke). Over 80% of stroke survivors have multiple, chronic health conditions (MCC). While the relationship between MCC and mortality and function during acute recovery has been explored, less is known about how MCC burden affects participation in chronic stroke survivors. OBJECTIVE: This study investigated whether MCC burden is related to participation in those with chronic stroke. METHODS: Two hundred and sixty-six participants with chronic (≥6 months) stroke were included in this cross-sectional and retrospective analysis. Participants had a mean age of 62.2 ± 12.8 years, and time since stroke (TSS) of 36.0 ± 44.6 months (114F/152 M). Participants completed the 6-minute Walk Test (6MWT), Activities-Specific Balance Confidence Scale (ABC), Modified Cumulative Illness Rating Scale (MCIR) to quantify the presence and severity of chronic illness across 14 body systems, and the Stroke Impact Scale - Participation subscale (SIS-P). Participation (SIS-P) was the dependent variable. Independent variables were entered into a sequential regression model in three blocks: demographic variables, physical capacity (6MWT distance) and balance self-efficacy (ABC), and MCC burden (MCIR). RESULTS: After adjusting for age, sex, and time since stroke, physical capacity and balance self-efficacy explained 31.4% (p < 0.001), and the MCC burden explained 2.0% (p = 0.004). Higher participation was related to lower MCC burden. CONCLUSIONS: MCC burden is a significant contributor to variance in participation in chronic stroke survivors, above and beyond demographics, physical capacity, and self-efficacy, and therefore should be considered when creating rehabilitation programs to improve participation.


Assuntos
Múltiplas Afecções Crônicas , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Pessoa de Meia-Idade , Idoso , Acidente Vascular Cerebral/terapia , Estudos Retrospectivos , Estudos Transversais , Dano Encefálico Crônico , Sobreviventes
10.
Int Arch Occup Environ Health ; 97(1): 45-55, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37971680

RESUMO

OBJECTIVE: Understanding the impact of physical capacity in combination with high physical workload could be beneficial for the prevention of health-related exits from work. Therefore, the aim of this study was to investigate the separate and combined effects of low cardiorespiratory fitness and high physical workload on disability pension (DP) due to any cause, musculoskeletal disorders (MSD), and cardiovascular diseases (CVD). METHODS: A total of 279 353 men born between 1951 and 1961 were followed regarding DP between 2006 and 2020, ages 45-64. Cardiorespiratory fitness was assessed during military conscription, using an ergometer bicycle test. Physical workload was based on a job-exposure matrix (JEM) linked to occupational title in 2005. Cox regression models estimated separate and combined associations with DP. RESULTS: Low cardiorespiratory fitness and high physical workload were associated with increased risk of DP. For all cause DP, the fully adjusted hazard ratio and 95% confidence interval for those with low cardiorespiratory fitness was 1.38 (1.32-1.46) and for those with high physical workload 1.48 (1.39-1.57). For all cause and MSD DP, but not for CVD DP, the combination of low cardiorespiratory fitness and high physical workload resulted in higher risks than when adding the effect of the single exposures. CONCLUSION: Both low cardiorespiratory fitness in youth and later exposure to high physical workload were associated with an increased risk of DP, where workers with the combination of both low cardiorespiratory fitness and a high physical workload had the highest risks (all-cause and MSD DP).


Assuntos
Aptidão Cardiorrespiratória , Doenças Cardiovasculares , Doenças Musculoesqueléticas , Masculino , Adolescente , Humanos , Estudos de Coortes , Suécia/epidemiologia , Carga de Trabalho , Seguimentos , Fatores de Risco , Pensões , Doenças Cardiovasculares/epidemiologia , Doenças Musculoesqueléticas/epidemiologia , Aptidão Física
11.
Front Med (Lausanne) ; 10: 1284689, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38089877

RESUMO

Introduction: Obesity is a chronic medical condition that affects, among others, the cardiovascular and respiratory systems. Interventions for its treatment focus on sustained weight reduction and general health improvement, leaving respiratory management aside. Our objective was to determine the effects of inspiratory muscle training (IMT) in patients with obesity. Methods: A systematic review was performed in Embase, Cochrane Library (CENTRAL), CINAHL, Web of Science, and PubMed/MEDLINE on June 26, 2023. Randomized clinical trials (RCTs), and quasi-randomized clinical trials investigating the effects of IMT in people with obesity were included. Selected studies were screened by two independent reviewers who extracted data and assessed the quality of the evidence. Results: The initial search returned 705 potential studies were included. Ultimately, eight studies met the criteria for eligibility and were included in the review. IMT improves physical capacity [6-minute walk test (6MWT): 44.5 m, 95% CI: 30.5 to 58.5; p < 0.0001] and the strength of the inspiratory muscles [maximal inspiratory pressure (MIP): -28.4 cm H2O, 95% CI: -41.9 to -14.8; p < 0.0001] compared to the controls, without differences in the pulmonary function, body mass index (BMI) and metabolic parameters. Conclusion: Inspiratory muscle training improves physical capacity and inspiratory muscle strength without significant changes in lung function, BMI, and metabolic parameters.Systematic review registration: PROSPERO, identifier CRD42023439625, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023439625.

12.
J Clin Med ; 12(23)2023 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-38068456

RESUMO

(1) Background: Type 2 Diabetes (T2D) is associated with reduced muscle mass, strength, and function, leading to frailty. This study aims to analyze the movement patterns (MPs) of older individuals with T2D across varying levels of physical capacity (PC). (2) Methods: A cross-sectional study was conducted among individuals aged 60 or older with T2D. Participants (n = 103) were equipped with a blinded continuous glucose monitoring (CGM) system and an activity monitoring device for one week. PC tests were performed at the beginning and end of the week, and participants were categorized into three groups: low PC (LPC), medium PC (MPC), and normal PC (NPC). Group differences in MPs and physical activity were analyzed using non-parametric Kruskal-Wallis tests for both categorical and continuous variables. Dunn post-hoc statistical tests were subsequently carried out for pairwise comparisons. For data analysis, we utilized pandas, a Python-based data analysis tool, and conducted the statistical analyses using the scipy.stats package in Python. The significance level was set at p < 0.05. (3) Results: Participants in the LPC group showed lower medio-lateral acceleration and higher vertical and antero-posterior acceleration compared to the NPC group. LPC participants also had higher root mean square values (1.017 m/s2). Moreover, the LPC group spent less time performing in moderate to vigorous physical activity (MVPA) and had fewer daily steps than the MPC and NPC groups. (4) Conclusions: The LPC group exhibited distinct movement patterns and lower activity levels compared to the NPC group. This study is the first to characterize the MPs of older individuals with T2D in their free-living environment. Several accelerometer-derived features were identified that could differentiate between PC groups. This novel approach offers a manpower-free alternative to identify physical deterioration and detect low PC in individuals with T2D based on real free-living physical behavior.

13.
J Occup Med Toxicol ; 18(1): 29, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-38102679

RESUMO

PURPOSE: Waste collection is considered particularly heavy work, although no previous study has yet investigated the strain of bulk waste collection. The aim of this study is to determine the workload of bulk waste workers in practice. METHOD: We conducted a cross-sectional field-study. Fourteen male volunteers from the bulk waste collection of the municipal sanitation department in Hamburg, Germany, were included. Performance was determined by cardiopulmonary exercise testing under laboratory conditions. During the shift, each worker was accompanied by a researcher, and heart rate (HR) was recorded under field conditions using an HR watch with a belt system. We examined mean HR, relative heart rate (RHR), relative aerobic strain (RAS), calculated oxygen uptake ([Formula: see text])  and individual ventilatory threshold 1 (VT1) as parameters of workload during their daily work. RESULTS: During the shift, HR was scaled: 102 bpm (SD 10.2), RHR: 36.9%, [Formula: see text]: 1267 ml/min (SD 161), RAS: 49.4% (SD 9.3), and [Formula: see text] in relation to VT1: 75% (SD 18.5). There was no significant difference between oxygen consumption during the main task of lifting and carrying bulky waste and the individual [Formula: see text] at VT1. CONCLUSION: Although the burden of the main task of lifting and carrying bulky waste is very high (at VT1 for more than 3 h), interruptions from other tasks or formal breaks spread the burden over the entire shift. The total workload exceeded most recommendations in the literature across the different work periods. However, the total burden remains below VT1, the only parameter that takes individual endurance performance into account. We recommend again VT1 as an individual upper limit for prolonged occupational work.

14.
Artigo em Inglês | MEDLINE | ID: mdl-38108961

RESUMO

Telerehabilitation for heart failure (HF) patients is beneficial for physical functioning, prognosis, and psychological status. The study aimed at evaluating the influence of hybrid comprehensive telerehabilitation (HCTR) on the level of anxiety in comparison to usual care (UC). The TELEREH-HF study was a multicenter prospective RCT in 850 clinically stable HF participants. Patients underwent clinical examinations, including the assessment of anxiety, at entry and after the 9-week training program (HCTR) or observation (UC). The State-Trait Anxiety Inventory (STAI) was used. 20.3% HCTR and 20.1% UC patients reported high level of anxiety as a state at baseline, with higher STAI results in younger participants (< 63 y.o.) (p = .048 for HCTR; p = .026 for UC). At both stages of the study, patients with lower level of physical capacity (measured by a peak VO2) had shown significantly higher level of anxiety. There were no significant changes in anxiety levels during the 9-week observation for the entire study population, although there were different patterns of change in anxiety (both trait and state) in younger and older groups,with the decrease in younger patients, and the increase-in the older group.Trial registry number NCT02523560 (Clinical Trials.gov), date of registration: August 14, 2015.

15.
Int. j. morphol ; 41(6): 1698-1705, dic. 2023. tab
Artigo em Espanhol | LILACS | ID: biblio-1528811

RESUMO

Los objetivos de este estudio fueron 1) describir factores antropométricos asociados a la obesidad y pruebas de condición física junto con 2) determinar la correlación entre estas variables en un grupo de escolares provenientes de la región de Valparaíso. Participaron un total de 109 escolares divididos por sexo y por grupos de edad. Los escolares fueron divididos en dos grupos entre 9 a 11 años (24 hombres= 47,98 ± 10,4 kg; 145,73 ± 7,3 cm; 25 mujeres= 45,06 ± 11,1 kg; 145,30 ± 6,6 cm) y entre 12 a 14 años (24 hombres= 54,85 ± 13,2 kg; 158,42 ± 8,8 cm; 36 mujeres= 52,21 ± 9,1 kg; 155,36 ± 6,1 cm). Se realizaron evaluaciones de la condición física utilizadas en el proceso de evaluación del Sistema de Medición de la Calidad de la Educación (SIMCE) de educación física para escolares chilenos. Estas evaluaciones incluyeron parámetros de flexibilidad, carrera, salto horizontal, y resistencia muscular. Junto con esto, se evaluaron variables antropométricas como peso, estatura y perímetro de cintura para establecer índices antropométricos de obesidad como el índice de masa corporal (IMC), el perímetro de cintura (PC) y el índice de cintura estatura (ICE). Se encontraron diferencias significativas entre los grupos de hombres de los diferentes grupos de edad en las pruebas de condición física, resistencia muscular abdominal (p = 0,001), salto horizontal (p = 0,002) y prueba de carrera (p = 0,003). Entre los grupos de mujeres se encontraron diferencias significativas en las variables de condición física, salto horizontal (p = 0,002) y carrera (p = 0,003). Tanto en hombres como en mujeres del grupo de 9 a 11 años se encontraron correlaciones significativas entre las variables antropométricas con pruebas de salto horizontal y capacidad de carrera (p = 0,03, r = -0,42 - 0,83, moderado a muy fuerte). En este mismo grupo solo las mujeres presentaron una correlación significativa entre parámetros antropométricos y la prueba de resistencia muscular en flexo extensiones de codo (p < 0,05, r = -0,42 - -0,52, moderado a fuerte) y abdominales (p < 0,05, r = -0,57 - -0,60, fuerte). Para el grupo entre 12 y 14 años se obtuvieron correlaciones negativas entre el ICE y la prueba de carrera en hombres (p < 0,016, r = -0,48, moderado), PC y la prueba de carrera en mujeres (p < 0,011, r = -0,41, moderado). Sólo en mujeres fue posible encontrar correlaciones significativas entre PC, IMC e ICE con salto horizontal (p < 0,05, r = 0,38 - 0,48, moderado). Los resultados sugieren una correlación negativa entre parámetros antropométricos de exceso de peso corporal y el rendimiento en pruebas físicas, siendo en el grupo de mayor edad las mujeres quienes presentan mayor cantidad de correlaciones significativas entre variables. Estos datos refuerzan la importancia de incluir abordajes integrales en las clases de educación física considerando estilos de vida activos y saludables en conjunto con la promoción de la actividad física.


SUMMARY: The objectives of this study were 1) to describe anthropometric factors associated with obesity and physical fitness tests and 2) to determine the correlation between these variables in a group of schoolchildren from the Valparaíso region. A total of 109 schoolchildren divided by sex and age groups participated. The schoolchildren were divided into two groups between 9 to 11 years (24 males = 47,98 ± 10,4 kg; 145,73 ± 7,3 cm; 25 females = 45,06 ± 11,1 kg; 145,30 ± 6,6 cm) and between 12 to 14 years (24 males = 54,85 ± 13,2 kg; 158,42 ± 8,8 cm; 36 females = 52,21 ± 9,1 kg; 155,36 ± 6,1 cm). Physical fitness assessments used by the Sistema de Medición de la Calidad de la Educación (SIMCE) evaluation process for physical education for Chilean schoolchildren were performed. These assessments included flexibility, sprint capacity, horizontal jump, and muscular endurance parameters. In addition, anthropometric variables such as weight, height and waist circumference were evaluated to establish anthropometric indices of obesity such as body mass index (BMI), waist circumference (WC) and waist-height index (WHI). Significant differences were found between the groups of men in the different age groups in the physical fitness tests, abdominal muscular endurance (p = 0.001), horizontal jump (p = 0.002), sprint test (p = 0.003) and the anthropometric index BMI (p = 0.048). Among the female groups, significant differences were only found in the physical condition variables, horizontal jump (p = 0.002) and sprint (p = 0.003). In both males and females in the 9- to 11- year-old group, significant correlations were found between anthropometric variables and tests of horizontal jumping and sprint ability (p = 0.03, r = -0.42 - 0.83, moderate to very high). In this same group, only females presented a significant correlation between anthropometric parameters and muscular endurance tests in elbow flexion (p < 0.05, r = -0.42 - -0.52, moderate to high) and abdominals (p < 0.05, r = -0.57 - -0.60, high). For the group between 12 and 14 years, negative correlations were obtained between WHI and the sprint test in males (p < 0.016, r = -0.48, moderate), WC and the sprint test in females (p < 0.011, r = -0.41, moderate). Only in women was it possible to find significant correlations between WC, BMI and ICE with a horizontal jump (p < 0.05, r = 0.38 - 0.48, moderate). The results suggest a negative correlation between anthropometric parameters of excess body weight and performance on physical tests, with women in the older age group presenting the highest number of significant correlations between variables. These data reinforce the importance of including integral approaches in physical education classes that consider active and healthy lifestyles together with the promotion of physical activity.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Estudantes , Antropometria , Aptidão Física , Obesidade , Índice de Massa Corporal , Chile , Distribuição por Idade e Sexo , Circunferência da Cintura , Razão Cintura-Estatura
16.
J Clin Med ; 12(21)2023 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-37959251

RESUMO

Moderate-intensity aerobic exercise improves gastrointestinal (GI) health and alleviates irritable bowel syndrome (IBS) symptoms. This study explored its effects on physical capacity (PC) and IBS symptoms in 40 patients from Southern Italy (11 males, 29 females; 52.10 ± 7.72 years). The exercise program involved moderate-intensity aerobic exercise (60/75% of HRmax) for at least 180 min per week. Before and after the intervention, participants completed the IBS-SSS questionnaire to assess IBS symptoms, reported their physical activity levels, and underwent field tests to evaluate PC. PC was quantified as the Global Physical Capacity Score (GPCS). A total of 38 subjects (21 males, 17 females; 53.71 ± 7.27 years) without lower GI symptoms served as a No IBS group. No significant differences were found between IBS patients and No IBS subjects, except for the symptom score, as expected. After the exercise, all participants experienced significant improvements in both IBS symptoms and PC. Higher PC levels correlated with greater benefits in IBS symptomatology, especially with GPCS reaching above-average values. Engaging in moderate-intensity aerobic exercise for at least 180 min per week positively impacts IBS symptoms and PC. Monitoring GPCS in IBS patients provides insights into the connection between physical activity and symptom severity, aiding healthcare professionals in tailoring effective treatment plans.

17.
Disabil Rehabil ; : 1-8, 2023 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-37787058

RESUMO

PURPOSE: Measures of physical capacity and self-efficacy may help rehabilitation professionals better understand and detect frailty in older adults. We aimed to characterize frailty, walking self-efficacy, physical capacity, and their inter-relationships in older adults with difficulty walking outdoors. MATERIALS AND METHODS: A secondary analysis of baseline data from 187 older adults (age ≥ 65 years) with mobility limitations was performed. Frailty was evaluated using the cardiovascular health study frailty index. Physical capacity was measured using the 10-meter walk test (10mWT), 6-min walk test (6MWT), 30-second sit-to-stand test (30STST), mini balance evaluation systems test (mini-BESTest), and hand dynamometry. Self-efficacy was assessed using the ambulatory self-confidence questionnaire (ASCQ). We evaluated associations between scores on physical capacity and walking self-efficacy measures and frailty level using an ANOVA or the Kruskal Wallis H-test. RESULTS: The percentage of participants not frail, pre-frail, and frail was 33.7%, 57.2%, and 9.1%, respectively. Median score on the 10mWT-comfortable pace, 10mWT-fast pace, 6MWT, 30STST, mini-BESTest, grip strength, and ASCQ was 1.06 m/s, 1.42 m/s, 354.0 m, 9.0 repetitions, 22 points, 23.0 kg, and 8.1 points, respectively. Scores on physical capacity and walking self-efficacy measures were associated with frailty level (p < 0.01). CONCLUSIONS: Findings provide insight into the utility of rehabilitation measures to indicate frailty among older adults with mobility limitations.

18.
J Clin Med ; 12(17)2023 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-37685695

RESUMO

Sarcopenic obesity (SO) constitutes the coexistence of skeletal muscle mass loss (sarcopenia) and excess adiposity (obesity). It is mainly considered as a condition in the elderly with health-threatening impacts ranging from frailty to mortality. Mitochondrial dysfunction consists one of the basic pathophysiological mechanisms leading to the development of SO and its consequences. Indirect indicators of mitochondrial function, such as VO2max and exercise capacity, have been demonstrated to be negatively affected in individuals with SO, while the positive effect of exercise on mitochondrial function has been widely proved; thus, in this review, we aimed at investigating the effects of endurance, resistance, and concurrent exercise training on indexes of mitochondrial dysfunction in SO patients. The results of the clinical trials evaluated reveal positive effects of chronic exercise on VO2max and physical capacity, as well as mitochondrial biogenesis and activity. It has been concluded that utilizing a systematic exercise training program that includes both aerobic and strength exercises can be an effective strategy for managing SO and promoting overall health in these patients.

19.
J Telemed Telecare ; : 1357633X231188394, 2023 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-37559399

RESUMO

INTRODUCTION: Individuals with severe coronavirus disease 2019 (COVID-19) may present respiratory and motor complications, requiring rehabilitation programs (RP) for long periods. However, access to cardiopulmonary rehabilitation is poor. Cardiopulmonary telerehabilitation is an alternative for cardiopulmonary dysfunction, improving functional capacity, dyspnea, and quality of life. Moreover, few clinical trials verified the effectiveness of telerehabilitation using functional exercise for post-COVID symptoms. Thus, the present study aimed to verify the effects of cardiopulmonary telerehabilitation using functional and accessible exercises in individuals after COVID-19 hospital discharge. METHODS: This blinded, randomized, and controlled clinical trial and included 67 adult individuals after COVID-19 hospital discharge. Participants were randomized into the groups of telerehabilitation (TG; n = 33) and control (CG; n = 34). TG underwent an individualized exercise program (functional and accessible exercises) supervised by a physical therapist (videoconference), and CG received guidance on general care and self-monitoring of vital signs (videoconference). The primary outcome was performance and physiological responses on the 6-minute step test (6MST). Secondary outcomes were performance on the 2-minute stationary walk test (2MSWT), 30-second chair stand test (30CST), and quality of life using the 36-Item Short Form Health Survey (SF-36) questionnaire physical functioning concept (PF). RESULTS: Functional capacity (6MST) improved by 28 ± 17 steps in TG and 15 ± 26 in CG (p = 0.04). For secondary outcomes, performance on 2MSWT increased by 39 ± 6 steps in TG and 10 ± 6 in CG (p = 0.00); 30CST by 3 ± 1 repetitions in TG and 1.5 ± 0.5 in CG (p = 0.05); and PF (SF-36) by 17 ± 4 points in TG and 12 ± 4 in CG (p = 0.00). Also, peak oxygen uptake VO2peak (6MST) improved by 3.8 ± 1 mL min-1 kg-1 in TG and 4.1 ± 1 in CG (p = 0.6), and heart rate demand (6MST) by 11 ± 37% in TG and -4 ± 19% in CG (p = 0.04). CONCLUSIONS: Cardiopulmonary telerehabilitation using functional exercises improved the exercise and functional capacity assessed using 6MST, 30CST, and 2MSWT and the quality of life of individuals after COVID-19 hospital discharge.

20.
Phys Ther ; 103(12)2023 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-37440440

RESUMO

OBJECTIVE: The purposes of this study were to determine the association between physical activity (PA) behavior and global cognitive function 3 months after stroke and to explore the role of physical capacity as a mediating factor. METHODS: Participants with stroke were successively recruited at 5 different hospitals in Norway. PA was measured using accelerometers, with a follow-up period of 7 consecutive days, and global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). The general pattern of PA and the percentage of participants adhering to World Health Organization PA recommendations (at least 150 minutes of moderate-intensity aerobic PA per week) were investigated using descriptive statistics. Multiple regression and mediator analyses were used to examine the relationship between PA behavior and MoCA scores; physical capacity, measured with the Short Physical Performance Battery, served as the mediating variable. RESULTS: A total of 193 women (42.6%) and 260 men (57.4%) with a median age of 73.7 years (25th and 75th percentiles = 65.8 and 80.4, respectively) and a median MoCA score of 25 points (25th and 75th percentiles = 22 and 27, respectively) were included. Mean total time spent walking at moderate intensity was 251.7 (SD = 164.6) min/wk (mean bout length = 20.9 [SD = 7.3] seconds), which indicated 69.3% adherence to World Health Organization guidelines. With each point decrease in the MoCA score, there was an expected 8.6% increase in the odds of nonadherence to PA recommendations. Physical capacity was identified as an important mediating factor, explaining the strength of the association between cognition and PA behavior. CONCLUSIONS: In contrast to previous research, in the present study, most participants adhered to the updated global PA guidelines. However, people who had survived stroke and had reduced cognitive function were at higher risk of inactivity, an association mediated by physical capacity. IMPACT: A better understanding of the association between cognition and PA behavior after stroke might help for developing more targeted early-onset interventions.


Assuntos
Atividade Motora , Acidente Vascular Cerebral , Masculino , Humanos , Feminino , Idoso , Cognição , Acidente Vascular Cerebral/complicações , Caminhada , Testes de Estado Mental e Demência
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