Active Exercise Program Research Articles

The Impact of Different Telerehabilitation Methods on Peripheral Muscle Strength and Aerobic Capacity in COPD Patients: A Randomized Controlled Trial.

Lung diseases have profound effects on the aging population. We aimed to hypothesize and investigate the effect of remote pulmonary telerehabilitation and motor imagery (MI) and action observation (AO) methods on the clinical status of elderly chronic obstructive pulmonary disease (COPD) patients. Twenty-six patients were randomly assigned to pulmonary telerehabilitation (PtR) or cognitive telerehabilitation (CtR) groups. The programs were carried out 3 days a week for 8 weeks. The 6-min walk test (6MWT), modified Medical Research Council dyspnea score, blood lactate level (BLL), measurement of peripheral muscle strength (PMS), and electromyography activation levels of accessory respiratory muscles were the main outcomes. There was a statistically significant improvement (p < 0.05) in both groups in the 6MWT distance and in secondary results, except for BLL. Generally, in the mean muscle activity obtained from the electromyography measurement after the program, there were statistically significant increases in the PtR group and decreases in the CtR group (p < 0.05). There was a statistically significant increase in PMS in both groups. An active muscle-strengthening program has the same benefits as applying the muscle-strengthening program to the patient as MI and AO. CtR can be a powerful alternative rehabilitation method in respiratory patients who cannot tolerate active exercise programs.

An Overview of Dermatomyositis By IJISRT

Dermatomyositis (DM) is an idiopathic inflammatory myopathy condition. It might be challenging to identify DM when the usual dermatologic symptoms or myopathy are not present. The onset of muscle involvement is often pain or myalgias, however, it can also be accompanied by proximal muscle weakening. The incidence rate was estimated to be 9.63 per 1,000,000 inhabitants in Olmsted County, Minnesota, according to a retrospective research that ran from 1967 to 2007. The exact reason(s) behind dermatomyositis are still a mystery. Environmental, immunological, and genetic variables may all have an impact, though. Diabetic myopathy (DM) is characterized by a progressive weakening of muscles, which might start mild and develop over a few weeks or months, or it can advance more rapidly. Typically, symmetric and proximal muscle involvement is the first to manifest, with distal muscle weakening developing later in the disease's progression. Muscle weakness, skin disease, and other underlying problems are the main focuses of dermatomyositis management. Systemic glucocorticoids, with or without immunosuppressants, are the initial line of defense against dermatomyositis-related muscle illness. Management relies heavily on physical therapy and rehabilitation. Active exercise programs should be advocated for patients with moderate illness.

Effectiveness of two different exergaming systems in addition to conventional treatment for physical therapy in patients with multiple sclerosis: A study protocol for a multicenter, assessor-blind, 24-week, randomized controlled trial.

The main aim is to evaluate and compare the effectiveness of two specific exergaming systems in addition to conventional treatment on improving physical functional capacity, balance, muscle strength, spasticity in lower limbs, and quality of life in patients with multiple sclerosis. The secondary aim is to compare the effectiveness of each exergaming system to isolated conventional treatment. A multicenter, assessor-blind, 24-week, randomized controlled trial. 39 patients diagnosed with multiple sclerosis will be allocated to three groups. A control group will perform a conventional treatment based on daily routine activities and/or combined training, whereas the experimental groups will be randomly divided to develop an active videogame-based exercise program through Nintendo Ring Fit Adventure© or Nintendo Wii Fit©, in addition to the conventional treatment. Study outcomes will be assessed at baseline and at 12 and 24 weeks. One-way ANOVA or Kruskal-Wallis tests will be used to analyze differences between groups at baseline and mixed ANOVA for differences between-within groups over time. The findings from this evidence-based trial, which includes both Nintendo© active videogames, could potentially establish exergame training as a valuable and reliable therapeutic tool for neurorehabilitation. It is essential to consider the customization, specifically in our case, on each multiple sclerosis condition, and ensure patients' adherence to the treatment.

Patiëntgerapporteerde zorgverlening voor het grote-trochanterpijnsyndroom

Patient-reported care for the greater trochanteric pain syndrome The greater trochanteric pain syndrome (GTPS) is a condition that mostly affects middle-aged women. At the University Hospitals Leuven (Belgium), many patients consult a physician for this problem. This retrospective cohort study evaluated the technical investigations and treatment options women with GTPS went through before presenting to a university hospital. Despite the fact that GTPS is described as a clinical diagnosis, most patients already underwent technical investigations. In literature, an MRI of the pelvis is often considered the gold standard for the differential diagnosis, but only a minority already got one. The most performed technical investigation was a hip radiography, followed by an ultrasound of the hip. Less than half of the patient population reported they already had physiotherapy with an active exercise program. About 25% received a corticosteroid injection. Both the proposed diagnostic examinations and treatment options for GTPS seem to differentiate among caregivers. This type of descriptive study makes them reflect critically about the care provided.

The Impact of Exercise Training on Physical Activity among Elderly Women in the Community: A Pilot Study.

According to a survey conducted by the Taiwanese government, the elderly spend most of their time watching TV for their daily leisure activities, and most do not pant or sweat during exercise. Relevant studies have shown that physical activity has benefits and importance for the physical functions of the elderly. The objective of this study was to investigate the effects of exercise training on the functional fitness of elderly females in the community. The women subjects were from the community of Kaohsiung City, Taiwan. In total, 34 females were randomly divided into an intervention group and a control group. The ages of the subjects ranged from 65 to 80 years old, with an average age of 75.13. The experimental group continued their physical activity intervention for 20 weeks. The control group had no training plan. The results of the study showed that after 20 weeks of intervention, participants in the intervention group experienced improvements in back grasping, right-hand grip strength, sitting to standing, right hip flexion, right knee extension, right ankle dorsiflexion, right sitting forward extension balance, and sitting back around objects. Six-minute walking distances also showed a significant difference in all cases. The results demonstrated that the 20-week physical activity program intervention used in this study can assist in improving back grasping, right-hand grip strength, sitting to standing, right-hand sitting posture, forward balance, sitting back around objects, and six-minute walking distance among older women in the community. In summary, we recommend a moderate-intensity physical activity exercise program for older women in the community.

The potential protective effects of pre-injury exercise on neuroimmune responses following experimentally-induced traumatic neuropathy: a systematic review with meta-analysis.

Pre-clinical evidence shows that neuropathy is associated with complex neuroimmune responses, which in turn are associated with increased intensity and persistence of neuropathic pain. Routine exercise has the potential to mitigate complications of future nerve damage and persistence of pain through neuroimmune regulation. This systematic review aimed to explore the effect of pre-injury exercise on neuroimmune responses, and other physiological and behavioural reactions following peripheral neuropathy in animals. Three electronic databases were searched from inception to July 2022. All controlled animal studies assessing the influence of an active exercise program prior to experimentally-induced traumatic peripheral neuropathy compared to a non-exercise control group on neuroimmune, physiological and behavioural outcomes were selected. The search identified 17,431 records. After screening, 11 articles were included. Meta-analyses showed that pre-injury exercise significantly reduced levels of IL-1β (SMD: -1.06, 95% CI: -1.99 to -0.13, n=40), but not iNOS (SMD: -0.71 95% CI: -1.66 to 0.25, n=82). From 72 comparisons of different neuroimmune outcomes at different anatomical locations, vote counting revealed reductions in 23 pro-inflammatory and increases in 6 anti-inflammatory neuroimmune outcomes. For physiological outcomes, meta-analyses revealed that pre-injury exercise improved one out of six nerve morphometric related outcomes (G-ratio; SMD: 1.95, 95%CI: 0.77 to 3.12, n=20) and one out of two muscle morphometric outcomes (muscle fibre cross-sectional area; SMD: 0.91, 95%CI: 0.27 to 1.54, n=48). For behavioural outcomes, mechanical allodynia was significantly less in the pre-injury exercise group (SMD -1.24, 95%CI: -1.87 to -0.61) whereas no overall effect was seen for sciatic function index. Post hoc subgroup analysis suggests that timing of outcome measurement may influence the effect of pre-injury exercise on mechanical allodynia. Risk of bias was unclear in most studies, as the design and conduct of the included experiments were poorly reported. Preventative exercise may have potential neuroprotective and immunoregulatory effects limiting the sequalae of nerve injury, but more research in this field is urgently needed.

노인 당뇨병 환자들의 신체활동이 우울과 삶의 만족에 미치는 영향

Objectives The primary aim of this study is to identify the factors that influence the psychological well-being of elderly individuals with diabetes through the implementation of a physical activity exercise program. Additionally, the study seeks to analyze the changes that occur in these factors.&#x0D; Methods A cohort of nine elderly diabetic patients, who received education at the J Diabetes and Hypertension Registration Education Center in J City, participated in an eight-week exercise program conducted on a weekly basis. Pre- and post-program assessments were performed to measure the outcomes. Subsequently, interviews were conducted with the participants upon completion of the program to evaluate its effects and analyze the obtained results.&#x0D; Results The findings of study indicated that the exercise program implemented for elderly diabetic patients had some impacts, albeit not statistically significant, on various health indicators. The intervention led to a minor reduction of 0.3 in body mass index and a 0.5 decrease in body fat percentage. However, these changes did not show statistical significance. Similarly, the Berg Balance Scale evaluation showed a moderate increase of 0.44, but this increase did not reach statistical significance either. Nonetheless, when examining specific aspects of balance perception, the study indicated noteworthy and statistically significant results (p&lt;.001). With respect to psychological factors, the findings indicated a slight reduction of 0.25 points in depression scores and a modest increase of 0.2 points in life satisfaction scores. However, similar to the physical health indicators, these changes did not show statistical significance. Notably, during the qualitative interviews conducted with the participants, positive experiences were reported by the participants regarding adecrease in depressive symptoms and an overall improvement in life satisfaction.&#x0D; Conclusions The findings of this study indicate that the exercise program leads to a significant reduction in body mass index and body fat, along with an improvement in balance perception. Additionally, it exerts a positive influence on psychological factors by reducing depressive symptoms and increasing life satisfaction among elderly individuals with diabetes. Further research is required to explore the health status, levels of depression, and life satisfaction of elderly diabetic patients in more depth.

Modulated effectiveness of rehabilitation motivation by reward strategies combined with tDCS in stroke: study protocol for a randomized controlled trial.

Stroke survivors often exhibit low motivation for rehabilitation, hindering their ability to effectively complete rehabilitation training task effectively and participate in daily activities actively. Reward strategies have been identified as an effective method for boosting rehabilitation motivation, but their long-term efficacy remains uncertain. Transcranial direct current stimulation (tDCS) has been recognized as a technique that facilitates plastic changes and functional reorganization of cortical areas. Particularly, tDCS can improve the functional connectivity between brain regions associated with goal-directed behavior when applied to the left dorsolateral prefrontal cortex (dlPFC). Combing reward strategies with tDCS (RStDCS) has been shown to motivate healthy individuals to exert more effort in task performance. However, research exploring the combined and sustained effects of these strategies on rehabilitation motivation in stroke survivors is lacking. Eighty-seven stroke survivors with low motivation and upper extremity dysfunction will be randomized to receive either conventional treatment, RS treatment, or RStDCS treatment. The RStDCS group will receive reward strategies combined with anodal tDCS stimulation of the left dlPFC. The RS group will receive reward strategies combined with sham stimulation. The conventional group will receive conventional treatment combined with sham stimulation. tDCS stimulation is performed over 3 weeks of hospitalization, 20 min/time, five times a week. Reward strategies refers to personalized active exercise programs for patients during hospitalization and at home. Patients can voluntarily choose tasks for active exercise and self-report to the therapist so as to punch a card for points and exchange gifts. The conventional group will receive home rehabilitation instructions prior to discharge. Rehabilitation motivation, measured using RMS. RMS, FMA, FIM, and ICF activity and social engagement scale will be compared at baseline, 3 weeks, 6 weeks, and 3 months post-enrollment to evaluate patients' multifaceted health condition based on the ICF framework. This study integrates knowledge from social cognitive science, economic behavioral science, and other relevant fields. We utilize straightforward and feasible reward strategies, combined with neuromodulation technology, to jointly improve patients' rehabilitation motivation. Behavioral observations and various assessment tools will be used to monitor patients' rehabilitation motivation and multifaceted health condition according to the ICF framework. The aim is to provide a preliminary exploration path for professionals to develop comprehensive strategies for improving patient rehabilitation motivation and facilitating a complete "hospital-home-society" rehabilitation process. https://www.chictr.org.cn/showproj.aspx?proj=182589, ChiCTR2300069068.

The experiences and acceptability of a novel multimodal programme for the management of fibromyalgia: Aqualitative service evaluation.

IntroductionFibromyalgia guidelines recommend multi‐modal, non‐pharmacological interventions but there is limited evidence on the optimal programme. The Fibromyalgia Active Management and Exercise programme (FAME) aimed to improve function and quality of life. It consisted of 12 sessions delivered by a multidisciplinary team and incorporated education, exercise, Cognitive Behavioural Therapy and mindfulness approaches.This qualitative service evaluation explored the experience and acceptability of FAME from the perspective of the patients' and healthcare practitioners' (HCP).MethodsAll patients and HCP involved in the first FAME programme were invited to attend either one audio‐recorded focus group or an individual semi‐structured interview. Topic guides were developed a priori. Data were transcribed verbatim and analysed thematically.ResultsThirteen participants (six HCP (three physiotherapists, two nurses, one psychologist)) and seven patients (mean age 46 (7.5) years, all female,) were enroled. FAME was acceptable to HCP participants but not to all patient participants. Where patient participants understood and anticipated the aims of FAME, the programme was found to be acceptable. Whereas, patient participants who did not fully understand the aims of the programme reported lower acceptability. Three themes were generated: expectations and preparation for FAME, the value of social support, and FAME as a learning opportunity. The themes could be explained by five constructs of the Theoretical Framework of Acceptability.ConclusionFAME was acceptable to HCPs but not to all patient participants. Patient and HCP participants valued social support and regarded this as central to their learning. Further adaptation of FAME is required to optimise acceptability.

The Fibromyalgia Active Management and Exercise (FAME) programme: A service evaluation

The Fibromyalgia Active Management and Exercise (FAME) programme: A service evaluation

Alleviative effects of foraging exercise on depressive-like behaviors in chronic mild stress-induced ischemic rat model

ABSTRACT Background Poststroke depression (PSD) is a common complication that seriously affects the functional recovery and prognosis of an individual. As some patients with PSD fail to respond to drug therapy, it is urgent to find a viable alternative treatment. Methods An active exercise program known as foraging exercise (FE), using food as bait, was designed. First, focal ischemia and chronic unpredictable mild stress (CUMS) were used to establish a PSD model in rats. FE was then performed for 4 weeks. Body weight and behavioral assessments were conducted at the end of the 4th and 8th weeks. Results After 8 weeks, the results revealed that, compared with the PSD group, the behavioral scores of the rats in the PSD/FE group were significantly improved, the expression of Iba-1 in the affected frontal lobe and striatum was decreased, and serum levels of IL-6 and the IL-6/IL-10 ratio were downregulated. However, the ratio of residual brain volume in rats that had experienced CUMS was significantly less than that in the stroke group. Conclusion FE can alleviate the behavioral scores of PSD rats, and its mechanism may be related to a modulation of the immune-inflammation response of microglia. Furthermore, chronic, persistent stress may increase the volume of cerebral infarction after stroke.

Beneficios de un programa de ejercicio físico comunitario prescrito desde Atención Primaria en la salud de mujeres perimenopáusicas/menopaúsicas

ObjectiveTo measure the benefits of a physical exercise program in a community, through the modifications in quality of life, and perimenopausal–menopausal women physical condition. SettingThe participants were recruited in PC consultations from two health centers in Molina de Segura (Murcia). ParticipantsWomen between 40 and 70 years old, or under 40 of age diagnosed with early menopause. DesignQuasi-experimental study, non-randomized, controlled, open and single-center with 2 parallel branches to study. InterventionExperimental group: ACTIVA Bone Health Program for six months. Control: inactive. Main measurements in both groupsThe SF 36 questionnaire was used to measure the Quality of life. Physical conditionAerobic condition, flexibility, balance and strength measured with the mile, flamenco, flexibility box tests, and throwing the medicine ball, respectively. Physical activity level through the GPPAQ Questionnaire. Sociodemographic variables were collected and the adherence to the program was measured. ResultsThe quality of life improved in the intervention group compared to the control group, except «Body Pain» dimension (p = 0.412). As regards the intragroup level, all dimensions showed significant improvement except both «Physical Function» (p = 0.263) and «Body Pain» (p = 0.136). The physical capacities that benefited most were aerobic fitness, strength and balance. ConclusionsThe Active Bone Health Physical Exercise Program piloting showed benefits on participants’ physical and mental quality of life. In addition, it has been shown that performing a specific physical exercise for premenopausal–menopausal women improves their physical condition.

Effects of Non-Pharmacological Treatment on Pain, Flexibility, Balance and Quality of Life in Women with Fibromyalgia: A Randomised Clinical Trial.

Background: The functional deficits in people with fibromyalgia can be related to the level of physical activity performed. This study investigated the effectiveness of an active exercise programme versus exercise for well-being improving pain, flexibility, static balance, perceived exertion and quality of life of women with fibromyalgia; Methods: A randomised, single-blind, controlled trial was conducted. A total of 141 of women diagnosed with fibromyalgia were enrolled and randomised to an active exercise program group (n = 47), where they performed physical active exercises, an exercise for well-being group (n = 47), which performed the Qi Gong exercises named ‘the twenty Wang Ziping figures for health and longevity’, and a control group (n = 47), which did not receive any intervention, for a period of 4 weeks. Measures were taken at baseline and after the treatment. The primary outcome measures were static balance and centre of gravity (Wii-Fit Nintendo ©), flexibility (test de Wells and Dillon), pain (Visual Analogue Scale) and quality of life (Spanish-Fibromyalgia Impact Questionnaire). The secondary outcome measure was the perceived exertion during activity (BORG Scale). Results: In total, 93 participants completed the study. The mean value of the age was 52.24 ± 6.19. The post intervention results showed statistically significant improvements in the exercise for well-being and the active exercise programme groups vs. the control group in relation to pain (p = 0.006 active exercise programme group, p = 0.001 exercise for well-being group), static balance (p < 0.001 active exercise programme group) and quality of life (p < 0.001 active exercise programme group, p = 0.002 exercise for well-being group). In addition, the mean scores related to perceived fatigue during the sessions were 6.30 ± 1.88 for the active exercise programme group and 5.52 ± 1.55 for the exercise for well-being group. These differences were not significant. Conclusions: The active exercise program and exercise for well-being improved flexibility, static balance, pain and quality of life of women with fibromyalgia. The participants of the active exercise programme achieved better results that those of the exercise for well-being.

Up to five-week delay in primary repair of Zone 2 flexor tendon injuries: outcomes and complications.

We report the outcomes of delayed primary repair of flexor tendons in Zone 2 in 31 fingers and thumb (28 patients) averaging 15days (range 4-37) after injury in 2020. The delay was longer than usual due to the COVID-19 pandemic. The tendons were repaired with a 6-strand core suture (M-Tang method) or a double Tsuge suture and a peripheral suture. This was followed by an early, partial-range, active flexion exercise programme. Adhesions in four digits required tenolysis. These patients were not with longest delay. Outcomes of two improved after tenolysis. The other two patients declined further surgery. One finger flexor tendon ruptured in early active motion. This was re-repaired, and final outcome was good. Overall excellent and good results using the Tang criteria were in 27 out of 31 fingers and thumbs (87%). The time elapsed between the injury and surgery is not an important risk factor for a good outcome, rather it depends on proper surgical methods, the surgeon's experience and early mobilization, properly applied. Adhesions may occur, but they can be managed with tenolysis.Level of evidence: IV.

EHealth to empower patients with musculoskeletal pain in rural Australia (EMPoweR) a randomised clinical trial: study protocol

BackgroundLow back pain (LBP) and knee osteoarthritis (OA) are major contributors to disability worldwide. These conditions result in a significant burden at both individual and societal levels. Engagement in regular physical activity and exercise programs are known to improve physical function in both chronic LBP and knee OA populations. For people residing in rural areas, musculoskeletal conditions are often more frequent and disabling compared to urban populations, which could be the result of reduced access to appropriate health services and resources in rural settings. EHealth is an innovative solution to help provide equitable access to treatment for people with musculoskeletal pain living in rural settings.Methods/designWe will conduct a randomised clinical trial investigating the effects of an eHealth intervention compared to usual care, for people with chronic non-specific LBP or knee OA in rural Australia. We will recruit 156 participants with non-specific chronic LBP or knee OA. Following the completion of baseline questionnaires, participants will be randomly allocated to either the eHealth intervention group, involving a tailored physical activity and progressive resistance exercise program remotely delivered by a physiotherapist (n = 78), or usual care (n = 78) involving referral to a range of care practices in the community. Outcomes will be measured at baseline, 3 and 6 months post-randomisation. The primary outcome will be physical function assessed by the Patient-Specific Functional Scale (PSFS). Secondary outcomes include pain intensity, physical activity levels, activity limitations, quality of life, pain coping. We will also collect process evaluation data such as recruitment rate, attendance and adherence, follow-up rate, participants’ opinions and any barriers encountered throughout the trial.DiscussionThe findings from this trial will establish the effectiveness of eHealth-delivered interventions that are known to be beneficial for people with LBP and knee OA when delivered in person. As a result, this trial will help to inform health care policy and clinical practice in Australia and beyond for those living in non-urban areas.Trial registrationThis study was prospectively registered on the Australian New Zealand Clinical Trials Registry (ACTRN12618001494224) registered 09.05.2018.

Practice Patterns of Physicians Using Adjunct Therapies with Botulinum Toxin Injection for Spasticity: A Canadian Multicenter Cross-Sectional Survey.

Adjunct therapies are nonpharmacological treatments used with botulinum toxin (BoNT) injection that may improve spasticity outcomes. It has been suggested that physicians consider adjunct therapies as a part of comprehensive spasticity management. It is unclear which adjunct therapies are used by physicians in clinical practice. To determine physician practice patterns and perceptions of use of adjunct therapies following BoNT injection for limb spasticity. Cross-sectional national survey of current clinical practice using a 22-item questionnaire developed by the authors. Not applicable. Survey respondents were physicians actively administering BoNT injections for limb spasticity management across Canada (N = 48). Not applicable. Types of adjunct therapies used by physicians; physician opinions on barriers to adjunct therapy use, patient preferences, and future research priorities. Most physicians prescribe home stretching programs, home active exercise programs, and splinting; however, many physicians perceive that these same adjunct therapies are unwanted by patients. A minority of physicians prescribe electrical stimulation (ES), transcutaneous electrical nerve stimulation (TENS), casting, and extracorporeal shockwave therapy; financial limitations and perceived lack of evidence were identified as barriers to their use. Significantly more physicians practicing in academic settings compared with nonacademic, community, and private practice settings used functional ES (59% vs 11%) and TENS (41% vs 0%) as adjunct therapies (P < .05). Research priorities included determining the effectiveness of immediate postinjection application of adjunct therapies (eg, injected muscle activation with ES or stretching) and nutraceuticals. Canadian physicians frequently use adjunct therapies in combination with BoNT injection to treat spasticity. Financial and time constraints are identified as barriers to implementation of adjunct therapies that are currently supported by research, and patient preferences may also affect compliance. Future research should focus on adjunct therapies that overcome these barriers.

Can Active Aerobic Exercise Reduce the Risk of Cardiovascular Disease in Prehypertensive Elderly Women by Improving HDL Cholesterol and Inflammatory Markers?

This study aims to verify the efficacy of exercise programs designed to prevent and treat hypertension-induced cardiovascular disease (CVD) by analyzing the effects of a 6-month active aerobic exercise program, administered to prehypertensive elderly women, on reducing the risk of developing CVD by enhancing their physical fitness level and improving the detailed markers of high-density lipoprotein cholesterol (HDL-C) and inflammatory markers. We assigned the elderly women (≥65 years) recruited into normal blood pressure (120–129/80–84; NBP, n = 18) and high-normal blood pressure (130–139/85–89; HNBP, n = 12) groups according to the European guidelines for the management of arterial hypertension. The exercise program was made up of combined workouts of elastic band resistance exercise and aerobics with dance music. The program took place three times a week for six months, with each session lasting 60 min. We measured pre- and post-intervention body composition, blood pressure, physical fitness level, blood lipids profile, HDL-C, SAA, TNF-α, IL-6, IL-4, IL-15, CRP, and HSP70 and calculated the Framingham risk scores for comparison. A significant post-intervention reduction in the mean systolic blood pressure (SBP) was observed in the HNBP group (p < 0.001), with significant increase in HDL-C (p < 0.01) and significant decrease in serum amyloid A (SAA) concentration (p < 0.01). A significant improvement in physical fitness factors such as physical efficiency index (PEI) was also observed in the HNBP group (p < 0.05). The post-intervention TNF-α, IL-6, and SAA concentrations were more significantly lower in the HNBP than in the NBP group (p < 0.05). Compared to the baseline values, a significant decrease in SAA concentration (p < 0.01) and significant increase in HSP70 concentration (p < 0.001) were observed in the HNBP group. The HNBP group’s 10-year CVD risk was also significantly reduced (p < 0.05). The pre–post differences in SBP and DBP were significantly correlated with those in the anti-inflammatory markers IL-4 and IL-15 (p < 0.01). In conclusion, the 6-month active aerobic exercise program of moderate intensity administered to prehypertensive elderly women (≥65 years) had the effect of reducing the 10-year CVD risk through a substantial reduction in SBP, overall physical fitness improvement, increase in HDL-C, decrease in SAA concentration, and substantial decrease in inflammatory biomarkers. It was also confirmed that an increase in anti-inflammatory markers, which showed a small range of increase with respect to the decrease in blood pressure, may have a major effect.

Electrical Stimulation Therapies for Active Duty Military with Patellofemoral Pain Syndrome: A Randomized Trial.

Patellofemoral pain syndrome (PFPS) is a common musculoskeletal disorder among military service members that causes knee pain, quadriceps strength loss, and impaired motor performance in otherwise healthy individuals. PFPS poses a threat to the health, fitness, and subsequent readiness of the total force. The goal of rehabilitation for military service members with PFPS is to regain physical capacity of strength and function and to reduce pain, in order to restore readiness in this population. The randomized controlled trial reported here compared an active home exercise program (HEP) alone with three different electrical stimulation treatment regimens implemented concurrently with HEP postulated improvements in lower extremity strength and physical functional performance while also reducing pain in active duty military diagnosed with PFPS. After baseline testing, 130 active duty military members with PFPS were randomized to 1 of 4 treatment groups: (1) neuromuscular electrical stimulation (NMES) with HEP; (2) transcutaneous electrical nerve stimulation (TENS) with HEP; (3) combined NMES/TENS with HEP; (4) active HEP only. The primary outcome measure was degree of change in knee flexion and extension strength over 9weeks. Secondary outcomes were physical functional performance and knee pain. The primary analyses used repeated measures, linear mixed-effects models with a random effect for subject, time as a continuous variable, group as a categorical variable, and a group and time interaction to test for differences in change over time among the groups. All three electrical stimulation treatment groups improved in knee extension strength in the PFPS limb to a greater extent than the HEP alone group over the 9-week treatment period. The NMES and NMES/TENS groups improved to a greater extent than the HEP alone group in knee flexion strength in the PFPS limb. The reported pain improved over time for all treatment groups with no significant group differences. All three stimulation groups performed better on the 6-min walk test than the HEP alone group. The findings from this study showed that all three electrical stimulation with HEP treatment groups showed greater improvement in strength compared to the HEP alone group. These findings could offer alternative forms of rehabilitation for AD military with PFPS as these treatment regimens can be easily implemented at home station or during deployment.

Adaptive Physical Activity for Stroke: An Early-Stage Randomized Controlled Trial in the United States

Background. As stroke survival improves, there is an increasing need for effective, low-cost programs to reduce deconditioning and improve mobility. Objective. To conduct a phase II trial examining whether the community-based Italian Adaptive Physical Activity exercise program for stroke survivors (APA-Stroke) is safe, effective, and feasible in the United States. Methods. In this single-blind, randomized controlled trial, 76 stroke survivors with mild to moderate hemiparesis >6 months were randomized to either APA-Stroke (N = 43) or Sittercise (N = 33). APA-Stroke is a progressive group exercise regimen tailored to hemiparesis that includes walking, strength, and balance training. Sittercise, a seated, nonprogressive aerobic upper body general exercise program, served as the control. Both interventions were 1 hour, 3 times weekly, in 5 community locations, supervised by exercise instructors. Results. A total of 76 participants aged 63.9 ± 1.2 years, mean months poststroke 61.8 ± 9.3, were included. There were no serious adverse events; completion rates were 58% for APA-Stroke, 70% for Sittercise. APA-Stroke participants improved significantly in walking speed. Sample size was inadequate to demonstrate significant between-group differences. Financial and logistical feasibility of the program has been demonstrated. Ongoing APA classes have been offered to >200 participants in county Senior Centers since study completion. Conclusion. APA-Stroke shows great promise as a low-cost, feasible intervention. It significantly increased walking speed. Safety and feasibility in the US context are demonstrated. A pivotal clinical trial is required to determine whether APA-Stroke should be considered standard of care.

Anticipatory Electromyographic Activity and Onset Time in Selected Muscles of Lower Limb Between the Active and Inactive Old Women

Introduction: This study aimed to investigate the onset time and the electromyographic activity level of the selected lower limb muscles in the active and inactive old women. Materials and Methods: In this case-control study, 28 old women with a Mean±SD age of 61.07±0.88 years were selected in the inactive (15 people) and active (13 people) groups. The electrical activity of the selected muscles of the lower limbs was collected by the EMG device in a stair down movement. Results: The onset time of tibialis anterior, vastus lateralis, and biceps femoris muscles are faster in the active group (p &lt;0.05). Besides, the activity level of the rectus femoris muscle in the interval of 100 ms before the initial contact and the ratio of the vastus medialis muscle to the biceps femoris muscle was significantly lower (p &lt;0.05) in the active group. Conclusion: It seems that the muscles of the lower limbs in the group of women with regular physical activity are activated faster than the inactive group and the decrease in the activity of the rectus femoris muscle and the ratio of the vastus medialis to the biceps femoris muscle in the active women may be accompanied by fatigue and reduced intra-articular forces. Therefore, it is recommended that old women participate in regular and active exercise programs to improve their onset times of muscle activity.