Search results for: lower limb exercise

Authors: Mohamed Aly, Aliaa Rehan Youssef, Emad Sawerees, Mounir Guirgis

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Relevance: Osteoarthritis (OA) is the most common degenerative disease seen in all populations. It causes disability and substantial socioeconomic burden. Evidence supports that exercise are the most effective conservative treatment for patients with OA. Therapists experience and clinical judgment play major role in exercise prescription and scientific evidence for this regard is lacking. The development of clinical prediction rules to identify patients who are most likely benefit from exercise may help solving this dilemma. Purpose: This study investigated whether body mass index and functional ability at baseline can predict patients’ response to a selected exercise program. Approach: Fifty-six patients, aged 35 to 65 years, completed an exercise program consisting of open kinetic chain strengthening and passive stretching exercises. The program was given for 3 sessions per week, 45 minutes per session, for 6 weeks Evaluation: At baseline and post treatment, pain severity was assessed using the numerical pain rating scale, whereas functional ability was being assessed by step test (ST), time up and go test (TUG) and 50 feet time walk test (50 FTW). After completing the program, global rate of change (GROC) score of greater than 4 was used to categorize patients as successful and non-successful. Thirty-eight patients (68%) had successful response to the intervention. Logistic regression showed that BMI and 50 FTW test were the only significant predictors. Based on the results, patients with BMI less than 34.71 kg/m2 and 50 FTW test less than 25.64 sec are 68% to 89% more likely to benefit from the exercise program. Conclusions: Clinicians should consider the described strengthening and flexibility exercise program for patents with BMI less than 34.7 Kg/m2 and 50 FTW faster than 25.6 seconds. The validity of these predictors should be investigated for other exercise.

Keywords: clinical prediction rule, knee osteoarthritis, physical therapy exercises, validity

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Authors: Hayden R Schott, John M Felder III

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Introduction: Chronic lower extremity wounds in the diabetic and vasculopathic populations are associated with a high degree of morbidity.When wounds require more extensive treatment than can be offered by wound care centers, more aggressive solutions involve local tissue transfer and microsurgical free tissue transfer for achieving definitive soft tissue coverage. These procedures of autologous tissue transfer (ATT) offer resilient, soft tissue coverage of limb-threatening wounds and confer promising limb salvage rates. However, chronic osteomyelitis and recalcitrant soft tissue infections are common in severe diabetic foot wounds and serve to significantly complicate ATT procedures. Stimulan is a resorbable calcium sulfate antibiotic carrier. The use of stimulan antibiotic beads to treat chronic osteomyelitis is well established in the orthopedic and plastic surgery literature. In these procedures, the beads are placed beneath the skin flap to directly deliver antibiotics to the infection site. The purpose of this study was to quantify the success of Stimulan antibiotic beads in treating recalcitrant infections in patients with diabetic foot wounds receiving ATT. Methods: A retrospective review of clinical and demographic information was performed on patients who underwent ATT with the placement of Stimulan antibiotic beads for attempted limb salvage from 2018-21. Patients were analyzed for preoperative wound characteristics, demographics, infection recurrence, and adverse outcomes as a result of product use. The primary endpoint was 90 day infection recurrence, with secondary endpoints including 90 day complications. Outcomes were compared using basic statistics and Fisher’s exact tests. Results: In this time span, 14 patients were identified. At the time of surgery, all patients exhibited clinical signs of active infection, including positive cultures and erythema. 57% of patients (n=8) exhibited chronic osteomyelitis prior to surgery, and 71% (n=10) had exposed bone at the wound base. In 57% of patients (n=8), Stimulan beads were placed beneath a free tissue flap and beneath a pedicle tissue flap in 42% of patients (n=6). In all patients, Stimulan beads were only applied once. Recurrent infections were observed in 28% of patients (n=4) at 90 days post-op, and flap nonadherence was observed in 7% (n=1). These were the only Stimulan related complications observed. Ultimately, lower limb salvage was successful in 85% of patients (n=12). Notably, there was no significant association between the preoperative presence of osteomyelitis and recurrent infections. Conclusions: The use of Stimulanantiobiotic beads to treat recalcitrant infections in patients receiving definitive skin coverage of diabetic foot wounds does not appear to demonstrate unnecessary risk. Furthermore, the lack of significance between the preoperative presence of osteomyelitis and recurrent infections indicates the successful use of Stimulan to dampen infection in patients with osteomyelitis, as is consistent with the literature. Further research is needed to identify Stimulan as the significant contributor to infection treatment using future cohort and case control studies with more patients. Nonetheless, the use of Stimulan antibiotic beads in patients with diabetic foot wounds demonstrates successful infection suppression and maintenance of definitive soft tissue coverage.

Keywords: wound care, stimulan antibiotic beads, free tissue transfer, plastic surgery, wound, infection

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Authors: Elham Saraee, Saurabh Singh, Margrit Betke

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Evaluation of a person’s posture while exercising is important in physical therapy. During a therapy session, a physical therapist or a monitoring system must assure that the person is performing an exercise correctly to achieve the desired therapeutic effect. In this work, we introduce a system called POSTURECHECK for exercise assessment in physical therapy. POSTURECHECK assesses the posture of a person who is exercising with the Proficio robotic arm while being recorded by the Microsoft Kinect interface. POSTURECHECK extracts unique features from the person’s upper body during the exercise, and classifies the sequence of postures as correct or incorrect using Bayesian estimation and majority voting. If POSTURECHECK recognizes an incorrect posture, it specifies what the user can do to correct it. The result of our experiment shows that POSTURECHECK is capable of recognizing the incorrect postures in real time while the user is performing an exercise.

Keywords: Bayesian estimation, majority voting, Microsoft Kinect, PostureCheck, Proficio robotic arm, upper body physical therapy

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Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

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Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

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Authors: Deirdre Mc Grath, Joanne Reid

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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide, with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has, in relation to this study, enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying programme theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving programme theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: exercise, ovarian cancer, co-design, implementation

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Authors: Jayden R. Hunter, Brett A. Gordon, Stephen R. Bird, Amanda C. Benson

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The World Health Organisation recognises the workplace as an important setting for exercise promotion, with potential benefits including improved employee health and fitness, and reduced worker absenteeism and presenteeism. Despite these potential benefits to both employee and employer, there is a lack of evidence supporting the long-term effectiveness of workplace exercise programs. There is, therefore, a need for better-informed programs that cater to employee exercise preferences. Specifically, workplace exercise programs should address any time, motivation, internal and external barriers to participation reported by sub-groups of employees. This study sought to compare exercise participation to perceived barriers and facilitators to workplace exercise engagement of university employees. This information is needed to design and implement wider-reaching programs aiming to maximise long-term employee exercise adherence and subsequent health, fitness and productivity benefits. An online survey was advertised at an Australian university with the potential to reach 3,104 full-time employees. Along with exercise participation (International physical activity questionnaire) and behaviour (stage of behaviour change in relation to physical activity questionnaire), perceived barriers (corporate exercise barriers scale) and facilitators to workplace exercise participation were identified. The survey response rate was 8.1% (252 full-time employees; 95% white-collar; 60% female; 79.4% aged 30–59 years; 57% professional and 38% academic). Most employees reported meeting (43.7%) or exceeding (42.9%) exercise guidelines over the previous week (i.e. ⩾30 min of moderate-intensity exercise on most days or ⩾ 25 min of vigorous-intensity exercise on at least three days per week). Reported exercise behaviour over the previous six months showed that 64.7% of employees were in maintenance, 8.3% were in action, 10.9% were in preparation, 12.4% were in contemplation, and 3.8% were in the pre-contemplation stage of change. Perceived barriers towards workplace exercise participation were significantly higher in employees not attaining weekly exercise guidelines compared to employees meeting or exceeding guidelines, including a lack of time or reduced motivation (p < 0.001; partial eta squared = 0.24 (large effect)), exercise attitude (p < 0.05; partial eta squared = 0.04 (small effect)), internal (p < 0.01; partial eta squared = 0.10 (moderate effect)) and external (p < 0.01; partial eta squared = 0.06 (moderate effect)) barriers. The most frequently reported exercise facilitators were personal training (particularly for insufficiently active employees; 33%) and group exercise classes (20%). The most frequently cited preferred modes of exercise were walking (70%), swimming (50%), gym (48%), and cycling (45%). In conclusion, providing additional means of support such as individualised gym, swimming and cycling programs with personal supervision and guidance may be particularly useful for employees not meeting recommended moderate-vigorous volumes of exercise, to help overcome reported exercise barriers in order to improve participation, health, and fitness. While individual biopsychosocial factors should be considered when making recommendations for interventions, the specific barriers and facilitators to workplace exercise participation identified by this study can inform the development of workplace exercise programs aiming to broaden employee engagement and promote greater ongoing exercise adherence. This is especially important for the uptake of less active employees who perceive greater barriers to workplace exercise participation than their more active colleagues.

Keywords: exercise barriers, exercise facilitators, physical activity, workplace health

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Authors: Riyona Chetty, Raisuyah Bhagwan, Nalini Govender

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Background: A myriad of physical, psychosocial, and environmental sequelae are associated with limb loss. However, there is a paucity of empirical South African data, which focuses on these sequelae, how they interface with the amputee’s quality of life as well as the challenges they experience following amputation. Objective: This study sought to explore the biopsychosocial effects of amputation and how amputation affected the quality of life of transtibial amputees. Setting: Participants were recruited from a medical facility, under the KwaZulu-Natal Department of Health in South Africa. Methods: A qualitative approach guided this study. Data was collected using one-on-one interviews with 14 unilateral transtibial amputees. Data was analysed thematically. Results: Five broad themes emerged from the inquiry, which captured amputees’ experiences of phantom limb pain, body image disturbances, and their challenges related to adapting to daily activities. Participants also expressed the salience of familial support as well as the importance of psychological interventions to cope. Conclusion: The findings suggested that support networks and professional psychological intervention are imperative in facilitating successful adjustment to the amputation experience. Raising awareness of limb loss in both, rural and urban settings may help reduce the stigma attached to it. Contribution: Quality of life comprises several domains, namely physical, psychological, environmental, and social albeit limited local and international data exists regarding the environmental and social effects. This study brought to the fore the positive and negative effects of amputation in each domain, as well as various strategies that facilitate successful adjustment to amputation.

Keywords: amputation, quality of life, biopsychosocial, phantom limb pain, body image, support

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Authors: James M. Geidner

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Objective: The purpose of this meta-analysis was to examine the evidence for the effectiveness of exercise interventions on reducing metabolic components in children and/or adolescents diagnosed with Paediatric Metabolic Syndrome. Methods: A computerized search was made from four databases: PubMed, PsycInfo, SPORTDiscus, Cochrane Central Register. The analysis was restricted to children and adolescents with metabolic syndrome examining the effect of exercise interventions on metabolic components. Effect size and 95% confidence interval were calculated and the heterogeneity of the studies was estimated using Cochran’s Q-statistic and I2. Bias was assessed using multiple tools and statistical analyses. Results: Thirteen studies, consisting of 19 separate trials, were selected for the meta-analysis as they fulfilled the inclusion criteria (n=908). Exercise interventions resulted in decreased waist circumference, systolic blood pressure, diastolic blood pressure, fasting glucose, insulin resistance, triglycerides, and High-Density Lipoprotein Cholesterol (HDL-C). Conclusions: This meta-analysis provides insights into the effectiveness of exercise interventions on markers of Paediatric Metabolic Syndrome in children and adolescents.

Keywords: metabolic syndrome, syndrome x, pediatric, meta-analysis

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Authors: Lucy Horrobin, Rebecca Fores

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Background: Muay Thai is an increasingly popular combat sport worldwide. Further academic research in the sport will contribute to its professional development. This research sought to produce normative data in relation to the physical and physiological characteristics of professional Muay Thai boxers, as, currently no such data exists. The ultimate aim being to inform appropriate training programs and to facilitate coaching. Methods: N = 9 professional, adult, male Muay Thai boxers were assessed for the following anthropometric, physical and physiological characteristics, using validated methods of assessment: body fat, hamstring flexibility, maximal dynamic upper body strength, lower limb peak power, upper body muscular endurance and aerobic capacity. Raw data scores were analysed for mean, range and SD and where applicable were expressed relative to body mass (BM). Results: Results showed similar characteristics to those found in other combat sports. Low percentages of body fat (mean±SD) 8.54 ± 1.16 allow for optimal power to weight ratios. Highly developed aerobic capacity (mean ±SD) 61.56 ± 5.13 ml.min.kg facilitate recovery and power maintenance throughout bouts. Lower limb peak power output values of (mean ± SD) 12.60 ± 2.09 W/kg indicate that Muay Thai boxers are amongst the most powerful of combat sport athletes. However, maximal dynamic upper body strength scores of (mean±SD) 1.14 kg/kg ± 0.18 were in only the 60th percentile of normative data for the general population and muscular endurance scores (mean±SD) 31.55 ± 11.95 and flexibility scores (mean±SD) 19.55 ± 11.89 cm expressed wide standard deviation. These results might suggest that these characteristics are insignificant in Muay Thai or under-developed, perhaps due to deficient training programs. Implications: This research provides the first normative data of physical and physiological characteristics of Muay Thai boxers. The findings of this study would aid trainers and coaches when designing effective evidence-based training programs. Furthermore, it provides a foundation for further research relating to physiology in Muay Thai. Areas of further study could be determining the physiological demands of a full rules bout and the effects of evidence-based training programs on performance.

Keywords: fitness testing, Muay Thai, physiology, strength and conditioning

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Authors: Wilawan Kanhachon, Yodchai Boonprakob, Uraiwon Chatchawan, Junichiro Yamauchi

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Introduction: Paslop is a traditional dance from Laos, which is popular in Laos and northeastern of Thailand. This unique type of Paslop dancing is to control body movement with the song. While dancing to the beat, dancers should contract their abdomen and back muscle all the time. Paslop may be a good alternative to improve strengthening, balance and flexibility. Objective: To investigate the effects of Paslop dance exercise on core strength, balance, and flexibility. Methods: Seven healthy participants (age, 20.57±1.13 yrs; height, 162.29±6.16 cm; body mass, 58.14±7.03 kg; mean± S.D.) were volunteered to perform the 45-minute Paslop dance exercise in three times a week for 8 weeks. Before, during and after the exercise period, core strength, balance and flexibility were measured with the pressure biofeedback unit (PBU), one-leg stance test (OLST), and sit and reach test (SAR), respectively. Result: PBU score for core strength increased from 2.12 mmHg in baseline to 6.34 mmHg at the 4th week and 10.10 mmHg at the 8th week after the Paslop dance training, while OLST and SAR did not change. Conclusion: The study demonstrates that 8-week Paslop dancing exercise can improve the core strength.

Keywords: balance, core strength, flexibility, Paslop

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Authors: Samira Mehrabi

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Geriatric depression is a common late-life mental health disorder that increases morbidity and mortality. It has been shown that exercise is effective in alleviating symptoms of geriatric depression. However, inconsistencies across studies and lack of optimal dose-response of exercise for improving geriatric depression have made it challenging to draw solid conclusions on the effectiveness of exercise in late-life depression. Purpose: To further investigate the moderators of the effectiveness of exercise on geriatric depression across the current body of evidence. Methods: Based on the Arksey and O’Malley framework, an extensive search strategy was performed by exploring PubMed, Scopus, Sport Discus, PsycInfo, ERIC, and IBSS without limitations in the time frame. Eight systematic reviews with empirical results that evaluated the effect of exercise on depression among people aged ≥ 60 years were identified and their individual studies were screened for inclusion. One additional study was found through the hand searching of reference lists. After full-text screening and applying inclusion and exclusion criteria, 21 studies were retained for inclusion. Results: The review revealed high variability in characteristics of the exercise interventions and outcome measures. Sample characteristics, nature of comparators, main outcome assessment, and baseline severity of depression also varied notably. Mind-body and aerobic exercises were found to significantly reduce geriatric depression. However, results on the relationship between resistance training and improvements in geriatric depression were inconsistent, and results of the intensity-related antidepressant effects of exercise interventions were mixed. Extensive use of self-reported questionnaires for the main outcome assessment and lack of evidence on the relationship between depression severity and observed effects were of the other important highlights of the review. Conclusion: Several literature gaps were found regarding the potential effect modifiers of exercise and geriatric depression. While acknowledging the complexity of establishing recommendations on the exercise variables and geriatric depression, future studies are required to understand the interplay and threshold effect of exercise for treating geriatric depression.

Keywords: exercise, geriatric depression, healthy aging, older adults, physical activity intervention, scoping review

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Authors: Alexandra Von Guionneau, William Sloper, Charlotte Burford

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The benefits of exercise for the prevention and management of chronic disease are well established and the importance of primary care practitioners in promoting exercise is becoming increasingly recognized. However, those with severe manifestations of the chronic disease are managed in a secondary care setting. Secondary care practitioners, therefore, have a role to play in promoting physical activity. Methods: In order to assess secondary care doctors’ knowledge of the Chief Medical Officer’s guidelines for physical activity, a 12-question survey was administered to staff working in a district general hospital in South England during team and unit meetings. Questions related to knowledge of the current guidelines for both 19 - 64 year olds and older adults (65 years and above), barriers to exercise discussion or prescription and doctors’ own exercise habits. Responses were collected anonymously and analyzed using SPSS Version 24.0. Results: 96 responses were collected. Doctors taking part in the survey ranged from foundation years (26%) to consultants (40%). 17.7% of participants knew the guidelines for moderate intensity activity for 19 - 64 year olds. Only one participant knew all of the guidance for both 19 - 64 year olds and older adults. While 71.6% of doctors felt they were adequately informed about how to exercise, only 45.6% met the minimum recommended guidance for moderate intensity activity. Conclusion: More work is needed to promote the physical activity guidelines and exercise prescription to doctors working within a secondary care setting. In addition, doctors require more support to personally meet the recommended minimum level of physical activity.

Keywords: exercise is medicine, exercise prescription, physical activity guidelines, exercise habits

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Authors: D. Maryama AG. Daud, Zuliana Bacho, Stephanie Chok, DG. Mashitah PG. Baharuddin, Mohd Hatta Tarmizi, Nathira Abdul Majeed, Helen Lasimbang

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Lifestyle, physical activity, food intake, genetics and medication are contributing factors for people getting obese. Which in some of the obese people were a low or non-responder to exercise. And obesity is very common clinical feature in women affected by Polycystic Ovarian Syndrome (PCOS). Labisia pumila var. alata (LP) is a local herb which had been widely used by Malay women in treating menstrual irregularities, painful menstruation and postpartum well-being. Therefore, this study was carried out to investigate the effect of LP with a structured exercise program on anthropometric, body composition and physical fitness performance of PCOS patients. By using a single blind and parallel study design, where by subjects were assigned into a 16-wk structured exercise program (3 times a week) interventions; (LP and exercise; LPE, and exercise only; E). All subjects in the LPE group were prescribed 200mg LP; once a day, for 16 weeks. The training heart rate (HR) was monitored based on a percentage of the maximum HR (HRmax) achieved during submaximal exercise test that was conducted at wk-0 and wk-8. The progression of aerobic exercise intensity from 25–30 min at 60 – 65% HRmax during the first week to 45 min at 75–80% HRmax by the end of this study. Anthropometric (body weight, Wt; waist circumference, WC; and hip circumference, HC), body composition (fat mass, FM; percentage body fat, %BF; Fat Free Mass, FFM) and physical fitness performance (push up to failure, PU; 1-minute Sit Up, SU; and aerobic step test, PVO2max) were measured at wk-0, wk-4, wk-8, wk-12, and wk-16. This study found that LP does not have a significant effect on body composition, anthropometric and physical fitness performance of PCOS patients underwent a structured exercise program. It means LP does not improve exercise responses of PCOS patients towards anthropometric, body composition and physical fitness performance. The overall data shows exercise responses of PCOS patients is by increasing their aerobic endurance and muscle endurance performances, there is a significant reduction in FM, PBF, HC, and Wt significantly. Therefore, exercise program for PCOS patients have to focus on aerobic fitness, and muscle endurance.

Keywords: polycystic ovarian syndrome, Labisia pumila var. alata, body composition, aerobic endurance, muscle endurance, anthropometric

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Authors: Hacer Unver, Rukuye Aylaz

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Aim: This study was conducted in order to determine the effects of exercising on quality of life in pregnancy. Material and Method: The population of the study was formed by 580 pregnants who were registered to 10 Family Health Center located in the city center of Malatya. The sample of the study, on the other hand, was formed by 230 pregnants who had minimal sample size according to known population sample size calculation. The data of this descriptive study was collected between October 2013 and September 2014 from the Family Health Centers located in the city center of Malatya. The data were collected using pregnant introductory form, exercise benefit and barrier scale, quality of life scale. Percentage distributions, t-test, Variance Analysis (ANOVA), Kruskal-Wallis, Mann-Whitney U and Pearson Correlation tests were used in the analysis of the data. Result: It was determined that 69.1% of the pregnants participating to the study did not know the benefits of exercising and 89.6% did not exercise. Quality of life mental health scores of those who exercised were determined to be higher and statistically significant (p<0.05). A positive correlation was determined between the exercise benefit scala and physical quality of life scores of the pregnants in this study (0.268, p=0.001). It was also detected that the more exercise performed led to higher total quality of life scores. Conclusion: In consequence, exercising was determined to positively affect the quality of life in pregnants. Therefore, it is recommended that nurses should give education regarding the importance and benefits of exercise during pregnancy in order to increase the quality of life.

Keywords: exercise, midwife, pregnant woman, quality of life

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Authors: M. Nasiri

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Aim: Considering the hypoglisimic ad hipolipidimic effect of the fenugreek seed and aerobic exercise training, this study was conducted to evaluate the effect of fenugreek and aerobic exercise training on insulin resistance in women with type 2 diabetes. Methodology: 32 patients with type II diabetes were selected and randomly divided into four groups: control, fenugreek, training and fenugreek - training. Fenugreek groups used 10 grams of fenugreek seeds daily for eight weeks on two occasions before noon and evening meal. Training of groups is also performed a regular program of aerobic exercise 65-55% of maximum heart rate (4 days per week).Two days before and after the training period, blood samples were taken from their brachial veins in a fasting state (12 hours prior to the test) in a sitting position. The data was analyzed used of t-independent and ANOVA at a significance level of α < 0.05. Results: Intra-group changes in all experimental groups showed that significant decrease insulin resistance, and the difference between groups showed significant difference between the groups of fenugreek - training than other groups there. Conclusions: According to the research findings to fenugreek combined with aerobic exercise more beneficial effect on the inhibition of insulin resistance in women with diabetes are recommended to them.

Keywords: fenugreek, training, insulin resistance, diabetes

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Authors: Ismail Okur, Betul Taspinar, Turkan Pasali Kilit, Eda O. Okur, Ferruh Taspinar

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Type 2 Diabetes Mellitus (T2DM) is one of the most important global health emergencies and every year more and more people are affected by T2DM. T2DM causes life-changing complications by affecting organ and systems. Although diet and exercise are the best way to treat patients with T2DM, those patients generally have a sedentary life style. This study was planned to determine whether patients with T2DM have kinesiophobia (fear of movement). A controlled trial was conducted on 87 adults. Forty-one individuals with T2DM (study group, 34 female and 7 male) and 46 nondiabetic individuals (control group, 39 female and 7 male) were included in the study. Patients were screened for fear of movement using the Tampa Scale for Kinesiophobia (TSK). The data including age, sex, weight, height, and TSK scores were obtained. Mann Whitney U test were used to analyse the data. The mean ages and BMI of study and control groups were 51.98 ± 6.03 year and 49.52 ± 5.61 year and 31.82 ± 2.88 kg/m2 and 30.22 ± 2.91 kg/m2, respectively. The groups have similar demographic properties. The kinesiophobia scores of study and control groups were 42.78 ± 5.50 and 39.48 ± 5.05, respectively and the difference was statistically significant (p=0.05). This study showed that patients with T2DM had high kinesiophobia scores rather than nondiabetics. Those patients might avoid to do exercise. In other words, patients with T2DM might have lower physical activity level. Therefore the authors suggest that to evaluate and interfere with kinesiophobia before conducting exercise therapy will be useful for diabetes care.

Keywords: diabetes, fear of movement, kinesiophobia, type 2 diabetes mellitus

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Authors: F. Arslan, S.D. Guven, A. Özcan, H. Vatansev, Ö. Taşgin

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Weight, hypertension and dyslipidemia control and increased physical activity are required for the treatment of metabolic syndrome (METS). The purpose of this study was to investigate the effect of core exercise, reflexology and intake chrome picolinate on METS. This study comprised a twelve-week randomized controlled trial. A total of 25 university workers with metabolic risk factors participated in this study voluntarily. They were randomly divided into three groups: Those undertaking a core exercise program (n=7), reflexology intervention group (n=8) and intake chrome group (n=10). The subjects took part in a core exercise program for one hour per day, three days a week and a reflexology interfered for thirty minutes per day, one days a week and chrome group took chrome picolinate every day in week for twelve weeks. The components of metabolic syndrome were analyzed before and after the completion of all the intervention. There were significant differences at pre-prandial blood glucose in the core exercise group and at systolic blood pressure in chrome group after the twelve week interventions (p < 0.005). While High Density Lipoprotein (HDL) excluding the components of METS decreased after the interventions on the all groups; levels of HDL and the other components of METS decreased in reflexology group. There was a clear response to the twelve-week interventions in terms of METS control. Besides, the reflexology intervention should not be applied to individuals with low HDL levels and core exercise and intake chrome picolinate suggested to improve the components of METS.

Keywords: blood pressure, body mass index, exercise, METS, pre-prandial blood glucose

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Authors: Chung Hyun Goh, Armin Yazdanshenas, X. Neil Dong, Yong Tai Wang

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Physical rehabilitation is a necessary step in regaining lower body function after a partial paralysis caused by a spinal cord injury or a stroke. The purpose of this paper is to present the development and optimization of a training device that accurately recreates the motions in a gait cycle with the goal of rehabilitation for individuals with incomplete spinal cord injuries or who are victims of a stroke. A functional electrical stimulator was used in conjunction with the training device to stimulate muscle groups pertaining to rehabilitative walking. The feasibility and reliability of the design are presented. To validate the design functionality, motion analyses of the knee and ankle gait paths were made using motion capture systems. Key results indicate that the robotic walking training device provides a viable mode of physical rehabilitation.

Keywords: functional electrical stimulation, rehabilitative walking, robotic walking training device, spinal cord injuries

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Authors: W. T. Hsu, H. L. Tsai

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The rapid aging of the population is a common trend in the world. However, the progress of modern medical technology has increased the average life expectancy. The global population structure has changed dramatically, and the elderly population has risen rapidly. In the face of rapid population growth, it must be noted issues of the aging population must face up to, which are the physiological, psychological, and social problems associated with aging. This study aims to investigate how insurance agents are actively dealing with an aging society, their own aging anxiety, and their exercise habits. Purposive sampling was the sampling method of this study, a total of 204 respondents were surveyed and 204 valid surveys were returned. The returned valid ratio was 100%. Statistical method included descriptive statistics, t-test, and one-way ANOVA. The results of the study found that the insurance agent’s age, seniority, exercise habits to aging anxiety are significantly different.

Keywords: insurance practitioners, aging anxiety, exercise habits, elderly

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Authors: Yesoda Bhargava

Abstract:

This work is an ongoing research on understanding the existence or the non-existence of infrastructure for fitness for physically challenged people in India. Through the extensive field visits, interviews with differently abled people and observation of the schools for differently abled children, there have been some common observations in the realm of paucity of appropriate machinery, exercise physiologists and infrastructure catering to the fitness needs of physically challenged people in India both for adults and children. Amidst the more tangibly seen health issues, this crucial change which can better the life of physically challenged people is not given the due consideration at the national scale. The results of this study can be used to influence the policy making and program making related to inclusive health in India. Health and fitness are inextricably linked to each other, and one cannot be served at the cost of other. One of the other objectives of this paper is to create a traction for the importance of exercise promotion for the physically challenged people.

Keywords: fitness, health, inclusive health, exercise physiologists

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Authors: Majid Mardaniyan Ghahfarokhi, Abdolhamid Habibi, Majid Mohammad Shahi

Abstract:

The combination of exercise and diet as the most important strategy to reduce weight and control obesity-related factors, including Irisin, Insulin, and Glucose was raised. The aim of this study was to investigate the effect of aerobic exercise combined with four different diets on serum levels of Irisin, Insulin, and Glucose in overweight men. Methods: In this quasi-experimental study, 8 overweight men (BMI 29.23±0.47) with average age of (23±1.6) voluntarily participated in 4 sessions by one-week interval. The study was done in exercise physiology lab. In each session, subjects performed a 30 minutes treadmill test with 60-70% of maximum heart rate, after consuming a high carbohydrate, high-fat, high-protein and normal diet. For biochemical measurement, three blood samples were taken in fasting state, two hours after meals and after exercise Results: Statistical analysis of data showed that the serum levels of Irisin after consumption all four diets had been reduced which this reduce as a result of high-fat diet that were significantly (p ≤ 0/038). Serum concentration of Insulin and Glucose increased after consuming four diets. However, increase in serum Insulin and Glucose was significant only after consuming high-carbohydrate diet (Respectively p ≤ 0/001, p ≤ 0/042). In addition, during exercise after consuming all four regular diet, high carbohydrate, high-protein and high-fat, Irisin significant increased significantly (Respectively p ≤ 0/021, p ≤ 0/049, p ≤ 0/001, P ≤ 0/003), Insulin decreased significantly (Respectively p ≤ 0/002, p ≤ 0/001, p ≤ 0/001, p ≤ 0/002) and Glucose were significantly reduced (Respectively p ≤ 0/001, p ≤ 0/001, P ≤ 0/001, p ≤ 0/002). After aerobic activity following the consumption of a high protein diet the highest increase in irisin levels, and after aerobic exercise following consumption of high carbohydrate diet the greatest decrease in insulin and glucose levels were observed. Conclusion: It seems that diet alone and exercises following different consumption diets can have a significant effect on Irisin, Insulin, and Glucose serum levels in overweight young men.

Keywords: acute aerobic exercise, diet, irisin, overweight

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Authors: Mehmet Yanardag, Ilker Yilmaz

Abstract:

Children with autism spectrum disorders (ASD) enjoy and success the aquatic-based exercise and play skills in a pool instead of land-based exercise in a gym. Some authors also observed that many children with ASD experience more success in attaining movement skills in aquatic environment. Properties of the water and hydrodynamic principles cause buoyancy of the water and decrease effects of gravity and it leads to allow a child to practice important aquatic skills with limited motor skills. Also, some authors experience that parents liked the effects of the aquatic intervention program on children with ASD such as improving motor performance, movement capacity and learning basic swimming skills. The purpose of this study was to investigate the effects of aquatic exercise training on water orientation and underwater working capacity were measured in the pool. This study included in four male children between 5 and 7 years old with ASD and 6.25±0.5 years old. Aquatic exercise skills were applied by using one of the error less teaching which is called the 'most to least prompt' procedure during 12-week, three times a week and 60 minutes a day. The findings of this study indicated that there were improvements test results both water orientation skill and underwater working capacity of children with ASD after 12-weeks exercise training. It was seen that the aquatic exercise intervention would be affected to improve working capacity and orientation skills with the special education approaches applying children with ASD in multidisciplinary team-works.

Keywords: aquatic, autism, orientation, ASD, children

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Authors: J. A. Batsis, G. G. Boateng, L. M. Seo, C. L. Petersen, K. L. Fortuna, E. V. Wechsler, R. J. Peterson, S. B. Cook, D. Pidgeon, R. S. Dokko, R. J. Halter, D. F. Kotz

Abstract:

Resistance exercise bands are a core component of any physical activity strengthening program. Strength training can mitigate the development of sarcopenia, the loss of muscle mass or strength and function with aging. Yet, the adherence of such behavioral exercise strategies in a home-based setting are fraught with issues of monitoring and compliance. Our group developed a Bluetooth-enabled resistance exercise band capable of transmitting data to an open-source platform. In this work, we developed an application to capture this information in real-time, and conducted three usability studies in two mixed-aged groups of participants (n=6 each) and a group of older adults with obesity participating in a weight-loss intervention (n=20). The system was favorable, acceptable and provided iterative information that could assist in future deployment on ubiquitous platforms. Our formative work provides the foundation to deliver home-based monitoring interventions in a high-risk, older adult population.

Keywords: application, mHealth, older adult, resistance exercise band, sarcopenia

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Authors: Ying-Yi Laio, Yea-Ru Yang, Yih-Ru Wu, Ray-Yau Wang

Abstract:

Background: Virtual reality (VR) systems are proved to increase motor performance in stroke and elderly. However, the effects have not been established in patients with Parkinson’s disease (PD). Purpose: To examine the effects of VR based training in improving muscle strength, sensory integration ability and walking abilities in patients with PD by a randomized controlled trial. Method: Thirty six participants with diagnosis of PD were randomly assigned to one of the three groups (n=12 for each group). Participants received VR-based Wii Fit exercise (VRWii group) or traditional exercise (TE group) for 45 minutes, followed by treadmill training for another 15 minutes for 12 sessions in 6 weeks. Participants in the control group received no structured exercise program but fall-prevention education. Outcomes included lower extremity muscle strength, sensory integration ability, walking velocity, stride length, and functional gait assessment (FGA). All outcomes were assessed at baseline, after training and at 1-month follow-up. Results: Both VRWii and TE groups showed more improvement in level walking velocity, stride length, FGA, muscle strength and vestibular system integration than control group after training and at 1-month follow-up. The VRWii training, but not the TE training, resulted in more improvement in visual system integration than the control. Conclusions: VRWii training is as beneficial as traditional exercise in improving walking abilities, sensory integration ability and muscle strength in patients with PD, and such improvements persisted at least for 1 month. The VRWii training is then suggested to be implemented in patients with PD.

Keywords: virtual reality, walking, sensory integration, muscle strength, Parkinson’s disease

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Authors: R. M. Chandler, A. J. Stringer

Abstract:

In adults, short bursts of high-intensity exercise (intensities between 80-95% of maximum heart rates) increase cardiovascular and metabolic function without the time investment of traditional aerobic training. Similar improvements in various health indices are also becoming increasingly evident in children in countries other than the United States. In the United States, physical education programs have become shorter in length and fewer in frequency. With this in the background, it is imperative that health and physical educators delivered well-organized and focused fitness programs that can be tolerated across many different somatotypes. Perhaps the least effective lag-time in a US physical education (PE) class is the first 10 minutes, a time during which children warm up. Replacing a traditional PE warmup with a 10 min high-intensity excise protocol is a time-efficient method to impact health, leaving as much time for other PE material such as skill development, motor behavior development as possible. This supplemented 10 min high-intensity exercise increases cardiovascular function as well as induces favorable body composition changes in as little as six weeks with further enhancement throughout a semester of activity. The supplemental high-intensity exercise did not detract from the PE lesson outcomes.

Keywords: cardiovascular fitness, high intensity interval training, high intensity exercise, pediatric

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Authors: Mohammad Soltani, Ayoub Saeidi, Nikoo Khosravi, Hanieh Nohbaradar, Seyedeh Parya Barzanjeh, Hassane Zouhal

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Exercise training and herbs supplement represent have role in the treatment for patients with type 2 diabetes (T2D). However, it is unclear combined effects of exercise training and herbs supplements on diabetic risk markers. This study aimed to determine the effect of 12 weeks of combined exercise and broccoli supplementation on decitin-1 and insulin resistance in men with type 2 diabetes. Forty-four type 2 diabetes men (age, 48.52 ± 4.36) were randomly allocated to training -supplement (TS, n = 11), training- placebo (TP, n = 11), supplement (S, n = 11) and control- placebo (CP, n = 11) groups. The combined exercise program included 12 weeks, three sessions per week, that each session contained 45 minutes of resistance training with intensity 60-70% of one maximal repetition and 30 minutes aerobic training (running) with intensity 60-70% of maximum heart rate. In addition supplement groups consumed 10 grams of Broccoli per day for 12 weeks. Plasma Decitin-1, HOMA-IR, Insulin, glucose and body composition were assessed before and after training. Plasma Dectin-1, HOMA-IR, glucose and BMI significantly decreased in TS, TP and S groups compared with CP group (P < .05). In addition Insulin and skeletal muscles mass showed significant increase in TS and TP groups compared with S and CP groups (P < .05). It is concluded that both combined exercise training (aerobic-resistance) or broccoli supplement can improve plasma Decitin-1 and insulin resistance in two diabetic patients however combine of exercise training and broccoli supplement have more effective on these markers.

Keywords: broccoli supplements, combined training, decitin-1, insulin resistance, type 2 diabetes

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Authors: Amlan Datta

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Dengue is an arboviral, vector borne infection, quite prevalent in tropical countries such as India. Approximately, 1 to 25% of cases may give rise to neurological complication, such as, seizure, delirium, Guillian-Barre syndrome (GBS), multiple cranial nerve palsies, intracranial thrombosis, stroke-like presentations, to name a few. Dengue fever, as an antecedent to GBS is uncommon, especially in adults.Here, we report a case about a middle aged lady who presented with an acute onset areflexic ascending type of polyradiculoneuropathy along with bilateral lower motor neuron type of facial nerve palsy, as well as abducens and motor component of trigeminal (V3) weakness. Her respiratory and neck muscles were spared. She had an established episode of dengue fever (NS1 and dengue IgM positive) 7 days prior to the weakness. Nerve conduction study revealed a demyelinating polyradiculopathy of both lower limbs and cerebrospinal fluid examination showed albuminocytological dissociation. She was treated with 5 days of intravenous immunoglobulin (IVIg), following which her limb weakness improved considerably. This case highlights GBS as a potential complication following dengue fever.

Keywords: areflexic, demyelinating, dengue, polyradiculoneuropathy

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Authors: Katarzyna Kwiatkowska, Izabela Walasik, Katarzyna Kosińska-Kaczyńska, Olga Płaza, Kinga Żebrowska

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Introduction Adequate physical activity of a pregnant woman has been proven to decrease the risk of pregnancy complications. The knowledge of women regarding physical exercise in pregnancy is a part of conscious motherhood, while a lack of it may lead to not taking up any form of physical activity during pregnancy. Aim: The aim of the study was to assess the knowledge and experience of women regarding physical activity during their latest pregnancy. Material and methodology: An anonymous questionnaire, consisting of 57 questions, was completed electronically in 2018 by women who gave birth at least once. The respondents were qualified as 'physically active during pregnancy' if they performed physical exercises such as regular walks, marching, jogging, working out at a gym, swimming, yoga, pilates, fitness, exercise-ball workouts or home gymnastics. Results: The study group consisted of 9345 women. 52% of them performed exercises during pregnancy. The main reasons for the lack of physical activity were: lack of interest in physical activity (45%), lack of energy (40%), lack of knowledge regarding proper exercise during pregnancy (34%), lack of time (27%) and medical contraindications (25%). Non-active respondents suffered from gestational hypertension (6,7% vs 9,2%; p<00,1) and gave birth prematurely (11% vs 15%; p < 001) to newborns with a lower birth weight significantly more often ( < 2500g vs > 2500g; p < 0,001). Physically active women reported suffering from pregnancy-related ailments such as fatigue, back pain or constipation significantly less often. 22% of all respondents were unable to identify reliable sources of information regarding exercise during pregnancy. A majority of the exercising women used the Internet to obtain gain information on physical activity during pregnancy (69,1%). 4% of women thought that exercising during pregnancy is forbidden, while 20% thought it is not allowed in the 3rd trimester. Physically active women had vaginal delivery more often (61% vs 55%; p < 0,05). Episiotomy was performed most often on non-active primiparous respondents (77,5% vs 71% active primiparous, p < 0,001). 13% of women felt discriminated due to their physical activity during pregnancy. 22% of respondents’ physical activity was not accepted by their environment. 39,1% of the women were told by others to stop physical exercise because it was bad for the baby’s health. Conclusion: The knowledge of Polish women regarding proper physical activity during pregnancy is insufficient, which may influence a lack of will to initiate such activity among pregnant women. Physical activity of a pregnant woman may have an impact on the course of pregnancy and birth.

Keywords: childbirth, discrimination, physical activity, pregnancy

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Authors: M. Wisnu Pamungkas, Patrianef Darwis

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Introduction: Critical limb ischemia (CLI) is a vascular disease that has a significant amputation and mortality risk with diabetes mellitus, the most significant risk factor in CLI, is very common among Indonesian. Endovascular intervention (EVI) is preferred in treating CLI because it is noninvasive and effective. Balloon angioplasty and stent angioplasty are the most common method of EVI in Indonesia. This study aims to compare the effectiveness of balloon angioplasty and stent angioplasty on wound healing in CLI. Method: A cross-sectional study enrolled 90 subjects of CLI who underwent endovascular intervention using balloon angioplasty and stent angioplasty from January 2013 to July 2017 in dr. Cipto Mangunkusumo General Hospital, Jakarta. The wound healing period between balloon angioplasty dan stent angioplasty was analyzed using unpaired T-test with p<0,05 considered as statistically significant. Data of intervention method wound healing period, and subjects characteristic data (age, amputation, BMI, smoking habit, DM, occlusion site, and blood profile) were obtained. Result: The wound healing period in balloon angioplasty and stent angioplasty distributed normally. Mean value of wound healing period in balloon angioplasty and stent angioplasty are 84,8+/-2,423 and 59,93 +/- 2,423 days with a mean difference of 25 days. The difference in wound healing period in both groups is statically significant (p<0,05). The amputation event in balloon angioplasty and stent angioplasty is 22 and 16 event with no difference statistically. Conclusion: Stent angioplasty is a better method than balloon angioplasty for wound healing in patients with CLI.

Keywords: critical limb ischemia, endovascular intervention, wound healing, angioplasty

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Authors: Dalila Chaid, Yacine Houmel, Mohamed Lamine Belloulou

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Peripheral neuropathy is a rare but worrying complication of peripheral local anaesthesia. It is caused either by needle contact with the nerve root or by the direct toxicity of local anaesthetics, leading to nerve damage, injury or irritation. Although uncommon, it remains a major concern for anaesthetists. The aim of the study was to assess the prevalence of nerve block-associated neuropathy in knee surgery and to identify the contributing factors in order to minimise the occurrence of this complication. The study also assessed the severity and evolution of lesions, as well as the factors leading to neuropathic pain. Methodology: It is a retrospective observational study on cases of neuropathy related to nerve blocks of the lower limb for knee surgery over a period of seven years (2016-2022). The study included a total of 6,000 patients Analyse the anaesthetic and neuropathic pain-related parameters received from these patients to determine the prevalence and severity of neuropathy. Findings: the prevalence of nerve block-related neuropathy in our study is 5.8‰ for the sciatic nerve and 0.9‰ for the femoral nerve. This was higher compared to the reported rates in the literature, which were between 0.0 to 5‰ for the Sciatic nerve and 0.0 to 3.4‰ for the femoral nerve. These findings highlight the importance of identifying and implementing an ideal anesthesia procedure to reduce the risk of neuropathy associated with nerve blocks. Theoretical Importance: The findings of this study contribute to the existing literature on peripheral neuropathy following locoregional anesthesia. By identifying the prevalence and severity of neuropathy related to nerve blocks, as well as the underlying factors, we provide valuable insights for anesthetists to improve patient safety. This study also emphasizes the need for compliance with technical safety rules to minimize the occurrence of neuropathy. Data Collection and Analysis Procedures: For this study, 25 clinics with retrospective data were collected of neuropathy associated with nerve blocks for knee surgery over a span of seven years. Parameters related to anaesthesia and neuropathic pain were analysed to determine prevalence,severity, and progression of neuropathy. Comparison of our results with the existing literature in order to assess their significance. Questions Addressed: This study aims to define the following points: 1. The prevalence of neuropathy associated with nerve blocks for knee surgery. 2. The factors underlying the development of neuropathy after nerve blocks. 3. Reducing the risk of neuropathy by complying with technical safety rules. 4. Assessing the severity and evolution of neuropathic pain in these cases. Conclusion: this study highlights the need for careful consideration and implementation of anesthesia procedures during nerve blocks for knee surgery. The prevalence of neuropathy linked to these blocks was higher compared to the literature, emphasizing the importance of identifying and minimizing contributing factors. Compliance with technical safety rules is crucial to reduce the risk of peripheral neuropathy. This study provides valuable insights to anesthetists and contributes to improving patient safety in the field of locoregional anesthesia.

Keywords: phantom limb, neuropathic pain, lower limb amputee, ultrasound-guided locoreginal anesthesia

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