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European Journal of Sport Science Jul 2024The aims of this study were to assess (i) the load-velocity relationship during the box squat exercise in women survivors of breast cancer, (ii) which velocity variable...
The aims of this study were to assess (i) the load-velocity relationship during the box squat exercise in women survivors of breast cancer, (ii) which velocity variable (mean velocity [MV], mean propulsive velocity [MPV], or peak velocity [PV]) shows stronger relationship with the relative load (%1RM), and (iii) which regression model (linear [LA] or polynomic [PA]) provides a greater fit for predicting the velocities associated with each %1RM. Nineteen women survivors of breast cancer (age: 53.2 ± 6.9 years, weight: 70.9 ± 13.1 kg, and height: 163.5 ± 7.4 cm) completed an incremental load test up to one-repetition maximum in the box squat exercise. The MV, MPV, and the PV were measured during the concentric phase of each repetition with a linear velocity transducer. These measurements were analyzed by regression models using LA and PA. Strong correlations of MV with %1RM (R = 0.903/0.904; the standard error of the estimate (SEE) = 0.05 ms by LA/PA) and MPV (R = 0.900; SEE = 0.06 ms by LA and PA) were observed. In contrast, PV showed a weaker association with %1RM (R = 0.704; SEE = 0.15 ms by LA and PA). The MV and MPV of 1RM was 0.22 ± 0.04 m·s, whereas the PV at 1RM was 0.63 ± 0.18 ms. These findings suggest that the use of MV to prescribe relative loads during resistance training, as well as LA and PA regression models, accurately predicted velocities for each %1RM. Assessing and prescribing resistance exercises during breast cancer rehabilitation can be facilitated through the monitoring of movement velocity.
Topics: Humans; Female; Breast Neoplasms; Middle Aged; Resistance Training; Muscle Strength; Adult; Cancer Survivors; Exercise Therapy
PubMed: 38956790
DOI: 10.1002/ejsc.12130 -
European Journal of Sport Science Jul 2024Improving peak oxygen uptake (V̇O) and maximal strength are key objectives of rehabilitation for patients with unspecific musculoskeletal disorders (MSDs). Although... (Randomized Controlled Trial)
Randomized Controlled Trial
Aerobic high-intensity interval training and maximal strength training in patients with unspecific musculoskeletal disorders improve V̇O and maximal strength more than moderate training.
Improving peak oxygen uptake (V̇O) and maximal strength are key objectives of rehabilitation for patients with unspecific musculoskeletal disorders (MSDs). Although high-intensity training yield superior outcomes for these factors, patients with MSDs may not tolerate high-intensity due to pain and fear. Therefore, we examined the effect and feasibility of incorporating aerobic high-intensity intervals (HIITs) and maximal strength training (MST) in a standard clinical rehabilitation program for patients with unspecific MSDs. 73 patients (45 ± 10 years) with MSDs partaking in a standard, public, and 4-week rehabilitation program were randomized to high-intensity training (HG: 4 × 4 minutes intervals at ∼90% of maximal heart rate; HR, and 4 × 4 repetitions leg press at ∼90% of 1 repetition maximum; 1RM, with maximal intended velocity) or keep todays treatment of low-to moderate-intensity training (MG: various cycling, walking, and/or running activities at ∼70%-80% of HR and 3 × 8 - 10 repetitions leg press at ∼75% of 1RM without maximal intended velocity). HG improved V̇O (12 ± 7%) and leg press 1RM (43 ± 34%) more than moderate-intensity group (V̇O; 5 ± 6%, 1RM; 19 ± 18%, both p < 0.001). We observed that no adverse events and no between-group differences in dropout rate or self-reported quality of life (both p > 0.05). There were positive correlations between improved V̇O and improved physical (p = 0.024) and emotional (0.016) role functioning. We conclude that both high-intensity interval training and MST are feasible and improve V̇O and maximal strength more than standard low-to moderate-intensity treatment of patients with unspecific MSDs. Our findings suggest that high-intensity training should be implemented as a part of standard clinical care of this patient population.
Topics: Humans; High-Intensity Interval Training; Male; Resistance Training; Middle Aged; Muscle Strength; Female; Adult; Oxygen Consumption; Musculoskeletal Diseases; Heart Rate
PubMed: 38956785
DOI: 10.1002/ejsc.12126 -
European Journal of Sport Science Jul 2024The purpose of this study was firstly to examine the sensitivity of heart rate (HR)-based and subjective monitoring markers to intensified endurance training; and...
The purpose of this study was firstly to examine the sensitivity of heart rate (HR)-based and subjective monitoring markers to intensified endurance training; and secondly, to investigate the validity of these markers to distinguish individuals in different fatigue states. A total of 24 recreational runners performed a 3-week baseline period, a 2-week overload period, and a 1-week recovery period. Performance was assessed before and after each period with a 3000m running test. Recovery was monitored with daily orthostatic tests, nocturnal HR recordings, questionnaires, and exercise data. The participants were divided into subgroups (overreached/OR, n = 8; responders/RESP, n = 12) based on the changes in performance and subjective recovery. The responses to the second week of the overload period were compared between the subgroups. RESP improved their baseline 3000 m time (p < 0.001) after the overload period (-2.5 ± 1.0%), and the change differed (p < 0.001) from OR (0.6 ± 1.2%). The changes in nocturnal HR (OR 3.2 ± 3.1%; RESP -2.8 ± 3.7%, p = 0.002) and HR variability (OR -0.7 ± 1.8%; RESP 2.1 ± 1.6%, p = 0.011) differed between the subgroups. In addition, the decrease in subjective readiness to train (p = 0.009) and increase in soreness of the legs (p = 0.04) were greater in OR compared to RESP. Nocturnal HR, readiness to train, and exercise-derived HR-running power index had ≥85% positive and negative predictive values in the discrimination between OR and RESP individuals. In conclusion, exercise tolerance can vary substantially in recreational runners. The results supported the usefulness of nocturnal HR and subjective recovery assessments in recognizing fatigue states.
Topics: Humans; Heart Rate; Running; Adult; Male; Fatigue; Female; Young Adult; Endurance Training; Surveys and Questionnaires; Physical Endurance; Exercise Test
PubMed: 38956784
DOI: 10.1002/ejsc.12115 -
Archives of Public Health = Archives... Jul 2024Childhood overweight, especially obesity, significantly impacts children's health and poses an increased risk of adult-onset diseases. This study aims to analyse the...
BACKGROUND
Childhood overweight, especially obesity, significantly impacts children's health and poses an increased risk of adult-onset diseases. This study aims to analyse the evolution of childhood overweight and obesity in Belgium from 1997 to 2018 and assess its variation across parental socioeconomic status (SES).
METHODS
The Health Interview Survey, a cross-sectional survey representative of the Belgian population, has been conducted since 1997, with the latest survey conducted in 2018. This study focuses on children aged 2-17 years. Body Mass Index (BMI, kg/m²) was derived from self-reported data, supplemented with proxy reports for children under 15 years old. Overweight and obesity were classified using age/sex-specific cut-off points. Highest parental educational level served as the indicator of SES. In addition to reporting the overall prevalence and the 95% confidence interval (95%CI) of childhood overweight and obesity by year, this study examines the absolute difference in prevalence between SES groups (low minus high) and calculates the Odds Ratio (OR, adjusted for age and sex) to evaluate the relative difference.
RESULTS
The overall prevalence of childhood overweight rose from 13.6% (95%CI = 11.2-16.1%) in 1997 to 18.9% (95%CI = 16.3-21.5%) in 2018; while it remained stable for obesity, fluctuating between 5.4% and 6.3% over the same period. This increase was more pronounced among children with low SES compared to those with high SES. Consequently, the absolute difference between children with low and high SES increased over time from 8.0% points (pp) in 1997 to 14.9 pp in 2018 for overweight, and from 3.1 pp to 6.8 pp for obesity. In terms of relative inequalities, overall, children with low SES exhibited significantly higher odds of overweight and of obesity than those with high SES (OR varying between 2 à 3 for overweight and between 2 and 4 for obesity).
CONCLUSIONS
The escalating disparities over time highlight SES as a significant risk factor for childhood overweight and obesity. Addressing these inequalities requires interventions such as providing healthy meals and increasing sports opportunities at school. Additionally, it is recommended to regulate fast food outlets near schools and limit unhealthy food marketing, particularly because children with low SES are more exposed to such influences.
PubMed: 38956737
DOI: 10.1186/s13690-024-01328-y -
Diabetology & Metabolic Syndrome Jul 2024Diabetic cardiomyopathy (DCM) stands as the primary cause of heart failure and mortality among patients with diabetes. Nevertheless, conventional treatment approaches...
BACKGROUND
Diabetic cardiomyopathy (DCM) stands as the primary cause of heart failure and mortality among patients with diabetes. Nevertheless, conventional treatment approaches are limited in their ability to effectively prevent myocardial tissue damage itself. Mesenchymal stem cell (MSC) therapy exhibits immense potential for treating DCM; however, the precise mechanisms involved in regulating inflammatory responses and pyroptosis processes, an emerging form of cellular death, within myocardial cells remain elusive. Hence, it is imperative to further elucidate the precise underlying mechanisms to facilitate the clinical implementation of MSC therapy.
METHODS
In vivo, we established a DCM mouse model by administering streptozotocin and fed the mice a high-glucose and high-fat diet, followed by MSC therapy. Cardiac function and myocardial injury were evaluated through echocardiography and histological analysis. Furthermore, the levels of inflammation and pyroptosis were assessed using ELISA, Western blotting, and qRT-PCR. In vitro experiments involved inducing H9C2 myocardial cell damage with high glucose treatment, followed by coculture with MSCs to investigate their role in modulating inflammation and pyroptosis mechanisms.
RESULTS
MSCs can maintain cardiac function and alleviate myocardial injury in mice with DCM. Moreover, they effectively suppress the activation of NLRP3 and reduce the release of inflammatory factors (such as IL-1β and ROS), thereby further downregulating the expression of pyroptosis-related proteins including NLRP3, Caspase-1, and GSDMD. Additionally, we experimentally validated that MSCs exert their therapeutic effects by promoting the expression of miR-223-3p in cardiac myocytes; however, this effect can be reversed by an miR-223-3p inhibitor.
CONCLUSION
MSCs effectively mitigate the release of inflammatory factors and cell lysis caused by pyroptosis through the regulation of the miR-223-3p/NLRP3 pathway, thereby safeguarding cardiomyocytes against damage in DCM. This mechanism establishes a novel theoretical foundation for the clinical treatment of cardiac conditions utilizing MSCs.
PubMed: 38956716
DOI: 10.1186/s13098-024-01389-7 -
BMC Sports Science, Medicine &... Jul 2024The aim of the study was to determine the role of isometric strength and range of motion in predicting Functional Movement Screen (FMS) scores of adults. A total of 120...
The aim of the study was to determine the role of isometric strength and range of motion in predicting Functional Movement Screen (FMS) scores of adults. A total of 120 participants (age = 34.62 ± 11.82 years; height = 170.56 ± 9.63 cm; weight = 73.62 ± 15.39 kg) volunteered to participate in the study. Anthropometric measurements were performed, including height, body weight, muscle mass, and body fat. Following this, the ranges of motion of the shoulder, hip, knee, and ankle joints were measured sequentially. Isometric strength and FMS tests were then performed. Hip extension isometric strength explained 23% of the variation in FMS. The common effect of knee flexion, shoulder flexion, and dorsiflexion joint range of motion explained 34% of the change in FMS (F = 20.375, p < 0.001). A significant relationship (R = 0.658, R = 0.413) was found between hip extension isometric strength, knee flexion, shoulder flexion, and dorsiflexion range of motion and FMS (F = 21.952, p < 0.001). The common effect of all these variables explains 43% of the change in FMS. The results indicate that the FMS test scores, which are utilized to evaluate the risk of injury in sedentary adults, can be significantly predicted by the effect of hip extension isometric strength and parameters related to knee flexion, shoulder flexion, and dorsiflexion joint range of motion. At this time, it is advised that range of motion and isometric strength be taken into account when determining a person's functional movement capacity.
PubMed: 38956714
DOI: 10.1186/s13102-024-00935-0 -
Italian Journal of Pediatrics Jul 2024Cortical visual impairment (CVI) is a verifiable visual dysfunction that cannot be attributed to disorders of the anterior visual pathways or any potentially...
BACKGROUND
Cortical visual impairment (CVI) is a verifiable visual dysfunction that cannot be attributed to disorders of the anterior visual pathways or any potentially co-occurring ocular impairment. Given the limited knowledge on the most effective interventions for visual impairment resulting from CVI, this case report provides valuable insights into an example of successful implementation of anti-amblyopia therapy in a patient with CVI.
CASE PRESENTATION
This case report presents a 5-year-old girl with CVI secondary to hypoxic-ischemic injury, resulting in visual impairment, dyspraxia, and abnormal visual evoked potential testing. The girl did not suffer from amblyopia, there was no evidence of relevant refractive errors or strabismus, so visual pathway damage was the cause of her visual deficit. Nevertheless, the patient underwent anti-amblyopia therapy and showed significant improvement in visual acuity after 12 months of treatment. The improvement, resulting from visual stimulation, was due to a good functional recovery by a better usage of the damaged visual pathways. The therapy included prescribing corrective glasses and implementing secondary occlusion of the better eye for 4 months, which was protracted for another 4 months, leading to further improvements in visual acuity.
CONCLUSIONS
The case report shows that addressing even minor refractive errors and implementing anti-amblyopia therapy can significantly improve vision in children with CVI, even without co-existing amblyopia. It also highlights the importance of early intervention and multidisciplinary rehabilitation in children with CVI, focusing on motor and cognitive skills. Additionally, it emphasizes the need for further research to establish evidence-based practice standards for improving vision in children with CVI.
Topics: Humans; Female; Child, Preschool; Amblyopia; Visual Acuity; Eyeglasses; Blindness, Cortical; Hypoxia-Ischemia, Brain; Evoked Potentials, Visual
PubMed: 38956699
DOI: 10.1186/s13052-024-01679-w -
Trials Jul 2024Moderately severe or major trauma (injury severity score (ISS) > 8) is common, often resulting in physical and psychological problems and leading to difficulties in...
Early vocational rehabilitation and psychological support for trauma patients to improve return to work (the ROWTATE trial): study protocol for an individually randomised controlled multicentre pragmatic trial.
BACKGROUND
Moderately severe or major trauma (injury severity score (ISS) > 8) is common, often resulting in physical and psychological problems and leading to difficulties in returning to work. Vocational rehabilitation (VR) can improve return to work/education in some injuries (e.g. traumatic brain and spinal cord injury), but evidence is lacking for other moderately severe or major trauma.
METHODS
ROWTATE is an individually randomised controlled multicentre pragmatic trial of early VR and psychological support in trauma patients. It includes an internal pilot, economic evaluation, a process evaluation and an implementation study. Participants will be screened for eligibility and recruited within 12 weeks of admission to eight major trauma centres in England. A total of 722 participants with ISS > 8 will be randomised 1:1 to VR and psychological support (where needed, following psychological screening) plus usual care or to usual care alone. The ROWTATE VR intervention will be provided within 2 weeks of study recruitment by occupational therapists and where needed, by clinical psychologists. It will be individually tailored and provided for ≤ 12 months, dependent on participant need. Baseline assessment will collect data on demographics, injury details, work/education status, cognitive impairment, anxiety, depression, post-traumatic distress, disability, recovery expectations, financial stress and health-related quality of life. Participants will be followed up by postal/telephone/online questionnaires at 3, 6 and 12 months post-randomisation. The primary objective is to establish whether the ROWTATE VR intervention plus usual care is more effective than usual care alone for improving participants' self-reported return to work/education for at least 80% of pre-injury hours at 12 months post-randomisation. Secondary outcomes include other work outcomes (e.g. hours of work/education, time to return to work/education, sickness absence), depression, anxiety, post-traumatic distress, work self-efficacy, financial stress, purpose in life, health-related quality of life and healthcare/personal resource use. The process evaluation and implementation study will be described elsewhere.
DISCUSSION
This trial will provide robust evidence regarding a VR intervention for a major trauma population. Evidence of a clinically and cost-effective VR intervention will be important for commissioners and providers to enable adoption of VR services for this large and important group of patients within the NHS.
TRIAL REGISTRATION
ISRCTN: 43115471. Registered 27/07/2021.
Topics: Humans; Return to Work; Rehabilitation, Vocational; Time Factors; England; Treatment Outcome; Wounds and Injuries; Pragmatic Clinical Trials as Topic; Cost-Benefit Analysis; Multicenter Studies as Topic; Quality of Life; Health Care Costs
PubMed: 38956682
DOI: 10.1186/s13063-024-08183-w -
Journal of Orthopaedic Surgery and... Jul 2024In patients undergoing total joint arthroplasty (TJA), the administration of dexamethasone may contribute to perioperative blood glucose (BG) disturbances, potentially... (Randomized Controlled Trial)
Randomized Controlled Trial
The effect of a split-dose intravenous dexamethasone and a single high-dose on postoperative blood glucose after total joint arthroplasty: a randomized double-blind placebo-controlled trial.
BACKGROUND
In patients undergoing total joint arthroplasty (TJA), the administration of dexamethasone may contribute to perioperative blood glucose (BG) disturbances, potentially resulting in complications, even in patients without diabetes. This study aimed to demonstrate the impact of different administration regimens of dexamethasone in postoperative BG levels.
METHODS
In this randomized, controlled, double-blind trial, 136 patients without diabetes scheduled for TJA were randomly assigned to three groups: two perioperative saline injections (Group A, placebo); a single preoperative injection of 20 mg dexamethasone and a postoperative saline injection (Group B), and two perioperative injections of 10 mg dexamethasone (Group C). Primary outcomes were the postoperative fasting blood glucose (FBG) levels. Secondary outcome parameters were the postoperative postprandial blood glucose (PBG) levels. Postoperative complications within 90 days were also recorded. Risk factors for FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl were investigated.
RESULTS
Compared to Group A, there were transient increases in FBG and PBG on postoperative days (PODs) 0 and 1 in Groups B and C. Statistical differences in FBG and PBG among the three groups were nearly absent from POD 1 onward. Both dexamethasone regimens did not increase the risk for postoperative FBG ≥ 140 mg/dl or PBG ≥ 180 mg/dl. Elevated preoperative HbA1c levels may increase the risk of postoperative FBG ≥ 140 mg/dl or PBG ≥ 180 mg/dl, respectively.
CONCLUSION
Perioperative intravenous high-dose dexamethasone to patients without diabetes has transient effects on increasing BG levels after TJA. However, no differences were found between the split-dose and single high-dose regimens. The elevated preoperative HbA1c, but not the dexamethasone regimens were the risk factor for FBG ≥ 140 mg/dl and PBG ≥ 180 mg/dl.
TRIAL REGISTRATION
Chinese Clinical Trail Registry, ChiCTR2300069473. Registered 17 March 2023, https://www.chictr.org.cn/showproj.html?proj=186760 .
Topics: Humans; Dexamethasone; Double-Blind Method; Male; Female; Blood Glucose; Middle Aged; Aged; Postoperative Complications; Injections, Intravenous; Postoperative Period; Arthroplasty, Replacement, Hip; Glucocorticoids; Arthroplasty, Replacement; Administration, Intravenous
PubMed: 38956678
DOI: 10.1186/s13018-024-04887-6 -
Journal of Orthopaedic Surgery and... Jul 2024Spinal cord injury (SCI) is a severe condition with an extremely high disability rate. It is mainly manifested as the loss of motor, sensory and autonomic nerve...
Spinal cord injury (SCI) is a severe condition with an extremely high disability rate. It is mainly manifested as the loss of motor, sensory and autonomic nerve functions below the injury site. High-frequency transcranial magnetic stimulation, a recently developed neuromodulation method, can increase motor function in mice with spinal cord injury. This study aimed to explore the possible mechanism by which transcranial magnetic stimulation (TMS) restores motor function after SCI. A complete T8 transection model of the spinal cord was established in mice, and the mice were treated daily with 15 Hz high-frequency transcranial magnetic stimulation. The BMS was used to evaluate the motor function of the mice after SCI. Western blotting and immunofluorescence were used to detect the expression of Connexin43 (CX43) and autophagy-related proteins in vivo and in vitro, and correlation analysis was performed to study the relationships among autophagy, CX43 and motor function recovery after SCI in mice. Western blotting was used to observe the effect of magnetic stimulation on the expression of mTOR pathway members. In the control group, the expression of CX43 was significantly decreased, and the expression of microtubule-associated protein 1 A/1b light chain 3 (LC3II) and P62 was significantly increased after 4 weeks of spinal cord transection. After high-frequency magnetic stimulation, the level of CX43 decreased, and the levels of LC3II and P62 increased in primary astrocytes. The BMS of the magnetic stimulation group was greater than that of the control group. High-frequency magnetic stimulation can inhibit the expression of CX43, which negatively regulates autophagic flux. HF-rTMS increased the expression levels of mTOR, p-mTOR and p-S6. Our experiments showed that rTMS can restore hindlimb motor function in mice after spinal cord injury via regulation of the Cx43-autophagy loop and activation of the mTOR signalling pathway.
Topics: Animals; Transcranial Magnetic Stimulation; Spinal Cord Injuries; Recovery of Function; Connexin 43; Autophagy; Mice; TOR Serine-Threonine Kinases; Mice, Inbred C57BL; Motor Activity; Disease Models, Animal; Male; Female
PubMed: 38956661
DOI: 10.1186/s13018-024-04879-6