Validity and reliability of a ruler drop test to measure dual-task reaction time, choice reaction time and discrimination reaction time.

BACKGROUND: The aim of this study was to determine the absolute and relative reliability of the Ruler Drop Test (RDT) for assessing dual-task, choice, and discrimination reaction time. In addition, the construct validity of the RDT is examined in comparison to the Deary-Liewald reaction time (DLRT). METHODS: Tests were administered by the same evaluator, one week apart. Intraclass Correlation Coefficient (ICC3.1) was used to measure relative reliability, and the standard error of measurement (SEM) and minimal detectable change (MDC95) were used to measure absolute reliability. Spearman correlation test was used to measure construct validity. RESULTS: The results showed that the relative reliability was good for the choice ruler drop (ICC = 0.81), moderate for the dual-task ruler drop test (ICC = 0.70) and discrimination ruler drop test (ICC = 0.72), and good for simple ruler drop test. However, the simple ruler drop test had poor reliability (ICC = 0.57). The RDT shows construct validity compared to the DLRT. CONCLUSION: We conclude that the RDT is a suitable instrument for measuring dual-task, choice and discrimination reaction time. Future studies should explore the reliability of these measures in other populations.

High Fragmented Physical Activity as an Early Risk Indicator of Frailty and Mortality in Adults Aged 50 Years and Over.

INTRODUCTION: This study aimed to explore the associations of activity fragmentation with frailty status and all-cause mortality in a representative US sample of people 50 years and over. METHODS: This prospective study used data from the 2003-2006 waves of the National Health and Nutrition Examination Survey (NHANES). Participants 50 years or over were included in the study (n = 2,586). Frailty status was assessed using a valid modification of the Fried criteria. Linked data from the National Death Index registry were used to ascertain mortality. Physical activity fragmentation was measured by accelerometry. To calculate activity fragmentation, an active-to-sedentary transition probability was calculated as the number of physical activity bouts divided by the total sum of minutes spent in physical activity. Age, gender, ethnicity, education, mobility issues, drinking status, smoking status, BMI, and self-reported chronic diseases were reported in the NHANES study. RESULTS: An increment of 1 SD in activity fragmentation was associated with an increased likelihood of frailty (odds ratio [95% confidence interval] = 1.36 [1.13-1.664]). Compared with participants in the high activity fragmentation/low physical activity category, participants in the low activity fragmentation/low physical activity and low activity fragmentation/high physical activity categories were associated with a lower likelihood of frailty. We found a nonlinear association between activity fragmentation and all-cause mortality. Compared with participants in the high activity fragmentation/low physical activity category, participants in the low activity fragmentation/low physical activity, low activity fragmentation/high physical activity, and high activity fragmentation/high physical activity categories were associated with a lower mortality risk. Participants with a low fragmented activity pattern may also overcome some of the detrimental effects associated with sedentary behavior. CONCLUSIONS: Our results suggest that a high fragmented physical activity pattern is associated with frailty and risk of mortality in adults and older adults. This association was independent of total volume of physical activity and time spent sedentary.

Associations between Hospitalization and Device-Assessed Physical Activity in a Representative Sample of Older Adults.

BACKGROUND: Evidence investigating associations between hospitalization and physical activity is scarce and limited to specific populations of older adults. OBJECTIVE: The current study aimed to describe the impact of past hospitalization on current physical activity levels of a large representative sample of European older adults with accelerometry data. METHODS: A representative sample of 856 European older adults aged 50 years and over was included in this study. Hospital admission and utilization (i.e., accumulated times and length of stay in hospital) in the last 12 months were self-reported retrospectively. Physical activity volume (mg) and distribution of intensity (intensity gradient) were assessed with thigh-worn accelerometers. RESULTS: Multivariate linear regressions indicated that hospital admission (15% of the sample) was associated with reduced physical activity volume (-4.29 mg; 95% confidence interval (95% CI), -9.07 to 0.47) of participants. Each additional hospital admission was associated with lower volume (-2.29 mg; 95% CI, -4.65 to 0.06) and poorer distribution of intensity (-0.07; 95% CI, -0.11 to -0.04). Total length of stay was not associated with physical activity. CONCLUSIONS: This study suggests that hospital admission and the number of times admitted, but not accumulated length of stay, may curb physical activity levels of older adults. Public health strategies to promote successful aging should target post-hospitalization physical activity.

Optimal dose and type of physical activity to improve functional capacity and minimise adverse events in acutely hospitalised older adults: a systematic review with dose-response network meta-analysis of randomised controlled trials.

OBJECTIVE: To identify the optimal dose and type of physical activity to improve functional capacity and reduce adverse events in acutely hospitalised older adults. DESIGN: Systematic review and Bayesian model-based network meta-analysis. DATA SOURCES: Four databases were searched from inception to 20 June 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials that assessed the effectiveness of a physical activity-based intervention on at least one functional outcome in people aged ≥50 years hospitalised due to an acute medical condition were included. Pooled effect estimates (ie, standardised mean differences for functional capacity and the ratio of means for adverse events) were calculated using random treatment effects network meta-analysis models. RESULTS: Nineteen studies (3842 participants) met the inclusion criteria. Approximately 100 Metabolic Equivalents of Task per day (METs-min/day) (~40 min/day of light effort or ~25 min/day of moderate effort activities) was the minimal dose to improve the functional capacity of acute hospitalised older adults (standardised mean difference (SMD)=0.28, 95% credible interval (CrI) 0.01 to 0.55). The optimal dose was estimated at 159 METs-min/day (~70 min/day of light effort or ~40 min/day of moderate effort activities; SMD=0.41, 95% CrI 0.08 to 0.72). Ambulation was deemed the most efficient intervention, and the optimal dose was reached at 143 METs-min/day (~50 min/day of slow-paced walking; SMD=0.76, 95% CrI 0.35 to 1.16), showing a high evidential power (87.68%). The minimal effective ambulation dose was estimated at 74 METs-min/day (~25 min/day of slow-paced walking; SMD=0.25, 95% CrI 0.01 to 0.41). Physical activity interventions resulted in a decrease in the rate of adverse events compared with usual care at discharge (ratio of means=0.96, 95% CrI 0.95 to 0.97; median time 7 days). CONCLUSIONS: This meta-analysis yielded low to moderate evidence supporting the use of in-hospital supervised physical activity programmes in acutely hospitalised older adults. As little as ~25 min/day of slow-paced walking is sufficient to improve functional capacity and minimise adverse events in this population. TRIAL REGISTRATION NUMBER: PROSPERO CRD42021271999.

Effects of respiratory muscle training on respiratory efficiency and health-related quality of life in sedentary women with fibromyalgia: a randomised controlled trial.

OBJECTIVES: Fibromyalgia syndrome (FM) is a complex disease that is mainly characterised by chronic pain, fatigue, and sleep disturbances and may be precipitated or worsened by many stressors. The aim of this study was to examine the effects of respiratory muscle training (RMT) on respiratory efficiency and health-related quality of life (HRQoL) in women with FM. METHODS: A total of 30 women with FM were included in the intention to treat analyses: 15 were assigned to the RMT group and 15 to the control group. The intervention consisted of 12 weeks of RMT. The primary outcome was the change in pulmonary function assessed by global body plethysmography at 12 weeks compared with baseline. Secondary outcomes included changes of scores in HRQoL assessed by the Short Form 36 Health Survey-Portuguese version. RESULTS: The maximal inspiratory pressure (MIP) improved by 17.5% (p-value = .033), maximal expiratory pressure (MEP) improved 21.6% (p-value = 0.045) and maximum occlusion pressure (P0.1 max) increased 27.7% (p-value = 0.007). HRQoL improved in the dimensions of physical function, physical role, bodily pain and vitality (p-value <0.05). CONCLUSIONS: RMT results in a significant improvement of respiratory efficiency and HRQoL after 12 weeks. RMT could be an effective therapy to enhance respiratory function and quality of life in women with FM.

Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries.

BACKGROUND: The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children's daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children's movement behaviours before and during the COVID-19 pandemic. METHODS: Parents of children aged 3-5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in movement behaviours and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). Physical activity (PA), sedentary screen time (SST) and sleep were assessed via parent survey. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Compliance with the World Health Organizations (WHO) Global guidelines for PA (180 min/day [≥60 min moderate- vigorous PA]), SST (≤1 h/day) and sleep (10-13 h/day) for children under 5 years of age, was determined. RESULTS: Nine hundred- forty-eight parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (Adjusted Odds Ratio [AdjOR] = 2.0, 95%Confidence Interval [CI] 1.0,3.8) and SST (AdjOR = 2.2, 95%CI 1.2,3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO Global guidelines (AdjOR = 3.3, 95%CI 1.1,9.8) than those who were not. Children of parents with higher compared to lower stress were less likely to meet all three guidelines (AdjOR = 0.5, 95%CI 0.3,0.9). CONCLUSION: PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting parents' mental health are important prerequisites for enabling pre-schoolers to practice healthy movement behaviours and meet the Global guidelines.

Integrating Sleep, Physical Activity, and Diet Quality to Estimate All-Cause Mortality Risk: A Combined Compositional Clustering and Survival Analysis of the National Health and Nutrition Examination Survey 2005-2006 Cycle.

We aimed to compare all-cause mortality risk across clusters of adults ≥50 years of age (n = 1,035) with common lifestyle behaviors patterns, enrolled in the US National Health and Nutrition Examination Survey (2005-2006). Log-ratio coordinates of 24-hour movement pattern and z scores of diet quality were used as input into a model-based clustering analysis. A Cox regression model was fitted to ascertain the all-cause mortality risk associated with each cluster. Participants were clustered into 4 groups: 1) a group characterized by a better physical activity profile and longer sleep duration coupled with an average diet quality (cluster 1); 2) a group with the poorest activity profile and shortest sleep but also the best diet quality (cluster 2); 3) another group featuring lower levels of activity of either intensity and higher levels of sedentary behavior and also a poor diet quality score (cluster 3); and 4) a group with an average diet quality and the best activity profile in the sample (cluster 4). A combination of a poorer diet and activity profile increased the prospective risk of all-cause mortality. Our findings emphasize the importance of considering the combination of diet quality and 24-hour movement patterns when developing interventions to reduce the risk of premature mortality.

Effects of Whole-Body Vibration on Functional Mobility, Balance, Gait Strength, and Quality of Life in Institutionalized Older People: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The aim of this study was to quantify the effect of whole-body vibration on balance, functional mobility, gait, functional performance, and quality of life in institutionalized older people. Eight databases were systematically reviewed, as recommended by the Cochrane Collaboration. This systematic review was designed to answer the acronym set by the participants, interventions, comparators, and outcomes (PICO)-model. Ten randomized controlled trials were included in the meta-analysis. The analysis of the mean differences (MDs) of the functional mobility assessed with Time Up and Go test was MD = -2.49 s (95% confidence interval, CI, [-4.37, -0.61]; I2 = 68%). In 279 participants from five studies, the overall MD = 0.49 (95% CI [-0.13, 1.11]; I2 = 23%) for gait, and MD = 0.96 (95% CI [-0.45, 2.37]; I2 = 85%) for balance, which represents the total Tinetti score, MD = 1.59 (95% CI [-0.52, 3.70]; I2 = 82%). In summary, whole-body vibration could have benefits on functional mobility in institutionalized older people.

Factors Associated with the Risk of Falls of Nursing Home Residents Aged 80 or Older.

BACKGROUND: Falls are the leading cause of mortality and morbidity in older and represents one of the major and most costly public health problems worldwide. PURPOSE: Evaluate the influences of lower limb muscle performance, static balance, functional independence and quality of life on fall risk as assessed with the timed up and go (TUG) test. DESIGN: Cross-sectional study. METHODS: Fifty-two residents aged 80 or older were assessed and distributed in one of the two study groups (no risk of falls; risk of falls) according to the time to complete the TUG test. A Kistler force platform and linear transducer was used to determinate lower limb muscle performance. Postural Stability (static balance) was measured by recording the center of pressure. The EuroQol-5 dimension was used to assess Health-related quality of life and the Barthel index was used to examine functional status. Student's t-test was performed to evaluate the differences between groups. Correlations between variables were analyzed using Spearman or Pearson coefficient. ROC (receiver operating charasteristic) analysis was used to determine the cut-off points related to a decrease in the risk of a fall. FINDINGS: Participants of no-fall risk group showed better lower limb performance, quality of life, and functional status. Cut-off points were determined for each outcome. CONCLUSIONS: Risk of falls in nursing home residents over the age of 80 is associated with lower limb muscle performance, functional status, and quality of Life. CLINICAL RELEVANCE: Cut-off points can be used by clinicians when working toward fall prevention and could help in determining the optimal lower limb muscle performance level for preventing falls.

Physical activity affects plasma coenzyme Q10 levels differently in young and old humans.

Coenzyme Q (Q) is a key lipidic compound for cell bioenergetics and membrane antioxidant activities. It has been shown that also has a central role in the prevention of oxidation of plasma lipoproteins. Q has been associated with the prevention of cholesterol oxidation and several aging-related diseases. However, to date no clear data on the levels of plasma Q during aging are available. We have measured the levels of plasmatic Q10 and cholesterol in young and old individuals showing different degrees of physical activity. Our results indicate that plasma Q10 levels in old people are higher that the levels found in young people. Our analysis also indicates that there is no a relationship between the degree of physical activity and Q10 levels when the general population is studied. However, very interestingly, we have found a different tendency between Q10 levels and physical activity depending on the age of individuals. In young people, higher activity correlates with lower Q10 levels in plasma whereas in older adults this ratio changes and higher activity is related to higher plasma Q10 levels and higher Q10/Chol ratios. Higher Q10 levels in plasma are related to lower lipoperoxidation and oxidized LDL levels in elderly people. Our results highlight the importance of life habits in the analysis of Q10 in plasma and indicate that the practice of physical activity at old age can improve antioxidant capacity in plasma and help to prevent cardiovascular diseases.

On the associations between physical activity and quality of life: findings from an Australian nationally representative panel survey.

PURPOSE: The purpose of this study is to provide a comprehensive analysis of the associations between the frequency of moderate or vigorous physical activity (MVPA) and quality of life (QoL) measures using longitudinal data and panel regression models on a large, representative sample of the Australian population. METHODS: This study used yearly panel data on over 23,000 individuals collected by the Household, Income and Labour Dynamics in Australia Survey between 2001 and 2011. Ordinary least squares and fixed effects regression models were used to examine the associations between the weekly frequency of MVPA and several indicators of QoL, including both measures of health-related QoL (such as those derivable from the SF-36) and global subjective well-being assessments (such as self-reported life satisfaction), controlling for observable and unobservable factors. RESULTS: Our results provided consistent evidence that the frequency of MVPA is related to QoL and proved to be robust. A higher frequency of MVPA was related to higher scores in each of the outcomes analysed and using either of two different estimation strategies. The most pronounced associations emerged between the frequency of MVPA and the physical and vitality dimensions of the SF-36. A change from undertaking no MVPA at all to undertaking such activity once a week was remarkably associated with higher QoL. The influence of MVPA on global life satisfaction was only partially channelled through physical and mental health. CONCLUSION: We provide strong evidence that MVPA is related to QoL, thus adding to the large body of scientific literature demonstrating the benefits of becoming physically active.

Test-retest reliability and minimal detectable change scores for fitness assessment in older adults with type 2 diabetes.

PURPOSE: To assess the intraclass correlation coefficients (ICCs) and to determine the minimal detectable change (MDC95 ) scores of the data for the Hand Grip Strength Test, the Chair Sit and Reach Test (CSRT), the Timed "Up and Go" (TUG) test, the 6-Minute Walk Test (6MWT) and 30 seconds Sit to Stand Test (30s-STS) test in older adults with type 2 NIDDM. DESIGN: Test-retest reliability. METHODS: Eighteen subject participated in two sessions (1 week apart), which included the different tests. FINDINGS: High ICCs (≥ 0.92) were found for all tests. The MDC95 scores were as follows: 4.0 kg for Hand Grip Strength Tests, 7.5 cm for the right leg-CSRT, 9.0 cm for the left leg-CSRT, 1.0 second for the TUG test, 27 m for the 6MWT, and 3.3 repetitions for the 30s-STS test. CONCLUSIONS: All tests evaluated are reliable outcome measures for type 2 NIDDM patients. CLINICAL RELEVANCE: This study has generated novel MCD95 data, which will assist nursing practitioners in both prescribing the most beneficial exercise and interpreting posttreatment changes after rehabilitation in patients with T2DM.

Dose-response associations of the American Heart Association's new "Life's essential 8" metrics with all-cause and cardiovascular mortality in a nationally representative sample from the United States.

BACKGROUND: Our aim was to examine the prospective dose-response associations of American Heart Association's (AHA) LIFE's Essential 8 (LE8) score and number of cardiovascular health (CVH) factors with high score with all-cause and cardiovascular disease (CVD) related mortality. METHODS: We pooled 6 consecutive waves of the National Health and Nutrition Examination Survey (NHANES) comprising rounds between 2007 and 2008 and 2017-2018. We calculated hazard ratios (HRs) and conducted restricted cubic splines models to assess the dose-response association of LE8 score and CVH factors with all-cause and CVD mortality. RESULTS: Analyses included 23,531 adults aged 18 years and over (mean [SD] age, 43.6 [16.7] years; 11,979 [51%] female; 8960 [38.1%] non-Hispanic white individuals) with a median follow-up of 7.3 years (IQR 4.3-10.1), corresponding to 168,033 person-years. The dose-response analyses showed a significant inverse curvilinear trend for the association between LE8 score with all-cause and CVD mortality. The optimal risk reduction for all-cause mortality was found at 100 points of the LE8 Score (HR, 0.50; 95% CI, 0.27-0.93) compared to the reference (median LE8 score [62.5 points]). Moreover, the dose-response association between LE8 and CVD mortality also exhibited a significant inverse curvilinear association up to 90 points (HR, 0.41; 95% CI, 0.17-0.99). Optimal levels of LE8 score may be able to avert around 40% of the annual all-cause and CVD deaths among the US adult population. CONCLUSIONS: Best-case scenario of CVH may reduce around 40% of the all-cause and CVD annual mortality among adults in the United States.

Optimal Dose and Type of Physical Activity to Improve Glycemic Control in People Diagnosed With Type 2 Diabetes: A Systematic Review and Meta-analysis.

BACKGROUND: The optimal dose or type of physical activity to control glycosylated hemoglobin (HbA1c) in people with diabetes remains unknown. Current guidelines do not include consideration of baseline HbA1c for activity prescription. PURPOSE: To examine the dose-response relationship between physical activity and HbA1c (%) in individuals with type 2 diabetes. DATA SOURCES: A systematic search was performed in Embase, MEDLINE, Scopus, CINAHL, SPORTDiscus, and Web of Science. STUDY SELECTION: We included trials that involved participants diagnosed with type 2 diabetes that included any type of physical activity as intervention. DATA EXTRACTION: Pre- and postintervention HbA1c data, population and interventions characteristics, and descriptive statistics were collected to calculate change scores for each study arm. DATA SYNTHESIS: We used Bayesian random-effects meta-analyses to summarize high-quality evidence from 126 studies (6,718 participants). The optimal physical activity dose was 1,100 MET min/week, resulting in HbA1c reductions, ranging from -1.02% to -0.66% in severe uncontrolled diabetes, from -0.64% to -0.49% in uncontrolled diabetes, from -0.47% to -0.40% in controlled diabetes, and from -0.38% to -0.24% in prediabetes. LIMITATIONS: The time required to achieve these HbA1c reductions could not be estimated due to the heterogeneity between interventions' duration and protocols and the interpersonal variability of this outcome. CONCLUSIONS: The result of this meta-analysis provide key information about the optimal weekly dose of physical activity for people with diabetes with consideration of baseline HbA1c level, and the effectiveness of different types of active interventions. These results enable clinicians to prescribe tailored physical activity programs for this population.

A primary care-based randomized controlled trial of 12-week whole-body vibration for balance improvement in type 2 diabetes mellitus.

OBJECTIVE: To determine whether a 12-week whole-body vibration (WBV) training program improved balance in participants with type 2 diabetes mellitus (T2DM). DESIGN: Randomized controlled trial. SETTING: Primary health care setting. PARTICIPANTS: Participants with T2DM (N=50). INTERVENTIONS: Participants were randomly allocated to either a WBV group (n=25), which performed a 12-week WBV-based exercise program on an oscillating platform (12-16Hz-4mm; 3 sessions/wk), or a usual-care control group (n=25). MAIN OUTCOME MEASURES: Clinical and sociodemographic variables were recorded at baseline. Static balance and dynamic balance were also assessed at baseline by measuring postural sway (measurement of center of pressure [COP] excursions in the anteroposterior and mediolateral directions) using a Wii Balance Board and the Timed Up and Go test. RESULTS: Significant between-group differences in COP excursions with participants' eyes closed were found with their feet apart and feet together. In addition, participants in the WBV group exhibited significantly lower COP excursions with their eyes closed after the intervention, while participants in the control group experienced a nonsignificant deterioration in COP excursions (ie, greater excursion) with their eyes open (mediolateral axis). There was no significant difference in the Timed Up and Go test values postintervention. CONCLUSIONS: WBV provides a safe and well-tolerated approach to improve balance in participants with T2DM. These findings may have important implications for falls prevention in those with T2DM in the primary health care setting.

Clinical effects of a nine-month web-based intervention in subacute non-specific low back pain patients: a randomized controlled trial.

OBJECTIVE: To test the clinical effect of a web-based lower back pain intervention on quality of life and selected lower back pain outcomes. DESIGN: A prospective single-blinded randomized intervention. SETTING: Occupational preventive service. SUBJECTS: One hundred office workers with non-specific subacute lower back pain. INTERVENTION: The 50 intervention group subjects were educated daily about sitting correctly and asked to perform exercises shown by video demonstrations on the university website. The exercise routines included strengthening, mobility and stretching exercises focused on the postural stability muscles. The 50 control group subjects only received standard occupational care. MEASURES: Outcomes were measured by the EuroQol questionnaire five dimensions three levels, the Oswestry Disability Index, and the StarT Back Screening Tool questionnaires. At nine months, the intervention group outcomes were compared to the baseline data and the control group outcomes. RESULTS: For 97% (n = 45) of the experimental group quality of life (clinical utility) improved significantly; 3.58 times greater than the control group. Oswestry Disability Index showed an odds ratio (OR) of 5.42 with a 37% (n = 17) change for the intervention group with respect to the control group. With regard to the StarT Back Screening Tool, 76% (n = 35) of the intervention group improved their clinical state (odds ratio = 3.04 with respect to the control group improvement). Logistic regression analysis revealed positive changes in EuroQol questionnaire, increasing the likelihood of observing positive changes in StarT Back Screening Tool (OR = 15.5) and Oswestry Disability Index (OR = 4.5). CONCLUSIONS: The intervention showed clinical improvements in quality of life and selected lower back pain outcomes in the experimental group compared to the control group.

Whole body vibration training improves leg blood flow and adiposity in patients with type 2 diabetes mellitus.

This study aimed at examined the effect of a 12-week whole body vibration (WBV) training program on leg blood flow and body composition in people with type 2 diabetes mellitus (T2DM). Forty participants were randomly assigned to either a WBV training group (WBV; n = 20) or usual-care control group (CON; n = 20). Body composition [waist circumference, waist to hip ratio (WHR), weight, height, percentage of body fat and fat-free mass], heart rate, and blood flow [femoral artery diameter, maximum systolic velocity, maximum diastolic velocity (DV), time averaged mean, pulsatility index and resistance index (RI), mean velocity (V med), and peak blood velocities (PBV)] were assessed at baseline and after 12 weeks. There were significant increases in the blood flow (p = 0.046), V med (p = 0.050), and DV (p = 0.037) after WBV compared with CON. Within-group analysis showed significant differences in V med, PBV, and DV in the WBV group. Significant decreases after the intervention in weight (p < 0.001), waist circumference (p < 0.001), WHR (p < 0.05), and body fat (p < 0.05) were also found, with significant between-groups decreases in all these outcomes in the WBV group. Significant correlations existed between changes in percent body fat and blood flow [blood flow (-0.761), V med (-0.607), PBV (-0.677), and RI (0.0510)]. WBV training can be considered an effective means to increase leg blood flow and to reduce adiposity in patients with T2DM.

Reanalysis of a tailored web-based exercise programme for office workers with sub-acute low back pain: assessing the stage of change in behaviour.

OBJECTIVE: To reanalyse a web-based intervention for physically untrained office workers with sub-acute non-specific low back pain in low back pain-related exercise behaviour terms. DESIGN: Reanalysis of a randomized controlled trial. SETTING: Occupational Preventive Medicine of University. METHODS: Participants were randomized to an intervention group (proposed intervention plus standard care) or a control group (usual care only). The intervention exercise and education materials were developed as an online resource, and included video demonstrations recorded in a laboratory. Resources were loaded onto a dedicated section of the University Preventive Medicine Service website. All sessions included stretching, and exercises to improve postural stability (abdominal, lumbar, hip and thigh muscles) strength, flexibility and mobility. Outcome measures were self-reported health status (visual analogue scale (VAS) of the Euroquol-5D questionnaire); functional health status (Oswestry disability questionnaire); and the stage of change questionnaire. At nine months, outcomes in the intervention group were analysed and compared with baseline and outcomes in controls. RESULTS: In the intervention group, significant positive effects were observed at nine-month follow up for stage of change in the behavioural domain as related with low back pain for all phases except for the contemplation phase. The positive change in the stage of change questionnaire correlated with the improvement observed in Oswestry (r = .388) and VAS (r = -.612). CONCLUSIONS: The reanalysis of the trial suggests that exercise behaviour related to low back pain improve after the intervention period. This improvement correlates with changes in clinical low back pain-related outcomes.

Exercise to treat psychopathology and other clinical outcomes in schizophrenia: A systematic review and meta-analysis.

BACKGROUND: Psychopathology and side effects of antipsychotic drugs contribute to worsening physical health and long-term disability, and increasing the risk of mortality in these patients. The efficacy of exercise on these factors is not fully understood, and this lack of knowledge may hamper the routine application of physical activity as part of the clinical care of schizophrenia. AIMS: To determine the effect of exercise on psychopathology and other clinical markers in patients with schizophrenia. We also looked at several moderators. METHOD: MEDLINE, Web of Science, Scopus, CINAHL, SPORTDiscus, PsycINFO, and Cochrane Library databases were systematically searched from inception to October 2022. Randomized controlled trials of exercise interventions in patients 18-65 years old diagnosed with schizophrenia disorder were included. A multilevel random-effects meta-analysis was conducted to pool the data. Heterogeneity at each level of the meta-analysis was estimated via Cochran's Q, I2, and R2. RESULTS: Pooled effect estimates from 28 included studies (1,460 patients) showed that exercise is effective to improve schizophrenia psychopathology (Hedges' g = 0.28, [95% CI 0.14, 0.42]). Exercise presented stronger effects in outpatients than inpatients. We also found exercise is effective to improve muscle strength and self-reported disability. CONCLUSIONS: Our meta-analysis demonstrated that exercise could be an important part in the management and treatment of schizophrenia. Considering the current evidence, aerobic and high-intensity interval training exercises may provide superior benefits over other modalities. However, more studies are warranted to determine the optimal type and dose of exercise to improve clinical outcomes in people with schizophrenia.