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Journal of Affective Disorders Nov 2023The rapid pace of life nowadays has seen a gradual increase in public involvement in weekend warrior (WW), a physical activity (PA) pattern that allows people to...
Whether weekend warrior activity and other leisure-time physical activity pattern reduce the risk of depression symptom in the representative adults? A population-based analysis of NHANES 2007-2020.
BACKGROUND
The rapid pace of life nowadays has seen a gradual increase in public involvement in weekend warrior (WW), a physical activity (PA) pattern that allows people to exercise once or twice a week, the recommended moderate-to-vigorous PA per week, since regular PA takes much time. We aim at exploring the effect of WW activity and other PA patterns on depression symptoms in U.S adults.
METHODS
The level of PA was measured by self-reporting activity patterns, (inactive, insufficiently active, WW and regularly active). Participants with Patient Health Questionnaire-9 (PHQ-9) scores above 10 are considered to have depression symptoms.
RESULTS
A weighted sample of 23,258 participants representing 1049.8 million non-institutionalized U.S adults aged from 20 to 80. Compared with the inactive group, general adults who met the PA guidelines with PA once or twice per week [WW, adjusted odds ratio (AOR) = 0.790, 95%CI: 0.638, 0.987] or more frequent PA [Regularly active, (AOR = 0.761, 95%CI: 0.671, 0.864)], were inversely associated with depression symptoms, while the association has not been observed in adults with insufficiently active PA (AOR = 0.892, 95%CI: 0.783, 1.017). Increase in minutes, sessions and intensity of PA in regularly active and WW groups brought additional benefits for depression symptoms.
CONCLUSION
WW and other equivalent PA intensities patterns may be sufficient to reduce the risk of depression symptom. With the same recommended levels of PA, whether spread over the week or done in fewer days, adults may achieve the same benefits.
Topics: Humans; Adult; Nutrition Surveys; Depression; Motor Activity; Exercise; Leisure Activities
PubMed: 37543116
DOI: 10.1016/j.jad.2023.07.113 -
Journal of the American Medical... Feb 2024To investigate the effect of an exercise program on falls in intermediate and high-level long-term care (LTC) residents and to determine whether adherence, physical... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To investigate the effect of an exercise program on falls in intermediate and high-level long-term care (LTC) residents and to determine whether adherence, physical capacity, and cognition modified outcomes.
DESIGN
Randomized controlled trial.
SETTING AND PARTICIPANTS
Residents (n = 520, aged 84 ± 8 years) from 25 LTC facilities in New Zealand.
METHODS
Individually randomized to Staying UpRight, a physical therapist-led, balance and strength group exercise program delivered for 1 hour, twice weekly over 12 months. The control arm was dose-matched and used seated activities with no resistance. Falls were collected using routinely collected incident reports.
RESULTS
Baseline fall rates were 4.1 and 3.3 falls per person-year (ppy) for intervention and control groups. Fall rates over the trial period were 4.1 and 4.3 falls ppy respectively [P = .89, incidence rate ratio (IRR) 0.98, 95% CI 0.76, 1.27]. Over the 12-month trial period, 74% fell, with 63% of intervention and 61% of the control group falling more than once. Risk of falls (P = .56, hazard ratio 1.08, 95% CI 0.85, 1.36) and repeat falling or fallers sustaining an injury at trial completion were similar between groups. Fall rates per 100 hours walked did not differ between groups (P = .42, IRR 1.15, 95% CI 0.81, 1.63). Program delivery was suspended several times because of COVID-19, reducing average attendance to 26 hours over 12 months. Subgroup analyses of falls outcomes for those with the highest attendance (≥50% of classes), better physical capacity (Short Physical Performance Battery scores ≥8/12), or cognition (Montreal Cognitive Assessment scores ≥ 18/30) showed no significant impact of the program.
CONCLUSIONS/IMPLICATIONS
In intermediate and high-level care residents, the Staying UpRight program did not reduce fall rates or risk compared with a control activity, independent of age, sex, or care level. Inadequate exercise dose because of COVID-19-related interruptions to intervention delivery likely contributed to the null result.
Topics: Aged; Humans; Accidental Falls; COVID-19; Exercise; Exercise Therapy; Long-Term Care; Aged, 80 and over
PubMed: 38042173
DOI: 10.1016/j.jamda.2023.10.022 -
Journal of Neurophysiology Nov 2021Many goal-directed actions that require rapid visuomotor planning and perceptual decision-making are affected in older adults, causing difficulties in execution of many...
Many goal-directed actions that require rapid visuomotor planning and perceptual decision-making are affected in older adults, causing difficulties in execution of many functional activities of daily living. Visuomotor planning and perceptual identification are mediated by the dorsal and ventral visual streams, respectively, but it is unclear how age-induced changes in sensory processing in these streams contribute to declines in visuomotor decision-making performance. Previously, we showed that in young adults, task demands influenced movement strategies during visuomotor decision-making, reflecting differential integration of sensory information between the two streams. Here, we asked the question if older adults would exhibit deficits in interactions between the two streams during demanding motor tasks. Older adults ( = 15) and young controls ( = 26) performed reaching or interception movements toward virtual objects. In some blocks of trials, participants also had to select an appropriate movement goal based on the shape of the object. Our results showed that older adults corrected fewer initial decision errors during both reaching and interception movements. During the interception decision task, older adults made more decision- and execution-related errors than young adults, which were related to early initiation of their movements. Together, these results suggest that older adults have a reduced ability to integrate new perceptual information to guide online action, which may reflect impaired ventral-dorsal stream interactions. Older adults show declines in vision, decision-making, and motor control, which can lead to functional limitations. We used a rapid visuomotor decision task to examine how these deficits may interact to affect task performance. Compared with healthy young adults, older adults made more errors in both decision-making and motor execution, especially when the task required intercepting moving targets. This suggests that age-related declines in integrating perceptual and motor information may contribute to functional deficits.
Topics: Adolescent; Adult; Age Factors; Aged; Aging; Decision Making; Female; Humans; Male; Middle Aged; Motor Activity; Psychomotor Performance; Visual Perception; Young Adult
PubMed: 34614375
DOI: 10.1152/jn.00073.2021 -
Seminars in Arthritis and Rheumatism Aug 2021To assess how patient characteristics and study design influence the effectiveness of control interventions in hand OA trials. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess how patient characteristics and study design influence the effectiveness of control interventions in hand OA trials.
METHODS
The study protocol was registered in PROSPERO (CRD42020163473). Two authors independently searched four electronic databases from their inception to December 31, 2019. Randomized and non-randomized controlled hand OA trials were included if pain intensity was assessed using a validated scale. We allocated control groups into one of the following: placebo, add-on treatment, no treatment, or active treatment. The standardized mean differences (d) of pain, as well as subjective function and hand strength, were pooled with 95% confidence intervals (CI) and 90% prediction intervals using random-effects models. Meta-regression and post-hoc subgroup analyses were performed to investigate which factors potentially impacted placebo analgesia and between-study heterogeneity.
RESULTS
Thirty-one placebo, 11 add-on, 12 no-treatment, and 10 active-treatment controls were included in meta-analyses. Effective pain relief was observed in placebo (d = -0.50, 95% CI -0.63 to -0.37), add-on (d = -0.35, 95% CI -0.59 to -0.12), and active-treatment (d = -0.92, 95% CI -1.35 to -0.48) groups. In subjective function, these treatments had smaller but beneficial effects; hand strength, contrastingly, was not improved. Placebo effects were larger when flare designs were used (d = -0.96) and more homogeneous when minimum pain thresholds were set (d = -0.46, 90% prediction intervals -0.79 to -0.14).
CONCLUSION
Placebo, add-on, and active control treatments were more effective than the no treatment control in relieving hand pain and improving subjective function. By choosing minimum pain thresholds and flare requirements at patient enrollment, moderate pain relief may be replicated among control participants in future randomized placebo-controlled trials.
Topics: Control Groups; Hand; Humans; Osteoarthritis; Pain; Randomized Controlled Trials as Topic
PubMed: 34146952
DOI: 10.1016/j.semarthrit.2021.04.006 -
Brain Injury Oct 2020Interventions are needed to address chronic health conditions, such as obesity and diabetes, faced by adults with traumatic brain injury (TBI). The objective of this... (Review)
Review
PRIMARY OBJECTIVE
Interventions are needed to address chronic health conditions, such as obesity and diabetes, faced by adults with traumatic brain injury (TBI). The objective of this narrative is to present the justification for and an exemplar of an active attention control condition as a needed comparison group in clinical trials for intensive lifestyle interventions after TBI.
RESEARCH DESIGN
Narrative review.
METHODS AND PROCEDURES
N/A.
MAIN OUTCOMES AND RESULTS
Despite the historical use in scientific research, integration of appropriate control conditions to account for not only the placebo effect, but also to isolate the "active ingredients" of behavioural interventions, remains a challenge. This is particularly true for intensive lifestyle interventions, especially with the increasing use of mobile health (mHealth) to augment these interventions. Herein we describe the design, content, and implementation of a group-based, attention control condition, referred to as the Brain Health Group, as an exemplar active comparison to an intensive lifestyle intervention for weight-loss among individuals with TBI (GLB-TBI).
CONCLUSIONS
Intervention studies should incorporate strong scientific designs and active control conditions to assess effectiveness and aid in replication. Following recommended guidelines, we provide an active control condition for future group-based intensive lifestyle interventions post-TBI.
Topics: Adult; Attention; Brain Injuries; Control Groups; Humans; Life Style; Obesity
PubMed: 33001707
DOI: 10.1080/02699052.2020.1825807 -
Bone Jan 2023The aim of this narrative review is to discuss the evidence on exercise for fall, fracture and sarcopenia prevention, including evidence that aligns with the specificity... (Review)
Review
The aim of this narrative review is to discuss the evidence on exercise for fall, fracture and sarcopenia prevention, including evidence that aligns with the specificity and progressive overload principles used in exercise physiology, implementation strategies and future research priorities. We also provide a brief discussion of the influence of protein intake and creatine supplementation as potential effect modifiers. We prioritized evidence from randomized controlled trials and systematic reviews. Resistance training can improve muscle mass, muscle strength and a variety of physical performance measures in older adults. Resistance training may also prevent bone loss or increase bone mass, although whether it needs to be done in combination with impact exercise to be effective is less clear, because many studies use multicomponent interventions. Exercise programs prevent falls, and subgroup and network meta-analyses suggest an emphasis on balance and functional training, or specifically, anticipatory control, dynamic stability, functional stability limits, reactive control and flexibility, to maximize efficacy. Resistance training for major muscle groups at a 6-12 repetitions maximum intensity, and challenging balance exercises should be performed at least twice weekly. Choose resistance training exercises aligned with patient goals or movements done during daily activities (task specificity), alongside balance exercises tailored to ability and aspects of balance that need improvement. Progress the volume, level of difficulty or other aspects to see continuous improvement (progressive overload). A critical future priority will be to address implementation barriers and facilitators to enhance uptake and adherence.
Topics: Humans; Aged; Sarcopenia; Exercise; Resistance Training; Muscle Strength; Fractures, Bone; Exercise Therapy
PubMed: 36208722
DOI: 10.1016/j.bone.2022.116573 -
In Vivo (Athens, Greece) 2023Bone response to exercise depends on the type and size of the mechanical stimulus. In rowing, athletes are exposed to low mechanical but large compression loads mainly...
BACKGROUND/AIM
Bone response to exercise depends on the type and size of the mechanical stimulus. In rowing, athletes are exposed to low mechanical but large compression loads mainly on the trunk. Thus, this study aimed to investigate the impact of rowing on total and regional bone quality and bone turnover parameters in elite rowing athletes vs. control subjects.
MATERIALS AND METHODS
Twenty world-class rowers and twenty active, but not athletic, men participated in the study. Bone mineral density (BMD) and body mineral content (BMC) were assessed by dual-energy X-ray absorptiometry (DXA). Bone turnover markers (OPG and RANKL) in serum were assessed by Elisa method.
RESULTS
The current research revealed no statistical difference in total bone mineral density (TBMD) and total body mineral content (TBMC) between elite-level rowers and control subjects. Nevertheless, Trunk BMC (p=0.02) and Trunk BMC/TBMC ratio (p=0.01) were significantly higher in rowers than those in the control group. In contrast, in the control group, the Lower limbs BMC/TBMC ratio (p=0.007) was statistically higher. Furthermore, RANKL (p=0.011) and OPG (p=0.03) were statistically significantly higher in rowers, whereas the OPG/RANKL ratio (p=0.012) was statistically higher in the control group.
CONCLUSION
Rowing, as a non-weight-bearing exercise, did not alter total bone density but induced a remarkable redistribution of bone density from the lower limbs to the trunk. In addition, the current evidence suggests that the underlying molecular mechanism is based on turnover of intermediates, rather than solely bone redistribution.
Topics: Male; Humans; Bone Density; Control Groups; Enzyme-Linked Immunosorbent Assay; Exercise; Lower Extremity
PubMed: 36881058
DOI: 10.21873/invivo.13119 -
Proceedings of the National Academy of... Jul 2022To understand the cortical neuronal dynamics behind movement generation and control, most studies have focused on tasks where actions were planned and then executed...
To understand the cortical neuronal dynamics behind movement generation and control, most studies have focused on tasks where actions were planned and then executed using different instances of visuomotor transformations. However, to fully understand the dynamics related to movement control, one must also study how movements are actively inhibited. Inhibition, indeed, represents the first level of control both when different alternatives are available and only one solution could be adopted and when it is necessary to maintain the current position. We recorded neuronal activity from a multielectrode array in the dorsal premotor cortex (PMd) of monkeys performing a countermanding reaching task that requires, in a subset of trials, them to cancel a planned movement before its onset. In the analysis of the neuronal state space of PMd, we found a subspace in which activities conveying temporal information were confined during active inhibition and position holding. Movement execution required activities to escape from this subspace toward an orthogonal subspace and, furthermore, surpass a threshold associated with the maturation of the motor plan. These results revealed further details in the neuronal dynamics underlying movement control, extending the hypothesis that neuronal computation confined in an "output-null" subspace does not produce movements.
Topics: Animals; Macaca mulatta; Motor Activity; Motor Cortex; Neurons; Psychomotor Performance
PubMed: 35867763
DOI: 10.1073/pnas.2122395119 -
American Journal of Epidemiology Oct 2021For self-controlled studies of medication-related effects, time-varying confounding by indication can occur if the indication varies over time. We describe how active...
For self-controlled studies of medication-related effects, time-varying confounding by indication can occur if the indication varies over time. We describe how active comparators might mitigate such bias, using an empirical example. Approaches to using active comparators are described for case-crossover design, case-time-control design, self-controlled case-series, and sequence symmetry analyses. In the empirical example, we used Danish data from 1996-2018 to study the association between penicillin and venous thromboembolism (VTE), using roxithromycin, a macrolide antibiotic, as comparator. Upper respiratory infection is a transient risk factor for VTE, thus representing time-dependent confounding by indication. Odds ratios for case-crossover analysis were 3.35 (95% confidence interval: 3.23, 3.49) for penicillin and 3.56 (95% confidence interval: 3.30, 3.83) for roxithromycin. We used a Wald-based method or an interaction term to estimate the odds ratio for penicillin with roxithromycin as comparator. These 2 estimates were 0.94 (95% confidence interval: 0.87, 1.03) and 1.03 (95% confidence interval: 0.95, 1.13). Results were similar for the case-time-control analysis, but both the self-controlled case-series and sequence symmetry analysis suggested a weak protective effect of penicillin, seemingly explained by VTE affecting future exposure exclusively for penicillin. The strong association of antibiotics with VTE suggests presence of confounding by indication. Such confounding can be mitigated by using an active comparator.
Topics: Bias; Case-Control Studies; Comparative Effectiveness Research; Control Groups; Cross-Over Studies; Humans; Outcome Assessment, Health Care; Penicillins; Research Design; Roxithromycin; Treatment Outcome; Venous Thromboembolism
PubMed: 33861309
DOI: 10.1093/aje/kwab110 -
Journal of Neurophysiology Jun 2020Humans exhibit various motor styles that reflect their intra- and interindividual variability when implementing sensorimotor transformations. This opens important...
Humans exhibit various motor styles that reflect their intra- and interindividual variability when implementing sensorimotor transformations. This opens important questions, such as, At what point should they be readjusted to maintain optimal motor control? Do changes in motor style reveal the onset of a pathological process and can these changes help rehabilitation and recovery? To further investigate the concept of motor style, tests were carried out to quantify posture at rest and motor control in 18 healthy subjects under four conditions: walking at three velocities (comfortable walking, walking at 4 km/h, and race walking) and running at maximum velocity. The results suggest that motor control can be conveniently decomposed into a static component (a stable configuration of the head and column with respect to the gravitational vertical) and dynamic components (head, trunk, and limb movements) in humans, as in quadrupeds, and both at rest and during locomotion. These skeletal configurations provide static markers to quantify the motor style of individuals because they exhibit large variability among subjects. Also, using four measurements (jerk, root mean square, sample entropy, and the two-thirds power law), it was shown that the dynamics were variable at both intra- and interindividual levels during locomotion. Variability increased following a head-to -toe gradient. These findings led us to select dynamic markers that could define, together with static markers, the motor style of a subject. Finally, our results support the view that postural and motor control are subserved by different neuronal networks in frontal, sagittal, and transversal planes. During human locomotion, motor control can be conveniently decomposed into a static and dynamic components. Variable dynamics were observed at both the intra- and interindividual levels during locomotion. Variability increased following a head-to-toe gradient. Finally, our results support the view that postural and motor control are subserved by different neuronal networks in the frontal, sagittal, and transversal planes.
Topics: Adult; Biomechanical Phenomena; Female; Humans; Individuality; Male; Middle Aged; Motor Activity; Nerve Net; Running; Walking; Young Adult
PubMed: 32319842
DOI: 10.1152/jn.00019.2019