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1.
BMC Public Health ; 20(1): 1520, 2020 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-33032564

RESUMO

BACKGROUND: New approaches on paediatric cancer treatment aim to maintain long-term health. As a result of radiotherapy, chemotherapy or surgery, paediatric cancer survivors tend to suffer from any chronic health condition. Endocrine dysfunction represents one of the most common issues and affects bone health. Exercise is key for bone mass accrual during growth, specifically plyometric jump training. The iBoneFIT study will investigate the effect of a 9-month online exercise programme on bone health in paediatric cancer survivors. This study will also examine the effect of the intervention on body composition, physical fitness, physical activity, calcium intake, vitamin D, blood samples quality of life and mental health. METHODS: A minimum of 116 participants aged 6 to 18 years will be randomized into an intervention (n = 58) or control group (n = 58). The intervention group will receive an online exercise programme and diet counselling on calcium and vitamin D. In addition, five behaviour change techniques and a gamification design will be implemented in order to increase the interest of this non-game programme. The control group will only receive diet counselling. Participants will be assessed on 3 occasions: 1) at baseline; 2) after the 9 months of the intervention; 3) 4 months following the intervention. The primary outcome will be determined by dual energy X-ray absorptiometry (DXA) and the hip structural analysis, trabecular bone score and 3D-DXA softwares. Secondary outcomes will include anthropometry, body composition, physical fitness, physical activity, calcium and vitamin D intake, blood samples, quality of life and mental health. DISCUSSION: Whether a simple, feasible and short in duration exercise programme can improve bone health has not been examined in paediatric cancer survivors. This article describes the design, rationale and methods of a study intended to test the effect of a rigorous online exercise programme on bone health in paediatric cancer survivors. If successful, the iBoneFIT study will contribute to decrease chronic health conditions in this population and will have a positive impact in the society. TRIAL REGISTRATION: Prospectively registered in isrctn.com: isrctn61195625 . Registered 2 April 2020.


Assuntos
Densidade Óssea , Sobreviventes de Câncer/estatística & dados numéricos , Terapia por Exercício/métodos , Telemedicina , Adolescente , Criança , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa
3.
Medicine (Baltimore) ; 99(38): e22136, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957335

RESUMO

The aim of this study was to investigate the effect of the jaw opening exercise (JOE) on the thickness of the suprahyoid muscle and hyoid bone movement compared with the head lift exercise (HLE) in patients with dysphagia after strokeThis study recruited 30 patients with dysphagia after stroke. The JOE group performed a JOE using a resistance bar. The HLE group performed the traditional HLE. The total intervention duration was 6 weeks. We measured the thickness of the digastric and mylohyoid muscles using ultrasound. Two-dimensional motion analysis of the hyoid bone was performed using Image J software. The Borg rating of the perceived exertion scale was used to assess the intensity level of physical activity during the 2 exercises.Both groups showed a significant increase in the thickness of the digastric and mylohyoid muscles (P < .05). Hyoid bone motion was significantly increased in the anterior and superior movement in both groups (P < .05). After the intervention, there was no significant difference between the 2 groups. The Borg rating of perceived exertion scale for the JOE group was significantly lower than that of the HLE group (P < .05).In conclusion, this study demonstrated that the JOE and the HLE had similar effects with respect to increasing suprahyoid muscle thickness and improving hyoid bone movement. However, the JOE required less perceived exertion than the HLE.


Assuntos
Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Terapia por Exercício/métodos , Acidente Vascular Cerebral/complicações , Transtornos de Deglutição/fisiopatologia , Feminino , Humanos , Osso Hioide/fisiologia , Masculino , Pessoa de Meia-Idade , Músculos do Pescoço/fisiologia , Projetos Piloto , República da Coreia
4.
Int J Chron Obstruct Pulmon Dis ; 15: 2127-2133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32982205

RESUMO

Pulmonary rehabilitation (PR) is an important, evidence-based treatment that improves outcomes for people with COPD. Individualized exercise programmes aim to improve exercise capacity; self-management education and psychological support are also provided. Translating increased exercise capacity into sustained behavioural change of increased physical activity is difficult. Other unresolved problems with PR programmes include improving uptake, completion, response and sustaining long-term benefit. We offer a different perspective drawn from clinical experience of PR, quantitative and qualitative studies of singing groups for people with COPD, and stroke rehabilitation research that gives psychological factors a more central role in determining outcomes after PR. We discuss Take Charge; a simple but effective psychological intervention promoting self-management--that could be used as part of a PR programme or in situations where PR was declined or unavailable. This may be particularly relevant now when traditional face-to-face group programmes have been disrupted by COVID-19 precautions.


Assuntos
Controle de Doenças Transmissíveis , Infecções por Coronavirus , Terapia por Exercício , Comportamentos Relacionados com a Saúde , Pandemias , Pneumonia Viral , Doença Pulmonar Obstrutiva Crônica , Pesquisa de Reabilitação , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Terapia por Exercício/métodos , Terapia por Exercício/organização & administração , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Sistemas de Apoio Psicossocial , Doença Pulmonar Obstrutiva Crônica/psicologia , Doença Pulmonar Obstrutiva Crônica/reabilitação , Projetos de Pesquisa , Autogestão/métodos , Autogestão/psicologia , Resultado do Tratamento
5.
Work ; 66(4): 751-753, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925136

RESUMO

The COVID-19 pandemic has led to the shutdown of much of the world's economic and social operations. Given shutdown of exercise facilities, there has been a sharp uptick in a sedentary lifestyle. As people have lost their normal daily activity patterns, it is reasonable to assume that musculoskeletal pain-related syndromes will consequently begin to increase. In addition, there has been a rise in social network, television, and online home-based workouts. In the wake of the COVID-19 pandemic, it is unclear whether previous recommendations for physical activities will remain sufficient, given cessation of normal physical activities from day-to-day life. We raise a variety of questions in dealing with the potential fallout of the COVID-19 shutdown from a musculoskeletal standpoint.


Assuntos
Infecções por Coronavirus/prevenção & controle , Terapia por Exercício/métodos , Comportamentos Relacionados com a Saúde/fisiologia , Dor Musculoesquelética/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Comportamento Sedentário , Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Terapia por Exercício/efeitos adversos , Humanos , Incidência , Dor Musculoesquelética/fisiopatologia , Dor Musculoesquelética/reabilitação , Fenômenos Fisiológicos Musculoesqueléticos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Quarentena/normas , Inquéritos e Questionários , Fatores de Tempo
6.
Medicine (Baltimore) ; 99(38): e22345, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957405

RESUMO

BACKGROUND: At the end of 2019, peoples normal lives were disrupted by a sudden plague (COVID-19), the huge impact of COVID-19 on society has never been appeared. How to effectively prevent and treat COVID-19 is a concern for all health care workers. Exercise as a green and cheap complementary therapy, which has been proven to improve the immune capacity of the body and prevent infection. The main purpose of this study is to provide a reliable methodological guidance and credible evidence for exercise on COVID-19 therapeutic. METHODS: This protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. We will search the following database sources for the Randomized controlled trials: the Cochrane Library, PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database (CNKI), Chinese Science and the Wanfang Database. All randomized controlled trials of exercise therapy for COVID-19 in the above database will be considered for inclusion, and high-quality articles will be screened for data extraction and analysis, to summarize the therapeutic effect of exercise on COVID-19 patients. RESULTS: In this study, we hope to find strong evidence for the treatment of COVID-19 by exercise. CONCLUSION: The conclusion of our study will provide credible evidence to judge whether exercise is an effective intervention on the COVID-19 patients therapeutic, and guide future researches.PROSPERO registration number: CRD42020200883.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Terapia por Exercício/métodos , Pneumonia Viral/terapia , Infecções por Coronavirus/virologia , Humanos , Metanálise como Assunto , Pandemias , Pneumonia Viral/virologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
7.
Medicine (Baltimore) ; 99(38): e22385, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32957420

RESUMO

INTRODUCTION: Reduced bone mineral density and increased risk of falls are related with Alzheimer disease, and these increase likelihood of bone osteoporotic fractures causing serious complications such as disability, fear of falling, loss autonomy, decreased quality of life, and anticipated mortality in elderly patients. Gait and balance disturb are 2 factors to favor falls in elderly, and in patients with cognitive impairment, the risk of falls increases to double. Exercise and Mediterranean diet produce beneficial effects for aging, cognitive decline, and are widely recommended to reduce the effects of osteoporosis, fall risk, and related fragility fractures. The primary objective of this study is to evaluate the short and medium-term effects during 6 months, of a multicomponent physical exercise program with a Mediterranean diet on bone mineral density, fall risk, balance, and gait by a controlled clinical trial in patients with Alzheimer disease. METHODS: The study is a 6-month, randomized controlled parallel-group, single-blinded clinical trial. Institutionalized patients with Alzheimer disease will be included. The intervention group will perform a multicomponent physical exercise program in reduced groups, with a frequency of 3 sessions per week, associated with a Mediterranean diet. This program includes strength, balance, and aerobic resistance exercises, and in the main part of the session, also ludic exercises to improve agility, coordination, and balance. The control group will receive usual care. The outcomes to assess are the change of physical functions, such as gait and balance, and the change of bone mineral density by calcaneal quantitative ultrasound, during the study follow-up at 1, 3, and 6 months. This clinical trial will generate more and new evidence on the effects of a multicomponent physical exercise program and Mediterranean diet in patients with Alzheimer disease on risk of falls and osteoporotic fractures, the relation of these with bone mineral density, gait and balance, and the correlations between them. ETHICS AND DISSEMINATION: This study protocol has been approved by the Ethics Committee of the University of Salamanca. The results will be published in peer-reviewed journals and disseminated in national and international conferences, to the participants and their families, and the general public through the associations of people with AD. TRIAL REGISTRATION ID: ClínicalTrials.gov ID: NCT04439097.


Assuntos
Doença de Alzheimer/terapia , Densidade Óssea , Dieta Mediterrânea , Terapia por Exercício/métodos , Acidentes por Quedas/prevenção & controle , Feminino , Marcha , Humanos , Masculino , Equilíbrio Postural , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Medicine (Baltimore) ; 99(36): e22021, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899055

RESUMO

BACKGROUND: Mild cognitive impairment (MCI) in the elderly is a health problem worldwide. Several clinical trials indicated that traditional Chinese medicine (TCM) exercise therapies can effectively improve MCI, such as Tai Ji, Baduan jin exercise, Liuzi jue, and finger exercise. However, there is still controversy over which therapy is the best for elderly MCI patients. In this study, we aimed to systematically evaluate and compare the effectiveness and safety of these 4 TCM exercise therapies in elderly patients with MCI. METHODS: The Web of Science, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Clinical Trials, China National Knowledge Infrastructure, Wangfang database, and Chinese Biomedical Medicine will be comprehensively searched to collect all randomized controlled trials which included elderly participants with MCI receiving TCM exercise therapies through July 2020. Two reviewers will independently screen and evaluate each included study and extract the outcome indexes. ADDIS 1.16.8 software will be used for the network meta-analysis and STATA 14 software will be used for drawing network evidence plots and funnel plots. RESULTS: We will use the Bayesian statistical model to conduct a network meta-analysis to rank the effectiveness and safety of these 4 interventions, and use the GRADE approach to interpret the results. CONCLUSION: This network meta-analysis will find out the optimal treatment plan for MCI and provide evidence-based bias for clinical treatments decision-making. PROTOCOL REGISTRATION NUMBER: INPLASY202070006.


Assuntos
Disfunção Cognitiva/terapia , Terapia por Exercício/métodos , Medicina Tradicional Chinesa/métodos , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisão Clínica , Terapia Combinada , Feminino , Humanos , Masculino , Testes de Estado Mental e Demência/normas , Pessoa de Meia-Idade , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Tai Ji/métodos , Resultado do Tratamento
9.
Medicine (Baltimore) ; 99(37): e22229, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925800

RESUMO

BACKGROUND: Since the outbreak of COVID-19, the number of COVID-19 patients has been on the rise. With the improvement of diagnosis and treatment level in various countries, more and more patients have recovered. Baduanjin exercise is a traditional Chinese health care method with a long history, easy-to-learn, and remarkable effect. It is not subject to the constraints of the field and can be practiced at any time. It can be used as an alternative therapy for COVID-19 rehabilitation patients. At present, there are no relevant articles for systematic review. METHODS: We will retrieve a randomized controlled trial of Baduanjin exercise for COVID-19 from the beginning to July 2020. The following databases are areas of concern: Published randomized Cochrane Central Register of Controlled Trials (Central), PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wan-fang Database-controlled trials in Chinese and English related to Baduanjin exercise and COVID-19 were included. The main result was the effect of Baduanjin exercise on the quality of life in patients recovering from COVID-19. Secondary results to accompany symptoms (such as muscle pain, cough, sputum, runny nose, sore throat, chest tightness, shortness of breath, difficulty breathing, fatigue, headache, nausea, vomiting, anorexia, diarrhea), disappearance rate, 2 consecutive (not on the same day) COVID-19 negative rate of nucleic acid test results, the quality of life improved, improve CT images, the average hospitalization time, severe form of common clinical cure rate and mortality. RESULTS: The results of this study will provide researchers in the field of COVID-19 with a current synthesis of high-quality evidence. CONCLUSION: The conclusion of this study will provide evidence for judging whether Baduanjin exercise is an effective intervention for the quality of life of rehabilitative patients. PROSPERO REGISTRATION NUMBER: CRD42020199443.


Assuntos
Infecções por Coronavirus , Terapia por Exercício/métodos , Pandemias , Pneumonia Viral , Qualidade de Vida , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/reabilitação , Humanos , Medicina Tradicional Chinesa/métodos , Metanálise como Assunto , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/reabilitação , Recuperação de Função Fisiológica , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
10.
Medicine (Baltimore) ; 99(31): e21373, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756125

RESUMO

BACKGROUND: Corona Virus Disease 2019 (COVID-19) is spreading fast starting late 2019. It mainly affects the human respiratory system. Many reports revealed that rehabilitation exercise can improve respiratory function and relieve the pressure from diseases, but there is no evidence to prove its effects on COVID-19. This protocol of systematic review and meta-analysis will clarify the safety and effectiveness of rehabilitation exercises on different COVID-19 patients. METHODS AND ANALYSIS: Related studies will be retrieved from Web of Science, Cochrane Library, PubMed, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, Wan fang Database, ClinicalTrials, WHO Trials, and Chinese Clinical Trial Registry. Pre-defined inclusion and exclusion criteria will be used by two researchers independently for extracting data from literatures. Clinical recovery time and effective rates will be assessed as the primary outcomes. Changes of patient's condition, pulmonary function, respiratory function and activity of daily living will be assessed as the secondary outcomes. Fixed effect model will be used for evaluating efficiency. Considering clinical heterogeneity, random effect model will be used for continuous outcomes. Funnel charts, subgroup analysis and sensitivity analysis will be used to explore sources of heterogeneity. Endnote X9.3 will be used to manage data screening. The statistical analysis will be completed by RevMan5.2 and Stata/SE 15.1 software. RESULT: This study will assess effects and safety for practicing rehabilitation exercises on COVID-19 patients. CONCLUSION: The conclusion of this study will provide evidence to prove the safety and effectiveness of rehabilitation exercises on COVID-19 patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/reabilitação , Terapia por Exercício/métodos , Pneumonia Viral/reabilitação , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Metanálise como Assunto , Pandemias , Pneumonia Viral/virologia , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
11.
Medicine (Baltimore) ; 99(31): e21542, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756208

RESUMO

BACKGROUND: Chronic nonspecific low back pain (CNLBP) has become a major global public health problem. Its high incidence rate and high disability rate are so damaging both to individuals and communities. At present, many countries' clinical guidelines recommend exercise therapy. Breath therapy is one of the exercise therapies, playing an important role in exercise therapy. Some studies have shown that breath therapy has a considerable therapeutic effect on low back pain, but there is no specific conclusion. The aim of our study is to answer the question: if breath therapy is effective and safe for CNLBP? METHODS: The following databases will be searched: English databases (including Web of Science, the Cochrane Library (Central), EMBASE, MEDLINE, Allied and Alternative Medicine) and Chinese databases (including Chinese National Knowledge Infrastructure, Wanfang data and Chinese Scientific Journals Database [VIP]). The literature search will be constructed around search terms for breath therapy, search terms for chronic nonspecific low back pain and search terms for randomized controlled trials. The primary outcomes were related to duration, intensity, attack frequency of pain, and the secondary outcomes were related to physical function, quality of life, and adverse events related to interventions. Endnote software 9.1 will be applied in selecting study, Review Manager software 5.3 will be applied in analyzing and synthesizing. RESULTS: The results will provide evidence to judge whether breath therapy is effective and safe for CNLBP. CONCLUSION: Our research will provide reliable evidence of breath therapy for CNLBP. REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO) CRD42020156340.


Assuntos
Terapia por Exercício/métodos , Dor Lombar/terapia , Doença Crônica , Terapia por Exercício/efeitos adversos , Humanos , Desempenho Físico Funcional , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa
12.
Medicine (Baltimore) ; 99(32): e21577, 2020 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-32769904

RESUMO

OBJECTIVES: To analyze the influence of Baduanjin exercise on blood pressure in patients with essential hypertension. METHODS: Randomized controlled trials were identified in Chinese and English databases to study the impact of Baduanjin exercise on essential hypertension. Qualified trials were selected and methodologic quality was critically evaluated. Two reviewers selected studies independently of each other. RESULTS: Twelve trials were included. There was a significant difference between the Baduanjin exercise intervention and control groups with regard to the change in systolic blood pressure (SBP) [SMD = - 1.80, 95% CI (- 2.86, - 0.73), P = .0009] and diastolic blood pressure (DBP) [SMD = -0.22, 95% CI (-2.00, -0.57), P = .0004]. Taking into account the subgroup analyses, the combined results showed that Baduanjin plus Antihypertensive drugs significantly reduced both SBP and DBP over a period > 12 weeks in all studies. CONCLUSIONS: Compared with control interventions, Baduanjin exercise seems to be an effective physical exercise in treating essential hypertension. Different training durations can lead to different effects.


Assuntos
Hipertensão Essencial/terapia , Terapia por Exercício/normas , Exercício Físico/fisiologia , Terapia por Exercício/métodos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos
13.
Medicine (Baltimore) ; 99(34): e21889, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846850

RESUMO

Electromyographic biofeedback (EMG-BF) therapy provides information on the state of contraction of the targeted muscles and relaxation of their antagonists, which can facilitate early active range of motion (RoM) after elbow surgery. Our aim in this study was to calculate the minimum detectable change (MDC) during EMG-BF therapy, initiated in the early postoperative period after elbow surgery.This study is an observational case series. EMG-BF of muscle contraction and relaxation was provided during active elbow flexion and extension exercises. Patients completed 3 sets of 10 trials each of flexion and extension over 4 weeks. The total range of flexion-extension motion and scores on the Japanese Society for Surgery of the Hand version of the disability of the arm, shoulder, and hand questionnaire and the Japanese version of the Patient-Rated Elbow Evaluation were obtained at baseline and weekly during the 4-week intervention period. A prediction formula was developed from the time-series data obtained during the intervention period, using the least-squares method. The estimated value was calculated by removing the slope from the prediction formula and adding the initial scores to residuals between the measured scores and predicted scores individually. Systematic error, MDC at the 95th percentile cutoff (MDC95), repeatability of the measures, and the change from the baseline to each time-point of intervention were assessed.The MDC95 was obtained for all 3 outcome measures and the range of values was as follows: RoM, 8.3° to 22.5°; Japanese version of the Patient-Rated Elbow Evaluation score, 17.6 to 30.6 points; and disability of the arm, shoulder, and hand questionnaire subscale: disability and symptoms score, 14.2 to 22.9 points.The efficacy of EMG-BF after elbow surgery was reflected in earlier initiation of elbow RoM after surgery and improvement in patient-reported upper limb function scores. The calculated MDC95 cut-offs could be used as reference values to assess the therapeutic effects of EMG-BF in individuals.


Assuntos
Biorretroalimentação Psicológica/métodos , Cotovelo/cirurgia , Amplitude de Movimento Articular/fisiologia , Reabilitação/métodos , Adulto , Idoso , Avaliação da Deficiência , Cotovelo/patologia , Eletromiografia , Terapia por Exercício/métodos , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Relaxamento Muscular/fisiologia , Medidas de Resultados Relatados pelo Paciente , Período Pós-Operatório , Reabilitação/tendências , Reprodutibilidade dos Testes , Inquéritos e Questionários , Resultado do Tratamento
14.
PLoS One ; 15(8): e0237133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760097

RESUMO

BACKGROUND: Accessory nerve shoulder dysfunction is common after neck dissection in oral cancer survivors. This study aimed to investigate the short-term effects of scapular muscle strengthening exercises with motor-control techniques on neck dissection-related shoulder dysfunction in oral cancer survivors before the initiation of radiotherapy. METHODS: Thirty-eight participants were randomly allocated into the motor-control and regular-exercise groups. Each group received conventional physical therapy and specific scapular muscle strengthening exercises for 1 month immediately after neck dissection. Motor control techniques were integrated with scapular strengthening exercises for the motor-control group. Shoulder pain, active range of motion (AROM) of shoulder abduction, and scapular muscle activities including upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) when performing maximal voluntary isometric contraction (MVIC) and scapular muscle exercises were evaluated at baseline and after 1 month of training. RESULTS: Both groups reduced shoulder pain and increased muscle activity of maximum voluntary isometric contraction (MVIC) of each muscle after the intervention. Increased AROM of shoulder abduction was only observed in the motor-control group (95% CI 3.80 to 20.51, p = 0.004). Relative to baseline evaluation, muscle activities of UT decreased in the motor-control group when performing shoulder shrug with 1-kg weight (95% CI -33.06 to -1.29, p = 0.034). Moreover, the SA activity decreased in the motor-control group (95% CI -29.73 to -27.68, p<0.001) but increased in the regular-exercise group (95% CI 28.16 to 30.05, p<0.001) when performing shoulder horizontal adduction and flexion. CONCLUSION: Early strengthening exercise with motor control techniques has greater benefits for improving AROM of shoulder abduction, muscle economy, and reducing compensatory scapular muscle activities in patients with neck dissection-related shoulder dysfunction before the initiation of radiotherapy.


Assuntos
Terapia por Exercício/métodos , Neoplasias Bucais/cirurgia , Força Muscular , Esvaziamento Cervical/efeitos adversos , Complicações Pós-Operatórias/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/radioterapia , Contração Muscular , Amplitude de Movimento Articular , Ombro/fisiopatologia , Músculos Superficiais do Dorso/fisiopatologia
15.
Health Psychol ; 39(9): 826-840, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32833484

RESUMO

This study utilizes the Science of Behavior Change (SOBC) experimental medicine approach to evaluate the effects of a 3-month, individually prescribed progressive exercise training program on neurobiological, cognitive and motivational mechanisms by which our exercise-training paradigm may foster exercise maintenance. We will investigate hypothesized relationships between exercise-training associated augmentation of neuropeptide Y (NPY) system function and improvements in self-regulation and reward sensitivity-cognitive control and motivational processes posited to promote self-efficacy and intrinsic motivation, which have been shown to predict exercise maintenance. This study will recruit Veterans with chronic low back pain and posttraumatic stress disorder (PTSD). Procedures include a baseline, acute cardiopulmonary exercise challenge assessment that will inform the exercise prescription for a 12-week progressive exercise training program comprised of three 45-minute aerobic exercise sessions per week-all of which will be supervised by an exercise physiologist. Additionally, a week-7 and week-14 exercise challenge assessment will track changes in NPY system function and the variables of interest. We hypothesize that increases in the capacity to release NPY in response to acute exercise testing will be associated with improvements in self-regulation and reward sensitivity, which will in turn be associated with self-efficacy and intrinsic motivation to maintain regular exercise. Ninety participants will be randomized either to the "active exercise training condition" or to the "wait list symptom monitoring condition". The study aims to demonstrate the feasibility of procedures and elucidate mechanisms relevant to developing individually prescribed, motivationally based exercise regimens to reduce negative consequences of PTSD and low back pain over the long-term. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Terapia por Exercício/métodos , Dor/reabilitação , Transtornos de Estresse Pós-Traumáticos/terapia , Feminino , Humanos , Masculino , Estudos Prospectivos
16.
PLoS One ; 15(8): e0237027, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32745112

RESUMO

The purpose of this study was to quantify training loads (TL) of high intensity sessions through original methods (TRIMP; session-RPE; Work-Endurance-Recovery) and their updated alternatives (TRIMPcumulative; RPEalone; New-WER). Ten endurance athletes were requested to perform five sessions until exhaustion. Session 1 composed by a 800m maximal performance and four intermittent sessions performed at the 800m velocity, three sessions with 400m of interval length and work:recovery ratios of 2:1, 1:1 and 1:2 and one with 200m intervals and 1:1. Total TL were quantified from the sessions' beginning to the cool-down period and an intermediate TL (TL800) was calculated when 800m running was accumulated within the sessions. At the end of the sessions high and similar RPE were reported (effect size, η2 = 0.12), while, at the intermediate 800m distance, the higher interval distances and work:recovery ratios the higher the RPE (η2 = 0.88). Our results show marked differences in sessions' total TL between original (e.g., lowest TL for the 800m and highest for the 200m-1:1 sessions) and alternative methods (RPEalone and New-WER; similar TL for each session). Differences appear in TL800 notably between TRIMP and other methods which are negatively correlated. All TL report light to moderate correlations between original methods and their alternatives, original methods are strongly correlated together, as observed for alternative methods. Differences in TL quantification between original and alternative methods underline that they are not interchangeable. Because of high exercise volume influence, original methods markedly enhance TL of sessions with higher exercise volumes although these presented the easiest interval distances and work-recovery ratios. Alternative methods based on exhaustion level (New-WER) and exertion (RPEalone) provided a new and promising point of view of TL quantification where exhaustion determines the highest TL whatever the exercise. This remains to be tested with more extended populations submitted to wider ranges of exercises.


Assuntos
Terapia por Exercício/métodos , Exercício Físico/fisiologia , Condicionamento Físico Humano/métodos , Adolescente , Atletas , Frequência Cardíaca , Humanos , Masculino , Consumo de Oxigênio , Esforço Físico , Corrida , Adulto Jovem
17.
Cochrane Database Syst Rev ; 8: CD009638, 2020 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-32829481

RESUMO

BACKGROUND: According to international guidelines and literature, all patients with intermittent claudication should receive an initial treatment of cardiovascular risk modification, lifestyle coaching, and supervised exercise therapy. In the literature, supervised exercise therapy often consists of treadmill or track walking. However, alternative modes of exercise therapy have been described and yielded similar results to walking. This raises the following question: which exercise mode produces the most favourable results? This is the first update of the original review published in 2014. OBJECTIVES: To assess the effects of alternative modes of supervised exercise therapy compared to traditional walking exercise in patients with intermittent claudication. SEARCH METHODS: The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase and CINAHL databases and World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials registers to 4 March 2019. We also undertook reference checking, citation searching and contact with study authors to identify additional studies. No language restriction was applied. SELECTION CRITERIA: We included parallel-group randomised controlled trials comparing alternative modes of exercise training or combinations of exercise modes with a control group of supervised walking exercise in patients with clinically determined intermittent claudication. The supervised walking programme needed to be supervised at least twice a week for a consecutive six weeks of training. DATA COLLECTION AND ANALYSIS: Two review authors independently selected studies, extracted data, and assessed the risk of bias for each study. As we included studies with different treadmill test protocols and different measuring units (metres, minutes, or seconds), the standardised mean difference (SMD) approach was used for summary statistics of mean walking distance (MWD) and pain-free walking distance (PFWD). Summary estimates were obtained for all outcome measures using a random-effects model. We used the GRADE approach to assess the certainty of the evidence. MAIN RESULTS: For this update, five additional studies were included, making a total of 10 studies that randomised a total of 527 participants with intermittent claudication (IC). The alternative modes of exercise therapy included cycling, lower-extremity resistance training, upper-arm ergometry, Nordic walking, and combinations of exercise modes. Besides randomised controlled trials, two quasi-randomised trials were included. Overall risk of bias in included studies varied from high to low. According to GRADE criteria, the certainty of the evidence was downgraded to low, due to the relatively small sample sizes, clinical inconsistency, and inclusion of three studies with risk of bias concerns. Overall, comparing alternative exercise modes versus walking showed no clear differences for MWD at 12 weeks (standardised mean difference (SMD) -0.01, 95% confidence interval (CI) -0.29 to 0.27; P = 0.95; 6 studies; 274 participants; low-certainty evidence); or at the end of training (SMD -0.11, 95% CI -0.33 to 0.11; P = 0.32; 9 studies; 412 participants; low-certainty evidence). Similarly, no clear differences were detected in PFWD at 12 weeks (SMD -0.01, 95% CI -0.26 to 0.25; P = 0.97; 5 studies; 249 participants; low-certainty evidence); or at the end of training (SMD -0.06, 95% CI -0.30 to 0.17; P = 0.59; 8 studies, 382 participants; low-certainty evidence). Four studies reported on health-related quality of life (HR-QoL) and three studies reported on functional impairment. As the studies used different measurements, meta-analysis was only possible for the walking impairment questionnaire (WIQ) distance score, which demonstrated little or no difference between groups (MD -5.52, 95% CI -17.41 to 6.36; P = 0.36; 2 studies; 96 participants; low-certainty evidence). AUTHORS' CONCLUSIONS: This review found no clear difference between alternative exercise modes and supervised walking exercise in improving the maximum and pain-free walking distance in patients with intermittent claudication. The certainty of this evidence was judged to be low, due to clinical inconsistency, small sample size and risk of bias concerns. The findings of this review indicate that alternative exercise modes may be useful when supervised walking exercise is not an option. More RCTs with adequate methodological quality and sufficient power are needed to provide solid evidence for comparisons between each alternative exercise mode and the current standard of supervised treadmill walking. Future RCTs should investigate outcome measures on walking behaviour, physical activity, cardiovascular risk, and HR-QoL, using standardised testing methods and reporting of outcomes to allow meaningful comparison across studies.


Assuntos
Teste de Esforço , Terapia por Exercício/métodos , Claudicação Intermitente/terapia , Caminhada , Adulto , Viés , Ciclismo , Doenças Cardiovasculares/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Treinamento de Resistência , Esqui , Teste de Caminhada
18.
PLoS One ; 15(8): e0237197, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790796

RESUMO

BACKGROUND: Recent concerns have cast doubt over the effectiveness of cardiac rehabilitation [CR] programmes for improving cardiorespiratory fitness [CRF] in patients with a history of cardiac disease in the United Kingdom [UK]. We aimed to characterise the weekly progression of exercise training dose over an 8-week Phase III CR programme as we felt this may be partly responsible for the lack of improvement in CRF reported in previous studies. DESIGN: Observational study. METHODS: We evaluated a community-based Phase III CR programme in the UK. During each training session, patients wore an Apple Watch and the weekly progression of exercise training dose/load was quantified. The analysis was based on 332 individual training sessions. Exercise intensity [% heart rate reserve] during the cardiovascular [CV] exercise training component [%HRR-CV], CV training duration; estimated changes in cardiorespiratory fitness [change in estimated metabolic equivalents (METs)]; session rating of perceived exertion [sRPE], sRPE training load [sRPE-TL], and exercise training impulse [TRIMP] were evaluated. RESULTS: Thirty cardiac patients [83% male; age [SD] 67.0 [10.0] years; body mass index [SD] 28.3 [4.6] kg∙m-2] were recruited to an 8-week programme [16 sessions in total]. Bayesian repeated-measures ANOVA indicated anecdotal evidence for the alternative hypothesis for changes in %HRR-CV (BF10 = 0.61), sRPE (BF10 = 1.1), and change in estimated METs (BF10 = 1.2) during CR. Conversely, Bayesian repeated-measures ANOVA showed extreme evidence for changes in CV training duration (BF10 = 2.438e+26), TRIMP (BF10 = 71436), and sRPE-TL (BF10 = 779570). CONCLUSION: The key exercise training principle of progressive overload was only partially applied. Increases observed in exercise dose were due to increases in the duration of CV training, rather than combined with increases in exercise intensity [%HRR-CV and sRPE]. Accordingly, allied health professionals must ensure that exercise intensity is more consistently progressed to optimise the exercise stimulus and improvements in CRF and patient outcomes.


Assuntos
Reabilitação Cardíaca/métodos , Aptidão Cardiorrespiratória , Terapia por Exercício/métodos , Idoso , Redes Comunitárias , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reino Unido
19.
Am J Phys Med Rehabil ; 99(10): 873-875, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32732744

RESUMO

A 65-yr-old man visited a primary care hospital with a continued fever of 38°C for 3 days. As his fever did not improve until 8 days after, he was admitted into another acute care hospital, where his respiratory condition rapidly worsened. Therefore, the patient was transferred to our hospital. On the day of transfer (day 1), he was started on mechanical ventilation. COVID-19 was diagnosed using a polymerase chain reaction assay 6 days after admission (day 6). The rehabilitation therapy was begun on day 6. The initial rehabilitation programs focused on positioning and postural drainage. The patient was extubated on day 19, and he began standing and stepping on the same day. Gait exercises began on day 22, and endurance training was initiated on day 28. The patient was discharged from our hospital on day 34 as he met the physical function milestones. One month after discharge, the Medical Research Council sum score and Barthel Index had each improved; therefore, muscle strength and daily activities had returned to normal. It was assumed that mobilization should be performed as soon as possible after the end of sedation during the acute phase of severe COVID-19 infection in patients receiving mechanical ventilation.


Assuntos
Infecções por Coronavirus/reabilitação , Drenagem Postural/métodos , Terapia por Exercício/métodos , Pneumonia Viral/reabilitação , Terapia Respiratória/métodos , Idoso , Betacoronavirus , Infecções por Coronavirus/virologia , Humanos , Japão , Masculino , Pandemias , Pneumonia Viral/virologia , Respiração Artificial , Resultado do Tratamento
20.
Sports Health ; 12(5): 470-477, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32776866

RESUMO

CONTEXT: High blood pressure is one of the leading preventable causes of cardiovascular death worldwide. In this regard, several studies have shown interest in the benefits of isometric exercise on blood pressure regulation. OBJECTIVE: To assess whether low-intensity isometric handgrip exercise (LI-IHE) is an effective strategy to lower blood pressure levels in prehypertensive and hypertensive patients. DATA SOURCE: This study was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and registered with PROSPERO. Potentially eligible studies were identified after a systematic search conducted on 4 international databases: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), PEDro, and SPORTDiscus. STUDY SELECTION: We included randomized controlled trials that comprised patients who received LI-IHE. STUDY DESIGN: Systematic review with meta-analysis. LEVEL OF EVIDENCE: Level 3. DATA EXTRACTION: Data related to patient characteristics, exercise programs, risk-of-bias assessment, and outcomes of interest were systematically reviewed independently by 2 authors. RESULTS: The following reductions (mean differences) were observed after LI-IHE: systolic blood pressure (SBP), (MD) = -5.43 mm Hg; (95% CI, -8.47 to -2.39; P = 0.0005); diastolic blood pressure (DBP), -2.41 mm Hg (95% CI, -4.33 to -0.48; P = 0.01); mean arterial pressure (MAP), -1.28 mm Hg (95% CI, -2.99 to 0.44; P = 0.14). CONCLUSION: LI-IHE seems to lower SBP, DBP, and MAP values in prehypertensive and hypertensive adults. It appears that LI-IHE reduces, in greater magnitude, blood pressure levels in hypertensive patients, specifically in patients aged <45 years, those who are overweight, and those on medications. Nevertheless, substantial heterogeneity in the main results and in the analyses by subgroups generated uncertainty about the real reduction magnitude that LI-IHE can produce on blood pressure.


Assuntos
Terapia por Exercício/métodos , Hipertensão/terapia , Pré-Hipertensão/terapia , Fatores Etários , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Exercício Físico/fisiologia , Força da Mão/fisiologia , Humanos , Hipertensão/tratamento farmacológico , Pré-Hipertensão/tratamento farmacológico
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