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1.
Arthritis Care Res (Hoboken) ; 72(2): 149-162, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31908149

RESUMO

OBJECTIVE: To develop an evidence-based guideline for the comprehensive management of osteoarthritis (OA) as a collaboration between the American College of Rheumatology (ACR) and the Arthritis Foundation, updating the 2012 ACR recommendations for the management of hand, hip, and knee OA. METHODS: We identified clinically relevant population, intervention, comparator, outcomes questions and critical outcomes in OA. A Literature Review Team performed a systematic literature review to summarize evidence supporting the benefits and harms of available educational, behavioral, psychosocial, physical, mind-body, and pharmacologic therapies for OA. Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of the evidence. A Voting Panel, including rheumatologists, an internist, physical and occupational therapists, and patients, achieved consensus on the recommendations. RESULTS: Based on the available evidence, either strong or conditional recommendations were made for or against the approaches evaluated. Strong recommendations were made for exercise, weight loss in patients with knee and/or hip OA who are overweight or obese, self-efficacy and self-management programs, tai chi, cane use, hand orthoses for first carpometacarpal (CMC) joint OA, tibiofemoral bracing for tibiofemoral knee OA, topical nonsteroidal antiinflammatory drugs (NSAIDs) for knee OA, oral NSAIDs, and intraarticular glucocorticoid injections for knee OA. Conditional recommendations were made for balance exercises, yoga, cognitive behavioral therapy, kinesiotaping for first CMC OA, orthoses for hand joints other than the first CMC joint, patellofemoral bracing for patellofemoral knee OA, acupuncture, thermal modalities, radiofrequency ablation for knee OA, topical NSAIDs, intraarticular steroid injections and chondroitin sulfate for hand OA, topical capsaicin for knee OA, acetaminophen, duloxetine, and tramadol. CONCLUSION: This guideline provides direction for clinicians and patients making treatment decisions for the management of OA. Clinicians and patients should engage in shared decision-making that accounts for patients' values, preferences, and comorbidities. These recommendations should not be used to limit or deny access to therapies.


Assuntos
Fundações/normas , Articulação da Mão , Osteoartrite do Quadril/terapia , Osteoartrite do Joelho/terapia , Guias de Prática Clínica como Assunto/normas , Reumatologia/normas , Analgésicos/administração & dosagem , Gerenciamento Clínico , Terapia por Exercício/métodos , Terapia por Exercício/normas , Articulação da Mão/patologia , Humanos , Osteoartrite do Quadril/diagnóstico , Osteoartrite do Quadril/epidemiologia , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/epidemiologia , Estados Unidos/epidemiologia
2.
Support Care Cancer ; 28(1): 43-54, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30980259

RESUMO

PURPOSE: Guidelines for cancer survivors recommend both aerobic physical activity (PA) and strength training (ST). Few kidney cancer survivors (KCS) are meeting single-activity or combined guidelines; therefore, examining factors influencing PA participation is warranted. The purpose of this study is to examine demographic, medical, social-cognitive, and environmental correlates of meeting independent (i.e., aerobic-only, strength training (ST)-only) and combined guidelines (i.e., aerobic and ST) in KCS. METHODS: KCS (N = 651) completed self-reported measures of PA and demographic, medical, social-cognitive, and perceived environmental factors. Built environment was assessed using the geographic information systems (GIS). Multinomial logistic regressions were conducted to determine the correlates of meeting the combined versus independent guidelines. RESULTS: Compared with meeting neither guideline, meeting aerobic-only guidelines was associated with higher intentions (p < .01) and planning (p < .01); meeting ST-only guidelines was associated with higher intentions (p = .02) and planning (p < .01), lower perceived behavioral control (PBC) (p = .03), healthy weight (p = .01), and older age (p < .01); and meeting the combined guidelines were associated with higher intentions (p < .01), planning (p = .02), higher instrumental attitudes (p < .01), higher education (p = .04), better health (p < .01), and localized cancer (p = .05). Additionally, compared with neither guideline, meeting aerobic-only (p < .01) and combined (p < .01) guidelines was significantly associated with access to workout attire. Compared with neither guideline, meeting aerobic-only guidelines was associated with proximity to retail (p = .02). CONCLUSION: PA participation correlates may vary based on the modality of interest. Interventions may differ depending on the modality promoted and whether KCS are already meeting single-modality guidelines.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Terapia por Exercício/métodos , Neoplasias Renais/epidemiologia , Neoplasias Renais/reabilitação , Cooperação do Paciente/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Sobreviventes de Câncer/psicologia , Cognição/fisiologia , Estudos Transversais , Demografia , Exercício Físico/fisiologia , Exercício Físico/psicologia , Terapia por Exercício/normas , Feminino , Humanos , Intenção , Neoplasias Renais/psicologia , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto/normas , Treinamento de Resistência , Autorrelato , Comportamento Social , Meio Social , Fatores Socioeconômicos , Inquéritos e Questionários
3.
Artigo em Inglês | MEDLINE | ID: mdl-31561424

RESUMO

The association between physical activity (PA) and mental well-being in individuals with a cardiovascular disease (CVD) is poorly studied. The objective of this study was to assess the association between mental well-being and adherence to the recommended guidelines for PA in a Scottish adult population with CVD. The study used data from 3128 adults who had CVD conditions (1547 men and 1581 women; mean age 63.29 years) who participated in the Scottish Health Survey between 2014 and 2017. The Warwick-Edinburgh Mental Well-Being Scale (WEMWBS) was used as a surrogate measure of mental health. PA was classified as "met" or "unmet" on the basis of the recommended PA guidelines (150 min of moderate activity or 75 min of vigorous activity per week). The relationship between PA guidelines being met and the WEMWBS score was explored using hierarchical linear regression accounting for a set of health and sociodemographic characteristics. Of the participants, ~41.8% met the recommended PA levels. Among those with CVD, the mean (SD) WEMWBS scores of individuals who did not have a long-standing illness (51.14 ± 7.65 vs 47.07 ± 9.54; p < 0.05), diabetes (48.44 ± 9.05 vs 46.04 ± 10.25; p < 0.05), or high blood pressure (48.63 ± 9.08 vs 47.52 ± 9.47; p < 0.05) were significantly higher than those of individuals with such conditions. Meeting PA recommendations was significantly associated with a higher mean WEMWBS score (50.64 ± 7.97 vs 46.06 ± 9.75; p < 0.05). Multiple regression analysis of health-related behaviors improved the prediction of mental well-being over and above meeting the recommended PA levels. Mental well-being was strongly correlated with PA adherence in CVD patients. It seems that for patients with CVD, PA should be tailored to meet patients' health conditions in order to promote mental well-being and improve overall health.


Assuntos
Reabilitação Cardíaca/métodos , Doenças Cardiovasculares/psicologia , Doenças Cardiovasculares/terapia , Terapia por Exercício/psicologia , Terapia por Exercício/normas , Exercício Físico/psicologia , Fidelidade a Diretrizes/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Escócia , Adulto Jovem
4.
Obstet Gynecol Surv ; 74(8): 481-489, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31418450

RESUMO

Importance: Physical activity during pregnancy can offer many maternal and fetal health benefits. Objective: The aim was to summarize American, Canadian, and international recommendations published recently on physical activity during pregnancy to aid health care providers in their delivery of advice on the topic. Evidence Acquisition: A descriptive review of 3 national guidelines and 1 international guideline on physical activity during pregnancy was conducted. The guidelines included the 2019 Canadian recommendations, the 2018 United States' Physical Activity Guidelines for Americans (second edition), the 2015 (reaffirmed in 2017) American College of Obstetrics and Gynecology guideline, and the 2016-2018 International Olympic Committee recommendations for recreational and elite athletes. Results: For apparently healthy women, under the guidance of their health care provider, moderate-intensity physical activity using both aerobic and muscle conditioning activities is recommended. The guidelines recommended at least 150 min/wk spread throughout the week (Canada, United States) or at least 20 to 30 min/d (American College of Obstetrics and Gynecology). Conclusions and Relevance: This summary of 4 recent guidelines can facilitate use of updated recommendations by health care providers regarding physical activity during pregnancy. More detailed evidence-based guidelines on physical activity during postpartum are needed.


Assuntos
Terapia por Exercício/normas , Exercício Físico , Obstetrícia/normas , Guias de Prática Clínica como Assunto , Cuidado Pré-Natal/normas , Canadá , Feminino , Humanos , Gravidez , Estados Unidos
5.
Games Health J ; 8(4): 237-249, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31386586

RESUMO

Introduction: Millions of people suffer from obstructive respiratory conditions globally. Including videogames in rehabilitation programs can be an interesting alternative to traditional programs or a complementary activity. Objective: To explore the use of videogames in the treatment of patients with obstructive respiratory diseases. Methods: A systematic literature search was performed to identify randomized clinical trials evaluating the effects of videogames on health outcomes in patients with respiratory obstructive diseases. The following databases were searched: PubMed, Web of Science, ScienceDirect, and Scopus. The methodological quality of the studies included was assessed with the Downs and Black quality assessment method. Results: Nine articles were included, of which three used videogames as physical training methods and managed to improve exercise capacity, strength, quality of life, and symptoms. The remaining six articles used videogames to educate patients about the disease and showed slight improvements in knowledge of the disease and use of medication. Conclusion: The results of this review show that videogames are a very useful complementary therapy. They can contribute to enhance rehabilitation programs, as they improve exercise capacity, muscle strength, quality of life, severity, control, and knowledge of the disease. Videogames should be supervised by a professional so that programs can be tailored to patients, proposing different activities in the game and controlling the correct performance, and generating an increase in adherence to treatment. Registry: prospective register of systematic reviews (PROSPERO) CRD42018094094.


Assuntos
Doença Pulmonar Obstrutiva Crônica/urina , Jogos de Vídeo/psicologia , Jogos de Vídeo/normas , Terapia por Exercício/métodos , Terapia por Exercício/normas , Humanos , Doença Pulmonar Obstrutiva Crônica/psicologia
6.
Medicina (Kaunas) ; 55(8)2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31443139

RESUMO

Background and Objectives: Indoor cycling is one of the most practiced activities in fitness centers for most people regardless of their physical conditioning level. Several studies have analyzed the effect of indoor cycling on several parameters related to health, such as maximal oxygen consumption, blood pressure, body composition, as well as biochemical markers such as HDL or LDL. However, no study has synthesized all health benefits associated with the indoor cycling practice in the form of a systematic review and established guidelines or recommendations. Therefore, the aim of this manuscript was to conduct a systematic review of published studies about the benefits of indoor cycling training and to establish recommendations for coaches, researchers, and practitioners. Materials and Methods: The PRISMA guidelines were followed to conduct the current systematic review. A systematic search was performed to retrieve relevant published articles until January 2019 using the following keywords: 'indoor cycling', 'indoor bicycle', and 'spinning exercise'. Information about participants, intervention, comparisons, outcomes, and study design (PICOS) was extracted. Results: A total of 300 studies were initially identified. After the revision process, 13 of them were included. The total sample size of the studies was 372 (306 women). Results revealed that indoor cycling may improve aerobic capacity, blood pressure, lipid profile, and body composition. These enhancements may be achieved as standalone intervention or combined with other physical exercises or diet. Conclusions: The combination of indoor cycling and diet is recommended to improve the lipid profile, lose weight, and reduce blood pressure. Furthermore, indoor cycling alone may also enhance aerobic capacity. Given the lack of randomized controlled trials, these conclusions should be taken with caution.


Assuntos
Ciclismo/normas , Terapia por Exercício/normas , Terapia por Exercício/métodos , Humanos
7.
Medicina (Kaunas) ; 55(8)2019 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-31370283

RESUMO

Background and objectives: Episodic specific induction (ESI) is a manipulation shown to enhance episodic memory function. Episodic specificity induction involves thoroughly unpacking a recently encoded memory, with this enhanced retrieval-induced process helping to facilitate subsequent cognitions. In addition to ESI, emerging work suggests that acute exercise may also help to facilitate episodic memory function. The purpose of this study was to evaluate the potential individual and combined effects of acute exercise and ESI on subsequent episodic memory performance. Materials and Methods: Participants (n = 120) were randomly assigned into one of four groups, (1) ESI and exercise (ESI + E), (2) ESI only (ESI), (3) exercise only (E), and (4) no ESI and no exercise (Control; C). The ESI protocol involved watching a short video and then recalling details about the setting, people, and actions in the video. The exercise protocol involved an acute bout (15 min) of treadmill exercise. After these tasks, episodic memory function was evaluated with an autobiographical interview assessment and a computerized episodic memory task involving what-where-when integration. Results: We did not observe significant main effects for exercise or ESI on memory function but did observe some suggestive evidence of an interaction effect of these two parameters on episodic memory. That is, for the exercise group, memory performance was higher when combined with ESI as opposed to without ESI. Conclusions: Acute exercise and ESI may interact to influence episodic memory function.


Assuntos
Terapia por Exercício/normas , Memória Episódica , Rememoração Mental/fisiologia , Adolescente , Adulto , Análise de Variância , Terapia por Exercício/métodos , Terapia por Exercício/estatística & dados numéricos , Feminino , Voluntários Saudáveis/estatística & dados numéricos , Humanos , Masculino
8.
Medicina (Kaunas) ; 55(8)2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31366161

RESUMO

Background and Objectives: Gait training with body weight-support has been shown to improve the walking speed of individuals with movement disorders. The AccesSportAmerica Gait Trainer is a low-cost, pre-market gait rehabilitation device that alters the stride characteristics of participants walking on a standard treadmill. The purpose of this study was to examine the biomechanical outcomes that training on this device has for people with brain injuries that affect motor functioning. It was hypothesized that there would be an increase in walking speed post-intervention, and that there would be an increase in step length and joint range-of-motion. Materials and Methods: An intervention study was conducted with 11 people with ambulatory difficulty caused by post-stroke hemiparesis (n = 7), traumatic brain injury (n = 3), and cerebral palsy (n = 1). The average time using the AccesSportAmerica Gait Trainer was 34.5 (SD = 6.0) minutes per session for 36.9 (SD = 21.8) sessions. Gait speed, step length and time, and joint flexion were measured during the 10 Meter Walk Test. Results: From pre- to post-intervention, there was a mean increase in walking speed of 0.19 m/s (SD = 0.06, p = 0.016, d = 0.40) and a decrease in step time of both affected and unaffected legs (affected: p = 0.011, d = 0.37; unaffected: p = 0.004, d = 0.67). There was no significant change in stride length or joint angles. Conclusions: The AccesSportAmerica Gait Trainer has the potential to improve the walking speed of people with ambulatory difficulty.


Assuntos
Equipamentos e Provisões/normas , Terapia por Exercício/instrumentação , Amplitude de Movimento Articular/fisiologia , Velocidade de Caminhada/fisiologia , Adulto , Fenômenos Biomecânicos , Equipamentos e Provisões/estatística & dados numéricos , Terapia por Exercício/economia , Terapia por Exercício/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reabilitação do Acidente Vascular Cerebral/instrumentação , Reabilitação do Acidente Vascular Cerebral/normas , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos
9.
JMIR Mhealth Uhealth ; 7(7): e12587, 2019 07 11.
Artigo em Inglês | MEDLINE | ID: mdl-31298221

RESUMO

BACKGROUND: The postpartum period is a vulnerable time for the pelvic floor. Early implementation of pelvic floor muscle exercises, appropriately termed as pelvic floor muscle training (PFMT), in the postpartum period has been advocated because of its established effectiveness. The popularity of mobile health (mHealth) devices highlights their perceived utility. The effectiveness of various mHealth technologies with claims to support pelvic floor health and fitness is yet to be substantiated through systematic inquiry. OBJECTIVE: The aim of this study was to determine the acceptability, feasibility, and potential effect on outcomes of an mHealth device purposed to facilitate pelvic floor muscle training among postpartum women. METHODS: A 16-week mixed methods pilot study was conducted to evaluate outcomes and determine aspects of acceptability and feasibility of an mHealth device. All participants received standardized examination of their pelvic floor muscles and associated instruction on the correct performance of PFMT. Those randomized to the iBall intervention received instructions on its use. Schedules for utilization of the iBall and PFMT were not prescribed, but all participants were informed of the standard established recommendation of PFMT, which includes 3 sets of 10 exercises, 3 to 4 times a week, for the duration of the intervention period. Quantitative data included the measurement of pelvic floor muscle parameters (strength, endurance, and coordination) following the PERFECT assessment scheme: Incontinence Impact Questionnaire scores and the Urogenital Distress Inventory (UDI-6) scores. Aspects of acceptability and feasibility were collected through one-to-one interviews. Interview transcripts were analyzed using Thorne's interpretive description approach. RESULTS: A total of 23 women with a mean age of 32.2 years were randomized to an intervention group (n=13) or a control group (n=10). Both groups improved on all measures. The only statistically significant change was the UDI-6 score within both groups at 16 weeks compared with baseline. There was no statistically significant difference between the intervention group and control group on any outcomes. Most participants using the iBall (n=10, 77%) indicated value in the concept of the mHealth solution. Technical difficulties (n=10, 77%), a cumbersome initiation process (n=8, 61%), and discomfort from the device (n=8, 61%) were reasons impeding intervention acceptability. Most participants (n=17, 74%) indicated that the initial assessment and training was more useful than the mHealth solution, a tenet that was echoed by all control group participants. CONCLUSIONS: Our pilot study demonstrated the potential for mHealth solution-enhanced PFMT in the early postpartum period. Usability issues in hardware and software hindered feasibility and acceptance by the participants. Our findings can inform the redesign of mHealth solutions that may be of value if acceptability and feasibility issues can be overcome. TRIAL REGISTRATION: ClinicalTrials.gov NCT02865954; https://clinicaltrials.gov/ct2/show/NCT02865954.


Assuntos
Terapia por Exercício/instrumentação , Aplicativos Móveis/normas , Mães/psicologia , Diafragma da Pelve/fisiologia , Adulto , Terapia por Exercício/métodos , Terapia por Exercício/normas , Estudos de Viabilidade , Feminino , Humanos , Aplicativos Móveis/estatística & dados numéricos , Mães/estatística & dados numéricos , Projetos Piloto , Período Pós-Parto/psicologia , Inquéritos e Questionários
10.
Medicina (Kaunas) ; 55(7)2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31315290

RESUMO

Background and objectives: Lymphoma patients experience a psychological and physiological decline that could be reversed by exercise. However, little is known about the effects of the exercise on psychological and physical fitness variables. Therefore, the purpose of this longitudinal study was to assess self-efficacy, fatigue and physical fitness before and after an eight-week exercise intervention. Materials and Methods: Thirty-six participants (54.4 ± 19.1 years) performed a supervised exercise program (~60 min, 2d·wk-1). Each session included a combined progressive training of cardiorespiratory, resistance, flexibility and postural education exercises. Self-efficacy and fatigue were measured with the Regulatory Emotional Self-Efficacy scale and 0-10 rating scale, respectively. Physical fitness was assessed with the body mass index, lower back flexibility, static balance, muscle strength and functional mobility. Results: Adherence to exercise was high (91.2% ± 4.8%) and no major health problems were noted in the patients over the intervention period. At baseline, significant differences were found between Hodgkin's lymphoma and non-Hodgkin's lymphoma patients by age and all dependent measures (p < 0.05). Fatigue significantly decreased and the perceived capability to regulate negative affect and to express positive emotions improved after exercise (p < 0.001). Significant improvements were found for body mass index, trunk lateral flexibility, monopodalic balance, isometric handgrip force and functional mobility (p < 0.001). Fatigue was significantly correlated with handgrip force (r = -0.56, p < 0.001) and functional mobility (r = -0.69, p < 0.001). Conclusions: The supervised exercise program improved psychological and physical fitness without causing adverse effects and health problems. Therefore, exercise to improve fitness levels and reduce perceived fatigue should be considered in the management of lymphoma patients.


Assuntos
Terapia por Exercício/normas , Linfoma/psicologia , Adulto , Idoso , Exercício Físico/psicologia , Terapia por Exercício/métodos , Terapia por Exercício/psicologia , Fadiga/diagnóstico , Fadiga/etiologia , Feminino , Força da Mão/fisiologia , Humanos , Estudos Longitudinais , Linfoma/complicações , Linfoma/terapia , Masculino , Pessoa de Meia-Idade , Aptidão Física/psicologia , Psicometria/instrumentação , Psicometria/métodos , Autoeficácia
11.
Medicina (Kaunas) ; 55(7)2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31340610

RESUMO

Background and Objectives: Several studies have reported that some conditions such as exercise and hypoxia induce DNA damage and dysfunction and apoptosis. Some plant foods contain numerous bioactive compounds and anti-inflammatory properties that can help fight DNA damage. Therefore, the current study evaluated the effect of supplementation of Adiantum capillus-veneris (ACV) extract on Bax/B-cell lymphoma 2 (Bcl-2) ratio apoptotic index and remodeling of pulmonary alveolar epithelial cells in lung tissue of healthy Wistar rats during stressful conditions (hypoxia). Materials and Methods: Twenty-seven Wistar male rats (four-week old, 72 ± 9 g) were randomly assigned into three groups: normoxic, sedentary, and not-supplemented (NG, n = 9); exercise and hypoxia and not-supplemented (HE, n = 9); and exercise and hypoxia and supplemented group (HS, n = 9). The NG remained sedentary in the normoxia environment for nine weeks. The HE group participated in a high-intensity (IT) program for six weeks, then remained sedentary in the hypoxia environment for three weeks. The low-pressure chamber simulated a ~2800 M altitude 24 h/d. HS participated in IT, then entered and remained sedentary in the hypoxia environment for three weeks, and they consumed 500 mg per kg of body weight ACV extract. Results: The Bax/Bcl-2 ratio of the HE group increased significantly (+50.27%, p ≤ 0.05), the average number of type I pneumocytes was reduced significantly (-18.85%, p ≤ 0.05), and the average number of type II pneumocytes was increased significantly (+14.69%, p ≤ 0.05). Also, after three weeks of consuming the ACV extract, the HS group in comparison with the HE group had their Bax/Bcl-2 ratio reduced significantly (-24.27%, p ≤ 0.05), the average number of type I pneumocytes increased significantly (+10.15%, p ≤ 0.05), and the average number of type II pneumocytes reduced significantly (-7.18%, p ≤ 0.05). Conclusion: The findings show that after three weeks of hypoxia following six weeks of high-intensity interval training in Wistar rats, the Bax/Bcl-2 ratio and the number of type II pneumocytes were increased and the number of type I pneumocytes was reduced significantly. These results strongly suggest that an apoptosis state was induced in the lung parenchyma, and consuming ACV extract modulated this state.


Assuntos
Adiantum/metabolismo , Apoptose/efeitos dos fármacos , Terapia por Exercício/normas , Hipóxia/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Alvéolos Pulmonares/efeitos dos fármacos , Animais , Modelos Animais de Doenças , Terapia por Exercício/métodos , Hipóxia/fisiopatologia , Extratos Vegetais/farmacologia , Alvéolos Pulmonares/fisiopatologia , Ratos , Ratos Wistar
12.
Wien Klin Wochenschr ; 131(Suppl 1): 151-163, 2019 May.
Artigo em Alemão | MEDLINE | ID: mdl-30980144

RESUMO

Recent epidemiological investigations have shown that approximately 2-3% of all Austrians suffer from diabetes with renal involvement, i. e. 250,000 people in Austria are affected. The risk of occurrence and progression of this disease can be ameliorated by life style interventions as well as optimization of blood pressure, blood glucose levels and special drug classes. The present article represents the joint recommendations of the Austrian Diabetes Association and the Austrian Society for Nephrology for the diagnostics and treatment strategies of diabetic kidney disease.


Assuntos
Nefropatias Diabéticas , Dietoterapia/normas , Terapia por Exercício/normas , Guias de Prática Clínica como Assunto , Áustria , Pressão Sanguínea , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/terapia , Humanos , Estilo de Vida , Comportamento de Redução do Risco , Resultado do Tratamento
13.
BMC Cancer ; 19(1): 321, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30953460

RESUMO

BACKGROUND: The purpose of this review is to update previously published reviews on exercise programming in exercise trials in prostate cancer survivors. We evaluated: 1) the application of the principles of exercise training in prescribed programs; 2) the reporting of the components of the exercise prescription; and 3) the reporting of adherence of participants to the prescribed programs. METHODS: Building upon a previous review, a systematic review was conducted searching OVID Medline, Embase, CINAHL, and SPORTDiscus databases from 2012-2017. Randomized controlled trials of at least four weeks of aerobic and/or resistance exercise in men diagnosed with prostate cancer that reported physical fitness outcomes, including body composition were eligible for inclusion. RESULTS: Specificity was appropriately applied by 93%, progression by 55%, overload by 48%, initial values by 55%, and diminishing returns by 28% of eligible studies. No study adequately applied the principle of reversibility. Most (79%) studies reported all components of the exercise prescription in the study methods, but no study reported all components of adherence to the prescribed intervention in the study results. CONCLUSIONS: Application of standard exercise training principles is inadequate in exercise trials in men with prostate cancer and could possibly lead to an inadequate exercise stimulus. While many studies report the basic components of the exercise prescription in their study methods, full reporting of actual exercise completed is needed to advance our understanding of the optimal exercise dose for men with prostate cancer and promote translation of controlled trials to practice.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Ensaios Clínicos como Assunto/normas , Terapia por Exercício/normas , Cooperação do Paciente/estatística & dados numéricos , Neoplasias da Próstata/reabilitação , Terapia por Exercício/estatística & dados numéricos , Humanos , Masculino
15.
Worldviews Evid Based Nurs ; 16(2): 92-101, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30854763

RESUMO

BACKGROUND: Exercise may effectively reduce side effects caused by chemotherapy. However, no meta-analyses of exercise during or postchemotherapy for cancer patients have been definitely performed to guide clinical practice. AIMS: To evaluate and summarize available scientific evidence to provide recommendations of an exercise intervention for cancer patients undergo chemotherapy. METHODS: A systematic review and meta-analysis were performed with databases searching of MEDLINE, Cochrane Library, and Embase from their inception to October 15, 2017. Literature was selected to identify randomized controlled trials of exercise during or postchemotherapy for cancer patients. Risk-of-bias assessment was performed by two reviewers independently. Data were analyzed using the Cochrane Collaboration's RevMan 5.3 (Review Man, Copenhagen, Denmark). RESULTS: A total of 10 trials with 838 participants were included in our study. Exercise could have a beneficial effect in cancer patients undergo chemotherapy in the outcome of physical fitness (MD: 0.16, 95% CI: 0.08-0.25, p < .01 and MD: 2.46, 95% CI: 1.44-3.47, p < .01) and depression (MD: -1.36, 95% CI: -2.68 to -0.04, p = .04), but not in FACT-G, FACT-B, anxiety, weight, and BMI (all p > .05). Exercise sequence (during or postchemotherapy) did not influence the effect of exercise for cancer patients undergo chemotherapy. In total, six studies were assessed as an overall low risk of bias. Subgroup analyses and sensitivity analyses reached results similar to those of the meta-analyses, which reflected our results were reliable and robust. LINKING EVIDENCE TO ACTION: Exercise seems to have a beneficial effect on physical fitness and depression, but not on quality of life, anxiety, weight, and BMI. More specific and detailed description of the implementation of exercise programs should be proposed in the future.


Assuntos
Tratamento Farmacológico/enfermagem , Terapia por Exercício/normas , Neoplasias/terapia , Tratamento Farmacológico/métodos , Terapia por Exercício/métodos , Humanos , Neoplasias/tratamento farmacológico
16.
Medicine (Baltimore) ; 98(11): e14898, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30882707

RESUMO

Osteoporosis and osteopenia prevailed in postmenopausal women and predisposed to osteoporotic fractures that increase mortality, morbidity, and the cost of social care. Here, we investigated the effect of 24 weeks of aerobic dancing on the bone miner density, physical fitness and health-related quality of life (HRQoL) in postmenopausal women with osteopenia. Total 80 participants (control [CON]: 40; exercise [EX]: 40) were included in the final analysis. The EX group underwent a 24-week aerobic dance intervention. Bone mineral density (BMD), physical fitness, and SF-36 questionnaire were assessed at baseline and 24-weeks. The BMD change in the femoral neck at the 24-weeks were significantly different between the 2 groups (CON: -1.3 ±â€Š2.7%, EX: 3.1 ±â€Š4.6%, P = .001). Grip strength, sidestep and physical functional domain of HRQoL in the EX group were significantly improved compared to the CON. The results were suggested 24-week aerobic dance intervention could result in the lower the incidence of bone fracture through increasing BMD and decreasing fall risk for postmenopausal women.


Assuntos
Densidade Óssea/fisiologia , Doenças Ósseas Metabólicas/terapia , Terapia por Exercício/normas , Aptidão Física/fisiologia , Qualidade de Vida/psicologia , Idoso , Antropometria/métodos , Doenças Ósseas Metabólicas/complicações , Estudos de Coortes , Terapia por Exercício/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Estudos Retrospectivos , População Rural/estatística & dados numéricos , Estatísticas não Paramétricas , Inquéritos e Questionários , Taiwan
17.
Games Health J ; 8(4): 250-256, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30730230

RESUMO

Objective: We aimed to confirm whether the practice of exergames produces an effect on children's mood states during school physical education (PE) classes. Materials and Methods: The children were allocated to experimental group (EG) and control group (CG). The EG performed exergames during PE classes, and the CG attended regular school PE classes. The Brunel Mood Scale, which evaluates six mood dimensions (tension, mental confusion, anger, vigor, depression, and fatigue), was used to assess the children's moods before (pre) and immediately after the third lesson (acute effect). Results: The practice of exergames during PE classes produced an acute effect on children's moods. The results indicated that playing exergames helped to increase vigor (P < 0.01; effect size [ES]: 0.50; confidence interval [CI]: 0.16-0.84) and fatigue (P < 0.01; ES: 0.50; CI: 0.16-0.84). Conclusion: Three exergame sessions produced an acute effect and improved children's moods during school PE classes. More research is needed to evaluate the long-term effect of exergames on children and adolescents.


Assuntos
Afeto , Terapia por Exercício/normas , Jogos de Vídeo/normas , Análise de Variância , Índice de Massa Corporal , Criança , Terapia por Exercício/métodos , Terapia por Exercício/estatística & dados numéricos , Feminino , Humanos , Masculino , Educação Física e Treinamento/métodos , Educação Física e Treinamento/normas , Educação Física e Treinamento/estatística & dados numéricos , Psicometria/instrumentação , Psicometria/métodos , Estatísticas não Paramétricas , Jogos de Vídeo/psicologia , Jogos de Vídeo/estatística & dados numéricos
18.
J Adv Nurs ; 75(9): 1823-1837, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30672011

RESUMO

AIM: To determine the impact of strategies to promote mobilization on physical function in hospitalized adults with medical conditions. BACKGROUND: Slow progress is noted on the promotion of mobilization during hospitalization for adult patients admitted for medical conditions. This may reflect the limited evidence on the evaluation of the impact of progressive mobilization activities on clinical endpoints in adult patients throughout hospitalization. DESIGN: A systematic review and meta-analysis of published randomized controlled trials in any language. DATA RESOURCES: The literature search was performed in the MEDLINE, CINAHL online, HealthStar, EMBASE, the Cochrane Library Controlled Trials Registry and LILACS databases (January 2000-February 2017). REVIEW METHODS: Two authors independently identified randomized trials meeting inclusion criteria, assessed their quality and extracted relevant data. Outcomes assessed were the changes in physical function evaluated by scales measuring either the aerobic (metres walked/second) or the balance domain (using the Time Up and Go test, in seconds), length of hospital stay (days), and adverse clinical events. We calculated pooled mean differences or Mantel-Haenszel odds ratios and 95% confidence intervals for continuous or dichotomous outcome data and obtained heterogeneity statistics across studies. RESULTS: Thirteen studies, including in total 2,703 participants, met our eligibility criteria. Patients in the intervention group showed significant improvement in physical function (aerobic domain), reduced length of stay, and a reduction of pulmonary embolism. CONCLUSION: Patients and health providers should consider a course of therapy that enhances the functional capacity of medical patients during hospitalization.


Assuntos
Terapia por Exercício/normas , Exercício Físico/fisiologia , Hospitalização , Limitação da Mobilidade , Equilíbrio Postural/fisiologia , Padrão de Cuidado/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto
19.
Rehabil Nurs ; 44(1): 60-66, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30601799

RESUMO

PURPOSE: The aim of the study was to investigate the effect of elastic band exercise activities on lower extremity rehabilitation in elderly patients subjected to an elastic band exercise intervention 2 and 4 weeks after total knee arthroplasty. DESIGN: A quasiexperimental study was conducted. Participants were recruited from southern Taiwan who were over 65 years old and had a first unilateral total knee arthroplasty for osteoarthritis. METHODS: The control and experimental groups comprised 25 patients each. The control group received conventional treatment after total knee arthroplasty; by contrast, the experimental group engaged in elastic band exercise activities demonstrated by instructors, in addition to receiving conventional treatment. Effects of the lower extremity rehabilitation of the two groups were evaluated 2 and 4 weeks after total knee arthroplasty. FINDINGS: Most of the participants were above 70 years of age, 17 of whom were in the control group (68%) and 16 in the experimental group (64%). The active and passive knee flexion angles of the experimental group were greater than those of the control group (p < .001) 2 and 4 weeks after surgery. The muscle strength of the quadriceps of the experimental group was higher than that of the control group (p < .001) 2 and 4 weeks after surgery. The experimental group exhibited significantly higher physical function than that of the control group 2 and 4 weeks after surgery (p < .001). CONCLUSIONS: The elastic band exercise program shows promising effects on improving the lower limb rehabilitation of elderly patients with total knee arthroplasty. CLINICAL RELEVANCE: Healthcare professionals who work with elderly patients with total knee arthroplasty may consider recommending and implementing the elastic band exercise program as a home rehabilitation method for this population. However, we recommend further testing of the long-term effects of this program on a larger population.


Assuntos
Artroplastia do Joelho/reabilitação , Bandagens Compressivas/normas , Terapia por Exercício/normas , Treinamento de Resistência/normas , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Joelho/métodos , Terapia por Exercício/métodos , Feminino , Humanos , Extremidade Inferior/lesões , Extremidade Inferior/fisiopatologia , Masculino , Amplitude de Movimento Articular , Treinamento de Resistência/métodos , Taiwan
20.
Support Care Cancer ; 27(4): 1215-1222, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30310988

RESUMO

PURPOSE: Physical activity (PA) is central to self-management for people with colorectal cancer (CRC) to support health behaviour and function secondary to cancer treatment. However, there is limited evidence on how health professionals (HPs) promote PA during cancer treatment. This study aimed to investigate how and when PA is promoted throughout the chemotherapy pathway among colorectal cancer survivors. METHODS: A qualitative study was conducted with adults with CRC receiving chemotherapy at a large cancer centre. Cross-sectional observation of clinical consultations was conducted at four points during the chemotherapy pathway: prior, midpoint, final cycle, and 8 weeks following chemotherapy. Following completion of treatment, audio-recorded, semi-structured interviews were conducted with patients and HPs and transcribed verbatim. Codes and themes were identified and triangulated from all the data using framework analysis. Observational themes are reported and complimented by interview data. RESULTS: Throughout the chemotherapy pathway (pre, midpoint, end), many opportunities were missed by HPs to promote PA as a beneficial means to maintain functioning and ameliorate cancer treatment side effects. When discussed, PA levels were used only to determine fitness for future oncological treatment. No PA promotion was observed despite patients reporting low PA levels or treatment side effects. Post-treatment, PA promotion was more routinely delivered by HPs, as evidenced by problem-solving and onward referrals to relevant HPs. CONCLUSION: PA promotion was largely absent during treatment despite it being a key component of patient self-management following treatment. This suggests considerable missed opportunities for HPs to provide cancer survivors with PA evidence-based interventions. Further research is necessary to identify how best to ensure PA is promoted throughout the cancer journey. IMPLICATION FOR CANCER SURVIVORS: These findings suggest many may not be receiving support to be physically active during treatment.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias Colorretais/terapia , Procedimentos Clínicos , Terapia por Exercício , Exercício Físico/fisiologia , Promoção da Saúde , Idoso , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/reabilitação , Terapia Combinada , Procedimentos Clínicos/organização & administração , Procedimentos Clínicos/normas , Procedimentos Clínicos/estatística & dados numéricos , Estudos Transversais , Terapia por Exercício/organização & administração , Terapia por Exercício/normas , Terapia por Exercício/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Promoção da Saúde/organização & administração , Promoção da Saúde/normas , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Autocuidado/métodos , Autocuidado/normas , Autocuidado/estatística & dados numéricos , Reino Unido/epidemiologia
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