Functional Outcomes and Quality of Life After Ankle Fracture Surgically Treated: A Systematic Review.

CONTEXT: Ankle fractures (AFs) are the most common fractures of the lower limbs found in emergency services. Approximately 53% of these fractures are unstable and treated surgically. OBJECTIVE: To conduct a systematic review evaluating functional outcomes and quality of life of patients with AFs surgically treated. EVIDENCE ACQUISITION: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Five electronic databases were searched, without any limit on publication dates. Only patients with an unstable AF that was surgically treated were included; functional outcomes and the quality of life were controlled by the 36-Item Short-Form Health Survey instrument. EVIDENCE SYNTHESIS: Five studies were included in the analysis, including 267 patients. The values of the Physiotherapy Evidence Database scale ranged between a minimum of 5 and a maximum of 7 points. Patients with surgically treated AF reported less functionality and physical capacity compared with the nonfractured population. Some patients experienced vitality, emotional, and mental health limitations for a long period. Most surgically treated patients reported no pain and a good health and social status. CONCLUSION: Limitations in functionality and physical capacity represent the main threats to health-related quality of life in patients with surgically treated AFs.

Combined exercise is more effective than aerobic exercise in the improvement of fall risk factors: a randomized controlled trial in community-dwelling older men.

OBJECTIVE: To compare the long-term effects of two community-based exercise programs on fall risk factors, such as balance, postural control, mobility and leg strength, in community-dwelling older men. DESIGN: Single-blinded randomized controlled trial, comparing three groups, with follow-ups at eight, 16, 24 and 32 weeks. SETTING: Older men independent-living residing in Maia city, Portugal. PARTICIPANTS: A total of 66 older men (aged 69.0 ±4.9 years) were randomly assigned to an aerobic exercise group ( n = 22), a combined aerobic and resistance exercise group ( n = 22) or a control group ( n = 22). INTERVENTIONS: Both community-based exercise programs consisted of three sessions each week for 32 consecutive weeks and were planned for moderate-to-vigorous intensity. The control group had no exercise intervention. MEASUREMENTS: Main outcomes were measured by the Timed Up and Go Test, functional reach test, 30-second chair stand test and 6-minute walk test, on five different occasions. RESULTS: Repeated measures of analysis of covariance revealed significant main effects between time × group interaction in all outcomes over time (Timed Up and Go Test: p < 0.001; functional reach test: p = 0.002; 30-second chair stand: p = 0.001; 6-minute walk test: p < 0.001). Both exercise groups reported improvements; however, better performance was identified in the combined aerobic and resistance exercise group compared with the aerobic exercise group (-20.3% vs. -9.1% on the Timed Up and Go Test, +27.5% vs. +10.9% on the functional reach test, +20.8% vs. +7.3% on 30-second chair stand, +10.9% vs. +3.5% on 6-minute walk test). CONCLUSIONS: Adding resistance exercise to aerobic exercise improves factors associated with an increased risk of falls. However, both exercise regimes, combined or aerobic alone, are more effective than no exercise in the reduction of fall risk factors. ClinicalTrials.org #NCT01874132.

Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis.

BACKGROUND: A growing body of evidence suggests that physical activity and exercise may improve erectile function. OBJECTIVE: To conduct a systematic review and meta-analysis evaluating the effects of physical activity modalities and exercise on erectile function in erectile dysfunction trials. METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. We searched 6 electronic databases between January 1990 and July 2016 and hand-searched reference lists for randomised controlled trials. Only patients with a diagnosis of erectile dysfunction were included. The mean differences between intervention and control groups were calculated for meta-analysis. RESULTS: 7 studies were eligible, including 478 participants allocated to aerobic, pelvic or combined exercise interventions. Follow-up ranged from 8 weeks to 2 years. The risk of bias in the trials was deemed moderate to high mainly due to impossible blinding of patients and personnel, as well as questionable blinding of outcome assessors. Random-effects meta-analyses were performed. Pooled data showed a statistically significant improvement in erectile function score (mean difference 3.85, 95% CI 2.33 to 5.37). A benefit was still demonstrable after a sensitivity analysis because the mean difference in International Index of Erectile Function (IIEF) score ranged from 3.39 (95% CI 1.92 to 4.87) to 4.28 (95% CI 2.54 to 6.02). A benefit was also detected in short-term and long-term interventions as well as in trials evaluating physical activity and exercise alone or in addition to usual care. CONCLUSIONS: The present study suggests that physical activity and exercise interventions improve patient-reported erectile dysfunction, particularly aerobic exercise with moderate-to-vigorous intensity.

Exercise prescription for patients with type 2 diabetes-a synthesis of international recommendations: narrative review.

BACKGROUND: Physical activity is a cornerstone of type 2 diabetes treatment and control. AIM: We analysed and synthesised the guidelines and recommendations issued by scientific organisations, regarding exercise prescription for patients with type 2 diabetes. METHOD: A systematic bibliographic search in Pubmed, Web of Science and Scopus databases was conducted. Clinical guidelines from major international scientific organisations in the field of diabetology, endocrinology, cardiology, public health and sports medicine were also considered. 11 publications were selected. RESULTS: Published guidelines recommend a weekly accumulation of a minimum of 150 min of aerobic exercise at moderate-to-vigorous intensity spread over a minimum of 3 days per week. Resistance exercise for muscle strengthening is also recommended at least 2 days a week. Flexibility exercises may complement other types of exercise. Combining aerobic and resistance exercise within the same exercise session is recommended by most guidelines. CONCLUSIONS: Exercise prescription for individuals with type 2 diabetes should include specific information on the type, mode, duration, intensity and weekly frequency. The exercise strategies must be adapted for each individual, based on comorbidities, contraindications and realistic personal goals.

Progressive resistance strength training and the related injuries in older adults: the susceptibility of the shoulder.

The benefits of progressive resistance training (PRT) among the older adults are evident, especially in the prevention of sarcopenia and improving muscle strength, which reverse the age-related loss of functional ability. However, PRT carries some risk, particularly when participants are older adults with a certain degree of muscle weakness. The purpose of this article is to discuss the PRT-related injuries, and present an overview of documented shoulder injuries among the elderly, discerning possible mechanisms of injury and risk factors. A literature search was conducted in the PUBMED database to identify the relevant literature using combinations of keywords: strength-training injuries, resistance-training injuries, sports injuries in the elderly, shoulder complex, shoulder injury, and shoulder disorder. Acute and chronic injuries attributed to PRT have been cited in the epidemiological literature. The shoulder complex, has been alluded to as one of the most prevalent regions of injury, particularly in exercises that place the arm extended above the head and posterior to the trunk. However, the risk for injuries appears to be higher for testing than for training itself. One-repetition maximum strength testing may result in a greater injury risk. This technique, though acceptable, needs additional precautions in inexperience older adults to prevent injury. Thus, the best treatment for PRT age-related injuries is prevention. Appropriate and individualized training programs, the use of safe equipment, careful warming up and cooling down, correct range of motion, progressive intensity training, cardiovascular and musculoskeletal fitness are essential aspects of injury prevention among the elderly.

Analysis of functionality, pain and quality of life after surgically treated ankle fractures in active and inactive individuals.

Although the ankle is often involved in low energy trauma, high-energy trauma may occur, being this considered more serious and more common of affecting young and active men. The purpose of the present study was to evaluate and compare the functionality, pain and quality of life of active and inactive adult individuals whose ankle fracture was surgically treated. Seventy-six patients split into two groups (active, n = 58 X inactive, n = 18), of the men (active, n = 38; inactive, n = 9) and women (active, n = 20; inactive, n = 9) gender participated in this prospective study. The IPAQ, MMSE, SF-36, VAS, sociodemographic and clinical questionnaires were applied in person right after surgery. The SF-36 and VAS questionnaires were reapplied 3 months in average after the surgery. Active and inactive patients of both genders show significant differences (p ≤ 0.05) in the functional capacity and physical aspect domains; and the bodily pain domain revealed significant difference in active and inactive men (p ≤ 0.05) between the periods post-surgical and 3 months after surgery (on average). Moderate and significant correlations were found (p ≤ 0.05) between functional capacity, physical aspect and bodily pain domains of the SF-36 and the VAS pain scores for active and inactive patients of both genders in the final follow-up period. Other significant correlations (p < 0.05) for inactive men (physical aspect and bodily pain) and inactive women (functional capacity and bodily pain) are observed (after 3 months of surgery). Three months after surgery (on average), active and inactive men had functional limitations and pain symptoms. These factors seem to have negatively influenced the patient's social involvement, worsening their quality of life. Most active and inactive patients had a positive self-perception of their general health status, emotional aspects and mental health domains. Regarding active women, we observed lower energy and vitality after the same postoperative period.

Prevention of exercise-related injuries and adverse events in patients with type 2 diabetes.

Physical activity is widely recommended as an essential non-pharmacological therapeutic strategy to the prevention and control of type 2 diabetes and cardiovascular risk. Microvascular and macrovascular complications associated with the natural progression of the disease and typical age and anthropometric profile of individuals with type 2 diabetes may expose these patients to an increased risk of injury and acute adverse events during exercise. These injuries and adverse events can lead to fear of new injury and consequent physical inactivity. Preventative measures are essential to reduce risk, increase safety and avoid the occurrence of exercise-related injuries in people with type 2 diabetes. This population can exercise safely if certain precautions are taken and if exercise is adapted to complications and contraindications of each individual. Conditions such as diabetic foot, diabetic retinopathy, diabetic nephropathy, diabetic autonomic neuropathy, cardiovascular risk factors, musculoskeletal disorders, hypoglycaemia, hyperglycaemia, dehydration and interactions between medication and exercise should be taken into consideration when prescribing exercise.

Changes in Registration Parameters for Ongoing Clinical Trials in Ukraine After 2022 Russian Invasion.

Importance: Clinical trial activity in Ukraine was seriously affected by the Russian invasion. However, data are lacking on how this conflict affects clinical trials. Objective: To evaluate whether registered changes to trial information reflect war-related disturbances to trials in Ukraine. Design, Setting, and Participants: This cross-sectional study included noncompleted trials conducted in Ukraine from February 24, 2022, to February 24, 2023. Trials conducted in Estonia and Slovakia were also analyzed for comparison. Study records within the ClinicalTrials.gov archive were accessed by using the change history feature in the tabular view for each record. Exposure: Russian invasion of Ukraine. Main Outcomes and Measures: The frequency of changes to the protocol and results registration parameters before and after the start of the war, February 24, 2022. Results: A total of 888 ongoing trials conducted only in Ukraine (5.2%) or in multiple countries (94.8%), and enrolling a median of 348 participants were analyzed. Almost all sponsors for 775 industry-funded trials were non-Ukrainian (99.6%). On February 24, 2023, 267 trials (30.1%) were without any recorded update in the registry after the war. In 15 (1.7%) multisite trials, Ukraine was removed as a location country after mean (SD) of 9.4 (3.0) postwar months. The rates of changes in 20 parameters 1 year before and after the war started had a mean (SD) absolute difference of 3.0% (2.5%). Besides study status changes in each study record version, the contacts and locations field was the most frequently modified (56.1%), with a higher rate for multisite (58.2%) than in only Ukrainian (17.4%) trials. This finding was consistent for all analyzed registration parameters. In trials conducted solely in Ukraine, the median number of record versions was the year before (95% CI, 0-0) and after February 2022 (95% CI, 0-1), similar to registered trials from Estonia and Slovakia. Conclusions and Relevance: Results of this study suggest that war-related changes in trial conduct in Ukraine may not be completely visible in the largest public trial registry, which is expected to present accurate and timely information on clinical trials. These findings raise questions regarding the updating practices for registration information, which should be mandatory, especially in times of crises, to ensure the safety and the rights of trial participants in a war zone.

Six-month effects of supervised exercise on walking ability and health-related factors in peripheral arterial disease: a pilot study.

BACKGROUND: In peripheral arterial disease (PAD) patients with intermittent claudication (IC), the combination of aerobic and resistance exercises could counteract muscle loss and attenuate disease progression. This study analyzed the effects of six months of a combined exercise program on walking ability, lower limb body composition, cardiovascular risk factors, and Ankle-Brachial Index (ABI). METHODS: Twenty-three patients (age 63.2±1.5 years and ABI 0.58±0.07) with PAD and IC were allocated to a control group (CG) or a supervised exercise group (SUP). Ten patients underwent six months of treadmill walking combined with resistance exercises, three times a week. The CG (N.=13) received a recommendation for walking. All patients were measured at baseline (M0), after three months (M3), and six months (M6). RESULTS: During constant treadmill protocol, the claudication onset time/distance (COT/COD), absolute claudication time/distance (ACT/ACD), and number of pauses of overall patients significantly improved at M3 and M6. Between groups were found significant differences in COT and COD at M6 (P=0.005 and P=0.007, respectively); and in ACT and ACD at M3 (P=0.003 for both) and at M6 (P=0.005 and P=0.005, respectively), with major improvements in the SUP. Over the six months, a significant group effect was found in fat-free mass (P=0.041) and predicted muscle mass (P=0.039) of the lower ABI leg, with greater improvements in the SUP. CONCLUSIONS: A supervised exercise program that combines aerobic and resistance training improves PAD symptoms and has additional benefits for patients. Patients in the program showed improvements in walking ability, lower-limb body composition, perceived exertion, and heart rate during treadmill walking.

Physiological Exercise and Post-Exercise Effects of Inverse Sequences of Combined Bench-Step Aerobics and Resistance Exercise.

The purpose of this study was to compare the effects of using inverse sequences of combined bench-step aerobics and resistance exercise on cardiorespiratory, hemodynamic and perceptual variables during exercise and one-hour post-exercise. The tested sequences were bench-step aerobics immediately before and immediately after resistance exercise. Thirteen apparently healthy and physically active women (age = 21.9 ± 6.1 years, body height = 160 ± 0.1 cm, body mass = 58.8 ± 7.5 kg, estimated fat mass = 17.2 ± 2.0% and estimated maximal oxygen uptake = 37.5 ± 2.6 mL∙kg-1∙min-1) performed a 20-minute bench-step aerobics routine, immediately before (STEP_RES) and after (RES_STEP) resistance exercise. Oxygen uptake and heart rate were continuously measured, systolic and diastolic blood pressure, body temperature and perceived exertion were measured at rest, immediately after each type of exercise and at 15, 30, 45 and 60 min after exercise. When resistance exercise was performed first (RES_STEP), oxygen uptake was higher (23.2 ± 3.9 vs. 20.5 ± 4.8 mL∙kg-1∙min-1), but the heart rate (164.5 ± 9.1 vs. 173.9 ± 11.7 bpm) and body temperature (36.5 ± 0.4 vs. 37.6 ± 0.6 ºC) were lower. In both sequences, the type of exercise performed first was pointed out with a lower perceived exertion or lower perceived intensity. Exercise and 60-min post-exercise blood pressure had a similar response in both sequences, and systolic blood pressure along with diastolic blood pressure were lower than pre-exercise from 30 min until 60 min post-exercise. The results suggest that the sequence affected oxygen uptake and perceived exertion during exercise and that this total workload, despite the sequence, promoted a post-exercise blood pressure decrease in normotensive participants.

Combined Aerobic and Resistance Exercise in Walking Performance of Patients With Intermittent Claudication: Systematic Review.

Background: The short-term benefits of aerobic and resistance exercise in subjects affected by Peripheral Arterial Disease (PAD) are scarcely examined in interaction. This study aimed to identify the effects of combined aerobic and resistance exercise programs on walking performance compared with isolated aerobic exercise or with the usual care in patients with intermittent claudication. Methods: A systematic review was conducted following the PRISMA statement. A total of five electronic databases were searched (until October 2019) for randomized and non-randomized controlled trials. The focus comprised PAD patients with intermittent claudication who performed a combined aerobic and resistance exercise program that assessed the walking performance. Results: Seven studies include combined aerobic and resistance exercise vs. isolated aerobic or vs. usual care. The studies represented a sample size of 337 participants. The follow-up ranged from 4 to 12 weeks, 2 to 5 times-per-week. The risk of bias in the trials was a deemed moderate-to-high risk. After the interventions, the percent change in walking performance outcomes had a large variation. In the combined and isolated aerobic programs, the walking performance always improved, while in the usual care group oscillates between the deterioration and the improvement in all outcomes. Combined exercise and isolated aerobic exercise improved the claudication onset distance from 11 to 396%, and 30 to 422%, the absolute claudication distance from 81 to 197%, and 53 to 121%, and the maximal walking distance around 23 and 10%, respectively. Conclusions: Currently, there is insufficient evidence about the effects of combined aerobic and resistance exercise compared to isolated aerobic exercise or usual care on walking performance. However, despite the low quality of evidence, the combined aerobic and resistance exercise seems to be an effective strategy to improve walking performance in patients with intermittent claudication. These combined exercise modes or isolated aerobic exercise produce positive and significant results on walking performance. The usual care approach has a trend to deteriorate the walking performance. Thus, given the scarcity of data, new randomized controlled trial studies that include assessments of cardiovascular risk factors are urgently required to better determine the effect of this exercise combination.

High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in Middle-Aged and Older Patients with Type 2 Diabetes: A Randomized Controlled Crossover Trial of the Acute Effects of Treadmill Walking on Glycemic Control.

BACKGROUND: This study aimed to compare the acute effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on glycemic control in middle-aged and older patients with type 2 diabetes (T2D), using treadmill walking as aerobic exercise mode. METHODS: Fifteen patients with T2D (60.25 ± 3.14 years; glycated hemoglobin 7.03 ± 0.33%; medicated with metformin and/or gliptins), participated in a randomized controlled crossover trial. They underwent three experimental conditions (treadmill walking HIIT session (5 × (3 min at 70% of heart rate reserve (HRR) + 3 min at 30% HRR)); treadmill walking MICT session (30 min at 50% HRR); and a control session of rest (CON)) in random order and in the postprandial state. Measurements of capillary blood glucose (BG) were taken immediately before, during, and until 50 min after the experimental conditions. RESULTS: Both HIIT and MICT treadmill walking sessions reduced BG levels during exercise and laboratory 50 min recovery period compared to CON (time*condition interaction effect; p < 0.001). The effect of HIIT was greater compared with MICT (p = 0.017). CONCLUSIONS: Treadmill walking HIIT seems a safe and more effective exercise strategy on immediate acute glycemic control compared with MICT in middle-aged and older patients with T2D under therapy with metformin and/or gliptins. TRIAL REGISTRATION NUMBER: ISRCTN09240628.

The Singularity of Cetacea Behavior Parallels the Complete Inactivation of Melatonin Gene Modules.

: Melatonin, the hormone of darkness, is a peculiar molecule found in most living organisms. Emerging as a potent broad-spectrum antioxidant, melatonin was repurposed into extra roles such as the modulation of circadian and seasonal rhythmicity, affecting numerous aspects of physiology and behaviour, including sleep entrainment and locomotor activity. Interestingly, the pineal gland-the melatonin synthesising organ in vertebrates-was suggested to be absent or rudimentary in some mammalian lineages, including Cetacea. In Cetacea, pineal regression is paralleled by their unique bio-rhythmicity, as illustrated by the unihemispheric sleeping behaviour and long-term vigilance. Here, we examined the genes responsible for melatonin synthesis (Aanat and Asmt) and signalling (Mtnr1a and Mtnr1b) in 12 toothed and baleen whale genomes. Based on an ample genomic comparison, we deduce that melatonin-related gene modules are eroded in Cetacea.

Physical activity and exercise on diabetic foot related outcomes: A systematic review.

BACKGROUND: Diabetic foot is one of the most common complications of diabetes. It has the potential risk of pathologic consequences including infection, ulceration and amputation, but a growing body of evidence suggests that physical activity and exercise may improve diabetic foot outcomes. OBJECTIVE: To analyze de effects of exercise and physical activity interventions on diabetic foot outcomes. METHODS: A comprehensive and systematic search was conducted according to PRISMA recommendations. Only controlled clinical trials with patients with diabetes were included. RESULTS: Six studies, involving 418 patients with diabetes, were included. Two studies used only aerobic exercise; two studies combined aerobic, resistance and balance exercise; and two studies combined aerobic and balance exercise by Thai Chin Chuan methods. Physical activity and exercise significantly improved nerve velocity conduction, peripheral sensory function and foot peak pressure distribution. Moreover, the ulcers incidence rate per year was lower in the intervention groups, compared with the controls [0.02 vs. 0.12]. CONCLUSION: This review suggests evidence that physical activity and exercise is an effective non-pharmacological intervention to improve diabetic foot related outcomes. Combined multi-disciplinary treatments are more effective in the prevention of foot complications in patients with diabetes.

Crystal structures of the free and sterol-bound forms of beta-cinnamomin.

The crystal structure of the elicitin beta-cinnamomin (beta-CIN) was determined in complex with ergosterol at 1.1 A resolution. beta-CIN/ergosterol complex crystallized in the monoclinic space group P2(1), with unit cell parameters of a = 31.0, b = 62.8, c = 50.0 A and beta = 93.4 degrees and two molecules in the asymmetric unit. Ligand extraction with chloroform followed by crystallographic analysis yielded a 1.35 A structure of beta-CIN (P4(3)2(1)2 space group) where the characteristic elicitin fold was kept. After incubation with cholesterol, a new complex structure was obtained, showing that the protein retains, after the extraction procedure, its ability to complex sterols. The necrotic effect of beta-CIN on tobacco was also shown to remain unchanged. Theoretical docking studies of the triterpene lupeol to beta-CIN provided an explanation for the apparent inability of beta-CIN to bind this ligand, as observed experimentally.

Implementing Low-Cost, Community-Based Exercise Programs for Middle-Aged and Older Patients with Type 2 Diabetes: What Are the Benefits for Glycemic Control and Cardiovascular Risk?

BACKGROUND: The purpose of this study was to analyze the effects of a long-term, community-based, combined exercise program developed with low-cost exercise strategies on glycemic control and cardiovascular risk factors in middle-aged and older patients with type 2 diabetes. METHODS: Participants (n = 124; 63.25 ± 7.20 years old) engaged in either a 9-month supervised exercise program (n = 39; consisting of combined aerobic, resistance, agility/balance, and flexibility exercise; three sessions per week; 70 min per session) or a control group (n = 85) who maintained their usual care. Glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease were assessed before and after the 9-month intervention. RESULTS: A significant time * group interaction effect (p < 0.001) was identified in the values of the glycated hemoglobin, fasting plasma glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference, and the 10-year risk of coronary artery disease. CONCLUSIONS: A long-term, community-based, combined exercise program developed with low-cost exercise strategies was effective in inducing significant benefits on glycemic control, lipid profile, blood pressure, anthropometric profile, and the 10-year risk of coronary artery disease in middle-aged and older patients with type 2 diabetes. Clinical Trial Identification Number: ISRCTN09240628.

Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes.

OBJECTIVES: Physical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic+resistance+agility/balance+flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes. METHODS: This was a non-experimental pre-post evaluation study. Participants (N=43; 62.92±5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70min per session) of 9 months' duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention. RESULTS: Significant improvements in the performance of the 6-Minute Walk Test (Δ=8.20%, p<0.001), 30-Second Chair Stand Test (Δ=28.84%, p<0.001), Timed Up and Go Test (Δ=14.31%, p<0.001), and Chair Sit and Reach Test (Δ=102.90%, p<0.001) were identified between baseline and end-exercise intervention time points. CONCLUSIONS: A long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings.

Physical exercise and functional fitness in independently living vs institutionalized elderly women: a comparison of 60- to 79-year-old city dwellers.

PURPOSE: To compare functional fitness (FF) levels among independent-living (IL) and day care (DC) elderly women of different age groups and to analyze changes in FF after 8 months of participation in an exercise program intervention for the IL elderly women. MATERIALS AND METHODS: A total of 674 elderly women were divided into four IL groups with age in the range of 60-64 years (IL60-64, n=149), 65-69 years (IL65-69, n=138), 70-74 years (IL70-74, n=135), and 75-79 years (IL75-79, n=83), and four DC groups with age in the range of 60-64 years (DC60-64, n=35), 65-69 years (DC65-69, n=34), 70-74 years (DC70-74, n=47), and 75-79 years (DC75-79, n=53). The intervention consisted of a multimodal exercise training, 3 days per week for 8 months. Senior Fitness Test battery performances were obtained at baseline and after 8-month intervention. RESULTS: Significant differences were identified between all IL groups and DC groups in all FF tests (P<0.001), except between IL70-74 and DC70-74 in the chair sit-and-reach. Analysis of covariance (ANCOVA) identified significant improvements in all FF tests between pre- and posttests in the IL groups (P<0.001), except in the chair sit-and-reach for the IL70-74. ANCOVA also showed a significant declining performance in all FF tests for DC groups (P<0.001), except in the chair sit-and-reach for the DC70-74 and DC75-79. CONCLUSION: IL women are more fit than institutionalized DC elderly women. The multimodal training was effective in improving all FF components related to daily living activities, in all age groups. In contrast, institutionalized elderly showed a clear tendency to worsen their FF over the time.

Soccer practice and functional and social performance of men with lower limb amputations.

Practicing sports together with rehabilitative treatment improves the development of motor, social and emotional abilities of lower limb amputees. The aim of this study was to compare the functional and social performance of individuals with lower limb amputations between those who played soccer and those who did not engage in any sports activities. A total of 138 individuals participated in the study and were divided into two groups: soccer players (n = 69, 34 ± 8.1 years) and non-athletes (n = 69, 38 ± 8.9 years). A checklist, based on the International Classification of Functioning, Disability and Health, was used. Data were analyzed using the Chi-square and Mann-Whitney tests. The soccer players group showed significantly better performance than the non-athletes group in most items of body function, body structure, occupational performance components and daily activities (p < 0.001 for all), and also in some important items of social and environment factors (p < 0.001 for all). The results strongly suggest that amputee soccer significantly improves the functional and social performance in individuals with lower limb amputations.