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JPMA. the Journal of the Pakistan... Jan 2020To compare the effectiveness of dual task specific training and conventional physical therapy in ambulation of patients with chronic stroke. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To compare the effectiveness of dual task specific training and conventional physical therapy in ambulation of patients with chronic stroke.
METHODS
The randomised controlled trial was conducted at the Habib Physiotherapy Complex, Peshawar, Pakistan, from January to August 2017, and comprised patients with chronic stroke. The patients were randomly assigned to two treatment groups. Group A received dual task training, while Group B received conventional physiotherapy. Dual task training included activities such as slowlywalking backward, sideways, and forward on a smooth surface while holding a 100gm sandbag. The conventional physiotherapy included mat activities, stretching and strengthening exercises and gait training. Pre-test and post-test data was taken for both spatial and temporal variables for both groups using Time Up and Go Test and 10-meter walk test. Step length, stride length, cycle time and cadence were also calculated before and after treatment. SPSS 23 was used to analyse the data.
RESULTS
Of the 64 patients, there were 32(50%) in each of the two groups that both had 17(53%) males and 15(47%) females. Mean age in Group A was 58.28 ± 7.13 years, while in Group B it was 58.87 ± 6.13 years. Baseline parameters had no significant differences between the groups (p>0.05). Post-treatments scores revealed significant improvement of spatial and temporal variable of gait, 10-meter walk, cadence, step length, stride and cycle time in Group A compared to Group B (p<0.05 each).
CONCLUSIONS
Conventional physical therapy and dual task training effectively improved gait ability of chronic stroke patients, and the latter showed significant improvement in all spatial and temporal gait variables compared to former.
Topics: Aged; Exercise Therapy; Female; Gait; Humans; Male; Middle Aged; Physical Therapy Modalities; Stroke Rehabilitation; Walk Test; Walking
PubMed: 31954014
DOI: 10.47391/JPMA.10443 -
Nutrients Apr 2020Food ingestion induces a metered response of the digestive system. Initially, the upper digestive system reacts to process and extract meal substrates. Later, meal... (Review)
Review
Food ingestion induces a metered response of the digestive system. Initially, the upper digestive system reacts to process and extract meal substrates. Later, meal residues not absorbed in the small bowel, pass into the colon and activate the metabolism of resident microbiota. Food consumption also induces sensations that arise before ingestion (e.g., anticipatory reward), during ingestion (e.g., gustation), and most importantly, after the meal (i.e., the postprandial experience). The postprandial experience involves homeostatic sensations (satiety, fullness) with a hedonic dimension (digestive well-being, mood). The factors that determine the postprandial experience are poorly understood, despite their potential role in personalized diets and healthy eating habits. Current data suggest that the characteristics of the meal (amount, palatability, composition), the activity of the digestive system (suited processing), and the receptivity of the eater (influenced by multiple conditioning factors) may be important in this context.
Topics: Affect; Digestion; Eating; Feeding Behavior; Gastrointestinal Microbiome; Humans; Postprandial Period; Satiation; Satiety Response
PubMed: 32252402
DOI: 10.3390/nu12040986 -
Thorax May 2020Pulmonary rehabilitation (PR) is an effective, key standard treatment for people with COPD. Nevertheless, low participant uptake, insufficient attendance and high... (Comparative Study)
Comparative Study Randomized Controlled Trial
RATIONALE
Pulmonary rehabilitation (PR) is an effective, key standard treatment for people with COPD. Nevertheless, low participant uptake, insufficient attendance and high drop-out rates are reported. Investigation is warranted of the benefits achieved through alternative approaches, such as pulmonary tele-rehabilitation (PTR).
OBJECTIVE
To investigate whether PTR is superior to conventional PR on 6 min walk distance (6MWD) and secondarily on respiratory symptoms, quality of life, physical activity and lower limb muscle function in patients with COPD and FEV <50% eligible for routine hospital-based, outpatient PR.
METHODS
In this single-blinded, multicentre, superiority randomised controlled trial, patients were assigned 1:1 to 10 weeks of groups-based PTR (60 min, three times weekly) or conventional PR (90 min, two times weekly). Assessments were performed by blinded assessors at baseline, end of intervention and at 22 weeks' follow-up from baseline. The primary analysis was based on the intention-to-treat principle.
MEASUREMENTS AND MAIN RESULTS
The primary outcome was change in 6MWD from baseline to 10 weeks; 134 participants (74 females, mean±SD age 68±9 years, FEV 33%±9% predicted, 6MWD 327±103 metres) were included and randomised. The analysis showed no between-group differences for changes in 6MWD after intervention (9.2 metres (95% CI: -6.6 to 24.9)) or at 22 weeks' follow-up (-5.3 metres (95% CI: -28.9 to 18.3)). More participants completed the PTR intervention (n=57) than conventional PR (n=43) (χ test p<0.01).
CONCLUSION
PTR was not superior to conventional PR on the 6MWD and we found no differences between groups. As more participants completed PTR, supervised PTR would be relevant to compare with conventional PR in a non-inferiority design. ClinicalTrials.gov (NCT02667171), 28 January 2016.
Topics: Aged; Anxiety; Depression; Exercise; Female; Forced Expiratory Volume; Humans; Male; Middle Aged; Patient Compliance; Pulmonary Disease, Chronic Obstructive; Quality of Life; Rehabilitation; Single-Blind Method; Symptom Assessment; Telemedicine; Walk Test
PubMed: 32229541
DOI: 10.1136/thoraxjnl-2019-214246 -
The Cochrane Database of Systematic... Mar 2023Individuals with pulmonary hypertension (PH) have reduced exercise capacity and quality of life. Despite initial concerns that exercise training may worsen symptoms in... (Review)
Review
BACKGROUND
Individuals with pulmonary hypertension (PH) have reduced exercise capacity and quality of life. Despite initial concerns that exercise training may worsen symptoms in this group, several studies have reported improvements in functional capacity and well-being following exercise-based rehabilitation.
OBJECTIVES
To evaluate the benefits and harms of exercise-based rehabilitation for people with PH compared with usual care or no exercise-based rehabilitation.
SEARCH METHODS
We used standard, extensive Cochrane search methods. The latest search date was 28 June 2022.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) in people with PH comparing supervised exercise-based rehabilitation programmes with usual care or no exercise-based rehabilitation.
DATA COLLECTION AND ANALYSIS
We used standard Cochrane methods. Our primary outcomes were 1. exercise capacity, 2. serious adverse events during the intervention period and 3. health-related quality of life (HRQoL). Our secondary outcomes were 4. cardiopulmonary haemodynamics, 5. Functional Class, 6. clinical worsening during follow-up, 7. mortality and 8. changes in B-type natriuretic peptide. We used GRADE to assess certainty of evidence.
MAIN RESULTS
We included eight new studies in the current review, which now includes 14 RCTs. We extracted data from 11 studies. The studies had low- to moderate-certainty evidence with evidence downgraded due to inconsistencies in the data and performance bias. The total number of participants in meta-analyses comparing exercise-based rehabilitation to control groups was 462. The mean age of the participants in the 14 RCTs ranged from 35 to 68 years. Most participants were women and classified as Group I pulmonary arterial hypertension (PAH). Study durations ranged from 3 to 25 weeks. Exercise-based programmes included both inpatient- and outpatient-based rehabilitation that incorporated both upper and lower limb exercise. The mean six-minute walk distance following exercise-based rehabilitation was 48.52 metres higher than control (95% confidence interval (CI) 33.42 to 63.62; I² = 72%; 11 studies, 418 participants; low-certainty evidence), the mean peak oxygen uptake was 2.07 mL/kg/min higher than control (95% CI 1.57 to 2.57; I² = 67%; 7 studies, 314 participants; low-certainty evidence) and the mean peak power was 9.69 W higher than control (95% CI 5.52 to 13.85; I² = 71%; 5 studies, 226 participants; low-certainty evidence). Three studies reported five serious adverse events; however, exercise-based rehabilitation was not associated with an increased risk of serious adverse event (risk difference 0, 95% CI -0.03 to 0.03; I² = 0%; 11 studies, 439 participants; moderate-certainty evidence). The mean change in HRQoL for the 36-item Short Form (SF-36) Physical Component Score was 3.98 points higher (95% CI 1.89 to 6.07; I² = 38%; 5 studies, 187 participants; moderate-certainty evidence) and for the SF-36 Mental Component Score was 3.60 points higher (95% CI 1.21 to 5.98 points; I² = 0%; 5 RCTs, 186 participants; moderate-certainty evidence). There were similar effects in the subgroup analyses for participants with Group 1 PH versus studies of groups with mixed PH. Two studies reported mean reduction in mean pulmonary arterial pressure following exercise-based rehabilitation (mean reduction: 9.29 mmHg, 95% CI -12.96 to -5.61; I² = 0%; 2 studies, 133 participants; low-certainty evidence).
AUTHORS' CONCLUSIONS
In people with PH, supervised exercise-based rehabilitation may result in a large increase in exercise capacity. Changes in exercise capacity remain heterogeneous and cannot be explained by subgroup analysis. It is likely that exercise-based rehabilitation increases HRQoL and is probably not associated with an increased risk of a serious adverse events. Exercise training may result in a large reduction in mean pulmonary arterial pressure. Overall, we assessed the certainty of the evidence to be low for exercise capacity and mean pulmonary arterial pressure, and moderate for HRQoL and adverse events. Future RCTs are needed to inform the application of exercise-based rehabilitation across the spectrum of people with PH, including those with chronic thromboembolic PH, PH with left-sided heart disease and those with more severe disease.
Topics: Female; Humans; Adult; Middle Aged; Aged; Male; Hypertension, Pulmonary; Exercise Therapy; Quality of Life; Exercise; Bias
PubMed: 36947725
DOI: 10.1002/14651858.CD011285.pub3 -
ELife Jul 2023Genomic analysis has shed light on how hadal snailfish have adapted to living at depths of several thousand metres.
Genomic analysis has shed light on how hadal snailfish have adapted to living at depths of several thousand metres.
Topics: Adaptation, Physiological; Perciformes; Animals
PubMed: 37436434
DOI: 10.7554/eLife.90216 -
JAMA Pediatrics Sep 2021Reports of associations between higher consumption of ultraprocessed foods (UPF) and elevated risks of obesity, noncommunicable diseases, and mortality in adults are...
IMPORTANCE
Reports of associations between higher consumption of ultraprocessed foods (UPF) and elevated risks of obesity, noncommunicable diseases, and mortality in adults are increasing. However, associations of UPF consumption with long-term adiposity trajectories have never been investigated in children.
OBJECTIVE
To assess longitudinal associations between UPF consumption and adiposity trajectories from childhood to early adulthood.
DESIGN, SETTING, AND PARTICIPANTS
This prospective birth cohort study included children who participated in the Avon Longitudinal Study of Parents and Children (ALSPAC) in Avon County, southwest England. Children were followed up from 7 to 24 years of age during the study period from September 1, 1998, to October 31, 2017. Data were analyzed from March 1, 2020, to January 31, 2021.
EXPOSURES
Baseline dietary intake data were collected using 3-day food diaries. Consumption of UPF (applying the NOVA food classification system) was computed as a percentage of weight contribution in the total daily food intake for each participant and categorized into quintiles.
MAIN OUTCOMES AND MEASURES
Repeated recordings of objectively assessed anthropometrics (body mass index [BMI; calculated as weight in kilograms divided by height in meters squared], weight, and waist circumference) and dual-energy x-ray absorptiometry measurements (fat and lean mass indexes [calculated as fat and lean mass, respectively, divided by height in meters squared] and body fat percentage). Associations were evaluated using linear growth curve models and were adjusted for study covariates.
RESULTS
A total of 9025 children (4481 [49.7%] female and 4544 [50.3%] male) were followed up for a median of 10.2 (interquartile range, 5.2-16.4) years. The mean (SD) UPF consumption at baseline was 23.2% (5.0%) in quintile 1, 34.7% (2.5%) in quintile 2, 43.4% (2.5%) in quintile 3, 52.7% (2.8%) in quintile 4, and 67.8% (8.1%) in quintile 5. Among those in the highest quintile of UPF consumption compared with their lowest quintile counterpart, trajectories of BMI increased by an additional 0.06 (95% CI, 0.04-0.08) per year; fat mass index, by an additional 0.03 (95% CI, 0.01-0.05) per year; weight, by an additional 0.20 (95% CI, 0.11-0.28) kg per year; and waist circumference, by an additional 0.17 (95% CI, 0.11-0.22) cm per year.
CONCLUSIONS AND RELEVANCE
These findings suggest that higher UPF consumption is associated with greater increases in adiposity from childhood to early adulthood. Robust public health measures that promote minimally processed foods and discourage UPF consumption among children are urgently needed to reduce obesity in England and globally.
Topics: Adiposity; Adolescent; Birth Weight; Body Mass Index; Body-Weight Trajectory; Child; Child, Preschool; Cohort Studies; Diet Records; England; Female; Food Quality; Humans; Longitudinal Studies; Male; Parents
PubMed: 34125152
DOI: 10.1001/jamapediatrics.2021.1573 -
International Journal of Environmental... Mar 2021This study determines the effect of walking backward on a treadmill on balance, speed of walking and cardiopulmonary fitness for patients with chronic stroke. Subjects... (Randomized Controlled Trial)
Randomized Controlled Trial
This study determines the effect of walking backward on a treadmill on balance, speed of walking and cardiopulmonary fitness for patients with chronic stroke. Subjects with chronic stroke for more than six months, whose level of Brunnstrom stage is greater than IV and who are able to walk more than eleven meters with or without assistive devices were recruited. After grouping for a single-blind clinical randomized controlled trial, the subjects were divided into two groups: eight in the control group and eight in the experimental group. All subjects were subjected to 30 min traditional physical therapy, three times a week for four weeks. The experimental group was subjected to an additional 30 min of walking backward on a treadmill. The Berg Balance Scale (BBS) and the Timed Up and Go test (TUG) were used to determine the functional balance and walking ability. The walking speed was evaluated using a timed 10-Meter Walk Test (10MWT), and the cardiopulmonary fitness was determined using a 6-Minute Walk Test (6MWT) and a pulmonary function test (PFT). All assessments were made at baseline before training commenced (pre-training) and at the end of the four-week training period (post-training). A paired -test and an independent -test were used to determine the effect on balance, speed of walking and cardiopulmonary fitness before and after training. The level of significance α was 0.05. After four weeks of training, the experimental group showed significant differences ( < 0.05) on TUG, BBS, 10MWT, 6MWT, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). This pilot study shows that the 30 min of walking backward on a treadmill three times a week for four weeks increased balance, speed of walking and cardiopulmonary fitness. Trial registration: Current Controlled Trials NCT02619110.
Topics: Exercise Therapy; Humans; Pilot Projects; Postural Balance; Single-Blind Method; Stroke; Stroke Rehabilitation; Time and Motion Studies; Treatment Outcome; Walking
PubMed: 33804374
DOI: 10.3390/ijerph18052376 -
Journal of Dentistry (Shiraz, Iran) Sep 2020Systemic conditions can affect the salivary glands and oral health. Hypertension induces xerostomia. Because the function of saliva is related to its quality and...
STATEMENT OF THE PROBLEM
Systemic conditions can affect the salivary glands and oral health. Hypertension induces xerostomia. Because the function of saliva is related to its quality and quantity, therefore, any changes in saliva can lead to diminished quality of patient's life.
PURPOSE
The aim of this study was to determine the relationship between pH and viscosity of cumulative unstimulated saliva and hypertension in adults with sustained hypertension.
MATERIALS AND METHOD
This cross sectional study took place on patients referred to oral medicine faculty of Shahid Sadoughi University of Medical Science. The patients' blood pressure was measured and the 135 patients fitting the inclusion criteria participated in the study. Their unstimulated cumulative saliva was collected by spitting method and pH of the samples was measured by digital pH-meter set. The viscosity of the samples was measured by comparing the amount of saliva displacement in the thistle tube with control fluids at mm/10 seconds. The data was analyzed by SPSS version 20 software and ANOVA tests and Tukey multiple comparison and their nonparametric equivalent (≤ 0.005).
RESULTS
The results of this study showed that there was a significant relationship between pH and viscosity of unstimulated saliva of normotensive and borderline hypertensive patients (<.0001and < .005, respectively) and between normotensive and stage I hypertensive patients (<.0001, <0.000). Therefore, hypertension had a direct and significant relationship with saliva viscosity but a reverse relationship with saliva pH.
CONCLUSION
Hypertension can reduce the pH and increase the salivary viscosity in hypertensive patients, which subsequently lead to changes in quality and quantity of secreted saliva and influence the oral health and quality of the patient's life.
PubMed: 33062812
DOI: 10.30476/DENTJODS.2019.80992.0