The Effect of Intradialytic Exercise Using Virtual Reality on the Body Composition of Patients with Chronic Kidney Disease.

BACKGROUND: Individuals with chronic kidney disease (CKD) often experience reduced muscle strength and diminished health-related quality of life (HRQoL), and engaging in regular exercise may improve them. The aim of this study was to assess the effect of intradialytic exercise using non-immersive virtual reality (VR) on body composition of patients with CKD on hemodialysis (HD). METHODS: This was a substudy in a clinical trial of intradialytic exercise intervention using a non-immersive VR game in which the patient interacted by moving the lower limbs. Body composition was determined by BCM Fresenius multifrequency stereoscopic bioimpedance. Body mass index (BMI), fat tissue index (FTI), lean tissue index (LTI), extracellular/intracellular water (EIW), and phase angle (PA) were recorded in 52 patients, 24 in the control group (CG) and 28 in the exercise group (EG). RESULTS: Statistically significant differences were observed between both groups. The LTI increased in the EG while it decreased in the CG. The FTI and the EIW decreased in the EG compared to the increase observed in the CG. CONCLUSIONS: Intradialytic exercise using non-immersive VR was associated with an increase in LTI and a decrease in FTI of CKD patients on HD.

[Effectiveness of physical rehabilitation methods based on the impact of eccentric load in upper limb injuries]. / Effektivnost' fizicheskikh metodov reabilitatsii, osnovannykh na vozdeistvii ekstsentricheskikh nagruzok, pri travmakh verkhnikh konechnostei.

The rehabilitation of patients after upper limb injuries is becoming increasingly relevant in current medical practice considering that this pathology is often occurred in professional athletes, elderly people, people with active lifestyle. OBJECTIVE: To study the effectiveness of isolated therapeutic exercises (TE) with eccentric muscle loads when using rubber cable compared to traditional TE to restore functional capabilities of patients after upper limb injuries. MATERIAL AND METHODS: The study included 38 patients with upper limb injuries diagnosed by orthopedic surgeon. Patients were randomly enrolled into group of isolated TE with eccentric muscle loads (group A, 20 patients, mean age 40.2±10.8 years) and group of traditional exercises (group B, 18 patients, mean age 38.6±12.3 years). The study consisted of anamnesis taking, clinical examination, functional tests applying (isometric dynamometry, joint mobility tests, functional scales and questionnaires). The rehabilitation effectiveness was assessed by comparing the indicators before and after treatment course. RESULTS: There has been a significant improvement in muscle strength, movement amplitude and decrease of pain syndrome in patients rehabilitated by eccentric muscle loads. A comparison with a control group using traditional TE methods confirmed the superiority of eccentric exercises in reducing recovery time and improving functional performance. CONCLUSION: The study confirmed the high effectiveness of eccentric muscular loads in the rehabilitation of patients after upper limb injuries. The method has shown significant improvement in clinical and functional indices, which allows to recommend it for inclusion in standard rehabilitation protocols. Further researches may extend application of this approach and reveal the TE effectiveness in other types of traumas and orthopedic injuries.

[Comprehensive approach to rehabilitation of patients with COVID-19. (A literature review)]. / Kompleksnyi podkhod v reabilitatsii patsientov s COVID-19. (Obzor literatury).

The COVID-19 epidemic has made significant changes in the organization of treatment process both at the inpatient and outpatient stages. OBJECTIVE: To analyze the work results of the rehabilitation units dealing with patients who have suffered from COVID-19, in order to summarize the used approaches to medical rehabilitation and improve the effectiveness of care delivery in the recovery phase. RESULTS AND CONCLUSION: Currently, the rehabilitation system has been effectively rebuilt to meet new challenges of the COVID-19 pandemic. Recovery of patients with pronounced neurotic disorders has become a showing good results direction in rehabilitation. It is necessary to implement a tight integration of physical exercises and telerehabilitation facilities in order to effectively settle the main issues directly related to the treatment and recovery of patients with COVID-19 and other pathologies. The control, prevention, treatment and rehabilitation of other infectious diseases will have great prospects regarding the possibility of remote follow-up of patients and correction of their functional state of the body in the nearest future.

[Physical methods of correction of arterial hypertension: modern concepts. (A literature review)]. / Fizicheskie metody korrektsii arterial'noi gipertenzii: sovremennye predstavleniya. (Obzor literatury).

Arterial hypertension is a major risk factor for cardiovascular disease, affecting a large proportion of the population worldwide. The study of the listed literature made it possible to assess the effectiveness and necessity of physical exercise in the treatment of hypertension syndrome, including various types of exercise, intensity, duration, and frequency, since drug treatment is not enough for successful therapy. To prevent and treat hypertension, a comprehensive approach is required, including aerobic exercise, which will lower blood pressure by dilating blood vessels.

mHealth-Based Just-in-Time Adaptive Intervention to Improve the Physical Activity Levels of Individuals With Spinal Cord Injury: Protocol for a Randomized Controlled Trial.

BACKGROUND: The lack of regular physical activity (PA) in individuals with spinal cord injury (SCI) in the United States is an ongoing health crisis. Regular PA and exercise-based interventions have been linked with improved outcomes and healthier lifestyles among those with SCI. Providing people with an accurate estimate of their everyday PA level can promote PA. Furthermore, PA tracking can be combined with mobile health technology such as smartphones and smartwatches to provide a just-in-time adaptive intervention (JITAI) for individuals with SCI as they go about everyday life. A JITAI can prompt an individual to set a PA goal or provide feedback about their PA levels. OBJECTIVE: The primary aim of this study is to investigate whether minutes of moderate-intensity PA among individuals with SCI can be increased by integrating a JITAI with a web-based PA intervention (WI) program. The WI program is a 14-week web-based PA program widely recommended for individuals with disabilities. A secondary aim is to investigate the benefit of a JITAI on proximal PA, defined as minutes of moderate-intensity PA within 120 minutes of a PA feedback prompt. METHODS: Individuals with SCI (N=196) will be randomized to a WI arm or a WI+JITAI arm. Within the WI+JITAI arm, a microrandomized trial will be used to randomize participants several times a day to different tailored feedback and PA recommendations. Participants will take part in the 24-week study from their home environment in the community. The study has three phases: (1) baseline, (2) WI program with or without JITAI, and (3) PA sustainability. Participants will provide survey-based information at the initial meeting and at the end of weeks 2, 8, 16, and 24. Participants will be asked to wear a smartwatch every day for ≥12 hours for the duration of the study. RESULTS: Recruitment and enrollment began in May 2023. Data analysis is expected to be completed within 6 months of finishing participant data collection. CONCLUSIONS: The JITAI has the potential to achieve long-term PA performance by delivering tailored, just-in-time feedback based on the person's actual PA behavior rather than a generic PA recommendation. New insights from this study may guide intervention designers to develop engaging PA interventions for individuals with disability. TRIAL REGISTRATION: ClinicalTrials.gov NCT05317832; https://clinicaltrials.gov/study/NCT05317832. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/57699.

Effects of exercise interventions on quality of life in patients with breast cancer: A systematic review and network meta-analysis.

OBJECTIVE: To compare and rank the effectiveness of four primary categories of exercise modalities (aerobic, resistance, mind-body, and combined exercise [CE]) in improving the Quality of life (QoL) of women with breast cancer in a network meta-analysis (NMA). METHODS: Articles published in English and indexed in the PubMed (MEDLINE), EBSCO, Web of Science, SPORTDiscus, The Cochrane Library, Google Scholar, PsycINFO, EMBASE, and CINAHL Plus databases were identified from inception to 12 October 2023. Studies that met the eligibility criteria were assessed for risk of bias. A frequentist NMA was conducted to appraise the efficacy of different exercise types. RESULTS: This study included 56 studies with 3904 participants. Aerobic, mind-body, and combined exercises effectively improved QoL compared to controls. The surface under the cumulative ranking curve (SUCRA) indicated that CE best improved patients' QoL (SUCRA = 96.7%). Analysis of the secondary outcomes suggests that exercise reduced patients' depression (standardized mean difference [SMD] = -0.38, 95% confidence interval [CI] = -0.70 to -0.06, p < 0.001; I2 = 79%) and anxiety (SMD = -0.50, 95% CI = -0.69 to -0.31, p < 0.001; I2 = 27.4%) but did not affect self-esteem. CONCLUSION: All exercise types but resistance were effective in improving the QoL of women with breast cancer, CE (the combination of aerobic and resistance exercise) had the highest likelihood of being optimal for improving QoL.

Process evaluation protocol plan for a home-based physical activity intervention versus educational intervention for persistent taxane-induced peripheral neuropathy (B-HAPI study): a randomized controlled trial.

BACKGROUND: Evaluation publications typically summarize the results of studies to demonstrate the effectiveness of an intervention, but little is shared concerning any changes implemented during the study. We present a process evaluation protocol of a home-based gait, balance, and resistance exercise intervention to ameliorate persistent taxane-induced neuropathy study according to 7 key elements of process evaluation. METHODS: The process evaluation is conducted parallel to the longitudinal, randomized control clinical trial examining the effects of the home-based gait, balance, and resistance exercise program for women with persistent peripheral neuropathy following treatment with taxanes for breast cancer (IRB approval: Pro00040035). The flowcharts clarify how the intervention should be implemented in comparable settings, fidelity procedures help to ensure the participants are comfortable and identify their individual needs, and the process evaluation allows for the individual attention tailoring and focus of the research to avoid protocol deviation. CONCLUSIONS: The publication of the evaluation protocol plan adds transparency to the findings of clinical trials and favors process replication in future studies. The process evaluation enables the team to systematically register information and procedures applied during recruitment and factors that impact the implementation of the intervention, thereby allowing proactive approaches to prevent deviations from the protocol. When tracking an intervention continuously, positive or negative intervention effects are revealed early on in the study, giving valuable insight into inconsistent results. Furthermore, a process evaluation adds a participant-centered element to the research protocols, which allows a patient-centered approach to be applied to data collection. TRIAL REGISTRATION: ClinicalTrials.gov NCT04621721, November 9, 2020, registered prospectively. PROTOCOL VERSION: April 27, 2020, v2.

Effects of non-pharmacological interventions for adults with subjective cognitive decline: a network meta-analysis and component network meta-analysis.

BACKGROUND: Non-pharmacological interventions have a myriad of available intervention options and contain multiple components. Whether specific components of non-pharmacological interventions or combinations are superior to others remains unclear. The main aim of this study is to compare the effects of different combinations of non-pharmacological interventions and their specific components on health-related outcomes in adults with subjective cognitive decline. METHODS: PubMed, Embase, Cochrane, CINAHL, PsycINFO, CENTRAL, Web of Science, and China's two largest databases, CNKI and Wanfang, were searched from inception to 22nd, January 2023. Randomized controlled trials using non-pharmacological interventions and reporting health outcomes in adults with subjective cognitive decline were included. Two independent reviewers screened studies, extracted data, and assessed risk of bias. Component network meta-analysis was conducted employing an additive component model for network meta-analysis. This study followed the PRISMA reporting guideline and the PRISMA checklist is presented in Additional file 2. RESULTS: A total of 39 trials with 2959 patients were included (range of mean ages, 58.79-77.41 years). Resistance exercise might be the optimal intervention for reducing memory complaints in adults with subjective cognitive decline; the surface under the cumulative ranking p score was 0.888, followed by balance exercise (p = 0.859), aerobic exercise (p = 0.832), and cognitive interventions (p = 0.618). Music therapy, cognitive training, transcranial direct current stimulation, mindfulness therapy, and balance exercises might be the most effective intervention components for improving global cognitive function (iSMD, 0.83; 95% CI, 0.36 to 1.29), language (iSMD, 0.31; 95% CI, 0.24 to 0.38), ability to perform activities of daily living (iSMD, 0.55; 95% CI, 0.21 to 0.89), physical health (iSMD, 3.29; 95% CI, 2.57 to 4.00), and anxiety relief (iSMD, 0.71; 95% CI, 0.26 to 1.16), respectively. CONCLUSIONS: The form of physical activity performed appears to be more beneficial than cognitive interventions in reducing subjective memory complaints for adults with subjective cognitive decline, and this difference was reflected in resistance, aerobic, and balance exercises. Randomized clinical trials with high-quality and large-scale are warranted to validate the findings. TRIAL REGISTRATION: PROSPERO registry number. CRD42022355363.

Effects of Nordic Walking on Functional Capacity of Women Cohort with Breast Cancer.

Background: Breast cancer is one of the most common tumours and one of the leading causes of death among women in all parts of the world. The aim of this study is to investigate the influence of Nordic walking on the functional capacity of women who have undergone surgery for breast cancer. Methods: The study involved a cohort of women who exercised through Nordic walking for 10 weeks (from March to May 2022). The subjects trained with a licenced instructor (INWA method), with two training sessions per week of 70-80 min each. We collected information on pain, arm mobility, hand grip strength, shoulder joint range of motion bilaterally, circumference of both arms, body mass index, physical activity, aerobic capacity, and endurance. Results: There were 14 women, median age 63. BMI was significantly lower (28.9/28.1; p = 0.013) after training and a difference in shoulder range of motion was better (anteflexion right (142.5/170, p = 0.002), retroflexion right (40/60, p = 0.005), abduction right (135/180, p = 0.005), abduction left (135/180, p = 0.005)). There was no difference in right hand strength, while there was a significant difference in left hand strength (19/20, p = 0.007). A correlation was found between BMI and the six-minute walk test (r = -0.70; p = 0.005). Conclusions: Considering the multidimensionality of the disease itself and the results of this study, we believe that Nordic walking is a favourable and good choice of physical activity for breast cancer patients.

Prehabilitation in patients with cirrhosis awaiting liver transplantation: protocol of a feasibility study.

INTRODUCTION: Patients with cirrhosis awaiting liver transplantation (LT) are often frail, and malnourished. The period of time on the waitlist provides an opportunity to improve their physical fitness. Prehabilitation appears to improve the physical fitness of patients before major surgery. Little is known about prehabilitation in patients with cirrhosis. The aim of this feasibility study will be to investigate the feasibility, safety, and effectiveness of a multimodal prehabilitation programme in this patient population. METHODS AND ANALYSIS: This is an open-label single-arm feasibility trial recruiting 25 consecutive adult patients with cirrhosis active on the LT waiting list of the McGill University Health Centre (MUHC). Individuals will be excluded based on criteria developed for the safe exercise training in patients with cirrhosis. Enrolled individuals will participate in a multimodal prehabilitation programme conducted at the PeriOperative Programme complex of the MUHC. It includes exercise training with a certified kinesiologist (aerobic and resistance training), nutritional optimisation with a registered dietician and psychological support with a nurse specialist. The exercise training programme is divided into an induction phase with three sessions per week for 4 weeks followed by a maintenance phase with one session every other week for 20 weeks. Aerobic training will be individualised based on result from cardiopulmonary exercise testing (CPET) and will include a high-intensity interval training on a cycle ergometer. Feasibility, adherence and acceptability of the intervention will be assessed. Adverse events will be reviewed before each visit. Changes in exercise capacity (6-minute walk test, CPET, liver frailty index), nutritional status and health-related quality of life will be assessed during the study. Post-transplantation outcomes will be recorded. ETHICS AND DISSEMINATION: The research ethics board of the MUHC has approved this study (2021-7646). Our findings will be submitted for presentation at national and international conferences, and for peer-reviewed publication. TRIAL REGISTRATION NUMBER: NCT05237583.

A comparative analysis of open heart surgery and minimally invasive cardiac surgery in exercise-based cardiac rehabilitation.

BACKGROUND: Historically, the majority of patients admitted to inpatient exercise-based cardiac rehabilitation (EBCR) have undergone open heart surgery (OHS). However, with advances in minimally invasive cardiac surgery (MICS), these patient groups are also increasingly referred for inpatient EBCR. Herein, we aimed to compare the progress of these groups during rehabilitation. METHODS: In this prospective, nonrandomized study, 403 inpatient EBCR patients were recruited from December 2022 until September 2023 and stratified into two groups: OHS, and MICS. Participants completed a 3-4-week certified EBCR program. The primary endpoint was defined as a change in the 6-minute walk test (6MWT). Moreover, a comprehensive panel of quality-of-life (QoL) assessments were performed at admission and discharge. RESULTS: At baseline, patients with OHS were older (66 years [IQR 59 - 72]), more often male (83%), and underwent emergency/urgent procedures more often (20%) than patients with MICS. Furthermore, patients with MICS showed a better 6MWT at admission (426 meters [IQR 336 - 483]) compared to patients with OHS (381 meters [IQR 299 - 453]). While all patients were able to increase the distance in the 6MWT, regression analyses in fully adjusted models showed no difference in improvements between the two groups (ß -5, 95% CI, -26 - 14, p = 0.58). Moreover, during EBCR, we observed significant improvements in all QoL measures in all groups. CONCLUSIONS: In this study, improvements in fitness, as assessed by the 6WMT were observed in all groups. Furthermore, multiple QoL measures improved equally across all groups. These encouraging results emphasize the importance of EBCR.

Effects of Upper Limb Control on the Less-Affected Side on Upper Limb Function, Respiration, Balance, and Activities of Daily Living in Stroke.

Background and Objectives: This study aimed to investigate the effects of upper limb control exercises on upper limb function, respiration, balance, and activities of daily living in patients with stroke. Materials and Methods: The 28 patients who met the selection criteria were randomly assigned to two groups of 14 patients each. Subsequently, upper limb control exercises using real-time feedback were applied. The same interventional exercise was applied to both the less-affected and affected limbs of the study participants, who were classified into a less-affected side upper limb control group and an affected side upper limb control exercise group. Interventional exercises, 30 min each, were performed five times weekly for 4 weeks, and follow-up examinations were performed 2 weeks after the end of exercise. Electronic muscle strength measurements and an electronic goniometer were used to evaluate upper limb function. A spirometer was used to measure respiration. Balance ability was evaluated using a force plate pressure distribution measuring system with a sensor that detects the movement of the body center on the ground. Daily life movements were evaluated using the Korean version of the modified Barthel index. Results: When examining the results, the upper limb function on the paralyzed side showed an increase in the electromyographic strength of shoulder joint depression and flexion angle. Improvements were also observed in respiration (forced vital capacity [L] and forced expiratory volume in 1 s [L]), balance (95% confidence ellipse area [mm2] and center of pressure displacement [mm]), and daily life activities, all of which showed statistically significant differences in the time × group interaction effect (p < 0.05). Conclusions: Thus, it was found that the upper limb control exercise on the less-affected side had a significant effect when the exercise was performed together with treatment on the affected side in patients with stroke. It is anticipated that this study will provide basic data for evaluating both the trunk and upper limbs of the less-affected and affected sides.

Effects of exercise during active surveillance for prostate cancer: A systematic review and meta-analysis.

PURPOSE: The efficacy of exercise in men with prostate cancer (PCa) on active surveillance (AS) remains unclear. In this meta-analysis, we aimed to examine the effects of exercise in PCa patients on AS. METHODS: A literature search was conducted in PubMed, EMBASE, and the Cochrane Library using search terms, including exercise, PCa, AS, and randomized controlled trials (RCTs). The means and standard deviations for peak oxygen consumption (VO2peak), prostate-specific antigen (PSA) levels, and quality of life (QoL) were extracted for the intervention and control groups. A random-effects model was used to summarize the effects of exercise. RESULTS: Of the 158 identified studies, six RCTs with 332 patients were included. The interventions included lifestyle modifications (aerobic exercise + diet) in three studies and different exercise modalities in three studies. The intervention duration was 2-12 months; three interventions were supervised and three were self-directed. The pooled weighted mean difference between exercise and usual care for VO2peak was 1.42 mL/kg/min (95% confidence interval [CI]: 0.30 to 2.54, P ≤ 0.001). A non-significant effect was observed for QoL (pooled standardized mean difference [SMD]: 0.24, 95% CI: - 0.03 to 0.51, P = 0.08) which became statistically significant and stronger after excluding one outlier study (P < 0.001). Exercise also had a positive effect on PSA levels (pooled SMD: - 0.43, 95% CI: - 0.87 to 0.01, P = 0.05). CONCLUSION: Exercise improves cardiorespiratory fitness and may improve QoL and PSA levels in men with PCa on AS. Further studies with larger sample sizes are warranted to obtain more reliable results.

Physical exercise in hypertensive heart disease: From the differential diagnosis to the complementary role of exercise.

Arterial hypertension (AH) is one of the most common pathologic conditions and uncontrolled AH is a leading risk factor for cardiovascular disease and mortality. AH chronically causes myocardial and arterial remodelling with hemodynamic changes affecting the heart and other organs, with potentially irreversible consequences leading to poor outcomes. Therefore, a proper and early treatment of AH is crucial after the diagnosis. Beyond medical treatment, physical exercise also plays a therapeutic role in reducing blood pressure, given its potential effects on sympathetic tone, renin-angiotensin-aldosterone system, and endothelial function. International scientific societies recommend physical exercise among lifestyle modifications to treat AH in the first stages of the disease. Moreover, some studies have also shown its usefulness in addition to drugs to reduce blood pressure further. Therefore, an accurate, personalized exercise prescription is recommended to optimize the prevention and treatment of hypertension. On the other hand, uncontrolled AH in athletes requires proper risk stratification and careful evaluation to practice competitive sports safely. Moreover, the differential diagnosis between hypertensive heart disease and athlete's heart is sometimes challenging and requires a careful and comprehensive interpretation in order not to misinterpret the clinical findings. The present review aims to discuss the relationship between hypertensive heart disease and physical exercise, from diagnostic tools to prevention and treatment strategies.

A gamified virtual environment intervention for gait rehabilitation in Parkinson's Disease: co-creation and feasibility study.

BACKGROUND: Treadmill gait training has been shown to improve gait performance in People with Parkinson's Disease (PwPD), and in combination with Virtual Reality, it can be an effective tool for gait rehabilitation. The addition of gamification elements can create a more stimulating and adherent intervention. However, implementation of new technologies in healthcare can be challenging. This study aimed to develop and evaluate the feasibility of a treadmill rehabilitation program in a Gamified Virtual Reality Environment (GVRE) for PwPD. METHODS: The GVRE was developed following a user-centered design approach, involving both PwPD and physiotherapists in the development and evaluation of the intervention. The intervention consisted of a walking simulation in three different environments (countryside, city, and park), which had a progressive increase in difficulty. To test its feasibility, three sessions were carried out with four PwPD and four physiotherapists. To assess the usability, the System Usability Scale (SUS), Assistive Technology Usability Questionnaire for people with Neurological diseases (NATU Quest) and Simulator Sickness Questionnaire (SSQ) were used. To assess the intervention's acceptability, feedback and in-game performance was collected from participants. RESULTS: Results showed the feasibility of the intervention, with a SUS score of 74.82 ± 12.62, and a NATU Quest score of 4.49 ± 0.62, and positive acceptability feedback. Participants showed clear preferences for naturalistic environments, and gamification elements were seen as positive. Difficulty settings worked as intended, but lowered enjoyment of the experience in some cases. CONCLUSIONS: This intervention was successfully shown as a feasible option for the training of gait under Dual Task conditions for PwPD. It offers a safe and replicable environment in which complex situations can be trained. However, further iterations of the intervention need to be improved in order to guarantee accurate tracking and a more realistic training progression. TRIAL REGISTRATION NUMBER: NCT05243394-01/20/2022.

An exercise and patient education intervention to reduce pain and physical limitations in adults with acetabular dysplasia: study protocol for a process evaluation integrated within a randomised controlled trial (the MovetheHip trial).

BACKGROUND: The Movethehip trial investigates the effectiveness of an exercise and patient education intervention for adults with acetabular dysplasia. The intervention involves eight tailored one-to-one sessions with trained providers who employ supportive feedback tools. The present protocol reports a planned process evaluation, which aims to determine how the intervention functions by examining the implementation of the intervention (process, dose and reach), its acceptability, mechanisms of change and the influence of contextual factors. METHODS: Two hundred trial participants aged 18-50 years will be recruited from a University Hospital in Denmark and randomised to the intervention or control group. Approximately ten providers will deliver the intervention. The process evaluation adopts a concurrent mixed-methods design. The implementation will be assessed using self-report questionnaires (at baseline and 6-month follow-up), training records and semi-structured focus group interviews with intervention providers (n = 10) and healthcare managers (n = 4-6). The mechanisms of change will be explored through semi-structured one-to-one interviews (at baseline and 6-month follow-up) with 15-20 purposefully sampled participants and by measuring changes in health outcomes (self-reported pain, physical functioning and quality of life completed at baseline and at 3- and 6-month follow-up). Additionally, change will be measured through an explorative examination of associations between dose and change in health outcomes, applying simple linear regression models. The acceptability of the intervention and the influence of contextual factors will be explored through one-to-one participant interviews and focus group interviews with 4-6 healthcare managers. The interviews will focus on expectations, experiences, events, personal understandings and interaction with interpersonal and organisational aspects. Interview data will be analysed using theoretical thematic analyses, and findings will be merged with quantitative data and reported jointly on a theme-by-theme basis. DISCUSSION: The process evaluation conducted as part of the MovetheHip trial will illuminate how the intervention functions, and if the intervention is proven effective, the findings of the evaluation will contribute to pinpoint how the intervention may be optimised to facilitate future up-scaling and implementation. TRIAL REGISTRATION: The MovetheHip protocol was approved by the Committee on Health Research Ethics in the Central Denmark Region. ClinicalTrials, NCT04795843. Registered on 20 March 2021.

Digital home-based post-treatment exercise interventions for female cancer survivors: A systematic review and meta-analysis.

BACKGROUND: Although exercise benefits female cancer survivors, clinical decision-making regarding timing, frequency, duration, and intensity is lacking. Optimizing exercise interventions in this population is necessary. This study aimed to describe existing digital home-based exercises and to assess their effectiveness at improving physical health in female cancer survivors upon completion of therapy. DESIGN: We conducted a systematic review using articles from Web of Science, Embase and Medline (Ovid). We included intervention studies examining the effects of digital home-based exercise programs on post-treatment recovery in female cancer survivors. Rob2 and ROBIN I were used to assess quality of studies. Quality-of-life, fatigue score, and physical performance were assessed using meta-analysis. RESULTS: This study involved 1578 female cancer survivors in 21 interventions. Following guidelines and supervised exercise with coaches led to better outcomes than interventions without guidelines, programs without coaches, or lower intensity exercise. Exercise led to significant improvement in some physical performance outcomes. Significant improvements were seen in physical performance outcomes, including the 6-min walk test, metabolic equivalent task, and number of steps per day. CONCLUSION: Providing cancer survivors with standard guidelines for home-based, coach-supervised, vigorous exercise on digital platforms could improve their physical function, health, and quality-of-life.

Effects of aerobic exercise on neurocognitive function in postmenopausal women receiving endocrine therapy for breast cancer: The Exercise Program in Cancer and Cognition randomized controlled trial.

Objective: The Exercise Program in Cancer and Cognition (EPICC) Study was a randomized controlled trial (RCT) designed to determine whether six months of moderate-intensity aerobic exercise improves neurocognitive function in women with breast cancer (BC) receiving endocrine therapy (ET). Methods: Postmenopausal women with hormone receptor+, early-stage BC, within two years post-primary therapy were randomized to the exercise intervention (six months, ≥150 minutes of moderate-intensity aerobic exercise/week) or usual care control condition. Outcomes were assessed at pre-randomization and after intervention completion. Groups were compared using linear mixed-effects modeling. Results: Participants (N=153) were X ¯ = 62.09 ± 8.27 years old, with stage I BC (64.1%) and a median of 4.7 months post-diagnosis. We found a group-by-time interaction (p=0.041) and a trend for the main effect of time (p=0.11) for processing speed with improved performance in the exercise group and no change in the controls. Similar main effects of time were observed for learning and memory (p=0.024) and working memory (p=0.01). Better intervention adherence was associated with improved processing speed (p=0.017). Conclusions: Six months of moderate-intensity aerobic exercise improves processing speed in postmenopausal women with BC receiving ET who initiate exercise within two years of completing primary therapy (surgery +/- chemotherapy). This is the first large-scale study to examine the effects of aerobic exercise on neurocognitive function in women with BC. Additional research is needed to address the long-term effects of aerobic exercise on cognitive function.

Effects of Gluteal Muscle Strengthening Exercise-Based Core Stabilization Training on Pain and Quality of Life in Patients with Chronic Low Back Pain.

Background: The World Health Organization reports that back pain is a major cause of disorder worldwide. It is the most common musculoskeletal disorder with limited pain, muscle tension, and stiffness, and 70-80% of all individuals experience it once in their lifetime, with higher prevalence in women than in men. This study aimed to investigate the effects of gluteal muscle strengthening exercise- based core stabilization training (GSE-based CST) on pain, function, fear-avoidance patterns, and quality of life in patients with chronic back pain. Methods: This study included 34 patients with non-specific chronic low back pain. Seventeen individuals each were included in GSE-based CST and control groups. The GSE-based CST group performed GSE and CST for 15 min, three times a week for four weeks, and the control group performed CST for 30 min a day, three times a week for four weeks. The numeric pain rating scale was used to evaluate pain before and after treatment, Roland-Morris disability questionnaire was used to evaluate function, fear-avoidance beliefs questionnaire was used to evaluate fear-avoidance patterns, and quality of life was measured using the short form-36. Results: In this study, pain, function, and fear-avoidance pattern decreased significantly in both groups (All p < 0.05). During the evaluation of quality of life, both groups showed significant increase in physical and mental factors (p < 0.05). There were significant differences in pain and quality of life (p < 0.05) between the GSE-based CST and control groups. Conclusions: Therefore, GSE-based CST can be used as a basis for effective intervention to enhance pain, function, fear-avoidance patterns, and quality of life, emphasizing the need for gluteal muscle strengthening exercises in patients with non-specific chronic back pain in the future.

The Effects of Cervical Mobilization with Clinical Pilates Exercises on Pain, Muscle Stiffness and Head and Neck Blood Flow in Cervicogenic Headache: Randomized Controlled Trial.

Background and Objectives: Physiotherapy approaches are used to eliminate the problems caused by cervicogenic headache (CHA), known as secondary headache associated with the structures of the upper cervical region. This study aimed to investigate the effects of cervical mobilization (CM) with clinical Pilates exercises (CPE) on pain, muscle stiffness and head-neck blood flow in CGH. Materials and Methods: A total of 25 patients participated in this randomized controlled study and were randomized into either the CM group or the CM+CPE group. All treatment methods were applied 3 days a week for 6 weeks. The outcome measure was headache intensity and frequency, the number of analgesics, muscle stiffness and vertebral artery (VA) and internal carotid artery (ICA) blood flow. Headache intensity was measured by a visual analogue scale, muscle stiffness by a myotonometer and blood flow by Doppler US. Evaluations were repeated after 6 weeks of treatment. Within-group comparisons were made by the Wilcoxon signed rank test, and between-group comparisons were made by the Mann-Whitney U test. Results: After treatments in the two groups, headache intensity and frequency and the number of analgesics decreased, the muscle stiffness of the suboccipital, upper trapezius and sternocleidomastoid (SCM) muscles decreased, and the blood flow of the ICA and VA increased (p < 0.05). There was a significant difference between the groups in terms of headache intensity (p = 0.025) and muscle stiffness in SKM (p = 0.044) in favor of the CM+CPE group. Conclusions: Non-pharmacological treatment approaches have an important role in CHA related to the upper cervical region. This study suggests that it would be beneficial to add CM in combination with CPE to the non-pharmacological treatment of patients with CHA.